여드름 환자에서 Propionibacterium acnes에 대한 항생제의 최저발육저지농도에 관한 연구

임연순(Yeon Soon Lim),명기범(Ki Bum Myung),정낙은(Nak Eun Chung),정화순(Wha Soon Chung) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.3

Background : Propioriacterium acnes plays an importantol in the development of inflammatory acne, and inflarnmatory lesions are improved by oralnc topical antibiotics. But as Pacnes frequently develop resistance to antibiotics in patients neing long term systemic antibiotic therapy, the theravuti effects diminish, and eventually thay fails. Objective : The purpose of this study is to evaluate theerral susceptability of P. acnes to antibiotics and the difference in the MIC depending on the of oral and/or topical antibiotics, therapeutic effects and disease duration in patients with acie ulgaris. Methods : We used twenty six strains of P. acnes which were obtained from patients with acne and performcd suseptibility testing for antibiotics usir the E test procedure. Results : 1. The growth of P. acnes was completely inhibited by e ythromycin and chloramphenicol at concentrations of 0.023ug/ml and 0.064ug/ml, respectively cefoxitin at 0.094ug/ml, and by tetracycline and clindarnycin at 0.190 ug/ml. 2. P. acnes was mot susceptible to erythromycin, and olwed by chloramphenicol, cefoxitin, tetracycline, clindamycin in order of decreasing susceptibilit . 3. There were no significant differences in the MIC in reat in to previous antibiotic treatment. 4. For tetracycline, The MIC was significantly lower(p<0.01) in patients who improved after treatment. 5, For tetracycline and chloramphenicol, the MIC was grficantly lower(p<0.05) in patients with less than 2 years disease duration. Conclusion : The susptibility of antibiotics for P. acneias highest in erythromycin. There were no significant differences in the MIC in relation to prvious antibiotic treatment, and for some antibiotics the suseptibility was low in patients who dill not show clinical improvement or who had long disease duration. (Kor J Dermatol 1995;33(3): 437-444)

각질형성세포주 HaCaT 세포에서 IFN- 에 의한 ICAM-1 발현증가에 미치는 adenosine의 영향

임연순(Yeon Soon Lim),최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),명기범(Ki Bum Myung) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.4

N/A Background:Intercellular adhesion molecule(ICAM)-1 mediates cell to cell adhesion by acting as a receptor for leukocyte surface antigen. Increased ICAM-1 expression was observed in chronic inflammatory skin diseases, such as psoriasis, atopic dermatitis and allergic contact dermatitis. Adenosine is an endogenous antiinflammatory agent released by cells under metabolically unfavorable conditions, recently the studies about antiinflammatory effects of adenosine in various tissues were increased, but there are few studies about the effect of adenosine on epidermal keratinocytes. Objective:We investigated the effects of adenosine on ICAM-1 expression in cultured human keratinocyte cell line HaCaT cells. Methods:Our study analyses the ICAM-1 expression in HaCaT cells by various stimulants and the effects of adenosine, adenosine receptor agonist & antagonist and an inhibitor of cellular adenosine uptake on ICAM-1 expression of cells stimulated by IFN-γ through the cell-ELISA (enzyme-linked immunosorbent assay) & FACS (fluorescence-activated cell sorter) analysis. Results:The results are summerized as follows: 1. ICAM-1 expression was significantly increased by IFN-γ(500U/ml), IFN-γ & TNF-α(10-8M) and IFN-γ & LPS(10-8M)(p<0.05), but not by TNF-α, LPS and TNF-α & LPS. 2. Incubation of HaCaT cells with IFN-γ(1-2000U/ml) for 48 hours induced dose-dependent expression of ICAM-1 at above 500U/ml of IFN-γ. 3. Adenosine had no effect on ICAM-1 expression of unstimulated cells. 4. Adenosine(esp. 10-4M) significantly inhibited ICAM-1 expression of cells stimulated by IFN-γ(p<0.01). 5. Adenosine(10-4M) significantly inhibited ICAM-1 expression of cells stimulated by IFN-γ(p<0.01), IFN-γ & TNF-α(p<0.05) and IFN-γ & LPS. 6. The inhibition of ICAM-1 expression was not observed when cells were preincubated with an adenosine A1 receptor agonist(R-PIA) or an adenosine A2 receptor agonist (NECA). 7. The inhibition of ICAM-1 expression of adenosine was not affected by pretreatment state with an adenosine A1 & A2 receptor antagonist(theophylline)(p<0.01). 8. The inhibition of ICAM-1 expression of adenosine was not observed by pretreatment state with an inhibitor of adenosine cellular uptake (dipyridamole). Conclusion:High concentration of adenosine inhibits enhanced ICAM-1 expression on HaCaT cells by stimulated with IFN-γ and these inhibitory effects of adenosine are mediated through other adenosine receptors excect adenosine A1 and A2 receptors. And we suggest that there may be an unknown intracellular mechanism about inhibition of ICAM-1 expression via intracellular-uptaken adenosine.(Korean J Dermatol 2000;38(4):472~480)

Alexandrite 레이저를 이용한 색깔 , 치료부위 및 기간에 따르는 문신치료의 효과

임연순 ( Yeon Soon Lim ),최혜영 ( Hai Young Choi ),명기범 ( Ki Bum Myung ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.5

Background: After the development of the Q-switched lasers, it was possible to remove tattoos without causing scarring. Currently, Q-switched ruby lasers, Q-switched Nd: YAG lasers and Q-switched alexandrite lasers are used selectively to treat tattoos. The objective of this study was to determine the difference of effectiveness aceording to color, site and duration in removing tattoo pigments by the alexandrite laser. Materials aad Methods : 30 tattoos were treated with a Q-switched alexandrite laser(model IL-l, Candela Laser Corporation. Wayland. U.S.A.). Pretreatment evaluation included a clinical desrviption of the site, color, duration and photographs were taken. The effects were examined by fether photo graphs and telephone follow-up. The response was expressed as the percentage area cleared of the tattoo. The clearance was graded as follows: clear, >95%; excellent, 76-95%; good, 51-75%; fair, 26-50%; poor < 25%. The occurence of adverse events were also examined. Results : 1he results are summarized as follows: 1. Treatment with fluences that ranged from 6.0-8.0J/cm2 was given on average 1.7 times and better results were achived than expected in 80% of all patients with tattoo. 2. The effectiveness of laser therapy correlated with the number of treatments. 3. After 1 laser session, tattoos of black and darkblue showed better results than light blue in terms of color. 4. After 1 laser session, the sites of tattoos on upper extremitise showed better results than those of the eyebmw, eyeline and face. 5. Differences in duration after 1 laser session were not seen. 6. Hyperpigmentation in 2 cases and bulla formation in 1 case occurred and all complications had ceased after a few months. Conclusion: The alexandrite laser is an effective treatment for cosmetic, general and traumatic tattoos with a low incidence of significant adverse effects and provides excellent cosmetic results. (Koreay J Dermatol 1998;36(5): 844-849)

Ki - 1 양성 림프종양 구진증

임연순 ( Yeon Soon Lim ),황규광 ( Kyu Kwang Whang ),김옥경 ( Ok Kyung Kim ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.3

Lymphomatoid papulosis, first described by Macaulay in 1558 is a chronic disease characterized by the recurrent self-healing papulonecrotic or nodular skin lision, showing histological features of malignant lymphoma. The clinical course is variable, with rogression to disseminated malignant lymphoma in up to 10-20% of patients. Ki-1 appears to the a representative marker for large cells ir lymphomatoid papulosis and these cells can be detected in l-1 lymphorna, Hodgkins diseasen other disorders with aetivated T cells. However, positive Ki-1 staining is useful for supporting a diagnosis of lymphomatoid papulosis, under the appropriate clinical and histopathologic findings. We report a case of positive lymphomatoid papulosis which is characterized by the typical findings of clinical, histojpathological and immunohistochemica sizdies. (Kor J Dermatol 1995;33(3): 551-556)

윤상 육아종의 임상 및 병리조직학적 고찰

임연순(Yeon Soon Lim),장경애(Kyoung Ae Jang),이미우(Mi Woo Lee),최지호(Jee Ho Choi),성경재(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.8

윤상 육아종은 원인 미상의 양성 피부질환으로서 임상및 병리조직학으로 전형적인 형태와 비전형적인 다양한 형태가 존재하고, 주로 신체의 말단 부위에 구진이나 판으로 나타나며 윤상의 형태를 보이는 경우가 많다. 여자에서의 발생율이 2~3배정도 높으며 모든 나이에 발생할수 있으나 어린아이나 젊은 성인에서 주로 발생한다. 발생기전은 면역기전이 관여할 것으로 생각되며 그중 세포매개성 면역이 주된 작용을 할 것이라고 생각되나 아직까지 정확한 기전은 정립되어 있지 않은 상태이다. 후천성 면역결핍증의 발생과 장기이식 등의 증가로 인한 면역결핍상태에서 윤상 육아종의 보고가 증가되고 있으며, 이로 인해 면역학적 발생기전의 연구에 더욱 관심이 모아지고 있다. 저자들은 1990년 1월부터 1998년 9월까지 서울 중앙병원 피부과에서 임상 및 병리조직검사 결과 윤상 육아종으로 진단받은 38명의 환자를 대상으로 임상과 병리조직학적 검색을 실시하였다. Background:Granuloma annulare(GA) is a benign skin disorder of unknoun etiology. Even though some cases were reported in Korean journals, systematic reviews of clinical and histopathologic features of granuloma annulare were not dene. Objective:The purpose of this study was to analyze the clinical and histological charcateristics of granuloma annulare. Methods:In a retrospective study including 38 patients and 44 skin biopsy specimens, we reviewed the clinical and histological features of granuloma annulare. Results:The results were as follows; 1. The ratio of female-to-male patients was 4.4:1 and in the majority of cases(68.4%), the onset of GA occured in the first three decades of life and the mean age of onset was 22.7 years. In the majority of cases(65.8%), the duration was less than 6 months and the mean duration was 22 months. 2. The clinical types were localized type(52.6%), subcutaneous type(26.3%), and generalized type(21.1%). 3. The lower extremities(42.9%), especially the knee joint was the most common anatomic site. 4. Ten patients(26.3%) have systemic diseases including diabetes mellitus(10.5%), thyroid disease, SLE, anemia, osteoarthritis, atopic dermatitis, and asthma. 5. Nine patients(23.7%) have precipitating factors including seasonal variation, insect bite, stress, and irritation of shoes and 15 patients(39.5%) have associated symptomes including an itching sensation and pain or tenderness. 6. The histological findings were as follows;The histologic types were dermal granuloma(50%) and subcutaneous type(50%). The dermal granulomatous lesions consist of interstitial type(11 cases, 25.0%), palisading type(8 cases, 18.2%), perforating type(2 cases, 4.5%), and epithelioid tubercle type(1 case, 2.3%). Mucin deposition was detected in the 88.6%, eosinophils in 31.8%, and neutrophils in 13.6%. Conclusion:Granuloma annulare has various clinical and histological variants, and some cases are associated with systemic diseases. And we need to have an interest because recently granuloma annulares developed in immunocompromised patients, such as AIDS and bone marrow transplants.(Korean J Dermatol 1999;37(8):1001~1008)

장병성 선단 피부염의 소견을 보인 아연 결핍성 피부질환의 임상적 고찰

임연순(Yeon Soon Lim),이미우(Mi Woo Lee),최지호(Jee Ho Choi),성경제(Kyung Jeh Sung) 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.2

N/A Background:Zinc is an essential trace and has a close relation with skin metabolism and zinc deficiency is associated with acrodermatitis enteropathica, inflammatory bowel disease, chemotherapy, intravenous hyperalimentation, chronic diarrhea and other malabsoption state. Objective:The purpose of this study was to analyze the clinical characteristics of zinc deficiency presented as a skin manifestation of acrodermatitis enteropathica. Methods:In a retrospective study including 45 patients, we reviewed the clinical features of zinc deficiency presented as a skin manifestation of acrodermatitis enteropathica. Results:The ratio of male-to-female patients was 1.14:1 and the onset of the disease occured in childhood in 14 cases, and adulthood in 31 cases. The associated diseases were bowel diseases(13 cases), chemotherapy(11 cases), and postgastrectomy state(5 cases), only acrodermatitis enteropathica without associated disease(4 cases), and the other associated diseases were anorexia nervosa, malnutrition in old age, chronic pancreatitis and alcoholic liver disease, etc. The most common skin manifestation was erythematous scaly patches with erosion(77.8%) and vesicles, bullae, pustules and acneiform eruptions also developed. The perianal area was the most common anatomic site and the skin lesions were associated with diarrhea(35.6%), candida infection(20.0%), and severe hair loss(2.2%). In laboratory findings, low serum zinc levels were present in 26 patients among the 36 patients and a lower limit of the normal range of serum zinc was present in 8 patients among the 10 patients with normal zinc levels. Decreased serum albumin and protein level(48.9%), anemia (26.7%), and decreased alkaline phosphatase(6.7%) were observed. Conclusion:We should pay special attention to the prevention of zinc deficiency in bowel disease, chemotherapy, chronic diarrhea and other malabsoption state. To prevent zinc deficiency, detailed skin examination was necessary and zinc should be added to maintenance therapy during chronic malnutrition and malabsorption state. (Korean J Dermatol 2000;38(2):155~162)

건강한 사람에서 발생한 다발성 조직구증

최유원,임연순,최혜영,명기범 ( Yoo Won Choi,Yeon Soon Lim,Hae Young Choi,Ki Bum Myung ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Multiple histiocytomas are rare and defined when more than 15 lesions are present according to Baraf and Shapiro. It has been reported occurring in patients with autoimmune disease, who were receiving immunosuppressive treatment. Reports in the literature of these multiple lesions occurring in a healthy person are very rare. A 45-year-old man had 26 asymptomatic nodules on the trunk and upper extremities of two years duration. The lesions varied from 5mm to 2cm in size, were brownish, round, firm, nontender and positive for dimple signs. Microscopic examination of the lesions were indistinguish able from those seen in dermatofibroma. Most cells react intensively with factor XIIIa. (Kor J Dermatol 1997;35(4): 819-823)

영아에서 발생한 구진성 황색종

서승리,최유원,임연순,최혜영,명기범 ( Seung Lee Seoi,Yoo Won Choi,Yeon Soon Lim,Hae Young Choi,Ki Bum Myung ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.6

Papular xanthoma is a persi;tent normolipemic, nonconfluent, eruptive xanthomatosis located on the face, trunk and rnucous m,mbranes with no internal involvement, which exclusively occurs in adults. Histologically there is an infiltration of foamy histiocyte-like cells and a few Touton giant cells in the upper dermis and middermis without inflammatovy cells or a pure histiocytic component. Papular xanthomas in the childhood age group were recently described and charact.erized by their self- healing course, leaving, anetoderma-like scars. We report a case of papylar xanthoma in a 21-month-old infant with typical clinical, histopathologic and immunohistochemical findings. The positive immunohistochemical staining with factor XIIIa confirms that papular xanthorna is included in the group of dermal dendrocytic disorder. (Korean J Dermatol 1997;35(6): 1230-1233)

비전형적인 임상 양상을 보인 전염성 연속종 17 예

강현영(Hyun Young Kang),임연순(Yeon Soon Lim),조윤화(Yoon Whoa Cho),한지윤(Jee Yoon Han) 대한피부과학회 2001 大韓皮膚科學會誌 Vol.39 No.10

N/A Background: Molluscum contagiosum is a commom benign viral disease of the skin characterized by discrete, 2-5 mm, flesh colored, slightly umbilicated, dome-shaped papules with frequent grouping. But atypical presentation of site, number and size is recently not rare, it may give rise to difficulty in diagnosis. Objective: The purpose of this study was to investigate the clinical and histopathological characteristics of various atypical molluscum contagiosa. Methods: We reviewed medical records, clinical photographs, and histopathologic findings in biopsy specimens of 17 patients with molluscum contagiosa diagnosed at Korea Veterans Hospital from January 1990 to June 2001. The ratio of male to female patients was 3:1, and the mean age at diagnosis was 30 years(range : 3-67). Results 1. Most commonly involved sites were trunk(80%), extremities(30%), and perianal(12%). 2. The duration of the lesion is 15 days to 3 years. 3. The size of lesion is 2 mm to 50 mm. 4. The number of lesions is one to over a hundred. 5. The clinical features were multiple papules without umbilication(9 cases, 53%) and giant tumor(2 case), pyogenic granuloma-like lesion(2 cases), solitary papule with flat surface(2 cases). 6. The combined disease are atopic dermatitis(1 case), epidermal cyst(1 case), and liver cirrhosis(1 case), diabetes mellitus(1 cases). Conclusion: This study shows various atypical molluscum contagiosa in immunocompetent patients. Histopathological examination in atypical molluscum contagiosa is necessary for the proper diagnosis and treatment. (Korean J Dermatol 2001;39(10): 1080-1085)

Potassium iodide(KI)로 치료한 Sweet 증후군

김진형(Jin Hyoung Kim),임연순(Yeon Soon Lim),최혜영(Hae Young Choi),명기범(Ki Bum Myung) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.8

N/A