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장민수,양준성,채영수,서기석,김상태 ( Min Soo Jang,Joon Sung Yang,Young Soo Chae,Kee Suck Suh,Sang Tae Kim ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4
Lymphomatous involvement of the skin has been reported to occur in approximately 15% to 20% of patients with lymphoma and in 5% it constitutes the initial presentation of lymphoma. In 1986 Saekow et al. described a patient with a progressively enlarging, indurated lymphomatous plaque on the chest and upper abdominal region that had the shape of a breastplate. They used the term lymphoma en cuirasse. We report a case of lymphoma en cuirasse in a 71-year-old female. She had a well defined, erythematous, hard, indurated plaque on the neck and chest. On physical examination, the right supraclavicular, left inguinal and both axillary lymph nodes were palpable. A Bone marrow aspiration test, chest X-ray and cmputerized tomogram revealed bone marrow and lymph node involvement. Histopathologic examination of the involved skin showed that hyperchromatic and anaplastic lymphocytes were clensely packed in the dermis and subcutaneous fat. On immunohistochemical examination, the tumor cells were positive for the leukocyte common antigen and UCHL-1. We tried to treat the patient with combination chemotherapy, but she refused. After discharge, the patient died one week later. (Kor J Dermatol 1997;35(4): 794-797)
임신 중 크기가 증가한 피부 상피양 혈관내피세포종 Dermoscopy 소견
장민수 ( Min Soo Jang ),한상화 ( Sang Hwa Han ),박종빈 ( Jong Bin Park ),강동영 ( Dong Young Kang ),김상태 ( Sang Tae Kim ),서기석 ( Kee Suck Suh ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.7
Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that has been reported in systemic organs and in the skin as a biologically “borderline” neoplasm with intermediate malignant potentials. Skin involvement in EHE is rare, but when present, it occurs most commonly in the upper and lower extremities, presenting as a solitary, slightly painful, soft tissue mass. Skin involvement is often associated with underlying soft tissues or bone tumors. Histopathological study reveals cords and nests of epithelioid endothelial cells in a myxoid or hyalinized background and small intracytoplasmic vacuoles containing red blood cells. There have been no reported cases yet describing the dermoscopic features of EHE. Herein, we describe a young woman who developed cutaneous EHE that enlarged during pregnancy, we provided the dermoscopic findings and a review of the relevant literature. (Korean J Dermatol 2013;51(7):539∼543)
전신 침범 없이 피부 소견만을 보인 탄력섬유 거짓황색종
장민수 ( Min Soo Jang ),강동영 ( Dong Young Kang ),강진석 ( Jin Seuk Kang ),백재우 ( Jae Woo Baek ),김상태 ( Sang Tae Kim ),서기석 ( Kee Suck Suh ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.1
Pseudoxanthoma elasticum (PXE) is a heritable disorder of elastic tissue and it has many systemic manifestations. PXE is a systemic disorder that most markedly affects the elastic tissues in the skin, retina and blood vessels. Defects in the ABCC6 gene lead to calcification of elastic tissue. We herein report on two cases of pseudoxanthoma elasticum that presented with focal involvement on the skin of the neck without marked wrinkling. (Korean J Dermatol 2011;49(1):53~57)
장민수 ( Min Soo Jang ),한상화 ( Sang Hwa Han ),김준희 ( Joon Hee Kim ),이강훈 ( Kang Hoon Lee ),박종빈 ( Jong Bin Park ),김상태 ( Sang Tae Kim ),서기석 ( Kee Suck Suh ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.1
Cutaneous metastases of malignant melanoma are usually confined to the dermis or subcutaneous fat. In someinstances, however, they may involve the epidermis. A 68-year-old woman with a malignant melanoma on thesubungual area of the right great toe presented with multiple blackish pinhead-sized macules surrounding anulcerative lesion on the right great toe. Histopathological study of the macules showed atypical melanocytes andmelanocytic nests in the papillary dermis and the dermoepidermal junction. A thinning of the epidermis, wideningof the dermal papillae by aggregated atypical melanocytes, epidermal collarette formation, and angiotropism werealso seen. A diagnosis of epidermotropic metastatic malignant melanoma (EMMM) was made. EMMM is a specificform of metastatic malignant melanoma that is associated with epidermotropism of melanoma cells and severalhistopathological features. The differential diagnosis between primary malignant melanoma and EMMM can bedifficult because of their similar clinical and histological features. Here, we report a case demonstrating EMMM. (Korean J Dermatol 2015;53(1):53∼57)
피부 부정형미코박테륨 감염의 임상적, 미생물학적 및 조직학적 소견에 대한 연구
장민수 ( Min Soo Jang ),한상화 ( Sang Hwa Han ),김상태 ( Sang Tae Kim ),서기석 ( Kee Suck Suh ) 대한피부과학회 2014 大韓皮膚科學會誌 Vol.52 No.1
Background: As the immunocompromised population has increased in recent years, the number of cutaneous nontuberculous mycobacterial (NTM) infections has also risen. However, since this affliction has no pathognomonic clinical or histological features, the diagnosis and treatment of cutaneous NTM infections are often delayed. Objective: The aim of this study was to investigate the microbiological, clinical, and histological findings of cutaneous NTM infections. Methods: We reviewed medical records and histologic slides of 10 patients diagnosed with cutaneous NTM infections confirmed by culture or polymerase chain reaction. Results: All patients except one were immunocompetent, and 5 of 10 patients had preceding factors including trauma, liposuction, and intralesional triamcinolone injection. Microbiologically, of the 10 infections, 5 were caused by Mycobacterium marinum, 3 by Mycobacterium fortuitum, and 1 each by Mycobacterium chelonae and Mycobacterium ulcerans, respectively. Of the 5 patients with M. marinum, 2 had a fish-related job and 1 reared fish at a home aquarium. The most common clinical presentation was erythematous nodules (7/10). Histologically, irregular acanthosis (4/10), mixed cell infiltrate of lymphocytes, histiocytes, neutrophils (9/10), suppurative granuloma (7/10), microcysts lined by neutrophils (5/10), fibrosis (4/10), and panniculitis (7/10) were identified. Conclusion: We found microcysts lined by neutrophils in 50% of the samples and considered this finding to be a diagnostic marker of NTM infection. These clinicopathologic features will assist clinicians in diagnosing NTM infection more rapidly and accurately. (Korean J Dermatol 2014;52(1):26∼33)
장민수 ( Min Soo Jang ),이강훈 ( Kang Hoon Lee ),한상화 ( Sang Hwa Han ),박종빈 ( Jong Bin Park ),이지범 ( Jee Bum Lee ),서기석 ( Kee Suck Suh ) 대한피부과학회 2014 大韓皮膚科學會誌 Vol.52 No.1
PNP is a rare autoimmune mucocutaneous blistering disease associated with neoplasms, most frequently of the lymphoproliferative type. As PNP is clinically characterized by polymorphous mucosal lesions and cutaneous eruptions, it is important to differentiate it from erythema multiforme, Stevens-Johnson syndrome, lichen planus, and other bullous diseases. A diagnosis of PNP can be confirmed by immunologic studies such as direct and indirect immunofluorescence, immunoblotting, immunoprecipitation. Rare PNP cases related to nonhematological solid tumors have been reported. A 54-year-old male visited us with generalized pruritic scaly lichenoid lesions on the whole body from 5 weeks prior to his first visit. He also presented with extensive painful ulcers and erosions on the oral mucosa and lips for 2 months. Histopathologic findings showed lichenoid infiltration with vacuolar interface change, lichenoid interface dermatitis, keratinocyte apoptosis, and suprabasal acantholysis with cleft. Indirect immunofluorescence using normal human skin showed IgG deposition at the intercellular space. Immunoblotting using normal epidermal extracts in the serum of patient detected antibody to the 190 kDa (envoplakin), 210 kDa (periplakin) molecules polypeptides. He also had a hepatocellular carcinoma and chemoradiotherapy done before. The diagnosis of paraneoplastic pemphigus (PNP) was made. To our knowledge, there are only two reports of PNP associated with hepatocellular carcinoma worldwide, yet no report in Korean literature. Herein, we report the first case of PNP associated with hepatocellular carcinoma in Korea. (Korean J Dermatol 2014;52(1):34∼39)
췌장 기능 부전증 환자에서 발생한 괴사 융해성 이동성 홍반 ( Necrolytic Migratory erythema )
장민수 ( Min Soo Jang ),김영진 ( Yeong Jin Kim ),채영수 ( Young Soo Chae ),서기석 ( Kee Suck Suh ),김상태 ( Sang Tae Kim ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.1
Necrolytic migratory erythema is a cutaneous reaction pattern with specific histopathologic features that is typically associated with a functioning pancreatic islet cell neoplasm such as a glucagonoma. However, cases without. glucagonoma have also been reported, such as, liver cirrhosis, chronic pancreatitis, celiac sprue etc. Other clinical features include anemia, glossitis and weight loss. We report a case of neccrolytic migratory erythema induced by a pancreatic insufficiency without glucagonoma. A 43-year-old male was seen at our department because of rnultiple erythematous, desquamative and erosive patches on the whole body for 1 month. He also had weight loss(25Kg) and stomatitis. Seven years previously he had a Whipple's procedure for a pancreatic head rupture. The laboratory data showed a low protein and zinc level, and high glucagon level. Histopathologic findings of the case showed epidermal edema and pallor, and superficial epiderrnal necrosis. The patient improved progressively after intravenous infusion of amino acids with a pancreatic enzyme supplementation. (Kor J Dermatol 1996;34(l): 166-170)