궤양성대장염이 동반된 급성 발열성 호중구성 피부병

장호선,이장수,문두찬,권경술,정태안 ( Ho Sun Jang,Jang Soo Lee,Doo Chan Moon,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1991 대한피부과학회지 Vol.29 No.4

A Case of Acute Febrile Neutrophilic Dermatosis Associated with Ulcerative Colitis Ho Sun Jang, M.D., Jang Soo Lee, M.D.*, Doo Chan Moon, M.D., Kyung Sool Kwon, M.D., Tae Ahn Chung, M.D. Department of Dermatology, College of Medicine, Pusan National University, Department of Dermatology, Pusan Medical Center*, Pusan, Korea We report a case of acute febrile neutrophilic dermatosis associated with ulcerative colitis occurred in a 58-year-old woman who showed well-demarcated, painful, erythematous papules, nodules, and plaques on the face, posterior neck, and both upper and lower extremities. The patient also experienced frequent diarrhea and intermittent bloody stool for about 10 years. Laboratory findings revealed polymorphonuclear leukocytosis, elevated erythrocyte sedimentation rate, and occult blood in stool. Findings of sigmoidoscopy, barium enema, and rectal biopsy were consistent with diagnosis of ulcerative colitis. Skin biopsy from the lesion on the posterior neck showed dermal edema resulting in subepidermal blisters and a dense inflammatory cell infiltration composed predominetly of polymorphonuclear leukocytes and a few mononuclear cells in the dermis. Biopsy from the lesion on the right shin revealed a moderate inflammatory cell infiltrate in the septa of the subcutaneous fat layer, composed chiefly of the lymphohistiocytes and a few eosinophils. The symptoms and signs responded well to orally administered prednisolone and sulfasalazine. This is a very rare case of acute febrile neutrophilic dermatosis with which ulcerative colitis was associated. (Kor J Dermatol 29(4) : 522-528, 1991)

융합성 망상 유두종증의 임상적 및 병리조직학적 관찰

장호선,문두찬,권경술,정태안 ( Ho Sun Jang,Doo Chan Moon,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1991 대한피부과학회지 Vol.29 No.4

N/A Clinical and Histopathological Observation of Confluent and Reticulated Papillomatosis Ho Sun Jang, M.D., Doo Chan Moon, M.D., Kyung Sool Kwon, M.D., Tae Ahn Chung, M.D. Department of Dermatology, College of Medicine, Pusan National University, Pusan, Korea Confluent and reticulated papillomatosis is a rare but clinically distinct dermatosis of which the etiology is unknown. We observed the clinical and histopathological findings of 14 patients of confluent and reticulated papillomatosis who had visited Pusan National University Hospital, and studied mycologically Pityrosporum orbiculare. The results were as follows : 1. The mean age of onset was 17.7 Years and the most common site of initial involvement was epigastrium(57.1%), and the most common sites of involvement were abdomen(85.7%), and back(85.7%). 2. Positive KOH/Parker ink direct smears were observed in 9 cases, and they were treated with oral and topical antifungal agents. Six out of the patients were responsive to these treatment. 3. Skin biopsy was performed in 13 patients. The major histologic features were hyperkeratosis, focal acanthosis, papillomatosis, parakeratosis, slight atrophy of stratum malpighiii, decreased granualr cell layer, hypermelanosis of basal cell layer, and slight perivascular infiltrate of mononuclear cells. Periodic acid-Schiff stain showed Pityrosporum orbiculare yeasts in the stratum corneum in 7 cases. 4. The cultrued Pityrosporum orbiculare colonies were inoculated on the inner ear surface of 5 rabbits, and one week after inoculation, thick yellowish scaly crusts were seen in 3 of 5 rabbits. Therefore, we believe that Pityrosporum orbiculare may play an important role in the pathogenesis of confluent and reticulated papillomatosis. (Kor J Dermatol 29(4) : 471-480, 1991)

수장족저 농포증에서 골관절병증의 임상적 연구

장호선,서경형,권경술,정태안,오창근 ( Ho Sun Jang,Kyung Hyung Seo,Kyung Sool Kwon,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.6

Background: Palmopl ntar pustulosis(PPP) is often associated with osteo arthropathy, especially sternocostoclavicular iiyperostosis(SCCH). The relation between PPP and SCCH or other types of seronegative arthropathy remains unclear. Objective : The purpose of this study was to investigate the distribution and the frequency of osteo-arthropathy in patients with PPP. Methods : Twenty fiv patients with PPP were included in this study, and checked for clinical symptoms and signs, labiratory findings, and radiologic findings including plain X-ray, 99mTc-MDP bone scan, and computeI t,omography. Results : The incidenc of osteo arthropathy in PPP was 64%. The prevalent age at onset of osteo arthropathy was the forth decade in males, and the sixth decade in females. The frequent, sites of osteo arthralgia were st,ernocostoclavicular areas, spines, shoulders, knees, and sacroiliac joints, and the frequent sites of increased radioisotope uptake were similar to t,he distribution of sites of osteoarthropathy. Tc-MDP bone scan was more sensitive in detecting osteo-arthropathy than plain X ray and commputed tomography. In laboratory findings, we observed an increase in the erythrocyte sedimentation rate, leukocyte counts, alkaine phosphatase, and the positivity of C-reactive pr otein. Conclusions : The frequent involvement of the anterior chest, wall, knees, spines, and sacroiliac joints was noted in pati .nt.s with PPP. 99mTc MDP bone scan may be the most helpful in making a diagnosis of osteo-arthropathy accompanied with PPP. (Korean J Dermatol 1997;35(6): 1143-1150)

성인에서 발생한 발진성 가성 혈관종증

서상희 ( Sang Hee Seo ),장호선 ( Ho Sun Jang ),목혜수 ( Hye Soo Mok ),김성준 ( Sung Jun Kim ),김병수 ( Byung Soo Kim ),김문범 ( Moon Bum Kim ),오창근 ( Chang Keun Oh ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8

Background: Eruptive pseudoangiomatosis (EPA) is a rare, benign, spontaneously regressing childhood exanthem. It is characterized by the sudden onset of several bright red angioma-like papules surrounded by pale halos with a distinct histopathology from true angiomas. Objective: This study was performed to evaluate the clinical and histopathologic characteristics of EPA occuring in adults. Methods: Ten adult patients who visited Pusan National University Hospital and Mok Hye-SooㆍJang Ho-Sun Dermatology Clinic from March 2005 to September 2006 were evaluated. We prospectively evaluated the sex, age, onset season, past medical history including immunosuppressive abnormalities, systemic disorders and other diseases including allergies. We also investigated the relations of mosquito biting, patients` occupations and outdoor activities to occurrence of EPA. In addition, simultaneous occurrence in family members, the clinical, histopathologic, laboratory findings, disease courses and responses to treatment were evaluated. Based on medical records, photographs and pathologic slides, we retrospectively diagnosed another 20 EPA patients suspected as insect bite from October 2003 to March 2005. The same questions were inquired as for the 10 patients who prospectively underwent evaluation. Results: In the study, female predominance (76.7%) was observed and the average age of onset was 54.2 years. Interestingly, there was no child patient during the period of study. Multiple, 2∼5 mm sized, red angiomatous papules surrounded by pale halos occurred on exposed areas such as the arms (86.7%), legs (50%), and face (46.7%), although it could also occur to a non-exposed area. EPA occuring in adults usually appeared in summer (80%). The mean disease duration was 3.4 weeks. Although EPA spontaneously regressed, it had the potential of recurrence (46.7%). Histopathologic findings showed dilated dermal blood vessels without the evidence of increase in numbers, and perivascular lymphocytes infiltration. Inside the lumen of dermal blood vessels, plump endothelial cells were found. Conclusion: EPA occuring in adults usually happened to exposed sites in summer, so it can be misdiagnosed as insect bite. We suggest that dermatologists should be concerned about EPA in adults and conduct further investigation to have a better understanding of the disease. (Korean J Dermatol 2007;45(8):797∼803)

피부 편평세포암의 원인 질환에 관한 임상적 관찰

임명규 ( Myeong Kyoo Lim ),정태안 ( Tae Ahn Chung ),장호선 ( Ho Sun Jang ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.1

Background:The incidence of cutaneous squamous cell carcinoma(SCC) has been increasing, but no analysis of the causative diseases of cutaneous SCC has been performed. Objective : The purpose of this study was to investigate the causative disease of SCC, Methods : Eighty-seven patients with cutaneous SCC were retrospectively studied. Results : The possible causative diseases of cutaneous SCC were actinic keratosis(18 csaes), Bowen's disease(17 cases), actinic cheilitis(8 cases), burn scar(4 cases), arsenical keratosis(3 cases), xeroderma pigmentosum(3 cases), chronic discoid lupus erythematosus(2 cases), epidermodysplasia verruciformis(2 cases), leukoplakia(1 case), chronic radiodermatitis(1 cases), erythroplasia of Queyrat (1 case), osteomyelitis sinus(1 case), lichen planus(1 case), porokeratosis of Mibelli(1 case), and the other 21 cases were of unknown origin. Conclusion : The causative diseases of cutaneous SCC were related to sun-exposure, and chronic dermatoses. (Kor J Dermatol 1996;34(1): 85-92)

수포성 전신성 홍반성 루프스 2 예

장호선(Ho Sun Jang),오창근(Chang Keun Oh),권경술(Kyung Sool Kwon),조주현(Ju Hyun Jo),김문범(Moon Bum Kim) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.3

Bullous systemic lupus erythematosus (bullous SLE) is an uncommon, distinctive clinical variant of systemic lupus erythematosus (SLE), histopathologically characterized by subepidermal blisters with neutrophil infiltration and immunopathologically linear IgG depositon at the dermoepidermal junction. A blistering eruption may occur during flares of SLE such as lupus nephritis. We report two cases of bullous SLE, confirmed by the clinical, histopathological and immunopathological features. In one patient who has been diagnosed as SLE with diffuse proliferative lupus nephritis (WHO class IV), a blistering eruption occurred during the course of treatment of SLE. In the other patient, the bullous eruption was the initial manifestation of SLE and then she was diagnosed as SLE. We review the recent literature and describe the distinctive features of this rare disorder. (Korean J Dermatol 2002; 40(3): 281~285)

마우스 각질형성세포에서 세균 수용체 발현 및 Lipopolysaccharide 자극시 사이토카인 분비에 관한 연구

장호선 ( Ho Sun Jang ),김천기 ( Cheon Ki Kim ),조주현 ( Ju Huyn Jo ),이재봉 ( Jae Bong Lee ),김문법 ( Moon Rum Kim ),오창근 ( Chang Keun Oh ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 2004 대한피부과학회지 Vol.42 No.5

안면경부 모낭성 홍색흑피증 12 예에 대한 임상 및 병리조직학적 고찰

장호선(Ho Sun Jang),이채욱(Chea Wook Lee),차정훈(Jung Hoon Cha),김성준(Sung Jun Kim),오창근(Chang Keun Oh),권경술(Kyung Sool Kwon) 대한피부과학회 2001 大韓皮膚科學會誌 Vol.39 No.5

N/A Background: Erythromelanosis follicularis faciei et colli(EFFC) is an infrequently diagnosed disorder. This condition consists of the clincal triad of well-demarcated erythema, hyperpigmentation, and follicular plugging on the face and neck. The etiology of EFFC remains obscure, and therapy for EFFC is only moderately successful. Objective: The aim of this study is to examine the clinical and histopathologic findings of erythromelanosis follicularis faciei et colli and suggest the new treatment method of erythema by 585 nm flashlamp-pumped dye laser. Methods: We evaluated 12 patients of erythromelanosis follicularis faciei et colli. Among them, we made a trial of 585nm flashlamp-pumped dye laser in erythema of EFFC on 11 cases. Results: The results were as follows; 1. The mean age of onset and that of the first visits made by patients was 12.1 and 18.9 years, respectively, and there was a male predominance. 2. Histologic features revealed hyperpigmentation in basal layer, perivascular and periadnexal lymphocytic infiltration, and vessel dilatation in upper dermis in all specimens. Follicular plugging(62.5%), hyperkeratosis without parakeratosis(55.6%), enlarged hair follicle containing lamellar body(25.0%), and sebaceous gland hypertrophy(22.2%) were also observed. 3. Electron microscopic studies showed abnormal melanosomes, such as a stippled appearance of the periphery of a melanosome and a large number in the cytoplasm of basal cells. 4. 585nm flashlamp-pumped dye laser treatment with fluences that ranged from 6.5-7.5J/cm2 was given on 1 time. In 2 cases, results were achieved in fair improvement of erythema. Hyperpi-gmentation occurred in 2 cases(2/11) . Conclusion: Characteristically, EFFC affects adolescent males predominantly. The histologic features, although nondiagnostic, correlate with the clinical features. We suggest the new treatment modality, 585nm flashlamp-pumped dye laser, for the treatment of erythema in EFFC. EFFC, which can cause significant cosmetic problems to patients, maybe much more common than recognized. However, it is not well known, may be because the small number of cases have been reported in the literature. It can be helpful to understand the pathogenesis and improve treatment modalities when it will be recognized by more physicians and patients.

Detection of clonal T-cell receptor gene rearrangements by polymerase chain reaction in Cutaneous Lesions of mycosis fungoides

장호선 ( Ho Sun Jang ),조주현 ( Ju Hyun Jo ),오창근 ( Chang Keun Oh ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 1999 초록집 Vol.37 No.20

카포시 육종과 동반된 Idiopathic CD4 + T Lymphocytopenia

이현태,장호선,권경술,정태안 ( Hyun Tae Lee,Ho Sun Jang,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

Idiopathic CD4+ T lymphocytopenia(ICL) is a new disease entity characterized by depletion of helper T cells apparently without any evidence of HIV infection. We report a case of ICL associated with Kaposis sarcoma(KS) and pneumocystis carinii pneumonia(PCP) in a 34-year old woman. She developed violaceous, protruding masses on scalp, back, both extremities, palms, soles, left. first toe and peritonsillar region for 2 months. These lesions were confirmed as KS by histopathologic findings. Chest X-ray and HRCT findings represented PCP and KS. Absolute deficiency of CD4+ T cell was detected in the count of T cell subsets. Serologic tests for HIV-1, 2 and HTLV I, -II were negative. And she was absent any defined immunodeficiency or therapy associated with decreased levels of CD4+ T cells. By CDC criteria, a diagnosis of ICL was made. Because of aggravation of PCP and lung involuement of KS, she died at 22nd day after admission. (Kor J Dermatol 1997;35(1): 191-195)