피지선 과형성에서 Demodex Folliculorum의 검출 및 병리조직학적 소견

정태안 ( Tae Ahn Chung ),오창근 ( Chang Keun Oh ),장호선 ( Ho Sun Jang ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.1

Background: The pathogenic role of Demodex is still a matter of debate. We accidentally found large numbers of Demodex from sebacous hyperplasia(SH), Objective : The aim of this study is to compare the number of Demodex in the with control group and to observe the histopathological finding of SH. Methods : Extraction was performed in 11 patients with SH, and in 40 controls. Excision biopsy was performed in 8 patients with SH. Results : The prevalence and density of Demodex was significantly higher in patients with SH (prevalence = 100%; mean density = 28.9/lesion) than in the controls(prevalence = 85%; mean density=2.1/follicle). Histopathologically, a dense homogenous eosinophilic material surrounding the mites(abnormal keratinization of ductal epithelium), sloughing of keratin, follicular plugging, obstruction of the hair follicle and sebaceous duct, cellular destruction of the sebaceous gland(degeneration), squamous metaplasia of sebaceous gland cells, and follicular and perifollicular inflammatory infiltration were observed. Demodex organisms were found in the hair follicle, sebaceous duct and sebaceous gland. Conclusion : The present study demonstrates a high density of Demodex in the lesion of SH and this finding suggests possible relationship of Demodex in the development of the skin lesion of SH. (Kor J Dermatol 1996;34(1): 52-57)

다발성 모낭상피종의 임상 및 병리조직학적 관찰

정태안,서경형,장호선,권경술,오창근 ( Tae Ahn Chung,Kyung Hyung Seo,Ho Sun Jang,Kyung Sool Kwon,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5

Background: The diagnostic dilemma in differentiation between multiple and solitary trichoepitheliomas from basal cell carcinoma(BCC) is well documented. Some authors reported that up to 35% of trichoepitheliomas were misdiagnosed initially as BCC, especially the keratinizing variant. Objective : The purpose of this study was to review the clinicopathological characteristics of the multiple trichoepitheliomas and to suggest specific findings and useful special staining methods for differentiating from BCC. Methods : We reviewed 14 cases of multiple trichoepitheliomas from a clinicopathological aspect. We performed H&E, periodic acid Schiff, Giemsa, Fite, and alcian blue staining using the formalin-fixed paraffin-embedded samples of multiple trichoepitheliomas. Results : The average age at onset was 24.7 and 78.6% of the cases showed autosomal dominant inheritance patterns. The sites of frequent involvement were the nasolabial folds and nose, and the average size of the lesions was 4.3x4.3 mm. The most important histopathological finding in differentiation was papillary mesenchymal tissue, and this was well observed with the Giemsa stain. Several other findings were also useful in differentiation, such as stellate structures in cystic walls, parakeratosis and eosinophilic necrotic bodies in the cystic walls, primitive hair follicles, epidermal connections, and mast cell infiltration. Conclusion : Several staining methods, such as the Giemsa, periodic acid Schiff, Fite, and alcian blue stains, were useful in differentiating the trichoepitheliomas from BCCs. (Korean J Dermatol 1997.35(5): 909-914)

후천성 수포성 표피박리증

이재봉,정태안,권경술,장호선,오창근 ( Jae Bong Lee,Tae Ahn Chung,Kyung Sool Kown,Ho Sun Jang,Chang Keun Oh ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Epidermolysis bullosa acquisita(EBA) is a rare chronic subepidermal bullous disease wit,h autoantibodies to type VII collagen. Clinically, EBA usually begins after the age of 50 with pruritic vesicle and blister formation often on traumatized skin and leaves atrophic scars and milia. A 48-year-old woman visited our department with a 5 month history of a generalized pruritic blistering eruption that began on the scalp and spread to the face, trunk, extremities, and lip. The biopsy specimen revealed dermoepidermal separation, infiltration of perivascular mononuclear cells. Direct immunofluorescence(DIF) showed positive linear deposition of IgG at the BMZ. Bullous pemphigoid was diagnosed and treated with prednisolone 20-40mg daily. The skin lesions were improved after 2 week. During follow-up, trauma-induced vesicles occurred frequently and healed with remaining malia and scars. The biopsy specimen of trauma induced vesicles revealed subepidermal blisters and inflammatory cell infiltration in the dermis. DIF of perilesional skin showed positive linear deposition of IgG at the BMZ. DIF of salt split skin showed linear IgG deposits on the dermal floor. EBA was confirmed. (Kor J Dermatol 1997;35(4): 814-818)

흉골늑골쇄골간 과골증을 동반한 수장 족저 농포증 ( 농포성 관절골염 ) 3예

오창근(Chang Keun Oh),최석주(Suk Joo Choi),문두찬(Doo Chan Moon),권경술(Kyung Sool Kwon),정태안(Tae Ahn Chung) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.5

Pustulotic arthro-osteitis is a rheumatic syndrome of unknovn cause, characterised by an inflammatory osteitis of the sternocostoclavicular region and pustuosis palmaris et plantaris. Although many ases of the disease have been reported in Japan, it, has not been reported in Korea so far. Three cases of pustulosis palmaris et plantaris associated i rith sternocostoclavicular hyperostosis or pustulotic arthro-osteitis are presented. (Kor J Dermatol 1992;30(5l:693-700)

Becker ` s Melanosis의 임상 및 병리조직학적 관찰

오창근(Chang Keun Oh),정태안(Tae Ahn Chung),하은희(Eul Hee Ha) 대한피부과학회 1994 大韓皮膚科學會誌 Vol.32 No.1

Background : Beckers melanosis is not an uncommon entity, and niany cases are probably not reported because the diagnosis is usually made clinically and the conditioii is benign with cosmetic significance only. The etiology remains obscure. Objective : Th

백서에서의 문신육아종 발생에 관한 실험적 연구

김초록,오창근,문두찬,권경술,정태안 ( Cho Rok Kim,Chang Keun Oh,Doo Chan Moon,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1991 대한피부과학회지 Vol.29 No.6

N/A Decorative tattooing has become popular among Korean women, done by many beauticians offering this service. This has resulted in various serious complications including cutaneous granulomas. We tried to produce granulomatous reaction in rats following the injection of eyebrow tattoo pigment. Thiry rats were divided into 3 groups and were injected in tradermally with following materials:tattoo pigment, tattoo pigment and Freund complete adjuvant, and Freund complete adjuvant, respectively. Using an inductively coupled plasma(ICP) spectrometry, quantitative elemental analysis of the original sample of the tattoo dye was done. The results were as follows : 1. In tattoo pigment injected group, foreign body granulomas we`e observed in 7 of 10 rats at one month, which consisted of macrophages, mononuclear cells and foreign body giant cells around tattoo pigment. Little difference was seen in the granulomas between one and two months. In the remaining 3 rats, macrophages that had ingested tattoo pigment and mononuclear inflammatory cells were diffusely scattered in the dermis. 2. In the tattoo pigment and Freund complete adjuvant injected group, all 10 showed foreign body granulomas at one month. Little difference was seen in the granulomas between one and two months. 3. In Freund complete adjuvant injected control group, macrophages and mononuclear inflammatory cells were present in the dermis, but well formed granulomas were not present. 4. By ICP spectrometry, cobalt(11280ppm), calcium(1101ppm), chromium(238ppm), lead(441.6ppm), aluminum(56.52ppm), sodium(456.8ppm), potassium(457.6ppm), magnesium(142.28ppm), phosphorus(25.95ppm), nickel(11.85ppm), copper(1.37ppm) and titanium(0.34ppm) were detected from the tattoo pigment.

유경성 지방섬유종의 임상 및 병리조직학적 관찰 - 표재성 피부지방종성 모반과의 비교 관찰 -

권경술,서경형,장호선,정태안,오창근 ( Kyung Sool Kwon,Kyung Hyung Seo,Ho Sun Jang,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5

유경성 지방섬유종(pedunculated lipofibroma)은 진피내 이소성 지방조직(ectopic fatty tissue)을 특징으로 하는 비교적 드문 결체조직 이상으로 병리조직학적 소견은 표재성 피부지방종성 모반(nevus lipomatosus cutaneous superficialis, 이하 NLCS)과 거의 유사하다. NLCS는 다발형과 단발형 병변으로 분류할 수 있는데 Mehregan 등은 단발형이 다발형에 비해 임상 및 조직학적으로 많은 차이점을 보인다는 점에서 유경성 지방섬유종으로 부를 것을 제안했다. 국내에서는 유경성 지지방섬유종에 대해 본 교실에서 처음 발표한 증례를 포함해 2예가 보고되었다. 이에 저자들은 본 교실에서 경험한 12예의 유경성 지방 섬유종에 대해 이들의 임상양상 및 병리조직학적 특징을 관찰하고, 본 교실의 NLCS 증례와 국내에 발표된 NLCS 증례를 문헌고찰하여 유경성 지방섬유종과 비교분석하였다. Background:Nevus lipomatosus cutaneous superficialis(NLCS) was originally classified into two clinical types:a multiple form and a solitary one. Mehregan et al proposed the term pedunculated lipofibroma for the solitary form of NLCS in view of its distinctive clinicopathological features. Objective:Pedunculated lipofibroma is a relatively rare benign connective tissue proliferation abnormality characterized by ectopic adipose tissue in the dermis. The purpose of this study was to investigate the differences in clinicopathological findings between pedunculated lipofibroma and NLCSs. Methods:we performed the comparative clinicopathological studies of pedunculated lipofibromas and NLCSs among 9,940 patients who had skin biopsies for hisitopathological diagnosis during a recent 20 yeat period. In addition, we reviewed the NLCS cases previously reported in Korea. Results:We found 12 cases(0.12%) of pedunculated lipofibromas which showed a female preponderance. The lesions usually appeared as large, solitary, slow-growing, pedunculated to dome-shaped, skin-colored nodules or masses showng predilection for the buttock and upper thigh. However, 33.3% of lesions were present on non-pelvic girdle areas such as the back, upper arm, scalp, axilla and anterior chest. Most of the patients had a solitary lesion except for two patients who had two lesions. Histopathologically, all of the lesions were characterized by the presence of a central fatty core of mature adipose tissue infiltration admixing with dense stromal collagen. Several appendageal structures, perivascular and periappendageal deposition of mucin, and perivascular infiltration of mast cells were present in all of the lesions. Otherwise obvious acanthosis or papillomatosis were not present in the epidermis. We found 4 cases(0.04%) of NLCSs and reviewed 9 reported cases of NLCSs, which did not show the sexual differences in incidence. The lisions usually appeared as skin-colored confluent nodules which formed the zosteriform or cerebriform plaques. The majority of lesions(92.3%) were present on the pelvic girdle area except for one case with shoulder lesions. Histopathologically, all of the lesions showed the mature adipose tissues, epidermal hyperkeratoses, acanthoses, follicular pluggings and well-developed pilo-sebaceous units. Conclusion:Because of the distinctive clinicopathological differences between the solitary and multiple forms of NLCS, we agree with Mehregan’s proposal of nominating this solitary lesion as pedunculated lipofibroma.(Korean J Dermatol 1997;35(5):854∼862)

전두부에 발생한 다발성 피지선암

이현태,장호선,권경술,정태안,오창근 ( Hyun Tae Lee,Ho Sun Jang,Kyung Sool Kwon,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Sebaceous carcinoma is a rare, aggressive, malignant tumor derived from the adnexal epithelium of sebaceous glands. This tumor occurs most frequently on the eyelids, but may occur on the extraoccular sites. Clinically, it is presented as a solitary tumor in most cases and very rarely as multiple ones. We report a case of multiple. sebaceous carcinomas on the frontal region in a 73 year-old man. He had well-demarcated, reddish, asymptomatical, protruding masses on the frontal region for 2 months. The histopathologic findings showed irregular, variable sized, lobular tumor nests of the entire dermis, and each lobule was composed of foamy cytoplasmic atypical cells and undifferentiated cells containing, eosinophilic cytoplasm. He was treated with surgical excision and no recurrence was observed during 6 months. (Kor J Dermatol 1997;35(4): 824 - 829)

인공피복재가 창상치유에 미치는 영향에 관한 실험적 연구

오창근,문두찬,권경술,정태안 ( Chang Keun Oh,Doo Chan Moon,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.5

융합성 망상 유두종증의 병인에 있어 세균과의 관련성에 관한 연구

이현태 ( Hyun Tae Lee ),정태안 ( Tae Ahn Chung ),권경술 ( Kyung Sool Kwon ),장호선 ( Ho Sun Jang ),오창근 ( Chang Keun Oh ) 대한피부과학회 1998 大韓皮膚科學會誌 Vol.36 No.1

Background: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. Objective : The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. Methods : We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. Results : 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. Conclusion : Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects. (Korean 1 Dermatol 1998;36(1): 78-85)