전신 광화학요법 ( PUVA ) 이 멜라닌세포 성장 및 백반증 환자의 항멜라닌세포 자가항체가의 변화에 미치는 영향

한승경,신항계,송민석,박윤기 ( Seung Kyung Hann,Hang Kye Shin,Min Seok Song,Yoon Kee Park ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

Background: PUVA has been used effectively in the treat,ment of vitiligo, but the mechanism by which PUVA stimulat.es melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. Objective : To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and t,he incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. Methods : The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. Results : 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo. (Kor J Dermatol 1997;35(1): 57-70)

수종의 일광차단제의 자외선 A 및 자외선 B에 대한 일광차단능력 측정

한승경(Seung Kyung Hann),김홍석(Hong Suk Kim),김수민(Soo Min Kim),최현주(Hyun Joo Choi),김종일(Jong Il Kim) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.6

Background:Recently, concerns regarding protection provided by sunscreens in the UVA spectrum have been raised. But there is no standard testing protocol for quantifying this protection. Objective:As an ideal test methodology, the PFA test using the concept of minimal pigment darkening dose(MPPD) was evaluated to determine its ability to quantify the UVA protection provided by a sunscreen. Methods:Sunscreen products were tested on unsensitized women subjects with both UVA from a Sellas UVA lamp in a protocol similar to the sun protection factor test(SPF) and UVB by the SPF protocol. Results:The protection factors in UVA ranged from 5.0 to 5.3 depending on the type of absorber and the UVB blocking filter. Conclusion:This test method provides a realistic in vivo estimate of the amount of UVA protection provided by sunscreens. (Korean J Dermatol 2000;38(6):735~741)

백반증의 면역학

한승경 (Seung Kyung Hann) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.5

Vitiligo is frequently associated with autoimmune diseases, such as multiple glandular insuffi ciencies and thyroid diseases. In addition, various circulating antiorgan antibodies are found in patients with vitiligo. This raises the possibility that vitiligo might also be an antibody associated au toimmune disease. Variou. alterations in peripheral mononuclear cells, especially T-cells and T-cell subsets have been desiribed in patients with vitiligo. The discovery of circulating antimelanocyte antibodies in patients with vitiligo demonstrateci that vitiligo may be associted with alterations in the specific immunity to melanocytes. These vit iligo antibodies, which are more common in patients with vitiligo than in normal individuals, react with cell surface pigment cell antigens with MWs of approximately 150, 90, 75, 40-45, and 35 kDa, and can kill rnelanocytes in vitro. It has been suggested tiat melanocytes are much more sensitive to toxic or immune mediatece injury that other cutaneou; cell types, thus explaining their apparently selective destruction in vitiligo despite the rather bro d specificity of these vitiligo antibodies. However vitiligo autoantibodies are not found in all vitilio patients. Some of t,hem are present in patients without vitiligo. Tak ing into account the common occurrence of circulation autoantibodies irrelevant to the pathogene sis of the cutaneous hypomelanosis in vitiligo patients, the pathogenetic role of these vitiligo anti bodies has not yet been demonstrated, and the possibility that they represent an impertineni epiphenomenon in vitiligo cannot be ruled out. (Kor J Dermatol 1995;33(5): 801-814)

한국인의 부분 백피증(Piebaldism) 1에 대한 임상적 고찰

한승경(Seung Kyung Hann),황성원(Sung Won Whang),김수민(Soo Min Kim) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.6

Background:Piebaldism is an uncommon congenital disease inherited in autosomal dominant pattern. It is characterized by stable leukoderma with white forelock and vitiligo-like amelanotic macules usually containing a few normally pigmented or hyperpigmented macules. There have been a few case reports, but no clinical study in Koreans. Objective:The purpose of this study was to investigate characteristic clinical features in Korean patients with piebaldism different from that of Caucasian. Methods:We evaluated 11 patients with piebaldism using retrospective method and telephone survey in regard to sex, family history, clinical features such as distribution of hypopigmented patches, white forelock, normo- or hyperpismented macules within hypopigmented patches, hyperpigmented macules in normal skin, associated systemic disease, and effect of treatment. Results:Ten patients showed autosomal dominant features but one occurred sporadically. The ratio of male to female was 3:8, and only 6 patients had white forelock. The most common site of hypopigmented patches was the lower leg(in all patients), followed by abdomen, left foot and left buttock, and chest. All patients had normo- or hyperpismented macules in hypopigmented patches, and 4 had hyperpigmented lesion in normal skin. Down's syndrome was associated in one case. We treated 3 cases with epidermal graft. Conclusion:Most cases were consistent with other western reports. But our patients revealed female predominance(3:8), lower incidence of white forelock(about 55%), frequent lower leg involvement(100%), and uncommon distribution of skin lesion such as foot and buttock. These differences reflected characteristic clinical features of piebaldism in Koreans different from those of Caucasians. (Korean J Dermatol 2000;38(6):721~728)

Indomethacin 투여가 마우스의 접촉 과민 반응에 미치는 영향

한승경(Seung Kyung Hann),박윤기(Yoon Kee Park),김형일(Hyung Il Kim),최응호(Eung Ho Choi) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.3

To study the effect of indomethacin treatment on the reactivity of contact hypersensitivity and discuss relevant mediators which could affect contact hypersensitivity, the following items were evaluated: the change in the plasma concentration of prostsglandin E following indomethacin treatment; the change of contact hypersensitivity following indomethacin treatment. The results ore summarized as follows: 1. The plasma level of prostaglandin E in indomethacin treated mice decreased. 2. The contact hypersensitivity of indomethacin treated mice was depressed. Considering the suppression of contact hyper sensitivity by indomethacin treatment, the metabolites of cyclo-oxygenase such as prostaglandin E may be the possible mediators of induction of contact hypersensitivity. (Kor J Dermatol 28(3): 278 282, 1990)

혀에 발생한 유두상 혈관내막 증식증

한승경(Seung Kyung Hann),조무연(Moo Yon Cho),이승헌(Seung Hun Lee),안성구(Sung Ku An) 대한피부과학회 1987 대한피부과학회지 Vol.25 No.5

Intravascular papillary endothelial hyperplasia is a benign solitary turnor that may be histologically misdiagnosed as angiosarcoma. We present herein a case of intravascular papillary endothelial hyperplasia occuring in 40-year-old female who hsd a slowly growing tumor on the tongue for 3 years. the histopathologic findings revealed. papillary endothelial hyperplasia in blood vessel accompanied with thrombi.

Chronic Actinic Dermatitis Showing a Good Response to Cyclosporine

한승경 ( Seung Kyung Hann ),조흔정 ( Heun Jung Cho ),이광훈 ( Kwang Hoon Lee ),박윤기 ( Yoon Kee Park ) 대한피부과학회 1996 초록집 Vol.34 No.10

전신성 백반증 환자 174예의 임상적 고찰

한승경(Seung Kyung Hann),박윤기(Yoon Kee Park),황규천(Kyu Chun Whang),김형주(Hyung Joo Kim) 대한피부과학회 1986 大韓皮膚科學會誌 Vol.24 No.6

This is an analysis of 174 patients classified as generalized vitiligo by Ortonnes' classification during the period from May till December in 1985. The retults are summarized as follows. There were 89 females(51.l%) and 85 males(48, 9%). 2. The mean age of onset was 24.2 years(male: 23.4, female: 24. 8). 3. The mean age at the first visit was 33 years(male: 32. 2, female: 34, 8) 4. The mean duration of t.he disease was 10. 8 years (male: 10. 3, female: 11. 3). 5. The mean interval between onset and visiting was 9 years(male: 8. 8, female: 10). 6. Mode of onset was unicentric in 90, 2% and multicentric in 9. 8% 7.The most common site of initial involvement was abdomen(15. 0%). 8. The most common precipitating factor was trauma(11%). 9.The most common previous treatment was sunlight irradiation after application of topical oxoralene(33.3%). 10. The most common degree of depigmented lesion was 5~10%.(39.7%). 1l. Family history was present in 12% and thyroid disease was associated in only one case.

Fiddler ` s Neck

한승경(Seung Kyung Hann),김덕현(Duck Hyun Kim),이성낙(Sung Nack Lee) 대한피부과학회 1986 대한피부과학회지 Vol.24 No.5

Fiddler's neck was first described by Peachey and Matthews in 1978 to denote a condition characterized by focal lichenification and pigmentation on the left side of violinist and violist neck just below the angle of the jaw. The etiologic facters are friction, local pressure, occlusion, poor hygiene and sweating. In only a few cases has a specific hypersensitivity to one or more of the ch!n rest material(wood, lacquer, dye) or the metallic fixing been found responsible. We report a case of 15-year-old female patient with Fiddler's neck who has played the violin for 8 years.

다형 홍반의 임상 및 병리조직학적 특성 - 수장족저부 병변과 비수장족저부 병변의 임상 및 병리조직학적 비교 -

홍창의,한승경,이광길,이일주 ( Chang Eui Hong,Seung Kyung Hann,Kwang Gil Lee,Il Joo Lee ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.6

Background: Erythema multiforme is an inflammatory disorder of the skin which may be characterized by erythematous papules, plaques, vesicles, and 'target-like' annular lesions. Mucosal lesions may occur. Symmetric irivolvement of the extrernities, especially the dorsurn of the hands and feet, and face is the classic: pattern of cutaneous distribution. Palmoplantar lesions of erythema multiforme are relatively uricornmon. Objective : Our purpose was to investigate the clinical and histopathological r,haracteristics of erythema multiforme involving the palm and sole. Methods : Thirty one cases of erythema multiforme involving the palm and sole, and thirty cases involving other sites wer collected and analysed with particular reference to epidemiological data, type and distribution of the skin lesion and histopathological characterist,ics. Results : 1. The median ages of both groups were the early thirties. There were no sexual predominances. 2. The clinical features of erythema multiforme involving the palm and sole were relatively mild and showed atypical skir, lesions including macules and papules compared with erythema multiforme involving the other sites. 3. The histopathological changes of the palmoplantar group were also mild, especially the epidermal changes which included keratinocytes necrosis, subepidermal blisters, focal parakeratosis, extensive epidermal necrosis and xocytosis etc. 4, The most import,ant and consistent histopathological finding of the palmoplantar erythema multiforme group was lymphoc;yte tagging along the basernent membrane, which was found consistently apart from one case. Conclusion : We investigated the clinical and histopathological features of erythema multiforme involving the palm and sole. They showed mild clinical features and atypical skin lesions cornpared with other group. The histopathological spectrum of this group was diverse, and reflected the early stage of pathomecha nisms of erythema multiforme. Among them, lyrnphocyte tagging was the most important and censistent finding in palmoplantar erythema multiforme. (Korean J Dermatol 1997;35(6): 1159-1167)