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)

표재성 및 심재성 진균증의 진단에 있어서 Fungi - FluorR solution 염색의 유용성에 관한 연구

권경술,임채성,장호선,정태안,오창근 ( Kyung Sool Kwon,Chae Sung Yim,Ho Sun Jang,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.5

Background: Mycoses of deep tissues requir e prompt recognition and early institution of treatment. Sometimes, it is quite difficult to find fungal elements in tissue section with special stains and to culture on Sabouraud media. Previously it has been shown that Fungi-Fluor solution (calcofluor white) bind t fungi present in frozen and paraffin tissue sections. Fungi present in such specimens stained with Fungi-Fluor solution have a distinct green-blue fluorescence when examined by fluorescent microscopy. Objective : The purpose of this study is to evaluate the diagnostic value of the Fungi-Fluor solution for detecting fungal element in the tissue. Methods : Fungi-Fluor staining was done with a paraffin-embedded tissue section of several superficial and cutaneous deep mycoses. Then we viewed this through a fluorescent microscope with excitation of 250-400 nm and compared these staining results to PAS staining. Results: The results of this study are summarized as follows : 1. In the several superficial mycoses such as tinea corporis & tinea capitis, Fungi-Fluor staining method revealed more fungal elements with high sensitivity compared to PAS stain. 2. In the several cutaneous deep mycoses such as sporotrichosis, Fungi-Fluor staining method revealed more fungal elements than PAS stain, and revealed some fungal elements which were not detected by PAS stain. Conclusion : The Fungi- fluor staining solution is a rapid, inexpensive, highly sensitive method to detect fungal element in the tissue. (Korean J Dermatol 1997;35(5): 870-876)

각화 극세포종과 편평 세포암에서 TGF - βs 발현에 관한 면역조직화학적 연구

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

Background: Because of the clinical and histological similarities of keratoacanthoma(KA) and squamous cell carcinoma(SCC), it is often difficult to differentiate. Transforming growth factor-bs (TGF-bs) are the multifunctional peptides that regulate the cellular growth and differentiation. It has been known that the isoforms of TGF-b(TGF-b1, TGF-b2, TGF-b3) are differently expressed in human cancers such as basal cell carcinoma, pancreatic cancer, thyroid cancer, etc. Objective : The purpose of this study was to examine the expression patterns of TGF-b isoforms on KA and SCC using the immunohistochemical staining method with anti-TGF-bs antibodies and to evaluate the usefulness of this method in distinguishing each other. Methods : We performed immunoperoxidase staining(LSAB technique) using polyclonal anti-TGF-b1, b2, and b3 antibodies from the formalin-fixed, paraffin-embedded biopsy specimens obtained from 11 patients with KA, 11 pntients with SCC, and 10 healthy volunteers. Results : In the normal skins, TGF-b1, b2 and b3 were almost negative or only weakly positive in the epidermis, whereas TGF-b3 was moderately to strongly positive in the suprabasal layer. In KAs, the expression patterns of TGF-b1, b2, and b3 were similar to those of the normal skins. In SCCs, however, the expression of TGF-b1 was increased and TGF-b3 was decreased compared with the normal skins. Conclusion : In these results, the immunohistochemical staining using the anti-TGF-bs antibodies, especially anti-TGF-b1 and b3, can be used for the differentiation of KA and SCC. Also, it can be suggested that the charige of expressions of TGF-b isoforms in the epidermis may play an important role in the carcinogenesis of SCC. (Korean J Dermatol 1997;35(5): 863-869)

건선 환자에서 혈청 지질 및 지질단백 검사 소견에 대한 연구

권경술 ( Kyung Sool Kwon ),서경형 ( Kyung Hyung Seo ),장호선 ( Ho Sun Jang ),정태안 ( Tae Ahn Chung ) 대한피부과학회 1996 大韓皮膚科學會誌 Vol.34 No.1

Background: Previous studies have demonstrated that patients with psoriasis may have an increased risk of contacting a variety of noncutaneous diseases, including arterial and venous occlusive diseases. Changes in plasma lipid and lipoprotein composition in patients with psoriasis may be the reason for the increased risk of atherosclerosis in these patients. Objective : This study was carried out to investigate the differences of serurn lipid, lipoprotein and apolipoprotein levels between the psoriasis patients and control groups and to suggest which are related with atherogenic risk in the psoriasis. Methods : Serum lipid, lipoprotein and apolipoprotein levels were measured in 100 patient with psoriasis and in 30 healthy people. Results : In the serum lipids study total cholesterol, TG, LDL-C and VLDL-C levels were lower and HDL-C level was higher in the psoriasis group than in the control group. Statistical significant differences were noticed in total cholesterol levels between the female psoriasis patients and the female control groups. In the serum lipoproteins study apolipoprotein B and lipoprotein (a) levels were higher and apolipoprotein A I level was lower in the psoriasis group than in the control group, and statistical significant differences of apolipoprotein B and lipoprotein (a) levels were noticed in the atherogenic risk group and severe psoriasis group compared with the control group. Conclusion : These findings suggest that the atherogenic risk in psoriasis is related with the high level of apolipoproteins especially apolipoprotein B, and is not related with serum lipid. (Kor J Dermatol 1996;34(1): 102-108)

황색태선

권경술(Kyung Sool Kwon),한을희(Eul Hee Han),정태안(Tae Ahn Chung),임명규(Myeong Kyoo Lim),박성귀(Sung Kwi Park) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.2

A case report of a 60 year-old man with lichen aureus of leg is presented. Clinically the solitary golden to purple colored patch consists of lichenoid papules, plsque, and mild petechiae around the lesion, and the histology reveals a dense and bandlike infiltrate hugging thepidermis. It consists of lymphocytes, histiocytes, eosinophils, and many extravasated erythrocytes and hemosiderin in dermis, but a few red cells and increased melanin pigment can also be seen in the epidermis. The eruption is mildly itchy and has been present 6 months. (Kor J Dermatol 1994; 32(2): 342-315)

육아종성 입주위염

권경술(Kyung Sool Kwon),한을희(Eul Hee Han),정태안(Tae Ahn Chung),신항계(Hang Kye Shin),김천기(Cheon Gi Kim) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.1

A 51-year-old female developed a distinctive perioral rash, conisting of discrete or confluent erythematous papules for one and a half years. Histopathologic examiriation revealed upper dermal granulomas admixed with lymphoytes. Pieces of hair shaft were staincd peri-dish by AFB in the center of granuloma, which might play a role in the formation of the granuloma She also had used corticosteroid ointment intermittently duririg this time. There were no associated systemic abnormalities. The lesions resolved after two month treatment with oral corticosteroid and tetrac cline. (Kor J Dermatol 1994; 32(1): 182-185)

균상 식육종의 침윤 T 림프구에 대한 면역조직화학적 연구 -건선 및 습진에서와의 비교 연구-

권경술 ( Kyung Sool Kwon ),장호선 ( Ho Sun Jang ),이재봉 ( Jae Bong Lee ),오창근 ( Chang Keun Oh ),정태안 ( Tae Ahn Chung ) 대한피부과학회 1998 大韓皮膚科學會誌 Vol.36 No.4

10년간 재발을 보이지 않은 원발성 피부 형질세포종

권경술(Kyung Sool Kwon),한을희(Eul Hee Han),정태안(Tae Ahn Chung),최석주(Suk Joo Choi),이준호(Joon Ho Lee) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.1

A 28-year-old female devei,oped five rice-sized erythematous telaniectatic solid papules of her left side of cheek and numerous light brownish flat papules of her face two years before visiting our department of dermatology. Biopsy results of the erythematous papule vere dermal infiltration by well-differentiated, however, somewhat atypical and varying sized plasma cells involving epidermis, and the flat papule was that of verwca plana. Bone marrow aspirate was essentially normal. Primary cutaneous plasmacytoma is a rare disease. A significant proportion of patients with this ent on to develop systemic disease with a poor prognosis. Our patient was not treatead, bit only excised partially for biopsy. All skin lesions involuted two years later spontaneously and rema ns well until now six years later without recurring. (Kor J Dermatol 1994; 32(1): 144-148)

최근 10년간 약진 환자 중 호산구 증가증 및 전신증상을 동반한 약진(DRESS)의 임상적 고찰

권경술 ( Kyung Sool Kwon ),김병수 ( Byung Soo Kim ),장봉석 ( Bong Suk Jang ),김문범 ( Moon Bum Kim ),오창근 ( Chang Keun Oh ),권유욱 ( Yoo Wook Kwon ),장호선 ( Ho Sun Jang ) 대한피부과학회 2005 大韓皮膚科學會誌 Vol.43 No.9

균상 (菌狀) 식육종 (息肉腫)

권경술 ( Kyung Sool Kwon ),이태경 ( Tae Kyung Lee ),김진권 ( Jin Gwon Kim ),정태안 ( Tae Ahn Chung ),( Tetszi Mitsui ) 대한피부과학회 1986 대한피부과학회지 Vol.24 No.5

We present a case of mycosis fungoides of an 52-year-old woman who showed multiple pruritic erythematous papules, plaques with ulcers on the trunk, extremities and face. Her skin biopsy specimens were studied irnmunohistochemically with, monoclonal antibodies against T cells(80%, Leu-4, OKT11), T-cell subsets (60% Leu-3a, OKT4a, 40% OKT8) and Langerhans cell(OKT6). We think that this case should be considered in the differential diagnosis of adult T-cell leukemia/lymphoma. The proliferating cells were negative for anti-Tac.