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- 저자 : 박건수 ( Gun Su Park ) (검색결과 8 건)
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모낭진드기 관련 질환에서 피부 표면 생검법을 이용한 모낭진드기 검사의 의의
박건수,조백기 ( Gun Su Park,Baik Kee Cho ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.6
모낭진드기(hair follicle mites) 중 Demodex folliculorum(이하 D. folliculorum)과 Demodex brevis(이하 D. brevis)는 인체 안면의 모낭에 주로 기생하는 진드기로, 수가 적을 때는 무해하나 수적 증가나 진피내 침투에 의하여 모낭충증(demodicidosis) 등의 안면 피부염을 유발한다. 주사(resacea)는 안면 중앙부위에 홍반과 모세혈관 확장을 배경으로 하여 구진과 농포가 발생하고 시간이 경과할수록 결합조직과 피지선의 비후를 보이는 질환이다. 주시의 병인으로는 여러 학설이 대두되고 있으나 확실하게 규명된 것은 없으며 모낭진드기가 관여한다는 설 또한 서로 상반되는 견해를 보이고 있다. 최근에는 특히 2기 주사와 모낭진드기가 연관이 있다는 설이 유력시되고 있다. 피부 표면 생검(skin surface biopsy)은 cyanoacrylate를 사용하여 각질층과 모낭 상부의 내용물을 채취하는 방법으로 1976년 모낭진드기 검사법으로 활용된 후로 모낭진드기 연구에 활용되고 있다. 현재까지 모낭진드기의 검출에는 다양한 방법이 사용되어 왔으나 객관적이지 못하거나 검출 방법이 효율적이지 못하였다. 이러한 단점을 보완한 피부 표면 생검을 일정한 부위와 동일한 면적에서 시행하면 모낭진드기 검출의 표준화를 이룰 수 있다고 생각되어 본 연구에서 사용하였다. 정상인에서 모낭진드기의 분포는 면포 압출법을 사용한 경우 한 모낭에서 2-6마리 이하이거나, 5개의 구진 또는 농포에서 10마리 이하인 경우 정상적이라고 하였고, 피부 표면 생검을 사용한 경우에는 1㎠당 5마리이하로 보고하여 사용한 방법에 따라 서로 비교하기 어려웠기 때문에 모낭진드기의 객관적인 지표가 정립되어있지 않다. 이와 같이 모낭진드기는 주사와 모낭충중 환자에서는 물론이고 정상인에서도 발견되므로 모낭진드기의 분포를 좀더 정확하고 객관적인 방법으로 조사하는 것은 모낭진드기와 관계 있는 피부 질환의 진단은 물론 감별 진단에 매우 유용할 것으로 생각된다. 저자들은 모낭진드기의 분포를 보다 간편하고 객관적인 방법으로 조사할 수 있는 피부 표면 생검법을 이용하여 주사 환자에서 모낭진드기의 분포를 조사하고 이것이 주사의 진단이나 모낭충증과의 감별 진단에 의미가 있는지를 알아보기 위하여 연구를 시도하였다. 또한 주사의 임상 시기별 모낭진드기 분포의 차이가 있는지를 조사하여 모낭진드기가 주사의 병인 또는 임상 경과에 관여하는지를 알아보고자 하였다. Background:The pathogenic role of the hair follicle mite in rosacea is still a matter of debate. Although the hair follicle mite may induce a pathologic condition by dermal invasion or excessive number of mites, the number of mites necessary to induce a pathologic condition has not been established in Korea. Objective:The purpose of our study was to know the causative role of the hair gollicle mite in resacea and the threshold value between ’normal’ and ’abnormal’ density of the hair follicle mite on Korean facial skin. Methods:We applied skin surface biopsy to investigate the population density and distribution of hair follicle mites in the facial skin of 50 patients with rosaces(9 with episodic erythema, 29 with stage Ⅰ, 12 with stage Ⅱ), 7 patients with demodicimens and 54 control subjects. The mites were counted in measured skin surface biopsy specimens obtained from three standard facial sites(2㎠ on cheek and chin, 1㎠ on nose) with cyanoacrylate glue. Results: 1. The mean mite count per 5㎠ was 3.4±0.7 in control subjects and 10.7±1.9 in patients with rosacea(p<0.05). The density of Demodex(mite count/5㎠) was significantly higher in patients with demodicidoses(115±14.2) than in the control(p<0.001) and rosacea patients(p<0.05). 2. The highest density of mites was found on the cheek in the control and diseased subjects. The incidence of hair follicle mites was higher on the nose than on the cheek in the control subjects and rosacea patients. In demodicilosis, the incidence of the hair follicle mites was higher on the cheek than on the nose. 3. The distribution of hair follicle mite was not significantly different among the three clinical stages of resacea. The mite counts in stage Ⅱ resacea were higher than those of control subjects(p<0.05). 4. The distribution of the hair follicle mite in the control subjects was related to a increase of age bur not related to sex. The distribution of the hair follicle mites in rosacea patients was no related to age or sex. 5. Hair follicle mites were found in 33 out of 54 control subjects(61%) and in 40 out of 50 resacea patients(80%). The mite counts of all control subjects and all rosacea patients were less than 5/㎠ and 10/㎠, respectively. The mite counts of all demodicidosis patients were more than 10/㎠. Conclusion:These results suggest that the increased number of mites play a part in the patho genesis of rosacea and demodicidosis is a specific disease entity differentiated from resacea. When the density of the hair follicle mites is above 5/㎠, a pathologic condition of the skin, such as rosacea and demodicidosis, would have to be considered. Demodicidosis should be suspected when the density of the hair follicle mites is above 10/㎠. In addition, skin surface biopsy is recom mended as the most simple and useful clinical method in search of the distribution of the hair follicle mites.
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피부표면 생검으로 진단한 전신성 화농형 개 모낭충증 1예
박건수,이동원,조백기,조준행,Park Gun-Su,Lee Dong-Won,Cho Baik-Kee,Cho Joon-Heang 대한수의사회 1994 대한수의사회지 Vol.30 No.9
A one-year-old female Korean dog was referred to our department with a week history of generalized bald patches. On physical examination, general weakness, lethargy, loss of appetite were noted. Skin findings were confluent erythematous scaly bald patches
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박건수(Gun Su Park),이준영(Jun Young Lee),김정원(Chung Won Kim),서은주(Eun Joo Suh) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.2
Histiocytosis X(Langerhans cell histiocytosis) is a rare prolifertive disorder of Langerhans cells that includes Lettere-Siwe disease, Hand-Shiiller-Christian his ase and eosinophilic granuloma. Since many authors have reported in anintermediate and poarl classified form histiocytosis X has a namenclatural had nosologic problem. We report a case benign cutaneous variant of histiocytisis X. A four-month-old boy had shown multiple skin-colour papules on the trunk, head and nik for one month. Extensive in- vestigations failed to detcct any systemic involvement. The clixron microscopic findings of the skin biopsy specimen were Qefinitely diagnostic for histiocytosi. X Since he did not sbow evidence of internal organ involvernent and any further progression of he skin lesion, no therapy was given. Over the next two months the disease underwent spontane us and complete remission. (Kor J Dermatol 1995;33(2): 379-383)
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김성욱,조백기,이혜경,박건수,이혜남,신상부,박석영 대한피부과학회 1999 大韓皮膚科學會誌 Vol.37 No.11
Neuroendocrine neoplasms have been described in virtually every organ where neuroendocrine cells are distributed throughout the body. It commonly exhibits multiple lines of divergent differentiation. We report a case of neuroendocrine carcinoma occurring in a 52-year-old woman. She had multiple subcutaneous nodules on the trunk. The light microscopic appearance and immunohistochemical stains were consistent with a neuroendocrine carcinoma. But it showed some differences from Merkel cell carcinoma in clinical and immunohistochemical findings. It may be strongly suggested that it was probably metastatic neuroendocrine carcinoma.
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신장이식 환자에서 발생한 Paecilomyces lilacinus에 의한 피부농양 1예
신상부,이혜남,김성욱,박건수,조백기,김희정 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2
Paecilomyces lilacinus is an ubiquitous saprophytic fungus and very rarely pathogenic to the human. Although it has been reported to cause endophthalmitis, orbital cellulitis, prosthetic velve endocarditis, and pulmonary infection, cutaneous infection caused by Paecilomyces lilacinus has been rarely reported. A 46-year-old Korean man had asymptomatic slowly growing multiple cutaneous nodules on the left arm and wrist for 8 months. He received a renal transplantation in 1991 because of end-stage renal disease. Postoperatively, he has taken cyclosporin and deflazacort for immunosuppression. Physical examination revealed that the lesions were discrete or confluent, firm, elevated, well defined fluctuating nodules. Histologic section showed multiple well-encapsulated intradermal abscesses with some foci of chronic granulomatous changes composed of Iymphocytes histiocytes and giant cells. PAS positive fungal hyphae and spores were also found. On the Sabouraud's dextrose agar media, the organism grew rapidly to form velvety lilac-colored colonies with shallow radiating furrows. Slide culture showed brush-like conidiophores ending in flask-shaped phialides carrying chain of conidia. Because of the poor response to the oral antifungal drug for 2 months, all the lesions were completely excised.
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