제57차 추계학술대회 및 총회 : 학술대회장 인사

고재경 ( Jai Kyoung Koh ) 대한피부과학회 2005 대한피부과학회 학술발표대회집 Vol.57 No.2

PTBD 관을 통한 담낭암의 피부 착상 전이 1 예

고재경 ( Jai Kyoung Koh ),문기찬 ( Kee Chan Moon ),최지호 ( Jee Ho Choi ),김경진 ( Kyoung Jin Kim ),김은성 ( Eun Sung Kim ),성경제 ( Kyung Jeh Sung ) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.5

The occurrence of metastatic center from the gallbladder to the skin is uncommon and only less than ten cases of distant cutaneous metastases of gallbladder cancer have been reported in literatures. However. cutaneous implantation metastases of gallbladder cancer following laparoscopic cholecystectomy or percutaneous biliary catheter have been described more commonly than distant metastasis. We present herein a case of cutaneous implantation metastasis of gallbladder adenocarcinoma at the sites of percutaneous transhepatic biliary drainage(PTBK).

Micropapular Sarcoidosis 1 예

고재경 ( Jai Kyoung Koh ),문기찬 ( Kee Chan Moon ),최지호 ( Jee Ho Choi ),김경진 ( Kyoung Jin Kim ),배지영 ( Gee Young Bae ),서호석 ( Ho Seok Suh ),성경제 ( Kyung Jeh Sung ) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.5

Cutaneous sarcoidosis occurs in 20-25% of systemic sarcoidosis and be presented without other organ involvement. Most frequent clicical are maculopapule, nodule, plaque, subcutaneous mokule, infiltrative scar and lupus pernio, but uncommon forms including ulcer, alopecia, hypopiminted and micropapular type have been described. Micropapular type is a rare from of cutaneous sarcoidosis with good prognosis. We present a case of generalized micropapular sarcoidosis without other organ involvement

Short Report / 모낭성 피지선 아포크린 분화를 보인 연골양 한관종 1예

고재경 ( Jai Kyoung Koh ),노기영 ( Kee Young Roh ),양정은 ( Jeong Eun Yang ),김형옥 ( Hyung Ok Kim ),강석진 ( Suk Jin Kang ) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.12

Chondroid syringoma is referred as mixed tumor because it has epithelial structure and mesenchymal elements. Mixed tumors could be divided into two distinct types, eccrine and apocrine. Mixed tumor with follicular, sebaceous and apocrine differentiation is considered as an expression of the common embryologic origin of elements of the folliculosebaceous-apocrine unit. A 32-year old man presented with an asymptomatic firm erythematous nodule on the left cheek. Histologically, it showed typical features of chondroid syringoma with tubules exhibiting branching and cystic dilatation in the myxoid and chondroid stroma. Our case is unique in that the tumor arose from follicular infundibulum with follicular, sebacesous and apocrine differentiation. (Korean J Dermatol 2000;38(12): 1673~1676)

제57차 추계학술대회 및 총회 : 학술대회장 인사

고재경 ( Jai Kyoung Koh ) 대한피부과학회 2005 초록집 Vol.43 No.20

악성 흑색종의 임상 및 병리조직학적 고찰

장경애 ( Kyoung Ae Jang ),최지호 ( Jee Ho Choi ),성경제 ( Kyung Jeh Sung ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ),김종혁 ( Chong Hyeok Kim ) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.11

Background:Cutaneous malignant melanoma represents a tumor arising within the melanocytic systems of the skin. Once considered an uncommon cancer, melanoma is now rising in incidence at a rate faster than any other cancer. Objective:The purpose of this study was to investigate the clinico-pathological characteristics of malignant melanoma. Methods:A total of 61 patients with malignant melanoma were enrolled in this retrospective study. We classified malignant melanoma as follows; ALMM, acral lentigious malignant melanoma, NMM, nodular malignant melanoma, SSMM, superficial spreading malignant melanoma, MM, mucosal melanoma, LMM, lentigo maligna melanoma. We used the staging system of American Joint Committee on Cancer to evaluate the clinical status in our subjects. The hospital charts and histopathological slides of patients with malignant melanoma diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. Immunohistochemical study was performed for S-100 and HMB-45 in 10 cases and for Ki-67 in 5 cases. Results:1. The male to female ratio was 1.3. The mean age at diagnosis was 52.6 years. ALMM was the most common type(52.5%) in this study. ALMM and NMM developed in elderly persons, while SSMM developed in younger persons. Malignant melanomas arising from pre-existing mole were 10 cases(16.4%). 2. In forty two cases(68.9%), malignant lesions were limited to skin, but 19 cases(31.1%) were disseminated to lymph nodes, skin or internal organ at the initial examination. Sole and heel were the favored sites in ALMM. Lower extremities and back were the favored sites in NMM and SSMM. Four patients were initially presented with metastatic symptoms such as dyspnea, abdominal mass, headache, or axillary mass, and cutaneous malignant melanoma eventually were diagnosed as their origin.3. Histopathologically, 6 cases were categorized into amelanotic type and 1 case was into desmoplastic type.4. More than a half cases developed metastases to other organs. Common metastatic sites were lymph nodes, lung, brain, skin, liver, bone, and bladder in decreasing order of frequency. 5. The five-year survival rate was 100% in stage IA, IB, and IIA but 0% in stage IV. Face, chest and lower extremities showed worse prognosis. Men had worse prognosis than women. NMM revealed the lowest 5-year survival rate(30%). Conclusion:Among the prognostic factors such as locations, clinical types, ages, and gender, the stages at the initial presentation was the most important predictable value in our study. Therefore, the early recognition of malignant melanoma is the key to possible cure.(Korean J Dermatol 2000;38(11):1435~1443)

피부 유육종증의 임상 및 병리조직학적 연구

장경애 ( Kyoung Ae Jang ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ),강숙경 ( Sook Kyung Kang ),서호석 ( Ho Seok Suh ),성경제 ( Kyung Jeh Sung ) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.12

Background:Sarcoidosis is a chronic granulomatous inflammatory disorder involving many organs including the skin with various clinical manifestations. Objective:The purpose of this study was to investigate the clinico-pathological characteristics of sarcoidosis. Methods:A total of 19 patients with cutaneous sarcoidosis were enrolled in this study. The hospital charts and histopathological slides of the patients with sarcoidosis diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. Results:1. Three male and sixteen female patients were included(M:F=1:5.3). Age at diagnosis ranged from 4 to 62 years. The mean age was 46 years in male patients and 44.9 years in female patients. 2. Multiple or several(more than 2) skin lesions were common(78.9%). Extremities were the favored sites. Clinically the lesions were presented as subcutaneous nodules, plaques, nodule, macules or papules, patches, psoriasiform, and pitted scar in decreasing order. Cutaneous lesions arising from the scar were present in 3 cases. Six patients(31.6%) complained of systemic symptoms such as fever or weight loss. 3. The systemic involvement was present in 11 cases(57.9%). Lung, hilar lymph nodes, and mediastinal lymph nodes were the most commonly involved organs. 4. Laboratory examinations revealed elevated erythrocyte sedimentation rate(71.4%) and angiotensin converting enzyme(ACE)(90%). In all the patients with elevated level of serum ACE the involvement of intrathorax was present, however one patient with systemic involvement showed normal level of ACE. Serum calcium level was normal in all the patients and the level of CD4/CD8 revealed variable results(1.3 to 3.9). 5. Histopathological evaluation revealed non-caseating epithelioid cell granulomas (100%) with multinucleated giant cells(52.6%) and asteroid body(31.6%). In 11 cases(57.9%), fibrosis was the prominent finding and in two cases(10.5%) partial interstitial necrosis was noted. Histopathologically subcutaneous pattern was predominant in 8 cases(42.1%). The patients with subcutaneous sarcoidosis did not show any specific clinical or laboratory differences from the other types in our study. (Korean J Dermatol 2000;38(12):1583~1589) Conclusion:Cutaneous sarcoidosis showed varied clinical and histopathological manifestations and ran various clinical courses. In cutaneous sarcoidosis women were more commonly involved than in systemic sarcoidosis and more elderly patients were involved in cutaneous sarcoidosis. Extensive work-up for systemic involvement may be mandatory when sarcoidosis is presented with cutaneous lesions or the level of serum ACE is elevated in cutaneous sarcoidosis. The level of CD4/CD8 may be a insignificant laboratory index in sarcoidosis. Also, subcutaneous sarcoidosis may not be a marker of the systemic involvement.

기저세포암의 임상 및 병리조직학적 연구

장경애 ( Kyoung Ae Jang ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ),성경제 ( Kyung Jeh Sung ) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.12

Background:Basal cell carcinomas(BCC) are seen almost on hair-bearing skin, especially on the face. There have been a few reports about BCC in Korea. Objective:The purpose of this study was to investigate the clinico-pathological characteristics of BCC. Methods:A total of 95 patients with BCC were enrolled in this study. The medical records and histopathological slides of BCC diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. We classified our cases based on the predominant histopathological findings as follows; solid, adenoid, pigmented, superficial multicentric, clear cell, keratotic, morpheic, basosquamous, trichoblastoma-like, fibroepithelioma of Pinkus-like. Results: 1. The male- female ratio was 1.1:1. The mean age at diagnosis was 64.8 years in male patients and 66.9 years in female patients. 2. The clinical diagnoses were BCC(76.8%), melanoma, actinic keratoses, seborrheic keratosis, and so on. 3. The face was the most preferred site, especially nose(41.2%). Solid, adenoid, keratotic, morpheic, and basosquamous types developed exclusively on the face, while superficial multicentric types did not show on the favored sites. 4. Pruritus of the lesion, easy bleeding, and rapid increment of the size were the main complaints. 5. Solid type was the most frequent type(30%). Three cases of BCC arising from organoid nevus were included. In two cases of organoid nevus-origin, fibrofolliculoma of Pinkus-like histopathological findings were noted. 3 cases were recurrent after laser therapy or simple curettage. 6. Ninety two cases were successfully treated with wide excision. One case was treated with radiation therapy, but the lesion persisted. The lesion was widely excised without recurrence. Systemic metastases were absent in our study. (Korean J Dermatol 2000;38(12):1575~1582)

국소형 피부 병변을 동반한 피하형 환상 육아종 1 예

김경진 ( Kyoung Jin Kim ),김은성 ( Eun Sung Kim ),최지호 ( Jee Ho Choi ),성경제 ( Kyung Jeh Sung ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.1

Subcutaneous granuloma annulare(SGA) is one type of granuloma annulare that occurs mainly in children as deep dermal or subcutaneous nodule. One-forth of SGA is known to be combined with typical localized granuloma annulare. Particularly, SGA on the scalp tends to be more fixed than in other sites, it is easy to be mistaken for the malignant skin manifestation of children. We describe a 5-year-old female patient with subcutaneous and localized type granuloma annulare both on the scalp and leg. We suggest that SGA must be included in the differential diagnosis of subcutaneous nodule on the scalp in the children. (Korean J Dermatol 2002;40(1):103~106)

중독성 표피 괴사융해증에서 고용량 면역 글로불린 정맥주사의 치료효과에 대한 고찰

김경진 ( Kyoung Jin Kim ),지민선 ( Min Sun Jee ),한만회 ( Man Heui Han ),최지호 ( Jee Ho Choi ),성경제 ( Kyung Jeh Sung ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.7

Background : Toxic epidermal necrolysis(TEN) is the most dramatic and life-threatening cutaneous drug reaction. However, specific and effective treatment for TEN have not yet been identified. Recently several reports suggested that high dose intravenous immunoglobulin(Ⅳ Ig) treatment has produced good results in patients with TEN. Objective : To analyze the efficacy and side effects of Ⅳ Ig in treatement of TEN. Methods : Ten patients with clinicopathological diagnosis of TEN were treated with IV Ig(1.6-3.4g/㎏), and clinical efficacy and side effects were observed. Results : Nine patients were healed and one died of sepsis. Interruption of further epidermal detachment occurred after an average 3 days from the onset of Ⅳ Ig therapy. Complete wound healing occurred after an average of 14.3 days. The side effects of Ⅳ Ig including headache, myalgia, nausea, transient neutropenia, and coombs positive hemolytic anemia were observed in 4 patients but normalized after cessation of Ⅳ Ig therapy. Three of them showed complete healing of detached skin but died with aggravation of underlying disease. Conclusion : Ⅳ Ig therapy represents a safe and very effective treatment for TEN. Furthermore, intensive care for underlying diseases is also very important for reducing the mortality rate in patients with TEN.