Updates in the management of Behcet’s disease

노주영 ( Joo Young Roh ) 대한피부과학회 2023 대한피부과학회 학술발표대회집 Vol.74 No.2

The Associated skin diseases and comorbid allergic diseases of Atopic Dermatitis

노주영 ( Joo Young Roh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Reporting guidelines

노주영 ( Joo Young Roh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Recent advances in the treatment of refractory chronic spontaneous urticaria

노주영 ( Joo Young Roh ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Chronic spontaneous urticaria (CSU) is a common disorder that has a prevalence of 0.5% - 1% in the general population. Although H1 antihistamine in effective mainstay of CSU, one out of 5 is resistant to conventional antihistamine monotherapy. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a IgG humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor (FcεR1). Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab in intractable CSU. In well-controlled clinical trials in patients with refractory CSU, add-on therapy with subcutaneous omalizumab 300 mg every 4 weeks for 12 or 24 weeks significantly reduced the severity of itching, and the number and size of hives, and increased patients` health-related quality of life compared with placebo. Rates of complete response were significantly higher in the omalizumab group (relative risk, 4.55; P<.00001). The introduction of omalizumab as an add-on therapy to H1 antihistamines as a management option has markedly improved the therapeutic possibilities and quality of life in CSU patients. Nevertheless, there are still many patients who do not tolerate or benefit from existing therapies including omalizumab. There are ongoing studies investigating treatment potential of novel therapeutic targets in CSU.

Bullous disorders affecting the oral mucosa

노주영 ( Joo Young Roh ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Bullous disorders affecting the oral mucosa are predominantly immune associated diseases including mucous membrane pemphigoid (MMP, cicatricial pemphigoid), pemphigus vulgaris (PV), paraneoplastic pemphigus, linear IgA dermatosis, lichen planus pemphigoides (LPP), lupus erythematosus and erythema multiforme. 1. Mucous membrane pemphigoid (MMP) - Heterogeneous group of autoimmune subepithelial blistering diseases affects primarily the mucous membranes. - Target antigens : α-6 and β-4 integrins, laminin-5, bullous pemphigoid antigen 2 (type XVII collagen), type VII collagen, laminin 332 (laminin-5), laminin-6, α-6 & β-4 integrin subunits, 120-kDa epithelial antigen - Patients who have restricted oral mucosal lesions have an excellent prognosis, they tend to have a mild to moderate disease process. MMP patients with ocular disease generally tend to follow a progressive disease process. - Diagnosis : direct immunofluorescence (DIF)- linear deposition of immunoglobulin (Ig) G or IgA, or complement component 3 (C3) at the dermoepidermal junction. - Treatment : topical corticosteroid, dapsone (50-200 mg/d) low dose of prednisone (0.5 mg/kg/d) azathioprine (100-150 mg/d), mycophenolate mofetil (1 g/d) 2. Pemphigus vulgaris - About 50%of patients affected by PV have the oral mucosa as primary infection site of the disease - Oral lesions are in the form of small bullae that burst rapidly, leaving painful erosions with a burning sensation. They affect mainly the buccal mucosa, soft palate, lips, gingiva - Target Ag : IgG) autoantibodies against desmogleins 1 and 3 - Dx : Direct immunofluorescence (DIF)- intercellular IgG and C3 deposits Indirect IF - circulating autoAb against intercellular junction of the substrate keratinocytes - Tx: topical steroids, prednisone, mycophenolate mofetil 3. Paraneoplastic pemphigus - The oral mucosa and lips were always affected, and in 45% of cases, appeared as the first signs of the disease - Oral cavity examinations show bullous lesions disseminated with serous-hemorrhagic content, which burst leaving very painful sores covered by hematic crusts - Dx : DIF - intercellular IgG and C3 in the epidermis and linear C3 deposits at the DE junction. IIF - circulating IgG antibodies of all subclasses(IgG1, IgG2, IgG4, and IgG3) Immunoprecipitation(IP)- autoAbs against desmoplakin (250kD), envoplakin (210 kD), desmoplakin 2 (210 kD), BPAG1(230 kD), plectin (466 kD), desmoglein 1(160kD), desmoglein 3 (130 kD), and a 170-kD antigen (alpha-2-macroglobulin-like-1 (A2ML1) 4. Lupus erythematosus (LE) - The frequency of oral lesions ranges between 9% and 45%, depending on the subtype - Sites : oral cavity and lips in the buccal mucosa, gums and palate - honeycomb plaque : a characteristic clinical feature of healing in mucosa on the palate - Histology: subepidermal blister resembles an oral interface mucositis rich in lymphocytes - DIF: granular and linear IgG, IgM, and IgA, complements, and fibrinogen along the BMZ - IIF: antibodies to type VII collagen on salt-split skin - Tx: topical steroid therapy

Effects of antihistamines on adhesion molecules and inflammatory mediators

노주영 ( Joo Young Roh ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Histamine receptor antagonists have been known to have clinical efficacy in a variety of allergic inflammatory disorders. Recent studies focused on the anti-inflammatory effects of new generation antihistamines other than the blockade of histamine receptors. Modulation of the expression of adhesion molecules has been demonstrated on cultured human epithelial cells. Fexofenadine was able to inhibit the release of soluble intercellular adhesion molecule (ICAM)-1 from human nasal epithelial cells and the expression of ICAM-1 in eosinophils from healthy donors cultured in the presence of IFN-γ and TNF-α. In clinical studies, several H1-antihistamines including cetrizine, azelastine, loratadine and levocabastine have been reported to reduce conjunctival ICAM-1 expression. Loratadine and desloratadine reduced the expression of P-selectin on the surface of the endothelium, H1-antihistamines proved capable of suppressing the secretion of proinflammatory cytokines. Inhibited expression and synthesis of cytokines, as well as those of chemokines, adhesion molecules or other proinflammatory mediators, may be the result of down-regulation of NF-κB. Low concentration of antihistamines cetrizine and azelastine have been shown to down-regulate NF-κB expression in parallel with inhibiting the production of cytokines, IL-1β, IL-6, IL-8, TNF-α and GM-CSF. It has been reported that cetirizine significantly reduced VCAM-1 expression in patients with atopic dermatitis. In psoriatic patients, cetirizine, at higher doses (30 mg/day) for 15 days, caused a significant reduction in the number of ICAM-1-positive, ICAM-3-positive and lymphocyte function-associated antigen (LFA)-1- positive cells in the lesional psoriatic skin. After treatment with fexofenadine at standar doses for 4 weeks, a significant reduction of the expression of ELAM-1 (endothelial-leukocyte adhesion molecule -1) and VCAM-1 was detected in the non-lesional skin of chronic urticaria patients. Future research might elucidate the role of antihistamines in anti-inflammatory therapy.

이형성 멜라닌 세포성 모반

노주영(Joo Young Roh),이성렬(Sung Yeol Lee),계영철(Young Chul Kye),신용우(Yong Woo Cinn),김수남(Soo Nam Kim) 대한피부과학회 1988 대한피부과학회지 Vol.26 No.3

The dysplasitc melanocytic nevus(DMN) of the skin is an atypical-appearing melanocytic tumor characterized by intraepidermal atypical melanocytic preliferation. Clinically, DMN has a diameter greater than 5mm, ill-defined irregular borders, irregularly distributed pigmentation surrounded by erythems,. Histopat- hologically, there are numerous discrete nests of atypical melanocytes situated at the dermoepidermal junction of elongated rete ridges. In the dermis, concentric lamellar fibroplasia, lymphocytic infiltrates and neovascularization are noted. We report herein a case of DMN developed on the trunk of 31-year-old Korean male.

IaC-VIMF: 사이버 공방 훈련을 위한 IaC 기반 가상 인프라 변이 생성 프레임워크

노주영(Joo-Young Roh),이세한(Se-Han Lee),박기웅(Ki-Woong Park) 한국정보보호학회 2023 정보보호학회논문지 Vol.33 No.3

Role of cytokines and chemokines in pruritus

노주영 ( Joo Young Roh ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

소아형 만성 골수성 백혈병과 신경섬유종증을 동반한 연소성 황색육아종

노주영(Joo Young Roh),박향준(Hyang Joon Park),신용우(Yong Woo Cinn),김수남(Soo Nam Kim),김순겸(Soon Gyum Kim) 대한피부과학회 1987 대한피부과학회지 Vol.25 No.3

Juvenile xanthogranuloma(JXG) is a a benign histiocytic proliferative disorder most frequently seen in infants. The usual course is self-limited, but it may be a manifestation of juvenile chronic myeloid leukemia(JCML). In addition to JXG, some patient with JCML may have multiple cafe-au-lait spots and a family history of neurofibromatosis(NF). The association of JXG and cafe-au-lait spots in patients with JCML is of interest in light of description of otherwise healthy children with JXG who also had cafe-au-lait spots. We report herein a case of JXG in 18-month-old boy who also had multiple cafe-au-alit spots, which predated the JCML.