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소아에서 다리에 Blaschko 라인을 따라 분절성 분포를 보인 심재성 루푸스
류한원 ( Han Won Ryu ),이규석 ( Kyu Suk Lee ),조재위 ( Jae We Cho ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.2
Lupus profundus is a rare subtype of chronic cutaneous lupus erythematosus, which shows a tender subcutaneous nodule or plaque. The face, arm, buttock, trunk and thighs are frequently involved. Lupus profundus can be associated with or without systemic lupus erythematosus. But due to its rarity, it is difficult to diagnosis and there are not many reports regarding its characteristics, including its distribution. In this case, a 13-year-old boy has visited with several violaceous non-tender nodules on Lt. upper thigh with segmental distribution, which follows the Blaschko`s line. Through skin biopsy and its immunoflourescent study, we diagnosed lupus profundus. We here report a case of lupus profundus with segmental distribution following the lines of Blaschko`s in a child. (Korean J Dermatol 2013;51(2):148∼150)
장기간 면역억제제를 복용한 천포창 환자에 발생한 심부 Adiaspiromycosis
류한원 ( Han Won Ryu ),이규석 ( Kyu Suk Lee ),조재위 ( Jae We Cho ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.9
Adiaspiromycosis is known as an infection that is due to Chrysosporium species which are filamentous soil saprophytes that cause pulmonary infection in rare cases but are classified mainly as a contaminant rather than a pathogen in dermatological areas. Deep fungal infections, commonly by Aspergillosis and Candida, are associated with patients who have an impaired skin barrier or immunosuppression and it takes a long time to identify the pathogen because it is hard to diagnosis it without clinical suspicion. In our case, a 56-year-old female living in a rural area who took immunosuppressants including cyclophosphamide, mycophenolate mefetil, and prednisolone due to pemphigus vulgaris presented at our clinic with an erythematous patch with pustular discharges on the left forearm for 2 months. She had been treated with antibiotics under the impression of cellulitis but was not responsive to it. A Chrysosporium species was identified by tissue culture and treatment was successful with an antifungal agent. We here report a case of deep fungal infection caused by Chrysosporium species without pulmonary infiltration which is a rare manifestation. (Korean J Dermatol 2011;49(9):818~821)
Bleomycin에 의해 유도된 경화성 동물모델 및 켈로이드 섬유모세포에서 Silibinin의 항 섬유화 효과
류한원 ( Han Won Ryu ),김상표 ( Sang Pyo Kim ),조재위 ( Jae We Cho ),이규석 ( Kyu Suk Lee ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.6
Background: Silibinin reduces the expression of Type I collagen in normal skin fibroblasts through down-regulation of the TGF-β/smad pathway. However, it is largely unknown whether silibinin can reduce the expression of Type I collagen in vivo sclerotic animal models, as well as in keloid fibroblasts. Objective: The purpose of this study was to investigate the effect of silibinin on the expressions of type I collagen, matrix metalloproteinase-1 (MMP-1), MMP-2, smad2/3, and TGF-b1 receptor in keloid fibroblasts in vitro, and to evaluate the anti-fibrotic effect of silibinin in a bleomycin-induced, scleroderma-like animal model in vivo. Methods: Keloid and normal skin fibroblasts were treated with silibinin (20∼100 mM), and the expressions of type I collagen, MMP-1, MMP-2, and TGF-b1 receptor were analyzed with western blot. The animal model was established by bleomycin treatment (1.0 mg/mL) for 2 weeks in C57/BL9 mice. Then silibinin was injected on one side of the back and the same volume of normal saline was injected on the other side of the back. The specimen was evaluated with H&E, Masson-trichrome, and TGF-β1 immunohistochemical staining. Results: Expressions of Type I collagen, MMP-1, and MMP-2 decreased, but the expression of TGF-β1 receptor increased in keloid fibroblasts after silibinin treatment. Thickened dermis with dense extracellular matrix and inflammatory cell infiltration of the bleomycin-induced, scleroderma-like animal model improved after silibinin treatment. Expression of TGF-β1 decreased after silibinin treatment in the bleomycin-induced, scleroderma-like animal model. Conclusion: Silibinin treatment decreased the expression of Type I collagen in keloid fibroblasts in vitro. In addition, silibinin decreased the expression of Type I collagen by inhibiting TGF-β1 expression in the bleomycininduced, scleroderma-like animal model. These results indicate that silibinin has the potential to be an effective antifibrotic agent. (Korean J Dermatol 2014;52(6):373∼380)
만성 하지 림프부종 환자에서 발생한 Stewart-Treves Syndrome
류한원 ( Han Won Ryu ),이규석 ( Kyu Suk Lee ),조재위 ( Jae We Cho ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.1
Angiosarcoma is a rare malignancy of a vasculo-eptihelial origin. It is divided into three categories. The first category is primary anigosarcoma, which occurs in the face and scalp of elderly patients without any predisposing factors. The second is Stewart-Treves Syndrome, which is a subset of chronic lymphedema. The third is a post irradiation angiosarcoma that occurs at the site of prior irradiation. Generally in Stewart-Treves Syndrome, there is a pre-existing chronic lymphedema on the upper extremities due to the wide excision of breast cancer with or without radiation therapy. We here report on a case of a 60-year-old female with chronic lymphedema on the leg and who had a history of hysterectomy due to cervical cancer. The patient had purple-colored tender nodule and ulcer with exudate on the chronic lymphedematous leg and was diagnosed as angiosarcoma by a skin biopsy. (Korean J Dermatol 2011;49(1):32~35)