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박언재 ( Oun Jae Park ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2012 大韓皮膚科學會誌 Vol.50 No.2
Background: Merkel cell carcinoma is a rare neuroendocrine tumor that typically presents as indurated nodules in elderly patients. It has an aggressive behavior and thus, such incidence has been increasing. Objective: Our purpose was to analyze clinical and histological characteristics of Merkel cell carcinoma, and to obtain a better understanding of this rare malignancy. Methods: We conducted a clinicopathologic evaluation of 11 patients from our center during 21 year period (1989~2010). We investigated personal and clinical information, including age, sex, time of onset, past history, histologic findings and clinical manifestations. Results: The age of the 11 patients ranged from 48 to 84, and the mean age of onset was 62.3, with a slight female predominance (1:1.7). The most prevalent site was the face then followed by the extremities. Subcutaneous nodular lesion with overlying erythema was the most common finding (72.7%, 8/11). Protruding tumorous lesions were 18.2% (2/11) and palpable lymphadenopathy was 9.1% (1/11), respectively. Histopathologically, pleomorphic atypical cells and granular nuclear dots ("salt and pepper") were observed. Immunohistochemical study showed positivity for pan-cytokeratin (CK), cytokeratin (CK20), CD56, synaptophysin, chromogranin (90%, 81.8%, 100%, 85.7%, 83.3%) and negative result for leukocyte common antigen (LCA, 0/7), and thyroid transcription factor-1 (TTF-1, 0/4), S100 (0/4). Conclusion: Merkel cell carcinomas were more frequent in old females and were rare in immunocompromised patients in Korea. Histologic and immunohistochemical features were similar to previous studies, but there was a case of rare type (CK7+/CK20-) of Merkel cell carcinoma. Surgery is a treatment of choice in Merkel cell carcinoma. But radiation or chemotherapy can be used as an adjuvant therapy. Based on this study, characteristics of Merkel cell carcinoma in Korea can be elucidated with more future cases. (Korean J Dermatol 2012;50(2):106~113)
박언재 ( Oun Jae Park ),인승균 ( Seung Gyun In ),강성민 ( Seong Min Kang ),홍승필 ( Seung Phil Hong ),박하나 ( Ha Na Bak ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( K 대한피부과학회 2010 대한피부과학회지 Vol.48 No.6
Adalimumab, a recombinant human IgG monoclonal antibody, selectively blocks tumor necrosis factor-alpha (TNF- α) and has been successfully used in the treatment of immune-mediated diseases. In particular, its efficacy has been proven in the treatment of rheumatoid arthritis, spondylarthritis, lymphoproliferative diseases and inflammatory bowel disease. Its use has also been studied for the treatment of psoriasis and yet, paradoxically, cases of new onset or exacerbation of psoriasis continue to increase in patients undergoing treatment with anti TNF-α agents. A 51-year-old woman had arthritis for a year and was diagnosed with psoriatic arthritis. After she had received adalimumab for psoriatic arthritis five times during one year, erythematous eruptions were found on her entire body. She then stopped adalimumab therapy for two months, although her skin lesions did not resolve. The patient was diagnosed with psoriasis through biopsy and began using cyclosporine, a topical steroid used for treatment of psoriasis. (Korean J Dermatol 2010;48(6):513∼516)
박언재 ( Oun Jae Park ),이상민 ( Sang Min Lee ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ),성경제 ( Kyung Jeh Sung ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.4
Fibrous hamartoma of infancy (FHI) is a rare benign soft tissue tumor that is composed of an organoid pattern of fibrous tissue and primitive mesenchyme and adipose tissue. The majority of cases of fibrous hamartoma of infancy occur within the first year of life as a single painless subcutaneous nodule. We experienced and report on an uncommon case of protruding fibrous hamartoma of infancy in an 1-year-old girl. (Korean J Dermatol 2011;49(4): 357∼359)
박언재 ( Oun Jae Park ),노태경 ( Tai Kyung Noh ),허식 ( Sik Haw ),장경애 ( Kyoung Ae Jang ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.6
There have been a small number of recent case reports of patients with erythematous patches around the joints, which histopathologically showed histiocytic aggregations in the dermal vessels. Intralymphatic histiocytosis (ILH) is a rare group of skin diseases that are characterized by the proliferation of histiocytes in a lymphatic vessel lumen, and this is thought to arise as a benign reaction to certain stimuli such as rheumatoid arthritis. The pathogenesis of this intralymphatic proliferation of histiocytes and the reasons they commonly present on the arms are still unknown. We report on a case of ILH with arthritis in a 68-year old female who had no underlying disease, and the ILH presented as irregular erythematous patches on the left antecubital area and these patches demonstrated the distinctive histopathological features of intralymphatic histiocytosis. (Korean J Dermatol 2011;49(6):538∼541)
이덕우 ( Deok Woo Lee ),박언재 ( Oun Jae Park ),김재경 ( Jae Kyung Kim ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.8
Choriocarcinoma is one of the malignant tumors of trophoblastic cells characterized by secretion of human chorionic gonadotrophin (hCG). Choriocarcinoma often metastasizes to the lung, liver, and brain but skin metastasis is rare. To our knowledge, only one case of cutaneous metastasis was reported in Korea. A 35-year-old female presented with hemoptysis for 1 month. Biopsy from lung nodules revealed metastatic choriocarcinoma. She was subsequently referred to our clinic for evaluation of a rapidly growing, reddish nodule with bleeding tendency on the scalp. Histologic examination demonstrated biphasic pattern of cytotrophoblasts and hCG-positive syncytiotrophoblasts with multiple foci of hemorrhage - typical histologic features of choriocarcinoma. The patient was diagnosed with metastatic choriocarcinoma. We herein report a case of choriocarcinoma with cutaneous metastasis. (Korean J Dermatol 2010;48(8):700~702)
Muir-Torre 증후군 유방암과 동반된 안검외 피지샘암
김명신 ( Myoung Shin Kim ),박언재 ( Oun Jae Park ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.8
Muir-Torre syndrome is defined by concurrent or sequential development of internal malignancy - most commonly colorectal cancer - and sebaceous neoplasm or multiple keratoacanthomas. Recent studies revealed it was caused by mutations in DNA mismatch repair genes, and suggested screening for mismatch repair gene defects may be of value for patients with Muir-Torre syndrome. We, herein, report a patient with Muir-Torre syndrome, who developed breast cancer and extra-ocular sebaceous carcinoma. In addition, we discussed our experience of immunohistochemical staining for mismatch repair protein with a review of the literature. (Korean J Dermatol 2010;48(8):696~699)