226Symposium 2-2-1 (SYP 2-2-1) : Generalized erythematous papules and confluent plaques on the whole body in a 30-year-old female

서기석 ( Kee Suck Suh ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

A 30-year-old woman presented with generalized erythematous papules and confluent plaques on the whole body of a month duration. The lesions gradually grew up during last few days. She was diagnosed with mycosis fungoides about seven years ago. After then, she was treated with psoralen and ultraviolet A, acitretin, methotrexate, and ultraviolet A-1. On physical examination, variable sized erythematous papules and confluent plaques were observed on the whole body. And there were spare skin folds. A skin biopsy was taken from the skin lesions. What is your diagnosis?

고용량 UVA-1으로 치료한 반상경피증

서기석 ( Kee Suck Suh ),이진우 ( Jin Woo Lee ),노효진 ( Hyo Jin Roh ),최수영 ( Soo Young Choi ),도기승 ( Ki Seung Doh ),김상태 ( Sang Tae Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.1

Morphea is a rare, sclerotic connective tissue disorder and is thought to be caused by a decreased collagenase activity. Numerous treatment modalities have been tried, such as infiltration with glucocorticosteroid, D-penicillamine, antimalarial agents and cyclosporine. However, all have shown only limited success. We report a case of a 21 year-old female with localized scleroderma, who showed a marked improvement after localized therapy with high dose UVA-1. (Korean J Dermatol 2007;45(1):76~78)

Hydroxyproline의 안면부 주름 개선 효과에 관한 연구

서기석 ( Kee Suck Suh ),최수영 ( Soo Young Choi ),김상태 ( Sang Tae Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.2

Background: Many treatment modalities for wrinkle reduction have been developed in the field of dermatology. Hydroxyproline plays a critical role in stabilizing the triple helix of collagen. The triple-helical conformation gives collagen most of its unique properties and is essential for normal fibrillogenesis. Objective: This study was performed to investigate the effect of hydroxyproline on the improvement of wrinkles in vitro and in vivo. Methods: Cultured fibroblasts and 25 human volunteers were used for in vitro and in vivo studies respectively. Hydroxyproline was administered to a fibroblast culture system and was also applied to periorbital wrinkle lesions twice daily for 12 weeks. The effect of hydroxyproline was examined by using an image analysis system with skin replica, and subjective and objective assessment of wrinkles were evaluated. Results: With the in vitro study, the number of cultured fibroblasts did not increase in the 10(-4), 10(-6) and 10(-8)ug/ml hydroxyproline groups compared to the control groups. Procollagen Type 1 C-peptide of cultured fibroblasts did increase in the 10(-8)ug/ml hydroxyproline group compared to the control group (p<0.05). With the in vivo study, there was a significant decrease in wrinkles at 8 and 12 weeks after application in the 0.5% hydroxyproline applied group compared to the control group (p<0.001). In the subjective visual assessment by the investigator and the subjects at 8 and 12 weeks after application, the 0.5% hydroxyproline treated group showed a significant improvement of wrinkles and more personal satisfaction than the control group (p<0.05). Conclusion: 0.5% hydroxyproline had an effect in vivo and in vitro on wrinkle improvement. It is suggested that hydroxyproline might be a candidate compound for treatment or reduction of wrinkles. (Korean J Dermatol 2007;45(2):140~148)

Granulocyte Colony-Stimulating Factor (G-CSF) 투여 후 비정형 골수세포와 혈관염을 보인 약진

서기석 ( Kee Suck Suh ),이진우 ( Jin Woo Lee ),노효진 ( Hyo Jin Roh ),최수영 ( Soo Young Choi ),도기승 ( Ki Seung Doh ),김상태 ( Sang Tae Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.10

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor (HGF) with many applications in cancer therapy. Many cutaneous adverse reactions associated with G-CSF have been reported in recent years, including injection site reactions, pyoderma gangrenosum, Sweet`s syndrome, cutaneous leukocytoclastic vasculitis, and widespread folliculitis. We report a case of vasculitis with atypical myeloid cell induced by G-CSF on the lower extremities (Korean J Dermatol 2007;45(10):1078∼1082)

발바닥에 국한된 편평태선 1예

서기석 ( Kee Suck Suh ),이진우 ( Jin Woo Lee ),노효진 ( Hyo Jin Roh ),최수영 ( Soo Young Choi ),도기승 ( Ki Seung Doh ),김상태 ( Sang Tae Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8

Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. As palmoplantar lichen planus do not usually have the classically clinical features of lichen planus, a biopsy is very useful. Histopathologic findings are identical to classic lichen planus. According to literature, similar lichen planus may be found elsewhere on the body in palmoplantar lichen planus. We report a case of lichen planus limited to the soles in a 50 year-old female, who presents with erythematous hyperkeratotic crusted pruritic plaques on both soles. (Korean J Dermatol 2007;45(8):855∼857)

Solitary Nodule in the Lower Lip

서기석 ( Kee Suck Suh ),도기성 ( Ki Seung Doh ),김상태 ( Sang Tae Kim ) 대한피부과학회 2003 대한피부과학회 학술발표대회집 Vol.55 No.1

Bowen모양 구진증의 임상, 병리조직학적 소견 및 추적관찰

서기석 ( Kee Suck Suh ),노효진 ( Hyo Jin Roh ),전영승 ( Yeong Seung Jeon ),류현열 ( Hyun Yul Rhew ),김상태 ( Sang Tae Kim ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.11

Background: Bowenoid papulosis occurs primarily on the genitalia of young adults and this is characterized by multiple, apparently benign maculopapular lesions. Bowenoid papulosis shows the histopathological findings of a squamous cell carcinoma in situ, but it follows a largely benign clinical course. If it is misdiagnosed as malignant tumor, unnecessary excessive therapy may be performed. Therefore, exact recognition of this entity is important. Objective: The purpose of this study is to examine the clinical and histopathologic features and outcomes of Bowenoid papulosis. Methods: Twelve patients who had been diagnosed with Bowenoid papulosis between June 1996 and September 2007 were reviewed clinicopathologically. Results: The mean age of the patients was 34.8 years (range: 23∼57 years), and the mean duration of Bowenoid papulosis until presentation was 6.3 months (range: 5∼48 months). Nine patients were males and 3 patients were females. Eleven patients (92%) had multiple lesions. The average size of the individual lesions was 1.4×0.6 cm in diameter. The colors of the papules were red to black. Seven of 9 male patients had lesions on the penile shaft, with 6 of those occurring at the proximal shaft. The other 2 male patients had lesions on the scrotum and perianal area, respectively. Three female patients had lesions on the labium major, labium major and clitoris, and perianal area respectively. Nine patients (75%) presented without symptom and 3 (25%) presented with mild pruritus. The histopathologic features were as follows: a rete ridge of approximately equal length and breadth throughout the entire lesion (100%), skipped areas of normal keratinocytes between zones of atypical keratinocytes (100%). necrotic keratinocytes (92%), parakeratosis (83%), mitotic figures (83%), vacuolated cells resembling owl`s eyes (83%), multinucleated cells (67%), residual changes of typical condyloma acuminatum (17%), involvement of acrotrichia (100%) and involvement of acrosyringia (100%). Eleven patients were effectively treated with surgical excision (8 patients), CO2 laser (2 patients), diphenylcyclopropenone (DPCP) and immunotherapy (1 patient) and 1 patient underwent biopsy only. We followed 12 patients for an average 78.1 months (from 24 to 137 months). During this period, no recurrence or malignant transformation was observed. Conclusion: Bowenoid papulosis shows a form of squmaous cell carcinoma in situ for its histopathology, but it hardly ever progresses to squmaous cell carcinoma. On our long term follow-up, there was no malignant transformation. Thus, excessive treatment of Bowenoid papulosis by amputation of the external genitalia is not necessary. Therefore, a through understanding of the clinical and histopathologic features of this entity is necessary for making the diagnosis, the treatment planning and determining the prognosis. (Korean J Dermatol 2008; 46 (11): 1463∼1469)

호산구증가증을 동반한 삽화성 혈관부종

서기석 ( Kee Suck Suh ),백재우 ( Jae Woo Baek ),김태권 ( Tae Kwon Kim ),이진우 ( Jin Woo Lee ),전영승 ( Young Seung Jeon ),임학 ( Hark Rim ),김상태 ( Sang Tae Kim ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.10

Angioedema with eosinophilia is classified as the episodic and transient types according to the clinical course, the presence of recurrence and the response to treatment. Episodic angioedema with eosinophilia is characterized by recurrent angioedema, urticaria, periodical weight gain, peripheral eosinophilia and fever. The pathophysiologic mechanism is unknown, but it has been suggested that T-lymphocytes, eosinophils and cytokines may be the causes of this disorder. We report here on a 35-year-old woman with episodic angioedema and weight gain that she experienced about 3 days before the onset of menstruation. (Korean J Dermatol 2009;47(10):1162∼1165)

유방암 환자에서 발생한 혈관 확장성 피부전이

서기석 ( Kee Suck Suh ),강진석 ( Jin Seuk Kang ),백재우 ( Jae Woo Baek ),김태권 ( Tae Kwon Kim ),전영승 ( Young Seung Jeon ),김상태 ( Sang Tae Kim ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.12

The incidence of cutaneous metastases of primary tumor has been reported to be rare, as compared with metastasis of other internal organ. Carcinoma of the breast is most common cause of cutaneous metastasis in women. We report here on a case of telangiectactic metastatic breast carcinoma in a 65-year-old female who had violaceous plaques and vesicles over the right side of the neck. Histopathological examinations of the cutaneous lesion revealed aggregations of tumor cells within the dilated blood vessels in the dermis. (Korean J Dermatol 2009;47(12):1375∼1378)

Exteriorization 후 이차적 창상치유와 부분층 피부이식으로 치료한 난치성 화농성 한선염

서기석 ( Kee Suck Suh ),백재우 ( Jae Woo Baek ),강동영 ( Dong Young Kang ),강진석 ( Jin Seuk Kang ),김태권 ( Tae Kwon Kim ),전영승 ( Young Seung Jeon ),박진형 ( Jin Hyung Park ),김상태 ( Sang Tae Kim ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.9

Hidradenitis Suppurativa (HS) is a chronic relapsing disease that involves the apocrine gland-bearing skin. It results in sinus tract formation, fibrosis and scarring. Many different treatments for HS have been reported, including topical and systemic antibiotics, intralesional steroids, systemic retinoids, hormonal therapies and immnunosuppressive agents, but they all have limited beneficial effects. Surgical treatments, including wide exteriorization with secondary intention, a skin graft and a flap can be effective treatments for recalcitrant HS. We present here the case of a 26-year-old man with recurred inguinal and axillary HS, and this was treated with secondary healing and a split thickness skin graft after exteriorization. Based on our experience, it is suggested that secondary healing and a split thickness skin graft after exteriorization are effective for recalcitrant HS with multiple interconnected tracts and abscesses. (Korean J Dermatol 2010;48(9):799~803)