증식성 모낭종양을 동반한 유전성 모낭종

김수조,천병남,유희준,손숙자,손진희 ( Soo Jo Kim,Byung Nam Chun,Hee Joon Yu,Sook Ja Son,Jin Hee Son ) 대한피부과학회 1988 대한피부과학회지 Vol.26 No.2

We report a case of hereditary trichilemmal cyst with proliferating trichilemmal tumor in a 64-year-oid man, who has generalized 157, variable sized firm cutaneous nodules for 40 years. The cystic nodules are chiefly located on the scalp and trunk which showed characteristic histopathologieal findings of trichilemmal cyst and proliferating trichilemmal tumors. His son also has multiple trichilemmal cysts and his mother seems to have had clinically similar lesions. The patient and his son were treated with surgical excision and therapeutic trial of oral isotretinoin for 2 months. Isotretionoin was ineffective in the patient, but the lesions of his son were decreased in size.

각화극세포종과 각화극세포종양 편평상피세포암에서 p53 단백과 Ki-67 항원의 발현에 관한 연구

전형진 ( Hyung Jin Jeon ),손숙자 ( Sook Ja Son ),김동준 ( Dong Jun Kim ) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.7

Background:Differential diagnosis of keratoacanthoma(KA) from squamous cell carcinoma(SCC) is often difficult, especially when SCC has KA-like features(KA-like SCC). A number of recent studies have been attempted to separate these two entities with the use of immunohistochemical stains. But the results were inconsistent and the studies with KA-like SCC are rarely reported. Objectives:The purpose of this study was to examine the expression patterns of p53 protein and Ki-67 antigen on KA and KA-like SCC using immunohistochemical staining method and to evaluate the usefulness of this method in distinguishing each other. Methods:We performed immunoperoxidase staining(LSAB technique) using monoclonal antibody to p53 protein(PAb1801) and Ki-67 antigen(MIB1) on the formalin-fixed, paraffin-embedded biopsy specimens obtained from 12 patients with KA, 8 patient with KA-like SCC, and 10 patients with well-differentiated SCC. Results:The results were as follows; 1) There was a significant difference in the p53 expression between KA(25%) and SCC group (KA-like SCC=88%, SCC=100%). 2) Mean Ki-67 labeling index was slightly higher for SCC group(KA-like SCC=30.72%, SCC= 31.23%) than for KA(25.30%), but this difference was not statistically significant. 3) In Ki-67 expression, KA showed more pheriperal basal pattern(91%), whereas SCC group showed more diffuse pattern(77%). Conclusion:Our results suggest that KA and SCC are distinct entities of different nature and that these immunohistochemical staining methods can be useful methods in differentiating KA-like SCC from KA.

베체트병과 재발성 아프타 구내염에서의 Pathergy 검사

이수근 ( Soo Keun Lee ),손숙자 ( Sook Ja Son ),김용재 ( Yong Jae Kim ),유희준 ( Hee Joon Yu ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.4

Background : Pathergy, or skin hypersensitivity to needle puncture has been reported as a diagnostic test for Behcets ciisease. But the positivity of pathergy test in recurrent aphthous stomatitis which can be a comporent of Behcets disease is obscure. In recent years it has been noted that the positivity of the test has decreased. It is possible to say that the disposable needles used nowadays are less trauniatic to initiate the reaction than are the nondisposable ones used in the preAIDS ara by some uthors. Objective : It is the porpose of this study to clarify the value of pathergy test in differentiating Behcets disease from recurrent aphthous stomatitis and to evaluate the difference of positivity using various kinds of needles, and finally to suggest the most profitable one. Methods : 34 patients with Behcets disease according to the diagnostic criteria of Shimizu(revisecl) 25 ones in case of applying that of International study group for Behcets disease(ISG) and 21 ones with recurrent aphthous stomatitis, and 25 normal controls were selected. A pathergy test, i.e., intradermal injection of 0.1 ml physiological saline by using 26 gauge k 20 gauge disposable needles and l.6 gauge R 20 gauge nondisposable ones were given and the evaluation was made after 24 hours and 48 hours. Results : 1. The positive rates of pathergy test using all kinds of needles in Behcets disease were significantly higher than thoen recurrent aphthous stomatitis and normal controls(p=0.00000-0.03600). The sensitivity were 29.4% 64.7% (Shimizu) and 32.0% 76.0% (ISG), respectively, and the specificity were 91.3%-100.0% for all of them. 2. In Behcets disease, the positive rates of the pathergy test using 26 gauge disposable needles were not significantly different from that of using ZO gauge disposable needles in total and active patients after 24 and 4.3 hours and so were 26 gauge R 20 gauge nondisposable ones(p=0.40134 -0.80603(Shimizu), 0.37551-0.77078(ISG) ). 3. In Behcets disease, the positive rates of pathergy test using 26 gauge nondisposable needles were 59%-68%(Shimiu) and 64% 79% (ISG), which were significantly different, from the test using 20 gauge disposable needles, i.e. 29%-36%(Shimizu), 40%-46%(ISG) in total and active patients(p==0.00753-0.01512) after 24 and 48 hours except for those by the criteria of ISG after 24 hours(p=0.14573-0.15597). Conclusion : This study shows that the pathergy test is obviously useful in differentiating Behcets disease from ecurrent aphthous stomatitis and we recommend the intradermal injection of 0.1 ml physiological saline by using 26 gauge nondisposable needle and the evaluation after 48 hours as a standard mithod of pathergy test. (Kor J Dermatol 1995;33(4): 625-632)

산소분압과 발생부위에 따른 켈로이드 배양섬유모세포의 혈관내피 성장인자(VEGF) 발현

문형식 ( Hyung Sik Moon ),손숙자 ( Sook Ja Son ),박건 ( Kun Park ),강희규 ( Hee Gyoo Kang ),임희정 ( Hee Joung Lim ),박향준 ( Hyang Jun Park ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.5

Background: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. Objective: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. Methods: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. Results: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. Conclusion: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis. (Korean J Dermatol 2009;47(5):539~546)

한국인에서의 기저세포암의 임상 및 병리조직학적 연구 -대한피부과학회 피부병리 연구분과위원회 공동연구-

임철완 ( Chull Wan Ihm ),손숙자 ( Sook Ja Son ),김방순 ( Bang Soon Kim ),고재경 ( Jai Kyoung Koh ),조백기 ( Baik Kee Cho ),김시용 ( Si Yong Kim ),원영호 ( Young Ho Won ),김종민 ( Jong Min Kim ),송은섭 ( Eun Sup Song ),김수남 ( Soo 대한피부과학회 2000 대한피부과학회지 Vol.38 No.6

Background:Basal cell carcinoma(BCC) does not commonly occur in dark-skinned people, although it is the most common cancer of light-skinned people. So it has been known that incidence of BCC is lower than that of squamous cell carcinoma(SCC) in Asian and Africans. However, several recent Korean articles have reported the reversal of the ratio of SCC to BCC. There has been no report about BCC following a nationwide survey in Korea. Objective:Our purpose was to confirm the trends in BCC and SCC, and to identify the clinical and histopathological characteristics of BCC. Methods:A clinical and histopathological analysis was done retrospectively with patients diagnosed as BCC from the Department of Dermatology of 15 University Hospitals or General Hospitals during the last 20 years(1977-1996). Annual incidence of BCC was compared with that of SCC at the same situation. We compared the results with those in other races statistically. Results:1. Incidence of BCC was 0.16% compared with 0.11% of SCC. The increasing incidence of BCC was more pronounced than that of SCC, although they were increased gradually. 2. The male-female ratio was 1:1.07, and the most frequent age group was the 6th decade(30.1%). 95% of the patients were older than the age of 40 years with the mean age of 62.7 years. 3. The most commonly involved site was the face(84.9%), especially on the nose, cheek, and eyelids. 4. The most frequent histologic pattern was nodulocystic type(35.4%), followed by mixed(30.1%), infiltrative(9.3%), superficial(6.7%), micronodular(6.2%), adenoid(5.9%), metatypical(4.0%), morpheaform(2.1%), and fibroepithelioma type(0.3%). 5. Histologically, 45.3% of BCC contained pigment. The histologic pattern most frequently associated with pigmented BCC was mixed type(53.1%) followed by nodulocystic(51.2%),superficial(46.8%), micronodular(38.6%), and adenoid type(33.3%). 6. Overall recurrence rate was 6.3%. Morpheaform, infiltrative, and metatypical BCC have a high erincidence of recurrence(26.3%, 13.2%, 8.1%, respectively). Therapeutic modalities that showed high recurrence rate was 5-FU, curettage and electrodessication, and cryotherapy(33.3%, 28.6%, 16.8%, respectively). Conclusion:It was confirmed following a nationwide survey that increasing incidence of BCC was more pronounced than that of SCC since early 1980s and BCC was the most common skin cancer in Korea. (Korean J Dermatol 2000;38(6):762~771)

집게손발톱의 수술적 치료 효과에 대한 연구

문형식 ( Hyung Sik Moon ),손숙자 ( Sook Ja Son ),박건 ( Kun Park ),박향준 ( Hyang Jun Park ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.5

Background: A pincer nail deformity is characterized by the presence of an excessively curved and distorted nail across the transverse dimension, particularly at the distal part of the nail plate. A multitude of therapeutic modalities has been implemented to treat this condition with limited efficacy. Objective: We sought to evaluate the efficacy of surgery of a pincer nail deformity with the use of the modified Haneke`s method. Methods: Six patients (seven toenails and two fingernails) with pincer nail deformities were treated with the modified Haneke`s method. Objective assessment was evaluated by use of the width index (width of the nail tip/width of the nail root) and height index (height of the nail tip/width of the nail root). Subjective assessment was evaluated by use of a visual analogue scale declared by patients. In addition, wound complications and recurrence were described. Results: The width index and height index were improved (width index: 15.4%→7.1%, height index: 63.9%→1.9%). Relief of pain could be determined in 100% of the cases. For subjective assessment, all of the patients were satisfactory (more than satisfactory: 100%). There was no recurrence during a 14 to 24 month period (mean time: 19.2 months). Conclusion: The modified Haneke`s method as a surgical approach might be effective and the procedure is easy to perform for a pincer nail deformity. (Korean J Dermatol 2009;47(5):509~515)

표재성 지방흡입술을 이용한 액취증 수술의 치료 효과에 대한 연구

이홍선 ( Hong Sun Lee ),박건 ( Kun Park ),손숙자 ( Sook Ja Son ),김성언 ( Seong Eon Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8

Background: Axillary osmidrosis is characterized by unpleasant odor, profuse sweating and occasionally staining of clothes. Classical surgical treatment of axillary osmidrosis may result in many complications, such as scarring, hematoma and necrosis. Objective: The purpose of this study is to evaluate the effect of superficial liposuction in the treatment of axillary osmidrosis. Methods: Through two 5 mm sized incisional windows, liposuction can be done in a two directional criss-cross pattern. Fifteen patients received this surgery for bilateral axillae on an outpatient basis. The follow-up period ranged from 8 months to 18 months, the mean follow-up period was 12.5 months. Results: Of the 30 axillae, 28 axillae (93%) had excellent to good results. The axillary scars were short and nearly negligible (90%). Complications including one minor wound infection (3.3%) and one hematoma (3.3%), were improved with proper post-operative treatment. Four patients experienced transient fibrotic bands. All of these complications disappeared after 1∼2 months. Conclusion: In axillary osmidrosis, superficial liposuction has the merits of high success rates, short scars, minimal postoperative care with a short term of compressive dressing and rapid recovery to normal life. (Korean J Dermatol 2007;45(8):785∼790)

원발성 피부 편평 세포암의 임상 및 병리조직학적 관찰

이승연 ( Seung Yeon Lee ),강훈 ( Hoon Kang ),손숙자 ( Sook Ja Son ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.5

Background: Squamous cell carcinoma(SCC) is the most common skin cancer in Korea and its incidence is increasing. Objective : Our purpose was to evaluate the clinical and histopathological characteristics of SCC. Methods : Forty cases of cutaneous SCC slides were retrieved from the files of the surgical pathology division of the National Medical Center. Hematoxylin and eosin stained sections were re-examined microscopically by two dermatologists independently. For the cases of reconfirmed SCC, clinical characteristics including incidence, age and sex distribution, location and underlying conditions and histopathologic grading by Broder's grade system were evaluated. For 3 control cases controls and 17 cases of the SCCs, cytokeratin expression patterns on immunohistochernical staining using monoclonal antithodies MNF 116, RCK 102 and NCL 5D3 were observed. Results : 1. Of 40 specimens, 33 specimens(73.3%) were histologically reconfirmed as true cutaneous SCCs. 2. The most commonly involved age group was the fifth decade of life and the median age when diagnosis was made was 57.3. 24 male patients and 9 female patients were involved and the ratio of male to female was 2.67: 1. 3. Most commonly involved sites were face and lower extremities and the incidence of occurrence on sun exposed areas increased in accordance with an increase of the age. 4. Underlying conditions such as burn scars, osteomyelitis or atomic bomb exposure were associated in 45.5% of SCCs. 5. Histopathologic grading of 33 cases of SCCs by Broder's grade was performed as follows.:23 cases(67.7%) of grade I, 8 cases(24.2%) of grade II and 2 cases(6.1%) of grade III. 6. The cytokeratin expressio pattern on immunohistochemical staining for 3 of the control cases and 17 cases of SCCs showed some differences between the highly and poorly differentiated groups of SCCs. Conclusion : We evaluated the clinical and histopathological characteristics of primary cutaneous SCCs in the National Medical Center from september 1978 to August 1993. (Kor J Dermatol 1996;34(5): 710-717)

중년 남성에서 발생한 색소침착저하 균상식육종

문형식 ( Hyung Sik Moon ),박건 ( Kun Park ),손숙자 ( Sook Ja Son ),이원미 ( Won Mi Lee ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.3

Hypopigmented mycosis fungoides is a variant of mycosis fungoides. It occurs commonly in younger people and affects those with dark skin. This condition is easily misdiagnosed as vitiligo, postinflammatory hypopigmentation due to its non-specific clinical manifestation. We report a case of hypopigmented mycosis fungoides on both thighs and buttocks in a 44-year-male patient. Histopathologic findings showed Pautrier microabscesses and epidermotropism of atypical lymphocytes in the epidermis. CD8 immunohistochemical staining was positive. After narrow band UVB therapy, the lesions were completely repigmented. There was no evidence of recurrence of lesions after 5 months. (Korean J Dermatol 2008;46(3):362∼364)

Short Report : 단발성 피부 망상조직구종 2예

강훈 ( Hoon Kang ),박영민 ( Young Min Park ),손숙자 ( Sook Ja Son ) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.5

Solitary cutaneous reticulohistiocytoma(SCR) is characterized by a solitary reddish nodule or papule confined to the skin without evidence of arthritis or underlying systemic illness. We describe here two women patients with SCR who presented with an asymptomatic, firm, dome-shaped papule on the left upper chest and an erythematous oozing macule on the right second index finger tip, respectively. There was no evidence of systemic involvement. The lesions were completely excised and no evidence of recurrence was observed. (Korean J Dermatol 2000;38(5):681~683)