모반양 기저세포암 증후군 2예

조광열(Gwang Yeol Joh),남종택(Ki Ho Kim),김기호(Jong Taik Nam),김영수(Young Soo Kim),이봉구(Bong Ku Lee) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.6

Nevoid basal cell carcinoma syndrome is inherited as an autcsonal dominant trait with a high degree of penetrane and variable expressivity. The mair features are basal cell carcinoma. jaw cysts, skeletal anornalies, ectopic calcifications and palmoplantar pits. We report varous clinical ma.nifestations in brother and sister, wnich are jaw cyst,, bifid rib, shortened fourth metacarpals, ectopie calcification, palrnoplanar pits and basal cell carcinoma, Microscopically, histologic patterns of basal cell cacinomas are superficial, nodulocystic, keratotic, pigmented, adenoid and follicullar nevoid. Lange numbers of basal cell carcinomas were electrodessicated and curetted under general,nesthesia. (Kor J Dermatol 1992;30(6):951-957)

만성 일광 피부염

김기호(Ki Ho Kim),남종택(Jong Taik Nam),조광열(Gwang Yeol Joh) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.6

Chronic actinic dermatitis was recently proposed to be a syndrome of chronic photosen-sitivity that incudes photosensitive eczema, persitent light reection, photosensitivity dermatitis and actinic reticuloid. We report herein a case of chronic actinic dermatitis which occured in a 60-year-old man. He suffered from a chronic eczematous dermatitis affecting e posed skin and some covered area with a feature of erythroderma. Phototesting showed abnormal photosensitivity to both UVB and UVA as will as to visible light. Skin biopsy specimes revealed histologic findings of spongiotic dermatitis in which dermal infiltrates were mainy consisted of T lymphocytes with suppressor T cells dominance on immunohistochemistry. (Kor J Dermatol 1992;30(6):908-912)

의치 이장재에 의한 알레르기성 접촉 구내염

김기호(Ki Ho Kim),조광열(Gwang Yeol Joh),김영수(Young Soo Kim) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.6

Many sensitizing chemicals and additives are used in manifacturing and mending dentures. Among them, phtolyldiethanolamine, a kind of accelerto for polymerization, is necessary only in self-curing acrylic resins which are available for repairing and relining of denture. Although the sotirce of denture stomatitis is still controversial, a true allergy to denture base materials can be recognized by a patch test. We report a case of allergic contact stomatitis due to dentn e relining materials in a 65-year-old denturecariying edentulous patient. Patch testievi.aled positive reaction to polyldiethanolamine which is considerd to be contained in a cold curing acrylic resin fluid. (Kor J Dermatd 1992;30(6):892-896)

모즈 미세도식 수술에 의한 기저세포암의 준임상적 침윤에 관한 연구

송기훈,김기호,조광열 ( Ki Hoon Song,Ki Ho Kim,Gwang Yeol Joh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5

Background: Mohs micrographic surgery is an ideal method for removing the BCC completely. Several studies defining proper lateral margin for excision of BCC have been reported. However, the study of invasion depth of BCC has not been specially addressed. Objective : In our study, we evaluated the safety lateral margin as well as depth of excision of BCC and the correlation with the histopathological aspects by using Mohs micrographic surgery technique. Methods : Fourty nine patients with BCCs(29 primary, 20 recurrent) diagnosed in the Department of Dermatology of Dong-A University Hospital from March, 1991 through February, 1997 were studied prospectively. Results: 1. Fifty five percent of tumors in our series had 2mm maxumal margins and 70% of recurrent BCC were eradicated with 4-mm more lateral margins. 2. Sixty two percent of BCC located in the cheek was eradicated with the excision within the mid-subcutaneous fat and more than 76% of the tumor in the nose required the removal of the periosteum or perichondrium. 3. In Ninety five percent of BCC, less than 14mm required a 4mm lateral margin and only 5% required a 6mm margin. However, seventy two percent of BCC was eradicated with a 4mm lateral margin and more than 36% was eradicated with a 6-mm or more lateral margin. 4. Eight percent of the micronodular type required 4mm or more lateral margins and had a tendency to invade more deeply. All nodular micronodular-infiltrative BCC had 4mm or more maximal subclinical extension and periosteum/perichondrial or deeper vertical invasion. Conclusion : Mohs micrographic surgery is an appropriate tool to use in proposing guidelines for treatment for BCC and clinicopathological characteristics of BCC such as anatomic location, tumor size, histopathological subtype may be helpful to plan the proper surgical margins. (Korean J Dermatol 1997;35(5): 915-923)

Toxic Pustuloderma

윤정호(Jung Ho Yoon),남종택(Jong Taik Nam),김기호(Ki Ho Kim),조광열(Gwang Yeol Joh) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.5

Generalized sterile pustular eruptions occur in various dermatoses including pustular psoriasis, erythema multiforme, Sneddon-Wilkinsan disease and others. Recentlr, acute eruptions of disseminated sterile pustules have been reported. The etiology is not related to a gepetic predisposition to psoriasis but to drug ingestion or viral infections, thus termed toxic pustuloderm; (T. P.). In this report, we present a typical case of T. P. observed iu our department. Our patient, an 18-year-old male, with no personal or family history of psoriasis, was given drug medication including amoxicillin for fever and chilling sensation. Pustilar eruptions first, appeared on his face about two days aft.er the medication and gradually spread to the trunk and limbs. The skin examination revealed numerous small pustules on an erythematous base. Laboratory examination revealed neutrophilic leukocytosis and an elevated sedimentation rate skin biopsy showed subeorneal and spongiform neutrophilic pustules Upon interruption of the amoxicillin, the pustules cleared rapidly in 3 days and there has been ri.o recui rence of any rash over a 7-month follow-up period. (Kor J Dermatol 1994;32(5):944-949)

외배엽 기원 세포암에서의 Metallothionein 발현의 의의

김기호,이민수,조광열 ( Ki Ho Kim,Min Soo Lee,Gwang Yeol Joh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.1

Background: Metallothioneins(MTs) are ubiquitous low molecular weight cytosolic proteins with high contents of cystein that xhibit a selective binding affinity for zinc, copper and other group II heavy metal ions. In additi~on to the sequestration function and detoxification action, MTs probably participate in the cellirlar protection against. ionizing radiation and alkylating agent cytotoxicity and in cellular pn:liferation. Qbject : The objective of this study was to evaIuate the expression of MTs and to clarify t.heir role in carcinogenesis and/or biological behaviour in the neoplasms of ectoderrnal origin. Methods : We performed immunohistochemical studies on the surgical specimens of rnalignant rnelanoma and squamous cell carcinoma and basal cell carcinoma. The results were compared with the normal skin and mu osa and hair t,issues and raf't-on culture tissues of skin and mucosal keratinocytes. Results . 1) MTs were strongly expressed in epidermal basal cells of the normal skin and raft-on cultured artificial skin They were also rnore weakly expressed in epithelial basal cells of the normal mucosa and raft on cultured artificial mucosa and in matrix cells of the normal hair. 2) In rnalignant melanoma, MTs were meaningfully expressed, i.e., a strong expression was seen in the lesions showing a rapid vertical growth phase with fatal out,comes, but a weak expression in the cases whose precursor lesions were thought as dysplastic nevi, compared to the negative finding of norrnal melanocyt,es. The strong expression in a case of congenit.al rnelanocyt.ic nevus is considered as the activation of nevoid melanocytes. 3) MTs were weakly expressed in squarnous cell carcinoma with a diffuse aattern within the tumor mass. St,rong expression of MTs was particularly apparent in the poorl. differentiated squamous cell carcinoma and at the growing border of well differentiated squamous cell carcinoma. 4) In basal cell carcinoma, MTs were rather weakly expressed in solid cireumscribed types with a diffuse pattern and in cystic type with a patchy pattern. However they were not expressed in the solid infiltrative type. Conclusion : From these resuilts, we concluded that MTs were ubiquitously present in possible stem cells of various epithelial tissues except melanocytes irrespective of normal or artificial skin and/or mucosa including norrnal hair tissues. In the neoplasms of ectodermal origin, MTs might be involved in the invasive growth of tumor cells in the malignant melanoma and squamous cell carcinoma. It was implied that the role of MTs in basal cell carcinoma might be related to early events of hasal cell carcinogeresis and its down regulating tendency could be possible in its infil trative stage. (Kor J Dermatol 1997;35(1): 107-113)

Interferon Alfa - 2a로 치료하여 호전된 Kasabach - Merritt 증후군

윤정호(Jung Ho Yoon),김기호(Ki Ho Kim),조광열(Gwang Yeol Joh) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.2

Kasabach- Merritt syndrame consists of thrombocytopenia, microangiopathic hemolytic anemia, and an acute or chronic censumptive coagulopathy in associati an with a rapidly enlarging hemangioma. Most vascular turrnrs causing Kasabach-Merritt syndon e are benign but the associated coagulopathy may be lifethreatening. Our patient, a 30-day-old female infant, was admitted after an increase in the size of a hemangioma present since birth on the right leg with extension to the lower abdomen and left inguinal area. Her herrnglobin count fell to 7.1g/dl, platelet count was 26,000/ul, prothrombin time was 26 seconds, and hypofibrinogenemia developed. The patient was treated with transfusions of platelets, fresh frozen plasma and red cells and prednisolone. for 2 weeks without improvement. We started interferon alfa-2a therapy. Over the past 6 months, he hemangioma progressively diminished in size withcut any serious complication. (Kor J Dermatol 1995;33(2): 363-368)

피부 편평상피세포암 및 암전구증에서의 p53 단백질 및 Skin Sulfhydryl Oxidase의 발현

윤정호 ( Jung Ho Yoon ),김기호 ( Ki Ho Kim ),조광열 ( Gwang Yeol Joh ) 대한피부과학회 1996 大韓皮膚科學會誌 Vol.34 No.4

Background: Extensive study of the p53 gene has established its role as a tumor-suppressor gene, and the mutant p53 gene is expressed in a wide spectrum of human malignancy. The conversion of sulfhydryl groups to disulfide bonds in epidermis is carried out by skin sulfhydryl oxidase(SSO) at the junction of the granular layer and horny layers. So it is of interest to investigate the localization and properties of SSO in epidermal keratinocytic neoplasms. Objective: Our purpose is to investigate the expression pattern of the p53 protein and SSO and to gain a better understanding of biologic behavior in epidermal keratinocytic neoplasms. Methods : We investigated the expression pattern of p53 protein and SSO by immunohistochemical method on formalin-fixed, paraffin-embedded tissue specimens in 8 cases of squamous cell carcinomas, several cases of recancerosis(1 Bowen's disease, 1 actinic keratosis, 1 arsenic keratosis) and benign keratinizing disorders(1 verruca vulgaris, 1 condyloma accuminatum and 2 cases of lichen planus), Results: 1. Seven out of 8 cases of squamous cell carcinama(88%) and 1 case of 1 Bowen's disease showed p53 protein expression 2. SSO was weakly present in squamous cell carcinoma and precancerosis compared to the normal skin. In the well differentiated squamous cell carcinoma and Bowen's disease, the presence of SSO was rather diffuse than poorly differentiated squamous cell carcinoma and concentrated in dyskeratotic cells and horn pearls. 3. p53-stained cells or areas were seldom stained with SSO antibody, especially in invading borders of squamous cell carcinomas. Conclusion: Our results suggest that p53 mutation is a common genetic change in epidermal tumorigenesis and it can be useful marker of tumor invasion in the squamous cell carcinoma and precacerosis of skin. (Kor J Detmatol 1996;34(4): 616-621)

주사에 대한 색소레이저 ( Flashlamp - Pumped Pulsed Dye Laser ) 의 치료효과에 관한 연구

남종택(Jong Taik Nam),김기호(Ki Ho Kim),조광열(Gwang Yeol Joh) 대한피부과학회 1994 大韓皮膚科學會誌 Vol.32 No.4

Background : Persistent facial elangiectssia, erythema, and flushing are the major cosmetic problems in patients with rosacea, However various therapeutic modalities for roacea papules and pustules, including topical antibiotics, systemic antibiotics, isotretinoin, and systernic and topical metronidazole, are not effective in reducing telangiectasia and flushing reactions present inrosacea patients. The flashlamp-pumped pulsed dye laser has been deacribed as a succqssful treatment for port wine stains with telangiectasia as part of their abnomalities. A clinical study was therefore undertaken in a group of rosacea patients, who recieves this laser to areas of facial taieous lesions. Objective : The purpose of the study was to evaluate the therapeutic effect of the flashlamp-pumped pulsed dye laser(SPTL-1) for osacea, especially telangiectasia and flusing reactions. Methods : Forty-eight. patient with rosacea were studied to evaluatic the therapeutic effects of the SPTL-1 flashlamp-pumped pulsed dye laser (Candela corp.Wayland Mass.) at the Department of Dermatology in Dong-A University Hospital for 20 months from Januarg 1991 to August 1992. Results : 1. Total therapeutic effects of this SPTL-1 laser showed excellent re:ults in 22.9%, good in 62.5%, fair in 8.3%, and poor in 6.3%. 2. Therapeutic effects of rosacea-associated lesions showed exeellerit or good results in 85.4% of patient,s with erythema and telangiectasia, 84% patients with papules, 100% patients with pustules, and 93.7% of patients with facial flushing. 3. Complications included trarsient hyperpigmentation (14.6%), section lary bacterial infection(6.3%), hypopigmentation(2.1%), and atropic scar(2.1%). 4. The recurrence rat.e was 2,9,%. Conclusion : The flashlamp-pumped pulsed dye laser (SPTL-1) is a dry effective mode of treatment for rosacea, including persistent telangiectasia and facial flushing ri.actions which were intractable to previous other therapeutic modalities. (Kor J Dermatol 1994; 32(4): 649-654)

Befunolol Hydrochloride ( 0 . 5 % BentosR ) 에 의한 알레르기성 접촉피부염

남종택(Jong Taik Nam),김기호(Ki Ho Kim),조광열(Gwang Yeol Joh) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.6

Befunolol hydrochloride is a B-adrenergic receptor antagonist cornnory used topically in treatment of glaucoma because of a satisfactory intraocular pressure lowering apcity without relevant topical or systemic side effects. We repart herein a case of allergic contact dermatit.is due to befunc ol nydrochloride in 0.5% Bentos eyedrops, A 52-year-old Korean woman had suffered from erythemanedema with itching sensation on her left eye since Novembeir 18, 1992. She had used various ophtalrnic preparations including Bentos eyedrops containing befinolol hydrochloride 0,5% as its activ cinstituent since October, 1992 for treatment of glaucoma of her left eye. Patch test with the European standard series, rubber series, the patiants eyedrops and their individual constituents showed positive. reactions only to 0.5% Bentos eyedrops(as is) and to befunolol hydrochloride. We noted rapid improvement of skin lesions and syipsms after the withdrawal of Bentos eyedrops and applicatior of another B-blocker(carteolol hydrocilcide). (Kor J Dermatol 1994; 32(6) 1142- 1146)