혈관중심성 T - 세포 림프종 : 4예의 임상 및 병리조직학적 관찰

지두현 ( Doo Hyun Chi ),서호석 ( Ho Seok Suh ),최지호 ( Jee Ho Choi ),성경제 ( Kyung Jeh Sung ),허주령 ( Joo Ryung Huh ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.4

Background: Angiocentric T-cell lymphoma(AL) is a rare subtype of cutaneous T-cell lymphoma and recently many cases have been reported from Taiwan and Japan. But little is known about the clinical and histopathologic features of AL and few data are available in Korea. Objective : Our purpose was to characterize the clinical and histopathologic features of the specific cutaneous manifestauons of AL and to investigate the association with Epstein-Barr virus (EBV), Methods : Clinical records and histopathologic evaluation of skin biopsy specimens from four patients with AL were reviewed. We also performed immunohistochemical staining using monoclonal antibodies against, surface markers of lymphocytes and in situ hybridization for EBV-encoded RNA(EBER) in lesional skin. Results : 1. The most common clinical finding in our patients was indurated plaque predominantly on the trunk. 2. The common histopathologic finding in skin biopsy specimens from all four patients was angiocentric, angioinvasive, and angiodestructive infiltrate containing atypical lymphocytes. 3. In three of four patients, EBER was demonstrated in lesional skin by in situ hybridization. Conclusion : AL is an unique clinicopathologic entity showing strong association with EBV in Korea. (Kor J Dermatol 1996;34(4): 555-560)

수장부에 발생한 단발성 과립세포종

지두현 ( Doo Hyun Chi ),김현수 ( Hyun Su Kim ),성경제 ( Kyung Jeh Sung ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.4

Granular cell tumors were originally described in 1926 by Abrikossoff as myoblastic myomas. They usually occur as solitary tumors but can be multiple in about 10% of cases. They have a predilection for the skin, subcutaneous tissue and tongue, but also occur in many other organs. We report a case of solitary granular cell tumor on the palm. This is a very unusual location of this disease which merits consideration. (Kor J Dermatol 19S5;33(4): 780-783)

원발성 상피성 피부악성종양의 임상적 관찰

지두현 ( Doo Hyun Chi ),성경제 ( Kyung Jeh Sung ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 1995 大韓皮膚科學會誌 Vol.33 No.6

Background : The incidence of primary epithelial skin cancers is rising steadily, but little is khown of the clinical features of primary epithelial skin cancers, and limited data are available in Korea. Objective : Our purpose was to analyze the clinical characteristics of primary epithelial skin cancers. Methods : A retrospective analysis was conducted of 106 cases of primary epithelial skin cancers observed between 1989 and 1995. Results : 1. Basal cell curcinoma(BCC), 41 cases, was the most common skin cancer. The numbers of cases of squamosis cell carcinoma(SCC) and Bowens disease(BD) were 33 and 24, respectively. There were 3 cases of mixed type(BCC + SCC), 2 cases of Pagers disease and 3 cases of extramammary Pgets disease. 2. The average age at ciragnosis and the mean duration of disease were as follows . BCC(65.5 years old 4.34 years), SCC(70.2 years old-1.63 years), BD(59.3 years old-2.85 years) 3. The face was the most common anatomic site for BCC(93%) and SCC(70%), but the trunk was the most common site for BD. 4. The most common c inical type of BCC was the noduloulcerative type(65% ) and the solid type was t.he most frequert histologic type of BCC. 5. In histologic grading of SCC, grade I and II lesions occupied in 88% of total cases. The numbers of special variants of SCC were as follows aenoid(4), spindle cell(1), verrucous(2) Conclusions : 1. The average age of patient with primary epithelial skin cancers was older thar: in earlier reports in Korea, and was closer to the recent, reports in western count.ries. 2. The number of cases of BD was much higher than that reported previously. This emphasizeci the importance of tissue examination for the pigmented lesions of the skin, especially on the trunk and extremities. (Kor J Dermatol 1995;33(6): 1085-1090)

피부에 발생한 혈관 중심성 T - 세포 림프종

조광현 ( Kwang Hyun Cho ),양성규 ( Seong Gyu Yang ),김철우 ( Chul Woo Kim ),지두현 ( Doo Hyun Chi ),고재경 ( Jai Kyoung Koh ),김영근 ( Young Keun Kim ) 대한피부과학회 1996 大韓皮膚科學會誌 Vol.34 No.6

Background: Angiocentric T-cell lymphomas are rare T-cell malignancies which involve extranodal sites, such as the skin, nasal cavity, soft tissue and gastrointestinal tract. They have been reported with significant frequency in Asia. Objectives . The main objective of this study is to characterize t.he clinical, pathological, and immunohistochemical featnres of cutaneous angiocentric T-cell lymphoma. Another objective is to search for the Epstein-Barr virus (EBV) in the tissues of cutaneous angiocentiric T cell lymphoma. Methods : Clinical records, laboratory data, and histopathologic sections of 12 patients with cutaneous angiocentric T-cell lymphoma were reviewed. Paraffin tumor tissues were immunophenotyped. In situ hybridizaion studies were performed to detect the EBV genomes. Results : The ages of the 12 patients ranged from 34 to 64 years(mean 45.8 years). The cuta- neous lesions were nodules or plaqes, and were with ulcerated or had intact skin. Eight patients had evidence of extracutaneous involvement, usually involving lymph nodes, liver, and spleen. Eleven patients showed the abnormal laboratory findings including anemia, leukopenia, and elevated level of LDH. The dis ase pursued an aggressive course and was not uncommonly resistant to treatment. Hist,ologically, the lymphomatous infiltrate occurred predominantly in the subcutaneous layer with involvement f the dermis. The pattern was mainly perivascular and periadnexal. A prominent feature was invasion of small or medium vesselsby lymphoma cells. The infiltrating lymphrcytes expressed CD45RO in all cases ; variable expression of CD3 and CD56 was detected in piaffin sections. Among the 11 cases where in situ hybridization was performed, EBV genome could be detected in 9 cases. Conclusion . Angiocentvic T-cell lymphoma of the skin is an aggressive lymphoma distinct from classic cutaneous T-cell lymphoma. However, further studies are needed to regard them as a ho- mogeneous entity of T-cell lymphoma involving the skin. (Kor J Dermatol 1996;34(6): 953-960)

Epstein-Barr virus(EBV)와 연관된 Nasal type T/Natural Killer(NK)-cell lymphoma 1예

지두현,최지호,성경제,문기찬,고재경 울산대학교 의과대학 1996 울산의대학술지 Vol.5 No.1

Nasal type T/NK-cell lymphoma는 병리조직학적으로 응고성 괴사가 동반된 혈관중심성 침윤을 특징으로하며 T-cell과 NK-cell 항원을 모두 표현하는 면역조직화학염색 소견을 보이는 매우 드문 피부 림프종으로서 EBV와의 연관성이 흔히 보고되고있다. 저자들은 42세 여자에서 발생한, 전신적인 홍반성 구진, 판, 결절의 임상양상을 보였으며 피부 병변에서의 EBV-encoded RNA(EBER)에 대한 in situ hybridization상 양성소견을 보였고 전산화단층촬영, 골주사, 갈륨주사 등의 검사상 비강, 위장관 및 다른 내부장기 침범소견은 보이지 않아서 피부에만 국한된 경우로 사료되는 nasal type T/NK-cell lymphoma 1예를 보고하는 바이다.

Acquired Tufted Angioma 1예

문기찬,성경제,지두현,김현수,고재경 울산대학교 의과대학 1995 울산의대학술지 Vol.4 No.1

Tufted angioma was first described by Wilson Jones in 1976. This is a rare vascular tumor usually appears in early childhood, having a predilection for neck, upper chest and shoulder, and most commonly appears as dull red to red-brown patches and plaques. We report a case of acquired tufted angioma in an adult presenting as multiple, discrete, reddish papules within macular patch on right chest and showing a good response to dye laser therapy. This is an unusual case which merits consideration.

Cutaneous Angiocentric T-cell Lymphoma

Choi, Jee-Ho,Chang, Sung-Eun,Chi, Doo-Hyun,Jang, Kyoung-Ae,Koh, Jai-Kyoung 울산대학교 의과대학 1995 울산의대학술지 Vol.4 No.2

Angiocentric T-cell lymphoma는 혈관중심성의 부정형 림프구 침윤을 특징으로 하는 매우 드문 피부 T세포 림프종의 한 아형으로서 전세계적으로 대만, 일본등 동아시아 국가에서 주로 보고되고 있다. 저자들은 62세 여자에서 발생한, 국소적으로 비교적 경계가 명확한 홍반성 판의 임상양상을 보였으며 전신 증상은 동반되지 않았고 전산화단층촬영, 골주사, 갈륨주사 등의 검사상 내부장기 침범소견은 보이지 않아서 피부에만 국한된 경우로 사료되는 Angiocentric T-cell lymphoma 1예를 보고하는 바이다.

Kaposi 육종의 임상 및 병리조직학적 연구

장경애,문기찬,성경제,최지호,지두현,고재경 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.1

Background:Kaposi's sarcoma (KS) is a multicentric neoplastic vascular tumor involving the skin or internal organs. KS is an extremely common tumor in tropical Africa and it is also a prime marker of acquired immunodeficiency syndrome (AIDS). Nearly all cases of KS can be classified in four groups: 1) classic, 2) African, endemic, 3) AIDS-associated, 4) iatrogenic immunosuppression- associated KS. Objective:The purposes of this study were aimed at evaluating the clinical and biological features of KS. Methods:The hospital charts and histopathologic slides of patients with KS diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. Immunohistochemical studies for factor VIII, CD31, and CD34 were performed. We also performed PCR-based analysis to determine whether human herpesvirus 8 (HHV8) is present in KS included in this study. Results: 1. Four male and four female patients were included. The mean age at diagnosis of KS was 59.6 years. 2. Our patients could be classified as follows, iatrogenic immunosuppression-associated (7/8) and classic KS (1/8). Iatrogenic immunosuppression-associated group was sub-classified into long-standing steroid use (2/7), chemotheraphy-associated (cancer related, 3/7), and kidney transplantation (KT)-associated group (2/7). Patients with AIDS-associated KS were absent. 3. KS was presented with varied clinical features showing from ill-defined purplish macules to fungating nodules or tumors. Interestingly, two cases were presented with zosteriform or cellulitis-like features. Although upper and especially, lower extremities were favored sites, mucosal involvement such as intraoral and perianal areas was noticed. The cases showing the involvement of systemic organ could not be detected except two cases involving the small intestine. 4. Immunohistochemical studies revealed that spindle cells in stroma were partially positive for CD31 and CD34 and negative for factor VIII. 5. HHV8 sequences were identified in all cases of KS. 6. Four patients (50%) died within 1-2 years after the diagnosis of KS due to underlying diseases. Radiation therapy and interferon-α were effective in one case, respectively. Classic KS showed indolent course. Conclusion:KS is a multicentric neoplasm for which the etiopathogenesis is still under discussion. We retrospectively studied seven cases with iatrogenic immunosuppression-associated KS and one with classic KS. KS should be considered when the cutaneous lesions newly developed in immunosuppressed patients. HHV8 may contribute to the pathogenesis of KS when other predisposing conditions are present.

자외선 B 조사에 의한 사람 각질형성세포주 HaCaT 세포의 Interleukin - 1α 생산에 미치는 1 , 25 - Dihydroxyvitamin D3 의 영향

성환태,최지호,성경제,임연순,지두현,장경애,여운철 대한피부과학회 2001 大韓皮膚科學會誌 Vol.39 No.2

Background: Keratinocyte-derived interleukin-1 (IL-1) αis one of the key cytokines in initiation of cutaneous inflammation. Release of IL-1 αfrom human keratinocytes may be induced by proinflammatory stimuli including ultraviolet B (UVB) irradiation, and subsequently, keratinocyte-derived IL-1 αmay exert numerous paracrine and autocrine effects. 1,25-dihydroxyvitamin D_3(1,25(OH)_2D_3) is involved in the regulation of keratinocyte proliferation and differentiation and is also recognized to have immunoregulatory properties such as an antiinflammatory effect. Objective: The purpose of this study was to investigate the in vitro effects of 1,25-(OH)_2D_3 on the production of IL-1 αby UVB irradiation in cultured human keratinocyte cell line HaCaT cells. Results: are summerized as follows; 1. The vialility of cultured HaCaT cells measured by MTS assay at 24 hours after UVB irradiation was significantly reduced at the doses of above 100 mJ/㎠ of UVB(p$lt;0.05). 2. The secretion of IL-1 αby HaCaT cells was significantly increased at the doses of above 30 mJ/㎠ of UVB(p$lt;0.05). UVB irradiation could not influence cm the secretion of IL-1 αby HaCaT cells. 3. At the concentrations of 10-8M and 10-6M of 1,25(OH)_2D_3, the production of IL-1 α by HaCaT cells(48 hours after 100 mJ/㎠ UVB irradiation) was significantly inhibited in tth culture supernatants and cell lysates(p$lt;0.05). Conclusion: UVB irradiation increased the production of IL-1 αby HaCaT cells and this stimulatory effect on the production of IL-1 αinduced by UVB irradiation was suppressed by 1,25-(OH)_2D_3. Calcipotriol(MC-903) had similar suppressive effect on the production of IL-1 αinduced by UVB irradiation in HaCaT cells to that of 1,25(OH)_2D_3

피부 백혈병의 임상 및 병리조직학적 연구

장경애,문기찬,성경제,최지호,지두현,고재경 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.1

Background:Leukemia cutis is regarded as a dissemination of aggressive systemic leukemia to the skin. The presence of leukemia cutis is usually associated with a grave prognosis. Objective:We evaluated the differences in the patienta' age and sex, the clinical appearance and distributions of the skin lesions, histopathological characteristics, interval between diagnosis of systemic leukemia and skin involvement, and prognosis according to the type of leukemias. Methods:We performed a retrospective study of 23 cases of leukemia cutis. We obtained the clinical characteristics from record reviews and we also reevaluateds biopsy materials of 23 patients diagnosed in Asan Medical Center from 1989 to 1999. Results: 1. The male-female ratio was 1.6 to 1. The mean age at diagnosis was 46.6 years. Leukemia cutis occurred in 4.3% of cases of AML(17/396), 0.4% of ALL(1/276), 9.5% of CML(2/21), and 0% of CLL(0/14) in Asan Medical Center from 1989 to 1999. The patients in this study comprised:3 patients with myelodysplastic syndrome(MDS), 1 acute lymphocytic leukemia(ALL), 17 acute myelocytic leukemia(AML), and 2 chronic myelocytic leukemia(CML). 2. The clinical appearance of leukemia cutis includes macules, papules, nodules, and erythema nodosum-like lesions. The papular lesions were the most common ones. Trunk and extremities were favored sites. There was no specific difference in the clinical findings of each type of leukemias. 3. Histopathological evaluation revealed perivascular and periadnexal infiltration of leukemic cells in the dermis with grenz zone in more than one third of the specimens. There was no specific difference in the histopathological findings of each type of leukemias. 4. In sixteen of the 23 patients (69.6%) with leukemia cutis, skin lesions developed after the systemic leukemia had been diagnosed. Three of the patients (13%) had skin lesions preceding the diagnosis of systemic leukemia and 4 patients (17%) had concomitant involvement. 5. Eighteen patients (78.3%) died after the diagnosis of leukemia cutis. The mean intervals between diagnosis of leukemia cutis and death was 4.8 months. Conclusion:Leukemia cutis is an uncommon manifestation of leukemia cutis that is strongly associated with the presence of extramedullary disease at other sites. Although AML was the most common type in this study, leukemia cutis has developed in CML, AML, ALL, and CLL in decreasing order of frequency in this study. The lesions showed varied morphology and could be difficult to distinguish both clinically and histopathologically from nonspecific dermatoses. The presence of leukemia cutis may be a sign of grave prognosis.