비강내에서 시작한 균상 (菌狀) 천육종 1 예

우태하,최길연,신홍상 대한피부과학회 1974 大韓皮膚科學會誌 Vol.12 No.2

The case of a 30 year old man is described, in whom mycosis Fungoides was originating from nose and followed by tumor stage of Mycosis Fungoides on skin. In January 1970, the patient leveloped nasal tumor, when he was n at E.N.T. department of Severance Hospital. At that time a biopsy of nasal tumor demonstrated only a non-specific inflammatory cell infiltrated mass. He received radiation therapy (Co 60) with satisfadory suppression of mass and resulted in right nasal septal deviation. In December 1970, thumb sized painful non-tender, movable mass developed on right supraclaviular area. In August 1971, thumb sized painful, tender, movable mass appeared at right posterolateral aspect of neck, which was excied and removed at local clinic. But excised wound was not healed and the mass was enlarged. One month after above lesion, pea sized same mass developed. On physical examination, there were 4*5cm round, erythematous, painful, tender, granulomatous ulceration mass on right postero-lateral aspect of neck and also same mass on postero-inferior site of above lesion. Two times of biopsy was done and it interpreted as tumor stage of Mycosis Fungoids. Treatment included radiation therapy with Co 60 (200r/day, total 6,000r), prednisolone 40mg/day and antibiotics. There has been good response 1 month after radiation therapy and mass is diminished in size and would begin to heal.

Disseminated Superficial Actinic Porokeratosis ( DSAP ) 의 9 예

우태하,최길연,진홍상 대한피부과학회 1974 大韓皮膚科學會誌 Vol.12 No.2

This clinical study of nine patients presented Disseminated Superficial Actinic Porokeratosis (DSAP) as a distinctive and recognizable entity characterized by multiple uniformly small, irregular marginated, keratotic plug with atrophic center developing during second or third decade of life on sun exposed area of skin. Six of nine patients had DSAP, which was inherited as autosomal dominant trait. The patient's father, two brothers and two sisters were known to have same skin lesions. Of nine patients, five were female and four were male. Eight patients were developed DSAP lesions during second decade of life and other one was third dcade of life. Three patients had pruritus. In alI patients, lesions were developed bilaterally over sun exposed area but was not always symmetrical. The number of lesion was multiple in all patients. The greatest number of lesions were found on distal part of extremities, neck, face, upper portion of anterior chest and back.

5-Fluorouracil 연고로 치료된 Erythroplasia of Queyrat 1 예

우태하,최길연,진홍상 대한피부과학회 1974 大韓皮膚科學會誌 Vol.12 No.3

Erythroplasia of Queyrat is a precancerous lesion, usually located to glans penis or prepuce. It is characterized by a slowly developing, circumscribed, usually velvety and shiny patch. The etiology was unknown, but it is extremely rare in those circumcised in early infancy. It had been suggested that phimosis had some etiologic importance. The typical case of Erythroplasia of Queyrat is presented. A 46 year old man had 4 months history of dark-brownish pea sized maculopapular rashes on sulcus of glans penis and prepuce associated with mild itching, which was increased in number day by day. He had a phimosis. On examination, there are sharply defined, slightly elevated, pea sized dark-brownish maculopapular rashes over erythematous infiltrated base on sulcus of glans penis and prepuce, which have moist and velvety appearance. A biopsy was performed from sulcus of glans penis. Histopathologically, there was acanthosis, with in epidermis many cells are vacuolated and showed individual cell keratiinization. Epithelial cell showed marked atypia, variation in nuclear size and there was intercellular, intracellular edema. The lesion was treaterd with topical application of 5% 5-fluorouracil twice daily 2 weeks and thereafter for 4 weeks. 2 months after treatment, no erythroplastic lesion was found and 3 months after treatment, rebiopsy was perforrned which showed marked improvement histopathologically.

Sclerema neonatorum 의 1 예

우태하,최길연,김종기 대한피부과학회 1974 大韓皮膚科學會誌 Vol.12 No.3

Sclerema neonatorum is a lesion of degeneration, necrosis or crystallization of adipose tissue of new born, and is classified into two types; the generalized type in which death occurs usually within one week without treatment, and the nodular type which is localized and heals spontaneously. In this report, nodular type was presented. Nut to palm sized indurated plaques on deltoid region, upper back and hip were noted 3 weeks after birth. Histopathologic findings of necrosis of subcutaneous tissue with early granulomatous reaction were showed in biopsy specimen. Literature was briefly reviewed for the discussion of clinical and microscopic findings of this disease.

부현피질 (副賢皮質) 홀몬성 좌창에 대한 연구

우태하,최길연,진홍상 대한피부과학회 1974 大韓皮膚科學會誌 Vol.12 No.4

Dermatologic treatment was greatly advanced when topical corticasteroids were introduced for the management of many inflammatory and pruritic dermatoses. Their use reduced or diminished mnst of the undiserable side effects which accompanied the systemic administration of these compounds. The good effects of topical application of hydrocortisone had been demonstration in the treatment of variaus dermatoses eg., atopic dermatitis, seborrheic dermatitis, contact dermatitis etc. The halogenated derivatives followed and led to the trend to most of analogs now in use. Especially, fluocinolone acetonide cream greatly enhanced its therapeutic effectiveness in psoriasis, chronic discoid lupus erythematosus, pustular bacterid, granuloma and neurodermatitis circumscripta. But many side effects of topical corticosteroids such as steroid acne. Stria were developed and also fluorinated topical corticosteroids resulted in telangiectasia, purpura, atrophy in skin. Weber reported that strong topical corticosteroids eg.. Betamethasone valerate and fluocinolone acetonide were resulted in rosacealikc dermatitis and it was steadily increased. These adverse side effcts of topical corticosteroids, especially steroid acne, were indisputable argument in dermatologic field, for the view that this topical corticosterodis is used for cosmetics and treatment of acne vulgaris in our country. Since the strong corticosteroid tnpical preparation, the peculiar form acne, so called steroid acne, was steadily increased in our clinic. Behrman and goodman reported that acneform eruption induced by hormone was not associated with oiliness and there were but few comedone. Sullivan and Zeligman reported that the the acneform eruption due to adrenal corticaa 1 hormone was uniform in size, small papule and few pustule, usualIy erythematous base. There were also differential histologic feature. The most important difference is the normal apperance of sebaceous glands in acneform eruption due to corticosteroids contrast with hyperplasia in acne vulgaris. Abscess formation was more frequent and more extensive in acne vulgaris. Sutton Jr and Van Scott & MacCardle described that histologically, the major component in lesion of steroid acne was excessive keratinization of follicle. Castor and Baker demonstrated that topical application of corticosteroids resulted in decrease of sebaceous gIands, decrease of mitosis and increased cornification in epidermis. The present study investigated clinical case of the steroid acne, which are induced by topical application and systemic administration of corticosteroids and experimentally induced the steroid acne with the topical application of corticosteroid. And also clinical cases and experimentally induced steroid acne were compared with acne vulgaris. Material and method Subjects are 13 Patients of steroid acne induced by strong topical corticosteroid eg., fluocinolone acetonide, fluocortolone, dexamethaone, betamethasone valerate and 4 patients of steroid acne induced by systemic administration of corticosteroid eg., prednisolone and also 10 patients of acne vulgaris. Biopsy was performed from 13 patients of topical steroid acne, 3 patients of steroid acne induced by systemic administration of steroid and one patient of acne vulgaris. In order to induce steroid acne, experimentally, strong topical corticosteroid such as beta methasone valerate, fluocinolone acetonide and fluocortolone were applied on back. Comment and conclusion In Clinical feature, the steroid acne by topical application and systemic administration of corticosteroid and experimentally induced steroid acne had unique clinicall features, that showed absence of comedone and uniform sized follicular papule on deep seated erythematous scaly base. The topical steroid acne was distributed the region where were applied. But the eruption of the steroid acne induced by systemic administration of corticosteroids was distributed to face, neck, and scalp. Above findings are quite different form acne vulgaris. Histopathologically, the steroid acne induced by topical application and systemic administration of corticosterojds showed hypoplasia of sebaceous glands and excessive follicular keratinization. Occlusion of pilosebaceous opening by keratotic plug in severe case by long term application showed atrophy of epidermis and sparsity of sebaceous glands with hypokeratosis and parakeratosis. In experimentally induced steroid acne, it was definitely specific features which were absolutely identcall with above cinical steroid acne

Lymphangioma Circumscriptum 1 예

이정복,우태하,최길연,소창조 대한피부과학회 1973 大韓皮膚科學會誌 Vol.11 No.1

Lymphangioma circumscriptum is a rare disease and the lesions are indistinguishable, clinically and histologically, from lymphangiectasis. The only difference is that lymphangiectasis is usually bilateral and develops in adult or late life, ie, condary to irradiation, surgical interruption, or some malignancies, but lymphangioma circumscriptum is congenital disease or develops soon after birth. The patient with lymphangioma circumsvriptum visited to Dermatologic Department of Severance Hospital in December, 1972. The result of clinicopathological findings observed in above patient were presented. Since 8 years ago, a 8 year old house-wife has been suffered from erythema and induration in the right side of buttock, and the lesions changed to deep-seated and grouped vesicles resembling frog spawn which were purplish in color and tense in consistence during last 2 years. The whole gross lesion was estimated to palm size. There were no evidences of irradiation, surgical interrupion or some malignancies. The histological picture showed cystically dilated lymph vessels lined by a single layer of endothelium in the upper most portion of the dermis, and also many dilated lymphatics with newly formed velssels in the deep dermis.

Glomus Tumor 의 1 예

우태하,김중기,최길연 대한피부과학회 1972 대한피부과학회지 Vol.10 No.1

A case of Lichen planus in 41 year old with predisposing emotional factor is reported here and reviewed therapeutic experiences and reveiwed of literatures. This patient who has been suffering from pruritic, dull erythematous maculo-papular eruptions of trunk and extremites which was preoccupied with imagination as if she were exposed sequela to atomic bomb explosion in Japan, World War II, is presented.