Search

Abstract During laser treatment for tattoo removal, pigment chromophores absorb laser energy, resulting in fragmentation of the ink particles via selective photothermolysis. The present study aimed to outline macroscopic laser-tattoo interactions in tissue-mimicking (TM) phantoms treated with picosecond- and nanosecond-domain lasers. Additionally, high-speed cinematographs were captured to visualize time-dependent tattoo-tissue interactions, from laser irradiation to the formation of photothermal and photoacoustic injury zones (PIZs). In all experimental settings using the nanosecond or picosecond laser, tattoo pigments fragmented into coarse particles after a single laser pulse, and further disintegrated into smaller particles that dispersed toward the boundaries of PIZs after repetitive delivery of laser energy. Particles fractured by picosecond treatment were more evenly dispersed throughout PIZs than those fractured by nanosecond treatment. Additionally, picosecond-then-picosecond laser treatment (5-pass-picosecond treatment + 5-pass-picosecond treatment) induced greater disintegration of tattoo particles within PIZs than picosecond-then-nanosecond laser treatment (5-pass-picosecond treatment + 5-pass-nanosecond treatment). High-speed cinematography recorded the formation of PIZs after repeated reflection and propagation of acoustic waves over hundreds of microseconds to a few milliseconds. The present data may be of use in predicting three-dimensional laser-tattoo interactions and associated reactions in surrounding tissue.

Summary:. Most cases of severely contracted nose require revision rhinoplasty and septoplasty, wherein preoperative and/or intraoperative expansion of nasal soft tissue is necessary for tension-free revision surgery. The present study aimed to evaluate the efficacy and safety of pre- and postoperative adjuvant therapy using polydeoxyribonucleotide (PDRN) and invasive, pulsed-type, bipolar, alternating current radiofrequency (RF) for revision surgery of a contracted nose. In total, 30 patients were treated with 16 sessions (8 preoperative sessions and 8 postoperative sessions) of intralesional injection of PDRN and invasive RF treatment using microneedle electrodes at 1-week intervals. One week after the final combined pretreatment using PDRN and invasive bipolar RF, the skin of contracted noses was sufficiently softened, and nasal skin mobility was notably improved in all the patients. During revision rhinoplasty and septoplasty, the contracted nasal skin in each patient was adequately released for proper covering of the nasal tip without tension. Postoperatively, 8 sessions of adjuvant therapy elicited marked clinical improvements in persistent nasal tip dimpling and contracture, septal deviation, and warping from the incomplete recovery of nasal contracture after revision surgery. In conclusion, our pre- and postoperative adjuvant therapies using PDRN and invasive bipolar RF remarkably improved the therapeutic outcomes of revision rhinoplasty and septoplasty for contracted skin of the nose without major side effects.

Kaposi's varicelliform eruption is a cutaneous eruption caused by the herpes simplex virus and a few other viruses that infect persons with pre-existing dermatosis such as atopic dermatitis. We report the case of a 56-year-old man who was treated with the mammalian target of rapamycin inhibitor, everolimus, for metastatic renal cell carcinoma. He presented with painful, umbilicated vesicles and pustules on his face, genital region, forearms, and legs suggestive of Kaposi's varicelliform eruption. He did not have a history of any visceral viral disease and pre-existing dermatosis. The diagnosis was based on the clinical features. He was treated with acyclovir for 7 days, with improvement of his skin lesions. We discuss the clinical manifestations of the Kaposi varicelliform-like eruption in an immunocompromised patient treated with everolimus.

Herpes simplex virus (HSV) infection is a possible pathogenic factor in Behçet's disease (BD). Using proteomics analysis, this study detected a target HSV protein. Serum IgA and IgG reactivities against the identified protein were evaluated in patients with BD and in BD-like mice. A total of 4 protein bands generated by immunoprecipitation were analysed by proteomics, and HSV UL48 was commonly found in both IgA- and IgG-reactive protein bands. Compared with controls, patients with BD and BD-like mice exhibited higher titres of IgA reacting with recombinant HSV UL48 protein. Further proteomics analysis revealed that human heat shock cognate 71 kDa protein (Hsc71) is a cross-reacting target antigen against anti-HSV UL48 antibody. In addition, our data demonstrated a very strong association between serum IgG reactivity against recombinant human Hsc71 and recombinant HSV UL48 in patients with BD. We suggest that HSV infection and impaired human Hsc71 activity may be associated with the activation of autoreactive lymphocytes. [ABSTRACT FROM AUTHOR]

Hypertrophie scars (HS) result from an imbalance between collagen biosynthesis and matrix degradation during wound healing. In this study a proteomics approach was used to compare the protein profiles of skin tissue obtained from patients with HS and healthy controls. One of the epidermal proteins, galectin-7 was markedly down-regulated in HS. Serum levels of galectin-7 in 27 patients with HS were less than 1/3 of those in 15 healthy controls. Tissue protein expression was subsequently evaluated using immunohistochemical staining on HS tissue and on serially-obtained control tissue during wound healing. Weaker galectin-7 immunoreactivity was detected along the cytoplasmic membrane of basal and suprabasal cells in samples from HS. In addition, galectin-7 was stained in the extracellular space of the upper papillary dermis in HS tissue. Ablative laser treatment, used to induce wound healing of healthy control tissue, demonstrated marked galectin-7 expression at the cytoplasmic membrane on days 3,5,14 and 21. Pronounced galectin-7 staining at the upper papillary dermis was detected on days 1, 3 and 10. These results suggest that the differences in galectin-7 expression and subcellular and extracellular distribution may be crucially involved in the pathogenic process of HS. [ABSTRACT FROM AUTHOR]

Purpose: Behçet's disease (BD) theoretically affects all sizes and types of blood vessels and results in multi-organ involvement. However, renal BD has not been fully characterized, though the kidneys are histologically rich in blood vessels. Materials and Methods: A total of 2007 patients who fulfilled the diagnostic criteria for BD were enrolled in this study. We reviewed the medical records and test results of the BD patients and used univariate and multivariate logistic regression analyses to determine the clinical significance of renal involvement in BD. Results: Among the 2007 BD patients, we noted hematuria in 412 (20.5%) and proteinuria in 29 (1.4%). Univariate analysis showed that the BD patients with hematuria were predominantly female and older, had higher erythrocyte sedimentation rates (ESRs), and more frequently presented with genital ulcerations. BD patients with proteinuria had higher ESR levels compared to BD patients without proteinuria. In the multivariate analysis, age, sex, and ESR were found to be significantly associated with hematuria in BD patients, whereas only ESR was associated with proteinuria in BD patients. We also found that IgA nephropathy was the most common pathologic diagnosis in 12 renal BD patients who underwent renal biopsies. Conclusion: We suggest that routine urinalysis and serum renal function tests be performed for the early detection of renal BD, especially in older female BD patients with recurrent hematuria, high ESR levels, and frequent genital ulcers, as well as in BD patients with proteinuria and high ESR levels. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine the prevalence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in a large group of Korean patients with Behçet's disease (BD), with and without joint involvement, and to compare these findings with the prevalences of anti-CCP antibodies in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Materials and Methods: We tested 189 patients with BD, 105 with RA, and 36 with SLE for anti-CCP antibodies and IgM rheumatoid factor in serum. We reviewed the medical records of patients with BD to investigate their personal and clinical characteristics as well as their laboratory test results. Results: Anti-CCP antibodies were detected in seven of the 189 BD patients (3.7%), at a mean titer of 30.6±44.4 U/mL, in 86 of the 105 RA patients (81.9%) with a mean titer of 198.8±205.7 U/mL, and in nine of the 36 SLE patients (25%) with a mean titer of 180.4±113.9 U/mL. One of the seven anti-CCP-positive BD patients fulfilled the diagnostic criteria for both BD and RA. Five of the seven anti-CCP-positive BD patients (71.4%) had polyarticular joint involvement, and the other two patients (28.6%) had oligoarticular involvement. Conclusion: We determined the prevalence of anti-CCP antibodies in a large group of Korean BD patients with and without joint involvement. Negative anti-CCP test in patients with BD may help to differentiate BD from RA and SLE, all of which present with similar clinical features. [ABSTRACT FROM AUTHOR]

Behçet's disease is a chronic relapsing multisystemic inflammatory disorder characterized by four major symptoms (oral aphthous ulcers, genital ulcers, skin lesions, and ocular lesions) and occasionally by five minor symptoms (arthritis, gastrointestinal ulcers, epididymitis, vascular lesions, and central nervous system symptoms). Although the etiology of Behçet's disease is still unknown, there have been recent advances in immunopathogenic studies, genome-wide association studies, animal models, diagnostic markers, and new biological agents. These advances have improved the clinical understanding of Behçet's disease and have enabled us to develop new treatment strategies for this intractable disease, which remains one of the leading causes of blindness. [ABSTRACT FROM AUTHOR]

Background Acquired bilateral nevus of Ota-like macules (ABNOM), or Hori's nevus, is a common dermal melanocytic hyperpigmentation in Asians. Aim To describe the effect of 1064-nm Q-switched Nd:YAG laser (QSNY) with low fluence in South Korean patients with ABNOM. Methods Fifteen South Korean patients (13 women and two men; mean age, 33.2 years; range, 26–52 years; Fitzpatrick skin type IV), clinically diagnosed with ABNOM, and treated using 1064-nm QSNY with low fluence, were enrolled in this study. Patients were treated with 1064-nm QSNY using a MedLite C6™ (HoyaConBio Inc., Fremont, CA, USA) at 1–2-week intervals. The laser settings were 2.2–2.6 J/cm2 using a 6-mm spot size, followed by 4–6 J/cm2 using a 4-mm spot size. Results The median number of QSNY treatment sessions was 11 (range, 10–15). Follow-up results 2 months after the final treatment revealed that seven of the 15 patients (46.7%) demonstrated clinical improvement of 76–100%, and five (33.3%) of 51–75%. Three patients showed moderate clinical improvement between 26% and 50%. Post-therapy dyschromia, including hypo- and hyperpigmentation, was not observed. Conclusion We suggest that QSNY with low fluence provides an easy-to-perform, low-downtime, effective treatment algorithm in certain cases of ABNOM in Asian patients. [ABSTRACT FROM AUTHOR]

BACKGROUND Current treatments for acne scars and enlarged facial pores have shown limited efficacy. OBJECTIVE To evaluate the efficacy and safety of the fractional photothermolysis system (FPS) with dynamic operating mode on acne scars and enlarged pores. MATERIALS AND METHODS Twelve patients with mild to moderate atrophic acne scars and enlarged pores were included in this study. Three sessions of FPS treatment were performed for acne scars and facial pores monthly. Two blinded dermatologists who compared before and after photos based on a quartile grading scale conducted objective clinical assessments of acne scar– and facial pore–treated areas. We took a biopsy immediately after one treatment with the laser from one of the authors to assess the histologic effects of the laser on facial pores. RESULTS Follow-up results at 4 months after the last treatment revealed that, of the 12 patients, for acne scars, five demonstrated clinical improvements of 51% to 75% and three demonstrated improvements of 76% to 100%, and for facial pores, five demonstrated moderate clinical improvements of 26% to 50% and three demonstrated improvements of 76% to 100%. Side effects, including pain, post-treatment erythema, and edema, were resolved within 1 week. CONCLUSION We suggest that the FPS may provide a new treatment algorithm in some cases with acne scars and enlarged pores. Considering the lack of placebo-controlled, split-face design of our study, optimized, prospective studies should be conducted to fully assess the efficacy of FPS with dynamic operating mode. [ABSTRACT FROM AUTHOR]

BACKGROUND. Whole-body 18F-fluorodeoxyglucose positron emission tomography (FDG PET) has been used for whole-body imaging modality in detecting malignancy in clinical oncology. However, only a few reports of FDG PET in skin cancers have been described, except for melanoma and lymphoma. OBJECTIVE. To report on the usefulness of FDG PET as a baseline workup study for patients with cutaneous squamous cell carcinoma (SCC). METHODS. There were 12 cases of SCC (9 cases with high-risk SCC). Of the 12, FDG PET was performed for staging in 11 patients and for restaging in 1 patient 1 year after wide excision. RESULTS. Primary lesions were detected in nine cases (83.3%), lymph node involvement in three cases (25.0%), and distant organ (lung) involvement in one case (8.3%). In one patient whose primary lesion was positive, stomach cancer with involvement of adrenal glands, omentum, and lymph nodes was incidentally detected. All of the patients with high-risk SCC showed FDG uptakes of the primary lesions, and the patients with FDG uptakes in lymph nodes and distant organ had high-risk SCC. CONCLUSION. There have been no comparative studies on the cost-effectiveness between sentinel lymph node biopsy and FDG PET in SCC patients. However, considering the noninvasiveness and thoroughness in checking the whole body, including distant organs, FDG PET may have clinical value as a baseline workup study for patients with high-risk SCC. [ABSTRACT FROM AUTHOR]

Many reports have described the presence of alopecia areata (AA) associated with other autoimmune diseases, which support the autoimmune nature of AA. Additionally, AA has been reported in association with malignancy as a paraneoplastic symptom. In this report, we describe three patients with diffuse large B-cell lymphoma, alveolar soft part sarcoma, and cavernous sinus arteriovenous fistula with embolization treatment, respectively, who characteristically presented with rectangular-patterned occipital AA. [ABSTRACT FROM AUTHOR]

The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

The article presents a case study of a young adult South Korean man who reported with an asymptomatic pedunculated nodule on the ventral side of the penile shaft. He cited that the lesion developed from a skin-colored papule and the resulting nodule had been hard on palpitation. His physical and examination results reveal the nodule to be a tumor. The article discusses the frequency, histopathology, and pathogenesis of hyalinizing Spitz nevus.

A letter to the editor is presented which discusses the Type 1 neurofibromatosis associated with asymptomatic cystic malformations of central nervous system (CNS).

Adverse cutaneous reaction to vitamin K manifests in sclerodermatous or erythematous plaque-like reactions. Most of the cases with erythematous plaque-like dermatitis arising at the site of intramuscular vitamin K injection were recalcitrant and did not respond to various attempts with topical and intralesional corticosteroid. The objective was to describe a 25-year-old woman with recalcitrant adverse reaction owing to vitamin K who was successfully treated with pulsed dye laser. Two consecutive pulsed dye laser treatments were performed 3 weeks apart with 450-μec pulse duration, 585-nm pulse width, and fluence of 5 and 7 J/cm2, respectively, using a 7-mm handpiece. One week after the second treatment, her skin lesion was cleared and she was followed without recurrence for 7 months. Although the precise mechanism remains yet to be proven, we have demonstrated successful treatment of localized adverse cutaneous reaction to vitamin K in one patient with the pulsed dye laser. JEANNE JUNG, MD, SUNG BIN CHO, MD, AND KEE YANG CHUNG, MD, PHD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [ABSTRACT FROM AUTHOR]

The article describes the case of a 9-year-old Korean girl diagnosed with segmented heterochromia in a scalp hair which is a hair condition caused by alternating eumelanin and pheomelanin. Topics discussed include the results of several tests performed on the patient including Wood's lamp, laboratory and transmission electron microscope analysis and segmented heterochromia as a rare pigmentary disorder.

The article presents a case study of a 38-year-old woman with Behcet's disease (BD) showing oral and genital ulcers and erythema skin lesions on the legs, diagnosed with tuberculous lymphadenopathy. The patient shows a positive response after one month on anti-tuberculous medication but treatment with colchinide and rebamipide is maintained due to oral ulcerations and arthritis. The article discusses BD as a multisystemic vasculitis that affects the small blood vessels.

A letter to the editor is presented in response to the article related to punctuate leucoderma after melasma treatment by M.J. Kim, J.S. Kim, and S.B. Cho.

The article presents a case study of a patient presented with multiple encrusted, erythematous ulcerations on her face. It states that the patient underwent carbon dioxide laser treatment for multiple seborrhoeic keratoses and lentigines at an outside clinic. It indicates that the patient was treated with systemic low-dose prednisolone and colchicine, and found improvement of skin lesions on both the face and forearm.

The article offers information on the treatment of enlarged facial pore with the use of chemical reconstruction of skin scars method. It notes that the method shortens the treatment time and raises patients' satisfaction. It discusses the use of a curved mosquito forceps to slow the flow rate of trichloroacetic acid (TCA) from the needle tip.