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Background: Scalp-related symptoms such as dandruff and itching are common with diverse underlying etiologies. We previously proposed a novel classification and scoring system for scalp conditions, called the scalp photographic index (SPI); it grades five scalp features using trichoscopic images with good reliability. However, it requires trained evaluators.Aim: To develop artificial intelligence (AI) algorithms for assessment of scalp conditions and to assess the feasibility of AI-based recommendations on personalized scalp cosmetics.Methods: Using EfficientNet, convolutional neural network (CNN) models (SPI-AI) ofeach scalp feature were established. 101,027 magnified scalp images graded according to the SPI scoring were used for training, validation, and testing the model Adults with scalp discomfort were prescribed shampoos and scalp serums personalized according to their SPI-AI-defined scalp types. Using the SPI, the scalp conditions were evaluated at baseline and at weeks 4, 8, and 12 of treatment.Results: The accuracies of the SPI-AI for dryness, oiliness, erythema, folliculitis, and dandruff were 91.3%, 90.5%, 89.6%, 87.3%, and 95.2%, respectively. Overall, 100 individuals completed the 4-week study; 43 of these participated in an extension study until week 12. The total SPI score decreased from 32.70 ± 7.40 at baseline to 15.97 ± 4.68 at week 4 (p < 0.001). The efficacy was maintained throughout 12 weeks.Conclusions: SPI-AI accurately assessed the scalp condition. AI-based prescription of tailored scalp cosmetics could significantly improve scalp health. [ABSTRACT FROM AUTHOR]

Integrating organic light-emitting diodes (OLEDs) with light therapy can significantly advance biomedical applications by offering non-invasive, precise, and customizable treatments. Developing innovative device designs and performing cellular tests is essential to assess the safety and effect of OLED-based light therapies in dermatology. As such, a wearable OLED medical device prototype has been created for easy attachment to the body, ensuring consistent exposure to skin injuries due to its comfortable fit and user-friendly operation. Moreover, it has demonstrated effectiveness in enhancing wound healing, as indicated by a max 23% increase in fibroblast proliferation at the cellular level. [ABSTRACT FROM AUTHOR]

There has been no validated tool for objectively quantifying the overall condition and characteristics of the scalp. This study aimed to establish and validate a new classification and scoring system for evaluating scalp conditions. The Scalp Photographic Index (SPI) using a trichoscope grades five features of scalp conditions (dryness, oiliness, erythema, folliculitis, and dandruff) on a score of 0–3. To evaluate the validity of SPI, SPI grading was performed by three experts on the scalps of 100 subjects along with a dermatologist's assessment of the scalps and a scalp-related symptom survey. For reliability assessment, 20 healthcare providers performed SPI grading for the 95 selected photographs of the scalp. SPI grading and the dermatologist's scalp assessment showed good correlations for all five scalp features. Warmth showed a significant correlation with all features of SPI and the subjects' perception of a scalp pimple had a significant positive correlation with the folliculitis feature. SPI grading demonstrated good reliability with excellent internal consistency (Cronbach's α = 0.90) and strong inter- and intra-rater reliability (Kendall's W = 0.84, ICC(3,1)=0.94). SPI is an objective, reproducible, and validated numeric system for classifying and scoring scalp conditions. [ABSTRACT FROM AUTHOR]

Neuronox® has not yet been investigated for its efficacy and safety in the treatment of lateral canthal lines (LCL). This study was a randomized, double-blind, active drug controlled, multicenter, 16 week, Phase I/III study designed to determine the non-inferiority of Neuronox® compared to onabotulinumtoxin A (ONA) in the treatment of moderate to severe LCL. Thirty subjects in Phase I and 220 subjects in Phase III were randomized in a 1:1 ratio to receive a single treatment (24 U) of either Neuronox® or ONA. The primary endpoint of the Phase III study was the responder rate according to the proportion of subjects achieving Grade 0 (none) or 1 (mild) from 2 (moderate) or 3 (severe) in LCL severity at maximum smile as assessed by the investigators at Week 4. Additional efficacy endpoints and safety endpoints (adverse events) were also evaluated. The primary endpoint was achieved as the proportion of responders was 83% for both Neuronox® and ONA, thus, supporting the non-inferiority of Neuronox® compare to ONA. The two groups also showed no statistical differences in safety analyses. Treatment of moderate to severe LCL with Neuronox® was effective and well-tolerated. [ABSTRACT FROM AUTHOR]

Treatment of periorbital wrinkles is a challenging task because of its anatomical significance and delicate nature. The aim of this study was to evaluate the efficacy and safety of a microneedle monopolar radiofrequency (RF) device for treating periorbital wrinkles. This retrospective study involved 21 patients who were treated for periorbital wrinkles using a RF device. The type of microneedle used, clinical photography, VISIA wrinkle score, and adverse events were collected from the medical chart. Two independent dermatologists assessed the photographs. There were 18 female and 3 male patients with a mean age of 50.24 years. The severity of wrinkle was improved according to photographic assessment and VISIA wrinkle score at 6-month post-treatment. When 21 sites treated with a long microneedle (LMN, 1.5 mm) and the other 21 sites treated with a short microneedle (SMN, 0.8 mm) were compared, significant improvement in the VISIA wrinkle score was observed only in those treated with the LMN. No serious adverse events, including scarring and postinflammatory hyperpigmentation, occurred. We demonstrated the efficacy and safety of the microneedle monopolar RF device in treating periorbital wrinkles. The LMN was superior to the SMN in reducing VISIA wrinkle score. [ABSTRACT FROM AUTHOR]

Background: Several local flaps have been introduced for the reconstruction of small-to-medium-sized nasal supratip defects. Objective: To evaluate the outcome of reconstructing supratip defects using tangential advancement flaps from the vertical alar groove tissue. Methods and materials: Medical records of 20 patients who underwent supratip reconstruction using this flap between January 2012 and July 2018 were retrospectively analyzed. The postoperative photographs were assessed by three dermatologists using a four-scale investigator's global assessment. Results: The male-to-female ratio was 9:11, with a mean age of 72.6 years (range, 56–89 years). In all 20 cases, defects were caused by a wide local excision of non-melanoma skin cancer on the nose. The mean diameter of the defects was 1.20 cm (ranging from 0.5 to 1.9 cm). The mean follow-up period was 14.0 months (ranging from 0.5 to 48 months). Excellent or good surgical outcome was reported in 95% of patients. Conclusions: Creating a tangential advancement flap using the vertical alar groove tissue is a simple, single-stage procedure with excellent surgical outcome. It may be useful in the reconstruction of supratip defects with a diameter of less than 2 cm. [ABSTRACT FROM AUTHOR]

Background: Pentasodium tetracarboxymethyl palmitoyl dipeptide-12 (PTPD-12), a newly-synthesized peptide, enhances the autophagy activity, ultimately managing inflammation. Objective: To determine the effect of a new moisturizer containing PTPD-12 as the treatment of mild-to-moderate atopic dermatitis (AD). Methods: In this double-blind, randomized, placebo-controlled trial, 43 patients with mild-to-moderate AD were randomly assigned to either the PTPD-12 or control groups. Evaluations were performed at baseline, week 2, and week 4, including SCORing Atopic Dermatitis (SCORAD) index score, corneometry, trans-epidermal water loss (TEWL), visual analog scale (VAS) for pruritus, 7-point investigator's global assessment (IGA), and collection of adverse events. Results: The PTPD-12 group showed significant improvement with respect to SCORAD score, skin hydration, TEWL, and pruritus at weeks 2 and 4 when compared with baseline. Although the control group showed significant improvement regarding the SCORAD score and skin hydration, no significant change in TEWL or pruritus was demonstrated throughout the study. The mean changes in the SCORAD index score, skin hydration, TEWL, pruritus, and number of patients with improvement in IGA were not statistically different between the two groups. Conclusion: The moisturizer with autophagy-stimulating property provides a good therapeutic option to mild-to-moderate atopic dermatitis by contributing to skin barrier restoration and control of inflammation. [ABSTRACT FROM AUTHOR]

Background: A few anecdotal case reports demonstrated that tofacitinib improved nail changes associated with AA. Objective: To investigate nail changes in patients with AA treated with tofacitinib and evaluate the relationship between nail and hair responses to tofacitinib. Methods: This is a retrospective study of 33 adult patients with moderate-to-severe AA treated with oral tofacitinib monotherapy for at least 4 months. Results: Fifteen patients had nail involvement and demonstrated more severe hair loss than those without nail involvement (p = .040). However, there was no significant difference in hair regrowth between two groups. Of 15 patients with nail involvement, 11 (73.3%) showed improvement regardless of type of nail change; the first improvement was observed at a median of 5 months (range, 1-11) after administration. Nail improvement was associated with neither initial severity of hair loss nor hair response to tofacitinib. Nail improvement tended to occur later than hair regrowth. Conclusions: Oral tofacitinib monotherapy improves nail involvement associated with AA. Nail involvement is not a poor prognosis factor in hair regrowth with tofacitinib treatment and there is no evident relationship between nail and hair responses. [ABSTRACT FROM AUTHOR]

Background: While the Q-switched Alexandrite laser (QSAL) and the Q-switched neodymium: yttrium-aluminum-garnet (QSNY) laser have been widely used in treating nevus of Ota, few studies compared them. Objective: To compare the efficacies of the QSAL and the QSNY laser in the treatment of nevus of Ota in Korean patients. Methods and materials: A retrospective multicenter study was conducted in 76 patients with nevus of Ota. Thirty-one patients were treated with a QSAL (5.5-8.0 J/cm2, 4-mm spot size) and 45 patients were treated with QSNY laser (6.0-12.0 J/cm2, 2-mm spot size). Treatment outcomes were categorized into five grades and the results were compared with the relevant variables taken into account using multivariate logistic regression analysis. Results: QSAL treatment was more likely to achieve a better response compared with that with QSNY laser treatment. The odds ratio of achieving an excellent response, compared with the odds ratio of having a poor response, was 12.213-times more likely when a QSAL was used than when a QSNY laser was used ( p = 0.026). Conclusion: The QSAL tends to be more efficient than the QSNY laser in the treatment of nevus of Ota in Korean patients. Further controlled, prospective comparison studies are needed. [ABSTRACT FROM AUTHOR]

Background: This is the first well-controlled study of the combined use of botulinum toxin type A (BoNT-A) and botulinum toxin type B (BoNT-B) for hyperkinetic lines in forehead. Objective: To evaluate the effectiveness and safety of a mixture of BoNT-A and BoNT-B with that of equipotent BoNT-A alone for treating patients with forehead rhytides. Materials and methods: Fourteen patients with forehead wrinkles completed this clinical study. On day 0, patients received a mixture of BoNT-A (5 U) and B (500 U) on one side of the forehead and BoNT-A (10 U) symmetrically on the other side. Clinical evaluation was made at the beginning and at weeks 1, 2, 4, 8, 12, and 16. Therapeutic efficacy was evaluated using clinical improvement scale by investigators and the subjective wrinkle assessment by patients. Results: According to investigator assessment, the differences between the average improvement scores of the two differently treated sides were not statistically significant at all follow-up visits. Moreover, the plateau of the clinical benefit was achieved at week 4. Conclusion: We observed the equivalent efficacy in the mixture of both toxins and BoNT-A alone. [ABSTRACT FROM AUTHOR]

Background: Melasma is a common acquired pigmentary disorder which is sometimes hard to treat with conventional methods. Various kinds of modalities have been applied for the treatment of melasma but none shows constantly good results. Objectives: In this study, we would like to know the effect of low-dose 1064-nm Q-switched Nd:YAG laser (QSNYL) on melasma and want to evaluate the changes of skin after laser treatment. Methods: Twenty melasma patients were enrolled. Two regions were evaluated from each patient; a total of 40 sites. The 1064-nm QSNYL at fluences of 2.0–3.5 J/cm2 was used to treat the whole face, including the melasma lesions. The fluence was adjusted individually and increased until erythema was developed on the laser-treated area. The treatment was performed five times with a 1-week interval. Non-invasive measuring methods, including a chromatometer, mexameter, cutometer, visioscan and a corneometer, were used before and after treatment. Results: The L-value from the chromatometer, which reflects the lightness of skin, was increased (0.86 ± 1.67, p < 0.05). The melanin index from the mexameter was significantly decreased (–28.23 ± 28.21, p < 0.001). The SEw value from the visioscan, which reflects the degree of wrinkling, decreased (–5.80 ± 0.59, p = 0.040). None of the other measurement parameters showed significant changes. Conclusions: Low-dose 1064-nm QSNYL appears to be an effective treatment modality for melasma. [ABSTRACT FROM AUTHOR]

Background: Patients with atopic dermatitis show a defective barrier function. In atopic skin, ceramide is significantly decreased and the secretion of lamellar bodies is also impaired. To mimic lamellar bodies, we prepared lipid granules composed of ceramide, fatty acids and cholesterol. Because these lipid granules contain multiple lamellar structures, it is expected that they will have superior affinity to skin; hence, they should have a good moisturizing effect. This study was performed to evaluate the effects of moisturizer containing lipid granules on atopic dermatitis. Methods: Patients with mild atopic dermatitis ( n = 30, aged 5–19 years) were recruited and instructed to apply a moisturizer containing physiologic lipid granules for 4 weeks. The SCORing Atopic Dermatitis (SCORAD) score and general symptoms were evaluated. In addition, transepidermal water loss (TEWL) and stratum corneum (SC) hydration were also measured. Results: Twenty-nine patients completed the study. The SCORAD value decreased dramatically after 4 weeks of moisturizer application ( p = 0.000). The general symptoms of atopic dermatitis were also greatly improved. At baseline, most patients reported their symptoms as mild and moderate, but after 4 weeks 20 of the patients (69%) had no symptoms. The TEWL was not changed, but the SC hydration increased significantly ( p = 0.000). No significant adverse effects were observed. Conclusions: Moisturizer containing lipid granules effectively controlled atopic dermatitis. [ABSTRACT FROM AUTHOR]

Background: Although systemic cyclosporine appears to be one of the treatment options for chronic severe alopecia areata (AA), the high recurrence rates after discontinuation and side effects make cyclosporine a nominal agent for the treatment of AA. Objective: This study was designed to determine whether the combination therapy of cyclosporine and methylprednisolone could be an effective treatment for severe AA. Methods: A total of 46 patients with severe AA were treated with a combination of cyclosporine (200 mg twice daily, two 100 mg tablets) and methylprednisolone (24 mg twice daily for men, 20 mg twice daily for women, and 12 mg twice daily for children). The doses of methylprednisolone were diminished by 4 mg/day weekly, and the dose of cyclosporine was decreased gradually after cessation of administration of methylprednisolone. Results: Three (6.5%) of 46 patients discontinued the treatment due to side effects. Of the remaining 43 patients, 38 (88.4%) had significant hair regrowth and five (11.6%) were considered to be treatment failures. Nine (23.7%) relapsed during the observation period of 12 months. Conclusions: Although limited by its uncontrolled character, this study shows that combination therapy with cyclosporine and methylprednisolone may be a useful treatment for severe AA. [ABSTRACT FROM AUTHOR]

Plasma cell cheilitis is a rare, idiopathic mucosal condition. The treatment of plasma cell cheilitis is often disappointing. It is often resistant to various topical treatments. We present a 65-year-old woman who had a painful, eroded area on her lower lip, which responded poorly to various topical treatments. A biopsy revealed a band-like infiltration composed mainly of plasma cells in the dermis. She was diagnosed as having plasma cell cheilitis, and was successfully treated with 0.03% topical tacrolimus ointment. [ABSTRACT FROM AUTHOR]