Chang-Hun Huh

Rapid healing and reduced erythema after ablative fractional carbon dioxide laser resurfacing combined with the application of autologous platelet-rich plasma.

BACKGROUND Fractional carbon dioxide laser resurfacing (FxCR) has shown considerable efficacy in reducing wrinkles, although complications such as scarring and prolonged erythema are more common and down‐time is longer than with nonablative laser treatment. Platelet‐rich plasma (PRP), a high concentration of platelets in a small volume of plasma, is known to enhance tissue healing. OBJECTIVE To evaluate the benefits of PRP in the wound healing process after FxCR. MATERIALS AND METHODS Twenty‐five subjects were treated with FxCR on the bilateral inner arms. PRP was prepared from 10 mL of whole blood and applied on a randomly allocated side, with normal saline being used as the contralateral control. Transepidermal water loss (TEWL) and skin color were measured on both sides. Skin biopsies were also taken from five subjects on day 28. RESULTS Significantly faster recovery of TEWL was seen on the PRP‐treated side. The erythema index and melanin index on the PRP‐treated side were lower than on the control side. Biopsy specimens from the PRP‐treated side showed thicker collagen bundles than those from the control side. CONCLUSION Application of autologous PRP is an effective method for enhancing wound healing and reducing transient adverse effects after FxCR treatment. The authors have indicated no significant interest with commercial supporters.

Does facial sebum excretion really affect the development of acne

Background  It is generally accepted that the severity of acne is correlated with facial sebum secretion. However, previous studies on the relation between seborrhoea and the development of acne did not consider topographical differences in facial sebum secretion and used relatively vague acne severity grading systems.

Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device-controlled multicenter trial.

Background Androgenetic alopecia (AGA) is a common disorder affecting men and women. Finasteride and minoxidil are well‐known, effective treatment methods, but patients who exhibit a poor response to these methods have no additional adequate treatment modalities. Objective To evaluate the efficacy and safety of a low‐level light therapy (LLLT) device for the treatment of AGA. Methods This study was designed as a 24‐week, randomized, double‐blind, sham device–controlled trial. Forty subjects with AGA were enrolled and scheduled to receive treatment with a helmet‐type, home‐use LLLT device emitting wavelengths of 630, 650, and 660 nm or a sham device for 18 minutes daily. Investigator and subject performed phototrichogram assessment (hair density and thickness) and global assessment of hair regrowth for evaluation. Results After 24 weeks of treatment, the LLLT group showed significantly greater hair density than the sham device group. Mean hair diameter improved statistically significantly more in the LLLT group than in the sham device group. Investigator global assessment showed a significant difference between the two groups, but that of the subject did not. No serious adverse reactions were detected. Conclusion LLLT could be an effective treatment for AGA.

5 mg/day finasteride treatment for normoandrogenic Asian women with female pattern hair loss.

Background  Various treatments have been attempted for female pattern hair loss (FPHL), including topical minoxidil, oral antiandrogen and finasteride. But, there is no consensus on the standard treatment options. Clinical efficacy of finasteride in treating FPHL is still in controversy, but there is a tendency to high dose finasteride, which is more effective than lower dose.

Proliferation and differentiation of the keratinocytes in hyperplastic epidermis overlying dermatofibroma: immunohistochemical characterization.

Epidermal changes overlying dermatofibromas (DFs) have been described as ranging from psoriasiform simple hyperplasia to basaloid hyperplasia sometimes morphologically indistinguishable from superficial basal cell carcinoma (BCC). To characterize epidermal hyperplasia overlying DFs and to determine its association with the disease process, we examined 30 cases of DF showing hyperplastic epidermis. We used nine immunohistochemical markers associated with keratinocyte proliferation or differentiation. In DFs, the dermal metallothionein (MT) expression and immunophenotypic changes with regard to epidermal differentiation varied depending on the stage of lesional evolution of the DFs. Immunostaining for epidermal growth factor receptor (EGFR), MT, and keratin 6 (K6) increased in simple hyperplastic epidermis (SHE) overlying DFs (n = 11), whereas it gradually diminished in basaloid hyperplastic epidermis (BHE) overlying DFs (n = 19). In SHE, there was a significant increase in K14 expression. Among 19 BHE cases, 12 showed premature expression of involucrin and delayed appearance of K1 along with aberrant expression of K14. Conversely, the remaining 7 BHE cases showed a pattern of involucrin and K1 similar to that of normal skin coinciding with decreased or absent dermal MT expression. Loricrin and filaggrin expression in all DFs was the same as that of normal skin. Based on the sparse positivity of Ki-67 in the hyperplastic epidermis overlying DFs, we found that the biologic ability of BHE and SHE was not apparent in the hyperproliferative state observed in psoriasis and BCC. These results suggest that the dermal fibrohistiocytic process may trigger the induction of SHE overlying DFs by an unknown mechanism and then mediate both the abnormal keratinocyte differentiation and the transformation of SHE to BHE through the evolution of the dermal lesions.

Low-dose 1064-nm Q-switched Nd:YAG laser for the treatment of melasma

Abstract 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.

Indole‐3‐acetic acid: A potential new photosensitizer for photodynamic therapy of acne vulgaris

ALA (5‐aminolevulinic acid) photodynamic therapy (PDT) is a new treatment option for acne. However, it needs a relatively long incubation period and adverse effects are common. Indole‐3‐acetic acid (IAA) is not toxic by itself but produces free radicals with ultraviolet B. In this study we examined the potential of IAA as a photosensitizer for acne treatment.

Efficacy and safety of liposome-encapsulated 4-n-butylresorcinol 0.1% cream for the treatment of melasma: A randomized controlled split-face trial

Melasma is an acquired pigmentary disorder that most commonly occurs in women of child‐bearing age. Melasma is therapeutically challenging, and most commercially available hypopigmenting agents include tyrosinase inhibitors, which regulate the rate‐limiting step of melanogenesis. 4‐n‐Butylresorcinol has received considerable attention as a novel hypopigmenting agent in the last 15 years because it has an inhibitory effect against tyrosinase and tyrosinase‐related protein‐1. However, the hypopigmenting effect of 4‐n‐butylresorcinol in human subjects has only been shown in a few studies. Liposome encapsulation is known to improve stabilization and enhance penetration of the product. Therefore, this study was conducted to evaluate the hypopigmenting efficacy and safety of liposome‐encapsulated 4‐n‐butylresorcinol 0.1% cream in patients with melasma. This was a randomized, double‐blind, vehicle‐controlled and split‐face comparison study. Twenty‐three patients with a clinical diagnosis of melasma were included. 4‐n‐Butylresorcinol 0.1% cream or vehicle was applied to each side of the face twice daily for 8 weeks. Clinical and photographic evaluations, Mexameter measurements and assessment of patient satisfaction and side‐effects were performed at baseline, 4 and 8 weeks. All subjects completed the study. Mexameter measurements demonstrated that the melanin index of the 4‐n‐butylresorcinol‐treated side showed a significant decrease when compared with the vehicle‐treated side after 8 weeks (P = 0.043). No adverse reactions were observed throughout the study. Subjectively, 4‐n‐butylresorcinol was considered to be efficacious in more than 60% of the patients after 8 weeks of treatment. In conclusion, liposome‐encapsulated 4‐n‐butylresorcinol 0.1% cream was well tolerated and showed significant higher efficacy than vehicle alone for the treatment of melasma.

Protective effects of EGCG on UVB-induced damage in living skin equivalents.

In this study, we evaluate the effects of (−)-epigallocatechin-3-gallate (EGCG) on ultraviolet B (UVB)-irradiated living skin equivalents (LSEs). Histologically, UVB irradiation induced thinning of the LSE epidermis, whereas EGCG treatment led to thickening of the epidermis. Moreover, EGCG treatment protected LSEs against damage and breakdown caused by UVB exposure. Immunohistochemically, UVB-exposed LSEs expressed p53, Fas, and 8-hydroxy-deoxyguanosine (8-OHdG), all of which are associated with apoptosis. However, EGCG treatment reduced the levels of UVB-induced apoptotic markers in the LSEs. In order to determine the signaling pathways induced by UVB, Western blot analysis was performed for both c-Jun NH2-terminal kinase (JNK) and p38 mitogen-activated protein kinase (MAPK), which are associated with UVB-induced oxidative stress. UVB activated JNK in the epidermis and dermis of the LSEs, and EGCG treatment reduced the UVB-induced phosphorylation of JNK. In addition, p38 MAPK was also found to have increased in the UVB-exposed LSEs. Also, EGCG reduced levels of the phosphorylation of UVB-induced p38 MAPK. In conclusion, pretreatment with EGCG protects against UVB irradiationvia the suppression of JNK and p38 MAPK activation. Our results suggest that EGCG may be useful in the prevention of UVB-induced human skin damage, and LSEs may constitute a potential substitute for animal and human studies.

Copper–GHK increases integrin expression and p63 positivity by keratinocytes

Glycyl-l-histidyl-l-lysyl (GHK) possesses a high affinity for copper(II) ions, with which it spontaneously forms a complex (copper–GHK). It is well known that copper–GHK plays a physiological role in the process of wound healing and tissue repair by stimulating collagen synthesis in fibroblasts. This study was conducted to investigate the effects of copper–GHK on keratinocytes. Proliferative effects were analyzed and hematoxylin and eosin staining and immunohistochemistry were conducted to evaluate the effects of copper–GHK in skin equivalent (SE) models. In addition, western blotting was performed. In monolayer cultured keratinocytes, copper–GHK increased the proliferation of keratinocytes. When the SE models were evaluated, basal cells became cuboidal when copper–GHK was added. Immunohistochemical analysis revealed that copper–GHK increased proliferating cell nuclear antigen (PCNA) and p63 positivity. Furthermore, the expression of integrin α6 and β1 increased in SE models, and these results were confirmed by Western blotting. The results of this study indicate that treatment with copper–GHK may increase the proliferative potential of basal keratinocytes by modulating the expression of integrins, p63 and PCNA. In addition, increased levels of p63, a putative stem cell marker of the skin, suggests that copper–GHK promotes the survival of basal stem cells in the skin.