Dae Hun Suh

The influence of dietary patterns on acne vulgaris in Koreans

The association between acne and food has been evaluated with inconsistent results. We enrolled 783xa0patients with acne and 502xa0control subjects. For the patients with acne, blood tests for insulin, insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), post prandial 2xa0hours blood glucose (PP2), and dehydroepiandrosterone sulphate (DHEAS) were performed. The acne patients were divided into an aggravated by food group (AF) and a not aggravated by food group (NAF). All participants were asked to fill out a questionnaire. The frequency of vegetables (yellow, green leafy, cruciferous) (P = .001) and fish (white flesh and green fish, blue tuna) ((P = .03) intake was significantly higher in the control group than in the acne group. Intake of instant noodles (P = .01), junk food (P = .002), carbonated drinks (P = .005), snacks (P = .001), processed cheeses (P = .04), pork (braised) (P = .02), pork (roast) (P < .001), chicken (fried) (P = .001), chicken (stewed) (P = .001), nuts (P = .002) and seaweed (P = .003) were significantly higher in the acne patients than in the controls. Intake of roast pork (P = .02), fried chicken (P < .02), and nuts (P = .03) was significantly higher in the AF than NAF. In addition, the regularity of inter-meal intervals (P < .001) and breakfast intake (P < .001) were significantly lower in the acne patients. IGF-1 and IGFBP-3 showed sexual differences. This study also showed that a high glycemic load diet, dairy food intake, high fat diet, and iodine in Korean foods appear to play a role in acne exacerbation. In addition, irregular dietary patterns were found to aggravate acne.

Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients.

Oral isotretinoin is a highly effective agent for the treatment of moderate to severe acne, but ever since oral isotretinoin was introduced as a modality for acne, the relationship between oral isotretinoin therapy and psychiatric problems, especially depression, has been controversial. The purposes of this study were to know the acute effects of oral isotretinoin therapy on psychiatric symptoms and to investigate the relationships among them, which have not been reported in the published work. This cohort study included 38 acne patients who started oral isotretinoin therapy. Individual patients were examined before administering oral isotretinoin and 2 and 8 weeks after commencement. Acne severity was graded using the Leeds revised acne grading system. Acute psychiatric effects of oral isotretinoin were assessed using a questionnaire authorized by two psychiatrists. This questionnaire included assessments of acne‐related quality of life (Assessment of the Psychological and Social Effects of Acne [APSEA]), depression (Becks depression inventory [BDI]), anxiety (Becks anxiety inventory [BAI]) and psychopathology (Symptomchecklist‐90‐revised [SCL‐90‐R]). Acne grading and APSEA showed similar change patterns. Both improved after 8 weeks of oral isotretinoin treatment. On the other hand, the severity of depression decreased after 2 weeks of treatment. A significant correlation was found between BDI and APSEA, but no correlation was found between BDI and acne grade. These results indicate that oral isotretinoin therapy alleviates depressive symptoms. Improvements in depression are directly related to acne‐related life quality improvements rather than to improvement in acne grade.

Nicotine-Enhanced Epithelial Differentiation in Reconstructed Human Oral Mucosa in vitro

Oral mucosal keratinocytes represent the cells that first encounter tobacco components. Therefore, tobacco-induced abnormal alteration of the mucosal keratinocytes may contribute to the development of oral white lesions. Nicotine is an ingredient of all tobacco products and pharmacologically the most active component of tobacco smoke. To clarify the effects of nicotine on the keratinization of oral mucosal and epidermal keratinocytes, we reconstructed artificial buccal mucosal and skin equivalents using keratinocytes and fibroblasts from noncornifying buccal mucosa and adult foreskin, respectively. The effect of nicotine on keratinization was assessed with morphology, immunohistochemistry and immunoblotting. Long-term treatment with nicotine for 2 weeks enhanced in a dose-dependent manner the expression of differentiation-specific proteins of oral mucosal keratinocytes on living oral mucosal equivalent and epidermal keratinocytes on living skin equivalent, respectively. The effect of nicotine on the cell viability was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay. Oral mucosal keratinocytes showed a higher resistance to nicotine toxicity than epidermal keratinocytes. Our results suggest that nicotine stimulates differentiation of both mucosal and epidermal keratinocytes, and this nicotine-induced abnormal differentiation may be associated with the development of oral white lesions.

Comprehensive outlook of in vitro tests for assessing skin irritancy as alternatives to Draize tests

In vitro alternative methods have been verified for the possibility to assess cutaneous irritancy because humans cannot be direct initial experimental subjects and animal experimentation could be forbidden in the near future. Many kinds of cell cytotoxicity assays have been tried, revealing their own advantages and limitations. Cell function-based tests have been used less frequently than cytotoxicity assays. Three-dimensional culture systems are promising because they are closer to the actual in vivo skin, and some of them are commercialized nowadays. The ultimate objective of in vitro irritancy tests, which is the high degree of correlation with human in vivo test results, has been accomplished in many experimental settings. Before applying these in vitro methods we must consider several points, including cell sources, irritant characteristics, exposure time, endpoint of experiment, extrinsic factors affecting irritation, etc. In vitro skin irritancy tests have been developed continuously, and in the future they could assume a heavy responsibility of estimating the irritancy in human skin in vivo.

Coexistence of disseminated superficial porokeratosis in childhood with congenital linear porokeratosis.

Abstract: Porokeratosis is a genodermatosis characterized by abnormal epidermal keratinization with the histologic finding of cornoid lamella. To date, five clinical variants have been identified. However, the coexistence of these variants in a single patient has been described only rarely. We report a 5‐year‐old girl with the simultaneous occurrence of porokeratotic lesions in linear and disseminated patterns. Linear lesions were detected at birth and the disseminated lesions developed at the age of 3 years. Histologically the lesions had cornoid lamella, which is typical of this condition.

A study of the efficacy of cleansers for acne vulgaris

Abstract Background: Acne treatments are sometimes expensive, and mild acne patients need some simpler form of treatment and, thus, the need for easier and cheaper ways of managing acne is increasing.Methods: An 8-week, double-blind, randomized clinical trial was conducted to determine whether cleansers are effective at producing clinical improvements in patients with acne vulgaris. A total of 13 acne patients applied cleanser A to one half of the face and cleanser B (cleanser A plus triclosan, salicylic acid, and azelaic acid) to the other half, twice daily.Results: The numbers of inflammatory and non-inflammatory lesions decreased on both sides. A rebound tendency was noted for cleanser A with respect to inflammatory lesions at 4 weeks post-discontinuation, whereas inflammatory lesions continued to decrease on sides treated with cleanser B during this period. However, non-inflammatory lesion counts were not significantly different in the two groups. Though patients were generally satisfied with both treatments, they were more satisfied with cleanser B. Moreover, histopathologic examinations showed a profound decrease in inflammatory reactions in the cleanser B group.Conclusion: These results show that acne cleansers reduced both inflammatory and non-inflammatory acne lesion counts, and might be helpful for acne treatment.

Evaluation of skin surface hydration in Korean psoriasis patients: a possible factor influencing psoriasis

Summary Psoriasis is recognized as a chronic, relapsing disorder of the skin, and its clinical course is influenced by various environmental factors. However, only a few articles have addressed the effect of low epidermal hydration status as an exacerbating factor of psoriasis. Our study was performed to investigate the relationship between subjective assessment and quantified data regarding dryness parameters in psoriasis patients. Seventy psoriasis patients were enrolled in our study. Subjective assessments were undertaken by evaluating the extent of involvement, erythema, scale and infiltration of individual lesions. Functional status of stratum corneum was evaluated by measuring electrical capacitance and conductance of the lesional and uninvolved skin of psoriatic patients. In addition, measurement of trans‐epidermal water loss was performed. The results showed poor hydration status and barrier function in involved psoriatic epidermis compared with the uninvolved skin. Subjective assessment showed fairly good correlation with the quantified values. In conclusion, the degree of dryness in psoriatic skin lesionsu2003−u2003which we presume to be one of the aggravating factors of psoriasisu2003−u2003seemed to be related to disease severity.

Clinical use of the Q-switched Nd:YAG laser for the treatment of acquired bilateral nevus of Ota-like macules (ABNOMs) in Koreans

BACKGROUND: There are still insufficient clinical reports about quality-switched Nd:YAG laser (QSNYL) in the treatment of acquired bilateral nevus of Otalike macules (ABNOMs) in Asians. OBJECTIVE: To analyze the efficacy and side-effect profiles of QSNYL treatment of ABNOMs in Korean skin. METHODS: A prospective study was designed to follow 10 Korean patients with ABNOMs through laser treatment until maximal eradication of the lesions had been achieved. RESULTS: Five patients (50%) with ABNOMs were treated with excellent or good results. The more treatments a patient underwent, the greater the possibility of improvement. There were no cases of persistent skin textural change or persistent erythema. CONCLUSION: The clinical data support QSNYL being a beneficial alternative tool for treating ABNOMs in brown skin. This is, to the best of the authors knowledge, the first report about laser treatment of ABNOMs using QSNNL.BACKGROUNDnThere are still insufficient clinical reports about quality-switched Nd:YAG laser (QSNYL) in the treatment of acquired bilateral nevus of Otalike macules (ABNOMs) in Asians.nnnOBJECTIVEnTo analyze the efficacy and side-effect profiles of QSNYL treatment of ABNOMs in Korean skin.nnnMETHODSnA prospective study was designed to follow 10 Korean patients with ABNOMs through laser treatment until maximal eradication of the lesions had been achieved.nnnRESULTSnFive patients (50%) with ABNOMs were treated with excellent or good results. The more treatments a patient underwent, the greater the possibility of improvement. There were no cases of persistent skin textural change or persistent erythema.nnnCONCLUSIONnThe clinical data support QSNYL being a beneficial alternative tool for treating ABNOMs in brown skin. This is, to the best of the authors knowledge, the first report about laser treatment of ABNOMs using QSNNL.

The use of Q-switched Nd:YAG laser in the treatment of superficial pigmented lesions in Koreans

AIM: There are still insufficient clinical reports concerning quality-switched Nd:YAG laser (QSNYL) in the treatment of superficial pigmented lesions in Asians. The purpose of this study was to analyse the efficacy and side effect profiles of QSNYL-assisted pigment removal in brown skin. METHODS: A total of 71 patients, presenting a wide gamut of superficial epidermal lesions, were treated with QSNYL. Clinical responses were assessed by comKeywords: paring photographs that were taken serially in every treatment. RESULTS: Treatment using the QSNYL is reported individually for the various superficial pigmented lesions in the skin of Korean patients. CONCLUSION: QSNYL may be a beneficial alternative tool for the treatment of a number of benign pigmented lesions including freckles, lentigines and unilateral lentiginosis.AIMnThere are still insufficient clinical reports concerning quality-switched Nd:YAG laser (QSNYL) in the treatment of superficial pigmented lesions in Asians. The purpose of this study was to analyse the efficacy and side effect profiles of QSNYL-assisted pigment removal in brown skin.nnnMETHODSnA total of 71 patients, presenting a wide gamut of superficial epidermal lesions, were treated with QSNYL. Clinical responses were assessed by comparing photographs that were taken serially in every treatment.nnnRESULTSnTreatment using the QSNYL is reported individually for the various superficial pigmented lesions in the skin of Korean patients.nnnCONCLUSIONnQSNYL may be a beneficial alternative tool for the treatment of a number of benign pigmented lesions including freckles, lentigines and unilateral lentiginosis.

Comparison of Clinical and Histological Effects between Lactobacillus-Fermented Chamaecyparis obtusa and Tea Tree Oil for the Treatment of Acne: An Eight-Week Double-Blind Randomized Controlled Split-Face Study

Background: Screening of natural compounds for the development of anti-acne therapeutic agents has been steadily required considering various side effects of acne medications. However, previous studies have mainly focused on experimental tests without clinical trials and histopathological analysis. Objectives: To compare the clinical efficacy, safety and histopathological changes between Lactobacillus-fermented Chamaecyparis obtusa (LFCO) and existing tea tree oil (TTO). Methods: A total of 34 patients were instructed to apply 5% LFCO to the involved areas of a randomly allocated side and 5% TTO extract to the other side for 8 weeks in a double-blind split-face clinical trial. Results: After 8 weeks, inflammatory acne lesions were reduced by 65.3% on the LFCO side and by 38.2% on the TTO side. LFCO was also superior to TTO in the onset time of efficacy (p < 0.05). The LFCO side further demonstrated improvement for non-inflammatory lesions (52.6%, p < 0.05), decreased size of sebaceous glands and sebum output reductions. Patients subjective satisfaction was also higher without severe adverse reactions. Protein expressions of nuclear factor κB decreased earlier on the LFCO side, and those of interleukin-1a (IL-1a), IL-8, insulin-like growth factor 1 receptor and sterol regulatory element-binding protein 1 decreased subsequently. Ultra-performance liquid chromatography/high-resolution mass spectrometry further demonstrated that the contents of dihydroxybenzoic acid, taxifolin and quercetin were increased in LFCO after fermentation. Conclusions: LFCO treatment was rapid and effective for treating acne lesions compared to TTO. Histopathological findings correlated well with the clinical acne grade and treatment response. This novel natural compound appears to be effective and safe for acne treatment.