Hong-Hui Xu

A Retrospective Study of Q-Switched Alexandrite Laser in Treating Nevus of Ota

BACKGROUND The Q‐switched alexandrite laser (QSAL) has been clinically proven to be effective in treating nevus of Ota, but a large‐scale retrospective study with long‐term follow‐up has never been performed. OBJECTIVE To evaluate the efficacy of the QSAL in treating nevus of Ota, the lasers long‐term side effects, complications associated with the treatments, and the recurrence rate. MATERIALS AND METHODS Eight hundred six patients (651 female, 155 male) with a diagnosis of nevus of Ota who had received a series of QSAL (wavelength 755 nm) treatments were recruited. The typical settings were fluences of 3.8 to 4.8 J/cm2 and a spot size of 3 mm. Follow‐ups were conducted via questionnaire with 590 patients who had completed the treatment at least 3 years earlier. RESULTS Overall, 93.9% of patients achieved complete clearance after an average of 5.2 sessions. All recurrences (0.8%) appeared beyond the previously treated sites. No long‐term adverse effects, including hypopigmentation, hyperpigmentation, textural changes, and malignant transformation, were observed. CONCLUSION The QSAL is a safe and effective modality for treating nevus of Ota. Recurrence was rare and appeared beyond the previously treated sites. The authors have indicated no significant interest with commercial supporters.

Lichen planus pemphigoides associated with Chinese herbs

We report a 62‐year‐old Chinese woman with a 2‐year history of lichen planus presenting with extensive violaceous maculopapules and plaques 1 week after taking an oral preparation of Chinese herbs. The patient developed vesiculobullous skin lesions 7 weeks later. Histopathological examination showed subepidermal blisters and adjacent bandlike lymphocytic infiltration. Direct immunofluorescence revealed linear deposits of IgG and C3 along the basement membrane zone. Indirect immunofluorescence showed IgG antibody deposition along the epidermal side of salt‐split human skin. Circulating anti‐bullous pemphigoid 180 antibodies were detected by ELISA. Lichen planus pemphigoides (LPP) was diagnosed. To our knowledge, this is the first report of LPP associated with oral Chinese herbs.

Localized linear IgA dermatosis induced by UV light-treatment for herpes zoster

We report a case of localized linear IgA dermatosis (LID). The patient suffered from herpes zoster on the right waist and received three localized ultraviolet (UV) light treatments. One month later he presented with bullae on the same site. Direct immunofluorescence showed deposition of linear IgA and weak C3 along the basement membrane zone. Indirect immunofluorescence on the salt‐split human skin demonstrated that IgA antibodies were bound to the epidermal side. To our knowledge, this is the first case of localized LID induced by UV light treatment for herpes zoster. It is also the third case of LID induced by UV light.

Lentigines following narrow‐band ultraviolet B phototherapy for mycosis fungoides

cantly different between lesion sites. Two weeks after cultured epidermal grafting, topical psoralen UVA (PUVA) or narrowband UVB (NB-UVB) therapy was performed twice a week for 2–6 months depending on an outcome. PUVA was started at 0.1 J ⁄ cm, with subsequent increments of 0.1 J ⁄ cm at alternate visits. NB-UVB was started at 250 mJ ⁄ cm, with subsequent increments of 15%. The dose was adjusted according to the sensitivity and tolerance of the individual patient. There was a limitation to the study, in that cultured and noncultured grafts might be of different ages when irradiated. The outcome of the treatment was evaluated every 3 months and the patients were followed up for > 12 months. The results obtained with the cultured epidermal grafts were very similar to those with the noncultured epidermal grafts (Table 1). For patients with segmental vitiligo and piebaldism, both noncultured and cultured methods were effective, but in five of the seven patients with generalized vitiligo, neither method was effective. This study differs from previous studies on cultured epidermal grafts in that we compared cultured epidermal grafts with noncultured epidermal grafts in the same patients. The results showed that the cultured epidermal grafts were as effective as the noncultured epidermal grafts, and suggest that patients with a satisfactory response to noncultured epidermal grafts can be effectively treated with cultured epidermal grafts. However, the establishment of the cultures for cultured epidermal grafts may not always be successful in all patients. Thus, before a cultured epidermal graft, noncultured epidermal grafts may be useful to predict the effectiveness of a cultured graft.

Multifactorial Diseases with Immunological Involvement

Urticaria is a disease with transient itching wheals/hives and/or angioedema. Urticaria is divided into acute urticaria (AU) or chronic urticaria (CU, duration more than 6 weeks) [1]. Urticaria may be the skin manifestation of food allergy, drug allergy, anaphylaxis, autoimmune disorders, or infections.