Hye In Lee

Clinicopathologic efficacy of copper bromide plus/yellow laser (578 nm with 511 nm) for treatment of melasma in Asian patients.

BACKGROUND Melasma is a common pigmentary disorder in Asians. Although the pathogenesis of melasma is not yet fully understood, there are several hypotheses supporting angiogenetic factors related to some types of melasma. OBJECTIVE To test the efficacy of copper bromide laser in the treatment of Korean women with melasma. MATERIALS AND METHODS Clinical parameters included physician and patient assessment and Melasma Area and Severity Index score. The intensity of pigmentation and erythema was measured using a chromometer. To evaluate histopathologic changes, punch biopsies from melasma were obtained from four patients. Immunohistochemical staining for Melan‐A, endothelin 1, CD34, and vascular endothelial growth factor (VEGF) antigen of the melasma lesions was observed. RESULTS Mean MASI score decreased dramatically after treatment. Patients exhibited telangiectatic erythema within the melasma lesion. The values of L* reflecting intensity of pigmentation increased, and the values of a* as the measurement of redness decreased after the treatments. Expression of Melan‐A, CD34, endothelin‐1, and VEGF decreased after treatment. CONCLUSION The potential application of an antiangiogenetic laser for the treatment of melasma specially accompanied by pronounced telangiectasia in Asian skin is a possible treatment option. The authors have indicated no significant interest with commercial supporters.

Fractional photothermolysis laser treatment of male pattern hair loss.

BACKGROUND Various trials have been conducted on the management of male pattern hair loss (MPHL). A variety of laser and light sources have been used for the treatment of MPHL. OBJECTIVE To understand the effects of a 1,550‐nm fractional erbium‐glass laser on the hair cycle in an alopecia mouse model and to study the clinical effects of the same laser used as treatment for MPHL. MATERIALS AND METHODS Irradiation was applied to the shaved skin of C3H/HeN mice using various energy and density settings and varied irradiation intervals. In a clinical pilot study involving human subjects, 20 participants were treated over five sessions at 2‐week intervals. A fractional photothermolysis laser was used at the energy of 5 mJ and a total density of 300 spots/cm2. RESULTS In the animal study, the hair stimulation effects were dependent upon the energy level, density, and irradiation interval. The anagen conversion of hair and the increase in Wnt 5a, &bgr;‐catenin signals were observed. In the human pilot study, incremental improvements in hair density and growth rate were observed. CONCLUSIONS This pilot study showed that a 1,550‐nm fractional erbium‐glass laser might induce hair growth, but more intensive studies are required to clarify the clinical applications of this treatment. The authors have indicated no significant interest with commercial supporters.

The Effect of Calcipotriol on the Expression of Human β Defensin-2 and LL-37 in Cultured Human Keratinocytes

Background. Vitamin D has been reported to regulate innate immunity by controlling the expression of antimicrobial peptides (AMPs). Objective. We investigated the effect of calcipotriol on the expression of AMPs in human cultured keratinocytes. Methods. Keratinocytes were treated with lipopolysaccharide (LPS), TNF-α, Calcipotriol and irradiated with UVB, cultured, and harvested. To assess the expression of human beta defensin-2 and LL-37 in the control group, not exposed to any stimulants, the experimental group was treated with LPS, TNF-α, or UVB, and another group was treated again with calcipotriol; reverse transcriptase-polymerase chain reaction, Western blotting, and immunohistochemical staining were performed. Results. In the experimental group treated with LPS, UVB irradiation, and TNF-α, the expression of β-defensin and LL-37 was increased more than in the control group and then decreased in the experimental group treated with calcipotriol. Conclusions. Calcipotriol suppressed HBD-2 and LL-37, which were stimulated by UVB, LPS, and TNF-α.

Full‐spectrum light phototherapy for atopic dermatitis

Background  Atopic dermatitis (AD) is a chronic skin disease resulting in a profound deterioration in quality of life. The FSL® is a newly developed phototherapy device generating full‐spectrum light (FSL) with a continuous wavelength (320–5000 nm). This study aimed to evaluate the efficacy and safety of FSL® phototherapy in AD.

Topical photodynamic therapy with methyl aminolevulinate may be an alternative therapeutic option for the recalcitrant Malassezia folliculitis

of BCC-MD have been previously reported in the literature. The term describes a rare variant of BCC that demonstrates differentiation towards hair matrix and histologically demonstrates shadow cells within nests of matrical (follicular germinative) basaloid cells. Shadow cells are cells with central unstained areas, surrounded by brightly eosinophilic cytoplasm and indistinct cell borders. It is believed that these cells represent a form of cell death with abortive hair follicle keratinization. These cells are commonly seen in hair matrix epithelial tumors including pilomatricoma and PC but have also been described in trichoepithelioma, proliferating trichilemmal tumor, trichilemmal cyst, chondroid syringoma, keratoacanthoma, squamous cell carcinoma, melanocytic matricoma, epidermal cysts of Gardner’s syndrome, condyloma acuminatum, alopecia areata, onychomycosis, and some unclassifiable hair follicle (trichogenic) neoplasms. It is important to differentiate this tumor from PC because of the significant risk of relapse and metastasis associated with the latter. In contrast, BCC is an invasive skin tumor, with a risk of locally aggressive behavior but one which rarely metastasizes to distant sites. Previous reports suggest that bcatenin, a 92 kDa protein involved in the Wnt signaling pathway, cellular adhesion, proliferation, and maturation of matrical cells, may play a role in the development and differentiation of matrical-derived tumors, including BCC-MD. b-Catenin staining and clinical follow-up of patients with BCC-MD have inferred that these tumors behave in a fashion similar to nodular variant BCC. Based on previous reports, no local recurrences or distant metastases have been reported in patients diagnosed with BCC-MD. Michael Murphy, MD Zendee Elaba, MD Division of Dermatopathology Department of Dermatology University of Connecticut Health Center Farmington, CT, USA E-mail: drmichaelmurphy@netscape.net

Sorafenib (Nexavar Ⓡ , BAY 43-9006)-induced Hand-foot Skin Reaction with Facial Erythema

Sorafenib (Nexavar®, BAY 43-9006) is a novel, orally administered multi-kinase inhibitor that has recently been approved for the treatment of metastatic renal cell carcinoma. It is also used to delay disease progression in patients with advanced solid organ malignancies and metastatic melanoma. Sorafenib is associated with a relatively high incidence of dermatologic adverse events. The commonly occurring dermatologic adverse events associated with sorafenib include hand-foot skin reaction, facial erythema, splinter subungual hemorrhages, alopecia, pruritus and xerosis. We report here on a case of a 50-year-old man who was diagnosed with metastatic hepatocellular carcinoma. He developed both facial erythema and hand-foot skin reaction after the administration of sorafenib.

A case of cutaneous bronchogenic cyst presenting with lymphoid follicles.

Cutaneous bronchogenic cysts are rare, and stem from developmental abnormalities of the tracheobronchial tree. The condition is often misdiagnosed clinically, with the correct diagnosis usually established by histopathologic examination. Published reports of bronchogenic or branchial anomalies are increasing, and the traditional defining characteristics of location and histopathology are proving to be less reliable for the identification of cutaneous bronchogenic cysts. In this report, we describe a case of a cutaneous bronchogenic cyst that presented with unusual histologic features, and was associated with several lymphoid follicles.

A Case of Dermatofibroma of the Upper Lip

Dermatofibroma (DF) is a common benign mesenchymal tumor composed of fibroblastic and histiocytic cells. It occurs anywhere on the body surface but has a propensity for the extremities. To our knowledge, DF arising in the oral cavity, especially on the lip, is quite rare. DFs of the head and neck region have been known to be most often of the cellular type and frequently recur, so a wider initial excision is recommended. Herein we report a case of DF in a 41-year-old female who presented with a deep-seated nodule on her upper lip.

A comparison of neuropeptide expression in skin with allergic contact dermatitis in human and mouse

Background  Allergic contact dermatitis (ACD) is a manifestation of a cell‐mediated immune response, but its mechanism remains unknown. Recently, we investigated whether ACD involves various neuropeptides. Substance P (SP) is a neuropeptide that is known to act as a neurokinin receptor when the immune response is initiated. Calcitonin gene‐related peptide (CGRP) is a distinct typical neuropeptide and, with SP, induces the immune response. Neuropeptides in neurogenic inflammation are regulated by the inactivation of receptors and enzymes that can cause neuropeptide degradation (e.g. angiotensin‐converting enzyme [ACE]), but no enzyme that can degrade SP and CGRP has yet been reported.