Hyo Hyun Ahn

Treatment of vascular skin lesions with the variable-pulse 595 nm pulsed dye laser.

BACKGROUND In the dermatology field, variable-pulse 595 nm pulsed dye lasers (PDLs) are now being widely used to treat vascular skin lesions. However, there is little information available on variable-pulse 595 nm PDL treatment of dark-skinned patients. OBJECTIVE The objective of this study was to evaluate the outcome of variable-pulse 595 nm PDL treatment on Korean patients. METHOD Two hundred thirty-nine patients (Fitzpatrick skin phototypes III to V) with vascular skin lesions, such as nevus flammeus, telangiectasia, or hemangioma, were included in this study. All patients were treated with a variable-pulse 595 nm PDL, and the outcomes were assessed by comparing preoperative and postoperative photographs. RESULTS The average number of treatments per patient was 4.29, and 51.9% of patients showed a good (51–75% clearance) to excellent (76–100% clearance) response. For nevus flammeus, 48.0% of the patients achieved good to excellent results. The gender and age of the patients did not influence the clinical response; however, lesions of the head and neck were found to respond more favorably to treatment. For telangiectasia, 78.0% of patients showed good to excellent results, and, again, the gender and age of the patients did not alter the treatment outcome. For hemangioma, the male to female ratio of patients was 1.0:3.1 and 54.1% of the patients achieved a good to excellent response. Superficial hemangioma showed a better clinical response than deep hemangioma, and the lesions of younger patients responded more favorably than those of older patients. CONCLUSION The variable-pulse 595 nm PDL was found to be effective for treating several vascular skin lesions in dark-skinned patients. However, there were differences in treatment outcome owing to disease, age, and the location of the lesions.

Clinical characteristics and risk of melanoma development from giant congenital melanocytic naevi in Korea: a nationwide retrospective study.

Background  Giant congenital melanocytic naevi (GCMN) are known risk factors for the development of melanoma. However, melanoma risk among Asians is rarely evaluated.

Treatment of Becker's nevi with a long-pulse alexandrite laser.

BACKGROUND Beckers nevus (BN) can be a distressing cosmetic handicap for patients and a treatment challenge for physicians. Various treatment modalities have been used, but repigmentation commonly occurs after treatment. OBJECTIVE To evaluate the efficacy of long‐pulse alexandrite laser in the treatment of BN. MATERIALS AND METHODS Eleven Korean patients with Fitzpatrick skin type III to V were included in this study. A long‐pulsed alexandrite laser with a wavelength of 755 nm and a pulse duration of 3 ms was used. Patients were treated with a fluence of 20 to 25 J/cm2 and a spot size of 15 to 18 mm. Cryogen spray cooling was not used. RESULTS Two patients had excellent responses, five had good responses, and four had fair responses. Hair density simultaneously decreased with treatment in all patients. Although mild hypopigmentation was observed in some patients, and partial hypertrophic scarring was observed in one patient, the outcomes were cosmetically acceptable. No repigmentation was noted during the follow‐up period. CONCLUSION A long‐pulsed alexandrite laser without cryogen spray cooling is an effective and safe alternative in the treatment of BN. The authors have indicated no significant interest with commercial supporters.

Ablative fractional laser treatment for hypertrophic scars: comparison between Er:YAG and CO2 fractional lasers

Background: Nonablative fractional photothermolysis has been reported to show early promise in the treatment of hypertrophic scars, but there are few reports on ablative fractional photothermolysis for the treatment of hypertrophic scars. Aim: To evaluate and compare the efficacy and safety of Er:YAG fractional laser (EYFL) and CO2 fractional laser (CO2FL) for treatment of hypertrophic scars. Methods: Thirteen patients with hypertrophic scars were treated with 2,940 nm EYFL, and ten were treated with 10,600 nm CO2FL. An independent physician evaluator assessed the treatment outcomes using Vancouver scar scale (VSS) and 5-point grading scale (grade 0, no improvement; grade 1, 1–25%; grade 2, 26–50%; grade 3, 51–75%; grade 4, 76–100% improvement). Patients are queried about their subjective satisfaction with the treatment outcomes. Results: After the final treatment, average percentage changes of VSS were 28.2% for EYFL and 49.8% for CO2FL. Improvement was evident in terms of pliability, while insignificant in terms of vascularity and pigmentation. Based on physicians global assessment, mean grade of 1.8 for EYFL and 2.7 for CO2FL was achieved. Patients subjective satisfaction scores paralleled the physicians objective evaluation.Conclusion: CO2FL is a potentially effective and safe modality for the treatment of hypertrophic scars, particularly in terms of pliability.

A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars.

BACKGROUND The use of ablative lasers based on the fractional approach is a novel strategy for the treatment of postoperative and acne scars in addition to wrinkles. OBJECTIVE To evaluate and compare the efficacy of carbon dioxide ablative fractional laser (AFL) and the pulsed dye laser (PDL) for the improvement of surgical scars. MATERIALS AND METHODS Fourteen Korean patients with surgical scars were enrolled for this study. Half of each scar was treated with a 10,600-nm AFL and the contralateral half with the 595-nm PDL. For early intervention of the postoperative scar, the laser treatments were begun after 2 weeks from the Mohs micrographic surgery. RESULTS Both PDL and AFL produced statistically significant improvements. However, comparatively, there was no statistical difference between them. In each variable, AFL was more effective than PDL in the improvement of pliability and thickness. In contrast, PDL was superior to AFL in the improvement of vascularity and pigmentation. CONCLUSION Pulsed dye laser and AFL treatments for surgical scar provide significant improvement. Pulsed dye laser was more effective in color of scar compared with AFL, which showed marked improvement in the contour of scar. Overall improvement was not statistically different in the Vancouver Scar Scale.

A quantitative assessment of the human skin surface using polarized light digital photography and its dermatologic significance

Background: Quantitative and objective investigations of parallel‐polarized light (PPL) photography for dermatologic purposes are scarce.

Digital camera images obtained using a light‐emitting diode illuminator and their dermatological applications

Background/purpose: Although digital cameras have powerful macrocapabilities, flash macrophotographs are often unsatisfactory. The aim of this study was to develop a light‐emitting diode (LED) illuminator for macro digital photography that allows colorimetric investigations of the skin.

Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis

Background Pigmented purpuric dermatoses (PPD) are a spectrum of disorders characterized by a distinct purpuric rash. Although PPD can be easily diagnosed, the disease entity remains an enigma and a therapeutic challenge. Objective The purpose of this study was to investigate the characteristics and clinical manifestations of PPD and to elucidate the relationship between assumed etiologic factors and the clinical manifestations of PPD and treatment responses. Methods Retrograde analyses were performed to identify appropriate PPD patients who visited Korea University Medical Center Anam Hospital from 2002 to 2012. Results Information on 113 patients with PPD was analyzed, and 38 subjects with skin biopsy were included for this study. Schambergs disease was the most frequent clinical type (60.5%). Concomitant diseases included hypertension (15.8%), diabetes (10.5%), and others. Associated medication histories included statins (13.2%), beta blockers (10.5%), and others. Possibly associated etiologic factors were recent upper respiratory infection (5.3%), high orthostatic pressure due to prolonged standing (2.6%), and strenuous exercise (2.6%). A total of 36 patients (94.7%) were treated with one or more treatment methods, including oral antihistamines, pentoxifylline, topical steroids, and/or phototherapy. There was no significant difference in disease progress according to underlying diseases, medications, or association factors (p>0.05). Conclusion Our overall results were grossly consistent with the existing literature, excluding several findings. Although a possible relationship between PPD and cardiovascular disease or cardiovascular medication was proposed at the beginning of the study, no statistically significant correlations were found according to the specific clinical types and treatment responses (p>0.05).

Syringocystadenoma Papilliferum in Co-existence with Tubular Apocrine Adenoma on the Calf.

Syringocystadenoma papilliferum (SCAP) occurs singly or in association with other tumors. Although it is rare, the association of tubular apocrine adenoma (TAA) with SCAP in the background of nevus sebaceous (NS) on the scalp is well documented. However, the co-existence of these two tumors without background of NS has not been reported on the extremities. We report a case of SCAP associated with TAA on the calf without pre-existing NS in an adult.

Fluorescence digital photography of acne using a light-emitting diode illuminator

Background/purpose: The fluorescence findings of several dermatological diseases, such as erythrasma, tinea versicolor, and acne are helpful for diagnosis and follow‐up. However, many experience difficulty taking photographic images of fluorescence. The aim of this study was to develop a 405 nm light‐emitting diode (LED) system for fluorescence digital photography of acne and to determine whether such a diode can be used to evaluate acne.