In Kwon Yeo

Investigation of the Degradation-Retarding Effect Caused by the Low Swelling Capacity of a Novel Hyaluronic Acid Filler Developed by Solid-Phase Crosslinking Technology

Background A variety of hyaluronic acid (HA) fillers demonstrate unique physical characteristics, which affect the quality of the HA filler products. The critical factors that affect the degradation of HA gels have not yet been determined. Objective Our objective was to determine the characteristics of HA gels that affect their resistance to the degradation caused by radicals and enzymes. Methods Three types of HA fillers for repairing deep wrinkles, Juvederm Ultra Plus (J-U), Restylane Perlane (Perlane), and Cleviel, were tested in this study. The resistance of these HA fillers to enzymatic degradation was measured by carbazole and displacement assays using hyaluronidase as the enzyme. The resistance of these fillers to radical degradation was measured by the displacement assay using H2O2. Results Different tests for evaluating the degradation resistance of HA gels can yield different results. The filler most susceptible to enzymatic degradation was J-U, followed by Perlane and Cleviel. The HA filler showing the highest degree of degradation caused by H2O2 treatment was Perlane, followed by J-U, and then Cleviel. Cleviel showed higher enzymatic and radical resistances than J-U and Perlane did. Furthermore, it exhibited the highest resistance to heat and the lowest swelling ratio among all the fillers that were examined. Conclusion The main factor determining the degradation of HA particles is the gel swelling ratio, which is related to the particle structure of the gel. Our in vitro assays suggest that the decrease in the swelling ratio will lead to a retarding effect on the degradation of HA fillers.

The Effects of 830 nm Light-Emitting Diode Therapy on Acute Herpes Zoster Ophthalmicus: A Pilot Study.

Background Skin lesions and pain are the most distinctive features of herpes zoster. Light-emitting diode (LED) therapy is an effective treatment known for its wound-healing effects. Objective To determine whether the LED treatment affects wound healing and acute pain in acute herpes zoster ophthalmicus. Methods We recruited 28 consecutive Korean patients with acute herpes zoster ophthalmicus for the study. In the control group (group A), 14 subjects received oral famcyclovir. In the experimental group (group B), 14 subjects received oral famcyclovir and 830 nm LED phototherapy on days 0, 4, 7, and 10. In order to estimate the time for wound healing, we measured the duration from the vesicle formation to when the lesion crust fell off. The visual analogue scale (VAS) was used for the estimation of pain on days 4, 7, 10, and 14. Results The mean time required for wound healing was 13.14±2.34 days in group B and 15.92±2.55 days in group A (p=0.006). From day 4, the mean VAS score showed a greater improvement in group B, compared with group A. A marginal but not statistically significant difference in the VAS scores was observed between the two groups (p=0.095). Conclusion LED treatment for acute herpes zoster ophthalmicus leads to faster wound healing and a lower pain score.

Treatment of hypertrophic burn scars by combination laser‐cision and pinhole method using a carbon dioxide laser

Hypertrophic burn scars induce cosmetic and functional complications. Although there are various treatment modalities, an ideal method has not yet been found. Recently, numerous laser treatment modalities have been introduced with encouraging results.

An epidemiological study of androgenic alopecia in 3114 Korean patients.

Androgenetic alopecia (AGA) is the most common type of hair loss, and is characterized by the transformation of terminal scalp hair into vellus hair. The epidemiology of AGA is not fully understood. A strong genetic basis has long been identified, although little is known of its nongenetic causes.

Comparison of High-Dose Corticosteroid Pulse Therapy and Combination Therapy Using Oral Cyclosporine with Low-Dose Corticosteroid in Severe Alopecia Areata

Background Severe alopecia areata (AA) is resistant to conventional treatment. Although systemic oral corticosteroids are an effective treatment for patients with severe AA, those drugs have many adverse effects. Corticosteroid pulse therapy has been introduced to increase therapeutic effects and reduce adverse effects. However, the treatment modality in severe AA is still controversial. Objective To evaluate the effectiveness of corticosteroid pulse therapy in patients with severe AA compared with treatment with oral cyclosporine with corticosteroid. Methods A total of 82 patients with severe AA were treated with corticosteroid pulse therapy, and 60 patients were treated with oral cyclosporine with corticosteroid. Both groups were retrospectively evaluated for therapeutic efficacy according to AA type and disease duration. Results In 82 patients treated with corticosteroid pulse therapy, 53 (64.6%) were good responders (>50% hair regrowth). Patients with the plurifocal (PF) type of AA and those with a short disease duration (≤3 months) showed better responses. In 60 patients treated with oral cyclosporine with corticosteroid, 30 (50.0%) patients showed a good response. The AA type or disease duration, however, did not significantly affect the response to treatment. Conclusion Corticosteroid pulse therapy may be a better treatment option than combination therapy in severe AA patients with the PF type.

Topical epidermal growth factor for the improvement of acne lesions: a randomized, double-blinded, placebo-controlled, split-face trial.

Acne is one of the most common adverse events associated with the use of anticancer agents, such as epidermal growth factor receptor (EGFR) inhibitors. Based on data from several previous reports, we predicted that topical application of EGF could improve acne vulgaris. To evaluate the clinical efficacy and safety of topical recombinant human EGF (rhEGF) cream for the treatment of facial acne vulgaris. Twenty Korean adults with mild to moderate acne vulgaris applied topical rhEGF cream on one half of the face and a vehicle cream on the other half twice daily for six weeks. Clinical assessments were conducted at baseline, two, four, and six weeks. Two assessment methods were applied: inflammatory and non‐inflammatory acne lesion counts and acne severity score by investigators global assessment. Skin sebum output level and hydration level were also measured at each visit. All volunteers completed the study. At the final visit, inflammatory acne lesions were reduced by 33.5% on the rhEGF‐applied side. Non‐inflammatory acne lesions also decreased by 25.4%, whereas the lesions on the control side increased. The majority of patients demonstrated improvement on the side of the face where rhEGF cream was applied. Sebum output decreased on the rhEGF side, and skin hydration level increased on both sides. No severe side effects were observed during the study. Topical rhEGF seems to be an effective and safe adjuvant treatment option for mild to moderate acne vulgaris.

The annual changes of clinical manifestation of androgenetic alopecia clinic in korean males and females: a outpatient-based study.

Background Androgenetic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. There are no studies that analyze annual changes in age, patterns, family history, and associated disease. Objective We investigated the severity of hair loss, age of onset, the frequency of family history, and past medical histories in Korean patients with AGA. Methods A retrospective chart review was performed to identify all patients with AGA referred to the Dermatology Clinic at Chung-Ang University Hospital from January 2006 to December 2010. Results The age of onset was also gradually decreased from 34.1±10.1 years to 31.6±10.9 years between 2006 and 2010. In female patients, specific annual changes were not observed. Hamilton-Norwood Type IIIv AGA was most common in male patients and Ludwig Type I AGA was most common in female patients at all times between 2006 and 2010. The majority of patients with AGA had a family history of baldness and was most commonly associated with a paternal pattern of inheritance. Seborrheic dermatitis was the most common associated disease in male and female patients. Conclusion Our results show the possibilities that the average age of onset is decreasing. The period of the present study was only 5 years, which is not sufficient for the precise determination of onset age for AGA. Clearly, a long-term study is needed.

Flame figures in histology associated with allergic contact dermatitis from a henna tattoo

this. Reactive angioendotheliomatosis has been associated with several systemic diseases, especially infectious and autoimmune, cryoglobulinemia, and lymphoproliferative disorders. Different stimuli can possibly lead to vessel occlusion, local hypoxia, and subsequently synthesis of angiogenic cytokines, which induce endothelial cell proliferation. To the best of our knowledge, metal implants have not until now been involved in the pathogenesis of reactive angioendotheliomatosis. However, several cases of intralymphatic histiocytosis following orthopedic metal implants have been reported in the last years. This entity is considered by some authors as a subtype of reactive angioendotheliomatosis. As previously suggested, lymphatic ectasia secondary to chronic inflammation due to implant surgery is essential for the development of intralymphatic histiocytosis; however, its role in the case of reactive angioendotheliomatosis remains unclear. As the histological findings in our case are different from the other cases of reticulated telangiectatic erythema that have been previously reported in the literature, we consider that this case and any other showing this histopathological reactive vascular pattern should be considered reactive intravascular angioendotheliomatosis rather than reticulated telangiectatic erythema.

Treatment of facial paraffinoma with a bipolar radiofrequency device

treatments at 2-week intervals, the skin lesion completely disappeared (Fig. 1d). This treatment was well tolerated. To date, there has been no recurrence of lesions. Our patient’s response to pricking with a needle does not necessarily prove a cause-and-effect relation because spontaneous resolution can never be excluded. However, given the fact that rapid resolution of the skin lesion was observed just after this treatment, the mechanical stimulation such as “pricking” treatment may promote spontaneous regression as others reported previously, although the mechanism remains poorly understood. One possible mechanism of this phenomenon is that minor injury could trigger resolution of GA, where turnover of matrix proteins are abnormally elevated, by initiation of an orderly process of wound healing with formation of granulation tissue, remodeling of the extracellular matrix, neovascularization and wound contraction. Our observation may provide a new, simple and low-cost treatment, and supports anecdotal evidence that trauma promotes spontaneous regression of GA, although the mechanisms still remain unknown.

Permanent leucoderma after hair transplantation surgery

pathic. However, at present the pathogenesis of CU is not completely clarified. Several clinical variations have shown that only a few weals may occur in the mild form, and that a slight increase in body temperature may induce extensive wealing accompanied by wheezing and shortness of breath in severe cases. Older children and young adults aged 10–30 years, are mainly affected, and many patients with mild disease do not seek medical advice. Because of the clinical variations of CU, diagnosis is not always easy. We report a case of postural CU induced by changing from a supine position to an upright standing position; this is the first such case reported, to our knowledge. The patient was a 16-year-old Japanese high-school student, who presented with a 3-year history of thumbtipsized pruritic and/or painful oedematous urticarial erythema on his legs, which appeared numerous times with brief disappearance and reappearance. In particular, the symptom appeared immediately after assuming a standing position and resolved within an hour. The patient did not have a history of orthostatic hypotension. The patient’s attending physician had prescribed fexofenadine and diphenhydramine cream for urticaria during the previous 2 months, but despite these interventions, the patient’s skin symptoms continued under the same conditions. The patient then presented to our hospital with a diagnosis of intractable idiopathic urticaria. After admission, a provocation test was conducted (Fig. 1a). Ten minutes after the patient moved from a supine to a standing position, a number of pruritic urticarial erythematous weals were observed on both his legs (Fig. 1b). Histopathological examination of a skin biopsy revealed mild oedema and perivascular lymphocytic infiltration mainly in the upper dermis, and these findings were compatible with urticaria (Figs 1c–d). Furthermore, we evaluated the patient’s sweat production by means of iodine–starch reaction at 30 °C and 60% humidity, and a quantitative sudomotor axon reflex test (QSART) on his forearm. For the QSART test, acetylcholine was applied to skin iontophoretically, which resulted in induction of urticaria around the site of acetylcholine application, indicating the presence of CU (Fig. 1e). No differences between the patient and a number of healthy volunteers were observed for these tests. The remarkable nature of this case was that the trigger of urticaria on the lower leg was movement into a standing position. As symptom provocation with acetylcholine administration was also found in this case, we speculate that that this effect is a physiological response to standing, from factors such as venous pressure or blood flow volume, which may induce the nerves to release acetylcholine and induce urticaria. Further examination of similar cases will afford a better understanding of the underlying mechanisms. A. Hirohata, T. Yamaoka, M. Hayashi, H. Murota, M. Tani, and I. Katayama Department of Dermatology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan E-mail: yamaoka@derma.med.osaka-u.ac.jp Conflict of interest: the authors declare that they have no conflicts of interest. Accepted for publication 9 June 2015