Jae-Hui Nam

Effect of Quilting Sutures on Hematoma Formation after Liposuction with Dermal Curettage for Treatment of Axillary Hyperhidrosis: A Randomized Clinical Trial

BACKGROUND Liposuction provides further reduction of axillary sweating and malodor when combined with dermal curettage with sharp rasping cannulas. This aggressive approach is associated with relatively higher rate of hematoma formation when compared to the conventional simple liposuction. OBJECTIVE The aim of this prospective, randomized, controlled trial was to evaluate the effect of quilting sutures on the incidence of hematoma formation after liposuction-curettage for treatment of axillary hyperhidrosis (AH). MATERIALS AND METHODS The trial randomized 59 male patients (118 axillae) undergoing liposuction-curettage for AH to quilting procedures (61 axillae) or control group (57 axillae) for intention-to-treat analysis. Outcome measures included the incidence of hematoma formation, operative time, degree of postoperative pain, and amount of analgesics consumption. RESULTS Quilting sutures significantly reduced the incidence of axillary hematoma from 28.1% to 4.9%. Quilting was associated with the lengthening of operative time but did not affect the postoperative pain. CONCLUSION Considering its efficacy in reducing postoperative hematoma, quilting is recommended in combination with aggressive liposuction-curettage procedure for treating AH and osmidrosis.

Eccrine hidrocystoma in a child: an atypical presentation.

Eccrine hidrocystomas are small benign cystic lesions that normally affect only adult females. Eccrine hidrocystoma is characterized by tense vesicles that are predominately located on the face and particularly on the periorbital areas. Histologically, eccrine hidrocystoma consists of one or more partially collapsed unilocular cysts in the dermis, and these cysts are often situated adjacent to normal eccrine ducts. An 8-year-old boy presented with multiple skin-colored to bluish tiny papules on his nose. Histopathologically, the dilated partial cystic structures in the middermis were lined by one or two layers of flattened or cuboidal epithelial cells. We report here on an atypical presentation of multiple eccrine hidrocystomas that were localized on the nose of a child.

Rosacea and its association with enteral microbiota in Korean females.

Rosacea is a chronic inflammatory dermatosis affecting the face and eyes. An association between systemic comorbidities and rosacea has been reported, but the link to enteral microbiota is uncertain. We aimed to investigate the link between rosacea and enteral microbiota. A cross‐sectional study was performed in a sample of Korean women who participated in a health check‐up programme at the Kangbuk Samsung Hospital Health Screening Center between 23 June 2014 and 5 September 2014. The gut microbiome was evaluated by 16S rRNA gene and metagenome sequence analyses. A total of 12 rosacea patients and 251 controls were enrolled. We identified links between rosacea and several changes in gut microbiota: reduced abundance of Peptococcaceae family unknown genus, Methanobrevibacter (genus), Slackia (genus), Coprobacillus (genus), Citrobacter (genus), and Desulfovibrio (genus), and increased abundance of Acidaminococcus (genus), Megasphaera (genus), and Lactobacillales order unknown family unknown genus. A link between rosacea and enteral microbiota was observed in this metagenomic study. A large and elaborate study is needed to confirm these findings and to elucidate the mechanisms involved.

Efficacy and safety of a novel picosecond laser using combination of 1 064 and 595 nm on patients with melasma: A prospective, randomized, multicenter, split-face, 2% hydroquinone cream-controlled clinical trial

Melasma is a common acquired, chronic hypermelanosis and still remains a therapeutic challenge. The low‐fluence 1 064 nm Q‐switched Nd:YAG laser is the most widely used for the treatment of moderate to severe melasma in Asia. Recently, the picosecond laser has been introduced for various pigmentary disorders such as melasma. We evaluated the efficacy and safety of a picosecond laser with dual‐wavelengths (1 064 and 595 nm) and topical 2% hydroquinone (HQ) combination therapy on patients with melasma, and compared results with those obtained with 2% HQ alone.

Erratum: Treatment and Classification of Nevus of Ota: A Seven-Year Review of a Single Institution's Experience

Background Nevus of Ota (NO) is a relatively common pigmentary disorder in Asians. Taninos classification is an old but tacit consensus to delineate the disease. Various treatment options have been presented. However, a few studies have been conducted on available laser options and current treatment strategies or the classification of NO. Objective To investigate current laser options and their effectiveness for the treatment of NO, contributing factors to clinical outcomes, and verification of classification. Methods A retrospective study of NO was conducted by reviewing medical charts and photographs of sixty-seven patients. Statistical analysis was used to compare excellent and poor outcomes and determine contributing factors. Results The median age of onset was below the age of 1 (interquartile range [IQR], 0~1). Taninos and PUMCH classification systems failed to classify patients in 24 (35.8%) and 6 (9.0%) of patients, respectively. A 1,064 nm Q-switched Nd:YAG laser without additional lasers was used most frequently in 42 patients (62.7%). The frequency of treatment was 19.0 (IQR, 10.0~23.0) in the cured group defined as subjects showing 95% improvement or above, compared to 10.0 (IQR, 6.25~13.75) in the unattained group defined as subjects showing less than 95% improvement (p=0.001). Conclusion A 1,064 nm Q-switched Nd:YAG laser is a reliable treatment armamentarium, functioning as a single infallible modality as well as a combination treatment modality for NO. Repetitive laser treatments without interruption seems to be the most suitable in clearing NO. The current classification systems of NO are defective. Thus, a new classification should be developed.

A Case of Perifollicular Fibroma

Perifollicular fibroma (PFF) is a very rare proliferative lesion of the perifollicular sheath. A flesh-colored, dome-shaped papulonodule is usually located on the face or the neck. These papulonodules may be single or multiple. Histologically, the lesion consists of a concentric arrangement of cellular fibrous tissue around a normal hair follicle. We describe here an unusual case of PFF in a 41-year-old female who had an asymptomatic small skin colored papule on the scalp, and this is an uncommon location for PFF.

Clinical Outcome of 1064-nm Picosecond Neodymium–Doped Yttrium Aluminium Garnet Laser for the Treatment of Hypertrophic Scars

ABSTRACT Background: Currently no study has evaluated the effect of the novel 1064–nm picosecond neodymium-doped:yttrium aluminium garnet laser (ps–Nd:YAG) for reducing Hypertrophic scarring (HS). Objective: The aim of this study was to verify the efficacy and safety of a 1064-nm ps-Nd:YAG in the management of HS. Materials and Methods: A retrospective chart review and photographic analysis were conducted on patients treated with a low-fluence 1064-nm ps-Nd:YAG for HS improvement. The Vancouver Scar Scale (VSS), 5-point Global Assessment Score (GAS), and patient satisfaction score were used to determine the effect of scar improvement. Results: A total of 24 Korean patients (9 males and 15 females; mean age of 33.25 ± 15.50 years) were retrospectively evaluated. Mean treatment settings were 1064-nm wavelength, 750 ps pulse duration, 7.94 mm spot size, 0.93 J/cm2 fluence, and 9.69 Hz frequency. The average VSS score decreased significantly (from 5.33 to 2.71) after laser treatment (p < 0.001). The average GAS (3.02 ± 0.93) showed fair cosmetic improvement, and patient satisfaction scores (6.88 ± 2.66) indicated moderate satisfaction. Conclusion: The novel low-fluence 1064-nm ps-Nd:YAG could be considered as an effective and safe optional modality for the treatment of HS in Asian skin.

A case of necrotizing infundibular crystalline folliculitis

Necrotizing infundibular crystalline folliculitis (NICF) is a rare folliculocentric disorder characterized by the deposition of filamentous eosinophilic materials and necrosis of the follicular ostium or infundibulum. NICF often appears on the head and neck. Multiple, well-demarcated, round papules recurrently occur on these areas. We present a case of a 34-year-old male suffering from pruritus and multiple waxy papules on his chest. The patient’s lesions appeared 1 year ago, and his symptoms were exacerbated for 10 days prior to admission. The lesions consisted of more than 50 papules with sizes varying between 0.1 and 0.3 cm in diameter (Fig. 1). His previous medical history was unremarkable. Histopathologic results revealed multiple eosinophilic, filamentous, and amorphous materials near follicular structures (Fig. 2). The borders between the follicles and the lesions were partially ruptured. Basophilic necrotic changes were observed in the surroundings. Polarized microscopy revealed negative birefringent filamentous crystalline materials in the eosinophilic remnant. Two weeks later, the fungal culture isolated yeast species. The bacterial culture showed no other microorganisms. Based on these histopathologic findings and the results of the polarized microscopy, we were able to diagnose the patient with NICF. The patient started treatment with 100 mg itraconazole, 10 mg ebastine, and 2 mg emedastine per day for a total of 4 weeks; 20 mg/g topical sertaconazole nitrate, 2.5 mg/g desoxymethasone, and tacrolimus hydrate 0.1% were also added.

A clinical study on the usefulness of autologous plasma filler in the treatment of nasolabial fold wrinkles

ABSTRACT Background: Recently, the efficacy of autologous plasma filler for the reduction of facial wrinkles has been demonstrated. Objective: The aim of our study is to validate the efficacy and safety of autologous plasma filler in treating nasolabial fold wrinkles. Material and methods: Twenty Korean patients with moderate-to-severe nasolabial fold wrinkles were enrolled. The patients were treated with one session of autologous plasma filler. The wrinkle improvement effects were evaluated at 1-week, 4-week, 8-week, and 12-week after the treatment. Three assessment methods were applied. First, two independent dermatologists assessed cosmetic results using a 5-point wrinkle assessment scale. Second, global aesthetic improvement score was used for assessment of the final cosmetic results. Third, patient satisfaction was surveyed. Also, the adverse effects associated to treatment were observed. Results: Mean age of the patients was 44.5 years. The average 5-point wrinkle assessment scale score was significantly improved at 1, 4, 8, and 12 weeks after treatment, comparing to before treatment (p < 0.01). The patients’ average global aesthetic improvement score also indicated better cosmetic outcomes. Conclusion: The clinical improvement with sufficient patients’ satisfaction and no significant adverse events demonstrated that novel autologous plasma filler could be considered as efficient and safety treatment option for nasolabial fold wrinkles.

Beneficial Effect of Low Fluence 1,064 nm Q-Switched Neodymium:Yttrium-Aluminum-Garnet Laser in the Treatment of Senile Lentigo

Background Low fluence 1,064 nm Q-switched (QS) Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser treatment, also known as laser toning, is widely used for pigmentary disorders. There has been no reliable evaluation of the effect of low fluence 1,064 nm QS Nd:YAG laser for senile lentigo. Objective To investigate the beneficial effect of low fluence 1,064 nm QS Nd:YAG laser in the treatment of senile lentigo on the face. Methods A retrospective review was conducted on patients treated only with repetitive low fluence 1,064 nm QS Nd:YAG laser. Among them, 12 patients with multiple senile lentigines before treatment were included. All side effects were recorded to assess the safety of the modality. Results Mean age was 56.1±7.8 years old and male-to-female ratio was 1:11. Mean treatment fluence was 1.62±0.16 J/cm2 and mean total treatment session was 8.8±2.6. Mean interval period between each session was 28.0±11.4 days and mean treatment session to reach marked and near total improvement was 8.7±2.8. At the final visit, seven of 12 (58.3%) patients reached marked and near total improvement, and three of 12 (25.0%) reached moderate improvement. No side effects occurred. Conclusion Repetitive low fluence 1,064 nm QS Nd:YAG laser treatment may be an effective and safe optional modality for senile lentigo.