Jae Yoon Jung

Comparison of a Pulsed Dye Laser and a Combined 585/1,064-nm Laser in the Treatment of Acne Vulgaris

BACKGROUND The effect of combined 585/1,064‐nm (sequential dual‐wavelength pulsed dye laser (PDL) and neodymium‐doped yttrium aluminium garnet) laser therapy for acne vulgaris has not been evaluated. OBJECTIVES To compare the efficacy and safety of PDL and of combined 585/1,064‐nm laser treatment for mild to moderate facial acne. METHODS A 12‐week, randomized, prospective, split‐face, double‐blind study was performed. Sixteen participants with mild to moderate acne were treated with a single pass of a combined 585/1,064‐nm laser on half of the face and PDL on the other half during each treatment session. Patients underwent three treatment sessions at 2‐week intervals and were followed up at 8 and 12 weeks after treatment commencement. RESULTS At the final visit, inflammatory acne lesions were reduced by 86% on the PDL sides and by 89% on the 585/1,064‐nm laser sides. Noninflammatory acne lesions showed corresponding reductions of 69% and 64%, respectively. A significant difference between the two treatments was observed for noninflammatory acne lesions at the eighth week. Histopathologic examinations showed that both treatments decreased inflammation and interleukin‐8 expression and increased transforming growth factor beta expression. CONCLUSIONS PDL and combined 585/1,064 nm laser were safe and effective for the treatment of inflammatory and noninflammatory acne lesions. The authors have indicated no significant interest with commercial supporters.

Acne treatment by methyl aminolevulinate photodynamic therapy with red light vs. intense pulsed light.

Various methods of photodynamic therapy (PDT) for acne have been introduced. However, comparative studies among them are still needed. We performed this study to compare the effect of methyl aminolevulinate (MAL) PDT for acne between red light and intense pulsed light (IPL). Twenty patients were enrolled in this eight‐week, prospective, split‐face study. We applied MAL cream over the whole face with a three‐hour incubation time. Then patients were irradiated with 22 J/cm2 of red light on one‐half of the face and 8–10 J/cm2 of IPL on the other half during each treatment session. We performed three treatment sessions at two‐week intervals and followed‐up patients until four weeks after the last session. Inflammatory and non‐inflammatory acne lesions were reduced significantly on both sides. The red light side showed a better response than the IPL side after the first treatment. Serious adverse effects after treatment were not observed. MAL‐PDT with red light and IPL are both an effective and safe modality in acne treatment. Red light showed a faster response time than IPL. After multiple sessions, both light sources demonstrated satisfactory results. We suggest that reducing the total dose of red light is desirable when performing MAL‐PDT in Asian patients with acne compared with Caucasians.

A study of the efficacy of cleansers for acne vulgaris

Abstract Background: Acne treatments are sometimes expensive, and mild acne patients need some simpler form of treatment and, thus, the need for easier and cheaper ways of managing acne is increasing.Methods: An 8-week, double-blind, randomized clinical trial was conducted to determine whether cleansers are effective at producing clinical improvements in patients with acne vulgaris. A total of 13 acne patients applied cleanser A to one half of the face and cleanser B (cleanser A plus triclosan, salicylic acid, and azelaic acid) to the other half, twice daily.Results: The numbers of inflammatory and non-inflammatory lesions decreased on both sides. A rebound tendency was noted for cleanser A with respect to inflammatory lesions at 4 weeks post-discontinuation, whereas inflammatory lesions continued to decrease on sides treated with cleanser B during this period. However, non-inflammatory lesion counts were not significantly different in the two groups. Though patients were generally satisfied with both treatments, they were more satisfied with cleanser B. Moreover, histopathologic examinations showed a profound decrease in inflammatory reactions in the cleanser B group.Conclusion: These results show that acne cleansers reduced both inflammatory and non-inflammatory acne lesion counts, and might be helpful for acne treatment.

Prospective randomized controlled clinical and histopathological study of acne vulgaris treated with dual mode of quasi-long pulse and Q-switched 1064-nm Nd:YAG laser assisted with a topically applied carbon suspension

BACKGROUND Acne treatments using laser and light devices have been reported to have varying degrees of efficacy. However, there has been no study of treatment of acne using a dual mode (quasi-long pulse and Q-switched mode) 1064-nm Nd:YAG laser assisted with a topically applied carbon suspension. OBJECTIVE To evaluate the clinical efficacy, safety, and histological changes of new laser treatment method for acne vulgaris. METHODS Twenty-two patients received 3 sessions of quasi-long pulse and Q-switched Nd:YAG laser treatment assisted with a topically applied carbon suspension at 2-week intervals in a randomized split face manner. RESULTS At the final visit, the inflammatory acne lesions were reduced on the laser-treated side by 58.6% (P < .001), but increased on the untreated side by 5%. The noninflammatory acne lesions were reduced on the laser-treated side by 52.4% (P < .001). Sebum output reduction, inflammatory cell and cytokine reductions, a decrease of the thickness of a perifollicular stratum corneum and a full epithelium, and skin rejuvenation effect were found. The histopathologic examination of the acne lesions showed decreased inflammation and immunostaining intensity for interleukin 8, matrix metalloproteinase-9, toll-like receptor-2, and nuclear factor kappa B, and tumor necrosis factor alpha was reduced significantly. No severe adverse reactions were reported. All patients reported mild transient erythema that disappeared in a few hours. LIMITATIONS The number of subjects studied was small. CONCLUSIONS This laser treatment was rapid and effective for treating not only the inflammatory but also the noninflammatory acne lesions when compared with the control side. The histopathologic findings correlated well with the clinical acne grade and treatment response. This novel laser treatment appears to be safe and effective for acne treatment.

Clinical and histological evaluation of 1% nadifloxacin cream in the treatment of acne vulgaris in Korean patients

Objectives  Nadifloxacin is a fluoroquinolone with broad‐spectrum antibacterial activity. Although it is used as an acne treatment in some European countries, it has not been used to treat Korean acne patients. We aimed to evaluate the clinical efficacy and safety of 1% nadifloxacin cream and the histological changes it incurs when used to treat mild to moderate facial acne in Korean patients.

A pilot study for triple combination therapy with a low-fluence 1064 nm Q-switched Nd:YAG laser, hydroquinone cream and oral tranexamic acid for recalcitrant Riehl’s Melanosis

Abstract Background: Riehl’s melanosis presents as a diffuse gray-brown to black hyperpigmentation around face. The treatment of this disease is challenging and quite limited despite patients’ excessive psychological stresses. Objective: In this prospective pilot study, we evaluated the efficacy and safety for a novel combination therapy based on low-fluence Q-switched 1064 nm Nd:YAG laser, hydroquinone cream and oral tranexamic acid for recalcitrant Riehl’s melanosis. Methods: Totally eight patients with Riehl’s melanosis who had failed improvements previously received multiple sessions (10–18 times) of combination treatment regimen. The primary endpoint was clinical score by the physician and the secondary endpoints were clinical score by the patients, instrumental analysis using melanin and erythema values, and histopathological score. Results: Among eight patients, three received “Almost clear” grade, the other five patients received “Marked improvement” grade at final visits. No serious adverse events and post-treatment downtime was observed. Mean Melanin and Erythema Indexes also showed significant decreases compared with baseline. Histopathologic examination confirmed a significantly greater reduction of melanin content in melanophages. Conclusion: This combination method can be a viable option for Asian patients having Riehl’s melanosis with high risk of post-inflammatory hyperpigmentation, maintaining low-dose laser irradiation.

Cutaneous manifestations of the subtypes of polycystic ovary syndrome in Korean patients

Polycystic ovary syndrome (PCOS) is a common endocrinological disorder in women of childbearing‐age. Although PCOS has common dermatological manifestations, including hirsutism, acne and androgenetic alopecia, little is known about the dermatological characteristics of PCOS patients in Asia.

Neonatal erythema multiforme: a case report.

Erythema multiforme (EM) is an extremely rare condition in infancy. To the best of our knowledge, there have been only three cases of neonatal EM described in the literature, and no such cases have been reported in Korea. A preterm neonate born at 35 weeks and six days of gestation presented with multiple annular erythematous patches with a targetoid shape over his entire body at 36 days of age (corrected age of 7 days). He had no systemic symptoms except for transient mild fever. No triggering factor except for hepatitis B and BCG vaccination was found. Neutropenia was noted upon laboratory analysis. Skin biopsy specimens showed findings suggestive of erythema multiforme. The skin lesions improved rapidly upon administration of intravenous methylprednisolone; however, neutropenia continued for a much longer period. The significance of neutropenia with respect to the development of EM was not clarified. There has been no recurrence of skin lesions over a one-year follow-up period.

Novel device‐based acne treatments: comparison of a 1450‐nm diode laser and microneedling radiofrequency on mild‐to‐moderate acne vulgaris and seborrhoea in Korean patients through a 20‐week prospective, randomized, split‐face study

While device‐based acne treatments are widely applied for patients not tolerating conventional medications, related controlled studies have been still limited. Recently, non‐ablative 1450‐nm diode laser (DL) and fractional microneedling radiofrequency (FMR) have been effectively used for acne, in addition to well‐recognized dermal remodelling effects.

Unilateral Psoriasis in a Woman with Ipsilateral Post-Mastectomy Lymphedema

Psoriasis is a multi-factorial disease with various clinical manifestations. We present a case of unilateral psoriasis associated with ipsilateral lymphedema that developed after mastectomy for breast cancer. A 42-year-old Korean woman was referred to our clinic with a 1-month history of multiple erythematous scaly patches on the right arm, back, and breast and was diagnosed with psoriasis by a skin biopsy. Three years previously, she had been diagnosed with breast cancer (T1N2), underwent a right quadrantectomy and axillary lymph node dissection, and completed adjuvant chemotherapy followed by high-dose adjuvant radiotherapy. She had started rehabilitation therapy on the right arm for secondary lymphedema 30 months previously. Because of the long interval between radiation and psoriasis, we speculated that changes in the local milieu caused by the lymphedema might be a causative factor. We hereby report a rare case of unilateral psoriasis following post-mastectomy lymphedema.