Jin Young Jung

Early postoperative treatment of thyroidectomy scars using a fractional carbon dioxide laser

BACKGROUND Ablative carbon dioxide fractional laser systems (CO2 FS) have been effectively used to improve the appearance of scarring after surgical procedures, but an optimal treatment time has not been established. OBJECTIVE To evaluate the efficacy and safety of CO2 FS in early postoperative thyroidectomy scars. METHODS Twenty‐three Korean women with thyroidectomy scars were enrolled in this study. All patients underwent a single session of two passes of a CO2 FS with a pulse energy setting of 50 mJ and a density of 100 spots/cm2 2 to 3 weeks after surgery. RESULTS Mean Vancouver Scar Scale (VSS) scores were statistically significantly lower after laser treatment. Three months after CO2 FS treatment of thyroidectomy scarring, 12 of 23 participants showed clinical improvement of more than 51% from 2 to 3 weeks after surgery. The mean grade of clinical improvement based on independent clinical assessment was 2.6 ± 0.9. CONCLUSION Early postoperative CO2 FS treatment of thyroidectomy scars is effective and safe. The authors have indicated no significant interest with commercial supporters.

Increased expression of interleukin-23 p19 mRNA in erythema nodosum-like lesions of Behçet's disease.

Background  Behçet’s disease (BD) is a multisystemic chronic inflammatory disease with unknown aetiology. Interleukin (IL)‐12, which is involved in the pathogenesis of BD, is a 70‐kDa cytokine made of p35 and p40 subunits. Recently, IL‐23, which is composed of a p19 subunit and a shared p40 subunit of IL‐12, was discovered; as a consequence, this raises the need to re‐examine previous IL‐12 reports to determine whether IL‐23 is also involved in BD pathogenesis.

The efficacy of topical 0.2% hyaluronic acid gel on recurrent oral ulcers: comparison between recurrent aphthous ulcers and the oral ulcers of Behçet's disease

Background  Hyaluronic acid (HA) is a primary component of the extracellular matrix, and the efficacy of HA on oral ulcers is rarely reported.

Lower-Fluence, Higher-Density versus Higher-Fluence, Lower-Density Treatment with a 10,600-nm Carbon Dioxide Fractional Laser System: A Split-Face, Evaluator-Blinded Study

BACKGROUND Adequate laser settings in the treatment of scars using a carbon dioxide fractional laser system (CO2 FS) have not been established. OBJECTIVE To compare the efficacy and safety of low‐fluence, high‐density with high‐fluence, low‐density treatment with CO2 FS on acne scars and enlarged pores. METHODS Ten patients with mild to severe atrophic acne scars and enlarged pores were enrolled. Half of each subjects face was treated with a single session of CO2 FS with a fluence of 70 mJ and a density of 150 spots/cm2; the other half was treated with a fluence of 30 mJ and a density of 250 spots/cm2. RESULTS Follow‐up results 3 months after a single low‐fluence, high‐density treatment with CO2 FS showed that four of 10 participants had clinical improvement of 51% to 75% from baseline. After the high‐fluence, low‐density CO2 FS treatment, five of 10 patients demonstrated marked clinical improvements of more than 76%. CONCLUSION Higher‐energy, lower‐density laser settings seem to be more effective than lower‐energy, higher‐density settings for acne scars and enlarged pores, although our results do not constitute a conclusive comparison of the two different modes of CO2 FS. &NA; The authors have indicated no significant interest with commercial supporters.

Autologous fat transplantation for depressed linear scleroderma-induced facial atrophic scars.

BACKGROUND Facial linear scleroderma results in depressed atrophic scars. Autologous fat transplantation has been widely used, and fat appears to be an ideal material for filling depressed atrophic scars and contour deformities, but long-term results for autologous fat transplantation are controversial. OBJECTIVE To review the short- and long-term results of 20 patients who underwent multiple autologous fat transplantations for depressed atrophic scar correction. METHODS Twenty patients with clinically inactive facial linear scleroderma were included. They received at least two transplantations and had a 12-month follow-up evaluation. RESULTS On the forehead, 51% to 75% improvement (average grading scale: 2.4) was achieved when observed at least 12 months after the last treatment. For the chin, correction was poor (average grading scale: 0.7) with less than 25% improvement. The infraorbital area showed fair correction, but the nose showed poor correction. Two of three patients with scalp reduction surgery showed excellent results, showing only slight scar widening. CONCLUSIONS Autologous fat transplantation is an effective method for long-term correction of depressed atrophic scars left by linear scleroderma on the forehead but is less effective for corrections on the nose, infraorbital area, and chin.

Comparison of Secondary Intention Healing and Full-Thickness Skin Graft After Excision of Acral Lentiginous Melanoma on Foot

BACKGROUND Melanoma in dark‐skinned individuals often develops in an acral lentiginous fashion on the foot. After wide excision, substantial defects usually develop and they may endure insufficient vascular flow. In addition, the final scar must withstand the mechanical stress of daily walking. Various repair methods are used to repair these defects, but secondary intention healing has not been evaluated in the repair of wounds of the foot. OBJECTIVE To compare the functional and cosmetic results of secondary intention healing and full‐thickness skin graft after wide excision of melanoma on the foot. METHODS Retrospective review of 25 patients who were treated using excision for melanoma on the foot. The defects of 13 patients were healed by secondary intention (secondary intention healing group; SIHG), and those of 12 patients were repaired by full‐thickness skin graft (skin graft group; SGG). RESULTS The SGG showed more rapid healing than the SIHG, but the SIHG showed better functional and cosmetic outcomes at complete re‐epithelialization than the SGG as evaluated by patients and independent physicians. CONCLUSIONS Secondary intention healing after excision of melanoma from the foot is a therapeutic option with acceptable functional and cosmetic outcomes. The authors have indicated no significant interest with commercial supporters.

Effects of ablative 10,600-nm carbon dioxide fractional laser therapy on suppurative diseases of the skin: a case series of 12 patients.

We have used an ablative 10,600‐nm carbon dioxide fractional laser system (CO2 FS) for suppurative diseases in order to attempt improvement. The purpose of our study was to demonstrate the effect of CO2 FS on the course of inflammatory reactions in suppurative diseases.

Comparison of non‐ablative and ablative fractional laser treatments in a postoperative scar study

Postoperative scarring after thyroidectomy is a problem for both patients and clinicians. Recently, both non‐ablative and ablative fractional laser (NFL and AFL) systems have attracted attention as potential therapies for the revision of thyroidectomy scars. The present split‐scar study was designed to directly compare the efficacy of these two methods for the treatment of post‐thyroidectomy scars.

The Influence of Pregnancy and Menstruation on the Deterioration of Atopic Dermatitis Symptoms

BACKGROUND Female patients with atopic dermatitis (AD) often experience cutaneous deterioration associated with their pregnancy or menstrual cycle. OBJECTIVE We wanted to determine the prevalence of symptom aggravation as related to pregnancy and the menstrual cycle in female patients with AD. METHODS One hundred female patients with AD were included in the study and interviews were performed. The total IgE level and the Eczema Area and Severity Index score of the patients were retrospectively reviewed. RESULTS Ninety seven patients replied the questionnaire, and among them, 23 patients had completed at least 1 pregnancy. Among the 23 women who experienced pregnancy, 14 (61%) had noticed deterioration of their clinical symptoms during pregnancy. Of the 97 females, 31 (32%) patients had noticed deterioration of their AD as related to their menstrual cycle. For the patients who were sub-grouped as the intrinsic type of AD, the prevalence of symptom aggravation as related to pregnancy was significantly higher as compared to that of the extrinsic type of AD patients (p=0.048). CONCLUSION Of the 97 patients, 45 (46%) females answered that they have experienced deterioration of AD during pregnancy or in relation to their menstrual cycle, and this suggests the relation of a hormonal influence on the clinical manifestations of AD.

Surgery and Perioperative Intralesional Corticosteroid Injection for Treating Earlobe Keloids: A Korean Experience

BACKGROUND The aesthetic implications of ear keloids, which affect people of all races, are serious and the treatment of earlobe keloids is known to be difficult. The high rate of recurrence following excision alone has led to investigating various types of adjuvant therapy, including intralesional corticosteroid injection. OBJECTIVE We evaluated the efficacy of excision combined with perioperative intralesional triamcinolone acetonide injection for treating earlobe keloids of Korean patients. METHODS From 1997 to 2006, eighteen keloids on the earlobes of fifteen Korean patients were treated. The patient age ranged from 15 to 32 years (mean age: 24 years). All the patients were female and the keloids occurred after ear piercing. Preoperative intralesional triamcinolone acetonide (TA) injection was administered twice at a 1-month interval. Postoperative intralesional TA injections were given every 1 month for several months, depending on the patients clinical progress. RESULTS The follow-up period ranged from 4 to 42 months (mean: 18.5 months). After the surgery, TA intralesional injections were given 2 to 13 times (mean: 5.2 times). Of the treated keloids, eleven showed good results (61.1%) and three recurred (16.6%). No complications from the TA intralesional injection were observed. CONCLUSION Among the various treatments for earlobe keloids, we suggest that excision with corticosteroid intralesional injection can be used as the first line therapy when considering its effect and economic advantage.