Joon Seok

Investigating skin penetration depth and shape following needle-free injection at different pressures: A cadaveric study

The effectiveness of needle‐free injection devices in neocollagenesis for treating extended skin planes is an area of active research. It is anticipated that needle‐free injection systems will not only be used to inject vaccines or insulin, but will also greatly aid skin rejuvenation when used to inject aesthetic materials such as hyaluronic acid, botulinum toxin, and placental extracts. There has not been any specific research to date examining how materials penetrate the skin when a needle‐free injection device is used. In this study, we investigated how material infiltrates the skin when it is injected into a cadaver using a needle‐free device.

Depressed scar after filler injection successfully treated with pneumatic needleless injector and radiofrequency device.

Fillers are known to be associated with a number of side effects, one of the most severe being skin necrosis. The most vulnerable areas are those that are supplied by a single arterial branch; for example, the glabellar and nasolabial folds are susceptible. In this study, we report good cosmetic outcomes were produced by utilizing the pneumatic needleless injector and radiofrequency device to treat depressed scars that occurred after necrosis following filler injection. Initially, applying light‐emitting diode treatment and following through with the two devices appears to have synergistic effects for scar remodeling when dealing with treatment of depressed scars with irregular borders.

A potential relationship between skin hydration and stamp-type microneedle intradermal hyaluronic acid injection in middle-aged male face

There is an increasing interest in skin rejuvenation using hyaluronic acid (HA) fillers beyond the improvement of deep wrinkles and volume deficiencies, which have been primary research foci in the past. We conducted a pilot study using a sample of six middle‐aged male subjects. Using an automatic intradermal injector with 0.020 mL of material contained in each injection point with a total of 100 points, 2 mL of non‐cross‐HA filler was injected into the entire face at every treatment session. We administered injections of HA for a total of three sessions per subject at 2‐week intervals and evaluated the results using a corneometer, TEWL, cutometer, measures of patient satisfaction, and the global aesthetic improvement scale (GAIS). Corneometer values increased steadily at each measurement, while the average value of TEWL increased in comparison with baseline after each application of the procedure. However, values returned to readings similar to those at 4 weeks after complete termination of the procedures. Cutometer values differed between the baseline and after procedures. All patients were assessed as “very much improved” or “much improved” according to GAIS, and all were pleased with the outcomes of treatment in terms of the enhancement of moisture, elasticity, and brightness.

Copy-number variation of the filaggrin gene in Korean patients with atopic dermatitis: what really matters, 'number' or 'variation'?

DEAR EDITOR, Since the articles reporting a methodological breakthrough on the full sequencing of the gene encoding profilaggrin (FLG), associations between loss-of-function mutations of FLG and atopic dermatitis (AD) have been reported across ethnicities. However, both the low prevalence of FLG mutations in patients with AD in some nations (< 4% in Italy) and the high prevalence of FLG mutations in healthy control in other nations (~ 10% in Ireland) suggest that factors other than FLG mutation may be at work. Brown et al. introduced an interesting new factor contributing to the risk of AD: copynumber variation aa(CNV). FLG is polymorphic, with allelic variants of 10–12 nearly identical repeats in exon 3. They

Efficacy of Cistanche Tubulosa and Laminaria Japonica Extracts (MK-R7) Supplement in Preventing Patterned Hair Loss and Promoting Scalp Health

Cistanche tubulosa and Laminaria japonica have been reported to have anti-oxidative, anticoagulant, anti-cancer and anti-inflammatory properties. They are expected to be a promising candidates for promoting hair growth and treating dandruff and scalp inflammation as a consequence. In this double-blinded, placebo-controlled clinical trial, we investigated the efficacy of Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) in promoting hair health in patients with mild to moderate patterned hair loss. Using phototrichogram (Folliscope 4.0, LeadM, Seoul, Korea), we compared the density and diameter of hairs in patients receiving a placebo or Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) at baseline, 8 and 16 weeks of the study. In order to determine the efficacy of treatment on dandruff and scalp inflammation, investigators assessment score and patients subjective score were also performed. We found a statistically significant increase in the hair density of the test group (n = 45, MK-R7 400 mg) after 16 weeks of consuming the MK-R7 (test group: 23.29 n/cm2 ± 24.26, control: 10.35 n/cm2 ± 20.08, p < 0.05). In addition, we found a statistically significant increase in hair diameter in the test group compared to control group at week 16 (test group: 0.018 mm ± 0.015, control: 0.003 mm ± 0.013, p < 0.05). There were also significant outcomes regarding the investigators visual assessment and patients subjective score of dandruff and scalp inflammation in the test group compared to those in control group. Based on the results of this clinical study, we conclude that Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) are promising substances for promoting health of the scalp and hair.

Hyaluronic acid filler combined with antioxidants for infraorbital rejuvenation: Report of two cases

Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea Department of Dermatology, Yemiwon Dermatologic Clinic, Seoul, South Korea Correspondence Choon Shik Yoon, Department of Dermatology, Chung-Ang University Hospital, Heukseok-dong, Dongjak-ku, Seoul, 06973, South Korea. E-mail: dermacsyoun@hanmail.net Beom Joon Kim, Yemiwon dermatologic clinic, Seoul, South Korea. E-mail: beomjoon@unitel.co.kr Funding information None

Needle-free jet injection of hyaluronic acid improves skin remodeling in a mouse model

PURPOSE The purpose of this study was to improve methods of jet injection using a mouse model. We investigated the mechanism of action, efficacy, and safety of the pneumatic device using injection of hyaluronic acid (HA) solution into a mouse model. METHODS We evaluated the efficacy and safety of an INNOJECTOR™ pneumatic device that pneumatically accelerates a jet of HA solution under high pressure into the dermis of mouse skin. We examined the treatment effects using skin hybrid model jet dispersion experiments, photographic images, microscopy, and histological analyses. RESULTS Use of the INNOJECTOR™ successfully increased dermal thickness and collagen synthesis in our mouse model. Jet dispersion experiments were performed using agarose gels and a polyacrylamide gel model to understand the dependence of jet penetration on jet power. The mechanisms by which pneumatic injection using HA solution exerts its effects may involve increased dermal thickening, triggering of a wound healing process, and activation of vimentin and collagen synthesis. CONCLUSIONS Collagen synthesis and increased dermal thickening were successfully achieved in our mouse model using the INNOJECTOR™. Pneumatic injection of HA under high pressure provides a safe and effective method for improving the appearance of mouse skin. Our findings indicate that use of the INNOJECTOR™ may induce efficient collagen remodeling with subsequent marked dermal layer thickening by targeting vimentin.

Squamous Cell Carcinoma and Multiple Bowen's Disease in a Patient with a History of Consumption of Traditional Chinese Herbal Balls

Arsenic has been classified as a class I human carcinogen, meaning that there is sufficient evidence of carcinogenicity to humans. Arsenic, however, remains a common contaminant in a number of traditional Chinese herbal balls. A 64-year-old man presented with an erythematous erosive patch on the left palm, multiple yellowish scaly patches on the right palm and an erythematous hyperkeratotic patch with bleeding on the left foot dorsum. He also had similar skin lesions on the back and buttock. He had a past medical history of chronic exposure to arsenic through consumption of traditional Chinese herbal balls. Skin biopsy revealed Bowens disease on the left palm and squamous cell carcinoma on left foot dorsum. We report this case to emphasize that we should investigate patients history thoroughly, including the use of Chinese herbal balls to find out arsenicism.

Targeting of sebaceous glands to treat acne by micro-insulated needles with radio frequency in a rabbit ear model

Many studies have investigated the application of micro‐insulated needles with radio frequency (RF) to treat acne in humans; however, the use of a micro‐insulated needle RF applicator has not yet been studied in an animal model. The purpose of this study was to evaluate the effectiveness of a micro‐insulated needle RF applicator in a rabbit ear acne (REA) model.

Hyaluronic acid injection via a pneumatic microjet device to improve forehead wrinkles.

arranged in a dense matted mass involving mainly the centred scalp area (Fig. 1). The hair mass was clean, and odour-free. No other associated lesions except for a mild seborrhoeic dermatitis could be noted on her scalp. Trichoscopic analysis of the compact mass showed 180° twisted hairs, bended and fractured hair shafts, retained telogen hairs and trichorrhexis nodosa (Fig. 2a and b). The treatment suggested was the hair cut. The exact ethiopathogenesis of AHM is still poorly understood, and multifactorial causes have been accepted. Excessive friction and compression in a liquid medium are believed to cause the conglomeration of contiguous hair fibres. However, some reports after regular use of harsh shampoos and following irritant contact dermatitis of the scalp have been described so far. The main differential diagnosis is neglected hair care, which may be associated with scalp inflammation and hair infestations. Specific hair practices, such as applying sticky materials over the hair or using dreadlocks, entangled masses of matted ropes of long hair, may also be misdiagnosed as AHM, although these are chronic processes usually with dirty and malodorous hairs. Trichoscopy is a non-invasive and practical diagnostic tool that can help to better assess hair and scalp conditions and to identify specific features in the hair shafts. Treatment of AHM involves cutting the matted hair, and manual separation using organic solvent can be tried in early cases. Prevention of AHM includes regular use of soft hair cleansers and deep hair conditioners, and gentle combing to avoid entangling of hair fibres.