Kwang Ho Yoo

Enhanced efficacy of photodynamic therapy with methyl 5-aminolevulinic acid in recalcitrant periungual warts after ablative carbon dioxide fractional laser: a pilot study.

BACKGROUND Photodynamic therapy (PDT) with aminolevulinic acid (ALA) has been used to improve recalcitrant periungual warts, but most lesions achieved complete remission after more than four sessions, and some lesions did not respond to the method. In this pilot study, the potential for synergistic effects of the combination of ablative carbon dioxide (CO2) fractional laser and methyl 5‐ALA (MAL)‐PDT for the treatment of recalcitrant periungual warts was examined. MATERIALS AND METHODS Twelve Korean patients (8 women and 4 men aged 20–45, mean age 27.9) with a total of 40 periungual warts were enrolled in the present study. The lesions were treated using an ablative CO2 fractional laser. Immediately after each fractional treatment, MAL was applied on the periungual warts, and 3 hours later, such areas were illuminated with a red light at a dose of 50 J/cm2 for 15 minutes. RESULTS After a mean of 2.2 treatments per wart, a mean clearance of 100% was achieved in 36 (90%) warts. Two warts (5%) had 50% clearance, and two (5%) showed no response after three treatments. There were no recurrences of the warts that had achieved 100% clearance during the follow‐up period of 6 months. Most of the treatments had no severe side effects during or after their administration. CONCLUSION A potential for enhanced clinical results when using combined ablative CO2 fractional laser and MAL‐PDT for the treatment of periungual warts was shown in this pilot study.

Effects of vitamin C vs. multivitamin on melanogenesis: comparative study in vitro and in vivo

Background  Vitamin C has been used for the treatment of hyperpigmented diseases. However, there is no study available on hypopigmenting effect of multivitamin.

Treatment of alopecia areata with fractional photothermolysis laser

Many studies have documented an abnormal cell-mediated immune reaction in alopecia areata (AA) 1 . The key histopatho logic feature of AA is a lymphocytic infiltrate around the lower hair follicle, which may appear in a characteristic “swarm of bees” pattern. The affected hair follicles terminate their anagen phase prematurely and regress via the induction of massive apoptosis of the lower portion of the follicle (the catagen phase), which results in a resting hair follicle (the telogen phase). The hair follicles may then reenter the anagen phase, but in the presence of a lymphocytic infiltrate, the anagen is terminated prematurely, which results in miniaturized hair follicles. AA represents a disorder of hair follicle cycling in a dual sense: it almost exclusively attacks anagen hair follicles and then greatly disturbs hair follicle cycling by “catapulting” anagen follicles into the catagen phase 2 . The treatment of AA depends on the severity and extent of the disease. The medications include a topical irritant, and in mild cases, topical and intralesional steroids. More aggressive therapy is used for severe cases, however, such as systemic corticosteroids, immunosuppressive drugs, and immune modulators 3 . These treatments frequently show side effects and a relatively high relapse rate, though. Recently, laser treatment of different wavelengths has been used to manage this roblem 1,3-

The use of 1540 nm fractional photothermolysis for the treatment of acne scars in Asian skin: a pilot study.

Background: Various modalities have been used to treat acne scars, but limited efficacy and considerable side effects have restricted their proper use. Recently, a new‐generation fractional photothermolysis modality has been introduced that has deeper penetrating ability; however, a 1540 nm fractional photothermolysis study has not yet been performed.

Successful Treatment of Depressed Scars of the Forehead Secondary to Herpes Zoster Using Subdermal Minimal Surgery Technology

Depressed facial scars can result from several pathologic processes, such as acne, scleroderma, cutaneous lupus erythematosus, trauma, and secondary changes to the herpes zoster site, as in the case described herein. There are multiple surgical techniques for the correction of these depressed facial scars. These treatments include subcision, mediumdepth chemical peels, fillers, carbon dioxide and erbium laser technology, nonablative laser treatment, dermabrasion, punch excision, and fat grafting, which have resulted in varying degrees of success and associated side effects. Therefore, treatment modalities that are effective in regenerating the dermal matrix and in improving depressed scars with minimal downtime and risk profile are highly desirable.

Branch-shaped Cutaneous Hypopigmentation and Atrophy after Intralesional Triamcinolone Injection.

Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. Linear hypopigmentation and atrophy after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect. A 30-year-old woman visited our dermatology department for a linear hypopigmented patch with atrophy from her left foot to the lower margin of the knee. The lesion developed after injection of an intralesional corticosteroid. The patient was diagnosed with linear hypopigmentation and atrophy secondary to the triamcinolone injection.

Herpes zoster duplex bilateralis in a patient with breast cancer.

The skin lesion of herpes zoster is classically limited to a single dermatome, and most cases of multi-dermatomal herpes zoster have contiguous skin lesions. Noncontigous multi-dermatomal herpes zoster is very rare in both immunocompetent and immunosuppressed persons. The phenomenon of zoster occurring in two non-contiguous dermatomes has been referred to as zoster duplex unilateralis or bilateralis. We report here on a case of herpes zoster duplex bilateralis in a 49-year-old woman who had previously received chemotherapy for breast cancer treatment.

The Use of Dynamic Ultrasonography for the Confirmation of Lower Leg Muscle Herniation.

The term muscle herniation represents focal muscular protrusions through an acquired or congenital fascial defect. The anterior tibialis muscle is the most common site of herniation. Dynamic ultrasonography has become an important tool in dermatology for diagnosing suspected muscle herniation because it is a non-invasive, highly accurate, readily available and cost-effective imaging technique. We present here the case of a 21-year-old male Korean soldier who underwent dynamic ultrasonography to confirm the diagnosis of anterior tibialis muscle herniation.

Cutis Verticis Gyrata and Alopecia Areata: A Synchronous Coincidence?

Cutis verticis gyrata (CVG) is a descriptive term for a scalp condition that is convoluted folds and deep furrows that resemble the surface of the cerebral cortex. It is categorized by the underlying etiology, as primary essential, primary non-essential and secondary. Alopecia areata (AA) is a common, organ specific autoimmune disease, and most AA cases are sporadic. There is clearly a strong genetic component. There is no established relationship between CVG and AA. We report one case which was affected with essential primary CVG and alopecia areata, and suggest a possibility of genetic association between CVG and AA, possibly both being related to mutations in the fibroblast growth factor receptor 2 (FGFR2).

Transcutaneous pneumatic injection of glucose solution: a morphometric evaluation of in vivo micropig skin and tissue-mimicking phantom.

Needle‐free, transcutaneous pneumatic injection systems can be used to deliver therapeutic solutions to targeted layers of skin in a minimally invasive manner.