Kyu-Yeop Lee

Clinical manifestations associated with high titer of anti-streptolysin O in Behcet's disease.

To evaluate the association of chronic infection with clinical features of Behcet’s disease (BD), we studied epidemiological and clinical features of 149 patients with only aphthous ulcer and 294 patients with BD. The incidence of chronic infection history was compared between both groups with age- and sex-matching and clinical manifestations of BD associated with high anti-streptolysin O (ASO) titer were investigated. BD patients had more common history of tonsillitis and dental caries than aphthous ulcer patients (P = 0.002 and P = 0.043, respectively). BD patients with persistently high anti-streptolysin O titers had more frequent history of tonsillitis (P = 0.001, odds ratio [OR] = 2.99, 95% confidence interval [CI] 1.53–5.82) and erythema nodosum (EN)-like lesions (P = 0.001, OR = 3.02, 95% CI 1.54–5.93) and fewer history of genital ulcer (P = 0.027, OR = 0.21, 95% CI 0.05–0.84) than BD patients with normal anti-streptolysin O titer. Our results suggest persistently high ASO titers in BD patients could indicate that streptococcal infections such as tonsillitis are related to BD symptoms such as EN-like lesions. In these patients, ASO titer can be used in the evaluation of BD disease activity and antibiotic treatments might be effective to control the symptoms of BD.

Use of the 308-nm excimer laser for nevus depigmentosus: A promising treatment for either nevus depigmentosus or vitiligo

Dear Editor, Nevus depigmentosus (ND) is a congenital, nonprogressive, hypopigmented lesion that is usually stable throughout life. ND can be frequently misdiagnosed as other dermatoses because it clinically resembles vitiligo and other leukodermas. Because definite therapeutic modalities to treat ND are not yet established, improper diagnosis can lead to considerable unnecessary costs and lost time during therapy. We present a case of a 5-year-old boy with an irregularly-shaped, unilateral, achromic patch involving his trunk that appeared 3 years earlier (Fig. 1). There was no alteration in its distribution or relative size during the preceding 3 years, nor any hyperpigmented border around the achromic area. According to clinical diagnostic criteria proposed by Coupe, we diagnosed it as ND. Treatment with a 308-nm excimer laser was started twice weekly at 200 mJ/cm with weekly increments of 50 mJ/cm depending on the duration of the persistent erythema after each treatment. Subtle improvement of the lesion was observed after only four treatments, and the skin lesion was almost cleared by 14 exposures with the total cumulative dose of 4950 mJ/cm. Hyperpigmentation on surrounding normal skin remained, but no complications related to the treatment were noticed (Fig. 2). To our knowledge, only a few therapeutic attempts have been made to achieve repigmentation of ND by surgical means, such as an autologous graft with melanocytes or a conventional epidermal graft. However, unlike in vitiligo, the epidermal graft has a limited role because the extension of repigmentation from graft foci with the migration of melanocytes is hard to expect in cases of ND. Moreover, there has been no reported attempt to induce repigmentation of ND using phototherapeutic modalities. The hypothesis that ND is caused by functional defects of melanocytes and morphological abnormalities of melanosomes is generally suggested. Ultraviolet irradiation (UVR) has profound effects on skin pigmentation through a variety of mechanisms. UVR results in increased transport of melanosomes

Knockdown of Moesin Expression Accelerates Cellular Senescence of Human Dermal Microvascular Endothelial Cells

Purpose Endothelial cells maintain the homeostasis of blood, which consists of plasma and cellular components, and regulate the interaction between blood and the surrounding tissues. They also have essential roles in vascular permeability, the circulation, coagulation, inflammation, wound healing, and tissue growth. The senescence of endothelial cells is closely related to the aging of the adjacent tissues and to age-related vascular disease. Recently, the expression of moesin was found to be decreased in elderly human dermal microvascular endothelial cells (HDMECs), and an association between moesin and senescence has been suggested. This study examined the functional role of moesin in cellular senescence. Materials and Methods To study the effects of decreased moesin expression on cellular senescence and metabolism, HDMECs were transfected with short hairpin-RNA (shRNA) lentivirus to silence moesin gene expression. In addition, specimens from young and old human skin were stained with anti-moesin and anti-p16 antibodies as an in vivo study. Results Using shRNAl-entivirus, moesin knock-down HDMECs developed characteristics associated with aging and expressed senescence associated-beta-galactosidase during early passages. They also showed increased p16 expression, decreased metabolic activity, and cell growth retardation. Human skin tissue from elderly persons showed decreased moesin expression and increased p16 expression. Conclusion These findings suggest that there is a functional association between moesin expression and cellular senescence. Further study of the functional mechanism of moesin in the cytoskeleton and cellular senescence is needed. In addition, this study provides a useful model for developing anti-aging treatments.

Isolated Extragenital Bowenoid Papulosis of the Toe-webs

© 2009 The Authors. doi: 10.2340/00015555-0603 Journal Compilation

Two Cases of Acute Leukopenia Induced by Colchicine with Concurrent Immunosuppressants Use in Behçet's Disease

Colchicine-induced leukopenia usually occurrs in intentional or accidental overdoses or inappropriate use in combination with intravenous and oral colchine; however, there have been several reports of hematologic toxicity in short-term and small-dose colchicine medication courses. We present two cases of leukopenia induced by colchicine use concurrent with immunosuppressants in Behçets disease. We postulate that the mechanism of colchicine-induced leukopenia might be the destruction of circulating leukocytes and an inhibition of leukocyte production by the immediate and direct toxic effect of colchicine on idiosyncrasies unique to each patient. The concurrently administered immunosuppressant might decrease the threshold for hematologic toxicity of colchicine in the leukocytes and their precursor cells.

Radiofrequency-selective nerve ablation for glabellar frown lines in East Asian patients.

Several treatments for glabellar frown lines have been proposed, including botulinum toxin injection into the corrugator supercilii muscle (CSM), resection of the CSM, soft-tissue augmentation, and surgical division or radiofrequency (RF) ablation of the nerve to the CSM. We treated two Korean patients (a 45-year-old woman and a 53-year-old man) for glabellar frown lines with RF ablation of the nerve to the CSM, using monopolar RF probes. Both patients had a previous history of botulinum toxin A injections into the CSM with transient effect. Otherwise, they had no pertinent personal or family medical history. Informed consent was obtained from each patient for the procedure. Photos were taken before the operation, with the patients posed furrowing their brows (Figs 1a and 2a). Outpatient-based RF ablation of the nerve to the CSM was performed under local anaesthesia using injections of 2 mL lidocaine 1% mixed with 1 : 10 epinephrine. A 20G guide needle and monopolar RF probes (temperature probe, TCLP-100 and cannula, TCLP-1005 ; Sometech Medical Co., Seoul, Korea) were inserted at the intersection of the lateral limbus and mid-portion of upper eyelid and advanced about 16 mm superior to the supraorbital ridge. A nerve-stimulating current was applied at 1.0–2.0 V. The needle was inserted or retracted until CSM twitching was detected, upon which nerve stimulation was ceased and RF

Sudden Eruption of Pigmentary Spots on Vitiligo Universalis Patient: Possible Misdiagnosis

© 2009 The Authors. doi: 10.2340/00015555-581 Journal Compilation