Myoung Shin Kim

Adverse events of non-ablative fractional laser photothermolysis: a retrospective study of 856 treatments in 362 patients

Background: Non-ablative fractional laser photothermolysis (NAFP) has been used effectively in the treatment of photodamaged skin and scars, with short post-operative recovery times; but, studies evaluating its adverse events and complication rates in Asian population have been limited. Objective: To determine the frequency and range of adverse events associated with NAFP treatment in Korean patients. Materials and methods: We retrospectively evaluated the outcomes of 754 1550-nm erbium-doped and 102 1927-nm thulium fiber fractional laser treatments in patients with skin phototypes III–IV treated at a single center. Adverse events were identified and tabulated, as were patient demographics and laser parameters. Results: From 856 treatments, there were 43 adverse events (5.0%), the most frequent being prolonged erythema (1.8%), post-inflammatory hyperpigmentation (1.1%) and aggravation of melasma (0.9%). Less frequently observed adverse events included herpes simplex outbreak (0.6%) and acneiform eruption (0.2%). There were no reports of long-term adverse events. Conclusion: Non-ablative fractional laser skin treatment has a relatively low complication rate. The adverse events found were temporary and did not result in long-term or severe sequelae such as hypertrophic scarring, atrophic scarring or permanent pigmentary alteration.

Long-pulsed Nd:YAG laser on periorbital wrinkles in Asian patients: randomized split face study

Background and objective: This study evaluated clinical usefulness of long-pulsed Nd:YAG laser (LPNY) for periorbital wrinkles in Asian patients. Methods: Twenty seven Korean patients were treated with several passes of LPNY (5 mm spot size, fluence: 54.7–61.8 J/cm2, pulse duration: 56.5 microseconds). Three treatment sessions were conducted every 2 weeks on the half side of face that was randomly assigned. Outcome assessments included photography, global evaluation by two blinded independent dermatologists (using Fitzpatrick Wrinkle Classification System), and objective measurements of skin elasticity. Adverse events were documented. Patients reported their degree of satisfaction on a 6-point {0–5) visual analog scale (VAS). Results: All patients showed modest improvement. The mean wrinkle score on the treated side decreased by 34.9% (p < 0.05), while it did not change significantly on the control site. Skin elasticity (R2) increased significantly on the treated site. The average VAS score was 2.85 at 2 months but it dropped down to 1.05 at 6 months follow-up. No adverse effects were noted except 2 weeks lasting erythema in one patient. Conclusion: LPNY may be considered as a safe treatment option for periorbital wrinkles in Asian patients. However, three treatment sessions are not enough for maintaining optimal clinical outcome.

Tranexamic acid solution soaking is an excellent approach for rosacea patients: A preliminary observation in six patients

1 Li L-F, Zhao J, Li S-Y. Exanthematous drug eruption due to Chinese herbal medicines Sanjieling capsule and Huoxuexiaoyan pill. Contact Dermatitis 1994; 30: 252. 2 Li LF, Wang J. Patch testing in allergic contact dermatitis caused by topical Chinese herbal medicine. Contact Dermatitis. 2002 Sep;47:166–168. 3 Chen HH, Sun CC, Tseng MP, Hsu CJ. A patch test study of 27 crude drugs commonly used in Chinese topical medicaments. Contact Dermatitis 2003 (Jul); 49 (1): 8–14. 4 Wahlberg JE. Patch testing. In: Rycroft RJG, Menne T, Frosch PJ, Benzra C, eds. Textbook of Contact Dermatitis. Berlin: Springer Verlag, 1992; 241–265. 5 Dragana P, Šolević Knudsen T, Krivokapić M. Sinalbin degradation products in mild yellow mustard paste. Hem Ind 2012; 66: 29–32.

Breakthrough disseminated fusariosis in an immunocompromised patient on voriconazole therapy.

adenocarcinoma. A Clinicopathologic study of cases. Arch Dermatol 1983; 119: 104–114. 7 Barzi AS, Ruggen S, Recchia F, Bertoldi I. Malignant metastatic eccrine poroma. Proposal for a therapeutic protocol. Dermatol Surg 1997; 23: 267–272. 8 Carlson JW, McGlennen RC, Gomez R, et al. Sebaceous carcinoma of the vulva: a case report and review of the literature. Gynecol Oncol 1996; 60: 489–491. 9 Asuquo M, Ugare G, Odio B, Ebughe G. Squamous cell carcinoma in Calabar, Nigeria. Nig J Surg Sci 2006; 16: 35–38.

Increased expression of activating transcription factor 3 is related to the biologic behavior of cutaneous squamous cell carcinomas.

Activating transcription factor 3, a member of the activating transcription factor/cyclic adenosine monophosphate response element-binding family of transcription factors, is an adaptive response gene that plays an oncogenic role in the development of various cancers. To our knowledge, few information are available on the possible role of activating transcription factor 3 in skin cancer. In this study, we investigated the expression of activating transcription factor 3 in basal cell carcinomas (n = 5), actinic keratoses (n = 7), squamous cell carcinomas (n = 19), and Bowen disease (n = 14) by immunohistochemistry. In results, activating transcription factor 3 was significantly expressed in squamous cell carcinomas (15/19), suggesting that it is involved in the pathogenesis of squamous cell carcinomas but not in basal cell carcinomas (0/5). In addition, higher expression of activating transcription factor 3 was observed in squamous cell carcinomas that were metastatic (P < .01) or arose in organ transplant recipients (P < .05). Therefore, activating transcription factor 3 appears to play an oncogenic role in the development of squamous cell carcinomas and may be related to the biologic behavior of them.

Efficacy and safety of a new monophasic hyaluronic acid filler in the correction of nasolabial folds: a randomized, evaluator-blinded, split-face study

Background: Hyaluronic acid (HA) fillers are frequently used for the correction of facial soft-tissue defects. Objective:To compare the efficacy and safety of a novel monophasic HA filler (mono-HA), and a well-studied biphasic HA filler (bi-HA), in the treatment of moderate to severe nasolabial folds. Methods: In this randomized, evaluator-blinded, split-face comparative study, subjects were randomized for injections with mono-HA or bi-HA on the left or right side of the face. Efficacy was determined by calculating the change in the Wrinkle Severity Rating Score (WSRS) relative to baseline. Local safety was assessed on the basis of subject diary entries which recorded erythema, swelling, induration, pruritus, irritation, mass, hematoma, pain, and dryness. Results: At week 24, the mean improvement in the WSRS from baseline was 2.18 ± 0.42 for the mono-HA side and 2.16 ± 0.41 for the bi-HA side. Both fillers were well-tolerated and adverse reactions were mild and transient in most cases. Conclusions: Mono-HA has a non-inferior efficacy to bi-HA in the treatment of moderate to severe nasolabial folds.

Atypical molluscum contagiosum accompanied by CD30-positive lymphoid infiltrates.

Abstract:  Atypical presentations of molluscum contagiosum require histophathologic examination and may show pleomorphic lymphocytic infiltrates of a reactive nature, mimicking cutaneous lymphoproliferative diseases. Serial sections of specimens or polymerase chain reactions to show T‐cell receptor clonality may be helpful for differential diagnosis. We report a case of atypical molluscum contagiosum accompanied by atypical lymphocytic infiltration showing CD30 positivity.

Epidemiology of deep cutaneous fungal infections in Korea (2006-2010)

Deep cutaneous fungal infections (DCFI) occur worldwide and their prevalence is influenced by personal factors of the affected patients and the geographic and cultural features. Surveillance studies of DCFI with respect to the various clinical backgrounds of affected patients can ultimately help to improve their outcome. Expanding on our previous study, we performed a retrospective analysis of patients with DCFI who were treated in a group of university teaching hospitals in Korea to determine the trends within a 5‐year period. A retrospective medical record review of patients with DCFI treated between 2006 and 2010 at 16 university teaching hospitals located throughout Korea was performed. Among the 51 cases of DCFI (median patient age, 47.0 years), opportunistic infections in immunocompromised hosts accounted for half. Patients in this group included 11 who were transplant recipients and 12 with malignancies. Overall, Candida (13/51) was the most common causative organism, followed by Sporothrix (12) and Aspergillus (6). Papuloplaques and nodular lesions were the typical presentation, with maculopatches and ulcers also occurring in considerable numbers. Ten patients had systemic involvement. Eight immunocompromised patients did not recover from the disease despite systemic antifungal treatment. Our results highlight the equal involvement of opportunistic and primary pathogens in DCFI, as determined in cases from a 5‐year period. Especially in immunocompromised hosts with non‐specific skin findings, clinical suspicion is important because failure to diagnose a DCFI causes significant morbidity and possibly even death.