S. B. Cho

Melasma treatment in Korean women using a 1064‐nm Q‐switched Nd:YAG laser with low pulse energy

The efficacy of a 1064‐nm Q‐switched neodymium:yttrium–aluminium–garnet (QS Nd:YAG) laser with low pulse energy in the treatment of melasma in 25 women was assessed by retrospective analysis of clinical photographs and patient satisfaction rates. Follow‐up results 2 months after the last treatment revealed that, as defined by our grading scale, 11 of the 25 patients (44%) had marked clinical improvement: 7 of these (28%) had near‐total clinical improvement, 5 had moderate clinical improvement and 2 had minimal to no improvement. Our data suggest that the use of a QS Nd:YAG laser with low pulse energy is an effective, easily performed treatment for melasma in selected East Asian patients.

Punctate leucoderma after melasma treatment using 1064-nm Q-switched Nd:YAG laser with low pulse energy

© 2009 The Authors JEADV 2009, 23, 954–982 Journal compilation

Treatment of post-inflammatory hyperpigmentation using 1064-nm Q-switched Nd:YAG laser with low fluence: report of three cases.

the inflammatory and ulcerated lesions. MCD is a well suited name for this form. The intertriginous and genital MCD present frequently as an isolated, indurated oedemata associated with rhagades. This infiltrated oedematous MCD would correspond to the presence of the non-caseating tuberculoid granuloma without or minimal vascular injury. For this form, often associated with an anoperineal CD, the term MCD is confused and we suggest to use oedematous cutaneous CD instead.

Treatment of segmental café‐au‐lait macules using 1064‐nm Q‐switched Nd:YAG laser with low pulse energy

A 55-year-old Korean woman with Fitzpatrick type IV skin presented with a pigmented patch and macules confined to the left side of the face that had persisted from childhood. She had been treated with several sessions of mechanical dermabrasion about 20 years previously, Q-switched laser treatments about 5 years previously, and intermittent use of bleaching agents at various private dermatology clinics. However, none of the treatments achieved satisfactory improvement, and the hyperpigmented lesions persisted. There was no personal or family medical history of relevance, and no history of neurofibromatosis or autoimmune diseases. On physical examination, a brownish, pigmented patch was seen, spreading from the left side of the forehead towards the nose and cheek on the left side of the face, and several discrete brownish macules were also noted on the same side (Fig. 1). The lesions were clinically diagnosed as segmental café-au-lait macules (CALMs); however, a skin biopsy was refused by the patient. After informed consent, five sessions of laser treatment [using a Q-switched 1064-nm neodymium:yttrium– aluminium–garnet (Nd:YAG) laser (MedLite C3 ; HoyaConBio Inc., Fremont, CA, USA) with low pulse energy] at 2-week intervals were performed. At each session, the entire face was completely cleansed with a mild soap and topical anaesthetic cream (eutectic mixture of 2.5% lidocaine HCl and 2.5% prilocaine; EMLA; AstraZeneca AB, Södertälje, Sweden) for local anaesthesia was applied under occlusion to both cheeks for 1 h before the procedure. Both cheeks, including the CALMs, were treated using 1.6 J ⁄ cm, 6-mm spot size, and two passes with appropriate overlapping, followed by treatments of 2.5–2.8 J ⁄ cm, 4-mm spot size, two passes with appropriate overlapping. The patient did not experience any marked complications or side-effects. After the fifth treatment, distinct clearing was observed, and an additional five sessions were performed (Fig. 2). At follow-up 6 months after the last treatment, the CALMs had not recurred. A CALM is a common, benign epidermal pigmented lesion, which can be solitary or associated with neurocutaneous (a)

A case of giant congenital nevocytic nevus with neurotization and onset of vitiligo

The authors report the case of a 21‐year‐old woman with a giant congenital nevocytic nevus (GCNN) who developed vitiligo at the age of 16 years on skin areas remote from the GCNN. This is the first reported case of GCNN developing neurotization combined with vitiliginous changes within the GCNN lesion. Treatment with PUVA achieved repigmentation of the vitiligo lesions, except for the hypochromic areas within the area of the nevus that were shielded from UVA radiation.

Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review

Tranexamic acid is a novel treatment option for melasma; however, there is no consensus on its use. This systematic review searched major databases for relevant publications to March 2016. Eleven studies with 667 participants were included. Pooled data from tranexamic acid-only observational studies with pre- and post-treatment Melasma Area and Severity Index (MASI) showed a decrease of 1.60 in MASI (95% confidence interval (CI), 1.20-2.00; p<0.001) after treat-ment with tranexamic acid. The addition of tranexamic acid to routine treatment modalities resulted in a further decrease in MASI of 0.94 (95% CI 0.10-1.79; p = 0.03). Side-effects were minor, with a few cases reporting hypo-menorrhoea, mild abdominal discomfort, and transient skin irritation. These results support the efficacy and safety of tranexamic acid, either alone or as an adjuvant to routine treatment modalities for melasma.

Weissella confusa Bacteremia in an Immune-Competent Patient with Underlying Intramural Hematomas of the Aorta

Weissella confusa is a catalase-negative and gram-positive coccobacillus that is intrinsically resistant to vancomycin [1]. This species can cause infections, such as bacteremia, endocarditis, and abscess in immunocompromised patients [2-7]. Until now, reports on infections caused by W. confusa have been limited as this species has been frequently misidentified as Lactobacillus or Leuconostoc when identified using commercial kits [8]. Herein, we report the second case of W. confusa bacteremia in an immunocompetent patient from Korea, who had intramural hematomas of the aorta.

Decreased Tissue and Serum Expression of Galectin-7 in Patients with Hypertrophic Scars

Hypertrophic scars (HS) result from an imbalance between collagen biosynthesis and matrix degradation during wound healing. In this study a proteomics approach was used to compare the protein profiles of skin tissue obtained from patients with HS and healthy controls. One of the epidermal proteins, galectin-7 was markedly down-regulated in HS. Serum levels of galectin-7 in 27 patients with HS were less than 1/3 of those in 15 healthy controls. Tissue protein expression was subsequently evaluated using immunohistochemical staining on HS tissue and on serially-obtained control tissue during wound healing. Weaker galectin-7 immunoreactivity was detected along the cytoplasmic membrane of basal and suprabasal cells in samples from HS. In addition, galectin-7 was stained in the extracellular space of the upper papillary dermis in HS tissue. Ablative laser treatment, used to induce wound healing of healthy control tissue, demonstrated marked galectin-7 expression at the cytoplasmic membrane on days 3, 5, 14 and 21. Pronounced galectin-7 staining at the upper papillary dermis was detected on days 1, 3 and 10. These results suggest that the differences in galectin-7 expression and subcellular and extracellular distribution may be crucially involved in the pathogenic process of HS.

Dome-shaped tumour with surface changes on the abdominal wall

A 22-year-old man presented with a dome-shaped papule on his upper abdominal wall. The papule had been present for 1 year, and it had been enlarging and protruding for the past 3 months. There was no relevant personal or family medical history. There was a reddish protruding portion about 10 mm in diameter, which was connected to a rubbery, skincoloured nodule, 30 mm in size, on the upper abdominal wall (Fig. 1). The patient reported no symptoms from the papule. The tumour was excised, and following excision, there was no recurrence of the tumour and the patient did not report any side-effects such as paraesthesia. Histological findings

A case of childhood flexural comedones

© 2008 The Authors JEADV 2009, 23, 317–368 Journal compilation