Soo Hong Seo

Treatment of Becker's nevi with a long-pulse alexandrite laser.

BACKGROUND Beckers nevus (BN) can be a distressing cosmetic handicap for patients and a treatment challenge for physicians. Various treatment modalities have been used, but repigmentation commonly occurs after treatment. OBJECTIVE To evaluate the efficacy of long‐pulse alexandrite laser in the treatment of BN. MATERIALS AND METHODS Eleven Korean patients with Fitzpatrick skin type III to V were included in this study. A long‐pulsed alexandrite laser with a wavelength of 755 nm and a pulse duration of 3 ms was used. Patients were treated with a fluence of 20 to 25 J/cm2 and a spot size of 15 to 18 mm. Cryogen spray cooling was not used. RESULTS Two patients had excellent responses, five had good responses, and four had fair responses. Hair density simultaneously decreased with treatment in all patients. Although mild hypopigmentation was observed in some patients, and partial hypertrophic scarring was observed in one patient, the outcomes were cosmetically acceptable. No repigmentation was noted during the follow‐up period. CONCLUSION A long‐pulsed alexandrite laser without cryogen spray cooling is an effective and safe alternative in the treatment of BN. The authors have indicated no significant interest with commercial supporters.

Ablative fractional laser treatment for hypertrophic scars: comparison between Er:YAG and CO2 fractional lasers

Background: Nonablative fractional photothermolysis has been reported to show early promise in the treatment of hypertrophic scars, but there are few reports on ablative fractional photothermolysis for the treatment of hypertrophic scars. Aim: To evaluate and compare the efficacy and safety of Er:YAG fractional laser (EYFL) and CO2 fractional laser (CO2FL) for treatment of hypertrophic scars. Methods: Thirteen patients with hypertrophic scars were treated with 2,940 nm EYFL, and ten were treated with 10,600 nm CO2FL. An independent physician evaluator assessed the treatment outcomes using Vancouver scar scale (VSS) and 5-point grading scale (grade 0, no improvement; grade 1, 1–25%; grade 2, 26–50%; grade 3, 51–75%; grade 4, 76–100% improvement). Patients are queried about their subjective satisfaction with the treatment outcomes. Results: After the final treatment, average percentage changes of VSS were 28.2% for EYFL and 49.8% for CO2FL. Improvement was evident in terms of pliability, while insignificant in terms of vascularity and pigmentation. Based on physicians global assessment, mean grade of 1.8 for EYFL and 2.7 for CO2FL was achieved. Patients subjective satisfaction scores paralleled the physicians objective evaluation.Conclusion: CO2FL is a potentially effective and safe modality for the treatment of hypertrophic scars, particularly in terms of pliability.

A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars.

BACKGROUND The use of ablative lasers based on the fractional approach is a novel strategy for the treatment of postoperative and acne scars in addition to wrinkles. OBJECTIVE To evaluate and compare the efficacy of carbon dioxide ablative fractional laser (AFL) and the pulsed dye laser (PDL) for the improvement of surgical scars. MATERIALS AND METHODS Fourteen Korean patients with surgical scars were enrolled for this study. Half of each scar was treated with a 10,600-nm AFL and the contralateral half with the 595-nm PDL. For early intervention of the postoperative scar, the laser treatments were begun after 2 weeks from the Mohs micrographic surgery. RESULTS Both PDL and AFL produced statistically significant improvements. However, comparatively, there was no statistical difference between them. In each variable, AFL was more effective than PDL in the improvement of pliability and thickness. In contrast, PDL was superior to AFL in the improvement of vascularity and pigmentation. CONCLUSION Pulsed dye laser and AFL treatments for surgical scar provide significant improvement. Pulsed dye laser was more effective in color of scar compared with AFL, which showed marked improvement in the contour of scar. Overall improvement was not statistically different in the Vancouver Scar Scale.

A quantitative assessment of the human skin surface using polarized light digital photography and its dermatologic significance

Background: Quantitative and objective investigations of parallel‐polarized light (PPL) photography for dermatologic purposes are scarce.

Comparative Study on the Sustained Efficacy of Diphencyprone Immunotherapy Versus Cryotherapy in Viral Warts

Abstract:  This study compared the sustained clearance rate of viral warts treated with topical diphencyprone (DCP) therapy (group A) versus cryotherapy (group B). After 12 months follow‐up, 93.3% (42/45) of group A and 76.3% (29/38) of group B presented sustained clinical clearance. Our data suggest that topical DCP therapy may lead to the induction of the long‐term immunity to human papillomavirus (HPV).

Cutaneous T Cell Pseudolymphoma at the Site of a Semipermanent Lip-Liner Tattoo

the infiltrated cells strongly expressed CD3 antigen ( fig. 2 b). The lymphocytes were CD68 negative, but the macrophages partially expressed CD68 ( fig. 2 c). CD20 and terminal deoxynuleotidyl transferase were negative ( fig. 2 d, e). Ki-67 had a low proliferation index ( fig. 2 f). A T cell receptor gene rearrangement study was performed on paraffin-embedded skin and showed a polyclonal pattern. We attempted treatment with a 595-nm pulsed dye laser, but there was no improvement after 4 sessions. Thereafter, the patient underwent intralesional triamcinolone injections at 2or 3-week intervals for 4 months. The lesion responded gradually and marked clinical improvement was observed ( fig. 1 b). During a fol-

Antiepiligrin Cicatricial Pemphigoid with Autoantibodies to the Beta Subunit of Laminin 5 and Associated with Severe Laryngeal Involvement Necessitating Tracheostomy

We report the case of a 67-year-old Korean woman with antiepiligrin cicatricial pemphigoid. The patient’s serum immunoprecipitated polypeptides that comigrated with those identified in serum from a representative patient with antiepiligrin cicatricial pemphigoid, and was reactive with the laminin β3-subunit on immunoblotting. She presented not only with cutaneous, oral and ocular, but also with laryngeal and esophageal involvement. Because the supraglottic stenosis was severe, she had to undergo tracheostomy to maintain airway patency.

Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis

Background Pigmented purpuric dermatoses (PPD) are a spectrum of disorders characterized by a distinct purpuric rash. Although PPD can be easily diagnosed, the disease entity remains an enigma and a therapeutic challenge. Objective The purpose of this study was to investigate the characteristics and clinical manifestations of PPD and to elucidate the relationship between assumed etiologic factors and the clinical manifestations of PPD and treatment responses. Methods Retrograde analyses were performed to identify appropriate PPD patients who visited Korea University Medical Center Anam Hospital from 2002 to 2012. Results Information on 113 patients with PPD was analyzed, and 38 subjects with skin biopsy were included for this study. Schambergs disease was the most frequent clinical type (60.5%). Concomitant diseases included hypertension (15.8%), diabetes (10.5%), and others. Associated medication histories included statins (13.2%), beta blockers (10.5%), and others. Possibly associated etiologic factors were recent upper respiratory infection (5.3%), high orthostatic pressure due to prolonged standing (2.6%), and strenuous exercise (2.6%). A total of 36 patients (94.7%) were treated with one or more treatment methods, including oral antihistamines, pentoxifylline, topical steroids, and/or phototherapy. There was no significant difference in disease progress according to underlying diseases, medications, or association factors (p>0.05). Conclusion Our overall results were grossly consistent with the existing literature, excluding several findings. Although a possible relationship between PPD and cardiovascular disease or cardiovascular medication was proposed at the beginning of the study, no statistically significant correlations were found according to the specific clinical types and treatment responses (p>0.05).

Syringocystadenoma Papilliferum in Co-existence with Tubular Apocrine Adenoma on the Calf.

Syringocystadenoma papilliferum (SCAP) occurs singly or in association with other tumors. Although it is rare, the association of tubular apocrine adenoma (TAA) with SCAP in the background of nevus sebaceous (NS) on the scalp is well documented. However, the co-existence of these two tumors without background of NS has not been reported on the extremities. We report a case of SCAP associated with TAA on the calf without pre-existing NS in an adult.

Retrospective analysis of melasma treatment using a dual mode of low-fluence Q-switched and long-pulse Nd:YAG laser vs. low-fluence Q-switched Nd:YAG laser monotherapy.

Abstract Background: Despite the effectiveness of low-fluence Q-switched Nd:YAG laser (QSNY) treatment in melasma, adverse events, including mottled hypopigmentation (MH) and rebound hyperpigmentation (RH) have been reported. Objective: To compare the effectiveness and safety of combination therapy using low-fluence QSNY and long-pulse Nd:YAG laser (LPNY) (Dual toning), with low-fluence QSNY monotherapy (QS toning), in Asian melasma patients. Materials and methods: Patients were treated for 10 sessions at 1-week intervals with QSNY (6 mm spot); 2.5–3.0 J/cm2 for QS toning (n = 177) or 2.1–2.5 J/cm2 for dual toning (n = 183). The dual toning group was immediately treated with LPNY (7 mm spot, 15–17 J/cm2). The results were evaluated using the modified Melasma Area and Severity Index (mMASI) score and the physicians global assessment. Results: MH or RH were significantly lower (1.1% vs. 14.1%) and the treatment efficacy was improved (median decrease of mMASI, 3.6 vs. 3.0) in the dual toning group compared with the QS toning group. Periorbital melasma showed distinctively high rates of adverse events in the QS toning group (23.9% vs. 5.7%), which were significantly reduced in the dual toning group (2.9%). Conclusion: Dual toning could represent a safe and effective treatment for Asian melasma patients, as it is associated with minimal adverse events and improved treatment efficacy compared with QS toning monotherapy.