Soo Nam Kim

Treatment of vascular skin lesions with the variable-pulse 595 nm pulsed dye laser.

BACKGROUND In the dermatology field, variable-pulse 595 nm pulsed dye lasers (PDLs) are now being widely used to treat vascular skin lesions. However, there is little information available on variable-pulse 595 nm PDL treatment of dark-skinned patients. OBJECTIVE The objective of this study was to evaluate the outcome of variable-pulse 595 nm PDL treatment on Korean patients. METHOD Two hundred thirty-nine patients (Fitzpatrick skin phototypes III to V) with vascular skin lesions, such as nevus flammeus, telangiectasia, or hemangioma, were included in this study. All patients were treated with a variable-pulse 595 nm PDL, and the outcomes were assessed by comparing preoperative and postoperative photographs. RESULTS The average number of treatments per patient was 4.29, and 51.9% of patients showed a good (51–75% clearance) to excellent (76–100% clearance) response. For nevus flammeus, 48.0% of the patients achieved good to excellent results. The gender and age of the patients did not influence the clinical response; however, lesions of the head and neck were found to respond more favorably to treatment. For telangiectasia, 78.0% of patients showed good to excellent results, and, again, the gender and age of the patients did not alter the treatment outcome. For hemangioma, the male to female ratio of patients was 1.0:3.1 and 54.1% of the patients achieved a good to excellent response. Superficial hemangioma showed a better clinical response than deep hemangioma, and the lesions of younger patients responded more favorably than those of older patients. CONCLUSION The variable-pulse 595 nm PDL was found to be effective for treating several vascular skin lesions in dark-skinned patients. However, there were differences in treatment outcome owing to disease, age, and the location of the lesions.

Digital camera images obtained using a light‐emitting diode illuminator and their dermatological applications

Background/purpose: Although digital cameras have powerful macrocapabilities, flash macrophotographs are often unsatisfactory. The aim of this study was to develop a light‐emitting diode (LED) illuminator for macro digital photography that allows colorimetric investigations of the skin.

Disseminated superficial actinic porokeratosis with both typical and prurigo nodularis-like lesions.

We report a 50‐year‐old Korean patient who developed a disseminated superficial actinic porokeratosis (DSAP) with two types of lesions. One was a typical DSAP lesion clinically and histopathologically. The other was clinically similar to prurigo nodularis, but histologic examination showed the findings of porokeratosis such as cornoid lamellae and loss of the granular layer in addition to those of chronic lichenified dermatitis, so it could be described as prurigo nodularis‐like porokeratosis. The nodular lesions seemed to develop on preexisting typical lesions of DSAP mainly during the summer by the aggravation of pruritic symptoms and scratching associated with sun exposure. Although we could not find any published reports describing lesions like those of our case, we think that such prurigo nodularis‐like porokeratosis can develop in patients with DSAP in some situations involving pruritus and scratching.

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.

Fluorescence digital photography of acne using a light-emitting diode illuminator

Background/purpose: The fluorescence findings of several dermatological diseases, such as erythrasma, tinea versicolor, and acne are helpful for diagnosis and follow‐up. However, many experience difficulty taking photographic images of fluorescence. The aim of this study was to develop a 405 nm light‐emitting diode (LED) system for fluorescence digital photography of acne and to determine whether such a diode can be used to evaluate acne.

Precursor B-cell lymphoblastic lymphoma presenting as solitary infiltrative plaque in a child.

Sir, Precursor B-cell lymphoblastic lymphoma (B-LBL) is a rare subtype of lymphoblastic lymphoma (LBL). LBL is the most aggressive, high-grade subtype of nonHodgkin’s lymphoma (NHL), accounting for only 5% of all NHL. Most cases of LBL are of T-cell lineage, and B-LBL comprises no more than 10% of LBL. B-LBL is composed of immature lymphocytes that demonstrate lymphoblastic morphology and express precursor and B-cell markers. Unlike precursor T-cell lymphoblastic lymphoma (T-LBL), relatively little is known about B-LBL and only a few cases have been reported in the dermatological literature (1–7). Clinically, B-LBL usually involves the skin, lymph nodes and bone, and occurs in childhood or young adulthood (1). Korea has a much lower rate of B-cell lymphoma than Western countries (3). We describe here a rare case of B-LBL.