Sun Young Huh

Efficacy and safety of liposome-encapsulated 4-n-butylresorcinol 0.1% cream for the treatment of melasma: A randomized controlled split-face trial

Melasma is an acquired pigmentary disorder that most commonly occurs in women of child‐bearing age. Melasma is therapeutically challenging, and most commercially available hypopigmenting agents include tyrosinase inhibitors, which regulate the rate‐limiting step of melanogenesis. 4‐n‐Butylresorcinol has received considerable attention as a novel hypopigmenting agent in the last 15 years because it has an inhibitory effect against tyrosinase and tyrosinase‐related protein‐1. However, the hypopigmenting effect of 4‐n‐butylresorcinol in human subjects has only been shown in a few studies. Liposome encapsulation is known to improve stabilization and enhance penetration of the product. Therefore, this study was conducted to evaluate the hypopigmenting efficacy and safety of liposome‐encapsulated 4‐n‐butylresorcinol 0.1% cream in patients with melasma. This was a randomized, double‐blind, vehicle‐controlled and split‐face comparison study. Twenty‐three patients with a clinical diagnosis of melasma were included. 4‐n‐Butylresorcinol 0.1% cream or vehicle was applied to each side of the face twice daily for 8 weeks. Clinical and photographic evaluations, Mexameter measurements and assessment of patient satisfaction and side‐effects were performed at baseline, 4 and 8 weeks. All subjects completed the study. Mexameter measurements demonstrated that the melanin index of the 4‐n‐butylresorcinol‐treated side showed a significant decrease when compared with the vehicle‐treated side after 8 weeks (P = 0.043). No adverse reactions were observed throughout the study. Subjectively, 4‐n‐butylresorcinol was considered to be efficacious in more than 60% of the patients after 8 weeks of treatment. In conclusion, liposome‐encapsulated 4‐n‐butylresorcinol 0.1% cream was well tolerated and showed significant higher efficacy than vehicle alone for the treatment of melasma.

The effect of photodynamic therapy using indole-3-acetic Acid and green light on acne vulgaris.

Background Photodynamic therapy (PDT) using topical aminolevulinic acid (ALA) has increasingly been used for the treatment of acne vulgaris and several studies have shown its clinical efficacy. However, ALA-PDT needs a relatively long incubation period and is frequently associated with adverse effects. Indole-3-acetic acid (IAA) has been introduced as a new photosensitizer for the treatment of acne in recent study. IAA-PDT requires only a short incubation period and the procedure is relatively painless in contrast to ALA-PDT. Objective To investigate the efficacy and safety of IAA- PDT in the treatment of acne. Methods Twenty-five patients with facial acne lesions were enrolled in this study. IAA-PDT was performed for five sessions at 1-week intervals (week 0~4). IAA was treated with 15 minute occlusion, and green light was given for 15 minutes. Clinical efficacy was determined by evaluating acne lesion counts, severity grading, and the Dermatology Life Quality Index (DLQI) at week 0, 2, 4, and 5. Sebum secretion and erythema index was measured by Sebumeter and Mexameter, respectively, at baseline and one week after each treatment session (week 1~5). Histopathological examination was performed at baseline and week 5. Adverse effects were recorded throughout the study. Results All the patients completed the study. Numbers of both inflammatory and non-inflammatory acne lesions were significantly decreased. Acne severity grade and the DLQI showed significant reduction. Sebum secretion and erythema were also reduced. Histopathological examination showed a reduction in inflammatory reactions. No adverse effects were observed except for transient pruritus in one patient. Conclusion PDT using IAA and green light was an effective, simple and safe treatment for acne.

Biology of melanogenesis and the search for hypopigmenting agents

Increased production and accumulation of melanin are characteristics of a large number of skin diseases, including melasma, post-inflammatory hyperpigmentation and lentigo. A number of clinical agents can reduce normal or abnormal pigmentation, but none of these have achieved satisfactory effects. This review discusses the mechanisms behind the different approaches. Tyrosinase is a pivotal enzyme in melanin synthesis. The majority of whitening or lightening agents act by specifically reducing the activity of tyrosinase via several mechanisms: (1) prior to melanin synthesis (interfering with its transcription and/or glycosylation); (2) during melanin synthesis (tyrosinase inhibition, peroxidase inhibition and reduction of byproducts); and (3) after melanin synthesis (tyrosinase degradation, inhibition of melanosome transfer, acceleration of skin turnover). Additional melanogenesis-associated mechanisms are also discussed.

Oligosaccharides of hyaluronic acid increased epidermal cell stemness by modulation of integrin expression

Hyaluronic acid (HA) is an abundant matrix component and is degraded into polymers of various sizes. These generated fragments appear to have properties that affect wound healing of the skin. In industry, small‐sized HA is used as a moisturizing agent but can have biologic effects when it is absorbed through the skin with barrier disruption.

A Case of Complication after Matridex® Injection

Matridex(R) is an injectable skin filler thats composed of a mixture of cross linked hyaluronic acid and dextranomer particles, and it was recently developed for soft tissue augmentation. To the best of our knowledge, there have been few previous reports on complications associated with Matridex. We report here on a delayed inflammatory reaction to an injection of Matridex in the glabellar fold, and this developed five weeks after the injection and it lasted more than a year. The patient was treated with oral doxycycline and intralesional injection of triamcinolone acetonide; this resulted in almost complete resolution of the lesion. The patient should be informed of the potential complications with the use of injectable fillers before treatment, for it could lead to undesirable aesthetic consequences.

Erythrocyte Malondialdehyde and Glutathione Levels in Vitiligo Patients

BACKGROUND Vitiligo is an acquired and progressive hypomelanotic disease that manifests as circumscribed depigmented patches on the skin. Although the precise mechanism remains to be elucidated, an imbalance of the oxidant/antioxidant system has been proposed as an important etiologic mechanism. OBJECTIVE The objective of this study was to evaluate the oxidant/antioxidant status of vitiligo patients at the erythrocyte level. METHODS Fifty-three vitiligo patients and 65 phototype-, age-, and sex-matched healthy controls were included in this study. Blood samples were collected from all subjects, and all patients were instructed to answer a questionnaire. RESULTS Erythrocyte levels of malondialdehyde (MDA) and glutathione (GSH) were measured. All patients were told to answer a questionnaire regarding their habitual behavior, including frequency of smoking and type of diet. We observed significantly lower levels of GSH in vitiligo patients, but the levels of MDA did not differ between patients and controls. Vitiligo patients who smoked showed significantly lower GSH levels compared to non-smoking patients, but the levels of MDA were unchanged between the 2 groups. CONCLUSION From our results, we conclude that reduced erythrocytic or systemic GSH levels constitute a distinctive feature in vitiligo patients regardless of disease activity.

Neonatal erythema multiforme: a case report.

Erythema multiforme (EM) is an extremely rare condition in infancy. To the best of our knowledge, there have been only three cases of neonatal EM described in the literature, and no such cases have been reported in Korea. A preterm neonate born at 35 weeks and six days of gestation presented with multiple annular erythematous patches with a targetoid shape over his entire body at 36 days of age (corrected age of 7 days). He had no systemic symptoms except for transient mild fever. No triggering factor except for hepatitis B and BCG vaccination was found. Neutropenia was noted upon laboratory analysis. Skin biopsy specimens showed findings suggestive of erythema multiforme. The skin lesions improved rapidly upon administration of intravenous methylprednisolone; however, neutropenia continued for a much longer period. The significance of neutropenia with respect to the development of EM was not clarified. There has been no recurrence of skin lesions over a one-year follow-up period.

A Case of Epstein-Barr Virus-associated Hydroa Vacciniforme

Hydroa vacciniforme (HV) is a photosensitivity disorder characterized by recurrent necrotic vesiculopapules on sun-exposed areas, which heal spontaneously during adolescence. Recently, an association has been reported between latent Epstein-Barr virus (EBV) infection and atypical HV-like eruption and malignant potential. However, latent EBV infection has also been reported in the setting of typical HV. An 11-year-old girl presented with recurrent, scattered, discrete vesicular eruptions with scarring on the face and the extensor surfaces of both forearms. In-situ hybridization was carried out to detect latent EBV infection. Based on the clinical and histopathological findings, typical EBV-associated HV was suspected.