Sung-Wook Park

β-Catenin expression in the transitional cell zone of pilomatricoma

Background β‐Catenin, a participant in the Wnt pathway, has been shown to play an important role in the morphogenesis of hair follicles and the formation of hair follicle‐related tumours, including pilomatricomas. It has been observed that at least 75% of human pilomatricomas possess activating mutations in β‐catenin. These findings suggested that β‐catenin plays an important role in the tumorigenesis of pilomatricomas. However, the pattern of β‐catenin expression in pilomatricoma tissues is still unclear.

Effectiveness of modified phenol peel (Exoderm) on facial wrinkles, acne scars and other skin problems of Asian patients.

Deep depth peeling using phenol is one of the most effective chemical peeling methods. However, it has been rarely used on Asian people because of side‐effects, especially hypopigmentation. In order to reduce side‐effects, a number of modified phenol peeling formulas were developed. Exoderm, a modified phenol peel, has shown reduced side‐effects such as arrhythmia, long‐lasting erythema, hypopigmentation, hypertrophic scar and keloid. In the present study, our aim was to evaluate the effectiveness of Exoderm on wrinkles, acne scars, and melasma and its safety for Asian patients. Forty‐six patients were treated with Exoderm. Twenty‐eight patients (61%) were treated for wrinkles and 11 patients (24%) for acne scars. Clinical improvement and side‐effects were evaluated and the degree of improvement was graded into four stages. The overall average improvement scores were 3.39 and 3.30 out of 4.00 as evaluated by the doctor and patient, respectively. Forty‐one patients (89%) showed 51% or more improvement. All patients with wrinkles improved 51% or more and their average improvement score was 3.64 out of 4.00. Seven of 11 patients (64%) with acne scars improved 51% or more and their average improvement score was 2.73 out of 4.00. The most frequent side‐effect was postinflammatory hyperpigmentation (74%). Prolonged erythema, keloid and milia were observed temporarily, however, hypopigmentation persisted for 6 months in the follow‐up period. All side‐effects were tolerable and reversible except for one complication of hypopigmentation. We conclude that Exoderm is very effective for treating the facial wrinkles and acne scars of Asian patients.

Congenital triangular alopecia in association with congenital heart diseases, bone and teeth abnormalities, multiple lentigines and café‐au‐lait patches

A 21-year-old male presented to our clinic to be treated for multiple lentigines on his face. The patient also had congenital triangular alopecia (CTA) on his left frontotemporal suture area, which was 3.0 cm × 1.8 cm in size (Fig. 1). We also found café-au-lait patches on his right hand and left foot. The lentigines and café-au-lait patches began developing 10 years previous, and the lentigines had since spread from the face to the trunk and extremities (Fig. 2). The patient had a history of tricuspid regurgitation, mitral regurgitation, pulmonary stenosis, pulmonary regurgitation and atrial septal defect, which were diagnosed with echocardiography, fibrous dysplasia on his right tibia, and mesiodens on maxilla. He has been followed up by cardiologists without specific treatments for the congenital heart diseases, as the defects were not serious and did not discomfort his normal life. Five years ago he received an extraction of mesiodens, and curettage and bone graft with prophylactic intramedullary nailing for fibrous dysplasia. The patient’s mother, during her pregnancy, had been physically abused several times by her husband, which included severe blows to her abdomen, and had also suffered from mental stress. The CTA had been noticed at birth and since then no changes in size and morphology have been found. Biopsy specimens were taken from the patient’s scalp and facial hyperpigmented lesion. Clinically and histochemically, the lesions corresponded exactly to the typical CTA and lentigines. Discussion

Serum levels of IL‐18 and sIL‐2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroids

Please cite this paper as: Serum levels of IL‐18 and sIL‐2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroids. Experimental Dermatology 2010; 19: 145–147.

Vegetative pyoderma gangrenosum in Behcet's disease

Sir, Pyoderma gangrenosum (PG) is a sterile, pustular, ulcerative process of unknown cause (1). It is frequently associated with various systemic diseases, including inflammatory bowel disease, arthritis, monoclonal gammopathy, malignant disease (2) and, rarely, Behcet’s disease (3). Four clinical and histological variants have been recognized: ulcerative, pustular, bullous and vegetative. Vegetative PG is usually not associated with systemic disease (2). We report here a case with vegetative PG in Behcet’s disease.

A case of hypermelanosis in a phylloid pattern

Pigmentary anomalies display a variety of different patterns. The phylloid pattern is characterized by a leaf-shaped arrangement reminiscent of floral ornaments. We describe a 20-year-old Korean man with hyperpigmented oblong patches and atypically short, thick hairs in a phylloid pattern on the face, the left shoulder, and the left side of the trunk. Associated musculoskeletal anomalies included equinovarus deformities, bilateral club foot, lumbar lordosis, spina bifida, and relative hypertrophy of the right thigh muscles.

Pneumothorax secondary to ipsilateral herpes zoster pectoralis.

Sir, Herpes zoster manifests as a result of the reactivation of varicella-zoster virus (VZV), in latent infection, in the sensory ganglia of the cerebral and spinal nerves. It is caused by various factors after childhood chickenpox. The vesicular eruption clusters around the sensory nerve distribution and is accompanied by severe pain. As the skin lesion recovers dependent on the extent of necrotic eschar, sequelae such as depressed scar, RamsayHunt syndrome, hearing loss and impaired vision remain (1). When cough and dyspnea accompany ipsilateral pain in herpes zoster pectoralis patients, diseases such as pneumothorax should also be considered, and careful physical examination and routine laboratory tests should be carried out. We report a case of secondary pneumothorax which seemed to be caused by herpes zoster pectoralis.