Tai Kyung Noh

Inflammatory features of melasma lesions in Asian skin.

Melasma is triggered by various factors including ultraviolet radiation and estrogen; however, its pathogenesis is unclear. To investigate the inflammatory features of melasma lesions as triggers for this disorder, 197 women with melasma who attended Asan Medical Center and Kangskin Clinic, Seoul, from June 2011 to October 2011 completed a questionnaire concerning triggering or aggravating factors. These cases were divided into “non‐inflammatory” and “inflammatory” groups. Skin biopsies and immunostaining for CD68, CD117, and leukocyte common antigen (LCA) were performed in the lesional and peri‐lesional skin of ten cases in the non‐inflammatory group and nine cases in the inflammatory group. Among the 197 subjects (mean age, 41.5 years; mean age of melasma onset, 33.8 years), 50 patients (25.4%) were categorized into the inflammatory group. This group comprised cases that had inflammatory symptoms and events that triggered the melasma lesions. The lesional dermis contained more CD68+ melanophages, CD117+ mast cells, and LCA+ leukocytes in the inflammatory group than in the non‐inflammatory group. Inflammatory clinical features and an increased number of inflammatory cells in the lesion may be involved in the development of melasma in Asian skin.

Gene Expression Profiling in Melasma in Korean Women

Background: There has been a paucity of data about the difference in gene expression between melasma lesional skin and normal adjacent one. Objective: Our aim was to identify novel genes involved in the pathogenesis of melasma. Methods: We performed a microarray analysis and confirmed the results on quantitative real-time polymerase chain reaction (qRT-PCR) in Korean women with melasma. Results: There were 334 genes whose degree of expression showed a significant difference between melasma lesional skin and normal adjacent one. Of these, five were confirmed on qRT-PCR. In melasma lesional skin, there were down-regulation of genes involved in the PPAR signaling pathway and up-regulation of genes involved in neuronal component and the functions of stratum corneum barrier. Conclusion: This result suggests that the pathogenesis of melasma might be associated with novel genes involved in the above signaling pathway in Korean women.

Q-Switched 660-nm Versus 532-nm Nd: YAG Laser for the Treatment for Facial Lentigines in Asian Patients: A Prospective, Randomized, Double-Blinded, Split-Face Comparison Pilot Study.

BACKGROUND Q-switched (QS) 532-nm lasers are widely used to treat solar lentigines. OBJECTIVE To compare the efficacy and safety of 660-nm and 532-nm QS neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers in the treatment for lentigines in Asians. MATERIALS AND METHODS The halves of each face (randomly chosen) of 8 Korean Fitzpatrick Skin Type III–IV women with facial solar lentigines were treated with either 660-nm or 532-nm lasers. Pigmentation was measured objectively using a profilometric skin analysis tool and subjectively using the pigmentation area and severity index (PSI) score, global assessment of the aesthetic improvement scale (GAIS), and a patient satisfaction score at Weeks 4 and 8. RESULTS Seven patients completed the study. No significant differences were found in the PSI, GAIS, patient satisfaction score, and melanin average score between the lasers. The melanin average level was significantly reduced by the 660-nm laser but not the 532-nm laser at Week 8 compared with the baseline. CONCLUSION Both 660-nm and 532-nm QS Nd:YAG lasers effectively reduce pigmentation for up to 8 weeks with high patient satisfaction. The new 660-nm laser therefore increases the treatment options for lentigines in Asian skin.

Atypical molluscum contagiosum accompanied by CD30-positive lymphoid infiltrates.

Abstract:  Atypical presentations of molluscum contagiosum require histophathologic examination and may show pleomorphic lymphocytic infiltrates of a reactive nature, mimicking cutaneous lymphoproliferative diseases. Serial sections of specimens or polymerase chain reactions to show T‐cell receptor clonality may be helpful for differential diagnosis. We report a case of atypical molluscum contagiosum accompanied by atypical lymphocytic infiltration showing CD30 positivity.

Effects of highly concentrated hyaluronic acid filler on nasolabial fold correction: A 24-month extension study

Abstract Background: A previous 6-month study using a more highly concentrated novel hyaluronic acid (HA) filler, PP-501-B, found nasolabial fold (NLF) improvements with increased tolerability. Objective: We investigated the long-term efficacy, durability and safety of PP-501-B in the correction of NLFs. Methods: Subjects completing the initial six-month study were enrolled in this 24-month, randomized, multicenter, double-blind, split-face, extension study. The injection areas and treatment procedures were identical to those of the initial study: each subject was injected with PP-501-B in one NLF and with Restylane Perlane (Q-med) in the contralateral NLF. We reassessed wrinkle improvement using the five-point Wrinkle Severity Rating Scale (WSRS) and changes in the Global Aesthetic Improvement Scale at 12, 18 and 24 months after the initial treatment. Results: Of the 81 patients enrolled, 72 completed the study. The WSRS score significantly decreased from baseline throughout the follow-up period after retreatment with both fillers. There was no significant difference in the WSRS scores between the two fillers at 24 months. Both fillers were well tolerated with no severe complications or adverse reactions. Conclusion: The new HA filler PP-501-B is safe and effective in the long term for the correction of moderate-to-severe NLFs, even after a second treatment.

Systemic lupus erythematous presenting with hydroa vacciniforme-like eruption: Mimicking Epstein–Barr virus-associated lymphoproliferative disorders

Dear Editor, Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple systems. Most SLE patients present various cutaneous manifestations which provide clues to the diagnosis at some point, but also may lead to confusions with other diseases. We herein describe a patient with SLE showing a papulovesicular eruption resembling hydroa vacciniforme (HV). A 14-year-old girl presented with a 2-week history of multiple erythematous papules with crusts on her face. One month before her visit, she developed mild fever and within 2 weeks it progressed to a high fever and facial rash. However, the exacerbation of her skin lesion did not seem to be related to photoexposure. Physical examination showed small, erythematous necrotic papules, vesicles and plaques on her face with edematous cheeks (Fig. 1). There were a few scattered papules on other sites of the body such as the abdomen and extremities. Although the spleen was palpable, hepatomegaly or lymphadenopathy was not detected. Laboratory evaluation revealed leukopenia, anemia, thrombocytopenia, and elevated aspartate transaminase and alanine Table 2. Comparison of dermatomyositis patients with and without mechanic’s hands