Vasanop Vachiramon

Cutaneous Mycobacterium abscessus Infection Associated with Mesotherapy Injection

Non-tuberculous mycobacterial skin infections have an increasing incidence. In immunocompetent patients, they usually follow local trauma. We present a case of cutaneous Mycobacterium abscessus infection following mesotherapy. The lesions were successfully treated with a combination of clarithromycin, ciprofloxacin, and doxycycline. Atypical mycobacterial infection should be suspected in patients who develop late-onset skin and soft tissue infection after cutaneous injury, injection, and surgical intervention, particularly if they do not respond to conventional antibiotic treatment.

Epidermal growth factor receptor inhibitors: a review of cutaneous adverse events and management.

Epidermal growth factor inhibitors (EGFRI), the first targeted cancer therapy, are currently an essential treatment for many advance-stage epithelial cancers. These agents have the superior ability to target cancers cells and better safety profile compared to conventional chemotherapies. However, cutaneous adverse events are common due to the interference of epidermal growth factor receptor (EGFR) signaling in the skin. Cutaneous toxicities lead to poor compliance, drug cessation, and psychosocial discomfort. This paper summarizes the current knowledge concerning the presentation and management of skin toxicity from EGFRI. The common dermatologic adverse events are papulopustules and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis, and postinflammatory hyperpigmentation. Radiation enhances EGFRI rash due to synergistic toxicity. There is a positive correlation between the occurrence and severity of cutaneous adverse effects and tumor response. To date, prophylactic systemic tetracycline and tetracycline class antibiotics have proven to be the most effective treatment regime.

Melasma in men

Melasma is an acquired hypermelanosis that results in localized hyperpigmentation, commonly found on the face. This condition is much more common in women than men. There are some features of melasma in men that seem to differ from those seen in women. However, there is a paucity of data on this topic. The aim of this article is to review the etiology, clinical presentation, and treatment of melasma in men. It is important for dermatologists to understand some unique aspects of melasma in this group to provide appropriate care for patients who suffer from this frustrating condition.

Early postoperative single treatment ablative fractional lasing of Mohs micrographic surgery facial scars: A split-scar, evaluator-blinded study

Despite precise surgical technique, some postoperative facial scars will depress and widen over time, likely due to weakened or inadequately replaced collagen fibers in the underlying dermis. The purpose of this study is to evaluate whether a 10,600 nm ablative carbon dioxide (CO2) fractional laser used early in the post‐surgical setting results in improved postoperative facial scars after a single treatment session.

Effects of a preceding fractional carbon dioxide laser on the outcome of combined local narrowband ultraviolet B and topical steroids in patients with vitiligo in difficult-to-treat areas

Conventional treatment of vitiligo on hands and feet often produces an unsatisfactory result. Various ablative treatment methods were tried with favorable results in facial, neck, and truncal areas. The aim of this study is to evaluate the efficacy and safety of combined fractional CO2 laser, narrowband UVB (NB‐UVB) phototherapy, and topical clobetasol propionate in managing stable vitiligo in difficult‐to‐treat areas.

Effectiveness of Onion Extract Gel on Surgical Scars in Asians

Background. Onion extracts have been shown in vitro to accelerate wound healing. Results from clinical studies on surgical scars in Caucasians were disappointing. The aim of this study is to evaluate the effectiveness of onion extract gel in improving the cosmetic and symptoms of surgical scars in Asians. Patients/Methods. Twenty Asians who had new Pfannenstiels cesarean section scars were recruited in this prospective double-blinded, split-scar study. Each side was randomly assigned treatment with onion extract gel or placebo at 7 days after surgery. The product was applied three times daily for 12 weeks. Subjects were evaluated at baseline and 4th and 12th weeks. Scar redness was assessed by calorimeter, scar height and pliability were assessed by blinded investigators, and scar symptoms and overall cosmetic improvement were assessed by subjects. Results. Sixteen subjects completed the study. A statistically significant difference between two sides of scar in terms of scar height and scar symptoms was found. There was no statistically significant difference in scar redness, scar pliability, and overall cosmetic appearance between two sides. Conclusions. The early use of topical 12% onion extract gel on Pfannenstiels cesarean section scar in Asians resulted in the improvement of scar height and scar symptoms.

Efficacy of narrowband ultraviolet B twice weekly for hypopigmented mycosis fungoides in Asians.

Hypopigmented mycosis fungoides (MF) is a rare variant of cutaneous T‐cell lymphoma. To date, there have been no data published about the efficacy of a twice‐weekly regimen of narrowband ultraviolet B (NB‐UVB) for the treatment of hypopigmented MF. We retrospectively reviewed 11 patients with hypopigmented MF who were treated with NB‐UVB twice weekly between 2001 and 2010. Of the 11 patients, 7 achieved a complete response with a mean of 40 treatments; the remaining 4 patients had a partial response. Upon discontinuation of treatment, three patients had clinical relapse after complete remission. Median time to relapse was 10 months. A twice‐weekly regimen of NB‐UVB is an effective treatment for hypopigmented MF with minimal side‐effects. However, the relapse rate is high, and unfortunately, no clinical or histological features can predict the relapse of the disease.

Approach to reticulate hyperpigmentation

Reticulate hyperpigmentation is a feature of a number of conditions, which differ in age of onset and distribution of the lesions. Associated clinical findings (e.g. hair, nail, teeth, systemic involvement), are used to differentiate between the conditions. Histopathological examination is useful in some disorders. Diagnosing the disorders is important, because the underlying causes may be treatable, and some of the disorders are associated with malignancies and life‐threatening systemic involvement. In this review, I present a concise, systematic approach to the treatment of the patient with reticulate hyperpigmentation.

Bilateral Linear Lichen Planus Pigmentosus Associated with Hepatitis C Virus Infection

Lichen planus pigmentosus is a rare subtype of lichen planus. We report a first case of lichen planus pigmentosus with bilateral linear distribution associated with hepatitis C virus infection. The lesion was improved after sun avoidance and treatment of hepatitis C virus infection with a combination of interferon and ribavirin. This case stresses the importance of screening for hepatitis C virus infection as lichen planus pigmentosus can be an associated condition.

Comparison of Q-switched Nd: YAG laser and fractional carbon dioxide laser for the treatment of solar lentigines in Asians

Solar lentigines are benign pigmented lesions that occur mostly on sun‐exposed areas. Q‐switched and ablative lasers are effective for removing these lesions but the high incidence of postinflammatory hyperpigmentation raises concern in darker skin types. The objective of this study is to compare the efficacy and degree of postinflammatory hyperpigmentation with the Q‐switched Nd:YAG and fractional carbon dioxide (CO2) laser for treatment of solar lentigines in Asians.