Woo Sun Jang

Multiple Pass Ultrasound Tightening of Skin Laxity of the Lower Face and Neck

BACKGROUND Skin laxity is a common complaint of patients who request skin rejuvenation. Radiofrequency and infrared light are widely used for nonablative treatment of skin laxity. Intense focused ultrasound (IFUS) has been investigated as a tool for the treatment of solid benign and malignant tumors for many decades but is only now beginning to emerge as a potential noninvasive alternative to conventional nonablative therapy. OBJECTIVES To evaluate the efficacy of IFUS for the treatment of face and neck laxity. METHODS Twelve female volunteers were enrolled in the study, and 10 were ultimately evaluated. The device under investigation was an IFUS. Areas treated included the face and neck. For treatment, the 4‐MHz, 4.5‐mm probe was used first, followed by the 7‐MHz, 3.0‐mm probe. Two blinded, experienced clinicians evaluated paired pretreatment and post‐treatment (day 90) photographs. Patient self‐assessments were also obtained. RESULTS On the first primary outcome measure, two blinded clinicians felt that 8 of 10 subjects (80%) showed clinical improvement 90 days after treatment. Nine of 10 subjects (90%) reported subjective improvement. CONCLUSIONS IFUS has many advantages for skin tightening.

Efficacy of 694-nm Q-Switched Ruby Fractional Laser Treatment of Melasma in Female Korean Patients

BACKGROUND Melasma is a common acquired symmetrical hypermelanosis of sun‐exposed areas of the skin. Although the classical Q‐switched ruby laser (QSRL) has been used successfully for the removal of tattoos and for the treatment of cutaneous pigmented lesions, its efficacy for melasma remains controversial. OBJECTIVE We used repeat low‐dose fractional QSRL treatment for melasma and analyzed the clinical results. METHODS Fifteen Korean women with melasma were enrolled. Each patient received six low‐dose fractional QSRL treatments to the face at 2‐week intervals. Two investigators independently evaluated Melasma Area and Severity Index (MASI) scores before each session and 4 and 16 weeks after the final session. The intensities of pigmentation and erythema were assessed by measuring skin reflectance using a tristimulus color analyzer. RESULTS Mean MASI score decreased from 15.1 ± 3.3 before treatment to 10.6 ± 3.9 16 weeks after the final treatment. The lightness of pigmentation (L‐value) increased from 56.6 ± 3.5 before treatment to 59.9 ± 2.8 16 weeks after the final treatment. CONCLUSIONS Multiple treatment sessions of low‐dose fractional QSRL may be an effective strategy for the treatment of dermal or mixed‐type melasma. The authors have indicated no significant interest with commercial supporters.

A pilot study of silver‐loaded cellulose fabric with incorporated seaweed for the treatment of atopic dermatitis

Because clothing has the longest and most direct contact with human skin, it is important to carefully choose suitable fabrics for atopic patients who have disrupted skin. To evaluate the clinical effectiveness and biophysical properties of a newly developed silver‐loaded cellulose fabric with incorporated seaweed, we enrolled 12 subjects with mild to moderate atopic dermatitis into a clinical control study. The subjects wore a two‐piece garment (top and leggings), each piece of which was divided into two parts: one side was made of SkinDoctor® fabric, and the other of 100% cotton. Treatment efficacy was measured with the modified SCORing Atopic Dermatitis (mSCORAD) index, transepidermal water loss (TEWL) and the patients’ subjective impressions. All three of these measures had significantly better scores on the side covered with SkinDoctor. These results suggest that SkinDoctor is a beneficial fabric that can improve the comfort of patients with AD.

Safety Evaluation of Stamp Type Digital Microneedle Devices in Hairless Mice

Background Microneedles provide a minimally invasive means to transport molecules into the skin. A number of specific strategies have been employed to use microneedles for transdermal delivery. Objective The purpose of this study was to investigate the safety of two new digital microneedle devices (Digital Hand® and Digital Pro®; Bomtech Electronics Co., Ltd., Seoul, Korea) for the perforation of skin in skin-hairless-1 mice. This device replaces conventional needles and is designed specifically for intradermal delivery. Methods We used two newly developed digital microneedle devices to perforate the skin of skin-hairless-1 mice. We conducted a comparative study of the two digital microneedle devices and DTS® (Disk type-microneedle Therapy System; DTS lab., Seoul, Korea). To evaluate skin stability, we performed visual and dermatoscopic inspections, measurements of transepidermal water loss, and biopsies. Results The two novel digital microneedle devices did not induce significant abnormalities of the skin on visual or dermatoscopic inspection, regardless of needle size (0.25~2.0 mm). No significant histopathological changes, such as inflammatory cell infiltration, desquamation of the stratum corneum, or disruption of the basal layer, were observed. The digital microneedle devices and microneedle therapy system produced similar results on measures of skin stability. Conclusion These two novel digital microneedle devices are safe transdermal drug delivery systems.

Thermography as a predictor of postherpetic neuralgia in acute herpes zoster patients: a preliminary study

Background/purpose: Infrared thermal images in patients suffering from herpes zoster (HZ) may exhibit thermal asymmetry due to the unilateral distribution of HZ lesions. This study examined the usefulness of infrared thermography in acute HZ as a predictor for the development of postherpetic neuralgia (PHN).

Combination Therapy with Cyclosporine and Psoralen Plus Ultraviolet A in the Patients with Severe Alopecia Areata: A Retrospective Study with a Self-Controlled Design

Background Alopecia areata (AA) is believed to be an organ-specific autoimmune disease in which a mononuclear cell infiltrate develops in and around anagen hair follicles. There is no definitive therapy for AA. Objective We sought to determine whether the combination therapy of cyclosporine and psoralen plus ultraviolet A (PUVA) could be an effective treatment for severe AA. Methods A total of 41 patients with severe AA were treated with oral cyclosporine and topical PUVA. Cyclosporine was given at an initial daily dose of 200 mg for adult and 100 mg for children for periods of up to 16 weeks. Eight-methoxypsoralen (Methoxsalen) was applied topically 20 minutes prior to ultraviolet A (UVA) exposure, and the patients were irradiated with UVA twice a week for 16 weeks. Results Of the total 41 patients, 2 (7.3%) patients were lost to follow-up, and 1 (2.4%) patient discontinued the treatment due to abdominal discomfort. Six (14.6%) patients were treated for less than 12 weeks. Of remaining 32 patients, 3 (9.4%) showed excellent response, 3 (9.4%) showed good response, 12 (37.5%) showed fair response, and 14 (43.7%) showed poor response. Conclusion Although limited by its uncontrolled character, this study shows that the combination therapy with cyclosporine and PUVA may be an additional choice for severe and recalcitrant AA.

Branch-shaped Cutaneous Hypopigmentation and Atrophy after Intralesional Triamcinolone Injection.

Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. Linear hypopigmentation and atrophy after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect. A 30-year-old woman visited our dermatology department for a linear hypopigmented patch with atrophy from her left foot to the lower margin of the knee. The lesion developed after injection of an intralesional corticosteroid. The patient was diagnosed with linear hypopigmentation and atrophy secondary to the triamcinolone injection.

An epidemiological study of androgenic alopecia in 3114 Korean patients.

Androgenetic alopecia (AGA) is the most common type of hair loss, and is characterized by the transformation of terminal scalp hair into vellus hair. The epidemiology of AGA is not fully understood. A strong genetic basis has long been identified, although little is known of its nongenetic causes.

Cutis Verticis Gyrata and Alopecia Areata: A Synchronous Coincidence?

Cutis verticis gyrata (CVG) is a descriptive term for a scalp condition that is convoluted folds and deep furrows that resemble the surface of the cerebral cortex. It is categorized by the underlying etiology, as primary essential, primary non-essential and secondary. Alopecia areata (AA) is a common, organ specific autoimmune disease, and most AA cases are sporadic. There is clearly a strong genetic component. There is no established relationship between CVG and AA. We report one case which was affected with essential primary CVG and alopecia areata, and suggest a possibility of genetic association between CVG and AA, possibly both being related to mutations in the fibroblast growth factor receptor 2 (FGFR2).

Anaphylactic reaction to ranitidine (Zantac

Ranitidine hydrochloride is an H2-receptor antagonist widely used for the treatment of peptic ulcers, acute stress ulcers, and gastroesophageal reflux and is usually well tolerated. Because it is considered to be safe, ranitidine is available over the counter all over the world. It is a drug commonly administered in accidents and emergencies. This drug has been associated with urticaria, anaphylactic reaction, cutaneous delayed reaction, toxic epidermal necrolysis, allergic contact dermatitis, lichenoid eruptions, ultraviolet B (UVB) photosensitivity, and exanthematous pustulosis. Cross-reactivity with other H2-receptor antagonists is exceptional, and only one case has been published, involving a cross-reaction with nizatidine.