Young Chul Kye

Resurfacing of pitted facial scars with a pulsed Er:YAG laser.

BACKGROUND. Laser resurfacing has beneficial effects for the treatment of several skin conditions. Recently, the pulsed Er: YAG laser has been shown to be a hightly effective treatment for several kinds of fitted facial scars. OBJECTIVE. The purpose of this study was to assess the efficacy and safety of pulsed Er. YAG laser skin resurfacing for pitted facial scars. METHODS. Four patients with small pox scars, five patients with chicken pox scars, and 21 patients with acne scars were included in this study. All patients were skin type III and IV. All patients were instructed to use tretinoin cream 0.05% nightly for 2—4 weeks prior to the laser treatment. The pulsed Er:YAG laser with 2‐mm handpiece at the setting of 500 mj/pulse, 3.5–4.5 W was used. Two weeks after laser treatment, topical application of hydroquinone 4%, tretinoin 0,05%, and hydrocortisone 1% cream was recommended for 2–4 weeks. Facial photographs were obtained at baseline and 2‐week intervals pastopemtively with a 35‐mm single lense reflex camera equipped with a lense mounted ring flash. The results of treatment were evaluated for the changes of skin texture and color at 2 weeks, 1 month, and 3 months. Three patients with acne scars agreed to skin biopsy. Results. Three months after laser treatment, all patients with small pox and chicken pox scars were improved about 55%, and patients with acne scars were improved about 40% on average. CONCLUSION. Pulsed Er:YAG laser skin resurfacing is an effective and safe treatment for pitted facial scars.

Up-regulation of TNF-alpha secretion by cigarette smoke is mediated by Egr-1 in HaCaT human keratinocytes

Please cite this paper as: Up‐regulation of TNF‐alpha secretion by cigarette smoke is mediated by Egr‐1 in HaCaT human keratinocytes. Experimental Dermatology 2010; 19: e206–e212.

Treatment of scars with a pulsed Er:YAG laser

BACKGROUND: Numerous revision procedures such as surgical excision, intralesional steroid injection, cryotherapy, dermabrasion, soft tissue augmentation, chemical peeling and laser therapy are available for the correction of various types of scars. Recently, Er:YAG laser resurfacing has proved to be a useful and safe means for several kinds of scars. OBJECTIVE: The purpose of this study was to assess the efficacy and safety of pulsed Er:YAG laser scar resurfacing for the various types of scars induced by trauma, burns, or surgery. METHODS: This study included 36 patients with various types of scars resulting from picking, scratching, knife injury, laceration, car accident, simple surgical excision, focal burn and focal inflammation. Twelve of these patients were treated for hypertrophic scars, 20 for depressed scars, and four for burn scars. The pulsed Er:YAG laser with a 2-mm handpiece at the setting of 500-1200 mJ/pulse at 3.5-9 W was used. Photographs were obtained at baseline and 2-week intervals postoperatively. The results of laser treatment were assessed by two independent physicians and the surgeon according to contour, skin texture and color. RESULTS: In all, 9 of 12 hypertrophic scars, 17 of 20 depressd scars, and two of four burn scars were improved more than 50%. In one patient who had a depressed scar, minimal postinflammatory hyperpigmentation was observed 3 months after laser treatment. Mild erythema was sustained 4 months after laser treatment in one patient with a depressed scar and in all patients with burn scars. No other side effects were observed. CONCLUSION: A pulsed erbium:YAG laser is an effective and safe treatment modality for scar revision.

Treatment of vascular skin lesions with the variable-pulse 595 nm pulsed dye laser.

BACKGROUND In the dermatology field, variable-pulse 595 nm pulsed dye lasers (PDLs) are now being widely used to treat vascular skin lesions. However, there is little information available on variable-pulse 595 nm PDL treatment of dark-skinned patients. OBJECTIVE The objective of this study was to evaluate the outcome of variable-pulse 595 nm PDL treatment on Korean patients. METHOD Two hundred thirty-nine patients (Fitzpatrick skin phototypes III to V) with vascular skin lesions, such as nevus flammeus, telangiectasia, or hemangioma, were included in this study. All patients were treated with a variable-pulse 595 nm PDL, and the outcomes were assessed by comparing preoperative and postoperative photographs. RESULTS The average number of treatments per patient was 4.29, and 51.9% of patients showed a good (51–75% clearance) to excellent (76–100% clearance) response. For nevus flammeus, 48.0% of the patients achieved good to excellent results. The gender and age of the patients did not influence the clinical response; however, lesions of the head and neck were found to respond more favorably to treatment. For telangiectasia, 78.0% of patients showed good to excellent results, and, again, the gender and age of the patients did not alter the treatment outcome. For hemangioma, the male to female ratio of patients was 1.0:3.1 and 54.1% of the patients achieved a good to excellent response. Superficial hemangioma showed a better clinical response than deep hemangioma, and the lesions of younger patients responded more favorably than those of older patients. CONCLUSION The variable-pulse 595 nm PDL was found to be effective for treating several vascular skin lesions in dark-skinned patients. However, there were differences in treatment outcome owing to disease, age, and the location of the lesions.

Treatment of Becker's nevi with a long-pulse alexandrite laser.

BACKGROUND Beckers nevus (BN) can be a distressing cosmetic handicap for patients and a treatment challenge for physicians. Various treatment modalities have been used, but repigmentation commonly occurs after treatment. OBJECTIVE To evaluate the efficacy of long‐pulse alexandrite laser in the treatment of BN. MATERIALS AND METHODS Eleven Korean patients with Fitzpatrick skin type III to V were included in this study. A long‐pulsed alexandrite laser with a wavelength of 755 nm and a pulse duration of 3 ms was used. Patients were treated with a fluence of 20 to 25 J/cm2 and a spot size of 15 to 18 mm. Cryogen spray cooling was not used. RESULTS Two patients had excellent responses, five had good responses, and four had fair responses. Hair density simultaneously decreased with treatment in all patients. Although mild hypopigmentation was observed in some patients, and partial hypertrophic scarring was observed in one patient, the outcomes were cosmetically acceptable. No repigmentation was noted during the follow‐up period. CONCLUSION A long‐pulsed alexandrite laser without cryogen spray cooling is an effective and safe alternative in the treatment of BN. The authors have indicated no significant interest with commercial supporters.

Thymic stromal lymphopoietin downregulates filaggrin expression by signal transducer and activator of transcription 3 (STAT3) and extracellular signal-regulated kinase (ERK) phosphorylation in keratinocytes

IL-33–activated mast cells and ILC2s, and may be involved in severe asthma via the recruitment of neutrophils and smooth muscle activation. Furthermore, the presence of other immune cells in the airway in an IL-33 milieu may result in an abundance of non–type 2 mediators, which could affect differential gene expression not otherwise seen in the coculture system. Thus, further studies need to be conducted in vivo to examine the effects of anti–IL-13 on airway inflammation, mucus expression, and hyperreactivity in response to IL-33. In conclusion, we have shown that IL-33–activated mast cells and ILC2s drive predominantly IL-13–regulated gene expression when cocultured with NHBE cells, which initiates a transcriptional program that can subsequently exacerbate airway pathology and contribute to fibrosis, eosinophilia, and mucous metaplasia. Although mast cells and ILC2s produce a diverse set of cytokines and other mediators of intercellular communication in response to IL-33, the predominant effect on airway epithelium in this in vitro coculture system is mediated by IL-13.

Ablative fractional laser treatment for hypertrophic scars: comparison between Er:YAG and CO2 fractional lasers

Background: Nonablative fractional photothermolysis has been reported to show early promise in the treatment of hypertrophic scars, but there are few reports on ablative fractional photothermolysis for the treatment of hypertrophic scars. Aim: To evaluate and compare the efficacy and safety of Er:YAG fractional laser (EYFL) and CO2 fractional laser (CO2FL) for treatment of hypertrophic scars. Methods: Thirteen patients with hypertrophic scars were treated with 2,940 nm EYFL, and ten were treated with 10,600 nm CO2FL. An independent physician evaluator assessed the treatment outcomes using Vancouver scar scale (VSS) and 5-point grading scale (grade 0, no improvement; grade 1, 1–25%; grade 2, 26–50%; grade 3, 51–75%; grade 4, 76–100% improvement). Patients are queried about their subjective satisfaction with the treatment outcomes. Results: After the final treatment, average percentage changes of VSS were 28.2% for EYFL and 49.8% for CO2FL. Improvement was evident in terms of pliability, while insignificant in terms of vascularity and pigmentation. Based on physicians global assessment, mean grade of 1.8 for EYFL and 2.7 for CO2FL was achieved. Patients subjective satisfaction scores paralleled the physicians objective evaluation.Conclusion: CO2FL is a potentially effective and safe modality for the treatment of hypertrophic scars, particularly in terms of pliability.

Tinea Incognito in Korea and Its Risk Factors: Nine-Year Multicenter Survey

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 ± 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.

A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars.

BACKGROUND The use of ablative lasers based on the fractional approach is a novel strategy for the treatment of postoperative and acne scars in addition to wrinkles. OBJECTIVE To evaluate and compare the efficacy of carbon dioxide ablative fractional laser (AFL) and the pulsed dye laser (PDL) for the improvement of surgical scars. MATERIALS AND METHODS Fourteen Korean patients with surgical scars were enrolled for this study. Half of each scar was treated with a 10,600-nm AFL and the contralateral half with the 595-nm PDL. For early intervention of the postoperative scar, the laser treatments were begun after 2 weeks from the Mohs micrographic surgery. RESULTS Both PDL and AFL produced statistically significant improvements. However, comparatively, there was no statistical difference between them. In each variable, AFL was more effective than PDL in the improvement of pliability and thickness. In contrast, PDL was superior to AFL in the improvement of vascularity and pigmentation. CONCLUSION Pulsed dye laser and AFL treatments for surgical scar provide significant improvement. Pulsed dye laser was more effective in color of scar compared with AFL, which showed marked improvement in the contour of scar. Overall improvement was not statistically different in the Vancouver Scar Scale.

A quantitative assessment of the human skin surface using polarized light digital photography and its dermatologic significance

Background: Quantitative and objective investigations of parallel‐polarized light (PPL) photography for dermatologic purposes are scarce.