Extensive Nevus Comedonicus with Inflammatory Nodules and Cysts Controlled with Adalimumab.

Nevus comedonicus is a very rare skin disorder characterized by the presence of comedo-like dilated pores with keratinous plugs, rarely resulting in painful recurrent inflammatory nodules or cysts. It presents as localized or extensive form. It displays unilaterally or bilaterally segmental distribution. Histopathologically, it is characterized by keratin-filled epidermal invagination with bulbous proliferation of keratinocytes. The condition may be caused by fibroblast growth factor receptor 2 mutation. Although it may be controlled by a variety of therapeutic modalities, it is difficult to achieve complete resolution. We report a case of extensive nevus comedonicus with inflammatory nodules and cysts controlled with adalimumab.

Usefulness of home-use microneedle devices in the treatment of pattern hair loss.

BACKGROUND: Microneedle devices have been used to reduce scarring and wrinkling as well as for the treatment of pattern hair loss. AIMS: Here, we investigated the efficacy and safety of a newly developed home-use microneedle device for the treatment of pattern hair loss. METHODS: Twenty-nine patients were assigned into three groups based on block randomization: home-use microneedle device only, a combination of home-use microneedle device and 5% minoxidil solution and 5% minoxidil topical solution only. Each treatment was performed twice a week. The study outcomes included hair counts, patient self-assessments, and adverse events at baseline and at 6 months. Statistical analyses were performed using analysis of variance (ANOVA), repeated measures ANOVA and Kruskal-Wallis test. RESULTS: The improvements in hair count were seen in the combination group at month 6, but the differences observed did not reach statistical significance in each group and among the three groups. The patient self-assessment showed the highest score in the combination group, but it did not reveal a statistically significant difference among the three groups. Mild and transient pruritus were reported by one patient who was using the microneedle device only. CONCLUSIONS: Our study shows that the home-use microneedle device may be a safe and 5% minoxidil solution penetration-enhancing therapeutic modality for stimulating hair growth.

Sentinel lymph node biopsy in acral melanoma: A Korean single-center experience with 107 patients (2006-2018).

BACKGROUND: Sentinel lymph node biopsy (SLNB) of primary cutaneous melanoma as an important staging method has not been popularly undertaken in Korea and only a few studies with small patient numbers have been published. AIM: We examined the clinical feasibility and overall outcomes of SLNB in acral melanoma (AM) of Korean in Kyungpook National University Hospital (KNUH) over the past 13 years. METHODS: SLNB in AM patients during 2006-2018 were analyzed retrospectively for sentinel lymph node (SLN) harvesting rate, positivity rate, positivity-relevant overall survival (OS) and disease-free survival (DFS), and its side effects. RESULTS: A total of 109 AM patients who underwent SLNB were enrolled. Harvested nodes were identified from 107 patients and SLN harvesting rate was 98.2%. The mean Breslow thickness (±standard deviation) was 3.38 ± 3.03 mm, and the proportion of ulcerated melanomas was 64%. Twenty-two (20.6%) had a tumor-positive SLN and, among them, 82% (18/22) underwent immediate complete lymph node dissection (CLND). The metastasis-positive nodal basin after CLND was detected in 16.7% of cases (3/18). Tumor-negative SLN cohorts showed significantly better OS and DFS than tumor-positive ones (P = 0.006 and P < 0.001 for each). Two side effects, one seroma and one lymphocele, were observed without major sequelae. CONCLUSION: SLNB, crucial management of melanoma, proved its efficacy to predict patients' prognosis and could be performed successfully and safely in Korean AM patients by interdisciplinary cooperation between dermatology and other surgical departments. SLN(-) showed significantly better OS and DFS than SLN(+). Significant risk factors for DFS were Breslow thickness, the presence of ulceration and the presence of SLN metastasis. SLNB should be encouraged in order to stage melanoma accurately and direct the proper management in Korean AM.

Effect of a sphingolipid-mimetic compound on the promotion of hair growth: A randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: Pattern hair loss is a very common skin disorder, but more therapeutic modalities for hair growth are still required. OBJECTIVE: We investigated the effect of a newly synthesized sphingolipid-mimetic compound (pseudo-ceramide: bis-oleamide isopropyl alcohol [BOI]) on the promotion of hair growth for patients with mild pattern hair loss. METHODS: A total of 58 patients with mild pattern hair loss participated in this clinical trial. A randomized, double-blind, placebo-controlled clinical trial was conducted for 6 months. Participants in the experimental group applied 1% BOI lotion (ceramide HS) on the whole scalp once a day for 6 months. Participants in the control group applied simulacrum using the same protocol. We evaluated daily hair loss, hair density, hair thickness, and hair length at intervals of 3 months; patient satisfaction and adverse events were evaluated at 6 months. RESULTS: At 6 months in the experimental group, daily hair loss at baseline (52.52 ± 33.98) decreased to 40.41 ± 24.78, vertex hair density at baseline (131.07 ± 43.73) increased to 156.00 ± 39.59, frontal hair density at baseline (104.21 ± 30.72) increased to 124.10 ± 28.28, thickness of vertex hair at baseline (0.067 ± 0.012 cm) increased to 0.075 ± 0.014 cm, thickness of frontal hair at baseline (0.070 ± 0.009 cm) increased to 0.076 ± 0.012 cm, and hair growth rate was 16.17 ± 1.89 mm/month. CONCLUSION: Ceramide HS may be a new candidate for the treatment of pattern hair loss.