The Combination of the Mini-Punch Technique and Photodynamic Therapy for the Treatment of Mandibular Keloids and Hypertrophic Scars.

BACKGROUND: Mandibular keloids and hypertrophic scars can exert significant effects on the appearance of a patient. However, current treatments are not effective in all cases. Consequently, it is vital to identify a safe and effective treatment method. OBJECTIVE: To investigate the therapeutic effect of the mini-punch technique combined with photodynamic therapy (PDT) on mandibular keloids and hypertrophic scars. PATIENTS AND METHODS: Twenty patients with mandibular keloids and hypertrophic scars were enrolled, including 5 cases of keloids and 15 cases of hypertrophic scars, with a total of 40 lesions. The mini-punch technique was performed first, and then, PDT was conducted, once a week on 3 occasions in total. RESULTS: After 12 months of follow-up, 30 lesions had improved by more than 50%, thus achieving a good therapeutic effect. The Vancouver Scar Scale score of patients ranged between 8 and 12 points with a mean of 9.60 ± 1.09 points before surgery and between 2 and 9 points with a mean of 4.15 ± 2.05 points at 12 months after surgery. The mean Vancouver Scar Scale score after treatment was significantly lower than that before treatment (t = 11.80, p < .001). CONCLUSION: A combination of the mini-punch technique and PDT is an effective treatment for mandibular keloids and hypertrophic scars.

Successful Treatment of Vitiligo on the Scalp of a 9-Year-Old Girl Using Autologous Cultured Pure Melanocyte Transplantation.

Leukotrichia frequently accompanies vitiligo on hairy areas such as the scalp. Treatment with conventional medical therapy is usually unsuccessful because of deficiencies in the melanocyte reservoir. We describe transplantation of autologous cultured pure melanocytes for scalp vitiligo with leukotrichia in a 9-year-old girl, resulting in almost complete and stable repigmentation of skin and hair.

[Transcriptional regulation of breast cancer resistance protein].

Breast cancer resistance protein (BCRP), also known as ABCG2, is a member of the ATP-binding cassette (ABC) transporter superfamily, and is known to play important roles in cancer multidrug resistance. The BCRP promoter lacks a TATA-box and contains a CAAT-box, lots of AP1, AP2 sites and several putative Sp1 sites which are downstream of a putative CpG island. Several transcription factors, such as progesterone receptor (PR), estrogen receptor (ER), nuclear factor-κB (NF-κB), hypoxia-inducible factors (HIFs), nuclear factor erythroid 2-related factor 2 (Nrf2), aryl hydrocarbon receptor (AhR), peroxisome proliferator-activated receptors (PPARs) and Krüppel-like factor 5 (KLF5), have been recently shown to bind to their response elements in the promoter/enhancer to activate the transcription of BCRP. BCRP transcription can be influenced by proinflammatory cytokines, growth factors, and homeobox protein MSX2. Signaling pathways, such as Sonic hedgehog (Shh), Notch and RAR/RXR pathways, may also involve in the transcriptional regulation of BCRP. In addition, promoter methylation and histone acetylation are essential for the BCRP transcription, especially for the drug-induced BCRP expression. This paper reviews the recent research progresses in this field with an emphasis on the roles of transcription factors and epigenetics in the transcriptional regulation of BCRP.

Small-sized lesions of childhood vitiligo treated by autologous epidermal grafting.

BACKGROUND: Currently many children and adolescents with vitiligo fail to respond to traditional medical treatment. However, their parents want the lesion to be removed as soon as possible. Although surgical therapies are viable alternatives in refractory and stabilized vitiligo, there are rare reports on surgical therapies for childhood vitiligo. OBJECTIVE: To assess the effectiveness and feasibility of using suction blister epidermal grafting for small-sized childhood vitiligo. METHODS: Twenty children with small-sized lesions of stable vitiligo were treated using epidermal grafts and followed-up for 6-12 months. RESULTS: After 6-12 months of follow-up, treatment outcomes were excellent in 17 patients (85%), good in two patients (10%), and poor in one patient (5%), out of a total of 20 patients. The mean repigmentation rate was 88.55%. The location of the lesions was probably a factor in determining the outcomes of transplantation. No scar formation or other complications were observed in any patients. CONCLUSION: Suction blister autologous epidermal grafting is a rapid, safe, and effective treatment for stable childhood vitiligo, especially in refractory and stable children with small-sized lesions.

Clinical, pathologic, and ultrastructural studies of progressive macular hypomelanosis.

BACKGROUND: Progressive macular hypomelanosis (PMH), a condition of uncertain etiology, is characterized by asymptomatic hypopigmented macules, predominantly located on the trunk. To date, the study of this disease has been sporadic and there are still no clinical diagnostic criteria. The aim of this study was to investigate the histopathologic and ultrastructural characteristics of PMH, and propose the clinical diagnostic criteria of PMH. METHODS: The Wood's lamp and Confocal Laser Scanning Microscopy were used to observe the lesions' features. Skin biopsies were used for hematoxylin and eosin staining, melanin staining, antibodies staining of S-100 protein, tyrosinase-related protein-1(TRP-1) and tyrosinase (T311), and also for ultra-structural study. Melanocytes were isolated and cultured from the lesions. RESULTS: Under Wood's lamp examination, the lesions of PMH showed punctiform red fluorescence. Confocal Laser Scanning Microscopy observation of the lesion showed that its "pigmented ring" around the dermal papillae was intact, but its melanin content was decreased compared with the surrounding normal skin. Ferrous sulfate staining showed that melanin content in the lesion of PMH was significantly decreased compared with the normal skin (P < 0.05). S-100 staining showed that the number of positive cells in the basal layer had no statistical significance (P > 0.05) between the lesion areas (8.25 ± 0.96) and the surrounding normal skin (8.75 ± 1.71). TRP-1 staining showed no significant difference between lesion areas (4.25 ± 0.96) and the surrounding normal skin (4.50 ± 1.29) (P > 0.05), and T311 staining also showed no difference between lesion areas (4.01 ± 0.87) and the surrounding normal skin (4.30 ± 1.05) (P > 0.05). Ultra-structural studies revealed a large reduction in the number of mature melanosome from PMH lesions. There were many membrane-bound groups in PMH lesions with normal appearance the margin, which contained a number of smaller type II-IV melanosomes, which were distributed in clusters. No degradation of melanosomes was present in the lysosomal compartments of PMH lesions. When melanocytes from the PMH lesions were cultured in vitro, the morphology of those melanocytes showed no difference compared with normal melanocytes. CONCLUSION: As a result of the above findings, we discussed and summarized the PMH's clinical diagnostic criteria.