755 nm picosecond laser for facial atrophic scar-Case reports of long-term clinical efficacy following up.

INTRODUCTION: Acne vulgaris is one of the most common dermatological problems in Asia. While the disease itself is self-limited and temporary, the dystrophic texture changes after the inflammatory process are often a serious aesthetic concern. Many energy-based devices have seen good results in treating atrophic acne scars, and the picosecond laser with specific lens is one of the newer options, and lack reports on its long-term efficacy. MATERIALS AND METHODS: We report three Taiwanese cases who, to our knowledge, consist of the longest clinical follow-up times for atrophic scar treatment with the 755 nm diffractive lens picosecond laser. Photographs were compared on a by-session basis by two blinded dermatologists independent of the primary treating physician and given an improvement range of <25%, 25%-50%, 50%-75%, and >75%. RESULTS: While there are minor (<25%) improvements in all cases after the first four treatment sessions, all three cases saw the greatest improvement in skin texture (>75% in two cases, 50%-75% in one) when they were followed up 6, 13.5, and 28 months post-last treatment. CONCLUSION: Our results demonstrate excellent, long-onset, and long-term efficacy of the picosecond laser with diffractive lens in the treatment of acne atrophic scars. It also demonstrates the safe use of the device on Asian skins without symptoms of postinflammatory hyperpigmentation.

Dimorphic exanthema manifested as reticular maculopapular exanthema and erythema multiforme major associated with pyrazolon derivatives.

The non-steroidal anti-inflammatory drugs, especially various pyrazole or pyrazolon derivatives, were one of the classes of drugs commonly implicated in erythema multiforme or Stevens-Johnson syndrome/toxic epidermal necrolysis. Reticular exanthem was a rare morphological pattern of maculopapular drug eruptions. Here we report a case of dimorphic exanthema presenting with partly reticular maculopapular exanthema and erythema multiforme-like lesions, associated with pyrazolon derivatives. Patch testing showed negative reaction to the suspected drugs. The possible mechanism underlying the association of dimorphic exanthema with NSAIDs is discussed.

Prevalence of skin disease among nursing home staff in southern Taiwan.

To establish the prevalence of skin disease among nursing home workers in southern Taiwan, dermatological examination was performed on 75 nursing home staff from 11 institutions in Tainan county. Fungal infections were the most common skin diseases identified, affecting 21.4% of all employees. Other conditions included xerosis (13.3%), scabies (10.7%) and dermatitis (8.0%). Fungus was found mainly on the feet and hands (68.7% and 31.3% of all fungal cases respectively). Most xerosis sites were identified on the lower leg (90.0% of all xerosis cases), while all workers with scabies had the disease on their forearm. Dermatitis was diagnosed predominately on the forearm (50.0% of all dermatitis cases). The prevalence of fungus and scabies was higher than other studies, while dermatitis occurred less frequently than previous reports. Although not statistically significant, we believe that wet work and occupational contact with nursing home patients may have been important risk factors for these conditions.

Prevalence of skin disease among nursing home patients in southern Taiwan.

BACKGROUND: Continuing advances in medical care and nutrition have prolonged the lifespan and expanded the elderly demographic world-wide. Despite increasing elderly populations within Taiwanese nursing homes, there has been a lack of dermatologic surveys, and the prevalence of skin conditions within this group is unknown. METHODS: To establish the prevalence of skin disease within nursing homes in southern Taiwan, we undertook a dermatologic and epidemiologic investigation of 398 patients in Tainan City, southern Taiwan, between November 1999 and February 2000. RESULTS: This study revealed that more than half of all nursing home patients suffered from fungus (61.6%) and xerosis (58.3%), while other pruritic skin diseases, such as dermatitis and scabies, were less prevalent at 7.3% and 3.3%, respectively. Risk factors for fungal infection included bedridden status (risk ratio (RR), 1.2; 95% confidence interval (CI), 1.1-1.4) and male gender (RR, 1.2; 95% CI, 1.0-1.3). Xerosis was statistically correlated with an age range of 80-90 years (RR, 1.2; 95% CI, 1.0-1.4) when compared to other age ranges. Current scabies diagnosis was strongly associated with a previous history of scabies (RR, 8.9; 95% CI, 1.7-21.1). CONCLUSIONS: Our study provides clinically relevant data regarding the prevalence of skin diseases in institutionalized Taiwanese patients for the first time. The results suggest that scabies persists within some nursing homes despite treatment, and that some patients remain undiagnosed. The dermatologic needs of these Taiwanese patients are not currently being satisfied.