A Randomized, Evaluator-Blinded, Split-Face Comparison Study of the Efficacy and Safety of a Novel Mannitol Containing Monophasic Hyaluronic Acid Dermal Filler for the Treatment of Moderate to Severe Nasolabial Folds

BACKGROUND: Mannitol containing monophasic filler with higher crosslinking has not been well studied for moderate and severe nasolabial fold (NLF) correction. OBJECTIVE: To compare the efficacy and safety of a novel mannitol containing hyaluronic acid (HA) filler (HA-G) with biphasic HA filler (HA-P) for moderate and severe NLF correction. METHODS: Thirteen subjects with symmetric moderate to severe NLF received HA-G (in one NLF) and HA-P (in other NLF) and were evaluated for 24 weeks. RESULTS: At both 12 and 24 weeks, the mean improvement in Genzyme 6-point grading scale from baseline was significantly greater in the side of face that was treated with HA-G than HA-P (1.96±0.91 vs. 1.54±0.73 at week 12; p=0.044, 1.88±0.78 vs. 1.3±0.79 at week 24; p=0.027, respectively). At 12 weeks, the mean Global Aesthetic Improvement Scale score was 2.92±0.93 for HA-G and 2.31±0.95 for HA-P (p=0.008). Both fillers were well tolerated. CONCLUSION: The HA filler HA-G provides better efficacy and similar local tolerability compared with HA-P in 6 months following treatment for moderate and severe NLF.

Fixed Drug Eruption due to Ciprofloxacin / 대한피부과학회지

Fixed drug eruption is a pattern of a drug-induced cutaneous reaction. It is characterized by skin erythematous plaques that recur at the same site each time the drug is administered. Now, we report the case of a 26-year-old woman who presented with 2 ill-defined erythematous patches on her back with itching sensation. The patient had a history of ciprofloxacin medication. The patch test with suspected drugs showed negative reactions, but intradermal tests were positive reactions. The patient was diagnosed with fixed-drug eruption due to ciprofloxacin.

Role of CD4(+)CD25(high+)FOXP3(+) Regulatory T Cells in Psoriasis

BACKGROUND: CD4(+)CD25(high+)regulatory T cells (Tregs) are considered to be of vital importance for maintaining immunologic self-tolerance and preventing autoimmune diseases. These cells have been found to be deficient in skin lesions and in the peripheral blood of patients with psoriasis. OBJECTIVE: To investigate the role of Tregs in the pathogenesis of psoriasis and to evaluate the changes in Tregs in relation to the severity and the clinical course of psoriasis. METHODS: Immunohistochemistry (CD3, 4, 8, 79 and FOXP3) was performed in 22 psoriatic patients compared to 5 normal controls. Flow cytometry (CD3, 4, 8, 25 and FOXP3) was performed in 18 psoriatic patients and 8 normal volunteers and reverse transcriptase polymerase chain reaction (foxp3 mRNA) was performed in 8 psoriasis patients. RESULTS: An increase in the FOXP3(+) cell fraction was detected in the lesional psoriatic skin irrespective of the severity of psoriasis as compared with the normal skin. However, a decrease in FOXP3(+) cells was observed in the samples obtained from psoriasis of 'acute course'. FOXP3(+) Treg populations in the blood of the 'acute course' psoriasis was not different compared to that of 'chronic course' psoriasis and normal controls. CONCLUSION: The deficiency of FOXP3(+) Tregs in the lesional psoriatic skin might be responsible for the exacerbation of psoriasis.

Effect of Cyclosporine on Peripheral Blood and Lesional Skin in Psoriatic Patients

BACKGROUND: Cyclosporine effectively suppresses immune responses and inhibits skin homing T cell responses in psoriasis. E-selectin is known to be up-regulated on vascular endothelium of inflammatory skin lesions such as psoriasis. PURPOSE: Based on our previous study that cyclosporine decreased lesional cutaneous lymphocyte antigen (CLA)+ T cells in psoriatic patients, we tried to find any change of CLA+ T cells in peripheral blood in psoriatic patients, since psoriasis is a disease of systemic T cell activation. Subjects and Methods: Peripheral blood of 8 patients with chronic plaque type psoriasis at 0, 3, 6, 12, 18 weeks after cyclosporine was examined by flow cytometry using anti-CLA antibody. Five skin biopsy samples at 0, 3, 6, 12, 18 weeks were immunohistochemically stained with anti E-selectin antibody. RESULTS: Our results demonstrate that the number of CD3+ CLA+ and CD4+CLA+ T cells was significantly reduced in the peripheral blood at week 3, but gradually increased to the level of baseline at 18 weeks. In psoriatic skin lesions, with decrease of PASI score and CLA+ T cells number, the expression of E-selectin on the endothelial cells was gradually decreased throughout 18 weeks of therapy. CONCLUSION: These results suggest that cyclosporine suppresses the migration of skin homing T cells to psoriatic skin lesions, in part, through the inhibition of E-selectin on the endothelial cells.

Expression of Neuropeptides and Their Receptors in Psoriatic Lesions / 대한피부과학회지

BACKGROUND: Neuroimmunocutaneous system alteration can be responsible for the induction and maintenance of the inflammatory process of psoriasis. OBJECTIVE: This study was carried out to examine the expression of Substance P (SP), calcitonin gene-related peptide (CGRP), somatostatin (SOM), neutral endopeptidase (NEP), SP receptor, and CGRP receptor in psoriatic lesions. METHODS: A skin biopsy was obtained from 10 psoriatic patients and 10 normal control subjects. Confocal laser scanning microscopy was performed. RESULTS: The SP and CGRP receptors consistently increased in psoriatic lesions, compared to the normal controls. CONCLUSION: The increased expression of neuropeptides and their receptors may be involved in the pathogenesis of psoriasis.

Two Cases of Fibroma of Tendon Sheath / 대한피부과학회지

Fibroma of the tendon sheath is a slow-growing tumor, adherent to mainly the volar aspect of the tendon sheath of the finger or hand. Histopathologically, these tumors are always well-circumscribed and may be lobulated. They are largely composed of interlacing bundles of hyalinized, hypocellular fibrous tissue with the occasional increased cellular area. A characteristic feature is the presence of slit-like vascular channels. They are benign lesions with a tendency to recur in upto 25% of cases, although becoming more generally recognized are not yet familiar to dermatologists. Herein, we report two cases of fibroma of the tendon sheath.

A Case of Adult-onset Urticaria Pigmentosa / 대한피부과학회지

Mastocytosis is a heterogenous group of disorders characterized by the proliferation and accumulation of mast cells in a variety of tissues, most often skin. Urticaria pigmentosa is the most common type of cutaneous mastocytosis in both adults and children. However, the clinical manifestation of adult-onset urticaria pigmentosa may have some differences such as smaller macules, more pruritic symptoms, and frequent association with systemic symptoms. We report a case of adult-onset urticaria pigmentosa in a 51-year-old woman which we compare to those cases reported in the literatures.

A Case of a Median Raphe Cyst which Developed on the Glans Penis / 대한피부과학회지

Median raphe cysts are rare mid-line developmental cysts, which can arise at any point between the external urethral meatus and the anus. They most commonly affect the ventral aspect of the penis, usually near the glans. They tend to be solitary, unilocular cysts, and the inner lining is usually composed of pseudostratified columnar epithelium. We present a case of a 3-year-old boy with a median raphe cyst affecting the glans penis. The cyst, located near the urethral meatus, was slightly pruritic and 0.3cmx0.3cmx0.1cm in size. A shave biopsy, followed by CO2 laser ablation was performed, and histopathological examination revealed a unilocular cyst lined with pseudostratified columnar epithelium, which showed decapitation secretion in part. For 2 years fallawing the shave biopsy, no clinical evidence of recurrence has been observed.

Clinico-pathologic Study and Detection of Human Herpesvirus 8 sequence of Kaposi's Sarcoma in Korea / 대한피부과학회지

BACKGROUND: Kaposi's sarcoma (KS) is a vascular neoplasm that was rarely seen before the AIDS and transplantation era. The isolation of human herpesvirus 8 (HHV-8) in all forms of KS strongly suggests a role of this agent in the pathogenesis. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathological features of KS and assess the presence of HHV-8 sequences in Korea. METHODS: The medical records and histopathologic slides of patients with KS, who were diagnosed at Asan Medical Center from 1989 to 2005, were reviewed. We also performed polymerase chain reaction (PCR) to find out the presence of HHV-8. RESULTS: 1.Among the 22 patients, classic KS was found in 9 and iatrogenic immunosuppressive-associated KS in 13 patients. 2.Clinical features were varied, usually limiting to the skin of the extremities, however, involvement of internal organs and mucosa was also detected. 3. The histology of cutaneous lesions associated with various clinical forms of KS was essentially identical, however, it presented different features according to their stage. 4. HHV-8 sequences were identified in all cases of KS, including the lesions of internal organs. 5.Classic KS responded well to radiation therapy, thalidomide or chemotherapy, except 2 patients. Iatrogenic immunosuppressive KS improved generally after radiation therapy, IFN-alpha, or chemotherapy, but some of the patients died due to underlying diseases. CONCLUSION: KS is a rare vascular neoplasm. We retrospectively studied twenty-two cases, and HHV-8 were detected in all cases, these supporting HHV-8 as the causative agent.