Innovative Use of Negative Air Ions As an Alternative Therapy for Acne Vulgaris: A Report of Three Cases

Acne vulgaris is a universal skin disease with multifactorial pathogenesis. Although an extensive range of treatment options exist for acne, a substantial number of patients are still struggling for an optimal treatment option due to the side effects or contraindications to the conventional acne treatment. Negative air ions (NAIs) are electrically charged molecules that naturally exist in the atmosphere. Since they are natural component of air, there are no known side effects and contraindications to their application. Furthermore, among the identified benefits of NAIs, certain mechanisms are related to acne pathogenesis, allowing them to be attractive candidates for acne treatment. Here, we describe three patients with acne who showed considerable clinical improvement after NAI therapy. All of the patients had failed to tolerate traditional acne treatment options. In all three cases, considerable improvement was observed in acne severity and the number of total lesions. Based on the three cases and a review of literature underlying the effects of NAIs, we suggest that NAIs may be a safe and effective alternative therapeutic option for acne vulgaris.

Anti-melanogenesis and Anti-inflammatory Effects of Cinnamomi Cortex Extract In Vitro / 대한피부과학회지

BACKGROUND: Many researchers have sought to identify safe, natural herbal extracts that exert an anti-melanogenesis effect. Cinnamomi cortex has been widely used as a herbal medicine in Asia and Europe. OBJECTIVE: To confirm the inhibitory effects of Cinnamomi cortex extract against melanogenesis and inflammation and to elucidate the underlying mechanism of these actions. METHODS: Effects of Cinnamomi cortex extract on melanin synthesis and tyrosinase activity in B16F10 melanoma cells were evaluated using an ELISA reader. Tyrosinase and MITF protein expression was determined using western blotting. Nitric oxide production in RAW 264.7 cells was measured using Griess reaction. PGE₂ was assayed with an ELISA kit. RESULTS: Cinnamomi cortex extracts inhibited melanin synthesis, tyrosinase activity, and MITF and tyrosinase expression through regulation of the ERK and CREB genes in α-MSH-induced B16 melanoma cells. In addition, Cinnamomi cortex extracts inhibited the expression of NO, PGE₂, and pro-inflammatory cytokines in lipopolysaccharide-induced RAW 264.7 cells. CONCLUSION: We suggest that Cinnamomi cortex may be a potentially useful agent for treating inflammatory skin diseases such as hyperpigmentation based on its inhibitory effects against melanin synthesis and inflammation response in vitro.

Symmetrical Drug-Related Intertriginous and Flexural Exanthema: Two Cases and Brief Literature Review

It has been reported that there are a range of causative drugs related to symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). The causative drugs reported so far include the following: antibiotics, intravenous immunoglobulin, chemotherapeutic agents, and biologics. In this study, we report two cases of SDRIFE and a review of the previous literature. We believe that our study makes a significant contribution to the literature because it demonstrates that intradermal injection of the Chinese herbal ball, and not its topical application, elicited a reaction that predicted the occurrence of SDRIFE. This finding is important for the diagnosis of SDRIFE in future studies. Our findings also provide evidence for a SDRIFE reaction after exposure to ranitidine and mosapride.

Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Systemic Treatment

BACKGROUND: Since the treatment guidelines for atopic dermatitis (AD) were issued by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been further advances in the systemic treatment of AD. OBJECTIVE: We aimed to establish updated evidence- and experience-based systemic treatment guidelines for Korean AD. METHODS: We compiled a database of references from relevant systematic reviews and guidelines regarding the systemic management of AD, including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy, phototherapy, adjunctive treatment, and complementary and alternative medicines. Evidence for each statement was graded and classified based on the strength of the recommendation. Thirty-nine council members of KADA participated in the three rounds of votes and expert consensus recommendations were established. RESULTS: The use of antihistamines is recommended to relieve pruritus and to prevent exacerbation due to scratching in AD patients. Infection should be controlled as needed and long-term medication should be avoided. For moderate to severe AD patients, concomitant active treatments with systemic immunomodulators are indicated. Cyclosporine is the first choice among systemic immunomodulators and others should be considered as second-line alternatives. Allergen-specific immunotherapy could be effective in AD patients with aeroallergen hypersensitivity. Phototherapy can be useful for moderate to severe AD patients and narrow-band ultraviolet B is the most effective option. Complementary and alternative medicines cannot be recommended for treating AD. CONCLUSION: We expect these recommendations to be a reference guide for physicians and AD patients in choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.

Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Systemic Treatment

BACKGROUND: Since the treatment guidelines for atopic dermatitis (AD) were issued by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been further advances in the systemic treatment of AD. OBJECTIVE: We aimed to establish updated evidence- and experience-based systemic treatment guidelines for Korean AD. METHODS: We compiled a database of references from relevant systematic reviews and guidelines regarding the systemic management of AD, including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy, phototherapy, adjunctive treatment, and complementary and alternative medicines. Evidence for each statement was graded and classified based on the strength of the recommendation. Thirty-nine council members of KADA participated in the three rounds of votes and expert consensus recommendations were established. RESULTS: The use of antihistamines is recommended to relieve pruritus and to prevent exacerbation due to scratching in AD patients. Infection should be controlled as needed and long-term medication should be avoided. For moderate to severe AD patients, concomitant active treatments with systemic immunomodulators are indicated. Cyclosporine is the first choice among systemic immunomodulators and others should be considered as second-line alternatives. Allergen-specific immunotherapy could be effective in AD patients with aeroallergen hypersensitivity. Phototherapy can be useful for moderate to severe AD patients and narrow-band ultraviolet B is the most effective option. Complementary and alternative medicines cannot be recommended for treating AD. CONCLUSION: We expect these recommendations to be a reference guide for physicians and AD patients in choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.

Multiple Epidermal Cysts as a Complication of Gold Acupuncture

No abstract available.

Safety Evaluation of Stamp Type Digital Microneedle Devices in Hairless Mice

BACKGROUND: Microneedles provide a minimally invasive means to transport molecules into the skin. A number of specific strategies have been employed to use microneedles for transdermal delivery. OBJECTIVE: The purpose of this study was to investigate the safety of two new digital microneedle devices (Digital Hand(R) and Digital Pro(R); Bomtech Electronics Co., Ltd., Seoul, Korea) for the perforation of skin in skin-hairless-1 mice. This device replaces conventional needles and is designed specifically for intradermal delivery. METHODS: We used two newly developed digital microneedle devices to perforate the skin of skin-hairless-1 mice. We conducted a comparative study of the two digital microneedle devices and DTS(R) (Disk type-microneedle Therapy System; DTS lab., Seoul, Korea). To evaluate skin stability, we performed visual and dermatoscopic inspections, measurements of transepidermal water loss, and biopsies. RESULTS: The two novel digital microneedle devices did not induce significant abnormalities of the skin on visual or dermatoscopic inspection, regardless of needle size (0.25~2.0 mm). No significant histopathological changes, such as inflammatory cell infiltration, desquamation of the stratum corneum, or disruption of the basal layer, were observed. The digital microneedle devices and microneedle therapy system produced similar results on measures of skin stability. CONCLUSION: These two novel digital microneedle devices are safe transdermal drug delivery systems.

Combination Therapy with Cyclosporine and Psoralen Plus Ultraviolet A in the Patients with Severe Alopecia Areata: A Retrospective Study with a Self-Controlled Design

BACKGROUND: Alopecia areata (AA) is believed to be an organ-specific autoimmune disease in which a mononuclear cell infiltrate develops in and around anagen hair follicles. There is no definitive therapy for AA. OBJECTIVE: We sought to determine whether the combination therapy of cyclosporine and psoralen plus ultraviolet A (PUVA) could be an effective treatment for severe AA. METHODS: A total of 41 patients with severe AA were treated with oral cyclosporine and topical PUVA. Cyclosporine was given at an initial daily dose of 200 mg for adult and 100 mg for children for periods of up to 16 weeks. Eight-methoxypsoralen (Methoxsalen) was applied topically 20 minutes prior to ultraviolet A (UVA) exposure, and the patients were irradiated with UVA twice a week for 16 weeks. RESULTS: Of the total 41 patients, 2 (7.3%) patients were lost to follow-up, and 1 (2.4%) patient discontinued the treatment due to abdominal discomfort. Six (14.6%) patients were treated for less than 12 weeks. Of remaining 32 patients, 3 (9.4%) showed excellent response, 3 (9.4%) showed good response, 12 (37.5%) showed fair response, and 14 (43.7%) showed poor response. CONCLUSION: Although limited by its uncontrolled character, this study shows that the combination therapy with cyclosporine and PUVA may be an additional choice for severe and recalcitrant AA.

The Effects of 830 nm Light-Emitting Diode Therapy on Acute Herpes Zoster Ophthalmicus: A Pilot Study

BACKGROUND: Skin lesions and pain are the most distinctive features of herpes zoster. Light-emitting diode (LED) therapy is an effective treatment known for its wound-healing effects. OBJECTIVE: To determine whether the LED treatment affects wound healing and acute pain in acute herpes zoster ophthalmicus. METHODS: We recruited 28 consecutive Korean patients with acute herpes zoster ophthalmicus for the study. In the control group (group A), 14 subjects received oral famcyclovir. In the experimental group (group B), 14 subjects received oral famcyclovir and 830 nm LED phototherapy on days 0, 4, 7, and 10. In order to estimate the time for wound healing, we measured the duration from the vesicle formation to when the lesion crust fell off. The visual analogue scale (VAS) was used for the estimation of pain on days 4, 7, 10, and 14. RESULTS: The mean time required for wound healing was 13.14+/-2.34 days in group B and 15.92+/-2.55 days in group A (p=0.006). From day 4, the mean VAS score showed a greater improvement in group B, compared with group A. A marginal but not statistically significant difference in the VAS scores was observed between the two groups (p=0.095). CONCLUSION: LED treatment for acute herpes zoster ophthalmicus leads to faster wound healing and a lower pain score.

Three Cases of Adverse Effects Following the Acupuncture in Oriental Medical Clinic / 대한피부과학회지

Oriental medicine is a broad range of medical practices that are based on traditions. These traditions include various forms of herbal medicine, acupuncture, massage, exercise, and dietary therapy. The views of the body place little emphasis on anatomical structures, but are mainly concerned with the identification of functional entities. Recently, most oriental doctors have expanded their range of medical treatment into a variety of aspects, and have introduced treatment remedies that include unproved methods, especially into the field of dermatology. Herein, we present 3 cases of adverse effects following the acupuncture for congenital melanocytic nevus, syringoma, and acne scar in oriental medical clinic. With the increasing popularity of acupuncture, we need to understand the current status of dermatologic treatments conducted in oriental clinics.

Clinical Study of StoneTouch(R) Far-infrared Device on Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.

Clinical Study of StoneTouch(R) Far-infrared Device on Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.

HIV-associated Eosinophilic Folliculitis Appearing in a Patient with End-stage AIDS / 대한피부과학회지

HIV-associated eosinophilic folliculitis is characterized by recurrent crops of severely-pruritic follicular papules, pustules and plaques that occur mainly on the face, trunk and upper extremities of AIDS patients. This disease is distinguished from Ofuji's disease by severe pruritus, leukopenia, sparing of the palm and sole and a good response to phototherapy. Up to now, only three such cases have been reported in the Korean literature. A 55-year-old man, who was confirmed as being HIV positive 6 months previously, presented with severely-pruritic, erythematous pinhead to half pea sized papules and nodules on the face, neck and anterior chest. The skin biopsy from a nodular lesion on the face revealed perifolliculitis with a predominant eosinophilic infiltrate.

A Case of Sarcoidosis on an Acupunctured Area / 대한피부과학회지

Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin that can involve any organ, including the skin. It has occasionally occurred on trauma sites, such as on the sites of herpes zoster infections and venepuncture, operations, cosmetic tattoos, and previous laser surgeries. About 25% of systemic-sarcoidosis patients have skin lesions, but cutaneous sarcoidosis can occur without a systemic disease, as in the patient whose case is described herein: a 40-year-old female who presented an erythematous plaque on the left nasolabial fold area, to which acupuncture was applied at an oriental clinic about 3 months earlier, as treatment for left facial nerve palsy.