Gut microbiota modulation and gold nanoparticle-mediated photothermal therapy for treatment of recalcitrant acne.

Recent studies highlight that gut dysbiosis, an imbalanced state of intestinal microbiota, exacerbates skin inflammation. Here, we showed the presence of gut microbiota alterations in two patients with recalcitrant acne and investigated the impact of its therapeutic modulation together with gold nanoshell-mediated photothermal therapy (gold PTT).

Comparative expression of matrix metalloproteinases in internal malignancies and paired cutaneous metastatic lesions.

BACKGROUND: Matrix metalloproteinase (MMP), tissue inhibitor of metalloproteinase (TIMP), and membrane-type 1 matrix metalloproteinase (MT1-MMP) are thought to be involved in the destruction of basement membrane and stromal invasion by cancer cells. OBJECTIVE: The aim of this study was to identify and compare MMP and TIMP expression in internal malignancies and paired cutaneous metastatic lesions. MATERIALS AND METHODS: We compared the expression of MMP-2, MMP-9, MT1-MMP, and TIMP-2 in the internal malignancy and paired cutaneous metastatic lesion using immunohistochemical stains. RESULTS: The cutaneous metastatic lesions expressed significantly more MMP-2, MMP-9, and MT1-MMP and significantly less TIMP-2 than did the paired internal malignancies. In breast cancer, cutaneous metastatic lesions expressed significantly more MMP-9 and significantly less TIMP-2 than did the primary breast cancer lesion. In lung cancer, the cutaneous metastatic lesion expressed significantly more MMP-2 and MT1-MMP than did the primary lesion. In stomach cancer, the cutaneous metastatic lesion expressed significantly less TIMP-2 than did the primary lesion. CONCLUSIONS: Our study demonstrates that cutaneous metastatic lesions have different MMPs and TIMP-2 expression patterns compared with their paired internal malignancies. Also, MMPs and TIMP-2 expression differs according to the type of primary cancer.

The effect of imiquimod on matrix metalloproteinases and tissue inhibitors of metalloproteinases in malignant melanoma cell invasion.

BACKGROUND: A number of reports have been published regarding the use of imiquimod for the treatment of melanoma in situ and metastatic melanoma. Essential steps in the process of melanoma invasion and metastasis include degradation of basement membranes and remodeling of the extracellular matrix by proteolytic enzymes, including matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). OBJECTIVE: To evaluate the antiinvasive effect of imiquimod in human malignant melanoma cell lines, SK-MEL-2 and SK-MEL-24, in vitro, and to investigate imiquimod-induced changes in the expression of MMPs and TIMPs. METHODS: Invasiveness of melanoma cell lines following imiquimod treatment was evaluated by invasion assays. In order to investigate the mechanism of the anti-invasive effect of imiquimod, mRNA and protein levels of MMP-2, -9, membrane type 1 (MT1)-MMP, TIMP-1, and -2 were assessed by real-time reverse transcription-polymerase chain reaction, gelatin zymography, and western blotting. RESULTS: Imiquimod treatment decreased in vitro viability of melanoma cells in a concentration-dependent manner. Imiquimod also elicited a concentration-dependent suppression of invasion in both melanoma cell lines. A concentration-dependent decrease in MMP-2 and MT1-MMP protein levels and a concentration-dependent increase in TIMP-1 and -2 protein levels by imiquimod was observed in both melanoma cell lines. However, expression of MMP-9 protein was increased in SK-MEL-2 but decreased in SK-MEL-24 with increasing imiquimod concentrations. Imiquimod elicited alterations in MMPs and TIMPs mRNA levels that parallel the observed changes in protein levels. CONCLUSION: Imiquimod may elicit an anti-invasive effect on human melanoma cells by regulating MMPs and TIMPs.

Comparison of secondary intention healing and full-thickness skin graft after excision of acral lentiginous melanoma on foot.

BACKGROUND: Melanoma in dark-skinned individuals often develops in an acral lentiginous fashion on the foot. After wide excision, substantial defects usually develop and they may endure insufficient vascular flow. In addition, the final scar must withstand the mechanical stress of daily walking. Various repair methods are used to repair these defects, but secondary intention healing has not been evaluated in the repair of wounds of the foot. OBJECTIVE: To compare the functional and cosmetic results of secondary intention healing and full-thickness skin graft after wide excision of melanoma on the foot. METHODS: Retrospective review of 25 patients who were treated using excision for melanoma on the foot. The defects of 13 patients were healed by secondary intention (secondary intention healing group; SIHG), and those of 12 patients were repaired by full-thickness skin graft (skin graft group; SGG). RESULTS: The SGG showed more rapid healing than the SIHG, but the SIHG showed better functional and cosmetic outcomes at complete re-epithelialization than the SGG as evaluated by patients and independent physicians. CONCLUSIONS: Secondary intention healing after excision of melanoma from the foot is a therapeutic option with acceptable functional and cosmetic outcomes.

Early postoperative treatment of thyroidectomy scars using a fractional carbon dioxide laser.

BACKGROUND: Ablative carbon dioxide fractional laser systems (CO(2) FS) have been effectively used to improve the appearance of scarring after surgical procedures, but an optimal treatment time has not been established. OBJECTIVE: To evaluate the efficacy and safety of CO(2) FS in early postoperative thyroidectomy scars. METHODS: Twenty-three Korean women with thyroidectomy scars were enrolled in this study. All patients underwent a single session of two passes of a CO(2) FS with a pulse energy setting of 50 mJ and a density of 100 spots/cm(2) 2 to 3 weeks after surgery. RESULTS: Mean Vancouver Scar Scale (VSS) scores were statistically significantly lower after laser treatment. Three months after CO(2) FS treatment of thyroidectomy scarring, 12 of 23 participants showed clinical improvement of more than 51% from 2 to 3 weeks after surgery. The mean grade of clinical improvement based on independent clinical assessment was 2.6 ± 0.9. CONCLUSION: Early postoperative CO(2) FS treatment of thyroidectomy scars is effective and safe.

Efficacy of the 1064-nm Q-switched Nd:YAG laser in melasma.

BACKGROUND: Melasma is difficult to treat and often recalcitrant to various treatments such as topical preparations and lasers. OBJECTIVES: To evaluate the efficacy and safety of the 1064-nm Q-switched Nd:YAG laser in Asian patients with melasma. METHODS: Twenty-three Korean patients (skin types III-V) with melasma were treated with the 1064-nm Q-switched Nd:YAG laser at 1-week intervals for 10 weeks. The melasma area and severity index (MASI) score, lightness of melasma, patient satisfaction score and side effects were assessed at baseline, 4, 7, and 10 weeks and 1, 2, and 3 months after the last treatment. RESULTS: A decreased MASI score and increased lightness of melasma were statistically significant at 7 and 10 weeks. Follow-up data was statistically significant at 1, 2, and 3 months after the last treatment (p-value < 0.05). The patient satisfaction score was statistically significant at 4, 7, and 10 weeks. Follow-up data were statistically significant at 1, 2, and 3 months after the last treatment (p-value < 0.05). No significant side effects were noted. CONCLUSION: The 1064-nm Q-switched Nd:YAG laser is a safe and effective modality for treating melasma in Asian patients.

Clinicopathological features and T-cell receptor gene rearrangement findings of mycosis fungoides in patients younger than age 20 years.

Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma that usually arises in middle-aged or older people. The incidence of childhood MF is low, but studies in childhood MF suggests that the incidence is rising. The number of studies in childhood MF are few and there are currently no studies about childhood MF in Asians. We investigated the clinicopathological features, T-cell receptor (TCR) gene rearrangement findings, treatment and follow up in childhood MF. The retrospective study was performed on a population consisting of 23 MF patients aged 4-19 years. The duration of the disease ranged from 1 month to 10 years (mean, 2.7 years). In Tumor-Node-Metastasis classifications, all cases were confined to stage IA or IB. Histopathological findings revealed epidermotropism and perivascular infiltrates, epidermotropism in the infundibulum, Pautrier's microabscess, haloed lymphocytes, epidermal lymphocytes larger than dermal lymphocytes, atypical cells with hyperchromatic nuclei and wiry bundles of collagen. TCRgamma gene rearrangement was performed except for four patients, and monoclonality was detected in 16 of 19 cases (84%). Treatment was done with psoralen and ultraviolet (UV)A, UVA1, narrow-band UVB, topical steroid, retinoic acid and calcipotriol. Most patients showed a good response. At a mean follow up of 90.4 months, no patient had either an exacerbation of the disease or extracutaneous involvement. Compared with adult-onset MF, MF in children may show a variety of clinical features. It is considered to have a good prognosis. Moreover, histopathological study and TCR gene rearrangement study can help in the diagnosis of MF in children.

The Inhibitory Effect of Phytoclear-EL1 on Melanogenesis.

BACKGROUND: Phytoclear-EL1, an extract from Euphorbia lathyris seeds, has a whitening effect due to inhibition of tyrosinase activity. OBJECTIVE: The purpose of this study was to investigate the inhibitory effect of phytoclear-EL1 on melanogenesis. METHODS: Cultured B-16 melanoma cells and 30 human volunteers were used for in vitro and in vivo studies, respectively. Phytoclear-EL1 was added to the cultured B-16 melanoma cells, and applied to UVB-induced hyperpigmented lesions of human volunteers twice daily for 7 weeks. Changes in the number of B-16 melanoma cells, as well as changes in morphology, melanin content, and tyrosinase activity, were measured and then compared with the normal control and the 10(-3)M arbutin groups. Also, the effect of phytoclear-EL1 on UVB-induced hyperpigmented lesions was examined through subjective and objective measurements. RESULTS: In the in vitro study (p<0.05), the number, melanin content, and tyrosinase activity of cultured B-16 melanoma cells were decreased in the 5microg/ml phytoclear-EL1 group compared to the control group. On objective assessment with a chromameter, the 0.2% phytoclear-EL1 group had a larger difference in the mean L values before and 7 weeks after applying phytoclear-EL1 as compared to the other groups. On subjective assessment by both the researchers and subjects 7 weeks after applying experimental materials, the 0.2% phytoclear-EL1 group and positive control (3% arbutin) had higher scores than the placebo groups. These results demonstrated that phytoclear-EL1 in vivo and in vitro had an inhibitory effect on melanogenesis. CONCLUSION: Phytoclear-EL1 may be a candidate extract in the control of hyperpigmentary disorders.

Post-steroid panniculitis in an adult.

Post-steroid panniculitis is known to be very rare and most of the reported cases have been in children after corticosteroid therapy. We present a case of post-steroid panniculitis occurring in a 60-year-old man after massive, long-term administration of corticosteroids for acute exacerbation of chronic obstructive pulmonary disease (COPD). Histopathological examination of a nodule revealed a patchy area of fat necrosis, several multinucleated giant cells containing needle-shaped clefts. The lesions subsided completely in approximately 12 weeks without any treatment. We suggest that post-steroid panniculitis is not confined to childhood but also occurs in adulthood.