RESUMEN
Background: A novel treatment has been developed to reconstruct large skin defects caused by the excision of giant congenital melanocytic nevi. It involves the reimplantation of high-hydrostatic pressurized nevus tissue as a cell-inactivated autologous scaffold for dermal regeneration, followed by the implantation of cultured epithelial autografts on the regenerated dermis. Because this treatment has shown promise in a first-in-human clinical trial which used a prototype pressure machine, a novel pressure device was specifically designed for clinical use. Methods: In a prospective investigator-initiated clinical trial involving three patients, we evaluated the safety and efficacy of the skin regeneration treatment using a pressure device. All three patients underwent surgical excision of the nevus tissue, primary reimplantation of the inactivated nevus tissue, and secondary implantation of cultured epithelial autografts. Results: Engraftment of inactivated nevus tissue and cultured epithelial autografts was successful in all three cases, with over 90% epithelialization at 8 weeks post-surgery. No serious adverse events or device malfunction were observed during the trial. Conclusion: The novel pressure device safely and effectively enabled dermal regeneration using the nevus tissue as an autologous scaffold. This innovative approach offers several advantages, including reduced invasiveness due to minimal sacrifice of normal skin for skin grafting and high curative potential resulting from full-thickness removal of the nevus tissue.
RESUMEN
PURPOSE: To report the ocular features of a father and son with central areolar choroidal dystrophy (CACD) who had similar fundus appearance. CASE: Case 1. A 37-year-old man noticed impairment of his vision since several months prior to his visit to our hospital. His corrected visual acuity was 0.6 OD and 1.0 OS. Well demarcated chorioretinal atrophy with a width of 2-3 disc diameters in the macular area was observed in both ocular fundi. Optical coherence tomography (OCT) at the chorioretinal atrophy areas showed thinning of retinal thickness with a disappearance of a line corresponding to the outer segment of the photoreceptor cells, but thickening of a line of the retinal pigment epithelium. Electroretinogram(ERG) and electrooculogram(EOG) showed deteriorated responses. Case 2 was a 67-year-old man, the father of patient 1. His corrected visual acuity was 0.1 OD and 0.2 p OS. Fundus appearance was similar to that of case 1. His ERG and EOG also showed similar impaired responses. His OCT also showed findings similar to those of case 1, but the retina was thinner than in case 1 in the chorioretinal atrophy area. DISCUSSION: The rest of the retina outside the chorioretinal atrophy area in these CACD patients also seemed to be damaged because both the ERG and EOG showed damage. These two cases revealed that a CACD patient could maintain relatively good visual acuity, even though the chorioretinal atrophy had involved the foveal area, and also indications were that retinal functions had been damaged.