Clinical Evaluation and Skin Care Habits among 222 Patients with Rosacea:A Comparison with 127 Patients with Acne / 대한피부과학회지

Background@#Rosacea is a chronic inflammatory facial disorder, leading to impaired skin barrier function. Many factors, including skin care habits, affect its occurrence and progress. @*Objective@#This study aimed to investigate clinical manifestation and aggravating factors of rosacea, focusing on skin care habits and lifestyle and to compare them with those of acne patients. @*Methods@#We conducted a cross-sectional survey among 222 patients with rosacea and 127 with acne who visited a university hospital and local dermatologic clinic between July 2021 and June 2022. The patients answered questionnaires consisting of information, such as demographic characteristics, clinical symptoms and signs, skin care habits, and aggravating factors. @*Results@#Age distribution of the patients with rosacea showed a peak incidence among those in their twenties, and the most common comorbidity was metabolic disease. The most common symptom and sign was itching, followed by burning sensation. Regarding skin care habits, 72.8% and 45.0% of the patients practiced excessive cleansing and double cleansing, respectively. The most frequently-used cleanser and basic cosmetic were foaming cleanser (77.5%) and toner (57.5%), respectively. Foundation was used by nearly half of the woman, many of whom used liquid type.Irregular or insufficient sleep and food were the two most common aggravating factor. When compared to patients with acne patients, those with rosacea tended to carry more systemic comorbidities and practiced double cleansing with basic cosmetics more actively. @*Conclusion@#It is important for clinicians to understand various factors affecting occurrence and aggravation of rosacea and educate patients on appropriate skin care habits and lifestyle.

Treatment Outcomes of Combination Therapy with 1,064-nm Neodymium-doped Yttrium Aluminum Garnet Laser and Efinaconazole 10% Solution for Big Toenail Onychomycosis: a Retrospective Study / 대한의진균학회지

BACKGROUND@#Laser therapy can be used as an alternative treatment for onychomycosis; however, there are somelimitations to its efficacy as a single agent.@*OBJECTIVE@#To evaluate the effectiveness of combination therapy with 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and topical efinaconazole in onychomycosis treatment and identify factors influencing the therapeutic outcomes of combination treatment.@*METHODS@#Big toenails with onychomycosis were treated by 1,064-nm Nd:YAG laser at 4-week intervals with daily application of topical efinaconazole. Therapeutic response was assessed through onychomycosis severity index (OSI) and percentage of nail infected (PNI), and its association with a variety of factors that may affect treatment outcome was evaluated.@*RESULTS@#One hundred big toenails were included in the study and significant clinical improvements were observed after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in treatment response according to the number of laser treatments, onychomycosis clinical type, or initial severity. However, patient age was negatively correlated with clinical improvement (p = 0.019). Also, female patients had better therapeutic responses than male patients.@*CONCLUSION@#Combined treatment with Nd:YAG laser and topical efinaconazole has a significant therapeutic effect on onychomycosis. A randomized controlled trial is warranted in the future.

Clinical Factors Influencing Outcomes of 1064 nm Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Laser Treatment for Onychomycosis

No abstract available.

An Open-Label, Split-Face Trial Evaluating Efficacy and Safty of Photopneumatic Therapy for the Treatment of Acne

BACKGROUND: Acne vulgaris is the most common skin disease worldwide, with many available treatment modalities, including oral and topical medications and laser therapy. Recently, a novel device (Isolaz, Pleasanton, CA, USA) that combines vacuum pressure and a broadband light source (400 nm to 1,200 nm) was developed for the treatment of acne. OBJECTIVE: To determine the clinical efficacy and safety of photopneumatic therapy for the treatment of acne vulgaris of the face. METHODS: Twenty adults with mild to moderate facial acne vulgaris received 4 successive treatments on one side of the face with a combined photopneumatic device (intense pulsed light: fluence=5.8 J/cm2; negative pressure=iMP mode) at 2 week intervals. Acne lesions on the opposite side of the face were not treated. Lesion counts were performed at baseline, prior to each treatment session, and at 3 months after the final treatment session. RESULTS: Significant lesion improvements and reduced numbers of acne lesions were observed on the treated side of the faces. Most patients experienced global clinical improvement. No severe side effects occurred during the study, with only a few patients experiencing transient erythema, purpura and/or exacerbation of pre-existing acne. CONCLUSION: Photopneumatic therapy is a safe and effective treatment for mild to moderate acne vulgaris.

Treatment of Striae Distensae by Thermage and 585-nm Pulsed Dye Laser(V-star(R)) / 대한피부과학회지

Striae Distensae is a very common cosmetic problem. The effectiveness of various lasers, such as the 585-nm pulsed dye laser on the treatment of striae distensae has recently been reported. However, the potential pigmentary alteration of dark skin by pulsed dye laser is known. Thermage is a radiofrequency capable of delivering higher energy fluences to a greater volume of tissue than nonablative lasers, with no epidermal injury. We report three patients who had striae distensae. They were treated with Thermage and 585-nm pulsed dye laser. The treatment was effective and safe for dark skin.

Three Cases of Facial Photorejuvenation by Intense Pulsed Light Quantum SR(TM) / 대한피부과학회지

Intense pulsed light (IPL) Quantum SR(TM) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad wavelength spectrum of 560-1200 nm. IPL Quantum SR(TM) has been effective for the treatment of photoaging skin as a nonablative method. Three patients with photoaged skin were treated with fifth full-face treatments at 3-4 week intervals using IPL Quantum SR(TM). The cut-off filters of 560 nm and integrated contact cooling system were utilized for treatments. After the last treatments, the patients showed the overall improvement in clinical appearance, reduction in pigmentation and telangiectasia and fine wrinkle with smoothening of skin textures. Histological evaluations showed new collagen production after treatment. Full-face photorejuvenation using IPL Quantum SR(TM) can be an effective treatment modality for photoaged skin. We report herein IPL photorejuvenation is safe and effective in skin rejuvenation.

Immunohistochemical Expression of E-Cadherin and Ur-Catenin in Fetal Skin / 대한피부과학회지

BACKGROUND: E-cadherin is the prime mediator of cell-cell adhesion in epithelial cells and the beta-catenin is the associated protein with E-cadherin in the formation of adhesion complexes in normal and tumor cells related with tumor spread. The present study aimed to find the distribution of E-cadherin and beta-catenin in fetal skin during development. OBJECTIVE: The purpose of this study was to observe the distribution of above two adhesion related proteins in the fetal skin during development, to find its relationship by expression and their distribution patterns. METHODS: Skin was obtained from the scalp, chest, and sole of 21 human fetuses, ranging from 13 to 37 weeks of gestational age. Immunohistochemical staining was performed by avidin biotin peroxidase complex method on paraffin embedded tissue using anti-human monoclonal antibody against the human E-cadherin and beta-catenin. RESULTS: E-cadherin and beta-catenin were expressed in cell membrane of intermediate cell layer of epidermis at 13th week followed by increased basal cell expression at 15th week and adult pattern in 24th week of gestation. Both showed similar distribution pattern in skin. Difference was that E-cadherin was expressed only in cell membrane, but beta-catenin was expressed in both cell membrane and cytoplasm, stronger in cell membrane. beta-catenin also expressed in mesenchymal tissue. In the skin adnexae, E-cadherin and beta-catenin were also expressed very similar distribution pattern both in hair follicular development and eccrine duct epithelium. CONCLUSION: Both E-caherin and beta-catenin showed the same expression in the fetal stage and distribution pattern suggesting that both adhesion molecules are highly related each other in function and development of epidermis and adnexae of the skin in fetal stage, though their expression are not noted in all epithelial cells.

Expression of Cytokeratin 1, 10 and 14 in Fetal Skin

BACKGROUND: During the fetal stage, the epidermis and adnexal epithelium might express different types of cytokeratin (CK) by developmental stages. The objective of this study is to observe the expressions of CK1, CK10 and CK14 in the skin of human fetuses. METHODS: Immunohistochemical stains were applied to the skin of 42 fetuses ranging from 10 to 36 gestation weeks. Three different portions of the body (i.e., scalp, chest and sole) were sampled. Immunohistochemical staining with monoclonal antibodies against CK1, 10, 14 were done. RESULTS: We found that CK14 was expressed in the basal layer of the epidermis and adnexae of fetuses beween 10 to 36 gestation weeks. However, stronger expression in the middle than the basal layer was noted in the soles of 15-week fetuses followed by exclusive basal expression. The sebaceous gland, the outer root sheath of the hair follicle and the eccrine duct epithelium also showed CK14 expressions, while CK14 was negative in hair germ and acini. Both CK1 and CK10 were expressed in the epidermis of fetuses ranging between 10 to 36 gestation weeks at the suprabasal layer of the scalp, chest and sole; while they were negative in the basal layer and skin adnexae including sebaceous, hair and eccrine gland. CONCLUSIONS: Expression of cytokeratins in the fetal skin were noted at 10 weeks throughout the entire gestation period and were similar in the three different sites, except in the early stage of the sole. The main expression sites of K14 were the basal layer of the epidermis, the eccrine ducts and the outer root sheath cells of hair, suggesting the same origin, while those of K1 and K10 were in the suprabasal layer of epidermis.

A Case of Papillary Eccrine Adenoma / 대한피부과학회지

The papillary eccrine adenoma is a rare benign sweat gland neoplasm, first described by Rulon and Helwig in 1977. It is usually present as a solitary dermal nodule on the distal extremities. Histological examination revealed a well circumscribed, non capsulated dermal nodule consisting of multiple ducts with various size. These ducts were composed of double layered epithelial cells mostly and intraluminal papillation with eosinophilic luminal materials was seen. We report a case of papillary eccrine adenoma in 52-year-old male who presented single nodule on the right midback, uncommon area.

A Case of Allergic Contact Dermatitis from Calcipotriol(Daivonex(R)) / 대한피부과학회지

The vitamin D3 analogue calcipotriol ointment(Daivonex(R)) has now been used successfully in the treatment of psoriasis for several years. It is usually well tolerated and safe. The adverse effects are mainly lesional and perilesional irritations, facial irritations, hypercalcemia, etc. The nature of calcipotriol-induced dermatitis is usually considered to be of irritant nature but allergic contact reactions have also been reported. We report a case of allergic contact dermatitis from calcipotriol (Daivonex(R)).

Two Cases of Lichen Amyloidosis Stained Negatively for Antikeratin Antibodies / 대한피부과학회지

Localized primary cutaneous amyloidosis consists of three types: nodular, macular, and lichenoid amyloidosis. Lichen amyloidosis is characterized by the appearance of paroxysmally itchy lichenoid papules on the shins. Although the origin of the amyloid is controversial and can not provide any definite answer, some of amyloid substances can be derived from epidermal cells and others from degenerative collagen fibers. We suggested the origin of amyloid in our cases as epidermal keratinocyte and collagen degenerations. Because degeneration of basal keratinocyte is observed on electron microscopy and degeneration of collagen is in H&E and Masson's trichrome stain although amyloid materials are negatively stained against pankeratin antibody and collagen antibody. The skin lesion was improved after triamcinolone intralesional injections which reduce collagen synthesis. We report two cases of lichen amyloidosis which stained negatively for antikeratin antibodies and improved with triamcinolone intralesional injection.

Ehlers-Danlos Synrome Type II / 대한피부과학회지

The Ehlers-Danlos syndromes(EDS) are a heterogenous group of inherited connective tissue disorders characterized clinically by skin fragility, skin hyperextensibility, joint hypermobility, and excessive bruising. At least 11 different subtypes of EDS have been classified based on genetic, biochemical, and clinical characteristics. We report a 25-year-old man with EDS type II who presented mild extensibility of skin and joint, skin fragility, and "cigarette paper" like atrophic scar. The EDS type II is more common than other different subtypes. While it may present with subtle clinical features, recognition is important so that good advice can be given to reduce the risks associated with certain careers and sports and to prevent the potential complications of pregnancy and surgery.

A case of Proteus Syndrome with Characteristic Clinical Manifestations / 대한피부과학회지

The term Proteus syndrome was coined in 1983 to describe a disorder of skeletal, hamartoinatous and other mesodermal malformations. The syndrome was named after the Greek god Proteus, whose name means "the Polymorphous". Major manifestations are hemihypertrophy, macrodactyly, exostoses, epidermal nevi, characteristic cerebriform masses involving the plantar or palmar surfaces, a variety of subcutaneous masses and scoliosis. We report a 12-year-old boy with Proteus syndrome who had the unique features of this syndrome.