Treatment Using a Long Pulsed Nd:Yag Laser with a Pulsed Dye Laser for Four Cases of Blebbed Port Wine Stains

Port wine stains (PWS) are congenital capillary malformations consisting of ectasia of capillaries and venules. At birth,lesions are flat and relatively uniform in color, but evolve with age to become raised, thickened, irregularly surfaced, and deeply colored. Therefore, it is considered optimal to begin treatment of patients at an early age. Conventional treatment modalities, such as electrocautery or excision, require considerable effort and may be cosmetically unsatisfactory. We have performed treatment of blebbed PWS of four patients using a 1,064 nm long pulsed Nd:YAG laser with a contact cooling device. According to their size, most blebs required three or fewer treatment sessions at 8-week intervals. Treatments were well tolerated by all subjects and patients showed moderate to good improvement of blebs. A 1,064 nm long pulsed Nd:YAG laser with contact cooling may be considered as a promising therapeutic option for treatment of blebbed PWS.

Tinea Faciei-like Demodicidosis / 대한피부과학회지

Demodex folliculorum is a common mite of the pilosebaceous unit. Usually demodex infestation does not lead to the manifestation of pathologic skin diseases. But, in specific environments such as immunologic deficiency, they can proliferate and provoke cutaneous lesions. A 58-year-old patient presented with multiple, erythematous, annular-shaped plaques on the nose and right cheek. He had a 9-year history of Sjogren disease and she was treated with oral steroids and methotrexate. We found numerous Demodex folliculorum mites through a KOH microscopic examination and histologic examination of the right cheek. Biopsy resultd revealed that Demodex folliculorum mites were contained in the dilated follicular infundibulum. We diagnosed this case as an unusual manifestation of a Demodex infestation in a patient with Sjogren disease. We report an annular plaque-forming demodicidosis treated successfully with metronidazole.

Efficacy of Hydrogel Mask with 2% Arbutin for Melasma / 대한피부과학회지

BACKGROUND: Melasma is a common, acquired, symmetrical hypermelanosis that occurs on sun exposed areas of the skin. It is more prevalent among Asian women than among Caucasian women. Many different treatment modalities have been used with various efficacies, but none of them have been completely satisfactory. Arbutin is a naturally occurring gluconopyranoside that may reduce tyrosinase activity, which is a rate-limiting enzyme for melanin production. OBJECTIVE: The purpose of this study was to investigate the depigmenting effect and safety of a mask that contains 2% arbutin for the treatment of melasma. METHODS: A total of 54 female volunteers with melasma were enrolled in this randomized, double-blind, 8-week treatment study. The patients were instructed to apply an arbutin-containing mask or an arbutin-free mask once a day for 8 weeks. The assessment of outcomes included the Melasma Area and Severity Index (MASI) score, colorimetric value (L*), overall patient satisfaction and investigator assessment score (evaluated using photography). RESULTS: The arbutin-containing mask significantly increased the right and left colorimetric values (L*) after the 8-week treatment (p0.05). The arbutin mask scored better than the control in patient satisfaction and investigator assessment. No significant adverse reactions were observed. CONCLUSION: The arbutin mask appears to be effective and well-tolerated when used for the treatment of melasma.

A Clinical and Histopathological Study of 122 Cases of Dermatofibroma (Benign Fibrous Histiocytoma)

BACKGROUND: Many variants of dermatofibromas have been described, and being aware of the variants of dermatofibromas is important to avoid misdiagnosis. OBJECTIVE: We wanted to evaluate the clinical and pathologic characteristics of 122 cases of dermatofibromas. METHODS: We retrospectively reviewed the medical records and 122 biopsy specimens of 92 patients who were diagnosed with dermatofibroma in the Department of Dermatology at Eulji Hospital of Eulji University between January 2000 and March 2010. RESULTS: Nearly 80% of the cases occurred between the ages of 20 and 49 years, with an overall predominance of females. Over 70% of the lesions were found on the extremities. The most common histologic variant was a fibrocollagenous dermatofibroma (40.1%). Other variants included histiocytic (13.1%), cellular (11.5%), aneurysmal (7.4%), angiomatous (6.5%), sclerotic (6.5%), monster (4.9%), palisading (1.6%) and keloidal dermatofibromas (0.8%). There were 9 dermatofibromas (7.3%) that were the mixed type with two co-dominant histologic features. CONCLUSION: The results of this study are consistent with previous reports on the clinical features of dermatofibromas. However, we observed several characteristic subtypes of dermatofibroma and we compared the frequency of the histologic subtypes.

Transverse Leukonychia Associated with Hypothyroidism / 대한피부과학회지

Transverse leukonychia, also termed leukonychia striata, usually occurs in association with trauma, nutritional deficiencies, exposure to toxin, and various combinations of chemotherapy. It also has been reported to be associated with various systemic diseases, including acute infection, myocardial infarction, lymphoma, hepatic failure, renal failure, and systemic lupus erythematosus. A 50-year-old woman with several months' history of nail changes presented with multiple discrete transverse white bands involving the entire width of the nail plates of her fingers. According to the patient's medical history, she had experienced fatigue, constipation, and cold intolerance for 6 months, and antithyroid antibodies were detected before noticing these nail changes. The patient was diagnosed as having an autoimmune hypothyroidism. Repeated KOH microscopic examination did not demonstrate fungal infection. We diagnosed this case as transverse leukonychia associated with hypothyroidism. This case report underlines the possible association of transverse leukonychia with hypothyroidism.

Multiple Eccrine Hidrocystoma of the Face, Neck, Anterior Chest and Both Arms / 대한피부과학회지

Eccrine hidrocystomas are benign cystic dilatations with eccrine differentiation. The clinical presentation usually occurs as a solitary tense vesicle or translucent papule located predominantly on the face, whereas multiple eccrine hidrocystomas are unusual. Histologically, eccrine hidrocystoma consists of one or more partially collapsed unilocular cysts in the dermis, which show flattened epithelium that is partially lined by two layer of cuboidal epithelium. We report here on a case of the patient with multiple eccrine hidrocystomas that showed an especially generalized presentation that included the face, neck, anterior chest and both arms.

A Case of Pseudoaneurysm of the Supraorbital Artery Treated with Percutaneous Glue Embolization / 대한피부과학회지

Pseudoaneurysm, or false aneurysm, rarely presents as a cause of facial tumor. Among the cases of pseudoaneurysm reported in the world literature, more than 75% have been of a traumatic origin. Pseudoaneurysm most frequently arises in the superficial temporal artery, but the pseudoaneurysm of our present case arose in the supraorbital artery, and this type of presentation has been only rarely reported on. The most typical clinical findings consist of a tender, growing, pulsating nodule. We report here on a case of pseudoaneurysm that was due to trauma, and the tumor was pulseless. This lesion was treated with percutaneous glue embolization.

A Case of Nicolau Syndrome Treated with Non-steroidal Anti-inflammatory Drug Injection Therapy / 대한피부과학회지

Nicolau syndrome, also known as livedoid dermatitis or embolia cutis medicamentosa, is a rare cutaneous adverse drug reaction characterized by the acute onset of cutaneous and soft-tissue necrosis following intramuscular drug injection. The typical presentation is pain around the injection site, developing into erythema, a livedoid patch, and necrosis of the skin, subcutaneous fat, and muscle tissue. We report a 72-year-old man who presented with a painful, erythematous patch on his left buttock. The patient was treated with non-steroidal anti-inflammatory drug (diclofenac sodium) injection.