ABSTRACT
Background@#Riehl’s melanosis of the face and neck has been reported in middle-aged women who have darker skin types. Recently, cases of Riehl’s melanosis have been on the rise in Korea, which might reflect the increased use of various cosmetic products and procedures. @*Objective@#This study was designed to analyze the clinicopathological characteristics and treatment outcomes of Riehl’s melanosis in Korean patients. @*Methods@#We closely observed 80 patients with Riehl’s melanosis diagnosed in Asan Medical Center and Hanyang University Medical Center between 2005 and 2015. A skin biopsy was analyzed in 51 patients, and a patch test was carried out in 16 patients. @*Results@#Patients with chronic Riehl’s melanosis (＞12 months) had an increased frequency of previous laser treatments. Patients with acute Riehl’s melanosis (＜3 months) reported a previous history of dry skin, itching, or irritation as a result of the use of hair dye. Patients older than 50 years, with darker skin type, and with a longer disease duration (＞12 months) had poor response rates. Chronic Riehl’s melanosis may be preceded by repeated irritation of barrier-compromised skin, and acute Riehl’s melanosis seems to be an allergic form of Riehl’s melanosis. @*Conclusion@#Riehl’s melanosis has different clinical manifestations according to disease duration and different treatment responses based on disease duration.
ABSTRACT
Background@#Hyaluronic acid (HA) is the material used most often for soft tissue augmentation. Both agent factors, such as type of fillers and host factors, including technical manipulation, are known to affect the longevity of HA fillers. Although the relationship between longevity and filler composition has been widely studied, quantitative analysis to evaluate the difference in longevity of HA filler depending on injection depth has not yet been reported.Objective This study estimates injection depth-dependent degradation of HA filler in vivo using a rat model to evaluate its longevity. @*Methods@#Three Sprague–Dawley rats were assigned to each group based on sampling timepoints. Four injections were administered intradermally on one side of the back of rats and four more injections were administered subcutaneously on the other side. Histological specimens from the injected site were obtained at 2 (Group 1), 5 (Group 2), 9 (Group 3), 13 (Group 4), 20 (Group 5), and 33 (Group 6) weeks after initial implantation. External size of the implant site was calculated using caliper measurement at sampling timepoints. @*Results@#Although caliper-based analysis did not reveal a significant difference between intradermal and subdermal sites in all groups (p＞0.05), volumetric analysis of histological specimens demonstrated a difference in injection depth-dependent degradation rate. The volume ratio decreased over time in the subdermal injection sites, but it maintained a greater volume ratio than intradermal injection sites during the experiment (Groups 1∼6, p＜0.007).At 20 weeks after implantation, approximately half of the HA filler remained in the subdermal injection sites, whereas ＞80% of the filler was lost from intradermal injection sites. After the initial injection, time taken for the implant volume to reduce to half of its original value at intradermal and subdermal sites was 13 and 20 weeks, respectively. @*Conclusion@#This study demonstrates histological changes occurring in implanted HA filler materials over time and compares the injection depth-dependent longevity of materials. Caliper-based analysis did not show a significant difference between the intradermal and subdermal sites. However, quantitative analysis based on histological volumetric analysis revealed that subdermal injection lasts longer than intradermal injection.
ABSTRACT
Cutaneous metastasis from gastric adenocarcinoma is uncommon, and the eyelid is a rare metastatic site. Three patterns of clinical presentation of eyelid metastasis have been described: nodular, infiltrative, and ulcerated. The infiltrative pattern, also known as an inflammatory diffuse pattern or mask-like metastasis, can be easily misdiagnosed as cellulitis or contact dermatitis. Here, we report a case of gastric adenocarcinoma in a 75-year-old man who presented with a localized erythematous plaque on his eyelid that developed four months earlier. The patient had been treated with an antimicrobial agent owing to suspicion of preseptal cellulitis. Gastric adenocarcinoma metastasis was diagnosed on the basis of histopathological examination and immunophenotyping (i.e., cytoplasmic epithelial membrane antigen, cytokeratin- 7, cytokeratin-20, and carcinoembryonic antigen). For patients with malignant neoplasms, persistent skin lesions similar to cellulitis or contact dermatitis should be suspected of metastasis derived from an internal malignancy, even for very rare sites of metastasis.
Subject(s)
Aged , Humans , Adenocarcinoma , Cellulitis , Cytoplasm , Dermatitis, Contact , Eyelids , Immunophenotyping , Keratin-20 , Mucin-1 , Neoplasm Metastasis , Orbital Cellulitis , Skin , UlcerABSTRACT
BACKGROUND: Fractional laser resurfacing treatment has been extensively investigated and is widely used. However, the mechanism underlying its effects is poorly understood because of the ethical and cosmetic problems of obtaining skin biopsies required to study the changes after laser treatment. OBJECTIVE: To evaluate the usefulness of human skin explants for the investigation of fractional photothermolysis. METHODS: Full-thickness discarded skin was treated in 4 ways: no treatment (control), fractional carbon dioxide laser, fractional Er:YAG laser, and fractional 1,550-nm erbium-doped fiber laser. Both treated and non-treated skin samples were cultured ex vivo at the air-medium interface for 7 days. Frozen tissue was sectioned and stained with hematoxylin & eosin for histologic examination and nitro blue tetrazolium chloride for viability testing. RESULTS: Skin explants cultured for up to 3 days exhibited histologic changes similar to those observed in in vivo studies, including microscopic treatment zones surrounded by a thermal coagulation zone, re-epithelialization, and formation of microscopic epidermal necrotic debris. However, the explant structure lost its original form within 7 days of culture. The viability of skin explants was maintained for 3 days of culture but was also lost within 7 days. CONCLUSION: The skin explant model may be a useful tool for investigating the immediate or early changes following fractional photothermolysis, but further improvements are required to evaluate the long-term and dermal changes.
Subject(s)
Humans , Biopsy , Cosmetic Techniques , Eosine Yellowish-(YS) , Hematoxylin , Laser Therapy , Lasers, Gas , Re-Epithelialization , Skin , Tissue Culture Techniques , Tissue SurvivalABSTRACT
Fixed drug eruption is a pattern of a drug-induced cutaneous reaction. It is characterized by skin erythematous plaques that recur at the same site each time the drug is administered. Now, we report the case of a 26-year-old woman who presented with 2 ill-defined erythematous patches on her back with itching sensation. The patient had a history of ciprofloxacin medication. The patch test with suspected drugs showed negative reactions, but intradermal tests were positive reactions. The patient was diagnosed with fixed-drug eruption due to ciprofloxacin.
Subject(s)
Female , Humans , Ciprofloxacin , Drug Eruptions , Intradermal Tests , Patch Tests , Pruritus , Sensation , SkinABSTRACT
Rosai-Dorfman disease or sinus histiocytosis with massive lymphadenopathy is an idiopathic, benign, histiocytic proliferative disease involving lymph nodes and extranodal sites. A 52-year-old woman presented with a 2-year history of multiple non-tender, erythematous nodules on her face. The initial punch biopsy showed lymphoid follicle-like aggregation of CD20 positive lymphocytes in the papillary dermis consisting of primary cutaneous marginal zone B-cell lymphoma. She underwent a 3-month course of radiotherapy, but the lesions progressed. The re-biopsy specimen revealed marked histiocytes with positive CD68 and S-100 proteins. The patient was treated with prednisolone and isotretinoin to which she responded slightly. Repeated histopathologic examinations enable us to make a definite diagnosis. Differentiating these two disorders as early as possible is crucial for appropriate treatment.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Dermis , Diagnosis , Histiocytes , Histiocytosis, Sinus , Isotretinoin , Lymph Nodes , Lymphocytes , Lymphoma, B-Cell, Marginal Zone , Prednisolone , Radiotherapy , S100 ProteinsABSTRACT
Panniculitis is a rare cutaneous finding in dermatomyositis (DM), presenting as tender subcutaneous nodules. Because panniculitis may precede other symptoms of DM, and its complications, including pain, lipoatrophy and carcinosis, might be severe and irreversible, early diagnosis and treatment of panniculitis is important. We herein describe a case of dermatomyositis first presenting as panniculitis in a 45-year old man.