A Case of Androgenetic Alopecia in an Adolescent Female with Response to Topical Minoxidil / 대한피부과학회지

Androgenetic alopecia (AGA) is a common form of hair loss that usually occurs in the third or fourth decades of life in men, with later onset in women. AGA does rarely occur, however, in the pediatric population. Adolescent AGA is pattern hair loss occurring in boys and girls between 12 and 18 years of age. We herein report the case of a 16-year-old girl with a 5-year history of diffuse hair loss on the crown. Her father had a history of AGA, and the hair pull test was negative. Sex hormone levels and thyroid function test were within the normal range. Phototrichogram analysis revealed diffuse hair thinning over the frontal and vertex areas, and the percentage of vellus hair was higher on the vertex than the occiput. We diagnosed the patient with adolescent AGA. She was prescribed 3% topical minoxidil, and improvement was visible on the clinical photograph and phototrichogram after 2 years of treatment.

Orbital Lymphangioma: Characteristics and Treatment Outcomes of 12 Cases

PURPOSE: To report the patient characteristics and treatment outcomes in 12 cases of orbital lymphangioma. METHODS: In this study, orbital lymphangioma was diagnosed based on clinical, radiologic (computed tomography, magnetic resonance imaging), and histologic findings when possible. Patients whose vision was not compromised by orbital lymphangioma, or that did not have increased intraocular pressure (IOP), received oral corticosteroids. Orbital lymphangioma that affected vision or increased IOP was treated by surgery, which included aspiration of blood or partial resection with or without injection of a sclerosant. RESULTS: Four patients without compromised vision responded well to oral corticosteroids. Eight patients with compromised vision underwent some form of surgery. Bleeding recurred in three patients after aspiration of blood and in two after partial resection and intralesional injection of a sclerosant. Overall, five patients were treated successfully by aspiration of blood, intralesional injection of a sclerosant, and application of continuous negative pressure by appropriate drainage. Partial resection was successful in two patients with organized hematoma. CONCLUSIONS: Orbital lymphangioma that does not compromise vision can be treated medically using oral corticosteroids. Patients with threatened vision or elevated IOP due to acute hemorrhage should be treated by aspiration of blood, intralesional injection of a sclerosant, and application of continuous negative pressure. Partial resection may be effective only in patients with organized hematoma.

Surgical Outcomes of Porcine Acellular Dermis Graft in Anophthalmic Socket: Comparison with Oral Mucosa Graft

PURPOSE: We describe our experience with the Permacol graft in anophthalmic socket reconstruction, and compare it to the autologous buccal mucosal graft, emphasizing the postoperative vascularization and contraction of each graft. METHODS: This was a retrospective comparative study. We measured the time necessary for the graft surface to be completely vascularized, as well as the fornix depth of the conjunctival sac in anophthalmic patients. RESULTS: Ten patients underwent Permacol graft reconstruction, with 44 undergoing buccal mucosal graft reconstruction. Seven eyelids (70%) in the Permacol group had a good outcome, with improvement in lower eyelid position and prosthesis retention. Nine out of 10 eyelids (90%) in this group showed complete vascularization of the graft at 2.6 ± 1.9 months postoperatively, while the grafted buccal mucosa was fully vascularized at 1.1 ± 0.3 months postoperatively (p < 0.01). Postoperative fornix depth in the Permacol group was 9.1 ± 2.2 mm, compared to 14.9 ± 4.5 mm in the buccal mucosal graft group (p < 0.01). Mean increases in fornix depth were 33.1% and 67.9% of the mean vertical length of the implanted graft. CONCLUSIONS: The Permacol graft can be useful as spacer graft material in anophthalmic socket patients. It takes longer to vascularize, and undergoes greater graft shrinkage with time, compared to the buccal mucosal graft.

Repeated Microneedle Stimulation Induces Enhanced Hair Growth in a Murine Model

BACKGROUND: Microneedle is a method that creates transdermal microchannels across the stratum corneum barrier layer of skin. No previous study showed a therapeutic effect of microneedle itself on hair growth by wounding. OBJECTIVE: The aim of this study is to investigate the effect of repeated microwound formed by microneedle on hair growth and hair growth-related genes in a murine model. METHODS: A disk microneedle roller was applied to each group of mice five times a week for three weeks. First, to identify the optimal length and cycle, microneedles of lengths of 0.15 mm, 0.25 mm, 0.5 mm, and 1 mm and cycles of 3, 6, 10, and 13 cycles were applied. Second, the effect of hair growth and hair-growth-related genes such as Wnt3a, β-catenin, vascular endothelial growth factor (VEGF), and Wnt10b was observed using optimized microneedle. Outcomes were observed using visual inspection, real-time polymerase chain reaction, and immunohistochemistry. RESULTS: We found that the optimal length and cycle of microneedle treatment on hair growth was 0.25 mm/10 cycles and 0.5 mm/10 cycles. Repeated microneedle stimulation promoted hair growth, and it also induced the enhanced expression of Wnt3a, β-catenin, VEGF, and Wnt10b. CONCLUSION: Our study provides evidence that microneedle stimulation can induce hair growth via activation of the Wnt/β-catenin pathway and VEGF. Combined with the drug delivery effect, we believe that microneedle stimulation could lead to new approaches for alopecia.

Synergistic Proliferating Effects of Electrical Stimulation and Minoxidil on Human Dermal Papilla Cells / 대한피부과학회지

BACKGROUND: Previous published clinical studies have demonstrated the positive effects of electrical stimulation (ES) on hair growth. Minoxidil (MXD) enhances hair growth by prolonging the anagen phase of hair follicles. MXD is used to promote hair growth in androgenetic alopecia. OBJECTIVE: To investigate the combined effect of ES and MXD on cultured human dermal papilla cells (hDPCs). METHODS: To investigate the combined effect of ES and MXD on cultured human dermal papilla cells (hDPCs). Methods: hDPCs were electrically stimulated with different parameter settings of alternating current. Electrically stimulated hDPCs were incubated in an MXD medium, after which cell proliferation was measured using an MTT assay. Ki-67 and β-catenin expressions were measured by immunofluorescence assay. In addition, Wnt/β-catenin pathway-related gene expressions were measured by real time-PCR, and phosphorylated ERK and AKT protein levels were measured by western blot assay. RESULTS: The combination of 8 V-1 MHz ES and MXD treatment promoted hDPC proliferation effectively, compared with that in the control, ES alone, or MXD alone treatment groups. The immunofluorescence assay showed that the expression of Ki-67 and β-catenin significantly increased in the combined treatment group. Most of the Wnt/β-catenin pathway-related gene expressions increased more with combined treatment than with the control, ES alone, or MXD alone treatments. However, there were no significant differences in the expression levels of phosphorylated ERK and AKT among the treatment groups. CONCLUSION: ES combined with MXD treatment had a synergistic effect on the proliferation of hDPCs. This might be through the synergistic activation of the Wnt/β-catenin pathway.

The Effects of Stress on Intraocular Pressure and Lacrimal Secretion

PURPOSE: To evaluate the effects of psychosocial stress on intraocular pressure and lacrimal secretion. METHODS: Twenty normal adult volunteers (40 eyes) who had no history of systemic or ocular disease such as dry eye syndrome or glaucoma were recruited from clinical research participants. Heart rate, intraocular pressure and lacrimal secretion were measured after the Trier Social Stress Test (TSST) which induces psychosocial stress. The same measurements were taken 1 week later and the recorded measurements were considered as the control group. RESULTS: Heart rate was elevated significantly after the TSST, indicating psychosocial stress was induced by the TSST. Compared to stress resolution status, intraocular pressure and lacrimal secretion were increased after the TSST (p = 0.027, p = 0.011). Elevation of intraocular pressure and lacrimal secretion was statistically significant in males (p = 0.031, p = 0.007), but not significant in females (p = 0.336, p = 0.554). CONCLUSIONS: Psychosocial stress can increase intraocular pressure and lacrimal secretion.

A Case Report of Bilateral Retinal Racemose Hemangioma Restricted to Peripapillary Area

PURPOSE: The authors of the present case report observed a bilateral retinal racemose hemangioma which was located within the peripapillary area. CASE SUMMARY: A 17-year-old man presented with floaters in both eyes. Fundus revealed tortuous and anastomosed retinal vasculature around the optic disc. In addition, fluorescein angiography showed a non-leaking retinal arteriovenous anastomosis. Seven years after the initial visit, vitreous hemorrhage occurred in the patient's left eye, and then 1 year later, subretinal hemorrhage was found in his left eye. CONCLUSIONS: Because retinal racemose hemangioma can accompany vitreous hemorrhage and subretinal hemorrhage regardless of size, a routine periodic ophthalmic examination is recommended.

Change in Angle Deviation After Visual Acuity Improvement in Monocular Deviated Patients

PURPOSE: Anisometropia can lead to monocular deviation if the refractive error is not corrected. Therefore, the authors evaluated the change in angle deviation after visual acuity improvement by refractive correction in monocular deviated patients with anisometropia. METHODS: Changes in angle deviation were collated retrospectively for 9 patients with anisometric monocular deviation, 7 with monocular exotropia and 2 with monocular esotropia, according to medical records. The patients were admitted for strabismus surgery performed using cataract extraction or clear lens extraction (8 patients) or were treated nonsurgically using contact lenses for visual acuity recovery (1 patient). RESULTS: Prior to corrective measures, patients with exotropia had, on average, exodeviation of 40.43 PD, and those with esotropia had, on average, esodeviation of 27.50 PD. After corrective measures were taken, all 7 exotropia patients had decreased angle deviation, and, upon final evaluation, exodeviation had decreased to 21.71 PD, on average. In two exotropia patients, measures taken to correct refractive error shifted the exotropia to exophoria. There was no change in angle deviation after Corrective measures in 2 esotropia patients. CONCLUSIONS: In cases of exotropia caused by decreased visual acuity, correction of the visual acuity should be performed first if the correction is possible. After the recovery of visual acuity, a significant decrease in angle deviation occurs.