ABSTRACT
Cutaneous papillomas or acrochorda usually appear after the 4th decade of life in areas with skin folds. Conventional methods of removal are associated with bleeding problems, pain and prolonged sequelae. Thus, acrochorda removal with lasers has gained attention. In this study, we compared the efficacy of two popular laser types with different wavelengths and pulse widths for removal of skin tags. A 60-year-old Korean male noticed skin tags on his neck bilaterally. All tags were treated in a single session, on one side with a picosecond (ps)-domain 532 nm Nd:YAG laser and on the contralateral side with a long-pulsed (LP) 755 nm alexandrite laser. The endpoint for the ps-532 laser was immediate whitening, while that for the LP and quasi-LP (QLP) 755 lasers were visible changes on the surface of the lesion. Antibiotic ointment was applied, dressing was done and clinical photographs were taken. Both lasers effectively removed the skin tags at all settings in a single session without bleeding and with minimal discomfort. Crust formation occurred on both sides with natural shedding within 1 to 2 weeks. Transient erythema lasted longer in the tags treated with the ps-532 laser. At the 5th month of follow-up, residual lesions were detected on the field treated with the ps-532 laser. No persistent side effects such as scarring or postinflammatory hyperpigmentation (PIH) were observed. In conclusion, both the ps-532 nm Nd:YAG and the 755 nm alexandrite lasers ensured safe and effective removal of skin tags in a single session without adverse sequelae.
ABSTRACT
Background@#Acne is a complex inflammatory disorder affecting the pilosebaceous follicles of the skin. In the search for effective acne treatments, patients frequently turn to various social media platforms, including Instagram.Notably, diverse occupational groups contribute to Instagram on acne treatment, showcasing significant variations depending on the specific group. @*Objective@#This study investigated the impact and accuracy of acne treatment posts on the Korean Instagram platform. @*Methods@#We systematically examined the “top posts” with the hashtag #acne treatment, and 107 posts were included for analysis. Posts were excluded if they were not Korean, had other medical conditions, or were duplicates. @*Results@#The distribution of posts and their respective proportions were as follows: dermatologists (n=12, 11.2%), non-dermatologists (n=17, 15.9%), skin care centers (n=54, 50.5%), influencers (n=22, 20.6%), and retailers (n=2, 1.9%). Notably, dermatologists’ posts demonstrated a significantly lower number of followers and likes compared to those of skin care centers or influencer (p＜0.001, each). The similar trend was observed for the assessment of total engagement power (calculated as likes×1＋comments×1). Additionally, we evaluated the treatment accuracy of each post using the DISCERN criteria. The average DISCERN score of dermatologists’ posts was significantly higher than that of skin care centers or influencers (p＜0.001). @*Conclusion@#Our findings underscore that, despite possessing a greater level of accuracy in their information, dermatologists exert comparatively less influence on the Korean Instagram platform. Considering the recent increase in medical content on Instagram and the growing interest among patients, the role of dermatologists in providing reliable and informed guidance has become increasingly important.
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Background@#Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize; however, in some cases, it is difficult to differentiate it from atypical dermatofibroma. Atypical dermatofibroma is a rare variant of a more aggressive nature and requires complete excision due to its tendency to recur. @*Objective@#To describe the clinical and dermoscopic features of dermatofibromas with special emphasis on the characteristics of atypical subtypes and to differentiate them from typical subtypes on the basis of results. @*Methods@#We retrospectively searched the databases of patients of Korea University Ansan Hospital from January 2010 to December 2019 who underwent skin biopsies or excision surgeries and had pathological reports of dermatofibroma. Analyses of the clinical characteristics (age, sex, number of lesions, anatomical site) and dermoscopic patterns were performed. @*Results@#Dermoscopic patterns were analyzed in 148 cases of dermatofibroma; peripheral delicate pigment networks and central white scar-like patches were the most common patterns found in 45 cases (30.4%). In eight cases of atypical dermatofibroma, three cases (37.5%) showed peripheral homogenous areas and central white networks, followed by multiple white scar-like patches in 2 cases (25.0%), peripheral delicate pigment networks, and central white scar-like patches in 2 cases (25.0%). Dermoscopy revealed a statistically significant difference in the peripheral homogenous area and the central white network pattern between the two groups. @*Conclusion@#In this study, we analyzed the dermoscopic findings of 148 patients with dermatofibroma and found that the peripheral homogenous area and central white network patterns were significantly more in atypical dermatofibroma.
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Background@#Pigmented purpuric dermatosis (PPD) is known as a chronic recurrent eruption which usually presents with petechiae and pigmented macules on the lower extremities.Dermoscopy is a noninvasive diagnostic tool in identifying pigmented and vascular lesions, which can also be beneficial in the evaluation of PPD. @*Objective@#We aimed to analyze the common dermoscopic characteristics of PPD, and correlate those findings with the histopathologic features. Additionally, dermoscopic and pathological findings in this study population were compared with other similar studies from the literature review. @*Methods@#A retrospective analysis was performed using data of 60 patients who were diagnosed as PPD by skin biopsy and had dermoscopic examination. The pathologic analysis was performed by categorizing the pattern into lichenoid, perivascular, interface, and spongiotic subtype, and the dermoscopic assessment was performed by the three authors independently. @*Results@#In dermoscopy, 96.7% of the patients showed red globules and dots, followed by brownish patch, coppery-red pigmentation, and annular comma-like vessels. The pathologic pattern analysis revealed statistically significant association of lichenoid pattern with coppery red pigmentation, perivascular pattern with annular/comma-like vessels, and spongiosis pattern with reticular pigmented network and linear vessels. The interrater similarity test showed total kappa value of 0.811which referred to “very good”. @*Conclusion@#In this study, the prevalence of dermoscopic features in Asian PPD patients was identified, which was similar with previous studies. The dermoscopic-pathologic correlation was found in four dermoscopic features. We suggest that dermoscopic examination is helpful in clinical diagnosis and pathological prediction of PPD.
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Background@#Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize; however, in some cases, it is difficult to differentiate it from atypical dermatofibroma. Atypical dermatofibroma is a rare variant of a more aggressive nature and requires complete excision due to its tendency to recur. @*Objective@#To describe the clinical and dermoscopic features of dermatofibromas with special emphasis on the characteristics of atypical subtypes and to differentiate them from typical subtypes on the basis of results. @*Methods@#We retrospectively searched the databases of patients of Korea University Ansan Hospital from January 2010 to December 2019 who underwent skin biopsies or excision surgeries and had pathological reports of dermatofibroma. Analyses of the clinical characteristics (age, sex, number of lesions, anatomical site) and dermoscopic patterns were performed. @*Results@#Dermoscopic patterns were analyzed in 148 cases of dermatofibroma; peripheral delicate pigment networks and central white scar-like patches were the most common patterns found in 45 cases (30.4%). In eight cases of atypical dermatofibroma, three cases (37.5%) showed peripheral homogenous areas and central white networks, followed by multiple white scar-like patches in 2 cases (25.0%), peripheral delicate pigment networks, and central white scar-like patches in 2 cases (25.0%). Dermoscopy revealed a statistically significant difference in the peripheral homogenous area and the central white network pattern between the two groups. @*Conclusion@#In this study, we analyzed the dermoscopic findings of 148 patients with dermatofibroma and found that the peripheral homogenous area and central white network patterns were significantly more in atypical dermatofibroma.
ABSTRACT
Background@#Pigmented purpuric dermatosis (PPD) is known as a chronic recurrent eruption which usually presents with petechiae and pigmented macules on the lower extremities.Dermoscopy is a noninvasive diagnostic tool in identifying pigmented and vascular lesions, which can also be beneficial in the evaluation of PPD. @*Objective@#We aimed to analyze the common dermoscopic characteristics of PPD, and correlate those findings with the histopathologic features. Additionally, dermoscopic and pathological findings in this study population were compared with other similar studies from the literature review. @*Methods@#A retrospective analysis was performed using data of 60 patients who were diagnosed as PPD by skin biopsy and had dermoscopic examination. The pathologic analysis was performed by categorizing the pattern into lichenoid, perivascular, interface, and spongiotic subtype, and the dermoscopic assessment was performed by the three authors independently. @*Results@#In dermoscopy, 96.7% of the patients showed red globules and dots, followed by brownish patch, coppery-red pigmentation, and annular comma-like vessels. The pathologic pattern analysis revealed statistically significant association of lichenoid pattern with coppery red pigmentation, perivascular pattern with annular/comma-like vessels, and spongiosis pattern with reticular pigmented network and linear vessels. The interrater similarity test showed total kappa value of 0.811which referred to “very good”. @*Conclusion@#In this study, the prevalence of dermoscopic features in Asian PPD patients was identified, which was similar with previous studies. The dermoscopic-pathologic correlation was found in four dermoscopic features. We suggest that dermoscopic examination is helpful in clinical diagnosis and pathological prediction of PPD.
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Background@#Pulsed dye laser treatment is a proven effective treatment for capillary malformation. Previous studies have shown different responses to pulsed dye laser depending on the anatomical location of the capillary malformation. @*Objective@#This retrospective study assessed the potential differences in treatment response depending on anatomical location and the factors affecting pulsed dye laser treatment response. @*Methods@#We retrospectively investigated 88 patients with capillary malformation (nevus flammeus or port-wine stain) in the head and neck area treated with pulsed dye laser between November 2005 and January 2019. Dermatologists evaluated the effect of treatment from photographs taken before and after treatment. The anatomical location in the head and neck, lesion size, number of treatments, and the presence of proliferative lesion were analyzed from medical records and photographs. @*Results@#The analyzed 88 patients included 121 lesions. The lesion size and the presence of proliferative lesions significantly affected the treatment effect; however, the location of the lesion in the head and neck did not. @*Conclusion@#Smaller lesion size and the absence of proliferative lesion showed better effects of pulsed dye laser treatment. Unlike previous studies, the lesion location did not significantly affect the treatment effect.
ABSTRACT
Basal cell carcinoma is a common cancer and has been reported to account for approximately 80% of non-melanoma skin cancers. Superficial basal cell carcinoma occurs mainly in the trunk or limbs and is characterized by clinical features of scaly erythema with or without epidermal atrophy. These clinical features require differentiation from those of other benign and malignant skin diseases. Recently, specific dermoscopic findings of basal cell carcinoma have been helpful for diagnosis. Common dermoscopic findings of superficial basal cell carcinoma include superficial telangiectasia and maple leaf-like areas. Herein, we report a case of superficial basal cell carcinoma that was not diagnosed by punch biopsy but by dermoscopy.
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No abstract available.
ABSTRACT
Erythema ab igne (EAI) is a persistent chronic skin condition that is characterized by reticulated macular hyperpigmented lesions caused by repeated exposure to infrared radiation. EAI has reemerged in recent years because of the increasing infrared exposure due to the use of new technologies, such as portable computers and automobile seat heaters. We report a case of a 54-year-old female patient presenting with asymptomatic mottled brownish plaque on both sides of her neck for 1 month prior to the visit. Patient history revealed that she had used a home skincare device for skin rejuvenation and relaxation. The clinicopathological features suggested a diagnosis of EAI. To our knowledge, there has only been one reported case of EAI on the neck related to a thermal pillow, and this was the first case of EAI related to the self-skincare devices. Herein, we report a rare case of EAI presenting on both sides of the neck due to the use of a modern home skincare device.
Subject(s)
Female , Humans , Middle Aged , Automobiles , Diagnosis , Erythema , Neck , Rejuvenation , Relaxation , SkinABSTRACT
Idiopathic neutrophilic eccrine hidradenitis is usually observed in healthy children with tender erythematous nodules on the soles or palms. We report a case of a 26-year-old man with a painful erythematous swollen patch on both hands and feet. His symptom recurred once monthly over 2 years; thus, he visited Orthopedics. However, no bony abnormality was identified. We performed a skin biopsy on an erythematous indurated patch on his right sole. Histopathological findings indicated neutrophilic eccrine hidradenitis. After 2 weeks of treatment with oral colchicine, his symptom resolved, and no relapses were observed during follow-up. Only a few case reports describe idiopathic neutrophilic eccrine hidradenitis in adults, which is not associated with malignant hematological disease, solid cancer, and chemotherapy. Conventional treatment comprises bed-rest and the administration of topical steroids. Colchicine can be a good treatment option for adults with severe or recurrent idiopathic neutrophilic eccrine hidradenitis.
Subject(s)
Adult , Child , Humans , Biopsy , Colchicine , Drug Therapy , Follow-Up Studies , Foot , Hand , Hematologic Diseases , Hidradenitis , Neutrophils , Orthopedics , Recurrence , Skin , SteroidsABSTRACT
Recently, various modalities for noninvasive reduction of adipose tissue, including cryolipolysis, radiofrequency, low-level laser therapy, and high-intensity focused ultrasound, have become available. Among these modalities, cryolipolysisis can selectively target certain tissues rich in lipids. Many preclinical and clinical studies have established the safety and efficacy of cryolipolysis for noninvasive body contouring. However, it can lead to serious adverse effects when performed by untrained clinicians. Thus, to promote the proper and safe use of cyolipolysis, we have summarized the history, basic principles, and adverse effects of cyolipolysis.
Subject(s)
Adipose Tissue , Low-Level Light Therapy , UltrasonographyABSTRACT
BACKGROUND: Recently, the pulse-in-pulse mode of intense pulsed light (IPL) has been used increasingly for the treatment of melasma. OBJECTIVE: To observe the morphologic changes in the melanophore in adult zebrafish after irradiation with conventional and pulse-in-pulse IPL and Q-switched Nd:YAG (QSNY) laser. METHODS: Adult zebrafish were irradiated with conventional and pulse-in-pulse mode of IPL. The conditions for conventional IPL were 3 mJ/cm², 560 nm filter, and pulse widths of 7, 20, and 35 msec. The pulse-in-pulse conditions were 3 mJ/cm² and on-time 1/off-time 2. The QSNY laser was used with the settings of 1,064 nm, 0.4 J/cm², a 7 mm spot size, and one shot. Specimens were observed using a light microscope, a transmission electron microscope (TEM), a scanning electron microscope (SEM) and a confocal microscope. RESULTS: After conventional IPL irradiation with a 7 msec pulse width, melanophore breakage was observed using light microscopy. Under TEM, irradiation with conventional IPL for 7 msec and pulse-in-pulse IPL induced melanophore thermolysis with vacuolization. However, changes in the melanophore were not observed with 35 msec IPL. Under SEM, unlike the control and QSNY groups, IPL-irradiated zebrafish showed finger-like fusion in the protein structure of scales. Specimens examined by a confocal microscope after conventional IPL irradiation showed a larger green-stained area on TUNEL staining than that after pulse-in-pulse mode IPL irradiation. CONCLUSION: Zebrafish irradiated with long pulse-IPL showed no morphologic changes using light microscopy, while morphological changes in melanophores were evident with use of TEM. Pulse-in-pulse mode IPL caused less damage than conventional IPL.
Subject(s)
Adult , Humans , In Situ Nick-End Labeling , Melanophores , Melanosis , Microscopy , Weights and Measures , ZebrafishABSTRACT
There are many therapeutic methods for treating vitiligo, including narrow-band UVB, topical corticosteroids, calcineurin inhibitors, excimer laser, and surgical methods, such as autologous epidermal grafting and dermabrasion. However, although various treatments have been tried, there is still no reliable treatment. Recently, there were several reports about the use of fractional laser combined with narrow-band (NB) UVB to treat vitiligo. A 33-year-old male patient presented with hypopigmented patch on lower right abdominal area. After being diagnosed with vitiligo, the patient underwent NB-UVB treatment and application of a topical agent for two years but failed to show response. To evaluate the efficacy of non-ablative fractional laser, a 1550-nm erbium:glass (Er:Glass) fractional laser was applied to whole area of the lesion. The area showed erythema and brown microscopic epidermal necrotic debris. Five days after the laser procedure, NB-UVB treatment with application of a topical agent was initiated once or twice a week, followed by pigmentation of the treated area . The fractional laser was reapplied three months later, and the patient is currently under observation and is still being treated with NB-UVB. We observed successful treatment of refractory vitiligo with the combination of non-ablative 1550-nm Er:Glass fractional laser, NB-UVB, and a topical agent. We consider non-ablative Er:Glass fractional laser as a favorable choice of treatment for refractory vitiligo.