ABSTRACT
Background@#The advent of fractionated picosecond (ps) lasers has provided an opportunity to explore new ways of creating microinjuries in the skin to induce skin rejuvenation. @*Objective@#To compare the efficacy and safety of diffractive optical element (DOE)-assisted ps neodymium: yttrium-aluminum-garnet (Nd:YAG) lasers with 532-nm and 1,064-nm wavelengths (532-nm and 1,064-nm Nd:YAG P-DOE) using a novel fractional handpiece for the treatment of photoaged skin. @*Methods@#An ex vivo guinea pig skin experiment was performed by evaluating the histology of the skin after 532-nm Nd:YAG P-DOE irradiation. A randomized, prospective, split-face study was performed on eight subjects with 532-nm and 1,064-nm Nd:YAG P-DOE. @*Results@#Based on the histological evaluation using ex vivo guinea pig skin, a reasonable safety profile and the potential to generate effective skin rejuvenation was observed using the 532-nm Nd:YAG P-DOE. Results demonstrated that both 532- and 1,064-nm Nd:YAG P-DOE were similarly effective in improving skin texture and skin pores; however, 532-nm Nd:YAG P-DOE was more effective in treating dyspigmentation. @*Conclusion@#At a preliminary level, this study revealed that 532-nm and 1,064-nm ps Nd:YAG lasers using DOE fractional technology may improve photoaged skin. In conclusion, 532-nm Nd:YAG P-DOE may be especially beneficial for skin with epidermal pigmentary lesions.
ABSTRACT
Becker’s nevus (BN) is a benign hamartoma that may present as a distressing cosmetic problem. The treatment of BN poses a significant challenge as current therapeutic modalities are suboptimal and have an increased risk of adverse effects, such as scarring and dyspigmentation. We present the use of non-ablative fractional laser therapy combined with Q-switched Nd:YAG laser as a possible therapeutic option for BN treatment and review relevant literature to discuss its efficacy and limitations.
ABSTRACT
Purpose@#Although previous research showed the importance of safety culture on health care workers' speaking up behaviors, it is not clear how particular safety culture domains are associated with the speaking up behaviors of hospital staff. Also, researchers have suggested that health care workers’ speaking up behaviors vary by profession, but there has been limited research into such differences. Thus, this study examined differences in perceptions of patient safety culture and the promotive and prohibitive speaking up behaviors of health care workers by profession and investigated the relationships between patient safety culture and the two types of speaking up behaviors. @*Methods@#A descriptive correlational study was conducted using secondary data collected through an online survey of health care workers at a private, nonprofit, tertiary-level teaching hospital in South Korea. The sample (N = 831) consisted of nurses (54.0%), physicians (13.0%), and other licensed and unlicensed hospital personnel (33.0%). Analyses of variance were conducted to examine differences in study variables by profession. Hierarchical regression analyses were conducted to evaluate the effects of the seven patient safety culture factors on promotive and prohibitive voice after controlling for tenure and profession. @*Results@#Perceptions of safety culture and promotive voice behaviors were higher for physicians compared with nurses. Communication openness, reporting patient adverse events, and unit supervisors' and hospital managements’ support for patient safety were significant predictors of both types of voice behaviors. @*Conclusion@#Hospital administrators and unit managers should create a supportive environment where staff feel free to voice their concerns and suggestions. They should also pay attention to the varying perspectives held by different groups of hospital workers and their different voice behaviors. Knowing which dimensions of patient safety culture are most strongly related to health care workers’ voice behaviors can guide patient safety improvement activities in health care organizations.
ABSTRACT
Development of newer generation of cost-effective ultrasonic devices in recent years has increased the use of ultrasonography in dermatology. Several lesions can be diagnosed and managed using ultrasonography. Calcinosis cutis involves the deposition of insoluble calcium salts in the cutaneous and subcutaneous tissues. On ultrasonography, it specifically presents as hyperechoic deposits with a posterior acoustic shadowing artifact due to the acoustic properties of calcium. A 62-year-old female patient presented with a solitary, skincolored, palpable nodule on the inner side of the right lower leg. The lesion was beneath the intact skin and detectable only on palpation. However, ultrasonography demonstrated a clear delineation of the lesion, showing hyperechoic deposits with a posterior acoustic shadow (15 MHz, linear probe). Skin biopsy and curettage were performed, revealing histological features consistent with calcinosis cutis. Four weeks after the procedure, ultrasonography performed to evaluate the outcome of treatment, showed recurrence. Another 18-year-old female patient presented with a skin-colored deep-seated nodule on the left temple. On ultrasonography, linear hyperechoic deposits with a posterior acoustic shadow were visible. Skin biopsy was performed, and histopathologic features showed calcified material in the subcutaneous tissue. These two cases of calcinosis cutis highlight the diagnostic value of ultrasonography in dermatology.
ABSTRACT
Background@#The Baumann skin type (BST) classification provides a new approach for clinical care of dermatologic patients. @*Objective@#To investigate the correlation of skin types with genetic factors and environmental factors that have an important influence on Korean skin by comparing and analyzing the correlation between phenotype and genotype. @*Methods@#From July to October 2016, 774 adults who visited the one online shopping mall were subjected to skin BST questionnaire and gene single-nucleotide polymorphism (SNP) tests. Oral epithelial cells of the subjects were collected using a Genoplan DNA analysis kit, and 14 genes were analyzed by a genetic analysis agency (Genoplan Inc., Fukuoka, Japan). @*Results@#The most abundant skin type was OSNT (oily, sensitive, non-pigmented, tight) observed in 205 participants (26.5%). Of the filaggrin (FLG) SNPs, 143 participants (18.5%) had the GG (good) SNP; 391 (50.5%), GA (normal) SNP; and 240 (31.0%), AA (poor) SNP. Among those whose FLG SNP was GG (good), 121 (84.6%) were sensitive and 22 (15.4%) were resistant. Of those whose filaggrin (FLG) SNP was GA (normal), 337 (86.2%) were sensitive and 54 (13.8%) were resistant. Of those whose FLG SNP was AA (poor), 213 (88.8%) were sensitive and 27 (11.3%) were resistant. There was also a statistically significant difference in the fruit-vegetable consumption and use of a sunbathing bed between sensitive and resistant type in the groups that classified the FLG SNP as GA. @*Conclusion@#This is the first study to investigate the association of BST with genetic factors and environmental factors.
ABSTRACT
Spider angioma (SA) may present as solitary or multiple lesions. Studies have shown that approximately 60% of pregnant women and 38% of healthy children have at least one spider telangiectasia. Hence, solitary SA in an otherwise healthy individual does not warrant further workup. However, multiple spider angiomas (MSAs) are usually suggestive of an underlying systemic disease. Physical examination for MSAs has been reported as the most reliable method to diagnose alcoholic liver cirrhosis; the presence of MSAs is more indicative of liver cirrhosis than just the history of alcohol use because a very low proportion of alcohol drinkers among the general population develop liver cirrhosis. We report a case of MSAs in a 42-year-old alcoholic woman suggesting that MSA is reliable indicator and a warning sign of liver cirrhosis, suggesting that further evaluation and management with the department of hepatology is necessary.
ABSTRACT
Acne vulgaris is a universal skin disease with multifactorial pathogenesis. Although an extensive range of treatment options exist for acne, a substantial number of patients are still struggling for an optimal treatment option due to the side effects or contraindications to the conventional acne treatment. Negative air ions (NAIs) are electrically charged molecules that naturally exist in the atmosphere. Since they are natural component of air, there are no known side effects and contraindications to their application. Furthermore, among the identified benefits of NAIs, certain mechanisms are related to acne pathogenesis, allowing them to be attractive candidates for acne treatment. Here, we describe three patients with acne who showed considerable clinical improvement after NAI therapy. All of the patients had failed to tolerate traditional acne treatment options. In all three cases, considerable improvement was observed in acne severity and the number of total lesions. Based on the three cases and a review of literature underlying the effects of NAIs, we suggest that NAIs may be a safe and effective alternative therapeutic option for acne vulgaris.
ABSTRACT
Background@#Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease triggered by diverse factors. Microbes are one of the crucial risk factors for AD development or exacerbation. However, the effect of a fungal burden on AD has been overlooked compared to bacteria. @*Objective@#This study aimed to comparatively analyze cutaneous fungal distribution between AD patients and healthy individuals by polymerase chain reaction (PCR)-based analysis. @*Methods@#Skin samples of AD outpatients and healthy individuals collected at the ChungAng University were analyzed. Representative AD-associated fungal genera, Candida, dermatophytes, and Malassezia, were analyzed using specific primer and amplification methods. Amplicons were sequenced, and the fungal distribution of both groups were compared. @*Results@#Totally, 211 patients and 23 healthy individuals were studied. Of the 211 patients, 10.90% (23/211) had Candida species, whereas 0% (0/23) healthy individuals showed its presence. The most frequently detected species in patients was Candida albicans (5.21%) followed by Candida parapsilosis (3.79%). For dermatophytes, 1.42% (3/211) of patients showed positive results, whereas 0% (0/23) healthy individuals showed positive results. Malassezia species were identified in 20.85% (44/211) and 8.70% (2/23) in patients and healthy individuals, respectively. Malassezia restricta was the most frequently identified species in the AD patient group, and the only species found in the healthy control group. @*Conclusion@#The distribution of Candida spp., dermatophytes, and Malassezia spp. are altered with AD development.
ABSTRACT
Background@#Trust is a key component for the good relationship between patients and healthcare professionals but trust for community pharmacists has not been studied much. @*Objectives@#This study aimed to measure public trust in community pharmacists and to investigate variables that affect trust level in South Korea. @*Methods@#A total of 25 questions, including 13-items for three dimensions of trust (pharmacists’ behavior/attitude, technical competence, communication skills) and 1-item for overall trust were developed. The survey was conducted online and the data from 416 respondents were analyzed with a t-test, an ANOVA and a multiple linear regression analysis. @*Results@#The average scores (mean ± standard deviation) for the three dimensions of trust in community pharmacists were 3.47±1.05 (out of 5 points) for pharmacists’ behavior/attitude, 3.67 ± 0.99 for technical competence, and 3.66±0.99 for communication skills. The average of the 13 items incorporating all parameters was 3.56±1.02 and the overall trust level was 7.16±1.62 (out of 10 points). The total sum of the 13 items differed significantly by age group (p=0.02) and frequency of pharmacy visits (p=0.04). Each dimension had an independent impact on the trust level, and pharmacists’ behavior/attitude had the greatest impact on trust levels. @*Conclusions@#This study showed that pharmacists’ behavior/attitude had the most significant impact on the trust level. However, the level of trust in pharmacists’ behavior/attitude is not yet sufficiently satisfactory, and further improvements are required to increase trust in community pharmacists.
ABSTRACT
Cutis verticis gyrata (CVG) is a rare scalp condition that presents as convoluted folds and furrows, which resemble the cerebral cortex. Although the pathogenesis is not fully elucidated, recent investigations suggest the possible role of fibroblast growth factor receptor 2 (FGFR2) which may contribute to dermal hypertrophy in CVG pathogenesis.On the other hand, acanthosis nigricans (AN) is a dermatosis that is commonly associated with benign endocrine disorders, and increasing evidence suggest that AN is a convergent phenotype resulting from the activation of tyrosine kinase growth factor receptors (TKR), with mitogenic and antiapoptotic effects on keratinocytes. CVG presenting with AN has only been reported once in the previous literature and no association regarding their pathogeneses has been drawn yet. We report a rare case of a patient presenting CVG with concurrent AN, and suggest a shared underlying pathogenesis in these two disease entities which may be related to FGFR2 signaling pathway.
ABSTRACT
Subject(s)
Adult , Female , Humans , Abdomen , Antibodies, Antineutrophil Cytoplasmic , Arm , Autoantibodies , Autoimmune Diseases , Axilla , Biopsy , Extracellular Matrix , Fibrosis , Hand , Hepatitis, Autoimmune , Liver Cirrhosis, Biliary , Liver Diseases , Neck , Scleroderma, Diffuse , Scleroderma, Systemic , Skin , ThighABSTRACT
Background@#Recent epidemiological studies have demonstrated that air pollution is associated with the inflammatory response and may aggravate inflammatory skin diseases such as atopic dermatitis (AD). However, it is unclear whether particulate matter (PM) aggravates AD symptoms. @*Objective@#The aim of this study was to investigate whether PM exposure affects the skin barrier dysfunction and aggravates AD symptoms using human keratinocytes (HaCaT) cells and a mouse model of oxazolone-induced AD-like skin. @*Methods@#Standard reference material (SRM) 1649b, which mainly comprises polycyclic aromatic hydrocarbons, was used as the reference PM. HaCaT cells and mouse model of oxazolone-induced AD-like skin were treated with PM. The mRNA or protein expression levels of stratum corneum (SC) and tight junction (TJ) proteins, inflammatory cytokines, as well as clinical and histological changes of the AD-like skin of mouse model were evaluated. The expression of genes and proteins was analyzed by real-time polymerase chain reaction and Western blotting. Levels of inflammatory cytokines were measured by enzyme-linked immunosorbent assay. @*Results@#The results revealed that PM downregulates the expression levels of several SC and TJ-related proteins in the mouse model with AD-like skin. Clinically, epidermal and dermal thickness was significantly increased and dermal inflammation was prominent in PM treated AD-like skin. @*Conclusion@#In conclusion, we found that PM aggravates skin barrier dysfunction, clinically augmenting epidermal and dermal thickening with dermal inflammation in AD-like skin. These results suggest that PM may trigger the exacerbation of AD symptoms via skin barrier dysfunction-related mechanisms.
ABSTRACT
BACKGROUND: The development of a safe and convenient agent that can promote hair growth in patients with androgenetic alopecia remains challenging. OBJECTIVE: This study was designed to investigate the efficacy of a newly developed hair tonic containing a human umbilical cord blood mesenchymal stem cell (hUCB-MSC)-derived conditioned medium in promoting hair growth. METHODS: This double-blind, placebo-controlled clinical study investigated the efficacy of a hair tonic containing an hUCB-MSC-derived conditioned medium in 30 patients with patterned hair loss. Treatment efficacy was determined using phototrichograms to evaluate the density, diameter, and hair growth rate at baseline levels and after 4, 8, and 16 weeks of treatment. RESULTS: The hair density in the group treated with the hair tonic significantly increased from 125.2 to 134.6 hairs/cm2 (p<0.05). In this same group, the thickness of hair also increased from 0.083 to 0.110 mm (p<0.05). Additionally, the hair growth rate increased from 0.285 to 0.338 mm/day (p<0.05). No severe adverse reactions were reported. CONCLUSION: A hair tonic containing an hUCB-MSC-derived conditioned medium could be a new effective alternative to treat patients with androgenetic alopecia.