Botulinum Toxin Type A for Facial Wrinkles and Benign Masseter Hypertrophy in Korean Patients / 대한피부과학회지

BACKGROUND: The utilization of botulinum toxin has rapidly expanded into various aesthetic applications. Achieving success with the aesthetic use of neurotoxins depends on several factors, including an understanding of the anatomy, the methods of dilution and the injection technique. Any guidelines representing a consensus for aesthetic treatments using botulinum toxin type A (BTA) have not been published in Korea. OBJECTIVE: We wanted to provide consensus recommendations on the treatment of facial wrinkles and benign masseter hypertrophy using BTA in Korean patients. METHODS: A panel of experienced Korean dermatologists was convened to develop a clinical consensus. The clinical consensus was comprised of the recommendations of the panel and the guidelines on general issues, such as the reconstitution and handling of the BTA, the procedural considerations, the dosing and injection-site standardizations, and the prevention and treatment of unwanted effects. Specific recommendations were provided according to the area of treatment, including glabellar lines, horizontal forehead lines, lateral periorbital wrinkles and benign masseter hypertrophy. RESULTS: The recommended final concentration of BTA was 50 units/ml (5 units/0.1 ml) after reconstitution with physiologic saline. For glabellar lines, the members recommend three injection points (a total of 8 units). For forehead wrinkles, the members recommend nine injections in two rows into the frontalis with 1 unit/point. For crow's feet, the members recommend three injections per side (7 units/side) at the lateral part of the orbicularis oculi. For benign masseter hypertrophy, three injections per side (24~30 units/side) were recommended. CONCLUSION: These consensus recommendations will provide a framework for Korean dermatologists who wish to perform safe and efficacious injection of BTA for facial rejuvenation.

Observation of T Lymphocyte Subsets Following use of a Multitest(R) CMI Kit in Patients with Herpes Zoster / 대한피부과학회지

BACKGROUND: The incidence of herpes zoster is higher among patients with impaired cell mediated immunity. Herpes zoster skin lesions frequently become more severe and run a more protracted course in such patients. OBJECTIVE: This study aimed to firstly elucidate whether there are changes in cell mediated immunity, even in immunocompetent, patients with herpes zoster, and secondly to investigate relationships between these change and the clinical appearance of herpes zoster. METHODS: T lymphocyte subsets in peripheral blood and delayed hypersensitivity reactions using the Multitest(R) CMI kit were measured in 33 healthy patients with herpes zoster and 28 controls. RESULTS: As compared with controls, there was a slight decrease in percentages of CD4 lymphocytes, a significant decr eas in percentages of CD8 lyrnphocytes, and a slight increase in CD4/ CD8 ratios in the acute phasr of herpes zoster. The percentages of CD3 lymphocytes were also significantly decreased. Based on the severity of the skin lesion, there was a significant increase in duration of acute herpetic pain. However, there were no signigicant differences in percentages of T lymphocyte subsets based on the severity of skin lesion and duration of acute horpetic pain. In delayed hypersensitivity reations with the Multitest(R)" CMI kit, the intensity and frequencies of positive reactions were significintly decreased in the patients group. CONCLUSIONS: There are significant changes in peripheral blood T lymphocyte subsets and delayed hypersensitivity reactions even in other wise healthy patients.

A Case of cutaneous Metastasis Originating from Prostatic Carcinoma / 대한피부과학회지

Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.

A Case of cutaneous Metastasis Originating from Prostatic Carcinoma / 대한피부과학회지

Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.