Treatment of a Becker's Nevus Using a Q-Switched ND: YAG Laser / 대한피부과학회지

BACKGROUND: Becker's nevus is a relatively common pigmented smooth muscle harmatoma that develops during adolescence and occurs primarily in young men. The nevus, characterized by hypertrichosis and hyperpigmentation, is usually located unilaterally over the shoulder, upper arm, and scapula. These nevi are not only cosmetically undesirable but also psychologically distressing, as traditional surgical therapies have been either unsuccessful or have resulted in scarring. OBJECTIVE: We evaluated the clinical improvement of 14 patients with a becker's nevus who were treated with a Q-switched (QS) frequency doubled ND: YAG laser in order to decrease pigmentation. METHODS: Our study was designed by analyzing the clinical improvement of outpatients with becker's nevus via clinical examination and photography. RESULTS: The results were as follows; Male to female ratio of 2.5: 1. The mean age was 19.7 years old and the subjects in most of the studies were young adult. The mean age of onset was 5.7 years old (below 5 years old: n=8, 57%). We treated 14 patients with a QS ND: YAG laser. The patients' response to treatment was; excellent; 14%, good; 36%, fair; 21%, and poor; 29%. Conparison, was made, of the positive clinical improvement in patients who received treatment once (n=10) and those who received treatment more than twice (n=4). Multiple treatments (75%) showed superior improvement compared with single treatment (40%). The clinical improvement, the according to the area of lesions, was the best in the neck (100%) and the worst in the trunk (25%). The lesions were accompanied by hair in 6 cases. Among these, the excellent or good cases were 33%. The other patients (8 cases) without hairs had more positive results (63%). Treatment effects according to laser fluence were not shown to be significant. During the study, the most common complication was hyperpigmentation (36%), followed by transient erythema (14%). Scarring or hypopigmenatation had resulted in none. CONCLUSION: Our data suggested that QS ND: YAG laser irradiation is an effective and safe method to treat the hyperpigmentation characteristic of a becker's nevus. Long-term further evaluation will be necessary to determine whether the favorable results observed in these patient will be permanent.

A Case of Tick Bite Caused by Haemaphysalis flava / 대한피부과학회지

We report a case of tick bite caused by Haemaphysalis flava which have never been reported in Korean medical literature. An 31-year-old woman had a asymptomatic erythematous indurated plaque with central crust by tick bite on the left upper back. A excisional biopsy specimen from the skin lesion showed eosinophilic degeneration with thrombosed blood vessels and dense inflammatory cells infiltration mainly composed of eosinophils in the reticular dermis. We could identify this causative tick as Hamaphysalis flava by using the scanning electron microscopic examination.

Verruca Vulgaris Developed on the Skin Tag

Skin tags are very common skin tumors in middle age. In spite of their frequent occurrence, there was no reported cases of verruca vulgaris developing on the soft fibroma. We report a case of verruca vulgaris developing on the bag-like skin tag. We think that the incidence of HPV infection on the large skin tags may be higher than on normal skin due to their protrusion and repetitive irritation.