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1.
J Cosmet Dermatol ; 2024 Jun 24.
Article in English | MEDLINE | ID: mdl-38923679

ABSTRACT

BACKGROUND: The microneedle fractional radiofrequency system (MFRS) is able to rejuvenate facial appearance by heating and coagulating certain depth of skin tissue. OBJECTIVE: To evaluate the safety and efficacy of a novel vacuum-assisted MFRS for facial contour tightening. METHODS: This prospective, randomized, split-face study included 21 patients who underwent three treatments with a vacuum-assisted MFRS at 1-month intervals. Half of the face was treated with the MFRS; the other half was untreated (control). Facial volume changes and wrinkles were objectively measured using a three-dimensional imaging system and VISIA-CR. RESULTS: Volume changes of the treated midface were -0.24 ± 0.75, -0.59 ± 0.92, and -0.55 ± 0.65 mL at 1, 3, 6 months follow-up; however, measurements of the control side were 0.08 ± 0.70, -0.08 ± 0.53, and - 0.10 ± 0.86 mL, indicating significant reductions (p < 0.05). The number of facial wrinkles on the treated side was significantly reduced to 12.44 ± 4.85 at 3 months and sustained at 6 months (11.11 ± 4.100) compared to the control side (14.89 ± 5.26 and 13.22 ± 4.44, respectively; p < 0.05). No long-term side effects occurred. CONCLUSION: The vacuum-assisted MFRS is safe and effective and is recommended for improving facial tightening and reducing wrinkles. This technology is sufficient to ensure the insertion depth, thus helping to improve the treatment accuracy and safety. The MFRS provides sustained effects for at least 6 months.

2.
BMC Med Res Methodol ; 23(1): 292, 2023 12 13.
Article in English | MEDLINE | ID: mdl-38093215

ABSTRACT

BACKGROUND: Complete reporting is essential for clinical research. However, the endorsement of reporting guidelines in radiological journals is still unclear. Further, as a field extensively utilizing artificial intelligence (AI), the adoption of both general and AI reporting guidelines would be necessary for enhancing quality and transparency of radiological research. This study aims to investigate the endorsement of general reporting guidelines and those for AI applications in medical imaging in radiological journals, and explore associated journal characteristic variables. METHODS: This meta-research study screened journals from the Radiology, Nuclear Medicine & Medical Imaging category, Science Citation Index Expanded of the 2022 Journal Citation Reports, and excluded journals not publishing original research, in non-English languages, and instructions for authors unavailable. The endorsement of fifteen general reporting guidelines and ten AI reporting guidelines was rated using a five-level tool: "active strong", "active weak", "passive moderate", "passive weak", and "none". The association between endorsement and journal characteristic variables was evaluated by logistic regression analysis. RESULTS: We included 117 journals. The top-five endorsed reporting guidelines were CONSORT (Consolidated Standards of Reporting Trials, 58.1%, 68/117), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, 54.7%, 64/117), STROBE (STrengthening the Reporting of Observational Studies in Epidemiology, 51.3%, 60/117), STARD (Standards for Reporting of Diagnostic Accuracy, 50.4%, 59/117), and ARRIVE (Animal Research Reporting of In Vivo Experiments, 35.9%, 42/117). The most implemented AI reporting guideline was CLAIM (Checklist for Artificial Intelligence in Medical Imaging, 1.7%, 2/117), while other nine AI reporting guidelines were not mentioned. The Journal Impact Factor quartile and publisher were associated with endorsement of reporting guidelines in radiological journals. CONCLUSIONS: The general reporting guideline endorsement was suboptimal in radiological journals. The implementation of reporting guidelines for AI applications in medical imaging was extremely low. Their adoption should be strengthened to facilitate quality and transparency of radiological study reporting.


Subject(s)
Artificial Intelligence , Periodicals as Topic , Humans , Checklist , Publishing , Reference Standards
3.
Plast Reconstr Surg ; 2023 Dec 04.
Article in English | MEDLINE | ID: mdl-38051121

ABSTRACT

BACKGROUND: Microneedle fractional radiofrequency (MFR) is commonly used for skin laxity treatment, and poly-L-lactic acid (PLLA) can stimulate collagen synthesis in the body. However, the synergy of their combination for skin rejuvenation has not been proven. We aimed to evaluate the combined efficacy of PLLA and MRF and the potential mechanism underlying skin laxity. METHODS: This prospective, randomized study included C57BL/6 mice treated with MFR, MFR+PLLA, and CO2 laser+PLLA and 32 patients who underwent split-face treatments with MFR or MFR+PLLA twice every 2 months. The global aesthetic improvement scale, Facial Laxity Rating scale of the whole face, ECCA grading scale of acne scars, and VISIA parameters on both treated sides were evaluated. Dermatological changes were measured by ultrasonography in the submental space, and adverse events were documented. RESULTS: PLLA was delivered by channels produced by MFR but not CO2 laser in the mice model. Thirty patients were treated with split-face MFRF+PLLA or MFRF, revealing an improvement in VISIA wrinkle percentile (0.020) compared with the age-matched controls (0.000). The thickness of the dermis increased, while the fat layer did not change significantly. No adverse effects were observed. CONCLUSIONS: PLLA can be delivered via microchannels produced by MFR. PLLA enhances the efficacy of MFR for skin laxity without lipolysis.

4.
J Cosmet Laser Ther ; 24(6-8): 91-97, 2022 Nov 17.
Article in English | MEDLINE | ID: mdl-36112733

ABSTRACT

Non-ablative fractional laser (NAFL) and radiofrequency (RF) are popular for treating periorbital wrinkles owing to short downtime and low risk of side effects. To compare the effectiveness and safety of infrared bipolar radiofrequency (IR-RF) and NAFL, including 1540 nm Er: glass and 1927 nm thulium-doped laser, to determine the better option for clinical treatment of periorbital wrinkles. Twenty-seven patients assigned to 3 groups underwent split-face treatment. Two of the three treatments were randomly selected for patients in each group: IR-RF, 1540 nm Er: glass NAFL, and 1927 nm thulium-doped NAFL. Therapeutic outcomes were subjectively and objectively evaluated six months after the last treatment. Side effects and pain evaluations were conducted. Fitzpatrick wrinkle scores revealed no statistical difference for IR-RF, whereas the NAFL-treated sides exhibited significant improvements (p < .05). VISIA analysis of skin texture showed similar results. In IR-RF-treated sides, patients over 50 years old exhibited significant improvements compared with those below 50 (p < .05). The sample size was small. More objective evaluations like photometer measurements are required. NAFL is effective and safe for improving periorbital wrinkles, but IR-RF might be more suitable for elderly patients, particularly those with low pain tolerance.


Subject(s)
Lasers, Solid-State , Skin Aging , Humans , Aged , Middle Aged , Lasers, Solid-State/adverse effects , Thulium , Radio Waves/adverse effects , Pain/etiology
5.
Lasers Surg Med ; 54(8): 1051-1059, 2022 10.
Article in English | MEDLINE | ID: mdl-36084202

ABSTRACT

BACKGROUND: Conventional high fluence Q-switched (HFQS) Alexandrite 755-nm are widely used in clinical café-au-lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q-switched (LFQS) Nd: YAG 1064-nm lasers. OBJECTIVE: To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs. METHODS: Within 3 months, 20 patients underwent prospective self-controlled split-lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow-up visit. Patient and physician preferences for laser selection were also recorded. RESULTS: The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82-2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment. CONCLUSIONS: The efficacy difference between the LFQS 1064-nm laser and HFQS 755-nm laser in treating CALMs in a 3-month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.


Subject(s)
Hyperpigmentation , Hypopigmentation , Lasers, Solid-State , Low-Level Light Therapy , Cafe-au-Lait Spots , Humans , Hyperpigmentation/etiology , Hypopigmentation/etiology , Hypopigmentation/radiotherapy , Lasers, Solid-State/therapeutic use , Prospective Studies , Treatment Outcome
6.
Eur J Dermatol ; 32(2): 244-248, 2022 04 01.
Article in English | MEDLINE | ID: mdl-35866900

ABSTRACT

Background: Laser treatment for congenital melanocytic nevi (CMN) is controversial. Correlations between anatomical distribution of facial CMN and efficacy of laser treatment have not been characterized. Materials & Methods: A total of 90 facial CMN treated with ablative laser (Er:YAG or CO2 laser) were retrospectively reviewed. Clinical assessments were completed by at least two plastic surgeons using the Investigator's Global Assessment (IGA) score. Results: The mean IGA score was 4.37. The IGA scores recorded at the periorbital, temple/forehead, nose, cheek and lip/chin areas were 3.68, 5.88, 4.63, 4.52 and 4.92, respectively (p = 0.03). Moreover, facial CMN with uniform pigment distribution showed higher IGA scores than those with a non-uniform pigment distribution. Thickening, hairiness and age at first treatment were not statistically correlated with laser efficacy. Conclusion: Correlations between anatomical distribution and the efficacy of laser treatment are described for the first time. The subdivided anatomical distribution of facial CMN can yield meaningful information on predicting the efficacy of laser treatment.


Subject(s)
Laser Therapy , Nevus, Pigmented , Skin Neoplasms , Humans , Immunoglobulin A , Nevus, Pigmented/congenital , Nevus, Pigmented/surgery , Retrospective Studies , Skin Neoplasms/congenital , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgery
8.
Dermatol Ther (Heidelb) ; 12(5): 1147-1156, 2022 May.
Article in English | MEDLINE | ID: mdl-35415801

ABSTRACT

INTRODUCTION: Post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH. METHODS: This retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4-6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections. RESULTS: On the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up. CONCLUSION: IPL is an effective and safe treatment for acne-related PIE and PIH.

9.
Dermatol Surg ; 48(5): 534-538, 2022 05 01.
Article in English | MEDLINE | ID: mdl-35404867

ABSTRACT

BACKGROUND: Studies have demonstrated that glycerol can act as an optical clearing agent (OCA) to increase the light penetration through the skin and laser deposition to the target chromophore, thus potentially increasing the efficacy of laser treatment. OBJECTIVE: To evaluate whether a pulsed dye laser (PDL) in combination with an OCA can increase the efficacy in treating port-wine stains (PWSs). METHODS: Thirteen patients with untreated PWSs underwent 3 treatment sessions at 6-week intervals. Each PWS was divided into OCA + PDL sites (PDL treatment after topical use of 0.5 mL hydrous glycerol for 5 minutes), PDL sites, and untreated sites. The chromametric evaluation and visual evaluation (VAS) of the efficacy and the assessment of side effects were conducted 3 months after the final treatment. RESULTS: Visual evaluation was 2.69 versus 2.07 (p = .025) and 3.38 versus 3.07 (p = .04) for OCA + PDL and PDL-only sites after the first and second sessions. After the third session, the chromameter and VAS indicated no significant difference between the 2 sites. Permanent side effects were not observed. CONCLUSION: Greater efficacy was observed after the first 2 treatments on the OCA + PDL sites. Although after multiple sessions, the OCA + PDL treatment did not improve efficacy over just PDL alone.


Subject(s)
Lasers, Dye , Port-Wine Stain , Glycerol/therapeutic use , Humans , Lasers, Dye/therapeutic use , Port-Wine Stain/radiotherapy , Port-Wine Stain/surgery , Prospective Studies , Treatment Outcome
10.
J Cosmet Dermatol ; 21(6): 2475-2480, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35349759

ABSTRACT

AIM: This study aimed to evaluate the safety and efficacy of a novel therapeutic strategy, a microneedle fractional radiofrequency system, for hand rejuvenation. MATERIAL AND METHOD: Sixteen subjects were enrolled in a self-controlled evaluator-blind prospective trial. All subjects received three microneedle fractional radiofrequency treatments at 4 weeks intervals. Hand volume was evaluated through subjective (Hand Volume Rating Scale) and quantitative measurements. Patients were also assessed on the Global Aesthetic Improvement Scale using digital photographs. Patients were followed up at 1, 3, and 6 months after the last radiofrequency treatment. RESULTS: Statistically significant improvements on the Global Aesthetic Improvement Scale and Hand Rating Volume Scale were noted (p < 0.05). Compared with the control side, the treated hand showed a 44% improvement in dorsal skin surface roughness (p < 0.05). Quantitative measurements of hand volume showed a trend toward increased volume for the treated hand, but the difference was not statistically significant. CONCLUSION: We conclude that microneedle fractional radiofrequency is a safe therapeutic option for hand rejuvenation.


Subject(s)
Cosmetic Techniques , Radiofrequency Therapy , Skin Aging , Cosmetic Techniques/adverse effects , Humans , Patient Satisfaction , Prospective Studies , Rejuvenation , Treatment Outcome
11.
Photobiomodul Photomed Laser Surg ; 40(3): 159-162, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35298284

ABSTRACT

Background: Vascular-targeted photodynamic therapy (PDT) is an effective alternative treatment choice for port-wine stains (PWSs). The histological characteristics of PWSs after PDT treatment have not yet been reported. Objective: To investigate the morphological features of PWSs treated by PDT and define the histopathological characteristics of PWS that achieve clinical cure. Methods: Thirteen patients with facial PWSs, who presented with complete regressive PWS lesions after a mean of 4.38 (standard deviation = 4.907) sessions of PDT. Post-treatment biopsy samples were obtained from each patient. The number of blood vessels, vascular diameter, and depth were measured and compared in all samples of PDT-regressive sites, PDT-resistant sites, and normal skin. Results: Within the 7-year follow-up after PDT, there was no recurrence in the regression area of PDT. In the PDT-regressive sites, within 800 µm of the dermal-epidermal junction, the dilated vessels were occluded and remained fissure-like after PDT. Conclusions: When the vascular lesions within 800 µm of the dermal-epidermal junction were closed after PDT, a stable clinical cure (no recurrence) was achieved.


Subject(s)
Photochemotherapy , Port-Wine Stain , Follow-Up Studies , Humans , Port-Wine Stain/drug therapy , Treatment Outcome
12.
Dermatol Surg ; 47(9): 1229-1232, 2021 09 01.
Article in English | MEDLINE | ID: mdl-34448759

ABSTRACT

BACKGROUND: Pulsed dye laser (PDL) treatment currently represents the mainstream choice for port-wine stain (PWS) treatment in accordance with selective photothermolysis. However, most PWS lesions cannot be removed despite several treatments. Intense pulsed light (IPL) is reportedly an effective alternative to PDL for PWS treatment. No studies have thus far been reported on the combination therapy of PDL with IPL in PWS treatment. OBJECTIVE: This study evaluated the efficacy and safety of PDL with IPL for PWS treatment. METHODS: A total of 33 PWS lesions underwent 3 treatment sessions. Each PWS was divided into IPL + PDL, PDL, and untreated sites. Therapeutic outcomes were evaluated by visual assessment and chromametric assessment 3 months after the final treatment. RESULTS: The overall average blanching rates were 36.2% and 32.6% at the sites treated with IPL + PDL and PDL, respectively (p > .05). No permanent side effects were reported. CONCLUSION: In this laser setting, although IPL + PDL is a safe and effective PWS treatment, no significant improvement in the efficacy was observed using IPL + PDL in contrast to PDL alone.


Subject(s)
Lasers, Dye/therapeutic use , Low-Level Light Therapy/methods , Port-Wine Stain/surgery , Adolescent , Adult , Child , Child, Preschool , Combined Modality Therapy , Female , Humans , Infant , Male , Middle Aged , Prospective Studies , Single-Blind Method
13.
Science ; 373(6555): 692-696, 2021 08 06.
Article in English | MEDLINE | ID: mdl-34353954

ABSTRACT

Incorporating passive radiative cooling structures into personal thermal management technologies could effectively defend humans against intensifying global climate change. We show that large-scale woven metafabrics can provide high emissivity (94.5%) in the atmospheric window and high reflectivity (92.4%) in the solar spectrum because of the hierarchical-morphology design of the randomly dispersed scatterers throughout the metafabric. Through scalable industrial textile manufacturing routes, our metafabrics exhibit desirable mechanical strength, waterproofness, and breathability for commercial clothing while maintaining efficient radiative cooling ability. Practical application tests demonstrated that a human body covered by our metafabric could be cooled ~4.8°C lower than one covered by commercial cotton fabric. The cost-effectiveness and high performance of our metafabrics present substantial advantages for intelligent garments, smart textiles, and passive radiative cooling applications.

14.
Photobiomodul Photomed Laser Surg ; 39(12): 795-798, 2021 Dec.
Article in English | MEDLINE | ID: mdl-33493015

ABSTRACT

Objective: Recurrence or redarkening of port-wine stain (PWS) after laser treatment occurs frequently. Background: Vascular-targeted photodynamic therapy (PDT) is an alternative adjuvant treatment for PWS. Methods: We report the first case of PWS recurrence after PDT with a 22-year follow-up. Results: Histological analysis was performed to indicate the possible mechanisms of PWS recurrence. Conclusions: This case demonstrates the possibility of PWS recurrence and suggests that patients be notified of this possibility before treatment.


Subject(s)
Photochemotherapy , Port-Wine Stain , Follow-Up Studies , Humans , Port-Wine Stain/drug therapy
15.
Lasers Surg Med ; 53(4): 435-442, 2021 04.
Article in English | MEDLINE | ID: mdl-32896932

ABSTRACT

BACKGROUND AND OBJECTIVES: Many types of lasers have been used to treat café-au-lait macules (CALMs) since the introduction of the selective photothermolysis theory. However, the efficacy and safety of picosecond lasers, compared with those of nanosecond lasers, have not been researched. To compare the efficacy and safety of 755 nm picosecond laser (PS-755 nm), Q-switched (QS) Alexandrite 755 nm nanosecond laser (QS-755 nm), and QS Nd:YAG 532 nm nanosecond laser (QS-532 nm) for treating CALMs. STUDY DESIGN/MATERIALS AND METHODS: Forty-one patients received several treatments at 3-month intervals. Lesions were divided into two or three approximately equal parts, which were randomly treated with PS-755 nm, QS-755 nm, and QS-532 nm. The safety and efficacy of three lasers were determined based on blinded visual assessments and self-reports of patients three months after the comparative trial. RESULTS: Visual assessment 3 months after the comparative trial revealed that there was no statistically significant difference among the sites treated by QS-755 nm (2.84 ± 1.11), QS-532 nm (2.63 ± 1.06), and PS-755 nm (2.74 ± 1.05) lasers. Five (26.32%) of 19 patients showed lesion recurrence. Adverse effects included acneiform miliaris, hypopigmentation, and hyperpigmentation, which were resolved within 12 months. Five (26.32%) of 19 patients who showed lesion recurrence 1-5 months after laser treatment had lightened or cleared at least 50% of the lesion. 46.67% of patients were satisfied or very satisfied with the outcome of the overall treatment. CONCLUSIONS: PS-755 nm, QS-755 nm, and QS-532 nm laser treatments were equally effective in treating and improving CALMs. PS-755 nm caused fewer adverse effects. Individuals can react differently to different types of lasers. Patch tests should be conducted before the treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.


Subject(s)
Hyperpigmentation , Lasers, Solid-State , Low-Level Light Therapy , Cafe-au-Lait Spots , Humans , Lasers, Solid-State/therapeutic use , Recurrence , Treatment Outcome
16.
Hereditas ; 157(1): 35, 2020 Aug 26.
Article in English | MEDLINE | ID: mdl-32847629

ABSTRACT

Congenital melanocytic nevus (CMN) represent a benign proliferative skin disease in the epidermis and dermis. CMN are historically known to be associated with activating NRAS or BRAF mutations. Melanoma frequently harbors the BRAF p.Val600Glu mutation, which is also commonly found in benign nevi. A recent study reported mutation of MAP2K1, a downstream effector of the RAS-RAF-MEK pathway, in melanoma with an overall frequency of 8%. Later, in 2019, Jansen P detected one activating MAP2K1 mutation in acral nevi. However, it is unknown whether MAP2K1 mutations are common in CMN, and how MAP2K1 contributes to the pathogenesis of CMN remains to be determined.In this study, we report one patient clinically and histologically diagnosed with CMN, with the MAP2K1 germline mutation and a BRAF p.Val600Glu somatic hit in the lesion. To the best of our knowledge, this is the first report of the coexistence of mutated BRAF and MAP2K1 in CMN, which may suggest that MAP2K1 mutations contribute to the occurrence and development of nevus expanding our knowledge of the genetics of CMN.


Subject(s)
Germ-Line Mutation , MAP Kinase Kinase 1/genetics , Mutation , Nevus, Pigmented/diagnosis , Nevus, Pigmented/genetics , Proto-Oncogene Proteins B-raf/genetics , Biopsy , Child , DNA Mutational Analysis , Female , High-Throughput Nucleotide Sequencing , Humans , Immunohistochemistry , Magnetic Resonance Imaging , Symptom Assessment
17.
Hereditas ; 157(1): 27, 2020 Jul 07.
Article in English | MEDLINE | ID: mdl-32635943

ABSTRACT

Capillary malformation-arteriovenous malformations (CM-AVMs) caused by a RASA-1 or EPHB4 mutation are characterized as hereditary sporadic or multifocal capillary malformations (CMs), associated with potential fast-flow vascular anomalies underlying erythema lesions. Because of the similar phenotype, CM-AVMs should be considered in the differential diagnosis of isolated CMs as well as other disorders with an erythema phenotype, such as hereditary hemorrhagic telangiectasia (HHT).Herein, we report a male patient with facial erythema. Red lesions were located in the V1 region of his left face, the V2 and V3 regions on his right side, and the nasal back. The patient was initially thought to have PWSs because of the unilateral and segmental distribution of his red facial lesions. In contrast to a previous diagnosis, we diagnosed the child with capillary malformation-arteriovenous malformation type 2 (CM-AVM2) based on a family history of erythema, the results of physical examination and ultrasound raising potential fast-flow lesions, and a genetic study revealing a germline EPHB4 mutation. This study emphasizes the importance of differential diagnosis for PWS and CM-AVM. A single clinical diagnosis can be limited, and molecular diagnosis is recommended to provide more information for the evaluation of the potential risk of fast-flow lesions underlying erythema lesions if necessary.


Subject(s)
Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/genetics , Capillaries/abnormalities , Erythema/diagnosis , Face/pathology , Port-Wine Stain/diagnosis , Child, Preschool , DNA Mutational Analysis , Diagnosis, Differential , Erythema/etiology , High-Throughput Nucleotide Sequencing , Humans , Male , Mutation , Phenotype , Port-Wine Stain/etiology , Port-Wine Stain/genetics , Receptor, EphB4/genetics
18.
Hereditas ; 157(1): 21, 2020 May 19.
Article in English | MEDLINE | ID: mdl-32430073

ABSTRACT

Congenital melanocytic nevus (CMN) is a benign proliferative skin disease in the epidermis and dermis. Large to giant CMNs are estimated to be associated with an increased lifetime risk of malignancy. It is necessary to estimate and monitor the risk of malignant transformation for giant CMNs. To date, the clinical "ABCD" criteria and immunohistochemistry studies can be confusing and, to some extent, subjective. Accordingly, the elucidation of genomic analyses of nevi is required to better understand the malignant transformation of CMNs. Here, we describe two large to giant CMNs of the scalp with opposite clinical-histological and molecular evaluations of potential malignancy risk. To our knowledge, this is the first description of a genetic study of large to giant CMNs of the scalp in East Asia. We recommend reviewing the molecular diagnosis together with careful medical history and histological information to facilitate the evaluation of the potential malignancy risk.


Subject(s)
Nevus, Pigmented/genetics , Scalp/pathology , Skin Neoplasms/genetics , Child, Preschool , DNA Mutational Analysis , Female , Humans , Infant , Nevus, Pigmented/pathology , Proto-Oncogene Proteins B-raf/genetics , Skin Neoplasms/pathology
19.
J Dermatol ; 47(4): 348-355, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32012364

ABSTRACT

Pulsed dye laser-resistant port-wine stains present a therapeutic challenge. The aim of this study was to evaluate the efficacy and safety of photodynamic therapy for treating these lesions. A total of 67 patients with pulsed dye laser-resistant cervicofacial port-wine stains were retrospectively assessed after undergoing photodynamic therapy mediated with a combination of hemoporfin and 532-nm light. For objective evaluation of photodynamic therapy efficacy, first, the colorimetric changes in the port-wine stain lesions were evaluated according to the L*a*b* color coordinate system, then the values of color changes (ΔE) and blanching rate were calculated. For subjective evaluation of improvement, photographs taken before and after photodynamic therapy were evaluated by three independent assessors blindly. Patient satisfaction was also used as a factor in the subjective evaluation. Adverse events were recorded after treatment. The median ΔE decreased significantly from the pretreatment value of 13.42 to 9.90 at the 2-month follow up (P < 0.001). The median blanching rate of port-wine stains was 28.04% after an average of 1.21 sessions of photodynamic therapy. Based on the overall visual assessment, 46.2% patients showed excellent or good levels of improvement (>50% color blanching). Adverse events were minimal, transient and self-limiting. In conclusion, photodynamic therapy serves as an alternative means to treat pulsed dye laser-resistant port-wine stains.


Subject(s)
Hematoporphyrins/administration & dosage , Lasers, Dye/therapeutic use , Low-Level Light Therapy/methods , Photochemotherapy/methods , Port-Wine Stain/therapy , Adolescent , Adult , Child , Child, Preschool , Disease Resistance , Face , Female , Humans , Male , Middle Aged , Neck , Patient Satisfaction , Retrospective Studies , Treatment Outcome , Young Adult
20.
Photobiomodul Photomed Laser Surg ; 37(6): 376-380, 2019 Jun.
Article in English | MEDLINE | ID: mdl-31188091

ABSTRACT

Objective: To compare the efficacy and safety of the two generation photosensitizers, PsD-007 and hematoporphyrin monomethyl ether (HMME), for photodynamic therapy (PDT) of port-wine stain (PWS). Background: Vascular-targeted PDT has shown potentially beneficial results in treating PWS; however, the efficacy and safety of various photosensitizers have not been fully investigated. Materials and methods: We retrospectively analyzed 38 patients with PWS, who were treated with one session of PsD-007-mediated (n = 21) or HMME-mediated (n = 17) PDT. Clinical efficacy was assessed by a chromameter and visual assessment of color blanching of the PWS lesion. Adverse events were evaluated. Results: Neither visual nor chromameter optical evaluations showed significant differences between the PsD-007 and HMME groups (p = 0.337 and p = 0.191, respectively). The total response rate was 76.2% (n = 16) in the PsD-007 group and 88.2% (n = 15) in the HMME group. Good or excellent clearance was achieved in 42.9% patients in the PsD-007 group and 29.4% patients in the HMME group. The average ΔE (color expressed change or improvement) and mean blanching rate measured optically were higher in the PsD-007 group than in the HMME group without statistical differences (8.51 vs. 7.39, p = 0.649; 0.37 vs. 0.29, p = 0.191). Incidences of swelling, pruritus, scab formation, and other adverse reactions were similar for the two groups. There were no blisters, scarring, or hypopigmentation in either group. Conclusions: Both PsD-007- and HMME-mediated PDTs are effective and safe for treatment of PWS. However, HMME has a shorter photosensitivity period than does PsD-007, which might be more recommended.


Subject(s)
Hematoporphyrins/therapeutic use , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Port-Wine Stain/drug therapy , Adolescent , Adult , Female , Humans , Male , Retrospective Studies
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