Applications of microneedling for various dermatologic indications with a special focus on pigmentary disorders: A comprehensive review study.

Microneedling can accelerate skin repair through numerous complex processes triggered by micro-injuries it produces on the skin surface with very thin needles. The current growth in the application of microneedling in the treatment of cutaneous diseases can be explained by its numerous effects on the skin as reported in the literature. Despite the numerous studies conducted on the application of microneedling in the treatment of skin lesions, its effects on pigmented skin lesions have remained relatively unexplored. The present review comprises an examination of the evidence for the application of microneedling in skin diseases in general and a comprehensive review of the applications of microneedling in pigmentation disorders. The review involved a search of all clinical studies, including trials, case reports, and case series, in the databases MEDLINE/PubMed and Google Scholar using the following keywords: "microneedling," "dermal needling," "percutaneous collagen induction," "skin needling," "dermaroller," and "dermatology disorder." Pertinent data were extracted from all relevant articles published from 1990 to April 2021, and focused on the application of microneedling in the treatment of pigmented skin lesions. Despite the limited number of available studies, evidence suggests the effectiveness and safety of microneedling in treating vitiligo, melasma, and periorbital hypermelanosis. It is noteworthy that the combination of any type of non-aggressive needing technique with other effective therapies (especially topical agents and mesotherapy) yields more promising therapeutic results than single therapy for melasma, dark cycles, and vitiligo as the prototype of pigmentary disorders. However, single needling therapy is significantly effective, too.

An update on adalimumab for pyoderma gangrenosum.

Pyoderma gangrenosum is a refractory disease characterized by chronic ulcers, presenting with central deep ulceration and undermined borders predominantly involving the lower extremities. Oral prednisolone and/or cyclosporine has been considered to be a first line of therapy; however, there are still unmet needs for treatment. Recently, effects of adalimumab for pyoderma gangrenosum in 22 Japanese patients were examined in an open-label, multicenter study during a 26-week treatment period and a further 26-week extension period. Pyoderma gangrenosum area reduction 100 (PGAR 100, defined as complete skin re-epithelialization) response for the target ulcer was observed in 3 patients (13.6%) as early as week 6, and at week 26, 12 patients (54.5%) achieved the primary endpoint of PGAR 100. The mean percent change from baseline in target ulcer area was -63.8% at week 26. A physician's global assessment score of 0 (PGA 0) was achieved by 8 patients (36.4%), while PGA 0/1 (completely/almost clear) was achieved by 12 patients (54.5%) at week 26. Adverse events were reported by 18 patients, most commonly infections (n = 11) and serious adverse events (n = 4). These results suggest that adalimumab is effective and generally well tolerated in Japanese patients with pyoderma gangrenosum active ulcers.

Hydroxychloroquine-induced hyperpigmentation in a 14-year-old female with systemic lupus erythematosus.

Hydroxychloroquine (HCQ)-induced hyperpigmentation is uncommon but is increasingly recognized. To our knowledge, HCQ-induced hyperpigmentation has not been reported in the pediatric age group. Herein, we present the case of a 14-year-old girl with systemic lupus erythematosus, who developed hyperpigmentation on her shins and dorsum of the left foot, approximately 3 years after initiating treatment with HCQ. Physicians who treat children with HCQ for reasons such as rheumatologic disorders, dermatologic disorders and, more recently, coronavirus disease-19 should be aware of this less-known side effect of HCQ.

Therapies and nursing care of women with vulvar dermatologic disorders.

Vulvar dermatologic disorders are common among women, and prevalence increases with age. Treatment can provide women with symptomatic relief and can halt further progression of disease. Numerous therapies are available, and nurses who work with women across the life span should have an understanding of vulvar dermatologic disorders and therapeutic modalities. We provide an overview of general vulvar care, four vulvar dermatologic disorders, and common treatment modalities including topical and systemic pharmacologic management.

A Survey on the Prevalence of Dermatologic Diseases and Skin Care Patterns in Elderly Outpatients at an Endocrinology Clinic / 대한피부과학회지

BACKGROUND: Advances in medicine and improved overall standard of living have brought people's attention to living a long healthy life. As a consequence, geriatric medicine is now gaining more and more attention in the field of medicine and dermatology is no exception. OBJECTIVE: The aim of this study was to examine features of the elderly in terms of the prevalence of dermatosis and general and medical skin care patterns. METHODS: A detailed survey and complete physical examination were performed on 525 patients aged over 65, who were treated at the endocrinology center at our hospital, from January to December 2011. RESULTS: The elderly gained most information on dermatologic diseases from their families and neighbors. The most common dermatologic disorder was senile lentigo (85.5%), followed by seborrheic keratosis (69.0%), xerosis cutis (63.0%), generalized pruritus (42.3%), onychomycosis (30.3%), and cherry angioma (26.9%). Furthermore, xerosis cutis was more often found in older patient groups among the elderly. When it comes to general skin care, one third of the elderly used moisturizers and 10.7% used sunscreens. Only 1.3% of the elderly received medical skin care. CONCLUSION: This study can be used as useful baseline data not only for the government to formulate a national health care plan but for each medical center to understand dermatologic disorders of the elderly and educate its staff members on the management of dermatologic problems of the elderly.

Clinical Study of Dermatologic Disorders in Patients with Breast Cancer / 대한피부과학회지

BACKGROUND: In Korea, breast cancer is the most common cancer in female and its incidence is increasing recently. Moreover, breast cancer is the most common cutaneous metastasis in female. However, dermatologic disorders manifested in patients with breast cancer have not been investigated yet. OBJECTIVES: Our purpose was to study the clinical characteristics of dermatologic disorders in patients with breast cancer. METHODS: A clinical observation and review of medical records were made by analyzing 359 cases of breast cancer who visited Our Lady of Mercy hospital from 1994 to 2003. Among them, 91 cases of the patients with breast cancer showed dermatologic disorders. Their photographs of cutaneous findings and histologic specimens were reviewed by more than 2 dermatologists. RESULTS & CONCLUSIONS: 1. The mean age at the diagnosis of breast cancer was 48.74+/-11.28 years old. 2. The stages of patients with breast cancer were as follows: stage 0 (4 cases), stage 1 (48 cases), stage 2 (196 cases), stage 3 (94 cases), stage 4 (2 cases), and others (15 cases). 3. The treatments of patients with breast cancer were as follows: surgery (358 cases), radiation therapy (115 cases), chemotherapy (256 cases), combination of chemotherapy and radiation therapy (82 cases), and others (9 cases). 4. The numbers of patients developing cutaneous infections among the patients with breast cancer were as follows: bacterial infection (18 cases), fungal infection (18 cases), and viral infection (14 cases). 5. The numbers of patients developing pruritus and eczema among the patients with breast cancer were as follows: contact dermatitis (7 cases), seborrheic dermatitis (3 cases), neurodermatitis (2 cases), and others (9 cases). 6. The numbers of patients developing treatment-associated dermatologic disorders among the patients with breast cancer were as follows: urticaria (11 cases), radiodermatitis (8 cases), drug eruption (6 cases), and lymphedema (1 case). 7. The number of patients developing skin metastasis among the patients with breast cancer was 10 cases. 8. The numbers of patients developing other dermatologic disorders among the patients with breast cancer were as follows: psoriasis (4 cases), erythema multiforme (2 cases), and others (16 cases). 9. The numbers of patients developing postoperative dermatologic complications were as follows: seroma (28 cases), arm swelling and lymphedema (9 cases), wound infection (6 cases), and others (5 cases).