Prognostic Significance of Epidermal Growth Factor Receptor Expression in Distant Metastatic Melanoma from Primary Cutaneous Melanoma.

BACKGROUND: Epidermal growth factor receptor (EGFR) is overexpressed in many cancers. However, EGFR expression in melanoma and its role are conflicting. OBJECTIVE: This study aimed to evaluate EGFR expression in distant metastatic melanoma and analyze its relationship with histologic and clinical characteristics and survival. METHODS: Diagnostic tissues from 55 cases of distant metastatic melanoma was evaluated by immunohistochemistry for EGFR expression. Clinicopathologic features and survival outcomes were analyzed according to EGFR expression. RESULTS: The positive EGFR expression in distant metastatic melanoma was significantly correlated with the absence of ulceration. The EGFR expression in distant metastatic melanoma was significantly associated with poor survival, under the conditions of male sex and primary cutaneous melanoma without ulceration or Breslow thickness ≤4.0 mm. This study bears limitations of a retrospective study in a single institution. CONCLUSION: EGFR immunostaining had predictive values for survival outcome. The EGFR expression in distant metastatic melanoma in male, no ulcer, or Breslow thickness ≤4.0 mm appeared to be involved in disease progression.

Clinical improvement of photoaging-associated facial hyperpigmentation in Korean skin with a picosecond 1064-nm neodymium-doped yttrium aluminum garnet laser.

Traditional attempts at alleviating photoaging-associated facial pigmentation conditions such as melasma, mottled hyperpigmentation, and post-inflammatory hyperpigmentation have yielded disfiguring cosmetic results. Laser toning using a low-fluence Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has been more commonly applied to date. However, the treatment efficacy and safety of this approach have not been widely reported. This study therefore evaluated the efficacy and safety of picosecond 1064-nm Nd:YAG laser application for photoaging-associated facial pigmentation treatment in Korean subjects. Forty-seven Korean subjects with photoaging-associated facial pigmentation underwent picosecond 1064-nm laser application. The clinical improvement of 17 patients was assessed by objective measurements such as melanin and erythema indices. All subjects received six biweekly treatments with the laser in a three-pass fashion delivering approximately 2000 to 2500 shots using a zoom handpiece with a spot size of 7 mm, fluence ranging from 0.4 to 0.7 J/cm2, and a repetition rate of 10 Hz. Clinicians evaluated the improvement of pigmentation using the pigmentation area and severity index (PSI), and subjects reported their satisfaction level on a four-point scale. Statistical analyses were performed using the SPSS version 19.0 for Windows software program (IBM Corp., Armonk, NY, USA). Forty-seven subjects (45 females and two males) completed this study with a 12-week follow-up period. The average decrease in PSI value at 12 weeks after treatment was 6.85 ± 6.35 points (p < 0.001). The average decreases in the values of the erythema and melanin indices were 19.41 ± 64.64 points (p = 0.234) and 28.88 ± 32.89 points (p = 0.002). An analysis of 32 subjects' reports (68.1%) suggested good or excellent improvement. No serious adverse effects were observed during treatment or the follow-up period. Picosecond 1064-nm Nd:YAG laser application appears to be safe and effective in improving various photoaging-associated facial pigmentation conditions in Korean skin.

[Dermatologic Manifestations in Inflammatory Bowel Disease].

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract with an unknown etiology and pathogenesis. The incidence and prevalence of IBD are increasing rapidly in Korea. Approximately one-third of patients with IBD appear to develop extra-intestinal manifestations with the skin being one of the most commonly affected organs. They may precede, occur simultaneously, or follow the diagnosis of IBD. In addition, they may parallel with the luminal symptoms or independent from the disease activity of IBD. This review outlines the skin manifestations associated with IBD and discusses their management. Skin manifestations should be managed in close collaboration with a dermatologist.