RESUMO
Carbon dioxide (CO2) laser is one of the most widely used lasers in dermatology. CO2 laser can precisely ablate the skin with good hemostasis, which makes it an ideal surgical laser. With the development of pulsed CO2 laser, which enabled cleaner ablation with less residual thermal damage, CO2 laser resurfacing became the gold standard for skin rejuvenation. The rejuvenation effect of full-face CO2 laser resurfacing is unparalleled to other methods; however, it is associated with a relative high incidence of side effects and prolonged downtime. Fractional CO2 laser was developed to overcome this problem. With a new technology of fractionating the laser beam into hundreds of microbeams, fractional CO2 laser resurfacing can improve various skin conditions including skin laxity, photodamage, and acne scars with short downtime and significantly lesser side effects. For optimal treatment results, clinicians have to decide the treatment depth and density based on proper understanding of the laser tissue interaction and underlying skin conditions.
Assuntos
Acne Vulgar , Dióxido de Carbono , Carbono , Cicatriz , Dermatologia , Hemostasia , Incidência , Lasers de Gás , Rejuvenescimento , PeleRESUMO
No abstract available.
RESUMO
BACKGROUND: Although ablative fractional resurfacing is known to be effective against photoaging and acne scars, studies on its efficacy, safety and changes in the skin characteristics of Asians are limited. OBJECTIVE: The aim of this study is to assess the efficacy and safety of carbon dioxide fractional laser (CO2FL) in Koreans treated for wrinkles and acne scars, and to define the changes in skin characteristics during recovery period. METHODS: We administered one session of CO2FL on 10 acne scar patients and 14 wrinkles patients with skin types IV and V. The surveillance of efficacy and side effects along with the measurement of biophysical properties was carried out before 1 day, 1 week, 1 month and 3 months after treatment. RESULTS: Using a non-invasive method, skin barrier damage, erythema and bronzing of skin during the recovery period were assessed, and all of the items eventually returned to the pre-treatment level. Skin elasticity was measured in the wrinkle group, and the statistically significant effect was sustained throughout the next three months. The outcome of treatment was found to be better than 'moderate improvement' in both the acne scar and wrinkle groups. Further, there were no serious side effects three months post-procedure. CONCLUSION: CO2 FL is thought to be an effective and safe method for treating moderate to severe acne scars and wrinkles in Asians.
Assuntos
Humanos , Acne Vulgar , Povo Asiático , Dióxido de Carbono , Cicatriz , Elasticidade , Eritema , PeleRESUMO
Tinea manuum comprises roughly 5% of all cases of tinea, and the main culprit is known to be Trichophyton (T.) rubrum, T. mentagrophytes var. erinacei is a dermatophyte that may be transmitted from hedgehogs, and it has been reported in Korea now that vast diversity of pets are brought into existence. Tinea manuum caused by T. mentagrophytes var. erinacei, is frequently localized to the initial site of exposure, and thus may be confused with hand eczema or pompholyx. The patient visited the outpatient clinic with an erythematous scaly patch with pustule on the right finger after being initially misdiagnosed with housewife eczema. Numerous hyphae were evident on KOH smear examination, and confirmative diagnosis of tinea manuum caused by T. mentagrophytes var. erinacei was made after culturing scales from the lesion for molecular biological analyses. The patient is currently under follow-up without relapse after being treated systemic and topical antifungal agents.
Assuntos
Humanos , Instituições de Assistência Ambulatorial , Antifúngicos , Arthrodermataceae , Eczema , Eczema Disidrótico , Dedos , Seguimentos , Mãos , Ouriços , Hifas , Coreia (Geográfico) , Recidiva , Tinha , Trichophyton , Pesos e MedidasRESUMO
BACKGROUND: Luliconazole (LLCZ) is an imidazole antifungal agent widely used in Japan for treatment of tinea, cutaneous candidiasis, and pityriaisis versicolor, etc. Theoretically, its potent antifungal activity should make it a viable option for various conditions of dermatophytoses, but there has been no studies to support the notion thus far. OBJECTIVE: This prompted the authors to investigate the distribution of minimum inhibitory concentration (MIC) of luliconazole by carrying out in vitro antifungal susceptibility test on Trichophyton (T.) species clinically isolated from Korean subjects with tinea pedis. METHODS: In vitro antifungal susceptibility test, with broth macrodilution method of luliconazole and terbinafine hydrochloride (TBF) as reference drug on two clinically isolated Trichophton species (22 strains of T. rubrum, 5 of T. mentagrophytes), was carried out. RESULTS: The range of MIC for LLCZ on the total of 27 strains was 0.0110~0.0140 microg/mL (geometric mean: 0.0027 microg/mL), and the range for TBF was 0.0120~0.0250 microg/mL (geometric mean: 0.0042 microg/mL). Additionally, the geometric mean for MIC of LLCZ on T. mentagrophytes was 0.0125 microg/mL, and on T. rubrum, it was 0.0019 microg/mL. No strain showed resistance in vitro. CONCLUSIONS: The authors hence demonstrated that antifungal activity of LLCZ in vitro against Trichophyton species clinically isolated from Korean subjects is quite superior. These findings emphasize the usefulness of LLCZ, a promising new imidazole, for the topical management of dermatophytoses.
Assuntos
Candidíase Cutânea , Imidazóis , Japão , Remoção , Testes de Sensibilidade Microbiana , Naftalenos , Entorses e Distensões , Tinha , TrichophytonRESUMO
BACKGROUND: Fractional photothermolysis makes thousands of minute areas called microthermal treatment zones on the skin surface and transmits thermal injury to facilitate heat shock protein formation around the dermis. Potential side effects include acneiform eruption, herpes simplex virus outbreak, erythema, and post-inflammatory hyperpigmentation. OBJECTIVE: To investigate and compare the changes in the skin of Asian patients after two different fractional photothermolysis systems (FPS) on a split face. METHODS: A half-split face study was performed with 10,600 nm carbon dioxide FPS on the left and 1,550 nm erbium-doped FPS on the right side of the face. Only one session of laser irradiation and several biophysical measurements were done. RESULTS: Although both FPS proved to be effective in treating acne scar and wrinkle patients, a slightly higher satisfaction rating was seen with the 10,600 nm FPS treatment. Both types of FPS showed a significant increase in transepidermal water loss which decreased gradually after treatment and returned to pre-treatment level after 1 week. A decreased reviscometer score was sustained for a longer period in wrinkle areas treated with 10,600 nm FPS. CONCLUSION: Even though the changes in skin varied according to different FPS wave-length, adverse outcomes, such as increased erythema and TEWL were entirely subdued within 3 months of treatment.
Assuntos
Humanos , Acne Vulgar , Erupções Acneiformes , Povo Asiático , Dióxido de Carbono , Cicatriz , Derme , Eritema , Proteínas de Choque Térmico , Metilmetacrilatos , Poliestirenos , Simplexvirus , Pele , Perda Insensível de ÁguaRESUMO
Fibroelastolytic papulosis of the neck (FEPN) encompasses a spectrum of two disorders that were previously reported as pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) and white fibrous papulosis of the neck (WFPN). The clinical presentation of FEPN is asymptomatic to mildly pruritic whitish-yellow papules that may coalesce into cobblestone patterned plaques that resemble pseudoxanthoma elasticum (PXE). The histology is characterized by a decrease or loss of elastic fibers in the papillary dermis and this is sometimes accompanied by a minimal or nodular increase of dermal collagen fibers. We report here on a 28-year-old Korean man with asymptomatic, multiple, skin-colored to slightly yellowish, match-head sized, cobblestone-patterned papules on the neck, and these were histologically consistent with FEPN and the papules showed slightly increased dermal collagen associated with decreased and fragmented elastic fibers, elastin and tropoelastin. The pathogenesis of FEPN in this case might have been related with mild dermal inflammation, followed by fragmentation, elastolysis and increased dermal collagen.
Assuntos
Adulto , Humanos , Colágeno , Derme , Tecido Elástico , Elastina , Inflamação , Pescoço , Pseudoxantoma Elástico , TropoelastinaRESUMO
Trichophyton(T.) rubrum is known to be the most common causative agent of tinea cruris, tinea corporis, and tinea pedis, and hygiene, nutritional status, and high temperature/humidity are known to play an important role in pathogenesis. Although there has been a report on a case of co-infection in which tinea pedis subsequently developing tinea cruris with the foot lesion being a reservoir of the later lesion, there is of yet no report which confirmed co-infection of two different lesions through identification of definite causative organisms. This case concerns a 32 year-old patient who presented with erythematous annular scaly patches on the groin and axilla. Although no organism was identified on mycosel culture, DNA base sequence and RFLP analysis of the scales revealed T. rubrum in both of the lesions. Considering that this is a rare case of tinea cruris accompanied by tinea corporis in the axilla and groin confirmed by molecular biological techniques, the authors present it with review of literature.
Assuntos
Humanos , Axila , Sequência de Bases , Coinfecção , DNA , Pé , Virilha , Higiene , Estado Nutricional , Polimorfismo de Fragmento de Restrição , Tinha , Tinha dos Pés , Pesos e MedidasRESUMO
Kerion Celsi is a highly inflammatory, suppurative fungal infection of the scalp caused by zoophilic or geophilic dermatophytes. We report a case of Kerion Celsi caused by Trichophyton verrucosum in a 19-year-old female presenting with an indurated, pus-discharging, erythematous boggy mass on the frontal scalp for 2 weeks. Restriction fragment length polymorphism shows 100% concordance with Trichophyton verrucosum, which we had maintained as our standard strain. Systemic treatment with steroid and antifungal agents was administered.