[Show abstract][Hide abstract] ABSTRACT: The rapid development of information and communication technology has replaced traditional books by electronic versions. Most print dermatology journals have been replaced with electronic journals (e-journals), which are readily used by clinicians and medical students.
The objectives of this study were to determine whether e-readers are appropriate for reading dermatology journals, to conduct an attitude study of both medical personnel and students, and to find a way of improving e-book use in the field of dermatology.
All articles in the Korean Journal of Dermatology published from January 2010 to December 2010 were utilized in this study. Dermatology house officers, student trainees in their fourth year of medical school, and interns at Korea University Medical Center participated in the study. After reading the articles with Kindle 2, their impressions and evaluations were recorded using a questionnaire with a 5-point Likert scale.
The results demonstrated that gray-scale e-readers might not be suitable for reading dermatology journals, especially for case reports compared to the original articles. Only three of the thirty-one respondents preferred e-readers to printed papers. The most common suggestions from respondents to encourage usage of e-books in the field of dermatology were the introduction of a color display, followed by the use of a touch screen system, a cheaper price, and ready-to-print capabilities.
In conclusion, our study demonstrated that current e-readers might not be suitable for reading dermatology journals. However, they may be utilized in selected situations according to the type and topic of the papers.
Annals of Dermatology 12/2014; 26(6):700-705. · 0.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Background: Aggravated melasma after treatment is vulnerable to stimulation, can easily deteriorate, and may be distressing without proper management. Objective: To retrospectively assess the effectiveness and safety of combination therapy using low-fluence Q-switched Nd:YAG laser (QSNY) and long-pulse Nd:YAG laser (LPNY) (dual toning) in patients with rebound melasma. Materials and Methods: A total of 30 patients with aggravated melasma after previous therapy who were treated with dual toning were enrolled. A total of 10 sessions were conducted at 1-week intervals, followed by maintenance treatment. The results were evaluated using the modified Melasma Area and Severity Index (mMASI) and the physician's global assessment (PGA) before and 2 months after completing the 10 treatment sessions. Results: The baseline mMASI was 10.48 ± 3.64, which significantly decreased to 3.22 ± 1.45 2 months after completing the 10 treatment sessions (p < 0.001). Twenty-four patients (80%) had PGA grade 4 (76-100% improvement) and 6 patients (20%) had PGA grade 3 (51-75% improvement). Conclusion: Dual toning may be a safe and effective salvage treatment for patients with aggravated melasma after previous treatment. LPNY may stabilize melasma activity to prevent rebound hyperpigmentation via dermal remodeling.
Journal of Cosmetic and Laser Therapy 11/2014; · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Background:Despite the effectiveness of low-fluence Q-switched Nd:YAG laser (QSNY) treatment in melasma, adverse events, including mottled hypopigmentation (MH) and rebound hyperpigmentation (RH) have been reported. Objective: To compare the effectiveness and safety of combination therapy using low-fluence QSNY and long-pulse Nd:YAG laser (LPNY) (Dual toning) with low-fluence QSNY monotherapy (QS toning) in Asian melasma patients. Materials and Methods: Patients were treated for 10 sessions at 1-week intervals with QSNY (6 mm spot); 2.5-3.0 J/cm2 for QS toning (n=177) or 2.1- 2.5 J/cm2 for dual toning (n=183). The dual toning group was immediately treated with LPNY (7 mm spot, 15-17 J/cm2). The results were evaluated using the modified Melasma Area and Severity Index (mMASI) score and the physician's global assessment. Results: MH or RH were significantly lower (1.1% vs. 14.1%) and the treatment efficacy was improved (median decrease of mMASI, 3.6 vs. 3.0) in dual toning group compared with QS toning group. Periorbital melasma showed distinctively high rates of adverse events in QS toning group (23.9% vs. 5.7%), which were significantly reduced in dual toning group (2.9%). Conclusion: Dual toning could represent a safe and effective treatment for Asian melasma patients, as it is associated with minimal adverse events and improved treatment efficacy compared with QS toning monotherapy.
Journal of Cosmetic and Laser Therapy 08/2014; · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Most studies about the structures of the human skin have been on the general histologic features of the skin. The purpose of this study was to understand the relationship between the microrelief (MR) pattern and histologic structure of the human skin, and to find the usefulness of the three-dimensional reconstruction (3DR) technique of pathological skin tissue.
Human skin specimens were obtained from the medial forearm, abdomen, and volar aspects of the finger tips of cadavers. Two-dimensional surface-viewed images of the skin showing MR patterns were obtained using dry dermoscopy. Histologic structures of the skin were evaluated by 3D images obtained using the 3DR technique.
MR was deeper and wider in the abdomen than in the medial side of the forearm. In the medial side of the forearm, 10.27 rete ridges were distributed in a plateau, on average. In the abdomen, about 14.37 rete ridges were distributed in a plateau. From 3DR technique, MR pattern thought to be a superordinate concept to rete ridges.
The 3DR technique was useful and may allow a better understanding of the pathogenetic changes in the skin surface in aging skin.
Skin Research and Technology 08/2013; · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Background: Non-ablative fractional photothermolysis has been reported to show early promise in the treatment of hypertrophic scars, but there are few reports on ablative fractional photothermolysis for the treatment of hypertrophic scars. Aim: To evaluate and compare the efficacy and safety of Er:YAG fractional laser(EYFL) and CO2 fractional laser(CO2FL) for treatment of hypertrophic scars Methods: Thirteen patients with hypertrophic scars were treated with 2,940 nm EYFL and ten were treated with 10,600 nm CO2FL. An independent physician evaluator assessed the treatment outcomes using Vancouver scar scale (VSS) and 5-point grading scale (grade 0, no improvement; grade 1, 1-25%; grade 2, 26-50%; grade 3, 51-75%; grade 4, 76-100% improvement). Patients are queried about their subjective satisfaction with the treatment outcomes. Results: After the final treatment, average % changes of VSS were 28.2% for EYFL and 49.8% for CO2FL. Improvement was evident in terms of pliability, while insignificant in terms of vascularity and pigmentation. Based on physician's global assessment, mean grade of 1.8 for EYFL and 2.7 for CO2FL was achieved. Patient's subjective satisfaction scores paralleled the physician's objective evaluation. Conclusion: CO2FL is a potentially effective and safe modality for the treatment of hypertrophic scars, particularly in terms of pliability.
Journal of Dermatological Treatment 04/2013; · 1.76 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The platelet-rich plasma (PRP) has been advocated as a way to introduce increased concentrations of growth factors and other bioactive molecules to injured tissues in an attempt to optimize the local healing environment. A 94-yr-old woman with various comorbidities presented with a two-week history of severe cutaneous ulcer on the left dorsum of foot. It was caused by recurrent mechanical trauma and did not respond to several wound debridement and simple dressings. However, after she was completed on seven times of autologous PRP treatments, we observed complete healing of the skin lesion within 3 months. Herein, we report a case of recalcitrant cutaneous ulcer with various comorbidities and discuss about the promising possibility of autologous PRP as an effective alternative therapeutic modality.
Journal of Korean medical science 12/2012; 27(12):1604-6. · 0.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Phacomatosis pigmentokeratotica (PPK) is a rare syndrome defined by the association of an organoid nevus occasionally with sebaceous differentiation, a speckled lentiginous nevus, and other extracutaneous anomalies. A preterm male infant of only 830 g at 27 week gestational age had an organoid nevus showing sebaceous differentiation. Also, he had multiple speckled-lentiginous nevus. Correlating the observed clinical presentation with the histopathological findings, the diagnosis of PPK was established. There have been less than 10 cases of PPK without extracutaneous manifestation. We present an uncommon case of a preterm patient with PPK who had no extracutaneous abnormalities.
Journal of Korean medical science 11/2012; 27(11):1444-6. · 0.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: AIM: Aneurysmal fibrous histiocytoma (AFH) is a variant of fibrous histiocytoma, which has a cleft-like cavernous blood-filled space in the tumor. It appears as a single reddish black tumor with variable levels of pain and size from its bleeding. And, it must be differentiated from other similar looking malignant conditions such as malignant melanoma. The visual mimicry of AFH to melanoma was raised by some careful dermatologists, but never be confirmed objectively by colorimetric analysis. MATERIALS, SUBJECTS, AND METHODS: In this study, we simply analyzed conventionally photographed digital images of thirty-seven cases of fibrous histiocytomas, including three AFH cases into colorimetrically useful color space, CIELAB, of which coordinates are L*, a*, and b* representing lightness, red to green, and yellow to blue axis, respectively. In addition, we also analyzed the clinical digital images of seven cases of malignant melanomas. Using statistical package, each coordinates of CIELAB were compared using Wilcoxon rank sum test between AFH and melanomas. The CIELAB coordinates of AFH and non-aneurysmal fibrous histiocytomas were compared statistically as well. RESULTS: Comparing with banal fibrous histiocytomas, the colors of AFH showed significantly smaller a* and b* coordinates (P = 0.008, 0.008, respectively), which implies more green and blue hue of AFH lesion. Rather, they were more like melanomas (P = 0.2839, 0.2040, respectively). As for L*, there were no significant differences for all comparisons. CONCLUSIONS: As a result, more objective analysis of the digital images using colorimetric color space confirmed the visual mimicry of AFH to melanoma.
Skin Research and Technology 09/2012; · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The distinction of a spitz nevus from a melanoma can be difficult and in some cases, impossible. A misdiagnosed spitz nevus can metastasize and lead to fatal outcomes, especially in children. A 5-yr-old girl presented with a 1-yr history of a solitary pinkish nodule on her left hand. On physical examination, she had a palpable left axillary lymph node. We performed biopsy and checked 3 sentinel lymph nodes (SLN) on her axillary area. The biopsy specimen showed multiple variably sized and shaped nests with large spindle or polygonal cells and SLN biopsy showed 3 of 3 lymph nodes that were metastasized. Under the diagnosis of spitzoid melanoma, she was treated with excision biopsy and complete left axillary lymph nodes were dissected. She received interferon-α2b subcutaneously at a dose of 8 MIU per day, 3 times weekly for 12 months, and shows no recurrence.
Journal of Korean medical science 04/2012; 27(4):454-7. · 0.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Syringocystadenoma papilliferum (SCAP) occurs singly or in association with other tumors. Although it is rare, the association of tubular apocrine adenoma (TAA) with SCAP in the background of nevus sebaceous (NS) on the scalp is well documented. However, the co-existence of these two tumors without background of NS has not been reported on the extremities. We report a case of SCAP associated with TAA on the calf without pre-existing NS in an adult.
Annals of Dermatology 10/2011; 23(Suppl 2):S175-8. · 0.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Giant basal cell carcinoma (BCC), defined as a lesion greater than 5 cm at its largest diameter, is a rare variant of BCC. In contrast to small BCC, giant BCC develops on skin that is not exposed to sunlight, including the back, shoulder, groin and thigh. Most of the histopathologic subtypes of giant BCC are micronodular, morpheaform and nodular, but the superficial subtype is rare. Giant superficial BCC arising on the scalp is extremely rare. We report the case of giant superficial BCC with four satellite lesions on the scalp in a 53-year-old male without predisposing factors.
[Show abstract][Hide abstract] ABSTRACT: Clinical guidelines suggest that suspicious pigmented lesions of the plantar or palmar area require biopsy for early detection of acral melanoma. We present here a case of acral lentiginous melanoma in which various melanocytic atypia was observed at each biopsy site, including focal melanocytic proliferation. We suggest that this atypical melanosis is part of a contiguous phase of invasive tumor growth, which is known as the very early stage of melanoma in situ. In addition, noninvasive dermoscopy has been effective for the early discovery of hidden lesions of acral melanoma.
Annals of Dermatology 08/2011; 23(3):400-4. · 0.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Several differences in basal cell carcinomas (BCCs) were found, according to the ethnic group; for example, pigmented BCCs was more common in Asian or Hispanic patients. However, there are few reports on the subclinical extension of the BCC in Asian patients.
The aim of this study was to evaluate the subclinical infiltration of the basal cell carcinoma in Asian patients.
All patients with BCC who visited the department of dermatology at Korea University Ansan Hospital were treated with Mohs micrographic surgery. In 81 patients, 83 tumors of BCC were completely eradicated by Mohs micrographic surgery (MMS) from April 2001 to August 2008, and were reviewed in this study. Information recorded included the total margin and the number of stages of Mohs micrographic surgery, anatomic location, tumor size, presence of pigmentation, clinical type, and pathological subtype. We divided the clinical types into nodular, ulcerated, and pigmented, and the pathological types into nodular, micronodular, morpheaform, and adenoid. The BCC was of pigmented type if pigmentation covered more than 25% of the tumor, regardless of whether pigmentation was distinct, or if there was apparent pigmentation that covered more than 10% of the tumor.
The nose and cheek were the most common sites requiring more than one stage of surgery. In tumors smaller than 1 cm, 91.7% required only one stage of excision, compared with 60.6% in tumors larger than 1 cm. More than two Mohs stages were required in 25% of non-ulcerated BCCs and in 46.2% of ulcerated BCCs. Sixty eight percent of pigmented BCCs required only one stage of Mohs micrographic surgery. In cases of non-pigmented BCCs, only 45% required one Mohs stage. More than one Mohs stage was required in 19.2% of non-aggressive BCCs and in 42.9% of aggressive BCCs.
Subclinical infiltration differed between the two groups according to the size of the BCC (1 cm threshold) and most of the BCCs were located in the head and neck area. Considering this result, indication for MMS can be extended for BCCs larger than 1 cm in Asian patients. Ulcerated BCCs required more Mohs stages than non-ulcerated BCCs. Pigmented BCCs might show lesser subclinical infiltration than non-pigmented BCCs. Aggressive pathological subtypes showed more subclinical infiltration than the non-aggressive types; however, after evaluation of the border that was excised with MMS, mixed histologic types were found to be more frequent than generally accepted. Therefore, we consider that, when planning surgery, dermatologists should not place too much confidence in the pathologic subtypes identified by biopsy.
Annals of Dermatology 08/2011; 23(3):276-81. · 0.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Obtaining consistent photomicrographic images of pathology slides is not always easy because of many different types and settings of the equipment such as the microscopes and digital cameras. In this study, we developed a photomicrography technique that could acquire consistent images of pathology slides. The neutral density (ND) filter was attached to a transparent glass slide as a reference slide, photographed using consistent settings, and acquired images that harbored all of the areas of gray, white, and black. In the same way, the slide was replaced by the actual pathology slide, and photomicrographed. To simulate different light environment, the above photographic session was repeated using two different light intensities and microscopes. A graphic program was used to adjust levels of the reference slide images and this leveling, or calibration, was saved as a file for each. This file for leveling process was applied to actual subsequent photomicrographic images. The same sites of noncalibrated and calibrated images of the pathology slide were calculated into CIELAB or CIE L*a*b* coordinates. Then, the color differences (ΔE*ab) were calculated. As results, in the study using a 50% transmittance ND filter, two original different images were made nearly identical to the unaided eye, especially in two-point (white and gray) and three-point (black, white, and gray) leveling. In comparison of different light intensities, the ΔE*ab of the selected area was 0.9 in two-point leveling. Between different microscopes, 10.7 of ΔE*ab was the smallest value in three-point leveling. This method would be helpful for acquiring consistent photomicrographic images of pathology slides.
Microscopy Research and Technique 05/2011; 74(5):397-400. · 1.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Digital photography can be used to measure skin color colorimetrically when combined with proper techniques. To better understand the settings of digital photography for the evaluation and measurement of skin colors, we used a tungsten lamp with filters and the custom white balance (WB) function of a digital camera.
All colored squares on a color chart were photographed with each original and filtered light, analyzed into CIELAB coordinates to produce the calibration method for each given light setting, and compared statistically with reference coordinates obtained using a reflectance spectrophotometer. They were summarized as to the typical color groups, such as skin colors. We compared these results according to the fixed vs. custom WB of a digital camera.
The accuracy of color measurement was improved when using light with a proper color temperature conversion filter. The skin colors from color charts could be measured more accurately using a fixed WB. In vivo measurement of skin color was easy and possible with our method and settings.
The color temperature conversion filter that produced daylight-like light from the tungsten lamp was the best choice when combined with fixed WB for the measurement of colors and acceptable photographs.
Skin Research and Technology 08/2010; 17(1):20-5. · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Quantitative and objective investigations of parallel-polarized light (PPL) photography for dermatologic purposes are scarce.
To determine the significance of quantitative analysis of PPL photography to develop objective measurement methods of skin surface characteristics.
For PPL photography, a digital camera, a light-emitting diode illuminator, and polarizing filters were arranged and kept constant. We analyzed the PPL photography images of the glabella, the medial aspect of the forearm, and the posterior aspect of the lower leg, and measured the CIELAB values. A dermatologist evaluated the clinical severity of the actual photographed sites with respect to glossiness and dryness. These clinical severities were compared statistically with the CIELAB values.
According to the correlation analysis, the L* value was negatively correlated with dryness (r=-0.29869, P=0.0047) and glossiness (r=-0.35367, P=0.0185).
The method used in this study is applicable to the quantitative evaluations of other dermatologic diseases or conditions, especially in relation to skin surface changes.
Skin Research and Technology 08/2010; 16(3):270-4. · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Heterotopia refers to the finding of normal tissue in foreign sites, entirely separate from the main organ. Heterotopic gastric mucosa has been observed throughout the alimentary tract, everywhere from the oral cavity to the rectum. However, occurrences in the umbilicus are an extremely rare and peculiar phenomena. We report the case of heterotopic gastric mucosa in the umbilicus.
Annals of Dermatology 05/2010; 22(2):223-5. · 0.95 Impact Factor