BACKGROUND: Striae distensae are atrophic dermal scars with overlying epidermal atrophy causing significant cosmetic concern. Although a variety of laser and light sources have been used for the treatment of striae distensae, to date no definite 'gold standard' treatment modality has been determined. OBJECTIVE: To assess and compare the efficacy and safety of nonablative fractional photothermolysis and ablative CO2 fractional laser resurfacing in the treatment of striae distensae. METHODS: Twenty-four ethnic South Korean patients with varying degrees of atrophic striae alba in the abdomen were enrolled in a randomized blind split study. The patients were treated with 1,550 nm fractional Er:Glass laser and ablative fractional CO2 laser resurfacing. Each half of the abdominal lesion was randomly selected and treated three times at intervals of 4-weeks using the same parameters. Digital photography was conducted and skin elasticity and the width of the widest striae in each subject were measured at the baseline and 4 weeks after the final treatment. Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs by two blinded physicians and participant satisfaction rates were evaluated. Skin biopsies were taken from three participants. All adverse effects were reported during the study. RESULTS: Although they do not statistically differ, both treatments with nonablative fractional laser and ablative CO2 fractional laser showed a significant clinical and histopathologic improvement of striae distensae over pretreatment sites. CONCLUSION: These results support the use of nonablative fractional laser and ablative CO2 fractional laser as effective and safe treatment modalities for striae distensae of Asian skin. However, neither treatment showed any greater clinical improvement than the other treatment.
Abdomen ; Asian Continental Ancestry Group ; Atrophy ; Biopsy ; Cicatrix ; Cosmetics ; Elasticity ; Humans ; Lasers, Gas ; Light ; Photography ; Skin ; Striae Distensae

We report here on a 63-year-old woman who presented with recurrent bruise-like infiltrative plaques on the left leg without systemic symptoms or laboratory abnormalities. The histopathologic findings showed an infiltration of panniculus by small to medium-sized atypical lymphocytes. But the prominent lymphoid atypia, fat necrosis, vascular thrombosis, erythrophagocytosis and striking dominance of CD8+ lymphocytes seen in subcutaneous panniculitis-like T-cell lymphoma (SPTCL) were not detected. The diagnosis of atypical lymphocytic lobular panniculitis (ALLP) was made based on these histopathologic and clinical features. The lesions responded well to systemic steroid treatment. But the CD4/CD8 ratio in the later lesion was more decreased than that of the initial lesion, and the patient is under clinical follow up.
Fat Necrosis ; Female ; Follow-Up Studies ; Humans ; Leg ; Lymphocytes ; Lymphoma, T-Cell ; Middle Aged ; Panniculitis ; Strikes, Employee ; Thrombosis

BACKGROUND: Topical photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) was originally used for treating superficial skin tumors. The application of PDT to other inflammatory dermatoses like acne vulgaris, psoriasis, granuloma annulare, localized scleroderma and lichen sclerosus has recently been introduced. However, the underlying mechanisms are not well understood. We've previously reported the induction of tumor growth factor (TGF)-beta1 and interleukin (IL)-10 after PDT with ALA and intense pulsed light (IPL) in cultured HaCaT cells. OBJECTIVE: The purpose of this study was to investigate the expressions of TGF-beta1 and IL-10 in cultured fibroblasts after PDT with using ALA and IPL. METHODS: Cultured fibroblasts were treated with ALA-IPL PDT (1micromol/L of ALA; 0, 4, 8 and 12 J/cm2 of IPL). The expressions of TGF-beta1 and IL-10 were investigated by reverse transcription-polymerase chain reaction and enzyme linked immunosorbent assay. RESULTS: TGF-beta1 mRNA and protein were reduced down to 0.52- and 0.63-fold, respectively, after PDT and the IL-10 protein was increased up to 2.74-fold after PDT. CONCLUSION: The reduction of TGF-beta1 was prominent after PDT and so an antisclerotic effect can be expected after PDT. The induction of IL-10 may contribute to the anti-inflammatory effect, which explains the therapeutic benefit of PDT for inflammatory dermatoses.
Acne Vulgaris ; Aminolevulinic Acid ; Fibroblasts ; Granuloma Annulare ; Interleukin-10 ; Interleukins ; Lichen Sclerosus et Atrophicus ; Light ; Photochemotherapy ; Psoriasis ; RNA, Messenger ; Scleroderma, Localized ; Skin ; Skin Diseases ; Transforming Growth Factor beta1 ; Triazenes

Anterior cervical hypertrichosis (ACH) refers to a patch of hair that is presented at the lower anterior aspect of the neck just above the sternal notch along the cervical midline. The condition occurs as an isolated defect or in association with other abnormalities. Eighteen out of the 28 ACH patients who were previously reported on in the English literature showed a familial inheritance pattern. Some of the reported cases were associated with other clinical symptoms such as peripheral sensory and motor neuropathy, developmental delay, retinal change and bony abnormality. Herein, we report on a case of 2 sisters and 1 brother who had familial anterior cervical hypertrichosis without any other abnormality.
Cervix Uteri ; Hair ; Humans ; Hypertrichosis ; Inheritance Patterns ; Neck ; Pharynx ; Retinaldehyde ; Siblings

PURPOSE: The aim of the study was to compare the clinical characteristics in emergency endotracheal intubation procedures between non-elderly and elderly patients. METHODS: Data for airway registry, which were collected in two emergency departments (ED) between April 2006 and March 2010, were retrospectively reviewed. The airway registry data included patient's demographic information and variables such as Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, complications of intubation, and clinical outcomes after intubation. RESULTS: A total of 1,457 patients were enrolled. The mean age of the patients was 62.2+/-15.7 and 62.1%(n=905) were male. A total of 726(49.8%) patients were classified as being in the elderly intubation group(> or =65 years). Cormack-Lehane grade, 3-3-2 finger analysis, the relationship between the number of attempts and success rate, the relationship between Cormack-Lehane classification and success rate, complications, and clinical outcomes after intubation showed no significant difference between elderly and non-elderly groups. CONCLUSION: Anatomical structures related to endotracheal intubation, the process and clinical outcomes of elderly patients are not different than for non-elderly adult patients. However, considering the lower physiologic reservoir and higher comorbidities of elderly patients, a more vigorous approach to emergency airway management in the elderly is needed.
Adult ; Aged ; Airway Management ; Comorbidity ; Emergencies ; Emergency Treatment ; Fingers ; Humans ; Intubation ; Intubation, Intratracheal ; Male ; Retrospective Studies

Eccrine syringofibroadenoma (ESFA) is a rare, benign adnexal neoplasm of eccrine ductal differentiation. It shows variable clinical findings ranging from a solitary papule or nodule to multiple lesions withlinear or diffuse distribution. Typically, it occurs as a solitary nodule on the extremities of elderly people. Histopathologic findings usually show proliferation of anastomosing cords and strands of cuboidal epithelial cells embedded in fibrovascular stroma. We report an uncommon case of solitary eccrine syringofibroadenoma with plasma cell infiltration on the dorsum of the foot of a 53-year-old man.
Aged ; Epithelial Cells ; Extremities ; Foot ; Humans ; Middle Aged ; Plasma Cells

Eccrine syringofibroadenoma (ESFA) is a rare, benign adnexal neoplasm of eccrine ductal differentiation. It shows variable clinical findings ranging from a solitary papule or nodule to multiple lesions withlinear or diffuse distribution. Typically, it occurs as a solitary nodule on the extremities of elderly people. Histopathologic findings usually show proliferation of anastomosing cords and strands of cuboidal epithelial cells embedded in fibrovascular stroma. We report an uncommon case of solitary eccrine syringofibroadenoma with plasma cell infiltration on the dorsum of the foot of a 53-year-old man.
Aged ; Epithelial Cells ; Extremities ; Foot ; Humans ; Middle Aged ; Plasma Cells

Perivascular epithelioid cell tumors (PEComas) are a rare, recently described group of mesenchymal tumors, which is composed of distinctive perivascular epithelioid cells. Primary cutaneous PEComas are composed of focally nested or trabecularly arranged groups of epithelioid cells with clear to eosinophilic cytoplasm and round to oval nuclei with obvious nucleoli. Here, we describe the case of a 27-year-old Korean man who was presented with a solitary, cutaneous nodule on his left popliteal fossa. Physical examination revealed a solitary, 1.2x1.0 cm-sized erythematous protruding nodule on his left popliteal fossa. Immunohistochemical evaluation showed that the epithelioid tumor cells were positive for HMB-45 and desmin. These clinical and histological findings were consistent with a diagnosis of primary cutaneous PEComa.
Adult ; Cytoplasm ; Desmin ; Eosinophils ; Epithelioid Cells ; Humans ; Perivascular Epithelioid Cell Neoplasms ; Physical Examination ; Skin

PURPOSE: To evaluate whether the Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon could reflect the genomic information of breast cancers and to suggest intuitive imaging features as biomarkers. METHODS: Matched breast MRI data from The Cancer Imaging Archive and gene expression profile from The Cancer Genome Atlas of 70 invasive breast cancers were analyzed. Magnetic resonance images were reviewed according to the BI-RADS MRI lexicon of mass morphology. The cancers were divided into 2 groups of gene clustering by gene set enrichment an alysis. Clinicopathologic and imaging characteristics were compared between the 2 groups. RESULTS: The luminal subtype was predominant in the group 1 gene set and the triple-negative subtype was predominant in the group 2 gene set (55 of 56, 98.2% vs. 9 of 14, 64.3%). Internal enhancement descriptors were different between the 2 groups; heterogeneity was most frequent in group 1 (27 of 56, 48.2%) and rim enhancement was dominant in group 2 (10 of 14, 71.4%). In group 1, the gene sets related to mammary gland development were overexpressed whereas the gene sets related to mitotic cell division were overexpressed in group 2. CONCLUSION: We identified intuitive imaging features of breast MRI associated with distinct gene expression profiles using the standard imaging variables of BI-RADS. The internal enhancement pattern on MRI might reflect specific gene expression profiles of breast cancers, which can be recognized by visual distinction.

Purpose: To investigate the correlation between magnetic resonance (MR) image-based radiomics features and the genomic features of breast cancer by focusing on biomolecular intrinsic subtypes and gene expression profiles based on risk scores. Materials and Methods: We used the publicly available datasets from the Cancer Genome Atlas and the Cancer Imaging Archive to extract the radiomics features of 122 breast cancers on MR images. Furthermore, PAM50 intrinsic subtypes were classified and their risk scores were determined from gene expression profiles. The relationship between radiomics features and biomolecular characteristics was analyzed. A penalized generalized regression analysis was performed to build prediction models. Results: The PAM50 subtype demonstrated a statistically significant association with the maximum 2D diameter (p = 0.0189), degree of correlation (p = 0.0386), and inverse difference moment normalized (p = 0.0337). Among risk score systems, GGI and GENE70 shared 8 correlated radiomic features (p = 0.0008–0.0492) that were statistically significant. Although the maximum 2D diameter was most significantly correlated to both score systems (p = 0.0139, and p = 0.0008), the overall degree of correlation of the prediction models was weak with the highest correlation coefficient of GENE70 being 0.2171. Conclusion Maximum 2D diameter, degree of correlation, and inverse difference moment normalized demonstrated significant relationships with the PAM50 intrinsic subtypes along with gene expression profile-based risk scores such as GENE70, despite weak correlations.