BACKGROUND: Laser facial skin resurfacing has become a method of treatment for photoaging and pigmentary conditions. Although excellent results can be obtained by high-energy, pulsed carbon dioxide(CO2) laser, significant morbidity exists due to the considerable thermal damage to the skin. The Erbium: Yttrium Aluminum Garnet(Er: YAG) laser, with a wavelength of 2940 nm, is well absorbed in water. This leads to a very small zone of thermal necrosis, compared ta the CO2 laser. OBJECTIVE: The purpose of this study was to evaluate the results of the combined use of the char-free CO2 laser and the Er: YAG laser in the treatment of facial wrinkles. METHODS: Forty-six patients, aged between 30 and 68 years, with facial wrinkles, were evaulated. Two types of resurfacing laser systems were utilized in this study, a high-energy, short-pulsed CO2 laser and a Er: YAG 1aser. Wrinkle improvement was evaulated by the patients satisfaction, clinical improvement, and photographic analysis before and after the resurfacing procedure. RESULTS: Twenty-six of the 46 patients had greater than an 80% improvement, and 19 patients had a 60-80% improvement. Only one patient showed a 50% or less improvement. CONCLUSIONS: The combination of char-free CO2 laser and Er: YAG laser for facial wrinkles is a safe and effective modality for laser skin resurfacing.
Aluminum ; Carbon Dioxide* ; Carbon* ; Erbium* ; Humans ; Lasers, Gas* ; Lasers, Solid-State* ; Necrosis ; Skin ; Water ; Yttrium

Letterer-Siwe disease in an acutely onset, progressive and fatal disorder of RES, usually appears in male children, chareacterized by constitutional signs and extraos-seous lesions. This case occurred in a 18-day-old female showing hepatomegaly, hemorrhagic crusted papular eruptions on the entire body, and abdominal distension. Direct smear of scraping materials from the skin lesion showed numerous histiocytes. Hematologic and other laboratory examinatons showed no abonormalities.
Child ; Female ; Hepatomegaly ; Histiocytes ; Histiocytosis, Langerhans-Cell ; Humans ; Male ; Skin

This statistical analysis was made out of 2,259 clinical cases (9. 9%) of akin disorders in the aged group over 50 years of age, among from the total 22,931 cases of outpatients, from 1974 to 1978, at Department of Dermatology, Sung-Sim HospitaI. Sex difference of the patients-male, 1, 057 (46. 8%), female, 1, 202 (53. 2%)-was found statistically significant. (countinued...)
Dermatology ; Female ; Humans ; Outpatients ; Sex Characteristics ; Skin*

BACKGROUND: Topical calcineurin inhibitors (TCIs) have been successfully used to treat seborrheic dermatitis (SD) patients. Meanwhile, treatment of atopic dermatitis (AD) with low-dose, intermittent TCI has been proved to reduce disease flare-ups. This regimen is known as a maintenance treatment. OBJECTIVE: The aim of this trial was to investigate the efficacy and tolerability of a maintenance treatment with tacrolimus ointment in patients with facial SD. METHODS: During the initial stabilization period, patients with facial SD or AD applied 0.1% tacrolimus ointment twice daily for up to 4 weeks. Clinical measurements were evaluated on either in the whole face or on separate facial regions. When an investigator global assessment score 1 was achieved, the patient applied tacrolimus twice weekly for 20 weeks. We also compared our results with recent published data of placebo controlled study to allow an estimation of the placebo effect. RESULTS: The time to the first relapse during phase II was similar in both groups otherwise significantly longer than the placebo group. The recurrence-free curves of two groups were not significantly different from each other; otherwise the curve of the placebo group was significantly different. There were no significant differences between the 2 groups in the number of DEs, and treatment days for disease exacerbations (DEs). The adverse event profile was also similar between the 2 groups. During the 20 weeks of treatment, the study population tolerated tacrolimus ointment well. CONCLUSION: The results of this study suggest that maintenance treatment with tacrolimus may be effective in preventing the occurrence of facial SD exacerbations.
Calcineurin ; Dermatitis, Atopic ; Dermatitis, Seborrheic* ; Humans ; Placebo Effect ; Recurrence ; Research Personnel ; Tacrolimus*

BACKGROUND: Topical calcineurin inhibitors (TCIs) have been successfully used to treat seborrheic dermatitis (SD) patients. Meanwhile, treatment of atopic dermatitis (AD) with low-dose, intermittent TCI has been proved to reduce disease flare-ups. This regimen is known as a maintenance treatment. OBJECTIVE: The aim of this trial was to investigate the efficacy and tolerability of a maintenance treatment with tacrolimus ointment in patients with facial SD. METHODS: During the initial stabilization period, patients with facial SD or AD applied 0.1% tacrolimus ointment twice daily for up to 4 weeks. Clinical measurements were evaluated on either in the whole face or on separate facial regions. When an investigator global assessment score 1 was achieved, the patient applied tacrolimus twice weekly for 20 weeks. We also compared our results with recent published data of placebo controlled study to allow an estimation of the placebo effect. RESULTS: The time to the first relapse during phase II was similar in both groups otherwise significantly longer than the placebo group. The recurrence-free curves of two groups were not significantly different from each other; otherwise the curve of the placebo group was significantly different. There were no significant differences between the 2 groups in the number of DEs, and treatment days for disease exacerbations (DEs). The adverse event profile was also similar between the 2 groups. During the 20 weeks of treatment, the study population tolerated tacrolimus ointment well. CONCLUSION: The results of this study suggest that maintenance treatment with tacrolimus may be effective in preventing the occurrence of facial SD exacerbations.
Calcineurin ; Dermatitis, Atopic ; Dermatitis, Seborrheic* ; Humans ; Placebo Effect ; Recurrence ; Research Personnel ; Tacrolimus*

Purpose: Effectiveness and safety of clofarabine (one of the treatment mainstays in pediatric patients with relapsed/refractory acute lymphoblastic leukemia [ALL]) was assessed in Korean pediatric patients with ALL to facilitate conditional coverage with evidence development. Materials and Methods: In this multicenter, prospective, observational study, patients receiving clofarabine as mono/combination therapy were followed up every 4-6 weeks for 6 months or until hematopoietic stem cell transplantation (HSCT). Response rates, survival outcomes, and adverse events were assessed. Results: Sixty patients (2-26 years old; 65% B-cell ALL, received prior ≥ 2 regimen, 68.3% refractory to previous regimen) were enrolled and treated with at least one dose of clofarabine; of whom 26 (43.3%) completed 6 months of follow-up after the last dose of clofarabine. Fifty-eight patients (96.7%) received clofarabine combination therapy. Overall remission rate (complete remission [CR] or CR without platelet recovery [CRp]) was 45.0% (27/60; 95% confidence interval [CI], 32.4 to 57.6) and the overall response rate (CR, CRp, or partial remission [PR]) was 46.7% (28/60; 95% CI, 34.0 to 59.3), with 11 (18.3%), 16 (26.7%), and one (1.7%) patients achieving CR, CRp, and PR, respectively. The median time to remission was 5.1 weeks (95% CI, 4.7 to 6.1). Median duration of remission was 16.6 weeks (range, 2.0 to 167.6 weeks). Sixteen patients (26.7%) proceeded to HSCT. There were 24 deaths; 14 due to treatment-emergent adverse events. Conclusion Remission with clofarabine was observed in approximately half of the study patients who had overall expected safety profile; however, there was no favorable long-term survival outcome in this study.