No abstract

Non-invasive selective cryolipolysis has been reported to be a safe and effective treatment modality for the reduction of excess adipose tissue. Therefore, cryolipolysis is a promising technology that could be an appropriate and safe therapeutic option for subcutaneous fat reduction.

Café-au-lait macules (CALMs) are light to dark brown macules or patches of increased melanin concentration found along the dermoepidermal junction. Although many attempts to treat CALMs using various kinds of laser/light-based devices have been reported, CALMs remain refractory thereto with high recurrence rates. In this case series, we describe four patients with idiopathic CALMs that were effectively and safely treated with a non-ablative, high-fluenced, Q-switched (QS), 1064-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser. The typical laser parameters for treating CALMs, including a spot size of 7-7.5 mm, a fluence of 2.4-2.5 J/cm, and one to two passes until the appearance of mild erythema, but not petechiae, were utilized in this study over 12-24 treatment sessions at 2-week intervals. We suggest that high-fluenced QS 1064-nm Nd:YAG laser treatment can be used as an effective and alternative treatment modality for CALMs with minimal risk of side effects.

Melasma is a very difficult pigmented disease to treat with high recurrence rate. Using low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QSNY) lasers repeatedly for the treatment of melasma is now a common practice in East Asia. However, one of the significant side effects is mottled hypopigmentation that appears as scattered white macules in the middle of melasma lesion. The pathophysiology of these hypopigmentation is yet unknown. The biopsy of the hypopigmented lesion showed decreased melanosome with intact melanocytes, and topical tretinoin may be the effective solution for these types of condition.

Micropunch grafting is the simplest surgical intervention for refractory vitiligo but is tedious and time-consuming. Therefore, we aimed to verify the efficacy and safety of dermal orientation grafting using motorized 0.5-mm micropunch grafting for vitiligo. In a preliminary animal study, 12-week-old rats were used to observe the healing process after the transplantation of dermal orientation grafts with various punch sizes. In a clinical trial, a total of 100 vitiligo patches in 50 patients with stable vitiligo were randomly allocated to motorized 0.5-mm micropunch grafting in epidermal and dermal orientations, respectively. The grafts were implanted at intervals of 5 mm at the recipient site. Treatment success was defined as greater than 75% repigmentation. In the animal study, all grafts were shown to be well integrated into the recipient site within 3 weeks. In the clinical trial, treatment success was achieved in 72% and 76% of the epidermal and dermal orientation groups, respectively; a cobblestone appearance was observed in 4% and 2%, respectively. In conclusion, we demonstrated that this new grafting method irrespective of epidermal-dermal orientation using motorized 0.5-mm micropunch grafting was effective and safe. We have named this the "skin seeding technique" and it differs from traditional punch grafting in that it can be performed regardless of the graft orientation.

Background and ObjectivesSkin laxity is a common complaint of patients who request a skin rejuvenation procedure. In this study, the clinical effectiveness of highintensity focused ultrasound (HIFU) for the treatment of facial laxity was evaluated. Materials and MethodsNineteen Korean women and one Korean man volunteers were enrolled and first treated with a 4.5-mm, 4-MHz HIFU probe, followed by a 3.0mm, 7-MHz HIFU probe. A split-face study was performed on one patient. Two blinded, experienced clinicians evaluated pre-treatment and post-treatment (3-months after) paired photographs. ResultsThe results revealed that 16 of the 17 subjects (94%) had clinical improvement post-treatment. In a split-face study, the treated site showed excellent improvement compared to the control site. There were no specific side effects noted. ConclusionIn conclusion, HIFU is a useful nonablative method for skin lifting in Asian patients.

Partial unilateral lentiginosis (PUL) is a pigmentation disorder characterized by multiple lentigines covering the normal skin with a unilateral, segmented pattern that stops at the midline. There has only been a few successful PUL treatments reported in the literature, and an ideal therapeutic method has not yet been identified. We report a case of facial PUL that was successfully treated with a 532-nm Q-switched neodymium-ser with subsequent low-fluence 1,064-nm QS Nd:YAG laser treatment. The patient did not experience recurrence until 3 years after the treatment. This appears to be a promising therapeutic approach for PUL. Additional research should be conducted for further assessment of this method.

Atrophic scars may arise from various causes, including herpes simplex virus (HSV) infection and burns. In treating atrophic scars, the application of individual treatments alone has proven to be ineffective. Meanwhile, however, combined treatment methods have been found to offer synergistic effects for better treatment results with minimal adverse reactions. In this report, we describe our experiences in treating two patients with atrophic scars: One with HSV-induced atrophic scars on the cheek, and the other with burn-induced atrophic and dyspigmented scars along the lower leg. Patients were effectively treated with combined treatment using a non-ablative 1,550-nm fractional erbium (Er):glass fiber laser and an ablative 2,940-nm fractional Er:yttrium aluminum garnet laser. We suggest that combined therapy with different kinds of fractional lasers may provide synergistic therapeutic effects in treating Asian patients with atrophic scars.