Background: Laser toning using a low-fluence 1,064 nm Q-switched Nd:YAG laser is one of the most frequently used treatment modalities for melasma. However, this therapy is time consuming because it requires a lot of treatment sessions. Recently, it has been reported that transdermal radiofrequency (RF) is effective for the treatment of melasma. Objective: To determine whether microneedle RF conduction could be an adjunct therapy for melasma, we have studied the effect of simultaneous treatments with laser toning and RF for melasma. Methods: Fifteen patients with melasma underwent five sessions of laser toning and microneedle RF on the right side of the face, and only laser toning on the left side. Responses to treatments were evaluated using the Mexameter Ⓡ (Courage Khazaka, Germany) score, the pigmentation and severity index (PSI) score, and the patient's overall assessment. Additionally, an electron microscopic study of a skin biopsy was performed. Results: Both laser toning and combination therapy showed significant decreases in the Mexameter Ⓡ and PSI score after five treatment sessions. Combination therapy showed a more significant improvement of melasma than laser toning. No remarkable side effects were reported. Electron microscopic analysis showed a greater number of vacuolar changes and increased loosening of melanocytes and adjacent epidermal cells after combination therapy. Conclusion: The combination treatment of laser toning and microneedle RF therapy showed a better therapeutic effect for melasma than laser toning alone. Therefore, the microneedle RF technique could be a new and safe adjunct therapy for the treatment of melasma. (Ann Dermatol 31(2) 133∼138, 2019

The occurrence of malignant tumor in proximity to an arthroplasty prosthesis has been a matter of debate since it was first reported in 1978. Upon considering the number of orthopedic implants used, the occurrence of malignancy is rare. Especially in case of angiosarcoma, only a few cases have been reported worldwide. In this case, we report an extremely rare case of angiosarcoma arising at the site of a revision total hip arthroplasty. A 69-year-old female had received total hip replacement on her left hip due to osteoarthritis 8 months ago. Four months later, she complained pain on her operated area, X-ray showed loosening of implanted cup on her left hip. Thereafter, erythematous and purpuric papules and nodules were developed and spread around on her left hip. Through the skin biopsy she was diagnosed with angiosarcoma, and then she died of a sharp deterioration. Herein, we report a rare case of angiosarcoma occurred after total hip replacement with a review of the literature.

Background and Objectives Although multiphoton microscopy (MPM) can visualize both cell and extracellular matrix (ECM) structures of the skin in high‐contrast without exogenous labeling, label‐free MPM is usually too slow to image clinically relevant large regions. A high‐speed MPM method would be beneficial for evaluating clinical skin specimens by increasing the imaging area. In this study, moxifloxacin labeling‐based MPM (moxifloxacin MPM) was characterized in various human skin cancer specimens. Study Design/Materials and Methods Moxifloxacin ophthalmic solution was used for cell‐labeling and MPM imaging was conducted afterwards. Moxifloxacin MPM was characterized in ex vivo normal human skin and skin cancer specimens in comparison with the label‐free MPM and fluorescence confocal microscopy (FCM) using acridine orange as a labeling agent. Then, moxifloxacin MPM was applied to various ex vivo human skin cancer specimens including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dermatofibrosarcoma protuberans (DFSP). Results of moxifloxacin MPM were compared with bright‐field clinical and histopathologic findings. Results Moxifloxacin MPM imaged both cells and collagen in the skin, similarly to label‐free MPM, but with enhanced fluorescence intensities in cells and enhanced imaging speeds. Moxifloxacin MPM imaged cells in the skin similarly to acridine orange‐based FCM. Moxifloxacin MPM of various human skin cancer specimens imaged their specific cellular features. The microscopic features detected in moxifloxacin MPM were confirmed with histological images. Conclusions This observational pilot study demonstrated that moxifloxacin MPM could detect specific cellular features of various skin cancers in good correlation with histopathological images in Asian patients at the higher imaging speed than label‐free MPM. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

No abstract