P102 Changes of lesional and non-lesional skin microbiome with the treatment course of atopic dermatitis

( Ji Young Choi ),( Sunyoung Kwon ),( Jung-won Shin ),( Chang-hun Huh ),( Kyoung-chan Park ),( Mi-hee Du ),( Sungrho Yoon ),( Jung-im Na ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Development of high-throughput sequencing has enabled to identify drastic changes of skin microbiota communities with AD flare. However, the changes in skin microbiome in the course of treatment are not completely characterized. Objectives: The aim of this study is to observe the change of skin surface microbiota of AD patients along with the treatment course. We also examined the effect of narrow band UVB phototherapy to see the influence of UV exposure. Methods: Eighteen enrolled patients were divided into two groups based on treatment methods, narrow band UVB phototherapy and topical corticosteroid (NBUVB+TCS group) and topical corticosteroid only (TCS group). Skin swab and high-throughput sequencing of 16S ribosomal RNS bacterial gene were performed when subjects visited before, after 6 weeks of treatment and 3 weeks after discontinuation of treatment. Results: Eleven subjects completed the study. Microbial diversity of lesional skin greatly increased after treatment. Proportion of S. aureus showed a significant positive correlation with eczema severity. Even though NBUVB treated patients didn’t exhibit additive effects in eczema improvement, they experienced continuous improvement after discontinuation of treatment. Conclusion: With eczema treatment, a drastic increase of microbial diversity and decrease of S. aureus composition was observed. NBUVB treatment failed to exhibit additive effects in eczema improvement, however it seemed to decrease eczema recurrence.

Differential Expression of TGF-β Isoforms in Human Kerationocytes by Narrow Band UVB

( Moon Chul Jung ),( Min Kyung Shin ),( Kyung Kook Hong ),( Ki Heon Jeong ),( Nack In Kim ) 대한피부과학회 2008 Annals of Dermatology Vol.20 No.3

Background: Transforming growth factor-β (TGF-β), a multifunctional growth factor, has three isoforms: TGF-β1, TGF-β2, and TGF-β3. Different isoforms of TGF-β are associated with different proliferation and differentiation states of the epidermis. Narrow band ultraviolet B (NBUVB) emits a concentrated UVB source of 311 nm. NBUVB 1,000 mJ/cm2 induces apoptosis in approximately 50% of keratinocytes. Objective: The purpose of this study was to evaluate whether irradiation with NBUVB would alter the expression and production of TGF-β1, 2, and 3. Methods: We measured TGF-β1, 2, and 3 mRNA and TGF-β1 and 2 protein levels at 800, 1,000, and 1,200 mJ/cm2 for 24 hours and 48 hours. Results: TGF-β1 mRNA levels were increased at both 24 hr and 48 hr, TGF-β2 mRNA levels were decreased at both 24 hr and 48 hr, and TGF-β3 mRNA levels were increased at 24 hr and similar to control at 48 hr. TGF-β1 protein levels were increased at 48 hr but decreased at 24 hr. TGF-β2 protein levels were decreased at both 24 hr and 48 hr. Conclusion: The results suggest a possible role for TGF-β1 after NBUVB irradiation and opposing roles for TGF-β1 and TGF-β2 isoforms in NBUVB irradiation. (Ann Dermatol(Seoul) 20(3) 113~119, 2008)

Successful treatment of hyperpigmented mycosis fungoides with narrowband ultraviolet B photothrapy

( Ji Yun Jang ),( Seol Hwa Seong ),( Myeong Hyeon Yang ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Hyperpigmented mycosis fungoides (HMF) is a rare variant of mycosis fungoides (MF). Clinically it is characterized by hyperpigmented patches and plaques without evidence of regression of pre-existing lesions and poikilodermatous changes such as epidermal atrophy and telangiectasia. Histopathologic findings of HMF show marked interface change, dermal melanophages, and melanin incontinence superimposed on features of classical MF. Narrowband ultraviolet B (NBUVB) is safe and effective treatment for early MF presenting as macules or patches. The therapeutic effect of NBUVB is related to T-cell apoptosis, suppression of intercellular adhesion molecule-1, and depletion or functional modulation of Langerhans cells. A 73-year-old female patient presented with multiple hyperpigmented patches and macules on the face and neck. Histopathologic findings showed atypical lymphocytic infiltrates in epidermis and upper dermis with interface changes. In addition, melanin incontinence and melanophages were observed in the upper dermis. In immunohistochemical staining, atypical lymphocytes were positive for CD4 and CD8. On the basis of these clinical, histopathologic, and immunohistochemical findings, the diagnosis of HMF was made. The patient was treated with NBUVB phototherapy 3 times a week. A significant improvement in skin lesions was achieved after 64th NBUVB phototherapy. Herein, we report a case of HMF successfully treated with NBUVB phototherapy.

Comparative Study of the Gross Interpretation of Photo-testing and Objective Measurement with Using a Spectrophotometer for Patients with Psoriasis and Vitiligo Treated with Narrow-band UVB

( Kyu Won Choi ),( Ki Ho Kim ),( Young Hun Kim ) 대한피부과학회 2009 Annals of Dermatology Vol.21 No.2

Background: Determination of the minimal erythema dose (MED) is important for developing a phototherapy protocol and to diagnosis photosensitivity disorders. But obtaining a precise and reproducible MED is quite difficult because a phototest for erythema is based on subjective assessment. Objective: The objective of our study was to compare the gross interpretation of a phototest and the objective measurement using a spectrophotometer for determining the parameters of cutaneous narrow-band UVB (NBUVB) therapy. Methods: A total of 14 psoriasis and 10 vitiligo patients who receiving NBUVB phototherapy with skin types III and IV were selected for this study. To perform phototesting, ten sites on the skin of the back were vertically exposed to a series of 10 NBUVB doses among 14 doses between 340 and 1,400 mJ/cm2. We interpreted the gross findings of erythema and measured the L*a*b* values with using a spectrophotometer at each phototest spot and at the control skin. Also, we evaluate the relationship between the gross presentation and the spectrophotometric analysis by delta E for the assessment of the minimal perceptible erythema (MPE) and MED. Results: For all the subjects, the MEDs were measured in the 490~1,000 mJ/cm2 range. The average of the colorimetric values for the control skin were L*:64.8, a*:7.9 and b*:19.8. Among them, the L* value and MED value were shown to be inversely correlated, and as the L* value was decreased, the MED was increased. For the MPE, the delta E, which was the color difference of the normal skin and the phototest area, was within the range of 1.5~3.0 in 17 of the 21 patients, and 4 patients were within the range of 1.0~1.5. For the MED, among the 21 patients, the delta E of 17 patients was within the range of 3.0~6.0, and 4 patients were within the range of 6.0~12.0. Conclusion: A spectrophotometer enables UV erythema to be assessed objectively and quantitatively, and this can compensate for the disadvantages of subjective gross interpretation when determining the MED. Delta E is a good novel and objective indicator for determining the MPE and MED. So, a spectrophotometer is a very useful instrument for developing a phototherapy protocol for psoriasis and other dermatoses and for making the diagnosis of photosensitivity disorders. (Ann Dermatol 21(2) 136~141, 2009)

단파장 자외선B 치료로 호전된 선상 경피증

안석용 ( Seok Yong Ahn ),박화영 ( Hwa Young Park ),이원수 ( Won Soo Lee ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.4

Morphea is a sclerotic connective tissue disorder and it is thought to be caused by the decreased activity of collagenase. Various therapeutic modalitiessuch as topical steroid and systemic steroid, antimalarial agents, cyclosporine and phototherapy have been shown to be effective to treat this illness. Recently, PUVA and UVA1 phototherapy for localized scleroderma have been shown to have excellent efficacy. But PUVA and UVA1 phototherapy also have some disadvantages. So another phototherapy modality is warranted. Herein we report on a case of a 7 year female patient with linear scleroderma and she obtained a successful result with NBUVB phototherapy. (Korean J Dermatol 2009;47(4):494~497)

Combination treatment of 10,600 nm ablative carbon dioxide fractional Laser and narrow band UVB in refractory non-segmental vitiligo: A prospective, randomized half-split body comparative study

( Jae Yong Shin ),( Jung Soo Lee ),( Sang Ho Oh ) 대한피부과학회 2011 초록집 Vol.49 No.20

Is vitiligo lesion a sacrosanct area for DSAP?

( In Hye Kang ),( Hye Jin Ahn ),( Eun Jae Shin ),( Min Jae Gwak ),( Ki Heon Jeong ),( Mu Hyoung Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Disseminated superficial actinic porokeratosis (DSAP) is distinguishable among the porokeratosis by large numbers of lesions on sun-exposed skin. The tendency to develop DSAP is inherited as an autosomal dominant characteristic. However, a certain amount of accumulated sun exposure and other factors such as immunosuppression, hepatitis, and rarely phototherapy can enhance this tendency. A 52-year-old Korean woman had had vitiligo on her forehead, anterior chest, and abdomen for 5 years. The patient was treated with topical application of corticosteroids, tacrolimus, and NB-UVB phototherapy for vitiligo. Several asymptomatic annular brown colored macules with thread-like borders were identified on her wholebody after 7 months of irradiation. Interestingly, none of the lesions appeared in the areas affected by vitiligo, even though over 100 lesions had developed on the whole body. A biopsy specimen disclosed the characteristic cornoid lamella, as well as irregularly arranged keratinocytes in the spinous layer underneath, and absence of the granular layer. Finally, the patient was diagnosed with DSAP based on her clinical manifestations and histology. Although these lesions are uncommon and the pathogenesis induced by NB-UVB is unclear, clinicians should be alert for their possible development in patients receiving NB-UVB. Further studies are needed to investigate the exact role of vitiligo in DSAP pathogenesis.