Dermal papilla cells (DPCs) are a rich source of nutrients and secrete multiple growth factors that can affect hair growth. As oxidative stress leads to hair loss in humans, it is considered to be one of the factors that can impair the function of DPCs. Herb-derived phytochemicals exhibit potent antioxidant activities; therefore, this study investigated whether a set of essential oils (lavender, lemongrass, rosemary, and chamomile oils) promote the hair-growth activity of DPCs. Intracellular reactive oxygen species (ROS) increased markedly in ultraviolet B-irradiated DPCs (50 mJ/cm2) and were efficiently blocked by essential oils. Essential oils upregulated the mRNA and protein levels of phase II enzymes (detoxifying and antioxidant), including heme oxygenase-1, NAD(P)H quinone oxidoreductase-1, and glutathione S-transferase pi. They also upregulated and activated nuclear factor E2-related factor 2, an essential transcription factor for phase II enzymes. Regarding biomarkers for hair growth, essential oils significantly increased vascular endothelial cell growth factor and insulin-like growth factor-1 mRNA levels. In conclusion, phytochemicals in essential oils enhance hair growth through ROS-scavenging activity in DPCs.

: A 12-year-old Korean female presented with a 1-month of tender group of reddish 1 to 3 mm sized dome-shaped papules on the left nipple (Fig. 1). She had no similar lesion on the other site and no family history of similar skin lesions. She had neither pigmented lesions in her skin or mucous membranes, nor any other known medical conditions. The lesion was totally excised and histopathologic examination showed well-circumscribed, non-encapsulated myxoid tumor (Fig. 2A), and stromal mucin was positive for Alcian blue staining (Fig. 2B). Tumor consisted of spindle and stellate cells as well as numerous thin-walled small vessels in the myxoid stroma (Fig. 2C). Immunohistological staining revealed tumor cells were positive for vimentin (Fig. 2D), and positive for α -smooth muscle actin ( α -SMA) (Fig. 2E). Endothelial cells of blood vessels were CD34 positive, but tumor cells were negative (Fig. 2F). The patient was diagnosed with superficial angiomyxoma (SAM) and there was no sign of recurrence after 12 months of follow-up. SAM is an

Department of Dermatology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Department of Dermatology, Pusan National University School of Medicine, Busan, Department of Dermatology, College of Medicine, Chosun University, Gwangju, Department of Dermatology, Gil Medical Center, Gachon University School of Medicine, Incheon, Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Department of Dermatology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Department of Dermatology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Department of Dermatology, National Medical Center, Seoul, Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Department of Dermatology, Chonnam National University Medical School, Gwangju, Department of Dermatology, Konkuk University School of Medicine, Seoul, Department of Dermatology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Department of Dermatology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, Department of Dermatology, The Catholic University of Korea, Incheon St. Mary’s Hospital, Incheon, Korea

Postmarketing surveillance is conducted to establish drug safety and effectiveness under real‐world practice. We aimed to validate the effectiveness and safety of ustekinumab in the treatment of adult Korean patients with plaque psoriasis under real‐world practice. This was a prospective, observational, and multi‐center study. Subjects aged 18 years or older who were treated with ustekinumab for plaque psoriasis were enrolled. We enrolled 977 patients; 654 (66.9%) were men, with mean body surface area (BSA, ± standard deviation) of 27.0 ± 18.3% and mean psoriasis area severity index (PASI) score of 18.1 ± 9.7. The effectiveness analysis was performed in 581 patients who had at least one follow‐up assessment and met treatment criteria per local label and reimbursement guidelines. Of these patients, 287 had effectiveness data for visit 6 at 53.7 ± 2.1 weeks. At visit 6, 91.6% (263/287), 51.2% (147/287), and 9.4% (27/287) patients achieved PASI 75, 90, and 100 responses, respectively. Adverse events (AEs) occurred in 112 of the 977 (11.5%) patients with an incidence rate of 21.5 per 100 patient‐years (PYs). Serious AEs occurred in eight (0.8%) patients with an incidence rate of 1.2 per 100 PYs. The estimated 1‐year drug survival rate was 87.7%. The multiple logistic regression analysis showed that higher baseline PASI score and no prior biologic exposure were significant predictors for PASI 90 response at visit 6. Ustekinumab was effective and safe, and displayed a high survival rate in the treatment of adult Korean patients with plaque psoriasis in real‐world practice.

Iontronic graphene tactile sensors (i-GTS) composed of a top floating graphene electrode and an ionic liquid droplet pinned on a bottom graphene grid, which can dramatically enhance the performance of capacitive-type tactile sensors, are presented. When mechanical stress is applied to the top floating electrode, the i-GTS operates in one of the following three regimes: air-air, air-electric double layer (EDL) transition, or EDL-EDL. Once the top electrode contacts the ionic liquid in the i-GTS, the spreading behavior of the ionic liquid causes a capacitance transition (from a few pF to over hundreds of pF). This is because EDLs are formed at the interfaces between the electrodes and the ionic liquid. In this case, the pressure sensitivity increases to approximate to 31.1 kPa(-1) with a gentle touch. Under prolonged application of pressure, the capacitance increases gradually, mainly due to the contact line expansion of the ionic liquid bridge pinned on the graphene grid. The sensors exhibit outstanding properties (response and relaxation times below 80 ms, and stability over 300 cycles) while demonstrating ultimate signal-to-noise ratios in the array tests. The contact-induced spreading behavior of the ionic liquid is the key for boosting the sensor performance.

Background: Methotrexate (MTX) has been prescribed to suppress atopic dermatitis (AD) symptoms and flares in moderate-to-severe cases. Objective: The purpose of this study was to evaluate the therapeutic efficacy and safety of MTX as well as the suppressive activity of MTX to reduce flares in moderate-to-severe AD patients. Methods: Patients with moderate-to-severe AD who were treated with MTX at the Chonnam National University Hospital were retrospectively studied. Results: Total 102 patients (79 males, 23 females) with a median age of 22.0 +/- 10.3 years were studied. The median initial dose of MTX was 10.3 +/- 2.6 mg/week, and the MTX-weekly dose was increased by 2.5 to 5 mg at an interval of 2 to 4 weeks to a maximum dose of 17.5 +/- 2.7 mg/week. The median maintenance dose was 11.7 +/- 2.1 mg/week; the median duration of treatment with MTX was 34.0 +/- 38.8 weeks. The initial response was noted after 5.8 +/- 3.7 weeks. Of the 102 patients, 60.8% (62/102) showed successful treatment response and 39.2% (40/102) showed mild or no improvement. MTX therapy effectively suppressed the frequency of AD flares by more than 50% in 71.1% (32/45) of the patients who responded among the MTX responders group. The most common adverse events were transient liver abnormality (5.9%, 6/102) and gastrointestinal discomfort (3.9%, 4/102), but no serious adverse events occurred. Conclusion: Our results reveal that MTX is a relatively safe drug to control moderate-to-severe AD with satisfactory therapeutic efficacy and inhibitory activity against AD flares.

The 52-week results from the CLEAR (NCT02074982) study showed high and superior efficacy of secukinumab versus ustekinumab in clearing skin and improving patient-reported outcomes, with comparable safety profile in subjects with moderate to severe psoriasis. Here, we analyzed the efficacy and safety of secukinumab in Asian subjects from the CLEAR study. In this double-blind, phase IIIb study, eligible subjects with moderate to severe plaque psoriasis were randomized (1:1) to receive s.c. injection of secukinumab 300 mg or ustekinumab as per label. Of 62 subjects included in Asian subanalyses, 23 were randomized to secukinumab and 39 to ustekinumab. A significantly higher proportion of subjects achieved 90% or more improvement in Psoriasis Area and Severity Index (PASI 90) with secukinumab versus ustekinumab at week 16 (78.3% vs 35.9%, P = 0.0010) and at week 52 (60.9% vs 33.3%, P = 0.0196). Similarly, a higher proportion of subjects achieved PASI 100 with secukinumab versus ustekinumab at week 16 (43.5% vs 10.3%, P = 0.0029) and at week 52 (30.4% vs 12.8%, P = 0.0704). The median time to achieve 50% improvement in baseline PASI was 2.8 weeks in the secukinumab group versus 6.3 weeks in the ustekinumab group. The safety profile of secukinumab was in line with the known profile and no deaths occurred. Overall, 95.7% and 84.6% of subjects remained on secukinumab and ustekinumab, respectively. Similar to the core study, secukinumab showed sustained and superior efficacy with faster response versus ustekinumab, and no new or unexpected safety concerns were identified, in Asian subjects with moderate to severe plaque psoriasis.

A 308‐nm excimer laser (EL) has been widely used to treat patients with localized vitiligo. However, data are rare on the influence of EL treatment on the risks of skin cancer. To evaluate the skin cancer risks after long‐term EL treatment, we performed a nationwide population‐based retrospective cohort study using the Korean National Health Insurance Claims Database. A total of 5,052 patients with vitiligo were classified into three groups according to the EL treatment sessions between 2009 and 2016: no, 50–99, and 100 or more EL treatments after 2‐year washout period (2007 and 2008). Using multivariable Cox proportional hazard models, we found that the risks of actinic keratosis, non‐melanoma skin cancers, and melanoma did not significantly differ among the groups, respectively. In conclusion, EL treatment would not increase the risks of premalignant skin lesions and skin cancers in patients with vitiligo. Based on our results, EL is likely to be a safe treatment option for patients with localized vitiligo.

Vol. 31, N o. 6, 2019 685 Received March 13, 2019, Revised May 7, 2019, Accepted for publication June 1, 2019 Corresponding author: Young Ho Won, Department of Dermatology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea. Tel: 82-62-220-6681, Fax: 82-62-222-4058, E-mail: yhwon@jnu.ac.kr ORCID: https://orcid.org/0000-0003-4640-4337 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © The Korean Dermatological Association and The Korean Society for Investigative Dermatology bacterium chelonae infection in a hospitalized patient. J Am Acad Dermatol 2014;71:e248-e250. 4. Yoo JS, Huh JW, Kim MS, Jue MS, Choi KH, Park HJ. Cutaneous atypical mycobacterial infection in a body scrubber (“Ddaemirri”). Korean J Dermatol 2017;55:156-157.

106 Ann Dermatol Received December 13, 2017, Revised January 14, 2018, Accepted for publication February 5, 2018 Corresponding author: Jee-Bum Lee, Department of Dermatology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea. Tel: 82-62-220-6684, Fax: 82-62-222-4058, E-mail: jbmlee@jnu.ac.kr ORCID: https://orcid.org/0000-0002-1477-4037 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © The Korean Dermatological Association and The Korean Society for Investigative Dermatology Fig. 1. Asymptomatic dark brownish ill-defined patches around the perioral area (A), and hyperpigmentation of both sclerae (B: right eye, C: left eye). https://doi.org/10.5021/ad.2019.31.1.106

Background: Acral melanomas are known to have a low frequency of BRAF mutation, in contrary to higher KIT mutation. Recently, VE1 immunostaining was reported to have a good correlation with BRAF mutation status. Objective: We aimed to evaluate the clinicopathological features of BRAF-mutated acral melanomas and validate the correlation of the VE1 immunohistochemical stains in those cases. Methods: The clinical features (age, sex, anatomical site), and histopathological characteristics of 41 patients with acral melanoma were evaluated. We performed a next-generation sequencing to detect BRAF mutation status. We also determined the correlation of VE1 immunohistochemical staining with BRAF mutation status. Results: Among 19 acral melanomas with BRAF mutation, common histopathological subtype was acral lentiginous melanoma (8/19, 42%) and nodular melanoma (8/19, 42%) and superficial spreading melanoma (3/19, 16%) followed. VE1 immunostaining results were positive in all 15 cases with BRAF V600E mutation (sensitivity 100%), and negative in 4 cases of BRAF non-V600E mutation. However, VE1 immunostaining was negative in all 22 patients with BRAF wild-type. Conclusion: VE1 immunostaining had a good correlation with BRAF V600E mutation status.