Review of chemical peeling in photoaging skin

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee ),Lisa Kwin Wah Chan(Lisa Kwin Wah Chan ),Kar Fai Victor Lee(Kar Fai Victor Lee ) 대한미용의학회 2023 대한미용의학회지 Vol.7 No.1

Photoaging is a process in which ultraviolet radiation damages the normal skin architecture. Topical chemical peeling is used to treat this condition. The authors aimed to understand the mechanism and level of evidence of the different depths of chemical peeling used to treat photoaging. Various topical chemical peelings have been used in cosmetic medicine for many years to treat photodamaged skin. This review compares the efficacy and the level of evidence. This systematic review evaluates the efficacy of different chemical peeling methods. Keywords included “Photoaging,” “Alpha-hydroxy acid,” “Lipo-hydroxy acid,” “Trichloroacetic acid,” “Jessner’s solution,” and “Phenol” were typed on Ovid, PubMed, MEDLINE for relevant studies published on photoaging treatment. There is a wealth of Level I evidence supporting the use of topical retinoic acid, vitamin B, and vitamin C. The evidence behind the use of topical vitamin E exists but is mainly drawn from studies from the Level IV of the evidence hierarchy. Topical vitamins can effectively treat photodamaged skin. Level of Evidence: I

Treatment of acne fulminans with intense pulsed light: a case report

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee),Kwin Wah Chan(Kwin Wah Chan),Kar Wai Phoebe Lam(Kar Wai Phoebe Lam ) 대한미용의학회 2022 대한미용의학회지 Vol.6 No.2

Acne fulminans is a severe form of acne that has a considerable psychosocial impact. Acne scarring is a potential complication of this condition. The treatment of acne fulminans includes conventional topical antibiotics, systemic antibiotics, hormonal therapy, isotretinoin, and light therapy. Intense pulsed light can have marked effects on acne fulminans. We aimed to describe the treatment of acne fulminans with intense pulsed light. This article is a case report together with a literature review to demonstrate how intense pulsed light can be used to treat acne fulminans. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on acne fulminans. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for acne fulminans. Our case report revealed that intense pulse light using multiple filters at certain energy levels can effectively treat acne fulminans. Current evidence suggests that ablative CO2 and Er:YAG lasers provide the best curative effect on acne scars on all skin types. Potential complications with intense pulsed light include pain, burns, and post-inflammatory hyperpigmentation. Intense pulsed light is an effective treatment modality for acne fulminans. However, more cases of acne fulminans treated with intense pulsed light need to be documented in order to affirm intense pulsed light as one of the best options for treating this severe form of acne.

Review of topical vitamins in photoaging skin

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee),Kwin Wah Chan(Kwin Wah Chan),Kar Fai Victor Lee(Kar Fai Victor Lee),Kar Wai Phoebe Lam(Kar Wai Phoebe Lam ) 대한미용의학회 2022 대한미용의학회지 Vol.6 No.2

Photoaging is a process of normal skin architecture damage caused by ultraviolet radiation. Topical vitamins have been used to treat these conditions. The authors aimed to understand the mechanism and level of evidence of topical vitamins used to treat photodamaged skin. A range of topical vitamins has been used in cosmetic medicine for many years to treat photodamaged skin. This review article compares their efficacy and level of evidence. This study was a systematic review to evaluate the efficacy of different topical vitamins. Keywords including “Photoaging,” “Botanicals,” “Peptides,” “Retinoids,” “Vitamins” were searched on Ovid, PubMed, MEDLINE for relevant studies published on photoaging treatment. There is a wealth of Level I evidence supporting the use of topical retinoic acid, vitamins B and C. There is evidence supporting the use of topical vitamin E although it is mainly drawn from Level IV studies of the evidence hierarchy. Topical vitamins can effectively treat photodamaged skin. Level of Evidence: I

Treatment of severe erythematotelangiectatic rosacea with intense pulsed light: a case report

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee ),Kwin Wah Chan(Kwin Wah Chan ) 대한미용의학회 2023 대한미용의학회지 Vol.7 No.1

Erythematotelangiectatic rosacea is a common, long-standing inflammatory skin disorder of unclear origin. It is characterized by facial erythema involving mainly the central face (malar areas, chin, nasal area, and forehead region), with a range of clinical manifestations varying from blood vessels hyperactivity to sebaceous glands hyperplasia. These can have a considerable psychosocial impact on the patients. Intense pulsed light treatment can have significant effects on severe erythematotelangiectatic rosacea. We aimed to describe the treatment of severe erythematotelangiectatic rosacea with intense pulsed light. This article is a case report together with a literature review to explore the views of researchers on the treatment of erythematotelangiectatic rosacea with intense pulsed light. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on severe erythematotelangiectatic rosacea. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for patients with severe erythematotelangiectatic rosacea. Our case report revealed that intense pulsed light using multiple filters at certain energy levels can effectively treat severe erythematotelangiectatic rosacea. We believe that, with more treatment sessions, patients can enjoy longer and more persistent results. Intense pulsed light is an effective treatment for erythematotelangiectatic rosacea. However, more erythematotelangiectatic rosacea cases treated with intense pulsed light will be required to consolidate intense pulsed light as one of the best treatment options for erythematotelangiectatic rosacea. Potential complications with intense pulsed light include post-inflammatory hyperpigmentation, burns, and pain.

Case report: treating vitiligo with intense pulsed light

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee ),Kwin Wah Chan(Kwin Wah Chan ) 대한미용의학회 2023 대한미용의학회지 Vol.7 No.1

Erythematotelangiectatic rosacea is a common, longstanding inflammatory skin disorder with unclear origin. It is characterized by facial erythema involving mainly the central face (malar areas, the chin, nasal area and forehead region) with a range of clinical presentations varying from hyperactivity of the blood vessels to sebaceous gland hyperplasia. It can lead to considerable psychosocial impact. Intense pulsed light (IPL) treatment can potentially have dramatic results on severe erythematotelangiectatic Rosacea. This is a case report of treating severe erythematotelangiectatic rosacea with IPL treatment. Pre-treatment and post-treatment clinical photos were provided to show the effect of IPL therapy on severe erythematotelangiectatic rosacea. This article is a case report together with literature review to explore the view of researchers on erythematotelangiectatic rosacea with IPL. No comparison is made with other treatment modalities. Nevertheless, it provides an alternative treatment option for patients with severe erythematotelangiectatic rosacea. Our case report shows that IPL at certain energy levels using multiple filters, can effectively treat severe erythematotelangiectatic rosacea. We believe with more treatment sessions patient can enjoy longer and persistent result. IPL is an effective treatment for erythematotelangiectatic rosacea. However, more erythematotelangiectatic rosacea cases treating with IPL will be required to consolidate IPL as one of the best treatment options in treating erythematotelangiectatic rosacea. Potential complications with IPL include post-inflammatory hyperpigmentation, burn and pain.

Laser resurfacing in acne scarring: a review

Lee Cheuk Hung,Lee Kar Wai Alvin,Chan Kwin Wah,Lam Kar Wai Phoebe,Wong Tin Hau 대한미용의학회 2022 대한미용의학회지 Vol.6 No.1

Scarring can complicate acne vulgaris and lead to considerable psychosocial implications. Resurfacing and collagen regeneration treatments for acne scars include cryotherapy, chemical peeling, lasers and lights, and radiofrequency. Lasers have become popular among these options. A range of lasers with varying designs, wavelengths, and fractional technologies have become available as treatment choices for acne scars. This review compares the efficacy and adverse effects of these treatments. This is a literature review to determine whether the use of a combination of laser treatments yields superior outcomes compared to a single-device method in the management of acne scars. Our literature review revealed that patient factors, including Fitzpatrick skin phenotype and acne scar subtype, are essential determinants of outcome success in acne treatment with laser. Evidence suggests that ablative CO2 and Er:YAG lasers provide the best curative effects on acne scars in all skin types. Both non-fractional and fractional techniques can effectively treat atrophic acne scars. However, when using a pulse-dye laser to treat hypertrophic scars, the outcomes are variable. Potential complications of ablative lasers include acne flares, infections, and scarring.

New method to immediate reconstitute Sculptra to create a more homogenous mixture for immediate use in year 2023

Arthur Yu,Cheuk Hung Lee,Kar Wai Alvin Lee,Lisa Kwin Wah Chan 대한미용의학회 2023 대한미용의학회지 Vol.7 No.2

Background: To create a sterile, non-pyrogenic solution, Sculptra must first be reconstituted with 5 ml sterile water for injection. This reconstitution process has evolved, has become the norm, and has been recommended for use across the globe since it was marketed to the public for aesthetic reasons. The granuloma formation problem of Sculptra Aesthetic is troublesome to some injectors. It can appear anywhere that you injected and is erratic. According to some patients, the inappropriate mixing of Sculptra microparticles with sterile water or the inability of the microparticles to fully dissolve into the solution are to blame for the development of granulomas. Objective: This article aimed to demonstrate a new reconstitution method (with images) for mixing Sculptra with normal saline. Methods: In the new reconstitution method, we attached a 21G sterile needle to a sterile, single-use 5 ml syringe. Thereafter, we withdrew 2.5 ml normal saline into the 5 ml syringe. The 21G sterile needle was then introduced into the stopper of the vial, and we slowly added all normal saline into the vial. The vial was shaken vigorously to ensure the full hydration of the content. After shaking, the physician could then add any volume of normal saline. Results: A homogenous mixture of Sculptra can be achieved using this new reconstitution method. The mixture is ready to use after the immediate reconstitution of Sculptra. Conclusion: This novel reconstitution technique for Sculptra will result in less unpleasant treatment and less foam wastage on the part of the physician.

Hepatic Decompensation in Cirrhotic Patients Receiving Antiviral Therapy for Chronic Hepatitis B

( Hye Won Lee ),( Terry Cheuk-fung Yip ),( Yee-kit Tse ),( Grace Lai-hung Wong ),( Beom Kyung Kim ),( Seung Up Kim ),( Jun Yong Park ),( Do Young Kim ),( Henry Lik-yuen Chan ),( Sang Hoon Ahn ),( Vinc 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: It is unclear if anti-hepatitis B virus (HBV) treatment can eliminate incident hepatic decompensation. Here we report the incidence and predictors of hepatic decompensation among cirrhotic patients receiving antiviral therapy for chronic hepatitis B. Methods: This is a post hoc analysis of two prospective HBV cohorts from Hong Kong and South Korea. Patients with liver stiffness measurement (LSM) ≥10 kPa and compensated liver disease at baseline were included. The primary endpoint was incident hepatic decompensation (jaundice or cirrhotic complications) with competing risk analysis. Results: 818 patients (mean age, 54.9 years; 519 male [63.4%]) were included in the final analysis. During a mean follow-up of 58.1 months, 32 (3.9%) patients developed hepatic decompensation, among whom 34% were secondary to HCC. Three (0.4%) patients experienced variceal bleeding alone, 27 (3.3%) had non-bleeding decompensation and 13 (1.6%) had more than 2 decompensating events. On multivariable analysis, baseline LSM (adjusted hazard ratio [aHR] 1.03), diabetes (aHR 3.27), platelet (aHR 0.99), and international normalized ratio (aHR 7.99) were independent predictors of hepatic decompensation. 30/506 (5.9%) patients fulfilling the Baveno VI criteria (LSM ≥20 kPa and/or platelet count <150ⅹ10⁹/L) and 2/312 (0.6%) patients not fulfilling the criteria developed hepatic decompensation (P<0.001). Conclusions: Hepatic decompensation is uncommon but not eliminated in patients receiving antiviral therapy for HBV-related cirrhosis, and only a third of decompensating events are secondary to HCC. The Baveno VI criteria, which was originally designed to detect varices needing treatment, can be effectively applied in this population to identify patients at risk of decompensation.

Re: Pilot study on efficacy and patient satisfaction with 1,450-nm laser boosting treatment after a thread lift procedure

Kar Wai Alvin Lee,Kwin Wah Chan,Cheuk Hung Lee 대한미용의학회 2023 대한미용의학회지 Vol.7 No.2

Cardiac Angiosarcoma Heralded by Recurrent Hemorrhagic Pericardial Effusions–Utility of MRI and CT

Fiona Fong-ying Wan,Jonan Chun-yin Lee,Jeanie Betsy Chiang,Kim-hung Tsang,Cheuk-bong Ho,Eric Chi-yuen Wong 아시아심장혈관영상의학회 2020 Cardiovascular Imaging Asia Vol.4 No.1

Cardiac angiosarcoma is a rare primary cardiac malignancy that should be considered in patients with recurrent pericardial effusions, especially those with spontaneous hemorrhagic pericardial effusion. A 34-year-old man presented for evaluation of pericardial effusion. Initial imaging and pericardial histopathological workup failed to provide a definitive diagnosis. Serum parvovirus B19 PCR test was positive and he was treated for viral pericarditis. In view of his recurrent hemorrhagic pericardial effusions and persistent right atrial thrombus, MRI was performed and revealed findings suggestive of cardiac angiosarcoma with lung metastases. The diagnosis was confirmed histologically. The patient’s condition progressed rapidly with massive hemothorax, and although he received systemic therapy for disease control, he succumbed to the disease five months after diagnosis confirmation.