Alitretinoin is the only systemic agent approved for the treatment of severe chronic hand eczema (CHE) unresponsive to potent topical corticosteroids. Clinical trials have shown the efficacy of oral alitretinoin with topical emollients for CHE treatment, but most studies have failed to reach a therapeutic success rate of 50%. Reasonably, we thought it would be more effective to combine topical corticosteroids with oral alitretinoin, but the concomitant use of topical corticosteroids has not been studied yet. One‐hundred and seven Korean patients diagnosed with CHE were recruited. The participants were divided into two groups depending on the concomitant use of topical corticosteroids. Comparative analysis was performed between the combined therapy (alitretinoin and topical corticosteroids) and monotherapy groups (alitretinoin only) by using physician global assessment (PGA), patient's global assessment (PaGA), modified total lesion symptom score (mTLSS), and recurrence rates. The combined therapy group showed a significantly higher treatment success rate than the alitretinoin monotherapy group for all efficacy parameters (PGA: P < 0.001, PaGA: P < 0.001, mTLSS changes: P < 0.001), but there was no significant difference in recurrence rates between the groups (P = 0.266). Combined use of topical corticosteroids is recommended for CHE patients being treated with oral alitretinoin due to clinically rapid and superior effectiveness.

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Summary Steatocystoma multiplex (SM) is a cutaneous disorder that presents with multiple yellowish intradermal cysts originating from the pilosebaceous ducts. Although various treatments have been attempted to improve cosmetic outcomes, no optimal treatment strategy has been established to date. A 41‐year‐old man presented with a 10‐year history of multiple skin‐colored papulonodules over his entire body. He was diagnosed with SM, and we treated his facial SM with a 1927‐nm diode laser. Two treatment sessions at a 5‐week interval led to cosmetically excellent outcomes. There was no recurrence at the 8‐month follow‐up. Herein, we present a case of SM that was successfully treated with a 1927‐nm fiber‐optic diode laser.

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Wrinkling has been attributed to the cumulative effects of acute Ultraviolet Radiation (UVR) exposure on the dermis. Previous studies have shown that the collagenase MMP-1 is secreted by dermal fibroblasts and degrades collagen immediately after UV exposure. However, skin ages gradually, and not intermittently after sun exposure. In this study we sought to examine the mechanism underpinning the gradual appearance of wrinkles, and to determine whether this is a result of intrinsic changes in the biology of the dermis. In vitro studies were performed using patient-derived human dermal fibroblasts from healthy skin, HFF and HDF cell lines. Cell lines were UV-protected or repeatedly exposed to UVB. Dermal fibroblasts from fairer skin types had higher levels of UV-induced mutations which, in multivariate analysis, was linked to higher expression of extracellular matrix degradation genes. This suggests that the background UVR exposure history influences the composition of the dermis as it ages. We investigated the mechanism driving collagen degradation in dermal fibroblasts with and without a history of UV damage. Fibroblasts with high background UV exposure have elevated levels of MMP-1 at rest. In addition, they show increased collagen degradation activity, which persists in the absence of acute UV exposure. Our study shows that dermal fibroblasts with a history of chronic UV exposure have higher levels of collagenase expression and activity, even in the absence of acute UV exposure. Importantly, these findings explain the mechanism driving gradual collagen degradation and wrinkling in the absence of UV light.