Background: The number of patients with atopic dermatitis who refuse to use topical corticosteroids because of personal fears seems to be increasing. However, studies on this subject are scarce. Consequently, we have investigated this issue further. Methods: A cross-sectional study based on a questionnaire. Between September 1998 and January 1999, a questionnaire was distributed to patients who responded to an announcement and to those attending 18 hospitals or clinics and 11 self-help groups throughout Japan to identify what makes patients resistant to applying topical corticosteroids. Results: Patients who are reluctant to use topical corticosteroids often experienced: ineffective or short-lasting results, adverse side effects and feelings of distrust towards their physician. These feelings of distrust were found to be significantly stronger among patients who were reluctant to apply topical corticosteroids than among patients who accepted the treatment with little or no feelings of resistance. External influences such as those from family members, acquaintances, mass media (television, newspapers and magazines), alternative ‘nondoctor’ therapists and self-help groups were not found to be a significant factor between both groups. However, the influence of the physician was found to be significant and directly related to the patients’ lack of trust. Conclusions: Patients with atopic dermatitis who refuse to use topical corticosteroids attribute their feelings of resistance to personal experiences rather than to information from external sources. Information or warnings about associated side effects from physicians may help to reduce these fears and ultimately benefit the physician-patient relationship.

The American Academy of Dermatology published a new guideline regarding topical therapy in atopic dermatitis in May 2014. Although topical steroid addiction or red burning skin syndrome had been mentioned as possible side effects of topical steroids in a 2006 review article in the Journal of the American Academy of Dermatology, no statement was made regarding this illness in the new guidelines. This suggests that there are still controversies regarding this illness. Here, we describe the clinical features of topical steroid addiction or red burning skin syndrome, based on the treatment of many cases of the illness. Because there have been few articles in the medical literature regarding this illness, the description in this article will be of some benefit to better understand the illness and to spur discussion regarding topical steroid addiction or red burning skin syndrome.

Background:Although platelet-rich plasma (PRP) is nowadays a common method in various medical fields, including cosmetic surgery or dermatology, the expensiveness of the kit for processing is still a hurdle.Methods:A new unique economic method for preparing PRP was reported. The method consists in a simple modification of a disposable 5-mL syringe that allows insertion into a common centrifuge and positioning of the syringe on the centrifuge so the PRP separates next to the tip of the syringe. Platelet-derived growth factor BB in PRP was measured under anticoagulant dextrose solution A (ACD-A) or heparin as anticoagulant and with or without prostaglandin E1 (PGE1) as a platelet aggregation suppressant.Results:The new method successfully created PRP with high platelet-derived growth factor BB in all conditions, and the highest value was obtained by using ACD-A and PGE1.Conclusions:The new method is useful, and the use of ACD-A and PGE1 is the most recommended.

BackgroundAlthough the thread-lifting technique for sagging faces has become more common and popular, medical literature evaluating its effects is scarce. Studies on its long-term prognosis are particularly uncommon.Patients and methodsOne hundred individuals who had previously undergone insoluble thread-lifting were retrospectively investigated. Photos in frontal and oblique views from the first and last visits were evaluated by six female individuals by guessing the patients’ ages. The mean guessed age was defined as the apparent age, and the difference between the real and apparent ages was defined as the youth value. The difference between the youth values before and after the thread-lift was defined as the rejuvenation effect and analyzed in relation to the time since the operation, the number of threads used and the number of thread-lift operations performed.ResultsThe rejuvenation effect decreased over the first year after the operation, but showed an increasing trend thereafter. The rejuvenation effect increased with the number of threads used and the number of thread-lift operations performed.ConclusionThe insoluble thread-lifting technique appears to be associated with both early and late effects. The rejuvenation effect appeared to decrease during the first year, but increased thereafter. A multicenter trial is necessary to confirm these findings.

Topical corticosteroids (TCS) are regarded as the mainstay treatment for atopic dermatitis (AD). As AD has a tendency to heal naturally, the long-term efficacy of TCS in AD management should be compared with the outcomes seen in patients with AD not using TCS. However, there are few long-term studies that consider patients with AD not using TCS. We designed a prospective multicenter cohort study to assess the clinical outcomes in patients with AD who did not use TCS for 6 months and then compared our results with an earlier study by Furue et al which considered AD patients using TCS over 6 months. Our patients’ clinical improvement was comparable with the patients described in Furue’s research. In light of this, it is reasonable for physicians to manage AD patients who decline TCS, as the expected long-term prognosis is similar whether they use TCS or not.