Hur Hoon, M.D., Ph.D.
Choice Dermatology Clinic, Pyeongchon, Korea
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Table 1. Indication of Dr. HurHoon's Golden Parameter therapy.
Dr. HurHoon’s GPT Can Be Summarized as Follows
First, the mechanism of GPT is to minimize the epidermal damage and destroy melanosomes in the epidermal melanocytes, which are changed into ghost cells due to the loss of function. Then, weekly GPT destroys melanocytes completely, accelerates apoptotic melanocyte cell death, thus removing abnormal epidermal melanocytes5,10,11,12. Eventually, abnormal melanocytes are displaced into normal melanocytes which migrate from outer root sheath of hair5,10,11,12. In conclusion, complete clearance of CALS,PUL and BN without side effects and recurrences can be achieved.
Second, patients with CALS or PUL or BN are treated with 30-50sessions of a 1064nm Q-switched Nd:YAGLaser(Spectra Laser, Lutronic, South Korea) at a one-week interval with a spot size of 7mm, a fluence of 2.4J/cm2 and apulse rate of 10Hzwith slowly one pass by sliding-stacking technique to the CALS or PUL or BN. One pass of fluence by sliding-stacking technique is very important to minimize the epidermal damage5. If two passes of fluence by sliding-stacking technique were performed, the epidermal damages might have occurred and the damaged keratinocytes might have secreted cytokines such as endothelin-1, -MSH, ACTH, bFGF, prostaglandin(PGE2,PGF2 and nitric oxide which could cause PIH and worsen CALS, PUL and BN5,10,11,12.
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Third, in case of CALS or PUL or BN on face, 30 GPT sessions are performed once a week. Small lesion with a diameter of less than 2cm requires 30 treatment sessions on a weekly basis. And large lesion with a diameter of larger than 3cm needs 50 treatment sessions once a week. In case of CALS or PUL or BN on other parts of body(arms, legs, and torso), more than 50 GPT sessions should be performed once a week regardless of the size of lesion. The advantage of GPT is that it minimizes the epidermal damage without petachiae and crusts so this therapy does not cause PIH. But GPT requires a long-term treatment for one year. In this study, one patient with a solitary CALS(Figure1),two patients with PUL(Figure4,Figure6)and one patient with BN(Figure8) were treated with GPT of a 1064nm Q-switched Nd:YAGLaser.one patient with a solitary CALS , two patients with PUL and one patient with BN were achieved complete clearance of the lesions(Figure2,Figure5,Figure7,Figure9). There is no recurrences at 18 months follow-up(Figure3).
Conclusion
The parameter for each GPT was a spot size of 7mm, a fluence of 2.4J/cm2with one pass and a pulse rate of 10Hz. This parameter does not provoke side effects such as petechiae, crusts, pain, and PIH during the Laser treatment. Therefore, the authors suggests GPTachieves complete clearance of CALS, PUL and BN with a very safe and effective profile.
-To be continued-
