Dermatologic Therapy最新文献

Background: Botulinum toxin-A (BoNT-A) injection is a widely used cosmetic procedure in Korea to improve calf contours; however, a standardized protocol has yet to be established. While other BoNT-A formulations have been studied for calf contouring, the efficacy and safety of Inco-BoNT-A (IncoBoNT-A) specifically for this purpose remain unclear.

Objective: This prospective case series study aimed to evaluate the effectiveness and safety of IncoBoNT-A for calf contouring.

Methods: Twenty Korean women (mean age: 35.55 ± 7.37) received 75–100 U of IncoBoNT-A per calf muscle (total 150–200 U for both calves), administered intramuscularly using a 30G 0.5-inch needle. Evaluations were conducted at baseline and at 1, 3, and 6 months postprocedure. Changes in muscle size were measured via ultrasound and tape, supplemented by clinical photographs. Observer evaluations (PGAIS, Merz scales for female Asian calf) and participant satisfaction (SGAIS) were assessed at each visit, along with body weight monitoring and daily activity assessments.

Results: Both calf circumference (measured by tape) and muscle thickness (measured by ultrasound) at 2 fixed locations declined over time, with significant reductions at each visit compared to baseline. The PGAIS and SGAIS scores demonstrated consistent clinical improvement and patient satisfaction. The Merz scale indicated a shift from “severe” and “very severe” to “mild” and “moderate” ratings over time. Notably, weight gain was associated with less reduction in calf circumference.

Conclusions: A single dose of 150–200 U IncoBoNT-A is safe and effective for calf contouring. Unlike facial wrinkle treatment, weight management may be essential for achieving optimal results in calf contouring with BoNT-A.

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that significantly impacts patients’ quality of life, particularly in relation to sexual health. Sexual dysfunction and erectile dysfunction are frequently reported among individuals with HS. However, the relationship between disease severity and sexual health outcomes remains unclear. This systematic review aims to explore the impact of HS on sexual dysfunction in both males and females, examining the physical and psychological factors involved.

Methods: A systematic literature search was conducted in PubMed, Medline (OVID), and Web of Science using keywords related to HS and sexual health, including “sexual dysfunction,” “sexual desire,” “erectile dysfunction,” “impotence,” and “infertility.” Studies were screened for relevance, and those that examined sexual health outcomes in HS patients were included. Thirteen studies met the inclusion criteria and were analyzed qualitatively due to the heterogeneity of the outcome measures. Nonrandomized studies were evaluated using the Newcastle-Ottawa Scale to assess methodological quality.

Results: The review found that sexual dysfunction was prevalent in HS patients, with rates ranging from 42% to 71.8%. Female patients consistently reported higher levels of sexual distress, while male patients experienced erectile dysfunction at significant rates, as measured by the FSFI and IIEF. Importantly, worsening disease severity did not consistently correlate with increased sexual dysfunction, suggesting that factors such as pain, odor, and psychological distress may have a greater influence.

Conclusion: This review demonstrates that HS significantly impacts sexual health, though the severity of HS does not always correlate with worsening sexual dysfunction. Psychological factors, pain, and genital involvement appear to play a more prominent role. Future research should focus on addressing both the psychological and physical aspects of sexual dysfunction in HS patients and explore the underlying mechanisms linking HS to infertility.

Introduction: Hematological disorders are often associated with dermatological conditions due to immune dysregulation and the use of polypharmacy. Such dermatological manifestations have the potential to impair quality of life and may also result in morbidity and mortality. Furthermore, in some instances, it may be necessary to modify the treatment regimen.

Methods: This study retrospectively evaluated dermatological consultations for patients in a hematology clinic, assessing clinical and demographic data, dermatological diagnoses, and the effects on hematological treatment and prognosis.

Results: The data from 434 consultations involving 304 patients were subjected to analysis, with the most prevalent hematological diagnoses being acute myeloid leukemia, multiple myeloma, and myelodysplastic syndrome. The majority of consultations (70.7%, n = 307) were inpatient, while the remainder were outpatient. The most frequently observed dermatological conditions were infections (37.3%) and drug reactions (15.7%). In 39.4% (n = 171) of cases, dermatological findings led to modifications in systemic treatment, primarily due to infections and drug reactions. Among these patients, 19 required modifications to their hematological treatment regimen. A diagnosis was reached through clinical examination in 74.9% of patients. In other cases, additional diagnostic procedures were necessary, including dermoscopy, histopathology, and microbial examination. The in-hospital mortality rate was 2.3% (n = 7). Only one death was directly associated with a dermatological condition: toxic epidermal necrolysis in a patient receiving brentuximab vedotin.

Conclusion: The results of this study highlight the importance of dermatological assessment in patients with hematological conditions. It is also crucial for clinicians to be more aware of the potential dermatological manifestations, including infections and drug reactions, that may occur in these patients.

Background: Xanthelasma palpebrarum (XP) currently lacks a universally endorsed treatment approach. The utility of picosecond 1064 nm Nd:YAG lasers in XP management has not been explored.

Objective: This study aimed to assess the efficacy and safety of picosecond 1064 nm Nd:YAG laser therapy in the treatment of XP.

Methods: A total of 47 patients with clinically confirmed XP received treatment with picosecond 1064 nm Nd:YAG laser at standardized settings. Patients were photographed using standardized photographic documentation, and the degree of clearance was evaluated.

Results: Following the initial treatment session, 97.87% of patients exhibited a good response to the picosecond laser, with some degree of lesion clearance. By the third session, 78.80% of patients achieved > 50% lesion clearance. Adverse effects were mild and transient, with postinflammatory hyperpigmentation observed in 2 (4.25%) patients.

Conclusion: The picosecond 1064 nm Nd:YAG laser demonstrated promising efficacy in the treatment of XP, with a potentially enhanced safety profile.

Background: Bromhidrosis can significantly impact a patient’s quality of life. Despite the availability of various treatment options, radical surgery remains the gold standard for permanent resolution. However, complications such as hematoma and malposition healing can occur postoperatively, necessitating the exploration of effective techniques to mitigate these risks and improve patient outcomes.

Objective: This study explores the application effect of skin puncture and external fixation techniques in preventing hematoma and malposition healing after radical surgery for bromhidrosis.

Methods: A total of 300 patients who underwent radical surgery for bromhidrosis in our hospital from June 2023 to April 2024 were retrospectively selected from medical records. They were divided into two groups based on whether skin puncture and external fixation techniques were applied, with 150 patients in each group after propensity score matching. Both groups underwent subcutaneous sweat gland removal using a small incision with a rotary cutter. The study group utilized skin puncture and external fixation techniques. The adverse reaction rates after surgery, postoperative negative emotion scores, surgical satisfaction rates, and scar Vancouver Scar Scale (VSS) scores of the two groups of patients were compared statistically.

Results: The total incidence of postoperative adverse reactions in the study group was significantly lower than that in the control group. Postoperative negative emotions were less frequent, and the overall surgical satisfaction rate was significantly higher than that in the control group. There was no statistically significant difference in scar VSS scores of wound scars within 3 months after surgery between the two groups.

Conclusion: Skin puncture and external fixation techniques effectively prevent adverse reactions such as hematoma and malposition healing after radical surgery for bromhidrosis. Patients experience fewer postoperative negative emotions, higher overall surgical satisfaction rates, and less noticeable scar formation.

Background: Scalp seborrheic dermatitis (SSD) is a chronic inflammatory dermatosis characterized by sebum imbalance and proliferation of Malassezia species. While various antifungal shampoos are commonly used to manage SSD, there remains a substantial demand for alternative treatments that provide a more rapid onset of action. Glycyrrhetinic acid is recognized for its antioxidative, anti-inflammatory, antimicrobial, and antiallergic properties. This study aimed to evaluate the efficacy of a novel scalp gel containing 4% glycyrrhetinic acid complex as a short-contact therapy for SSD.

Methods: A total of 40 patients with SSD were enrolled in this study and treated with the 4% glycyrrhetinic acid complex gel using a short-contact therapy approach. Clinical efficacy was assessed by the Adherent Scalp Flaking Score (ASFS) and Dermatology Life Quality Index (DLQI) at baseline, Week 1, and Week 2, all evaluated by the same dermatologist. Treatment satisfaction was measured at Week 2 using the Treatment Satisfaction Questionnaire (TSQ).

Results: Significant improvements in ASFS and DLQI were observed at both Week 1 and Week 2 compared to baseline. Patient satisfaction, as measured by the TSQ, yielded a mean score of 4.2 ± 0.8 on a 5-point scale.

Conclusions: This study demonstrates the clinical efficacy of the novel 4% glycyrrhetinic acid complex scalp gel as a short-contact therapy for SSD. The rapid onset of action and significant improvement in symptoms suggest that this gel could serve as an effective alternative for managing SSD in the acute phase.

Purpose: While the 2021 Chinese rosacea guidelines recommend hydroxychloroquine (HCQ) and doxycycline as A-level treatments for erythema, monotherapy with these agents has shown suboptimal clinical efficacy against both erythema and flushing symptoms. This study aimed to evaluate whether combination therapy could enhance therapeutic outcomes without increasing adverse effects (AEs).

Methods: In this randomized, double-blind, placebo-controlled trial conducted at Guizhou Provincial People’s Hospital (January 2022–January 2024), 73 moderate-to-severe rosacea patients were randomized to receive either (1) HCQ 200 mg bid plus doxycycline 100 mg qd (intervention group, n = 36) or (2) placebo plus doxycycline 100 mg qd (control group, n = 37). Treatment duration was 8 weeks with follow-up assessments at Weeks 0, 4, 8, and 12.

Results: Among 58 completers (29 per group), the intervention group demonstrated significantly higher clinical efficacy at Week 8: erythema improvement rates (89.67% vs. 68.97%, p < 0.05), flushing reduction (68.97% vs. 44.83%, p < 0.05), and greater quality-of-life improvement (RosQoL score Δ23.66 vs. Δ17.00, p < 0.05). Investigator’s Global Assessment showed comparable results (72.22% vs. 65%, p > 0.05). Both regimens were well tolerated with no severe AEs reported.

Conclusion: The HCQ–doxycycline combination demonstrates superior efficacy over doxycycline monotherapy for improving erythema, flushing symptoms, and quality of life in moderate-to-severe rosacea patients, with comparable safety profiles.

Trial Registration: Chinese Clinical Trial Register: ChiCTR2400089784

Androgenetic alopecia (AGA) affects about half of men and many women worldwide, yet current treatments often fall short. This review summarizes key pathogenic mechanisms of AGA, centering on three interconnected processes: the dihydrotestosterone–prostaglandin D2 (DHT–PGD2) loop, oxidative stress and inflammation, and lipid metabolism dysregulation. These factors converge to suppress Wnt/β-catenin signaling, the core pathway for hair growth. DHT and PGD2 reinforce each other to drive follicular miniaturization via CXXC5 and GSK-3β activation. Oxidative stress and chronic inflammation—exacerbated by scalp microbiome imbalance, notably excess Cutibacterium acnes and Malassezia—further damage the follicular environment. Suppressed PPARγ signaling disrupts adipocyte-follicle crosstalk, reducing growth factor support. These insights reveal emerging therapeutic targets, including DP2 antagonists, CXXC5/GSK-3β inhibitors, antioxidants, microbiome modulators, and PPARγ agonists. By integrating molecular, microbial, and metabolic perspectives, this review outlines a framework for multitarget strategies to address the limitations of existing AGA treatments.