Dermatologic Surgery最新文献

Background: Melasma, a common skin hyperpigmentation disorder, has traditionally been linked to hormonal changes in genetically predisposed individuals. Recent studies, however, highlight the role of photoageing, particularly from visible light exposure, as a significant contributing factor. Effective treatments for melasma and associated signs of photoageing remain a clinical challenge.

Objective: This study aimed to evaluate the efficacy and safety of Poly-d,l-lactic acid (PDLLA) delivered via laser-induced microjet injectors in treating melasma and signs of photoageing.

Patients and methods: Eighteen Korean participants aged 42 to 74, with Fitzpatrick skin types III to IV, were enrolled. All participants exhibited melasma, signs of photoageing, or both. PDLLA was administered using the Mirajet device over 5 to 9 sessions. Clinical outcomes were assessed using the modified Melasma Area and Severity Index (MASI) and the Glogau Classification for photoageing. Adverse events were monitored throughout the study.

Results: Significant improvements were observed in both melasma severity and signs of photoageing. The mean MASI score decreased from 22.72 to 7.31 (p =.004). Photoageing severity, as assessed by the Glogau Classification, also improved notably. Minimal side effects were reported, primarily transient bleeding.

Conclusion: PDLLA administered via laser-induced microjet injectors appears to be a safe and effective treatment for melasma and photoageing, particularly in patients with more severe melasma. These findings suggest the potential for PDLLA in skin rejuvenation; however, further randomised controlled trials are warranted to confirm these results and optimise treatment protocols.

Background: RelabotulinumtoxinA (RelaBoNT-A) is a complex-free, ready-to-use, liquid botulinum toxin A.

Objective: Efficacy/safety of RelaBoNT-A treatment for lateral canthal lines (LCL).

Methods: Randomized adults received RelaBoNT-A (30 U/side; n = 230) or placebo (n = 73) during a 6-month, double-blind, Ph3 study (Relabotulinumtoxin Aesthetic Development Study-2 [READY-2]). Primary end points (Month 1, maximum smile) comprised: composite ≥2-grade responder rate using concurrent LCL severity investigator live assessment (LCL-ILA) and subject live assessment (LCL-SLA); LCL-ILA 0 (none)/1 (mild) responder rate. Subject satisfaction and adverse events were also reported.

Results: Month 1 composite ≥2-grade responder rates were 51.8% (RelaBoNT-A) and 1.4% (placebo; (p < .001). Month 1 none/mild LCL-ILA responder rates were 87.2% (RelaBoNT-A) and 11.9% (placebo; p < .001). Onset was reported Day 1 by 34%. At Month 6, LCL-ILA responder rates for RelaBoNT-A remained at 23.3% (none/mild) and 35.9% (≥1-grade improvement). Median return to baseline severity was 24.7 weeks; 64% (RelaBoNT-A group) had not returned to baseline at Month 6. RelaBoNT-A satisfaction was high through Month 6 (71%). Mild/moderate treatment-related adverse events occurred in 6.1% (RelaBoNT-A) and 5.5% (placebo).

Conclusion: RelaBoNT-A (60 U) treatment provided statistically significant improvement of moderate-to-severe LCL. One-third of subjects reported onset within 1 day and improvements were maintained through Month 6. Treatment satisfaction was high. RelaBoNT-A was well tolerated.

Background: The light-emitting diode cap being investigated is FDA cleared for the treatment of androgenetic alopecia (AGA).

Objective: Evaluating 3 versions of a red and blue light LED cap: (1) 625- and 660-nm red light, (2) 425-nm blue light, and (3) both 425-nm blue light and 625- and 660-nm red light against sham.

Patients and methods: Twenty-six-week, multicenter, randomized, controlled, double-blinded study. Adults aged 18 to 65 years with AGA were randomized to an active device or sham and underwent 10-minute treatments daily.

Results: One hundred sixty subjects were randomized. Ninety-one subjects were excluded for the per-protocol analysis. The per-protocol population included participants who completed 16 weeks of treatment, had no major protocol violations, and were at least 80% treatment compliant. Although the primary endpoint (mean change in non-vellus hair count from baseline to week 16) did not reach statistical significance in the individual study arms, in the pooled analysis (combining the 3 active study arms), there was a statistically significant (p = .033) difference versus sham. The pooled study cap group achieved 28.5 more hairs per cm2 when compared with sham.

Conclusion: The LED caps were well tolerated and increased hair density in patients with AGA.

Background: Pruritus and pain symptoms secondary to hypertrophic scars (HTSs) are associated with multiple factors, with age, body mass index (BMI), and scar thickness being the main risk factors (RFs).

Objective: This study mainly discusses the clinical symptoms associated with postburn HTSs and analyzes RFs for itching and pain requiring pharmacological intervention.

Materials and methods: All clinical data of 93 patients with postburn HTSs who visited the Burn Department of Shanghai Seventh People's Hospital between January 1, 2021 and January 1, 2023 were collected and analyzed retrospectively. Referring to the University of North Carolina "4P" Scar Scale, patients were rated as either "with" or "without" according to whether they had "scar itching symptoms requiring pharmacological intervention."

Results: Smoking, third-degree burns, unused silicone drugs, and total burn surface area 30% to 50% were independent RFs for requiring pharmacological intervention for postburn scar pruritus (odds ratio [OR] = 2.998, 3.924, 3.588, and 5.965, p < .05). Age, increased BMI, greater scar thickness, and duration of hyperplasia not more than 1 year significantly increased the risk of scar pain requiring medical intervention (OR = 1.626, 2.441, 20.830, 11.646, and 11.136, p < .05).

Conclusion: The clinical value of these factors is that they can help physicians better identify those patients who may require pharmacological intervention to control itching and pain.