Dermatologic Surgery最新文献

Background: Infraorbital hollowing and hyperpigmentation are common cosmetic concerns resulting from structural volume loss, pigmentary changes, vascular prominence, and skin laxity.

Objective: To systematically review current and emerging treatments for infraorbital concerns with an emphasis on patient selection and anatomy-driven approaches.

Materials and methods: A systematic PubMed search was conducted in March 2025 per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for English-language studies published after 2010. Fifty studies were selected and categorized by treatment type. Each modality was evaluated for efficacy, safety, and patient suitability.

Results: Treatments were organized into injectables, energy-based devices, microneedling, peels, topicals, polynucleotides, platelet-rich plasma/platelet-rich fibrin, neuromodulators, and surgery. Fillers remain foundational for volume loss; lasers address melanin, vascularity, and skin laxity. Microneedling and polynucleotides target texture and fine rhytides. Chemical peels and topicals are effective for superficial dyschromia. Botulinum toxin benefits orbicularis oculi hypertrophy and sequelae. Surgery is preferred for herniated fat and poor lower eyelid support. Patient-specific factors, including fat pad integrity, skin quality, and eyelid support, are critical for optimal results.

Conclusion: Infraorbital concerns are multifactorial and require individualized treatment strategies. This review integrates evidence and clinical expertise to guide personalized, anatomy-driven interventions that optimize outcomes in periorbital rejuvenation.

Background: Several monikers are used for tacking sutures in reconstructive skin surgery, typically reflecting either tissue fixation technique or function. The varying terminology results in a lack of clarity in the literature.

Objective: The objectives of this study were to compile a comprehensive resource that defines tacking sutures for facial reconstruction and to propose a unified system of nomenclature.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was followed to query the archives of 5 leading journals in skin surgery and the MEDLINE database for terms used to describe tacking sutures in facial reconstruction. The search yielded 1,493 articles of which 98 relevant articles were selected for inclusion. The suture technique described in each article was categorized by name given by the authors, tissue fixation technique, and function.

Results: Definitions for terms used to describe tacking sutures in the literature were developed based on consensus from the articles reviewed. Monikers for tacking sutures were dichotomized into descriptors of tissue fixation technique and function.

Conclusion: A new classification system for tacking sutures is proposed, using binomial nomenclature in which the first term describes the tissue fixation technique and the second term describes function.

Background: Congenital earlobe clefts, particularly the defective type with severe tissue deficiency, present unique reconstructive challenges requiring specialized techniques.

Objective: To evaluate the efficacy and safety of a preformed, inverted, and anastomosed subauricular tongue-shaped flap technique for treating defective-type congenital earlobe clefts.

Materials and methods: Twenty patients (12 male and 8 female patients; aged 8-34 years) with unilateral defective-type congenital earlobe clefts underwent surgical correction using a tongue-shaped flap from the subauricular region. Outcomes were evaluated using a 15-point scoring system by 2 independent surgeons.

Results: The mean assessment score was 13.4 (range: 10-15), with substantial interrater reliability (κ = 0.85). Eighteen patients (90%) achieved good outcomes, whereas 2 (10%) had fair outcomes. Minor complications occurred in 2 patients (10%). Patient satisfaction was high, with 85% reporting being "very satisfied" with overall appearance.

Conclusion: The preformed, inverted, and anastomosed subauricular tongue-shaped flap technique provides a reliable method for repairing defective-type congenital earlobe clefts, offering natural appearance and minimal scarring.

Background: The current Micrographic Surgery and Dermatologic Oncology (MSDO) fellowship match process requires applicants and fellowship directors to rank each other with limited information. Fellowship directors receive standardized information about applicants, but applicants lack comparable program data.

Objective: To determine how MSDO applicants learn about fellowship programs, and what program characteristics influence their rank list decisions.

Materials and methods: All MSDO applicants to the University of Pennsylvania for the 2025 to 2026 fellowship year were invited to participate in a web-based survey distributed via email. The survey evaluated applicant characteristics, preferred information sources to learn about programs, program characteristics impacting applicants rank list, and which applicant achievements and personal characteristics they believed fellowship directors valued most. Data collection concluded when 20% of the estimated 2024 national MSDO applicant pool responded.

Results: This survey analyzed responses from 39 MSDO applicants (26% of the estimated national applicant pool). Applicants primarily relied on interviews (84.6%), program websites (82.0%), and mentors (71.8%) for information. The most valued program characteristics were clinical autonomy, complex case volume, and prior fellows' satisfaction.

Conclusion: Fellowship directors can improve match outcomes by providing clear, standardized information through program websites, structured interviews, and details on clinical training, case complexity, and fellow autonomy.

Background: Androgenetic alopecia (AGA) is the leading cause of patterned hair loss. Current therapies are limited, and injectable therapy has emerged for intradermal delivery of bioactive agents. Despite increasing use, protocols and outcomes remain heterogeneous.

Objective: To systematically evaluate the agents, techniques, efficacy, and adverse effects of injectable therapy for AGA.

Materials and methods: A systematic review was conducted in July 2025 following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Embase, and Scopus were searched using the terms "mesotherapy" and "AGA." Studies were screened for relevance, with 30 meeting inclusion criteria.

Results: Included studies comprised 7 interventional, 11 observational, and 12 descriptive reports. The most frequently studied agents were multivitamin and peptide formulations, followed by dutasteride, minoxidil, bicalutamide, growth factors, and finasteride. Techniques varied in needle type, depth, and dosing schedules. Reported outcomes ranged from increased hair density and shaft diameter to stabilization of shedding. Adverse events were generally mild but included paradoxical alopecia, scarring, and acute dermatitis.

Conclusion: Injectable therapy may provide cosmetic benefit in AGA, particularly with dutasteride, but current evidence is limited by small sample sizes, variable protocols, and short follow-up. Standardized randomized trials are required before injectable therapy can be recommended as routine therapy.