Dermatologic Surgery最新文献

Background: Nonablative lasers treat photoaged skin and stimulate new collagen formation while sparing epidermal damage.

Objective: To evaluate the effectiveness and safety of nonablative fractional diode combination laser skin resurfacing treatment (1440 and 1927 nm) in mild-to-moderate photoaged skin.

Materials and methods: The entire face was treated with both 1440-nm and 1927-nm wavelengths per treatment, with a total of 4 treatments spaced 1 month apart. Follow-up occurred at 1 and 3 months post-treatment. Outcomes were improvement in the appearance of ≥1 measure of photodamage (rhytides, skin texture, dyschromia/pigment, skin radiance, pore size, and overall appearance) at the 3-month (primary) and 1-month (secondary) follow-up visits. Safety was monitored throughout the study.

Results: Participants (N = 28; 89% female; mean age, 40 years) experienced significant mean improvement from baseline in all measures of photodamage with combination laser treatment at 1 and 3 months post-treatment (all p < .001). No serious adverse events occurred. Post-treatment erythema and edema were minimal, and pain levels remained consistent throughout treatment. Most participants (96.4%) considered their overall appearance as improved and expressed satisfaction with treatment outcomes.

Conclusion: Nonablative combination laser skin resurfacing treatment was well tolerated and significantly improved measures of photodamage in photoaged skin across diverse skin types.

Background: Artificial skin substitutes are a flexible alternative to autografting in Mohs micrographic surgery (MMS), but the characteristics and clinical outcomes of skin substitutes are not well defined.

Objective: Summarize clinical data of skin substitutes in MMS for cutaneous malignancy.

Methods: A MEDLINE/Embase/Web of Science search was conducted. Articles with original data on outcomes after skin substitute use in MMS for cutaneous malignancy were included. Articles not in English or without original data were excluded. Bias was assessed using the Oxford CEBM Levels of Evidence Table. Outcomes were synthesized using weighted averages. This study was prospectively registered in PROSPERO.

Results: Of 1,007 articles, 40 met eligibility for inclusion. In total, 898 patients who underwent MMS and received a skin substitute were included. Xenografts were most commonly used ( n = 613). Semi-synthetic grafts (∼$<1/cm 2 ) and xenografts (∼$10/cm 2 ) are most affordable. Overall, outcomes were excellent for all skin substitutes, with a small proportion of patients experiencing correctable complications.

Conclusion: Skin substitutes are highly effective in MMS, with enormous potential. While the data demonstrate positive outcomes, they predominately draw from small, retrospective studies or case reports. There is also a scarcity of data comparing skin substitutes with each other or controls. Prospective studies are recommended.

Background: Hair transplantation has become a major method for improving upper facial contour. Hairline contour (HC) and hair growth direction (HGD) are the main factors affecting postoperative aesthetic outcomes. However, studies on natural HC and HGD in Chinese women are scarce.

Objective: To summarize the HC and HGD of hairlines in Chinese female participants.

Materials and methods: Standard photographs of the forehead were obtained from healthy Chinese volunteers older than 18 years. Hairline contour features were classified into 5 groups: round, bell-shaped, M-shaped, rectangular, and triangular. Hair growth direction was classified into 5 groups: Type ⅠA, Type ⅠB, Type ⅡA, Type ⅡB1, and Type ⅡB2. The authors performed hairline corrections in female participants.

Results: A total of 568 women participated in this study. The proportions of participants with different HC features were as follows: round (8.10%), bell-shaped (15.84%), M-shaped (23.24%), rectangular (44.19%), and triangular (8.63%). The proportions of participants with different HGDs were as follows: Type ⅠA (7.75%), Type ⅠB (27.64%), Type ⅡA (30.81%), Type ⅡB1 (28.34%), and Type ⅡB2 (5.46%).

Conclusion: Both HC and HGD were categorized into 5 types in Chinese women. Shaping the hairline into a round type along with the preexisting direction was suggested in most instances.

Background: Periorbital hyperpigmentation (POH) is a therapeutic problem. Platelet-rich plasma (PRP) has been successfully used in some pigmentary disorders including POH. Proper evaluation of treatment in POH can be difficult.

Objective: To assess the efficacy and safety of PRP injections for POH in skin phototypes III and IV by multiple clinical tools.

Methods: A clinical trial included 30 patients with POH, skin phototypes III and IV. Three sessions of intradermal PRP injections were used in periorbital area every month. Treatment was assessed on different clinical levels 1 month after the last session by POH severity grading, blinded photographic assessment, and patient satisfaction. Adverse effects of PRP were evaluated.

Results: A significant improvement in POH was documented by disease severity grading, patient satisfaction, and to a lesser extent by photographic evaluation. Grade II-POH showed the best improvement. More than half of the cases were satisfied and very satisfied. Lower disease grades, constitutional POH, and epidermal pigmentation showed significant improvement. Side effects were mostly tolerated.

Conclusion: The present results confirmed the beneficial role of PRP in improving POH. Multiple clinical tools are preferred for a more reliable assessment of treatment. Certain clinical types and grades of POH are suggested to respond more to PRP therapy.