Dermatologic Surgery最新文献

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.

Background: Erythematotelangiectatic rosacea (ETR) lacks a gold-standard treatment. Recent studies show that intradermal Botulinum Toxin-A (BoNT-A) is effective for erythema, though objective data are limited.

Objective: This study aims to evaluate the efficacy and tolerability of intradermal BoNT-A in patients with ETR.

Methods: In this randomized, double-blind, split-face study, 30 patients were enrolled. One side of the face received 15 units of BoNT-A, reconstituted in 10 mL of saline, while the control side received saline injections. Assessments were made at baseline and 1-month posttreatment. Clinician's Erythema Assessment (CEA) scale and Patient Self-Assessment (PSA) scores were recorded. Erythema and Melanin Index measurements using a Mexameter. Background erythema was assessed through dermatoscopy, while vascular structure and density were evaluated using Investigative Global Assessment (IGA) scores through videocapillaroscopy.

Results: The BoNT-A-treated side demonstrated significant reductions in CEA scores, Erythema Index, and dermatoscopic background erythema, while no significant changes were observed on the saline control side. IGA scores indicated a significant response to treatment on the BoNT-A side. Patient Self-Assessment scores improved on both sides. No serious adverse events requiring hospitalization were reported.

Conclusion: Intradermal BoNT-A effectively reduces erythema and vascular density in patients with ETR and is well-tolerated.

Background: Psoriasis is a common chronic systemic disease affecting the skin, nails, and joints. Nails are commonly associated with a greater severity of the disease. Radiofrequency (RF) is a nonionizing radiation that provides energy originating from electric current to generate heat inside the dermis with anti-inflammatory effects.

Objective: To assess the efficacy of nonablative bipolar radiofrequency in treating fingernail psoriasis.

Methods: Forty-three affected fingernails were treated with nonablative bipolar RF. Sessions were performed every 2 weeks for 2 months, with a maximum of 5 sessions. The 32-point target nail psoriasis severity index (tNAPSI), ultrasonography, and the physicians' global assessment were used for assessment at baseline, 1 month, and 3 months from the last treatment session.

Results: One month after the last RF session, a significant reduction in median tNAPSI score from baseline was recorded (p = .002), with a 58.33% reduction in pit count. The median thickness of subungual hyperkeratosis decreased significantly from baseline (p = .024), and the median score of onycholysis was also significantly reduced (p = .005). Ultrasonography revealed a significant reduction in the median nail matrix, bed thickness, and nail vascularity (p = .020, p < .001, and p = .013, respectively).

Conclusion: Radiofrequency may offer a safe and effective treatment modality for fingernail psoriasis.

Background: Thread lifts are a noninvasive technique for suspending ptotic skin. Previous studies have failed to show long-term efficacy data with absorbable threads.

Objective: To review the recent literature evaluating mid and lower facial absorbable thread lifts over a four-year period from October 2018 to December 2022.

Methods: A systematic review was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed database. Search terms included "lift," "face lift," "thread lift," "suture suspension," "silhouette suture," "silhouette lift," "rhytidectomy," and "Aptos." Technique articles with objective results were included.

Results: Twelve studies met criteria for analysis (n = 818). The most common thread evaluated was suture suspension using polydioxanone followed by poly-l-lactic acid/polycaprolactone absorbable threads. Scores according to the Global Aesthetic Improvement Scale, Wrinkle Severity Scale, Barton's Grading System, and FACE-Q improved in all cases immediately after the procedure. The longest follow-up assessments were at 2 years. Complications were mild.

Conclusion: In the appropriate patient, thread lifts are immediately effective, and the risk of dangerous complications is low, but long-term efficacy data are lacking.