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Evaluation of Wrinkle and Dermal Thickness in the Forearm before and after Picosecond Laser Therapy. 皮秒激光疗法前后对前臂皱纹和真皮厚度的评估
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.4103/JCAS.JCAS_80_22
Putri Hendria Wardhani, Cita Rosita Sigit Prakoeswa, Muhammad Yulianto Listiawan

Background: Skin wrinkles are generated as a result of the aging process. Dermal thickness underneath a wrinkle decreases absolutely. Approximately 20% of dermal thickness disappears as people become elderly. In recent times, people have attempted to reduce wrinkles using various procedures. Currently, available picosecond lasers in dermatology can create mechanical stress and the energy can be fractionated via diffractive lens arrays (DLA). An emerging indication for the picosecond laser includes photorejuvenation. Non-ablative laser skin rejuvenation therapy demonstrates the dermis can be safely reconstructed by only irradiating the skin surface with a laser. The clinical effects of picosecond pulse laser have been frequently reported, but few studies have included histological investigation.

Aims and objectives: This study aimed to evaluate wrinkle and dermal thickness in the forearm before and after picosecond laser therapy.

Materials and methods: Twenty healthy male and female subjects between 36 and 55 years old with wrinkles in the forearm who met the sample requirements and were willing to participate were recruited in this study. Clinical examination and biopsy for histopathological examination were carried out before and 4 weeks after therapy, then treatment was carried out using a picosecond laser.

Results: At 1-month follow-up, a significant improvement was noted in wrinkle and dermal thickness (P < 0.05).

Conclusions: This picosecond 755 nm alexandrite laser with DLA was found to be very effective in treating wrinkles, which was confirmed by a dermatologic assessment from forearm photographic assessment scaled and dermal thickness improvement.

背景介绍皮肤皱纹的产生是衰老过程的结果。皱纹下方的真皮厚度会绝对减少。随着年龄的增长,约有 20% 的真皮厚度会消失。近来,人们尝试使用各种方法来减少皱纹。目前,皮肤科使用的皮秒激光可产生机械应力,能量可通过衍射透镜阵列(DLA)进行分馏。皮秒激光的一个新兴适应症包括光子嫩肤。非烧蚀激光嫩肤疗法表明,只需用激光照射皮肤表面,就能安全地重建真皮层。皮秒脉冲激光的临床效果屡有报道,但很少有研究包括组织学调查:本研究旨在评估皮秒激光治疗前后前臂的皱纹和真皮厚度:本研究招募了 20 名年龄在 36 至 55 岁之间、前臂有皱纹且符合样本要求并愿意参与的健康男性和女性受试者。在治疗前和治疗后 4 周进行临床检查和活组织病理学检查,然后使用皮秒激光进行治疗:结果:随访1个月后,皱纹和真皮厚度均有明显改善(P < 0.05):皮秒755 nm紫翠宝石激光器和DLA对治疗皱纹非常有效,前臂照片评估和真皮厚度的改善证实了这一点。
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引用次数: 0
A comparative study of fractional CO2 laser with topical triamcinolone acetonide versus intralesional triamcinolone acetonide in the treatment of alopecia areata. 治疗斑秃的二氧化碳点阵激光与局部使用曲安奈德与局部使用曲安奈德的比较研究。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.4103/JCAS.JCAS_31_23
Harish Prasanna, Rajashekar Talari Srinivas, Suresh Kumar Kuppuswamy, Hanumanthayya Keloji, Pavithra Thotta Ravikumar

Introduction: Alopecia areata (AA) is a non-scarring alopecia of chronic autoimmune etiology with heterogenous severity against the anagen hair follicle over the scalp, beard, or any part of the body and is associated with a significant psychological morbidity in the mental status of the patients leading the patients to seek treatment for cosmetic reasons. The management of AA is very unpredictable and is associated with various cosmetic adverse effects. This study aimed at comparing the efficacy and safety of a novel procedure of laser-assisted drug delivery system of steroids with the first-line procedure of intralesional steroids (ILS) for the treatment of patchy AA.

Aims and objectives: To assess and compare the efficacy and safety of fractional CO2 laser in combination with topical triamcinolone acetonide aqueous solution and intralesional triamcinolone acetonide as a monotherapy and in the treatment of AA.

Materials and methods: A total of 60 patchy AA patients were included in this study. Patients were randomized into two equal groups: Group A and Group B with 30 patients in each group using a computer-generated block randomization. Patients in Group A received fractional CO2 laser with topical triamcinolone acetonide aqueous solution and Group B received ILS. Both groups received treatment for five settings with each setting a gap of 3 weeks. The efficacy and safety of treatment modalities in both groups were assessed using global photograph assessment (GPA)-scale, lesional area density score percentage of improvement (LAD score improvement %), visual discomfort scale (VDS), visual analogue scale, and documentation of adverse effects in each setting.

Results: Efficacy of treatment modality-assessed using means score of GPA-scale and LAD score improvement % suggests quicker results to patients in Group B in initial settings but drastic improvement happens to patients in Group A in subsequent settings. At the end of 5th setting, GPA-scale and LAD score improvement % suggest maximum efficacy in patients in Group A and they are statistically significant (P-value < 0.001). The mean VDS in both groups suggests maximum discomfort in Group A, yet the patient satisfaction at the end of 5th setting was maximum with patients in Group A and they are statistically significant (P-value < 0.001). Cosmetic notable adverse effect of atrophy of skin was documented in 30% of patients in Group B.

Conclusion: This study showed that fractional CO2 laser with topical triamcinolone acetonide is a better treatment modality than the intralesional triamcinolone acetonide for the treatment of AA with respect to efficacy, safety, and adverse events.

简介斑秃(AA)是一种慢性自身免疫性非瘢痕性脱发,严重程度不一,主要针对头皮、胡须或身体任何部位的生长期毛囊。AA 的治疗非常难以预测,而且与各种美容不良反应有关。本研究旨在比较激光辅助类固醇给药系统这一新型疗法与治疗斑片状 AA 的一线疗法--局部注射类固醇(ILS)的疗效和安全性:评估并比较点阵二氧化碳激光联合外用曲安奈德水溶液和鞘内曲安奈德水溶液作为单一疗法和治疗AA的有效性和安全性:本研究共纳入60名斑片状AA患者。将患者随机分为两组:A组和B组,每组各30名患者。A 组患者接受点阵 CO2 激光治疗,并外用曲安奈德水溶液,B 组患者接受 ILS 治疗。两组患者均接受了五次治疗,每次治疗间隔 3 周。两组治疗方法的疗效和安全性均采用全局照片评估(GPA)量表、皮损区密度评分改善百分比(LAD评分改善百分比)、视觉不适量表(VDS)、视觉模拟量表进行评估,并记录每次治疗的不良反应:结果:使用 GPA 量表平均值和 LAD 评分改善率评估的治疗方法的疗效表明,B 组患者在初始治疗中见效较快,但在随后的治疗中,A 组患者的病情有了显著改善。在第 5 次治疗结束时,GPA 量表和 LAD 评分改善率显示 A 组患者的疗效最高,且具有统计学意义(P 值 < 0.001)。两组患者的平均 VDS 显示,A 组患者的不适感最强,但在第 5 次治疗结束时,A 组患者的满意度最高,且具有统计学意义(P 值 < 0.001)。B 组有 30% 的患者出现了皮肤萎缩这一显著的美容不良反应:这项研究表明,在治疗 AA 方面,点阵 CO2 激光与局部使用曲安奈德是一种在疗效、安全性和不良反应方面都优于局部使用曲安奈德的治疗方式。
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引用次数: 0
Surgical pearl: Modified hypodermic needle and its cap for guarded prick incision. 外科珍珠改良皮下注射针及其针帽,用于防护性刺入切口。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.4103/JCAS.JCAS_62_21
Muhammed Mukhtar

There are many instruments to prick the comedone before its extraction and scalp during hair transplantation. These instruments are not well guarded, and it can cause deep injury and fear in the patients. Here we described how to guard these needle for safety during procedure.

在植发过程中,有许多器械可以在提取粉刺之前刺破粉刺和头皮。这些器械没有很好的防护措施,可能会对患者造成很深的伤害和恐惧。在此,我们介绍了如何在手术过程中保护这些针头的安全。
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引用次数: 0
Full Thickness Macular Hole in Aesthetician Occurring Due to Accidental Self-exposure to Cosmetic Laser Machine Trying to Take Special Precautions Against COVID-19. 美容师在尝试对 COVID-19 采取特别防护措施时,意外自行暴露于美容激光机,导致全厚黄斑孔。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.4103/JCAS.JCAS_74_21
Alay S Banker, Bansri M Mahadevia, Harita Shah, Ahan A Banker

A 25-year-old aesthetician was operating Q-switch pulse (SPECTRA) cosmetic laser machine of 1,064 nm wavelength, for the purpose of skin bleaching. The probe suddenly slipped over the plastic sheet that had been placed to avoid COVID-19 exposure after which she complained of sudden loss of vision. She was diagnosed as having vitreous hemorrhage in her right eye and was treated conservatively for one month. She then complained of central scotoma and was diagnosed to have developed a full-thickness macular hole, for which she was advised vitrectomy surgery. The purpose of this case report is to emphasize the importance of taking precautions during the COVID-19 era and while doing that making sure how to handle the machines so as not to inflict any accidental injury to the operating physician. Macular Holes following skin bleaching with Nd:YAG laser occurring in operating aesthetician is rare as compared to that occurring in the patients.

一名 25 岁的美容师正在操作波长为 1,064 nm 的 Q 开关脉冲(SPECTRA)美容激光机进行皮肤漂白。探头突然滑过为避免 COVID-19 暴露而放置的塑料布,随后她抱怨视力突然下降。她被诊断为右眼玻璃体出血,接受了一个月的保守治疗。之后,她主诉出现中心视力障碍,并被诊断为黄斑全厚孔,医生建议她进行玻璃体切除手术。本病例报告旨在强调在 COVID-19 时代采取预防措施的重要性,同时要确保如何操作机器,以免对手术医生造成任何意外伤害。使用 Nd:YAG 激光漂白皮肤后,在操作美容师身上出现的黄斑孔与在患者身上出现的黄斑孔相比非常罕见。
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引用次数: 0
Anaphylactic shock secondary to topical EMLA 继发于外用 EMLA 的过敏性休克
Q3 Medicine Pub Date : 2023-11-30 DOI: 10.4103/jcas.jcas_30_23
V. M. V. Gowda, S. Shenoi, K. M. Augustine
The eutectic mixture of local anesthetics (EMLAs) is an anesthetic cream frequently used by dermatologists for various aesthetic procedures on a daily basis. Although side effects of EMLA are usually mild local skin reactions, rare complications such as methemoglobinemia, central nervous system toxicity, and cardiotoxicity can occur. Herein, we are reporting a case of anaphylactic shock to topical application of EMLA.
局麻药共晶混合物(EMLAs)是皮肤科医生日常在各种美容手术中经常使用的一种麻醉膏剂。虽然 EMLA 的副作用通常是轻微的局部皮肤反应,但也可能出现高铁血红蛋白血症、中枢神经系统毒性和心脏毒性等罕见并发症。在此,我们报告一例局部使用 EMLA 引起过敏性休克的病例。
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引用次数: 0
Spontaneous and induced degradation of dermal fillers: A review 皮肤填充剂的自发降解和诱导降解:综述
Q3 Medicine Pub Date : 2023-11-30 DOI: 10.4103/jcas.jcas_137_23
Uwe Wollina, A. Goldman
Dermal fillers are among the most versatile tools in esthetic medicine. A broad range of temporary, semipermanent, and permanent filler products is on the market. We performed a narrative review on spontaneous and induced degradation of dermal fillers in vitro and in vivo. Hyaluronic acid-based fillers are the most frequently used temporary fillers. The products differ in their hyaluronic acid content, cross-linking, and rheological parameters. Endogenous hyaluronidase and reactive oxygen species are responsible for the spontaneous degradation of these fillers. Hyaluronidase digests the filler material by cleavage of the β-1,4 glycosidic linkage between N-acetyl-glucosamine and d-glucuronic acid. The enzyme can be used for treatment of medical and cosmetic adverse events due to hyaluronic acid-based filler. Higher hyaluronidase content and higher degree of cross-linking are major factors contributing to filler persistence over time. Semipermanent fillers are poly-(d),l-lactic acid and calcium hydroxylapatite. These filler types are decomposed by hydrolysis and osteoclastic enzymes. They usually persist up to 2 years, in single patients even more than 5 years. Sodium thiosulfate can stimulate degradation of calcium hydroxylapatite, but it is slow acting and not effective in case of emergency. Permanent fillers may show some kind of modification in situ, but spontaneous or induced degradation has not been documented. Once implanted the permanent fillers remain lifelong. Intralesional laser treatment supports the removal of permanent filler material as an alternative to surgery. Besides biocompatibility and toxicity, filler materials should also be assessed for degradation to improve patient safety.
皮肤填充剂是美容医学中用途最广泛的工具之一。市场上有多种临时性、半永久性和永久性填充产品。我们对皮肤填充剂在体外和体内的自发降解和诱导降解进行了叙述性综述。透明质酸类填充剂是最常用的临时性填充剂。这些产品的透明质酸含量、交联度和流变参数各不相同。内源性透明质酸酶和活性氧是这些填充剂自发降解的原因。透明质酸酶通过裂解 N-乙酰葡糖胺和 d-葡萄糖醛酸之间的 β-1,4糖苷键来消化填充材料。这种酶可用于治疗透明质酸类填充剂引起的医疗和美容不良反应。较高的透明质酸酶含量和较高的交联度是导致填充物长期存在的主要因素。半永久性填充物是聚-(d),l-乳酸和羟基磷灰石钙。这些类型的填充物会被水解和破骨细胞酶分解。它们通常可维持 2 年,个别患者甚至可维持 5 年以上。硫代硫酸钠可以促进羟磷灰石钙的降解,但作用缓慢,在紧急情况下无效。永久性填充物可能会在原位发生某种改变,但自发降解或诱导降解还没有记录。永久性填充物一旦植入,将终身有效。作为手术的替代方法,区域内激光治疗有助于去除永久性填充材料。除了生物相容性和毒性外,还应对填充材料的降解情况进行评估,以提高患者的安全性。
{"title":"Spontaneous and induced degradation of dermal fillers: A review","authors":"Uwe Wollina, A. Goldman","doi":"10.4103/jcas.jcas_137_23","DOIUrl":"https://doi.org/10.4103/jcas.jcas_137_23","url":null,"abstract":"Dermal fillers are among the most versatile tools in esthetic medicine. A broad range of temporary, semipermanent, and permanent filler products is on the market. We performed a narrative review on spontaneous and induced degradation of dermal fillers in vitro and in vivo. Hyaluronic acid-based fillers are the most frequently used temporary fillers. The products differ in their hyaluronic acid content, cross-linking, and rheological parameters. Endogenous hyaluronidase and reactive oxygen species are responsible for the spontaneous degradation of these fillers. Hyaluronidase digests the filler material by cleavage of the β-1,4 glycosidic linkage between N-acetyl-glucosamine and d-glucuronic acid. The enzyme can be used for treatment of medical and cosmetic adverse events due to hyaluronic acid-based filler. Higher hyaluronidase content and higher degree of cross-linking are major factors contributing to filler persistence over time. Semipermanent fillers are poly-(d),l-lactic acid and calcium hydroxylapatite. These filler types are decomposed by hydrolysis and osteoclastic enzymes. They usually persist up to 2 years, in single patients even more than 5 years. Sodium thiosulfate can stimulate degradation of calcium hydroxylapatite, but it is slow acting and not effective in case of emergency. Permanent fillers may show some kind of modification in situ, but spontaneous or induced degradation has not been documented. Once implanted the permanent fillers remain lifelong. Intralesional laser treatment supports the removal of permanent filler material as an alternative to surgery. Besides biocompatibility and toxicity, filler materials should also be assessed for degradation to improve patient safety.","PeriodicalId":15415,"journal":{"name":"Journal of Cutaneous and Aesthetic Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139201751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of topical 0.5% humic acid gel on male rats with skin ulcer 外用 0.5% 腐植酸凝胶对雄性皮肤溃疡大鼠的影响
Q3 Medicine Pub Date : 2023-11-30 DOI: 10.4103/jcas.jcas_104_23
Fatemeh Samiee-Rad, Fatemeh Ghasemi, Ensiyeh Bahadoran, M. Sofiabadi, Zahra Shalbaf, Armane Taherkhani, N. Gheibi
Humic derivatives have antibacterial and anti-inflammatory properties. This study aimed to assess the experimental wound-healing effect of 0.5% humic acid gel. A full-thickness skin wound was created on the dorsal side of 24 Sprague Dawley male rats (220–250g). The animals were then randomly divided into the control, sham, and experimental groups. Skin wounds were bandaged daily using sterile gauze dipped in normal saline, carboxymethylcellulose, and 0.5% humic acid for 21 days. The wound-healing rate was evaluated grossly and histologically at various time intervals post-injury. Wound-healing percentage was significantly higher in the gel treatment group at all time points (P < 0.05). The mean number of inflammatory cells was significantly lower in the humic acid gel group than in the other groups (P < 0.001). Moreover, the number of new vascular cells and fibroblasts were significantly increased in the humic acid gel compared to the control (P < 0.001). These data confirmed that 0.5% humic acid gel accelerates wound healing, probably by anti-inflammatory effects, as well as by promoting vascular and fibroblast proliferation. Therefore, the humic acid gel may be used to improve wound care.
腐植酸衍生物具有抗菌消炎的特性。 本研究旨在评估 0.5% 腐植酸凝胶的伤口愈合效果。 在 24 只 Sprague Dawley 雄性大鼠(220-250 克)的背侧创建一个全厚皮肤伤口。然后将动物随机分为对照组、假组和实验组。每天用蘸有生理盐水、羧甲基纤维素和 0.5% 腐植酸的无菌纱布包扎皮肤伤口,持续 21 天。在受伤后的不同时间间隔,对伤口愈合率进行大体和组织学评估。 在所有时间点上,凝胶处理组的伤口愈合率都明显更高(P < 0.05)。腐植酸凝胶组的炎症细胞平均数量明显低于其他组(P < 0.001)。此外,与对照组相比,腐植酸凝胶组新生血管细胞和成纤维细胞的数量明显增加(P < 0.001)。 这些数据证实,0.5% 腐植酸凝胶可加速伤口愈合,这可能是通过抗炎作用以及促进血管和成纤维细胞增殖实现的。因此,腐植酸凝胶可用于改善伤口护理。
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引用次数: 0
Custom-made dental prosthetic clip for postoperative management of earlobe keloids 定制义齿夹用于耳垂瘢痕疙瘩术后治疗
Q3 Medicine Pub Date : 2023-11-30 DOI: 10.4103/jcas.jcas_16_23
Vikas Pathania, Rahul Udayasankar
Earlobe keloids are a common condition with varied and cross-specialty presentation. The condition is often recalcitrant and difficult to treat on account of its location. Frequent recurrences following excision is often frustrating for the patient and the surgeon. Application of pressure along with intra-operative and postoperative intralesional steroids is a popular choice and is in vogue by surgeons and dermatologists. However, considering the uniqueness of the structure for every individual, it is often difficult to ensure one size fits all when using pressure therapy as an adjunct. We designed a simple PMMA dental prosthesis to ensure comfortable yet effective constant pressure over the lesion to ensure complete aesthetic outcome without recurrence in an operated earlobe keloid.
耳垂瘢痕疙瘩是一种常见的疾病,其表现多种多样,而且涉及多个专科。由于位置的原因,这种疾病往往顽固难治。切除后经常复发往往令患者和外科医生感到沮丧。在术中、术后使用类固醇激素的同时加压治疗是外科医生和皮肤科医生的普遍选择。然而,考虑到每个人的结构都不尽相同,在使用压力疗法作为辅助手段时,往往很难确保一刀切。我们设计了一种简单的 PMMA 牙科假体,以确保对病变部位施加舒适而有效的恒定压力,从而确保手术后耳垂瘢痕疙瘩不复发,达到完全美观的效果。
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引用次数: 0
Pedunculated superficial angiomyxoma of the thigh mimicking molluscum pendulum 模仿软疣的大腿有蒂浅表血管瘤
Q3 Medicine Pub Date : 2023-11-30 DOI: 10.4103/jcas.jcas_72_23
Abdulmooti Hawilo, Wejdene Fakhfakh, N. Litaiem
Superficial angiomyxoma (SAM) is a rare acquired benign neoplasm. It may be sporadic or associated with Carney’s complex. Typical locations for SAM are the head, neck, and trunk. It usually presents as a skin-colored papule or sessile lobulated nodule. Large pedunculated forms are less common. We describe a sporadic massive pedunculated SAM of the thigh occurring in a 75-year-old man and provide a comprehensive summary of SAM characteristics.
表皮血管瘤(SAM)是一种罕见的获得性良性肿瘤。它可能是散发性的,也可能与卡尼氏综合征有关。SAM的典型发病部位是头部、颈部和躯干。它通常表现为皮肤色丘疹或无梗分叶结节。大的有蒂结节较少见。我们描述了一名 75 岁男性大腿上的散发性大块有蒂 SAM,并全面总结了 SAM 的特征。
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引用次数: 0
Giant neglected unresectable ulcerated basal cell carcinoma of face: Radiotherapy at rescue 面部巨大的被忽视的无法切除的溃疡性基底细胞癌:放射治疗抢救
Q3 Medicine Pub Date : 2023-11-30 DOI: 10.4103/jcas.jcas_62_23
Shubham Kumar, S. Patra, Bharti Devnani, Varun Rajagopalan, Maninder Kaur
Basal cell carcinomas are typically considered indolent and slowly progressing tumors, but giant basal cell carcinomas are more aggressive with more risk of invasion and poor prognosis. management of such giant BCCs is difficult due to difficulty in surgical approach. we hereby reporting a case of giant ulcerated BCC of face treated with radiotherapy as a rescue treatment.
基底细胞癌通常被认为是进展缓慢的轻度肿瘤,但巨型基底细胞癌更具侵袭性,侵袭风险更高,预后较差。
{"title":"Giant neglected unresectable ulcerated basal cell carcinoma of face: Radiotherapy at rescue","authors":"Shubham Kumar, S. Patra, Bharti Devnani, Varun Rajagopalan, Maninder Kaur","doi":"10.4103/jcas.jcas_62_23","DOIUrl":"https://doi.org/10.4103/jcas.jcas_62_23","url":null,"abstract":"Basal cell carcinomas are typically considered indolent and slowly progressing tumors, but giant basal cell carcinomas are more aggressive with more risk of invasion and poor prognosis. management of such giant BCCs is difficult due to difficulty in surgical approach. we hereby reporting a case of giant ulcerated BCC of face treated with radiotherapy as a rescue treatment.","PeriodicalId":15415,"journal":{"name":"Journal of Cutaneous and Aesthetic Surgery","volume":"85 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Cutaneous and Aesthetic Surgery
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