Previous studies showed the prevalence of melasma, plateau facial telangiectasia, and vitiligo varied in different regions but were absent in high-altitude areas.
Aims
To investigate the prevalence of three common pigmented skin disorders (melasma, plateau facial telangiectasia, and vitiligo) among the general population in Lhasa, aiming to provide a scientific basis for their prevention and management in high-altitude areas.
Methods
From May 2021 to October 2021, multistage stratified cluster random sampling was conducted in Lhasa to carry out a questionnaire and a second on-site physical examination, and the results were statistically analyzed.
Results
The study included 4988 participants, revealing a prevalence of 14.94% for melasma, 17.14% for plateau facial telangiectasia, and 0.38% for vitiligo. Notably, the prevalence of melasma and plateau facial telangiectasia were significantly higher among women, particularly those aged 31–50 years, compared to men. Urban residents also showed a higher prevalence than their rural counterparts.
Conclusions
Our study concludes that the prevalence of the three pigmented skin disorders in Lhasa is notably higher than in lower-altitude areas, with UV radiation being a significant risk factor. Our findings underscore the need for enhanced public health interventions, including screening, education, and prevention efforts, to mitigate the impact of these skin disorders in high-altitude regions. Our research contributes valuable insights toward the understanding and management of pigmented skin disorders in such unique environments. It may also provide an easy-to-use epidemiological survey method for socioeconomically underdeveloped areas.
{"title":"Pigmented Skin Disorders in High-Altitude: Cross-Sectional Epidemiological Analysis in the General Population of Lhasa, China","authors":"Mingming Xu, Zha Zhen, Ying Chen, Shuo Zhang, Jing Li, Nan Li, Ruiyu Li, Suolang Quzong, Liming Huang, Wei Zhang","doi":"10.1111/jocd.70030","DOIUrl":"https://doi.org/10.1111/jocd.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies showed the prevalence of melasma, plateau facial telangiectasia, and vitiligo varied in different regions but were absent in high-altitude areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To investigate the prevalence of three common pigmented skin disorders (melasma, plateau facial telangiectasia, and vitiligo) among the general population in Lhasa, aiming to provide a scientific basis for their prevention and management in high-altitude areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From May 2021 to October 2021, multistage stratified cluster random sampling was conducted in Lhasa to carry out a questionnaire and a second on-site physical examination, and the results were statistically analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 4988 participants, revealing a prevalence of 14.94% for melasma, 17.14% for plateau facial telangiectasia, and 0.38% for vitiligo. Notably, the prevalence of melasma and plateau facial telangiectasia were significantly higher among women, particularly those aged 31–50 years, compared to men. Urban residents also showed a higher prevalence than their rural counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study concludes that the prevalence of the three pigmented skin disorders in Lhasa is notably higher than in lower-altitude areas, with UV radiation being a significant risk factor. Our findings underscore the need for enhanced public health interventions, including screening, education, and prevention efforts, to mitigate the impact of these skin disorders in high-altitude regions. Our research contributes valuable insights toward the understanding and management of pigmented skin disorders in such unique environments. It may also provide an easy-to-use epidemiological survey method for socioeconomically underdeveloped areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Consumers are searching for a solution to rejuvenate the eye area. Surgical blepharoplasties are a common solution, but they lack improvement in skin quality.
Aims
To present a novel procedure of a laser upper blepharoplasty in combination with erbium laser resurfacing of the lower eyelid for optimal rejuvenation and minimal complications.
Methods
The authors present a laser upper blepharoplasty with the CO2 laser performed at the same time as lower eyelid resurfacing using an erbium laser. The authors used an artificial intelligence large language model to assess the patient before and after photographs to quantify cosmetic improvement.
Results
After this novel procedure, patients demonstrated significant improvements in upper eyelid contour, reduced skin laxity, and smoother lower eyelid texture. Patient satisfaction was high, with each patient reporting an overall rejuvenated appearance and a more “awake” and youthful look. The artificial intelligence algorithm showed cosmetic improvement in line with the clinical evaluations by the patient and physician.
Conclusions
The combination of CO2 laser blepharoplasty and Er:YAG laser resurfacing addresses both upper eyelid dermatochalasis and lower eyelid wrinkles effectively while minimizing recovery time and the potential for complications. Artificial intelligence models were used to enhance this study and corroborate evaluator cosmetic improvement.
{"title":"A Novel Technique for Eye Rejuvenation: A Case Series of the Combined Use of CO2 Laser Blepharoplasty and Erbium: YAG Resurfacing and A Novel Artificial Intelligence Model to Quantify Laser Results","authors":"Chelsea E. Kesty, Katarina R. Kesty","doi":"10.1111/jocd.70022","DOIUrl":"https://doi.org/10.1111/jocd.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Consumers are searching for a solution to rejuvenate the eye area. Surgical blepharoplasties are a common solution, but they lack improvement in skin quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To present a novel procedure of a laser upper blepharoplasty in combination with erbium laser resurfacing of the lower eyelid for optimal rejuvenation and minimal complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors present a laser upper blepharoplasty with the CO<sub>2</sub> laser performed at the same time as lower eyelid resurfacing using an erbium laser. The authors used an artificial intelligence large language model to assess the patient before and after photographs to quantify cosmetic improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After this novel procedure, patients demonstrated significant improvements in upper eyelid contour, reduced skin laxity, and smoother lower eyelid texture. Patient satisfaction was high, with each patient reporting an overall rejuvenated appearance and a more “awake” and youthful look. The artificial intelligence algorithm showed cosmetic improvement in line with the clinical evaluations by the patient and physician.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of CO<sub>2</sub> laser blepharoplasty and Er:YAG laser resurfacing addresses both upper eyelid dermatochalasis and lower eyelid wrinkles effectively while minimizing recovery time and the potential for complications. Artificial intelligence models were used to enhance this study and corroborate evaluator cosmetic improvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Plasma gel, also known as plasma-rich in growth factors (PRGF) gel or platelet-rich gel, is a novel application of platelet-rich plasma (PRP), created by heating platelet-poor plasma (PPP) to induce denaturation, forming a gel-like substance. This gel is then combined with PRP to create a new injectable biomaterial that offers both the regenerative benefits of PRP and structural support due to its gel-like consistency. Plasma gel has been increasingly used not only for its biological regenerative properties but also as a cosmetic filler to enhance tissue volume and improve skin aesthetics. It shows promise in facial rejuvenation by improving skin texture and elasticity, and reducing the appearance of wrinkles. However, the detailed in vivo behavior of plasma gel, particularly its absorption rate and regenerative efficacy, remains underexplored.</p> </section> <section> <h3> Aims</h3> <p>This study aims to investigate the in vivo behavior of plasma gel, focusing on its absorption rate and its ability to stimulate tissue regeneration. Specifically, we aim to assess how quickly plasma gel is absorbed after subcutaneous injection and to evaluate its effects on collagen production and neovascularization using a nude mouse model.</p> </section> <section> <h3> Methods</h3> <p>Plasma gel was prepared by heating PPP to create a gel-like substance, which was then mixed with PRP. This mixture was injected subcutaneously into nude mice. The absorption of the gel was monitored over time by measuring the remaining volume at different time points. Tissue samples were analyzed using Masson's trichrome staining to detect collagen and CD31 immunohistochemical staining to assess neovascularization to understand the regenerative effects induced by plasma gel.</p> </section> <section> <h3> Results</h3> <p>The study found that plasma gel is absorbed rapidly, with approximately 50% of the volume disappearing within the first week and almost complete absorption by eight weeks. Despite this rapid absorption, significant increases in collagen deposition and new blood vessel formation were observed, indicating strong regenerative properties even after the gel had been largely absorbed.</p> </section> <section> <h3> Conclusions</h3> <p>The main findings of this study suggest that while plasma gel is quickly absorbed and may not be suitable for long-term volumizing effects, it shows significant potential for temporary volume enhancement
{"title":"In Vivo Assessment of Plasma Gel: Regenerative Potential and Limitations as a Filler","authors":"Hao Cheng, Ju Li, Yong Zhao, Xun Xia, Yan Li","doi":"10.1111/jocd.16765","DOIUrl":"https://doi.org/10.1111/jocd.16765","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Plasma gel, also known as plasma-rich in growth factors (PRGF) gel or platelet-rich gel, is a novel application of platelet-rich plasma (PRP), created by heating platelet-poor plasma (PPP) to induce denaturation, forming a gel-like substance. This gel is then combined with PRP to create a new injectable biomaterial that offers both the regenerative benefits of PRP and structural support due to its gel-like consistency. Plasma gel has been increasingly used not only for its biological regenerative properties but also as a cosmetic filler to enhance tissue volume and improve skin aesthetics. It shows promise in facial rejuvenation by improving skin texture and elasticity, and reducing the appearance of wrinkles. However, the detailed in vivo behavior of plasma gel, particularly its absorption rate and regenerative efficacy, remains underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to investigate the in vivo behavior of plasma gel, focusing on its absorption rate and its ability to stimulate tissue regeneration. Specifically, we aim to assess how quickly plasma gel is absorbed after subcutaneous injection and to evaluate its effects on collagen production and neovascularization using a nude mouse model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma gel was prepared by heating PPP to create a gel-like substance, which was then mixed with PRP. This mixture was injected subcutaneously into nude mice. The absorption of the gel was monitored over time by measuring the remaining volume at different time points. Tissue samples were analyzed using Masson's trichrome staining to detect collagen and CD31 immunohistochemical staining to assess neovascularization to understand the regenerative effects induced by plasma gel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that plasma gel is absorbed rapidly, with approximately 50% of the volume disappearing within the first week and almost complete absorption by eight weeks. Despite this rapid absorption, significant increases in collagen deposition and new blood vessel formation were observed, indicating strong regenerative properties even after the gel had been largely absorbed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The main findings of this study suggest that while plasma gel is quickly absorbed and may not be suitable for long-term volumizing effects, it shows significant potential for temporary volume enhancement ","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.16765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Hao, Mengjie Shan, Hao Liu, Yijun Xia, Xinwen Kuang, Kexin Song, Youbin Wang
Objectives
To establish, evaluate and compare three recurrence prediction models for keloid patients using machine learning methods.
Methods
We enrolled 301 keloid patients who underwent surgery and postoperative radiotherapy, dividing them into a training set (70%) and a validation set (30%). Three recurrence prediction models were established in the training set: the logistic regression model, the decision tree model, and the random forest model. We then evaluated and compared the performance of these models in the validation set, using metrics such as accuracy, sensitivity, specificity, recall, precision, kappa coefficient, and the area under the ROC curve (AUC).
Results
We developed three machine learning-based prediction models for keloid recurrence. KAAS, mean arterial pressure levels, postoperative complications, and the proportion of inflammatory cells played crucial roles in these models. The decision tree model outperformed both the random forest and logistic regression models in terms of accuracy, and it also exhibited the highest overall precision. Regarding AUC, logistic regression performed the best, followed by random forest and decision trees.
Conclusions
This study established three prediction models for keloid recurrence using machine learning techniques, highlighting the significance of KAAS, blood pressure levels, postoperative complications, and inflammatory cell proportions. When compared from various dimensions, the logistic regression model demonstrated the most favorable prognostic performance in terms of AUC.
{"title":"Comparison of Predictive Models for Keloid Recurrence Based on Machine Learning","authors":"Yan Hao, Mengjie Shan, Hao Liu, Yijun Xia, Xinwen Kuang, Kexin Song, Youbin Wang","doi":"10.1111/jocd.70008","DOIUrl":"https://doi.org/10.1111/jocd.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To establish, evaluate and compare three recurrence prediction models for keloid patients using machine learning methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 301 keloid patients who underwent surgery and postoperative radiotherapy, dividing them into a training set (70%) and a validation set (30%). Three recurrence prediction models were established in the training set: the logistic regression model, the decision tree model, and the random forest model. We then evaluated and compared the performance of these models in the validation set, using metrics such as accuracy, sensitivity, specificity, recall, precision, kappa coefficient, and the area under the ROC curve (AUC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We developed three machine learning-based prediction models for keloid recurrence. KAAS, mean arterial pressure levels, postoperative complications, and the proportion of inflammatory cells played crucial roles in these models. The decision tree model outperformed both the random forest and logistic regression models in terms of accuracy, and it also exhibited the highest overall precision. Regarding AUC, logistic regression performed the best, followed by random forest and decision trees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study established three prediction models for keloid recurrence using machine learning techniques, highlighting the significance of KAAS, blood pressure levels, postoperative complications, and inflammatory cell proportions. When compared from various dimensions, the logistic regression model demonstrated the most favorable prognostic performance in terms of AUC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alina Kilasoniya, Lidia Zabegina, Andrey Shalaev, Anna Artemyeva, Anastasia Malek
Background
This study investigates the potential of extracellular vesicles (EVs) in skin regeneration and rejuvenation. EVs, nanoscale vesicles released by various cell types, play a crucial role in intercellular communication.
Objective
To reaffirm the pivotal role of blood-derived exosomes in intercellular communication and their potential for skin tissue regeneration, leveraging existing research, including human data, to advocate for exosomes as a viable cell-free therapy for skin health.
Methods
The study employs a novel isolation technique combining PEG and Dextran with ultracentrifugation to extract EVs from plasma. Characterization techniques, including NTA, AFM, Cryo-TEM, and FC, confirm the successful isolation and characterization of EVs.
Results
The study demonstrates positive effects of blood-derived EVs on fibroblast proliferation, collagen, and elastin production in murine and human models. Despite advancements, challenges persist in obtaining consistent EVs quality and concentration. The findings support the clinical relevance of EVs in skin health and suggest potential applications for skin rejuvenation. Future research directions and study limitations are also discussed, contributing to the evolving understanding of EVs-based therapies.
{"title":"Stimulatory Effect of Mammalian Exosomes on Intradermal Fibroblast Proliferation","authors":"Alina Kilasoniya, Lidia Zabegina, Andrey Shalaev, Anna Artemyeva, Anastasia Malek","doi":"10.1111/jocd.70027","DOIUrl":"https://doi.org/10.1111/jocd.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigates the potential of extracellular vesicles (EVs) in skin regeneration and rejuvenation. EVs, nanoscale vesicles released by various cell types, play a crucial role in intercellular communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To reaffirm the pivotal role of blood-derived exosomes in intercellular communication and their potential for skin tissue regeneration, leveraging existing research, including human data, to advocate for exosomes as a viable cell-free therapy for skin health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study employs a novel isolation technique combining PEG and Dextran with ultracentrifugation to extract EVs from plasma. Characterization techniques, including NTA, AFM, Cryo-TEM, and FC, confirm the successful isolation and characterization of EVs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study demonstrates positive effects of blood-derived EVs on fibroblast proliferation, collagen, and elastin production in murine and human models. Despite advancements, challenges persist in obtaining consistent EVs quality and concentration. The findings support the clinical relevance of EVs in skin health and suggest potential applications for skin rejuvenation. Future research directions and study limitations are also discussed, contributing to the evolving understanding of EVs-based therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The ocular adverse reactions caused by the diffusion of BoNT-A injection are self-limiting, with symptoms ameliorating over time. Thyroid-associated ophthalmopathy (TAO) is an autoimmune disease characterized by symptoms such as exophthalmos, diplopia, and eyelid retraction, which may overlap the side effects of BoNT-A injections. It is crucial to consider other ocular diseases when assessing side effects after BoNT-A injection, particularly in patients with a history of thyroid disease.
Aims
To describe a complicated case of concurrent malignant exophthalmos and unilateral blepharoptosis following an additional dosage of BoNT-A injection for glabellar wrinkles.
Patient
A 58-year-old female patient received BoNT-A injection for glabellar wrinkles. Two weeks later, the patient requested an additional dose of BoNT-A to enhance the effects, receiving an extra 8 units BoNT-A in the brow muscles. Twenty days later, she presented with a ptosis in the left eye, which progressively manifested into symptoms of exophthalmos, uncoordinated movement, blurred vision, and double vision. Ultimately, she was diagnosed with malignant exophthalmos.
Results
The blepharoptosis following BoNT-A injection typically manifests a significant improvement within 1–3 months. However, if the symptoms of ptosis persist without evident amelioration and are accompanied by additional ocular discomfort, particularly in patients with thyroid disease, the potential presence of concomitant TAO should be considered.
Conclusions
This report highlights the potential relationship between botulinum toxin and thyroid disease, emphasizing the complexity of complications following cosmetic injections. Clinicians should carefully take the history of a patient, thereby facilitating better identification and management of potential complications.
{"title":"Unilateral Blepharoptosis Combined With Malignant Exophthalmos After Botulinum Toxin Injection to Glabellar Lines: A Case Report","authors":"Junli Zou, Zhen Li, Xiaozhen Li, Hong Cai","doi":"10.1111/jocd.70028","DOIUrl":"https://doi.org/10.1111/jocd.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The ocular adverse reactions caused by the diffusion of BoNT-A injection are self-limiting, with symptoms ameliorating over time. Thyroid-associated ophthalmopathy (TAO) is an autoimmune disease characterized by symptoms such as exophthalmos, diplopia, and eyelid retraction, which may overlap the side effects of BoNT-A injections. It is crucial to consider other ocular diseases when assessing side effects after BoNT-A injection, particularly in patients with a history of thyroid disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe a complicated case of concurrent malignant exophthalmos and unilateral blepharoptosis following an additional dosage of BoNT-A injection for glabellar wrinkles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient</h3>\u0000 \u0000 <p>A 58-year-old female patient received BoNT-A injection for glabellar wrinkles. Two weeks later, the patient requested an additional dose of BoNT-A to enhance the effects, receiving an extra 8 units BoNT-A in the brow muscles. Twenty days later, she presented with a ptosis in the left eye, which progressively manifested into symptoms of exophthalmos, uncoordinated movement, blurred vision, and double vision. Ultimately, she was diagnosed with malignant exophthalmos.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The blepharoptosis following BoNT-A injection typically manifests a significant improvement within 1–3 months. However, if the symptoms of ptosis persist without evident amelioration and are accompanied by additional ocular discomfort, particularly in patients with thyroid disease, the potential presence of concomitant TAO should be considered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This report highlights the potential relationship between botulinum toxin and thyroid disease, emphasizing the complexity of complications following cosmetic injections. Clinicians should carefully take the history of a patient, thereby facilitating better identification and management of potential complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical diagnosis and staging of vitiligo often rely on the patient's subjective recollection, physician's experience, or clinical evaluation methods. An objective, quantitative diagnostic approach is lacking.
Aims
This study was performed to compare the sensitivity and specificity of different lesion areas and full scanning of lesion areas using reflectance confocal microscopy (RCM) for diagnosis and staging of vitiligo.
Methods
Clinical and RCM data of patients diagnosed with vitiligo were collected. RCM data were gathered from three sites of a lesion: the center of the lesion, the margin of the lesion, and the perilesional normal skin. Scoring was conducted for each method, categorizing the results as either the progressive or stable stage of vitiligo.
Results
The sensitivity was significantly lower in the perilesional normal skin than at multiple sites (p < 0.001). The specificity was significantly lower in the center of the lesion and at the margin than at multiple sites and significantly higher in the perilesional normal skin than at multiple sites (p < 0.05 for all).
Conclusions
The results of RCM of different lesion areas of vitiligo showed that the rate of missed diagnosis of the progressive stage was lowest in the center of the lesion and comparable to that of multiple sites. The misdiagnosis rate for the stable stage was lowest in the perilesional normal skin, significantly differing from the other sites. Overall, scanning multiple sites yielded the most accurate results, offering flexibility in selection according to the patient's compliance.
{"title":"Sensitivity and Specificity Analysis of Different Lesion Areas of Vitiligo by Reflectance Confocal Microscopy","authors":"Jiyuan Wu, Miaomiao Sun, Zijia Wei, Qian Jiang, Hongying Chen, Liuqing Chen","doi":"10.1111/jocd.70006","DOIUrl":"https://doi.org/10.1111/jocd.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical diagnosis and staging of vitiligo often rely on the patient's subjective recollection, physician's experience, or clinical evaluation methods. An objective, quantitative diagnostic approach is lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study was performed to compare the sensitivity and specificity of different lesion areas and full scanning of lesion areas using reflectance confocal microscopy (RCM) for diagnosis and staging of vitiligo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical and RCM data of patients diagnosed with vitiligo were collected. RCM data were gathered from three sites of a lesion: the center of the lesion, the margin of the lesion, and the perilesional normal skin. Scoring was conducted for each method, categorizing the results as either the progressive or stable stage of vitiligo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sensitivity was significantly lower in the perilesional normal skin than at multiple sites (<i>p</i> < 0.001). The specificity was significantly lower in the center of the lesion and at the margin than at multiple sites and significantly higher in the perilesional normal skin than at multiple sites (<i>p</i> < 0.05 for all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results of RCM of different lesion areas of vitiligo showed that the rate of missed diagnosis of the progressive stage was lowest in the center of the lesion and comparable to that of multiple sites. The misdiagnosis rate for the stable stage was lowest in the perilesional normal skin, significantly differing from the other sites. Overall, scanning multiple sites yielded the most accurate results, offering flexibility in selection according to the patient's compliance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Asilian, Parisa Mohammadian, Hadiseh Mahram, Reza Shahriarirad, Mohammad Bigham
Background
Mohs micrographic surgery is the gold standard treatment for skin cancers in cosmetically sensitive anatomic areas, with a cure rate close to 100%. Managing post-Mohs surgery wounds can pose challenges, particularly in elderly patients. This study evaluates the Cicaglocal drug, a supplement with bromelain, Centella asiatica, hyaluronan, vitamins, and minerals, for enhancing wound healing post-Mohs surgery.
Method
This double-blinded, randomized clinical trial conducted at Al-Zahra Hospital in 2023 involved 24 patients aged 50–80 with SCC or BCC undergoing Mohs surgery. Patients were randomized into two groups Cicaglocal and placebo. Treatments were administered postoperatively, and outcomes such as erythema reduction, early healing score (EHS), full recovery, and patient and physician satisfaction levels were evaluated 7 and 14 days after initiation. Data were collected through clinical assessments and standardized wound photographs.
Result
Oral Cicaglocal demonstrated significantly improved outcomes compared to their respective placebo groups in terms of erythema score, EHS, full recovery score, and patient and physician satisfaction levels.
Conclusion
Cicaglocal can enhance wound healing and lead to improved clinical outcomes following Mohs micrographic surgery.
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Lei Zhang, Qian Zhao, Qilei Che, Wenju Wang, Tao Chen, Xiao Tang, Xin Zhao, Nianou Wang, Ke Li, Qingbiao Wa
Background
Melasma and facial aging are prevalent dermatological concerns. The combined use of a home-based radiofrequency (RF) device and a topical depigmentation agent, such as an arbutin-based cream, has shown potential in addressing both conditions.
Aims
This study evaluated the effectiveness and safety of combining a home-based RF device with arbutin cream to treat melasma and facial aging.
Methods
This single-center, open-label study included 38 participants. The treatment involved using a home-based RF device alongside an arbutin cream three times a week for 4 weeks, followed by a 4-week rest period. Key outcomes included changes in modified Melasma Area and Severity Index (mMASI) scores, melanin index (MI), erythema index (EI), facial wrinkles, skin texture, and periorbital dermal thickness. The participants also provided a self-assessment of the treatment efficacy.
Results
After 4 and 8 weeks of treatment, compared with baseline, the mMASI scores decreased by 20.8% and 25.6%, whereas the MI decreased by 22.0% and 22.8%, respectively. The EI decreased by 5.94% and 6.86%, facial wrinkles decreased by 30.9% and 35.9%, and skin texture scores decreased by 19.7% and 21.4% at 4 and 8 weeks posttreatment, respectively. Significant improvements in periorbital dermal thickness and subcutaneous tissue thickness were observed after combined RF and arbutin cream treatment. None of the 38 participants experienced adverse events, and all reported satisfaction with the results.
Conclusion
The combination of a noninvasive home-based RF device and arbutin cream is effective in improving melasma and achieving facial rejuvenation, offering a safe and patient-friendly treatment option.
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<p>Localized facial blanching usually resolves shortly after the botulinum toxin injection. Herein, we report the case of a patient who experienced localized blanching on her forehead and outer canthus following Botulinum toxin type A (BTX-A) injection for a longer time. This is the first documented occurrence of such a side effect in Asians in the literature. We have conducted a brief analysis of possible reasons for this phenomenon.</p><p>We present a case study of a 34-year-old Asian female who developed localized blanching on her forehead and outer canthus several hours after receiving BTX-A (BoNT A, Allergan) injections (Figure 1). The patient received 35U of BTX-A for forehead wrinkles (C-line, 14U; four distinct wrinkle areas, 6U) and female pattern hair loss (5 points, 15U) and 6U per side for canthus wrinkles (3 points) at the outer canthus. We performed injection with a (34G, 4 mm) needle. Upon review of the patient's medical history, it was confirmed that she had not received any BTX-A prior to this incident. The patient notice this change within a few hours of the injection. However, 12 h later, there was still no improvement. The dermatologist conducted a thorough examination and relevant tests (such as blood routine, tests of the coagulation cascade, and Digital Subtraction Angiography), and advised her to continue monitoring and exercising cautiously. The condition was mostly resolved 96 h after the injection. The blanching area near the surrounding skin color did not cause any discomfort to the patient during the procedure.</p><p>We reviewed the factors that may contribute to complications throughout the injection process, from preoperative preparation to postoperative management. These factors include the anesthetic gel, disinfectants, saline, and the postoperative application of ice packs. Subsequently, these potential factors were re-evaluated in relation to the patient, and no blanching were observed.</p><p>The patient denied blanching elsewhere on her body and had not received any additional injections, undergone cosmetic surgery, or experienced facial trauma prior to the onset of symptoms. She is currently not taking any medications and has no family history related to this phenomenon.</p><p>We here present a case of a temporary facial blanching after BTX-A. To the best of our knowledge, this is the first report of this complication which has features of spontaneous remission in Asian. As a rare complication, we aim to elucidate its cause through an examination of the mechanisms of botulinum toxin. Before delving into the mechanism of botulinum toxin, it is essential to have a comprehensive understanding of its function and common complications.</p><p>Botulinum toxin injection subcutaneously or intramuscularly to temporarily block nerve impulses between nerves and muscles [<span>1</span>]. This helps weaken muscle strength, reduce facial wrinkles, improve skin elasticity, and shape muscles in a targeted manner. The procedure
{"title":"Temporary Facial Blanching After Botulinum Toxin Injection in Asian: A Case Report and Review of the Literature","authors":"Hao Chen, Qiuyue Fu, Tianqi Zhang, Gang Chen","doi":"10.1111/jocd.16794","DOIUrl":"https://doi.org/10.1111/jocd.16794","url":null,"abstract":"<p>Localized facial blanching usually resolves shortly after the botulinum toxin injection. Herein, we report the case of a patient who experienced localized blanching on her forehead and outer canthus following Botulinum toxin type A (BTX-A) injection for a longer time. This is the first documented occurrence of such a side effect in Asians in the literature. We have conducted a brief analysis of possible reasons for this phenomenon.</p><p>We present a case study of a 34-year-old Asian female who developed localized blanching on her forehead and outer canthus several hours after receiving BTX-A (BoNT A, Allergan) injections (Figure 1). The patient received 35U of BTX-A for forehead wrinkles (C-line, 14U; four distinct wrinkle areas, 6U) and female pattern hair loss (5 points, 15U) and 6U per side for canthus wrinkles (3 points) at the outer canthus. We performed injection with a (34G, 4 mm) needle. Upon review of the patient's medical history, it was confirmed that she had not received any BTX-A prior to this incident. The patient notice this change within a few hours of the injection. However, 12 h later, there was still no improvement. The dermatologist conducted a thorough examination and relevant tests (such as blood routine, tests of the coagulation cascade, and Digital Subtraction Angiography), and advised her to continue monitoring and exercising cautiously. The condition was mostly resolved 96 h after the injection. The blanching area near the surrounding skin color did not cause any discomfort to the patient during the procedure.</p><p>We reviewed the factors that may contribute to complications throughout the injection process, from preoperative preparation to postoperative management. These factors include the anesthetic gel, disinfectants, saline, and the postoperative application of ice packs. Subsequently, these potential factors were re-evaluated in relation to the patient, and no blanching were observed.</p><p>The patient denied blanching elsewhere on her body and had not received any additional injections, undergone cosmetic surgery, or experienced facial trauma prior to the onset of symptoms. She is currently not taking any medications and has no family history related to this phenomenon.</p><p>We here present a case of a temporary facial blanching after BTX-A. To the best of our knowledge, this is the first report of this complication which has features of spontaneous remission in Asian. As a rare complication, we aim to elucidate its cause through an examination of the mechanisms of botulinum toxin. Before delving into the mechanism of botulinum toxin, it is essential to have a comprehensive understanding of its function and common complications.</p><p>Botulinum toxin injection subcutaneously or intramuscularly to temporarily block nerve impulses between nerves and muscles [<span>1</span>]. This helps weaken muscle strength, reduce facial wrinkles, improve skin elasticity, and shape muscles in a targeted manner. The procedure","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.16794","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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