Aging reduces the production of hyaluronic acid (HA) in the skin, leading to wrinkles and sagging. HA-based skincare products are being studied to improve skin quality. This systematic review and meta-analysis aimed to compare the effectiveness of HA-based injectable products for reducing wrinkles and enhancing skin elasticity, hydration, and radiation.
Methods
Eligible trial reports were found by searching PubMed, Embase, Scopus, and Web of Science systematically until May 2024. A random-effects meta-analysis was performed to evaluate the effect of HA injection on skin aging. The protocol of the study has been registered in PROSPERO with a registration ID of CRD42024540703.
Results
Overall, 12 studies met the inclusion criteria, of which 6 studies had enough data for meta-analysis. The random-effect meta-analysis showed improved hydration (SMD = 1.34, 95% CI = 0.14–2.54, and p < 0.05) and radiance (SMD = 0.51, 95% CI = 0.22–0.80, and p < 0.05) after HA filler injection. However, there was no significant difference in elasticity (SMD = 0.25, 95% CI = −0.20–0.70, and p = 0.27) and melanin index (SMD = −1.74, 95% CI = −4.89–1.41, p = 0.28) compared to controls.
Conclusions
According to the results of a meta-analysis, hyaluronic acid injections have been found to improve skin hydration and radiance, thus reversing the effects of skin aging. However, the study did not find any significant changes in the skin's elasticity or melanin index. Further research is required to confirm the effectiveness of hyaluronic acid in treating skin aging.
背景：衰老会减少皮肤中透明质酸（HA）的产生，导致皱纹和下垂。人们正在研究以ha为基础的护肤品，以改善皮肤质量。本系统综述和荟萃分析旨在比较基于ha的注射产品在减少皱纹和增强皮肤弹性、水合作用和辐射方面的有效性。方法：截止2024年5月，系统检索PubMed、Embase、Scopus和Web of Science，找到符合条件的试验报告。随机效应荟萃分析评估透明质酸注射对皮肤老化的影响。本研究方案已在PROSPERO注册，注册ID为CRD42024540703。结果：总的来说，12项研究符合纳入标准，其中6项研究有足够的数据进行meta分析。随机效应荟萃分析显示，注射透明质酸可以改善皮肤的水合作用（SMD = 1.34, 95% CI = 0.14-2.54, p）。结论：根据荟萃分析的结果，注射透明质酸可以改善皮肤的水合作用和光泽，从而逆转皮肤衰老的影响。然而，该研究并未发现皮肤弹性或黑色素指数有任何显著变化。透明质酸治疗皮肤老化的有效性还需要进一步的研究来证实。
{"title":"The Effect of Local Hyaluronic Acid Injection on Skin Aging: A Systematic Review and Meta-Analysis","authors":"Rongying Zhou, Mei Yu","doi":"10.1111/jocd.16760","DOIUrl":"10.1111/jocd.16760","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aging reduces the production of hyaluronic acid (HA) in the skin, leading to wrinkles and sagging. HA-based skincare products are being studied to improve skin quality. This systematic review and meta-analysis aimed to compare the effectiveness of HA-based injectable products for reducing wrinkles and enhancing skin elasticity, hydration, and radiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligible trial reports were found by searching PubMed, Embase, Scopus, and Web of Science systematically until May 2024. A random-effects meta-analysis was performed to evaluate the effect of HA injection on skin aging. The protocol of the study has been registered in PROSPERO with a registration ID of CRD42024540703.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 12 studies met the inclusion criteria, of which 6 studies had enough data for meta-analysis. The random-effect meta-analysis showed improved hydration (SMD = 1.34, 95% CI = 0.14–2.54, and <i>p</i> < 0.05) and radiance (SMD = 0.51, 95% CI = 0.22–0.80, and <i>p</i> < 0.05) after HA filler injection. However, there was no significant difference in elasticity (SMD = 0.25, 95% CI = −0.20–0.70, and <i>p</i> = 0.27) and melanin index (SMD = −1.74, 95% CI = −4.89–1.41, <i>p</i> = 0.28) compared to controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>According to the results of a meta-analysis, hyaluronic acid injections have been found to improve skin hydration and radiance, thus reversing the effects of skin aging. However, the study did not find any significant changes in the skin's elasticity or melanin index. Further research is required to confirm the effectiveness of hyaluronic acid in treating skin aging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978821","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}
Di-Ya Su, Mu-Yan Zou, Shi-Wei Wang, Lei Dong, Jia-Xu Wu, Xi-Yue Hu, Jie-Qing Wang
Background: Tear trough deformities are indicative of aging, progressively manifesting as pronounced infraorbital hollows. Although hyaluronic acid (HA) dermal fillers are favored for their safety and efficacy, quantifiable evidence of their effect of action still remains insufficient.
Aims: To investigate the efficacy of non-cross-linked HA compound in tear trough enhancement.
Methods: Twenty-one subjects with moderate to severe infraorbital hollows underwent a single treatment including subcutaneous to supraperiosteal injections of a non-cross-linked HA compound. The effectiveness was assessed through Allergan Infraorbital Hollows Scale (AIHS), satisfaction rates, the Global Aesthetic Improvement Scale (GAIS), and quantitative analyses via Canfield VECTRA 3D imaging and MRI measurements during the 6-month follow-up.
Results: A total of 0.67 ± 0.31 and 0.77 ± 0.42 mL of the non-cross-linked HA compound were injected into the left and right suborbital regions, respectively. Substantial improvements in AIHS were observed in 85.71% and 80.95% of subjects at 6 months posttreatment, as assessed by blinded evaluators and treating investigators, respectively. 3D imaging showed volume increases of 0.87 ± 0.32 (left) and 0.99 ± 0.45 mL (right). MRI analysis provided closely aligned results to the 3D analysis. The GAIS and satisfaction rate were 85.71%, 90.48% for treating investigators and were 90.48% and 95.24% for subjects 6 months posttreatment.
Conclusions: The non-cross-linked HA filler demonstrated a safe and efficacious profile for the correction of infraorbital hollows with significant patient satisfaction and sustained outcomes up to 6 months posttreatment. These results support their clinical value in periorbital rejuvenation and reduction of infraorbital hollowing.
{"title":"Quantitative Evaluation of Improvement of Tear Trough With a Non-Cross-Linked Sodium Hyaluronic Compound: A Three-Dimensional and MRI Analysis.","authors":"Di-Ya Su, Mu-Yan Zou, Shi-Wei Wang, Lei Dong, Jia-Xu Wu, Xi-Yue Hu, Jie-Qing Wang","doi":"10.1111/jocd.16718","DOIUrl":"https://doi.org/10.1111/jocd.16718","url":null,"abstract":"<p><strong>Background: </strong>Tear trough deformities are indicative of aging, progressively manifesting as pronounced infraorbital hollows. Although hyaluronic acid (HA) dermal fillers are favored for their safety and efficacy, quantifiable evidence of their effect of action still remains insufficient.</p><p><strong>Aims: </strong>To investigate the efficacy of non-cross-linked HA compound in tear trough enhancement.</p><p><strong>Methods: </strong>Twenty-one subjects with moderate to severe infraorbital hollows underwent a single treatment including subcutaneous to supraperiosteal injections of a non-cross-linked HA compound. The effectiveness was assessed through Allergan Infraorbital Hollows Scale (AIHS), satisfaction rates, the Global Aesthetic Improvement Scale (GAIS), and quantitative analyses via Canfield VECTRA 3D imaging and MRI measurements during the 6-month follow-up.</p><p><strong>Results: </strong>A total of 0.67 ± 0.31 and 0.77 ± 0.42 mL of the non-cross-linked HA compound were injected into the left and right suborbital regions, respectively. Substantial improvements in AIHS were observed in 85.71% and 80.95% of subjects at 6 months posttreatment, as assessed by blinded evaluators and treating investigators, respectively. 3D imaging showed volume increases of 0.87 ± 0.32 (left) and 0.99 ± 0.45 mL (right). MRI analysis provided closely aligned results to the 3D analysis. The GAIS and satisfaction rate were 85.71%, 90.48% for treating investigators and were 90.48% and 95.24% for subjects 6 months posttreatment.</p><p><strong>Conclusions: </strong>The non-cross-linked HA filler demonstrated a safe and efficacious profile for the correction of infraorbital hollows with significant patient satisfaction and sustained outcomes up to 6 months posttreatment. These results support their clinical value in periorbital rejuvenation and reduction of infraorbital hollowing.</p>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":" ","pages":"e16718"},"PeriodicalIF":2.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Verma, Brandon Block, Raphaella A. Lambert, Grace Rabinowitz, Nicholas Gulati, Benjamin Ungar
<p>We recently read with interest the novel publication “Oral tranexamic acid treats papulopustular rosacea by improving the skin barrier” by Xu et al. [<span>1</span>] The authors describe their single-centered randomized controlled trial (RCT) conducted at Xi'an Jiaotong University in Shaanxi Province, China, where patients in the experimental arm received a combined dose of oral tranexamic acid (TXA) 250 mg twice daily and 50 mg oral doxycycline. At the end of eight weeks, significant improvements were observed in clinical erythema, investigators' global assessment of rosacea, and patient-self assessment of rosacea, without major adverse events, including those related to coagulopathy. This trial represents a significant step in the expansion of the currently limited arsenal of pharmacologic therapies for rosacea. The authors' findings show potential for oral TXA for the treatment of rosacea. While the authors took great care in following subjects' coagulation parameters over the course of 12 weeks, we believe that the long-term safety of oral tranexamic acid in rosacea patients merits further discussion.</p><p>Although oral TXA has been shown to pose a limited risk of deep venous thrombosis (DVT) in patients with melasma, the evidence is lacking for patients with chronic inflammatory skin diseases like rosacea [<span>2</span>]. One case report has been published on this topic, in which a 37-year-old female patient with rosacea who previously failed first-line treatment saw significant improvement after 8 weeks of triple therapy with oral propranolol, minocycline, and TXA (250 mg) [<span>3</span>]; however, the long-term safety profile of oral TXA in patients with inflammatory skin disease has not been well established. The authors of this RCT were careful to follow patients for 1 month following discontinuation of TXA, but additional data on whether the therapeutic effect and safety profile of oral TXA persist beyond this time point is an important consideration for future studies. The chronic, recurrent, and relapsing nature of the disease could require long-term use of oral TXA, which might increase the risk of thrombotic adverse events beyond the 12-week duration studied in this RCT. In addition, patients in the experimental arm of this RCT received 50 mg of doxycycline daily, while patients in the control arm received only 40 mg; the difference in this dosing of doxycycline was not clear and could have potentially influenced the differences in measures of clinical response. We feel that further investigation into the long-term efficacy and safety profile of oral TXA is warranted.</p><p>The literature suggests that rosacea itself may be linked to increased prevalence of thrombosis, potentially due to its systemic inflammatory nature. A prior case–control study conducted at Beth Israel Deaconess Medical Center found that patients with rosacea had increased adjusted odds of venous thromboembolism and DVT compared to healthy controls [<span>4
{"title":"Oral Tranexamic Acid Treats Papulopustular Rosacea by Improving the Skin Barrier: Correspondence","authors":"Hannah Verma, Brandon Block, Raphaella A. Lambert, Grace Rabinowitz, Nicholas Gulati, Benjamin Ungar","doi":"10.1111/jocd.16788","DOIUrl":"10.1111/jocd.16788","url":null,"abstract":"<p>We recently read with interest the novel publication “Oral tranexamic acid treats papulopustular rosacea by improving the skin barrier” by Xu et al. [<span>1</span>] The authors describe their single-centered randomized controlled trial (RCT) conducted at Xi'an Jiaotong University in Shaanxi Province, China, where patients in the experimental arm received a combined dose of oral tranexamic acid (TXA) 250 mg twice daily and 50 mg oral doxycycline. At the end of eight weeks, significant improvements were observed in clinical erythema, investigators' global assessment of rosacea, and patient-self assessment of rosacea, without major adverse events, including those related to coagulopathy. This trial represents a significant step in the expansion of the currently limited arsenal of pharmacologic therapies for rosacea. The authors' findings show potential for oral TXA for the treatment of rosacea. While the authors took great care in following subjects' coagulation parameters over the course of 12 weeks, we believe that the long-term safety of oral tranexamic acid in rosacea patients merits further discussion.</p><p>Although oral TXA has been shown to pose a limited risk of deep venous thrombosis (DVT) in patients with melasma, the evidence is lacking for patients with chronic inflammatory skin diseases like rosacea [<span>2</span>]. One case report has been published on this topic, in which a 37-year-old female patient with rosacea who previously failed first-line treatment saw significant improvement after 8 weeks of triple therapy with oral propranolol, minocycline, and TXA (250 mg) [<span>3</span>]; however, the long-term safety profile of oral TXA in patients with inflammatory skin disease has not been well established. The authors of this RCT were careful to follow patients for 1 month following discontinuation of TXA, but additional data on whether the therapeutic effect and safety profile of oral TXA persist beyond this time point is an important consideration for future studies. The chronic, recurrent, and relapsing nature of the disease could require long-term use of oral TXA, which might increase the risk of thrombotic adverse events beyond the 12-week duration studied in this RCT. In addition, patients in the experimental arm of this RCT received 50 mg of doxycycline daily, while patients in the control arm received only 40 mg; the difference in this dosing of doxycycline was not clear and could have potentially influenced the differences in measures of clinical response. We feel that further investigation into the long-term efficacy and safety profile of oral TXA is warranted.</p><p>The literature suggests that rosacea itself may be linked to increased prevalence of thrombosis, potentially due to its systemic inflammatory nature. A prior case–control study conducted at Beth Israel Deaconess Medical Center found that patients with rosacea had increased adjusted odds of venous thromboembolism and DVT compared to healthy controls [<span>4","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970994","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}
To compare the postoperative scarring, complication rates, and efficacy between the hydrosurgery system and traditional single-incision surgical techniques for treating axillary osmidrosis.
Methods
A retrospective collection was conducted of all patients who underwent radical surgery for axillary osmidrosis at the Day Surgery Unit of the Department of Plastic Surgery at the First Affiliated Hospital of the Army Medical University from January 2023 to January 2024. Patients were screened based on inclusion and exclusion criteria and divided into the hydrosurgery group and the traditional surgery group. The evaluation was done through medical records, follow-up records, electronic questionnaires, and photographs. Assessments included 6-month postoperative scarring conditions, comprehensive effectiveness scores, postoperative odor/hair/sweating scores, postoperative dermatological life quality scores, and complication rates.
Results
A total of 73 patients completed this study: 34 in the hydrosurgery group and 39 in the traditional surgery group. 6 months postoperatively, the hydrosurgery group had significantly lower scores of the Vancouver Scar Scale (VSS), 0.5 (range 0.0–2.0) compared with 1.5 (range 0.5–3.0) in the traditional surgery group (p = 0.018). The incidence of complications such as subcutaneous hematoma, epidermal necrosis, and wound dissidence was also lower (26.5% vs. 51.3%, p = 0.031). Additionally, the surgical incision length in the hydrosurgery group was significantly smaller than in the traditional surgery group (1.200 cm (1.000, 1.275) vs. 2.500 cm (2.500, 3.000), p < 0.001). There were no significant differences between the two groups regarding comprehensive effectiveness scores, postoperative odor/hair/sweating scores, postoperative dermatological life quality index, and surgical duration.
Conclusion
Compared with traditional single-incision surgical techniques, patients in the hydrosurgery group exhibited lower scar scores 6 months postsurgery, required smaller surgical incisions, and had lower rates of surgical complications. Thus, the hydrosurgery is suitable for the minimally invasive surgical treatment of axillary osmidrosis, offering a safe, effective, and aesthetically superior treatment method.
目的：比较水手术系统与传统单切口手术技术治疗腋窝积液的术后瘢痕、并发症发生率及疗效。方法：回顾性收集2023年1月至2024年1月在陆军军医大学第一附属医院整形外科日间外科行根治性腋窝积臭手术的所有患者。根据纳入和排除标准对患者进行筛选，分为水手术组和传统手术组。通过病历、随访记录、电子问卷和照片进行评估。评估包括术后6个月疤痕状况、综合疗效评分、术后气味/毛发/出汗评分、术后皮肤生活质量评分和并发症发生率。结果：共73例患者完成本研究，其中水手术组34例，传统手术组39例。术后6个月，水手术组温哥华疤痕量表（VSS）得分为0.5分（范围为0.0 ~ 2.0），显著低于传统手术组的1.5分（范围为0.5 ~ 3.0）（p = 0.018）。皮下血肿、表皮坏死、创面不一致等并发症的发生率也较低（26.5%比51.3%,p = 0.031）。此外，水手术组的手术切口长度明显小于传统手术组(1.200 cm (1.000, 1.275) vs. 2.500 cm（2.500, 3.000）。p结论：与传统单切口手术技术相比，水手术组患者术后6个月瘢痕评分较低，手术切口较小，手术并发症发生率较低。因此，水手术适合于腋窝积臭的微创手术治疗，提供了一种安全、有效、美观的治疗方法。
{"title":"A Retrospective Cohort Study Comparing the Clinical Outcomes of the Hydrosurgery System and Traditional Single-Incision Surgery for Axillary Osmidrosis","authors":"Lufan Xia, Mu He, Xiaoqiang Liu, Jinghong Zhang, Ying Chen, Jiaping Zhang","doi":"10.1111/jocd.16755","DOIUrl":"10.1111/jocd.16755","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare the postoperative scarring, complication rates, and efficacy between the hydrosurgery system and traditional single-incision surgical techniques for treating axillary osmidrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective collection was conducted of all patients who underwent radical surgery for axillary osmidrosis at the Day Surgery Unit of the Department of Plastic Surgery at the First Affiliated Hospital of the Army Medical University from January 2023 to January 2024. Patients were screened based on inclusion and exclusion criteria and divided into the hydrosurgery group and the traditional surgery group. The evaluation was done through medical records, follow-up records, electronic questionnaires, and photographs. Assessments included 6-month postoperative scarring conditions, comprehensive effectiveness scores, postoperative odor/hair/sweating scores, postoperative dermatological life quality scores, and complication rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 73 patients completed this study: 34 in the hydrosurgery group and 39 in the traditional surgery group. 6 months postoperatively, the hydrosurgery group had significantly lower scores of the Vancouver Scar Scale (VSS), 0.5 (range 0.0–2.0) compared with 1.5 (range 0.5–3.0) in the traditional surgery group (<i>p =</i> 0.018). The incidence of complications such as subcutaneous hematoma, epidermal necrosis, and wound dissidence was also lower (26.5% vs. 51.3%, <i>p =</i> 0.031). Additionally, the surgical incision length in the hydrosurgery group was significantly smaller than in the traditional surgery group (1.200 cm (1.000, 1.275) vs. 2.500 cm (2.500, 3.000), <i>p</i> < 0.001). There were no significant differences between the two groups regarding comprehensive effectiveness scores, postoperative odor/hair/sweating scores, postoperative dermatological life quality index, and surgical duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with traditional single-incision surgical techniques, patients in the hydrosurgery group exhibited lower scar scores 6 months postsurgery, required smaller surgical incisions, and had lower rates of surgical complications. Thus, the hydrosurgery is suitable for the minimally invasive surgical treatment of axillary osmidrosis, offering a safe, effective, and aesthetically superior treatment method.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970992","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}
{"title":"The Role of Exosomes in Medical Dermatology: Literature Review and Update","authors":"Victoria Dukharan, Milaan Shah, Luke Broughton, Carol Stegura, Luna Samman, Nina Schur, Todd Schlesinger","doi":"10.1111/jocd.16761","DOIUrl":"10.1111/jocd.16761","url":null,"abstract":"<p>January 30, 2025: This article published prematurely in error. The article will republish shortly.</p>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965424","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}
<p>An 86-year-old woman presented with a rapidly growing right facial mass of more than 1 year duration, associated with bleeding, crusting, and occasional pain. Physical examination revealed an 8.0 cm × 8.0 cm mass on the right side of the face with clear margins, mild ulceration, and exudation (Figure 1A). Mild ectropion of the right eyelid was noted. Imaging studies showed no evidence of metastasis. Laboratory tests revealed that blood cell counts and coagulation function tests, including PT, APTT, INR, and D-dimer, were within normal limits. In addition, LDH, an important prognostic marker for various tumors, was measured at 131 U/L, also within the normal range [<span>1</span>]. Based on the tumor size and the absence of distant metastases, the clinical stage was determined to be T3NxM0 [<span>2</span>]. Given the patient's age and tumor size, wide local excision (WLE) with a 6 mm margin was performed. However, due to the proximity of the tumor to the orbit, it was difficult to achieve a 6 mm margin in this area and the final margin was 2–4 mm (Figure 1B). Postoperative pathology revealed a moderately to poorly differentiated cutaneous squamous cell carcinoma (cSCC) with no evidence of perineural invasion (PNI) (Figure 1D,E). Immunohistochemistry showed positive staining for CK5/6, p40, Ki67, and p63 (Figure 2). Residual tumor cells were also found around the cutting edge. The wound surface was treated with three consecutive sessions of photodynamic therapy (PDT) starting on postoperative day 2, with each session separated by 1 week. It was treated locally with 20% 5-aminolaevulinic acid (ALA) cream, followed by the application of a dark saran wrap for 3 h. Narrowband red light with a wavelength of 633 ± 10 nm was then applied at an intensity of 150 J/cm<sup>2</sup>. Each irradiation session lasted approximately 20 min, depending on patient tolerance. Secondary intentional healing (SIH) was chosen for reconstruction, with moist dressings used to facilitate wound healing. Dressings were changed every 2–3 days, starting with a layer of oil emulsion dressing mixed with antibiotic ointment, followed by clean gauze until wound healing was completed. By postoperative day 60, the majority of the wound had healed with no deformation of the surrounding tissue and minimal scarring (Figure 1C). A 6-month follow-up showed no recurrence.</p><p>Multivariate analysis of tumor characteristics identified five high-risk factors as statistically independent prognostic indicators for cSCC: poor differentiation, PNI, tumor diameter > 2 cm, invasion of subcutaneous fat, and location in the ear, temple, or genital area. PNI, which is associated with disease-specific mortality, can extend contiguously along with the perineural space to larger nerves before spreading proximally to the skull base [<span>3, 4</span>]. In this patient, the tumor was located near the temple area of the face and was more than 2 cm in diameter, presenting several high-risk prognostic f
{"title":"A Case of Giant Squamous Cell Carcinoma of the Face Treated by Surgery Combined With Photodynamic Therapy","authors":"Fanfan She, Huiying Wang, Kongchao Yang, Xiaoming Qin, Ruzhi Zhang","doi":"10.1111/jocd.16791","DOIUrl":"10.1111/jocd.16791","url":null,"abstract":"<p>An 86-year-old woman presented with a rapidly growing right facial mass of more than 1 year duration, associated with bleeding, crusting, and occasional pain. Physical examination revealed an 8.0 cm × 8.0 cm mass on the right side of the face with clear margins, mild ulceration, and exudation (Figure 1A). Mild ectropion of the right eyelid was noted. Imaging studies showed no evidence of metastasis. Laboratory tests revealed that blood cell counts and coagulation function tests, including PT, APTT, INR, and D-dimer, were within normal limits. In addition, LDH, an important prognostic marker for various tumors, was measured at 131 U/L, also within the normal range [<span>1</span>]. Based on the tumor size and the absence of distant metastases, the clinical stage was determined to be T3NxM0 [<span>2</span>]. Given the patient's age and tumor size, wide local excision (WLE) with a 6 mm margin was performed. However, due to the proximity of the tumor to the orbit, it was difficult to achieve a 6 mm margin in this area and the final margin was 2–4 mm (Figure 1B). Postoperative pathology revealed a moderately to poorly differentiated cutaneous squamous cell carcinoma (cSCC) with no evidence of perineural invasion (PNI) (Figure 1D,E). Immunohistochemistry showed positive staining for CK5/6, p40, Ki67, and p63 (Figure 2). Residual tumor cells were also found around the cutting edge. The wound surface was treated with three consecutive sessions of photodynamic therapy (PDT) starting on postoperative day 2, with each session separated by 1 week. It was treated locally with 20% 5-aminolaevulinic acid (ALA) cream, followed by the application of a dark saran wrap for 3 h. Narrowband red light with a wavelength of 633 ± 10 nm was then applied at an intensity of 150 J/cm<sup>2</sup>. Each irradiation session lasted approximately 20 min, depending on patient tolerance. Secondary intentional healing (SIH) was chosen for reconstruction, with moist dressings used to facilitate wound healing. Dressings were changed every 2–3 days, starting with a layer of oil emulsion dressing mixed with antibiotic ointment, followed by clean gauze until wound healing was completed. By postoperative day 60, the majority of the wound had healed with no deformation of the surrounding tissue and minimal scarring (Figure 1C). A 6-month follow-up showed no recurrence.</p><p>Multivariate analysis of tumor characteristics identified five high-risk factors as statistically independent prognostic indicators for cSCC: poor differentiation, PNI, tumor diameter > 2 cm, invasion of subcutaneous fat, and location in the ear, temple, or genital area. PNI, which is associated with disease-specific mortality, can extend contiguously along with the perineural space to larger nerves before spreading proximally to the skull base [<span>3, 4</span>]. In this patient, the tumor was located near the temple area of the face and was more than 2 cm in diameter, presenting several high-risk prognostic f","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965495","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}
In recent years, the field of aesthetic dermatology has witnessed a surge in demand for minimally invasive procedures aimed at rejuvenating aging skin. This study aims to address this demand by evaluating the effectiveness of the injectable gel in rejuvenating aging skin, particularly by targeting collagen regeneration and lifting effect.
Materials and Methods
The study involved 43 participants who underwent three monthly injection sessions targeting retaining ligaments. The injections were administered deeply to ensure proper targeting. Follow-up assessments were conducted after each treatment session and three months after the final injection. Evaluation methods included subjective assessments by both patients and investigators using the Global Aesthetic Improvement Scale (GAIS), as well as objective assessments using a 3D photosystem to measure wrinkle conditions and vectors of traction.
Results
All participants completed the study, with no significant adverse effects observed apart from mild swelling at the injection sites. Despite the high viscosity of HA necessitating the use of a 27 G needle, the injection process was generally comfortable and minimally painful. Subjective evaluations revealed consistent improvements in skin appearance from the first application, which continued to increase throughout the study and remained high even 3 months post-treatment. Objective evaluations demonstrated significant improvements in wrinkle conditions and lifting effects, with a substantial increase in the standard deviation score for wrinkle conditions and the average traction vector length measuring 1.6 mm.
Conclusion
The study findings confirm the safety and efficacy of the injectable formula, with high patient satisfaction, noticeable lifting effects, and significant improvements in wrinkle conditions. These results support the use of the injectable as a promising option for non-invasive skin rejuvenation treatments.
{"title":"Novel Gel Formulation and Deep Injection Techniques for Lifting Effects in Cosmetic Dermatology","authors":"Irina Poleva","doi":"10.1111/jocd.16789","DOIUrl":"10.1111/jocd.16789","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In recent years, the field of aesthetic dermatology has witnessed a surge in demand for minimally invasive procedures aimed at rejuvenating aging skin. This study aims to address this demand by evaluating the effectiveness of the injectable gel in rejuvenating aging skin, particularly by targeting collagen regeneration and lifting effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The study involved 43 participants who underwent three monthly injection sessions targeting retaining ligaments. The injections were administered deeply to ensure proper targeting. Follow-up assessments were conducted after each treatment session and three months after the final injection. Evaluation methods included subjective assessments by both patients and investigators using the Global Aesthetic Improvement Scale (GAIS), as well as objective assessments using a 3D photosystem to measure wrinkle conditions and vectors of traction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All participants completed the study, with no significant adverse effects observed apart from mild swelling at the injection sites. Despite the high viscosity of HA necessitating the use of a 27 G needle, the injection process was generally comfortable and minimally painful. Subjective evaluations revealed consistent improvements in skin appearance from the first application, which continued to increase throughout the study and remained high even 3 months post-treatment. Objective evaluations demonstrated significant improvements in wrinkle conditions and lifting effects, with a substantial increase in the standard deviation score for wrinkle conditions and the average traction vector length measuring 1.6 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study findings confirm the safety and efficacy of the injectable formula, with high patient satisfaction, noticeable lifting effects, and significant improvements in wrinkle conditions. These results support the use of the injectable as a promising option for non-invasive skin rejuvenation treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965421","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}
Acne is a common condition observed in adolescents and in most severe acne the scars develop. There are numerous treatment options for acne scars. However, no standardized guidelines have been established to guide physicians in the optimal treatment of acne scars.
Aims
The objective of this systematic review is to evaluate the existing evidence on various fillers used for the treatment of acne scars and to compare their effectiveness with one another.
Methods
The study was designed following PRISMA guidelines, and the information was retrieved in May 2024 using the PubMed database and ClinicalTrials.gov registry. The inclusion criteria were that studies involving patients of any age or gender with acne scars of any type treated with synthetic dermal fillers, and studies published in English. The exclusion criteria were studies with less than 10 participants and studies that did not use synthetic dermal fillers. To assess the risk of bias in the included studies, the Cochrane Collaboration's Risk of Bias tool was used for randomized controlled trials, and in observational studies, the Newcastle–Ottawa Scale was used.
Results
Twenty-six studies were included with a total of 1121 participants. Fourteen studies evaluated HA on 372 subjects, five studies focused on PMMA on 305 subjects, four on CaHA on 392 subjects, two on PLLA on 42 subjects, and one on PCL on 10 subjects.
Conclusions
Most of the studies included in this review were of low quality, as indicated by their scores on quality assessments, lack of high-quality RCTs, and small sample sizes. Future research should focus on conducting randomized, controlled, split-face studies with an adequate number of participants and a detailed examination of different scar subtypes.
{"title":"Synthetic Dermal Fillers in Treating Acne Scars: A Comparative Systematic Review","authors":"Salma Albargawi","doi":"10.1111/jocd.16752","DOIUrl":"10.1111/jocd.16752","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acne is a common condition observed in adolescents and in most severe acne the scars develop. There are numerous treatment options for acne scars. However, no standardized guidelines have been established to guide physicians in the optimal treatment of acne scars.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The objective of this systematic review is to evaluate the existing evidence on various fillers used for the treatment of acne scars and to compare their effectiveness with one another.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was designed following PRISMA guidelines, and the information was retrieved in May 2024 using the PubMed database and ClinicalTrials.gov registry. The inclusion criteria were that studies involving patients of any age or gender with acne scars of any type treated with synthetic dermal fillers, and studies published in English. The exclusion criteria were studies with less than 10 participants and studies that did not use synthetic dermal fillers. To assess the risk of bias in the included studies, the Cochrane Collaboration's Risk of Bias tool was used for randomized controlled trials, and in observational studies, the Newcastle–Ottawa Scale was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six studies were included with a total of 1121 participants. Fourteen studies evaluated HA on 372 subjects, five studies focused on PMMA on 305 subjects, four on CaHA on 392 subjects, two on PLLA on 42 subjects, and one on PCL on 10 subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most of the studies included in this review were of low quality, as indicated by their scores on quality assessments, lack of high-quality RCTs, and small sample sizes. Future research should focus on conducting randomized, controlled, split-face studies with an adequate number of participants and a detailed examination of different scar subtypes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949958","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}
Nina Schur, Luna Samman, Milaan Shah, Victoria Dukharan, Carol Stegura, Luke Broughton, Todd Schlesinger
Background
Exosomes are a nanoscale extracellular vesicles derived from different cell types that have been investigated for various clinical applications, including functioning as biomarkers and use as direct therapeutics. Given the role of exosomes in multiple pathophysiologic pathways and potential practical applications, they have garnered significant interest in the scientific community but much is still unknown about their development and use.
Aims
This literature review covers the background, mechanisms of action, use as biomarkers, methods of application, and direct therapeutic applications of exosomes.
Methods
A literature review on the background and uses of exosomes was conducted. Key articles describing the pathophysiologic pathways and applications of exosomes were summarized and described.
Results
Exosomes impact several cellular pathways which allow them to function as biomarkers for malignancy and inflammatory dermatoses and may make them useful therapeutics for skin rejuvenation, hair loss, and wound repair. Limitations of exosomes include an incomplete understanding of their functions and impacts and a lack of standardization in their production and application.
Conclusions
Exosomes are a unique and novel cellular medium that offer promise as a diagnostic tool and therapy. While there are limitations to the uses of exosomes as well as our current understanding of them, further investigation may yield additional applications and a larger role in medicine for exosomes.
{"title":"Exosomes: Historical Evolution and Emerging Roles in Dermatology","authors":"Nina Schur, Luna Samman, Milaan Shah, Victoria Dukharan, Carol Stegura, Luke Broughton, Todd Schlesinger","doi":"10.1111/jocd.16769","DOIUrl":"10.1111/jocd.16769","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Exosomes are a nanoscale extracellular vesicles derived from different cell types that have been investigated for various clinical applications, including functioning as biomarkers and use as direct therapeutics. Given the role of exosomes in multiple pathophysiologic pathways and potential practical applications, they have garnered significant interest in the scientific community but much is still unknown about their development and use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This literature review covers the background, mechanisms of action, use as biomarkers, methods of application, and direct therapeutic applications of exosomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature review on the background and uses of exosomes was conducted. Key articles describing the pathophysiologic pathways and applications of exosomes were summarized and described.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Exosomes impact several cellular pathways which allow them to function as biomarkers for malignancy and inflammatory dermatoses and may make them useful therapeutics for skin rejuvenation, hair loss, and wound repair. Limitations of exosomes include an incomplete understanding of their functions and impacts and a lack of standardization in their production and application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Exosomes are a unique and novel cellular medium that offer promise as a diagnostic tool and therapy. While there are limitations to the uses of exosomes as well as our current understanding of them, further investigation may yield additional applications and a larger role in medicine for exosomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949774","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}
Skin pigmentation disorders may increase patients' psychological burdens. Consequently, they are increasingly attracting attention. Dermal fibroblasts have been shown to regulate pigmentation by secreting soluble factors.
Aim
This study aimed to summarize recent findings on the effects of dermal fibroblasts on hyperpigmentation and hypopigmentation, enabling the discovery of new therapeutic targets.
Methods
PubMed was searched for literature on fibroblast factors, hyperpigmentation, and hypopigmentation, and a comprehensive summary and analysis were performed.
Results
Fibroblasts secrete both cytokines that promote pigmentation, including stem cell factor (SCF) and keratinocyte growth factor (KGF), and small amounts of those that inhibit pigmentation, such as Dickkopf1 (DKK1) and transforming growth factor (TGF)-β. Fibroblast-derived extracellular matrix (ECM) can also affect melanocyte tyrosinase activity and the transfer of melanosomes. In hyperpigmentation disorders, such as melasma and solar lentigines, the secretion of pigmentation-promoting factors increases, and the activity of key enzymes in melanin production is elevated. In hypopigmentation disorders, including vitiligo, the secretion of melanogenic factors decreases while the factors that inhibit pigmentation increase. Fibroblasts may serve as a new therapeutic target, providing new insights to precisely treat pigmentary disorders.
Conclusions
Fibroblasts synthesize and secrete various cytokines and proteins that modify melanin synthesis and transfer through different signaling pathways, playing prominent roles in pigmentary skin disorders, such as photoaging, melasma, solar lentigo, and vitiligo.
{"title":"Emerging Roles of Dermal Fibroblasts in Hyperpigmentation and Hypopigmentation: A Review","authors":"Xingyue Gao, Wenzhong Xiang","doi":"10.1111/jocd.16790","DOIUrl":"10.1111/jocd.16790","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Skin pigmentation disorders may increase patients' psychological burdens. Consequently, they are increasingly attracting attention. Dermal fibroblasts have been shown to regulate pigmentation by secreting soluble factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to summarize recent findings on the effects of dermal fibroblasts on hyperpigmentation and hypopigmentation, enabling the discovery of new therapeutic targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed was searched for literature on fibroblast factors, hyperpigmentation, and hypopigmentation, and a comprehensive summary and analysis were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fibroblasts secrete both cytokines that promote pigmentation, including stem cell factor (SCF) and keratinocyte growth factor (KGF), and small amounts of those that inhibit pigmentation, such as Dickkopf1 (DKK1) and transforming growth factor (TGF)-β. Fibroblast-derived extracellular matrix (ECM) can also affect melanocyte tyrosinase activity and the transfer of melanosomes. In hyperpigmentation disorders, such as melasma and solar lentigines, the secretion of pigmentation-promoting factors increases, and the activity of key enzymes in melanin production is elevated. In hypopigmentation disorders, including vitiligo, the secretion of melanogenic factors decreases while the factors that inhibit pigmentation increase. Fibroblasts may serve as a new therapeutic target, providing new insights to precisely treat pigmentary disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fibroblasts synthesize and secrete various cytokines and proteins that modify melanin synthesis and transfer through different signaling pathways, playing prominent roles in pigmentary skin disorders, such as photoaging, melasma, solar lentigo, and vitiligo.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949667","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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