Journal of Clinical and Aesthetic Dermatology最新文献

V-to-Y advancement flap is a successful repair technique that preserves vascular and tissue integrity adopted after Mohs micrographic surgery to repair cutaneous defects on the head and neck. However, defects at the lateral distal nasal ala requires large extension beyond cosmetic margins that increase risk of skin webbing, an undesired result on a cosmetically sensitive location to the patient. In this article, we present a novel approach to modifying the procedure employing the V-to-Y advancement flap by truncated the trailing end of the island pedicle to allow for successful healing and better patient satisfaction.

In the past three decades, there has been a remarkable surge in the popularity and use of herbal medicines. However, despite their widespread use, herbal remedies remain inadequately regulated, exposing consumers to potential adverse effects. This case series examines eight patients with severe cutaneous manifestations resulting from the topical application of Nigella sativa (black cumin) oil, emphasizing the critical significance of patch testing, thorough history-taking regarding exposures and herbal supplement usage, and the necessity for enhanced regulatory measures. Additionally, it delves into various treatment modalities, offering valuable insights for clinicians managing similar cases.

Background: Dimethyl fumarate (DMF) is an oral treatment approved by the European Medicines Agency (EMA) to treat moderate-to-severe plaque psoriasis among adult patients.

Objectives: This study aims to evaluate sociodemographic, anthropometric, and medical characteristics in patients with psoriasis without previous history of traditional systemic therapy and to observe if the efficacy or AEs of dimethyl fumarate correlate to any of the patients' characteristics.

Methods: Ninety-two patients with mild-to-moderate psoriasis were enrolled. Each patient was reviewed at 4, 12, 24 and 36 weeks. The PASI score and any clinical side effects or blood count abnormalities were recorded.

Results: After 4 weeks, a decrease in the median value of PASI index was already noticeable (p<0.001). After 12 weeks of treatment, 43.9% of patients reached PASI-50, 12.3% PASI-75. The patients achieving PASI-75 after 12 weeks of treatment were significantly younger than those who did not. Age, BMI index, gender and gastroprotection used were not significantly related to the occurrence of side effects.

Conclusion: Profiling of patients could be useful in predicting the response to treatment. In our study, younger patients were found to respond better to dimethyl fumarate.

This article explains the value and rationale behind the use of checklists. Included is a surgery checklist used successfully over many years by a highly experienced dermatologist and dermatologic surgeon. This approach is used by all clinicians and office staff in a very busy ambulatory practice that incorporates medical, cosmetic, and surgical dermatology, including Mohs micrographic surgery.

Background: Acne vulgaris is a chronic, inflammatory skin disease of the pilosebaceous unit frequently cited as the most common condition diagnosed and treated by dermatologists. Among the many therapies developed for treating acne, none are effective for all patients and new treatments are always being sought. A commercial nutraceutical formulated with vitamins, minerals and a proprietary blend of botanicals has been used as a safe and effective adjunctive therapy for non-cystic acne (Clear Skin Formula; VitaMedica®).

Objective: The objective of this study was to evaluate the safety and efficacy of this nutraceutical for treating non-cystic acne.

Methods: Subjects randomly received study product (n=26) or placebo capsules (n=14) which were taken daily for 84 days.

Results: Treatment with the nutraceutical supplement decreased mean (SD) inflammatory lesions counts from 21.4 (9.3) to 10.4 (8.1) (p=0.0001), decreased non-inflammatory lesion counts from 35.0 (17.1) to 19.5 (13.2) (p<0.0001) versus nonsignificant changes for placebo-treated subjects. Mean baseline IGA scores improved by nearly 1 grade from 2.3 (0.5) to 1.4 (0.6) after 84 days of treatment (p<0.0001) versus no change for subjects treated with placebo. The clinical improvements corresponded with significant improvements in acne-related quality of life measures. The nutraceutical supplement was well-tolerated.

Conclusion: These results demonstrate this nutraceutical to be safe and effective adjunctive therapy for patients with non-cystic acne. ClinicalTrial.gov Identifier NCT05879406.

Objective: The desire for improved hair appearance, hair growth and strength are common drivers of supplementation for women experiencing thinning hair. This study examined the effect and safety of a gummy supplement containing B vitamins, zinc and botanical ingredients to improve hair growth, strength and perceived hair quality outcomes.

Methods: Healthy females (n=65) ages 18 to 60 with thinning hair were enrolled. After obtaining consent, subjects were evaluated for hair density and tensile strength, then randomized to either a placebo or test product. The test product consisted of two gummies consumed daily. Subjects returned after six months and were again evaluated using phototrichogram for hair density and tensile strength assessment and completed a Self-Assessment Questionnaire reporting hair quality outcomes.

Results: Subjects who consumed the test product showed increased hair density between baseline and 6 months (10.1% increase, p<0.001) as well as compared to placebo (2% decrease) (p<0.001). Hair strength tensile measurements were improved in the test group from baseline (10.2% improvement, p<0.002) compared to placebo (9.3% improvement), yet the difference was not statistically significant between groups. Self-assessed improvements in shedding, strength, breakage and brightness were noted compared to the placebo group (p<0.05). There were no adverse events or reactions.

Limitations: This study did not assess hair for longer than a six-month period and utilized subject perception for outcomes that differ from clinical assessments.

Conclusion: Daily use of a dietary supplement gummy was associated with significant improvement in hair growth as well as self-assessed improvements in hair strength, shedding, and appearance.

We present a case of a patient with longstanding psoriasis vulgaris who developed an atopic dermatitis-like eruption following long-term IL-17A inhibitor therapy. Following many years of excellent disease control with secukinumab and later ixekizumab, he developed a de novo eczematous eruption, which showed spongiotic dermatitis upon biopsy. The patient was successfully treated for both psoriasis and atopic dermatitis with upadacitinib, a Janus kinase inhibitor. This case suggests an interplay between Th1/Th17 and IL-4/IL-13 immune axes during prolonged biologic therapy, potentially due to upregulation of IL-4 following IL-17 blockade. It highlights the complex immune interactions in inflammatory skin diseases and demonstrates the utility of broader cytokine inhibition in managing evolving presentations.

Background: Intradermal injections of highly diluted botulinic neuroprotein is a popular aesthetic medicine procedure to improve the texture of the skin, enlarged pores, and fine lines.

Objective: The authors present a case report of nine subjects who received treatment with botulinic neuroprotein combined with an amino acid cluster and low molecular weight hyaluronic acid.

Methods: Nine women between the ages of 30 to 59 years old in a stable medical condition with moderate to severe lateral cantal wrinkles and smile lines at maximum expression and were recruited. The typical exclusion criteria for botulinum neurotoxin and hyaluronic acid injections were fulfilled.

Results: No complications were observed. In all treated patients, there was clinical improvement in skin surface and texture, as well as attenuation of fine lines, with preserved natural facial mimetic activity. In two patients who were prone to rosacea, we noticed an improvement in erythema and flushing. Three patients with oily skin showed decreased oiliness and pore size.

Conclusion: The Jalu-toxin technique is a safe and efficient method for skin quality enhancement.