Journal of Clinical and Aesthetic Dermatology最新文献

Superficial thrombophlebitis is an uncommon but notable complication following dermal filler injections. This case highlights a 39-year-old female individual presenting with bilateral submental superficial thrombophlebitis following hyaluronic acid filler to the jawline and chin. To the author's knowledge, this is the first reported case of superficial venous thrombosis (SVT) in the neck following dermal filler injection. This report uniquely highlights longitudinal follow-up, ultrasound imaging documentation, and outcome, making it the first case documented in such detail. Through clinical evaluation and a multidisciplinary approach to management, this case emphasizes the importance of diagnosis and continued follow-up when addressing rare complications in aesthetic medicine.

Background: For individuals with acne-prone skin, identifying a topical regimen that does not lead to progression of their inflammatory issues often poses a challenge. A topical skin probiotic regimen containing a specific strain of Cutibacterium acnes (C. acnes) subspecies defendens, XYCM42, has been shown to be beneficial in improving skin health and appearance in individuals with generally healthy skin, but the use of the skin probiotic has not been sufficiently assessed in individuals with acne-prone skin.

Objective: The purpose of this study was to evaluate the safety and efficacy of daily application of a topical skin biome care regimen containing a living C. acnes subsp. defendens derivative strain, XYCM42, its ferment, and adjunct topicals in individuals with acne-prone skin.

Methods: This eight-week study was conducted at five locations and included 136 total participants. At baseline, Week 1, Week 4, and Week 8, subjects completed product questionnaires and symptom severity surveys. Of the study subjects, 20 were enrolled for clinical efficacy evaluation at all timepoints. Clinical assessments included blemish lesion counts, Investigator's Global Assessment (IGA) of acne lesion severity, and clinical grading of skin cosmetic and safety parameters.

Results: As early as Week 1 of regimen application, clinical observations demonstrated statistically significant improvements in acne severity scores, with no subjects reporting increased or worsened acne during the study. By Week 4, subjects showed significant changes in nearly all skin cosmetic parameters assessed, including skin texture, clarity, tone, fine wrinkling, undereye dark circles, dryness, and erythema. Lesion counts were significantly reduced from baseline at all timepoints, with 100 percent of subjects experiencing fewer non-inflammatory lesions and 70 percent and 30 percent with fewer papule and pustule inflammatory lesions, respectively, by the end of the study. No adverse events were reported.

Conclusion: This at-home use study demonstrates that use of the XYCM42-based topical skin biome care regimen is both safe and appropriate for individuals with acne-prone skin. More broadly, the outcomes of this study provide further support toward the beneficial and commensal nature of C. acnes subsp. defendens in promoting skin health.

Pembrolizumab is an immune checkpoint inhibitor that is used in the treatment of various cancers. The reported mode of action of pembrolizumab is via binding to the PD-1 receptor which leads to blocking both immune-suppressing ligands, PD-L1 and PD-L2, from interacting with PD-1 to modulate the immune response. A common side effect of immune checkpoint inhibitors is pruritus, reported to occur in 14 to 47 percent of patients, which often reduces overall quality of life. This case report chronicles a patient suffering from significant pruritus and a lichenoid skin eruption after initiation of pembrolizumab treatment that was refractory to topical corticosteroid therapy, narrow band ultraviolet B light, and application of emollients. A topical phosphodiesterase-4 (PDE-4) inhibitor, roflumilast cream 0.3%, was subsequently initiated. Roflumilast is a selective inhibitor of PDE-4, approved by the United States Food and Drug Administration (FDA) in a 0.3% cream vehicle in 2022 for treatment of plaque psoriasis of any severity, and in a 0.3% foam vehicle in 2023 for treatment of seborrheic dermatitis of any severity. In 2024, roflumilast was FDA-approved in a 0.15% cream vehicle for treatment of mild-to-moderate atopic dermatitis in patients six years of age and older. In this adult patient, pruritus was improved within 48 hours after initiation of roflumilast cream 0.3% applied once daily and continued to be effective with use over time.

Despite the development of advanced targeted topical treatments for chronic inflammatory skin diseases and recent calls for caution when prescribing topical corticosteroids (TCS), TCS continue to be the most prescribed dermatologic agent. Yet the perception that adverse effects are uncommon with TCS use persists. To combat this misperception, I selected examples of patients from my practice that illustrate the real-world risks associated with TCS use. This case series provides several key clinical pearls for managing TCS use in everyday clinical practice including: 1) Even using TCS for short periods and as prescribed is not without risks. 2) Long-term TCS use (even intermittent use) can result in permanent skin changes that can even outlast the disease the TCS was used to treat. 3) TCS overuse can have serious adverse effects resulting in hospitalization, including adrenal suppression, infection, and even sepsis. 4) Patients who are dissatisfied with older TCS-sparing treatments might continue to seek more potent TCS, resulting in doctor/clinic hopping and potential TCS misuse. 5) Patients might repurpose TCS prescriptions for other body areas, leading to high-potency TCS being applied to thin-skinned areas and irreversible skin damage.

Safety concerns associated with topical corticosteroids (TCS) have been increasingly recognized and well documented in medical literature for many decades. In response, advanced targeted topical (ATT) therapies have emerged as safer, effective alternatives for managing chronic inflammatory skin diseases. In this review, a group of experienced dermatology nurse practitioners (NPs) and physician assistants/associates (PAs) summarize key consensus statements from a 2025 physician-expert-panel literature review and consensus statement publication addressing the safety and efficacy of TCS and the role of ATT therapies for chronic inflammatory skin diseases. It highlights practical recommendations for incorporating ATT therapies into clinical practice and emphasizes the vital role of NPs and PAs in monitoring cumulative corticosteroid exposure to minimize the risk of both cutaneous and systemic adverse effects associated with TCS use.

Background: Hidradenitis suppurativa (HS) is an inflammatory skin condition that presents with nodules or abscesses associated with sinus tracts. Inflammatory bowel diseases (IBD) are inflammatory gastrointestinal (GI) conditions presenting with irregular bowel movements. Although HS and IBDs may have similarities in their clinical presentation and pathophysiology, they can differ in their cutaneous manifestations. Both conditions are potentially caused by genetic changes in the human leukocyte antigen (HLA), cause skin inflammation, and are characterized by abscesses in the GI and sinus tracts.

Objective: We sought to determine the extent of coincident IBD and HS and the associated risk factors.

Methods: The Ovid Medline database was searched for all current literature on the correlations between HS and IBD. Articles were then included and removed according to specific inclusion and exclusion criteria, and a systematic review was performed on the remaining articles.

Results: Thirteen papers that met the inclusion and the exclusion criteria were selected, and after data collection, a significant correlation was found between the development of HS and IBD. Most of the articles reviewed stated that the corresponding association was a causal link between the two diseases. Furthermore, there were various risk factors and comorbidities associated with HS and the development of IBD, including smoking, obesity, perianal disease, and genetic predispositions such as HLA-B27 mutations.

Discussion: Studies show that there is a potential correlation with HS and IBDs. Additional research should to determine the genetic correlations between HS and IBDs and the underlying pathophysiological mechanism.

Objective: Ferulic acid (FA) is gaining popularity in skincare products for its antioxidant and anti-inflammatory properties. However, its effectiveness and optimal use in humans require critical evaluation. This study aims to review the use of topical FA in skincare.

Methods: A search of PubMed and Cochrane using keywords related to skin effects and ferulic acid was conducted. Studies involving human subjects from January 1983 to June 2023 were included.

Results: Eighteen human studies have investigated the efficacy of FA in various cutaneous conditions, demonstrating effectiveness in enhancing one or more aspects such as skin erythema, pigmentation, hydration, elasticity, and texture. FA proved effective both alone and in combination with other active ingredients, and in subjects with and without dermatologic diagnoses.

Limitations: The main limitations of this review include small sample sizes, limited diversity in study populations (Fitzpatrick skin types), a lack of robust randomized controlled trials, and varying compositions of formulations across studies which make it challenging to isolate FA's specific contributions.

Conclusion: Existing literature supports the effectiveness of FA-containing formulations in reducing skin erythema, hyperpigmentation, and signs of aging in adults. Further studies are warranted to better understand and characterize FA's efficacy and mechanisms in treating skin conditions.

Optimizing ergonomics and patient positioning is essential for enhancing patient safety and improving outcomes in dermatologic surgery. Proper patient positioning can prevent provider strain, improve surgical accuracy, and increase overall efficiency. Key strategies include maintaining a neutral body plane, providing neck and knee support, and shielding the eyes to reduce patient stress. Adjustments in limb positioning can enhance skin laxity and tension management, facilitating better wound closure and healing. Equally important is the surgeon's ergonomics, with proper posture, adjustable seating, and strategic breaks to reduce fatigue and improve performance. Attention to these factors supports both patient comfort and long-term sustainability of high-quality care.

Objective: The authors sought to evaluate the impact of the COVID-19 pandemic on the incidence, tumor thickness, and time between diagnosis and first treatment of cutaneous melanoma patients.

Methods: A retrospective observational study was conducted based on the analysis of electronic medical records of patients treated at a reference service in Cutaneous Oncology within the scope of the Unified Health System in Belo Horizonte, Brazil. The population was evaluated according to the date of diagnosis and was classified into three periods: 1) pre-pandemic period (January 2019 to March 2020), 2) pandemic period 1 (April 2020 to June 2021), and 3) pandemic period 2 (July 2021 to September 2022). Sociodemographic characteristics of the study population, tumor characteristics, and the time interval between diagnosis and first treatment were evaluated.

Results: Seventy-six patients were evaluated, 25 (32.89%) diagnosed in the pre-pandemic period, 22 (28.94%) in pandemic period 1, and 29 (38.15%) in pandemic period 2. No significant differences were observed between the sociodemographic characteristics of the population, tumor thickness, and the presence of ulceration in the three periods analyzed. There was also no delay between diagnosis and the first treatment during the pandemic.

Limitations: The size of the population, and the use of retrospective data extracted from medical records, without a systematized record of information.

Conclusion: The COVID-19 pandemic did not impact the incidence, thickness of melanomas, or the time between diagnosis and first treatment. This study demonstrated the importance of adapting the routine of health services and adapting the flow of oncology care in times of health crisis.

Background: Acne is a common inflammatory dermatosis in all parts of the world, including Japan. While effective prescription treatments are available, patients often prefer to try to manage their acne, particularly when it is mild, using over-the-counter (OTC) approaches.

Objective: This open-label study evaluated the efficacy and safety of an OTC serum containing a multi-acid complex and niacinamide (niacinamide 2%, lactic acid 1%, hydroxyethylpiperazine ethane sulfuric acid [HEPES] 0.5%, phytic acid 0.2%, and salicylic acid 0.2%) used twice daily for eight weeks in Japanese women aged 16 to 34 years with acne.

Methods: An eight-week, split-face, open-label study of multi-acid complex and niacinamide containing dermocosmetic used twice daily in Japanese women aged 16 to 34 years was conducted. Participants had mild-to-moderate inflammatory acne (up to 20 inflammatory lesions on half the face) and assessments included number and severity of acne lesions as well as standard safety assessments.

Results: A total of 50 women enrolled, with 46 eligible for evaluation at Week 8. Significant improvements in acne severity, the number of inflammatory lesions, and skin texture as indicated by pore size were observed (P<0.05 for all). In addition, patients' quality of life significantly improved from baseline to Week 8 (P<0.01). The serum was well tolerated. Four cases of skin discomfort were reported; all were mild in severity and resolved spontaneously.

Conclusion: This multi-acid/niacinamide OTC serum effectively improved acne in Japanese women.