Journal of Clinical and Aesthetic Dermatology最新文献

Objective: This study aims to assess the correlation between Centers for Disease Control-reported syphilis incidence rates and case burden and public interest in syphilis as indicated by Google search trends.

Methods: This study utilized Google Trends data to analyze popular syphilis-related search terms from 2013 to 2023. The latest Centers for Disease Control-reported syphilis incidence rates for 2022 were compared to Google Trends data to identify patterns or correlations.

Results: Google Trends data showed a 37.65-percent increase in average annual searches for syphilis-related terms in the United States from 2013 to 2023. The largest increase in search volume was observed from 2021 to 2022, with a 14.09 percent rise. Mississippi had the highest ten-year average for syphilis-related search terms (97.9). Arkansas, Oklahoma, Mississippi, Nevada, and Louisiana were among the top ten highest reported primary and secondary syphilis rates and were among the top ten states with the highest Google Trends search volume. Texas was the only state to be in the top ten highest Google Trend searches and among the top states with the highest reported absolute number of cases.

Limitaitons: Limitations include the inability for Google Trends analysis to provide absolute search volumes and limited transparency in its algorithm. Additionally, the study relies on data collected from internet users and may potentially exclude individuals without internet access.

Conclusion: The findings suggest that while public interest in syphilis is increasing overall, there may still exist disparities in awareness and education across different regions of the United States.

Giant cell tumors of tendon sheath (GCTTS), also known as synovialomas, are benign tumors that originate from the fibrous sheath, or soft tissue, that surround tendons. These tumors predominantly present on the hand, but can present in the wrist, ankle, knee, elbow, or hip. The classic presentation of GCTTS is a painless, firm, slow growing mass present for weeks to months. The pathogenesis of GCTTS remains unknown. Histopathological examination of the tumor is required to confirm the diagnosis. The preferred treatment is surgical excision with long-term follow up. To our knowledge, this is the third reported case of GCTTS originating in the subunguium and the first reported case of GCTTS in the subunguium of the toe.

Objective: We sought to compare the safety and efficacy of combining fractional 2940-nm Erbium:YAG (Er:YAG) laser with autologous platelet-rich plasma (PRP) versus its combination with low-level laser therapy (LLLT) for enhancing the outcome of postsurgical and post-traumatic scars.

Methods: Fourty-five individuals with post-surgical or post-traumatic scars were randomly divided into three groups: Group A received four fractional Er:YAG laser sessions spaced four weeks apart along with eight sessions of intradermal PRP injections spaced two weeks apart; Group B received four fractional Er:YAG laser sessions spaced four weeks apart along with two sessions of light emitting diode (LED) weekly; and Group C received four fractional Er:YAG laser sessions spaced four weeks apart. Treatment efficacy was evaluated using clinical photographs, Vancouver Scar Scale (VSS), patient satisfaction and histopathology.

Results: Regarding vascularity following treatment and the total VSS score, there were significant differences between the studied groups, with scoring was the lowest in Group A compared to Group B and C. Patient satisfaction was the highest in Group A compared to Group B and C.

Limitations: A limitation of the current study is the short follow-up period.

Conclusion: Scar revision therapy using combined fractional Er:YAG laser with either PRP or LLLT were found to be more efficient and superior to fractional Er:YAG laser alone.

Objective: Non-surgical facial aesthetics (NSFA) is a rapidly growing field involving the use of dermal fillers and botulinum toxin for aesthetic enhancement. The aesthetic injectables market is expanding, attracting interest from individuals seeking NSFA procedures. There has also been marked interest among healthcare professionals (HCPs) aspiring to become aesthetic practitioners. Conferences play a crucial role as educational platforms for HCPs venturing into NSFA. We used a national NSFA conference as an education tool for undergraduate and postgraduate healthcare students, assessing the utility of this conference in imparting knowledge on topics such as training pathways, regulations and complications in NSFA.

Methods: The FACExpo conference, held in November 2022, was organized by both qualified and aspiring aesthetic practitioners. Pre- and post-conference questionnaires were administered to attendees to evaluate their interest in facial aesthetics and their knowledge before and after the conference.

Results: A total of 68 delegates responded to the pre-and post-conference questionnaires. There was a statistically significant improvement in awareness of training pathways, regulations, and complications (p<0.0001). Only 39.71 percent of delegates were aware of the NSFA regulations before the conference, which increased to 91.18 percent in the post-conference survey. Similarly, 38.24 percent of delegates were confident in their understanding of training pathways pre-conference which increased to 97.10 percent post-conference.

Conclusion: This study demonstrates that facial aesthetic conferences can be used as an educational tool for aspiring practitioners and highlights the existing knowledge gap among current practitioners. Further research is needed to assess the overall impact of aesthetic conferences on the education of aspiring practitioners.

Objective: We sought to analyze the effectiveness, recurrence, safety, and patient satisfaction rates following xanthelasma palpebrarum (XP) treatment with trichloroacetic acid (TCA) 80%.

Methods: This was a retrospective review of patients treated with TCA 80% for XP between January 2012 and August 2022. A prospective telephone questionnaire was administered to the same patient population to evaluate recurrence, patient satisfaction, and side effects.

Results: In total, 77 patients were included in this retrospective review. Most patients received one treatment (n=38; 49.4%) and had XP located bilaterally (n=59; 76.6%) on either the lower eyelids only (n=18; 23.4%) or both the upper and lower eyelids (n=18; 23.4%). Following treatment, 94.2 percent (n=49) of patients expressed satisfaction and 97.2 percent (n=70) displayed a clinician-reported improvement in XP. In the prospective patient questionnaire, the reoccurrence of XP was self-reported in 24.7 percent (n=19) of all patients. The adverse events, reported by the clinician during the retrospective review and the patient during the prospective questionnaire, included erythema (n=2; 2.6%), hyperpigmentation (n=4; 5.2%), hypopigmentation (n=3; 3.9%), and scarring (n=2; 2.6%).

Limitations: Limitations may exist due to the retrospective nature of the chart review, missing data, and lack of a comparator cohort. Thus, further studies are required to validate this study's preliminary results.

Conclusion: XP has a strong likelihood of recurrence. However, TCA 80% for XP management should be considered as a treatment option due to high patient satisfaction, mild side effects, low cost, and long-term cosmetic results.

Objective: The authors sought to compare the results in Fitzpatrick Skin Type (FST) reporting among providers, trainees, and patients. They discussed the implications of discordance in FST reporting among these groups.

Methods: This survey-based study was offered to all adult patients (18 years or older), dermatology residents, and dermatology faculty providers at University of Oklahoma Dermatology Clinic in Oklahoma City, Oklahoma. Deidentified information from the patient survey, provider-assigned FST, and provider credentials were consolidated, and data was analyzed by a biostatistician.

Results: The provider-assigned FST was more accurate than the patient's own estimation of their own ability to tan versus burn. The patient's race played an important factor in a discrepancy between provider and patient described FST. Additionally, provider years in practice increased the odds of any discrepancy existing.

Limitations: This study was conducted at one clinic location encompassing only the immediate geographic population.

Conclusion: Despite being the most used skin tone classification system in dermatology, the FST system has many limitations. The classification system needs to be reevaluated or replaced with methods that more accurately, appropriately, and reliably describe skin tones and skin photo reactivity. Education is necessary for current trainees to avoid erroneous use of classifications such as the FST.

There has been a notable rise in the prevalence of cosmetic dermatology services worldwide, involving a diverse range of providers. Patients presenting with cosmetic concerns should be thoroughly assessed and require meticulous attention because subtle, unexpected clinical cues might necessitate the application of dermatologic expertise. In this study, we present a case series involving patients who sought cosmetic care at an academic cosmetic dermatology center, revealing subsequent diagnoses of significant medical conditions. This underscores the critical importance of comprehensive training and substantial clinical exposure for practitioners in the highly nuanced field of dermatology.

Acne is a chronic dermatologic disorder that can require long-term treatment. To prevent recurrence after oral treatment for severe acne, topical maintenance treatment is recommended; however, there is little guidance or research on maintenance regimens. This article briefly summarizes literature on oral isotretinoin and topical retinoids and presents a case series of patients who received tazarotene 0.045% lotion as maintenance following oral isotretinoin. While oral isotretinoin is efficacious, relapse/remission rates range from 0 to 69 percent depending on the definition of relapse/remission, dose, and duration of treatment/follow-up. In addition, oral isotretinoin is a known teratogen, and long-term use (>2 courses of 15-20 weeks) is not recommended. Topical treatments such as retinoids are recommended for maintenance, and some studies support that adapalene and tazarotene provide a benefit. Tazarotene 0.045% lotion is efficacious and safe, with demonstrated reductions in acne, acne-induced post-inflammatory hyperpigmentation, and melasma. In my clinic, patients with severe recalcitrant acne received once-daily oral isotretinoin for at least 20 weeks until clinically clear. On the day of last isotretinoin dose, once-daily topical tazarotene 0.045% lotion was initiated for 6 to 12 months. A total of 12 patients completed 24.3 (6.7) weeks (mean [standard deviation]) of isotretinoin (cumulative dose: 184.6 [75.1] mg/kg) and 13.0 (6.7) months of post-isotretinoin tazarotene 0.045%. No patients relapsed and all showed subjective visual improvements in acne-related scarring with topical tazarotene. None discontinued tazarotene due to adverse events. These case reports show that tazarotene 0.045% lotion may be an effective and safe treatment to prevent relapse after initial oral isotretinoin treatment.

Objective: Dermatologic office procedures involving needles including injection of local anesthetic both cutaneously and intraorally, botulinum toxin, fillers and keloids, as well as venipuncture and a plethora of other procedures can often cause pain that ranges from mild to severe. The technique of utilizing vibration frequently lessens pain. Vibration anesthesia is a non-invasive, inexpensive, virtually side-effect free, and well-established method of lessening pain during dermatologic procedures. We conducted a review of prior studies which used vibration anesthesia in a variety of invasive procedures.

Methods: A comprehensive search was performed using PubMed and EMBASE (Ovid) to look for original studies related to the usage of vibration to reduce pain in invasive procedures. Terms searched were "vibration anesthesia", "vibration analgesia", "vibratory anesthesia", and "vibratory analgesia." Since these terms, especially the most commonly accepted, "Vibration Anesthesia", are generally but not universally recognized, a small number of journal articles were found by searching references of acceptable papers. A total of 35 papers were included for analysis.

Results: Many studies have reported that vibration anesthesia is a useful method for reducing uncomfortable symptoms before dermatologic procedures.

Limitations: A small number of suitable papers, especially in the dermatologic literature, met the criteria. The instrumentation and techniques used are not standardized.

Conclusion: Studies involving injection of local anesthesia as well as venipuncture in pediatric populations show vibration anesthesia as a useful method to minimize pain. There is additional literature suggesting that vibration is able to help minimize discomfort associated with injections of botox, fillers, intramuscular antibiotic injections and intralesional cortisone for keloids.