The latest medical research on Procedural Dermatology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about procedural dermatology gathered by our medical AI research bot.

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Frontal-Temporal Triangle Area Hair for Eyebrow Restoration in Asians: A Comparative Study With Periauricular and Occipital Hair.

Dermatol Surg

The frontal-temporal triangle area (FTTA) hair has a slow growth rate and thin caliber, which are similar to those of eyebrow hair. However, a comparison of cosmetic outcomes between FTTA and other scalp hair grafts in eyebrow transplantation has not been performed.

To compare the cosmetic outcomes of FTTA hair and periauricular and occipital area (POA) hair in eyebrow restoration.

A retrospective analysis of 155 patients with FTTA or POA hair transplants was performed. Comparative variables included patient characteristics, hair density, diameter, percentage of one-hair follicular units (FUs), number of transplanted FUs, harvesting time, transection rate, hair survival rate, frequency of eyebrow trimming, and patient satisfaction.

There was a significant difference in hair density, diameter, percentage of one-hair FUs, and harvesting time between the FTTA and POA hair transplants. The FTTA hair grew significantly slower than the POA hair did. The patients in the FTTA group trimmed their postoperative eyebrows at a significantly longer interval than those in the POA group. The percentage of patients who were very satisfied with the surgery results was higher in the FTTA group.

The FTTA hair grafts can provide aesthetically pleasing cosmetic results in eyebrow restoration.

Cheek Donor Site for Full-Thickness Skin Graft Repair of the Nasal Ala: Outcomes of a Retrospective Cohort Study.

Dermatol Surg

Full-thickness skin grafts (FTSGs) are useful repairs for reconstructing nasal alar defects. Traditional donor sites include the preauricular, postauricular, and supraclavicular skin.

To evaluate esthetic outcomes and complications of nasal alar defects repaired with FTSGs from the medial cheek.

A retrospective chart review of Mohs surgery patients who had FTSG repair of the nasal ala between January 2015 and August 2020 was performed. Demographic, surgery, and follow-up visit data were reviewed. Cosmesis was rated by a facial plastic surgeon, a Mohs surgeon, and a plastic surgeon using baseline, defect, and follow-up visit photographs.

Sixty-nine patients with FTSG repairs of nasal alar defects were identified. 51 of 69 patients (73.9%) had the cheek donor site, and 18 of 69 patients (26.1%) had a noncheek donor site. The mean (SD) rater visual analog score for both cohorts was good with no significant difference (cheek: 65.9 [13.8]; noncheek: 66.1 [15.3]; p = .96). A notable difference in the complication rate by donor site was observed (cheek: 6.9%, noncheek: 16.7%; p = .13), although it did not reach significance.

The cheek is a reliable FTSG donor site for nasal alar defects after Mohs micrographic surgery, with a trend toward fewer complications.

Quantifying Skin Uptake of Topicals After 1,927-nm and 1,440-nm Nonablative Fractional Diode Laser Treatment.

Dermatol Surg

Although the stratum corneum limits transdermal absorption of topicals, laser devices can enhance topical uptake by disrupting the skin barrier. Nonablative lasers are commonly used, but their effects on topical uptake should be quantified to optimize outcomes.

The objective of this study is to analyze transdermal uptake of 4 topicals after nonablative fractional diode laser pretreatment.

Human donor tissue was pretreated ex vivo with a nonablative fractional diode laser (1,927 nm or 1,440 nm, at varying treatment densities, powers, and peak energies) followed by application of either 2% salicylic acid, 10% ascorbic acid, over-the-counter mineral eye serum, or 4% hydroquinone. Topical uptake was quantified over 24 hours.

Despite lower power settings, pretreatment with the 1,927 nm wavelength was associated with greater uptake of 10% ascorbic acid, mineral eye serum, and 4% hydroquinone than the 1,440 nm wavelength. In addition, 1,440-nm laser pretreatment with higher density (320 microscopic treatment zones [MTZ]/cm2) and peak power (3 W) was associated with similar uptake but greater retention of 2% salicylic acid and greater uptake of 10% ascorbic acid than that with lower density (80 MTZ/cm2) and peak power (1.2 W).

When using laser pretreatment, device settings should be adjusted to balance outcomes with potential side effects.

Complementary and integrative remedies in the treatment of chronic pruritus: A review of clinical trials.

J Cosmet Dermatol

Chronic pruritus is one of the most common conditions in dermatology as well as a common manifestation in many systemic diseases. Since the etiology of chronic pruritus remains somewhat unknown, hence, conventional medications may not always show a good therapeutic response. This finding has led both investigators and patients to use herbal and complementary remedies for its treatment. The aim of this study was to review clinical trials in which herbal and complementary medicine was used in the control and treatment of chronic pruritus.

In this study, we reviewed related articles in this domain, from 2000 to 2020. The search involved electronic databases including PubMed, Scopus, Web of Science, Cochrane, Google Scholar, and SID databases using the keywords "pruritus", "itch", "herb", "complementary medicine", "traditional medicine", "integrative medicine", and their related MeSH terms. Finally, we extracted the pertinent information from these articles and summarized the results.

The findings of this study showed that 17 clinical trials have been conducted to date in order to evaluate the efficacy of herbal remedies and complementary medicines in the treatment of chronic pruritus. Herbal remedies including turmeric, Fumaria parviflora, Avena sativa, capsaicin, sweet almond oil, peppermint oil, violet oil, vinegar, as well as manual therapies including aromatherapy, auricular acupressure and acupuncture, were significantly effective in the treatment of chronic pruritus.

There are only a few studies published on the therapeutic efficacy of herbal remedies and complementary medicine in the treatment of chronic pruritus. Some have shown promising results. Therefore, more evidence-based studies are needed in order to determine if herbal remedies and complementary medicine could be an effective alternative or adjuvant treatment modality in chronic pruritus.

Is there a lınk between alopecıa areata and gut?

J Cosmet Dermatol

There may be an association between increased intestinal permeability and the progression of alopecia areata (AA).

The present study aimed to investigate the role of intestinal permeability in the etiopathogenesis of AA and its association with the severity of the disease.

Serum zonulin levels of 70 patients with AA who were not receiving any systemic treatment and of 70 healthy control subjects were measured.

The median serum zonulin level in the patient group (46.38 ng/mL) did not differ significantly from that in the control group (50.34 ng/mL) (p = 0.828). Moreover, there was no significant relationship between serum zonulin levels and the severity of the disease (p = 0.549).

We did not observe an increase in intestinal permeability secondary to zonulin expression in patients with AA. However, in order to generalize this result to all patients with AA, serum zonulin levels need to be evaluated in studies including more patients with severe disease, AT, and AU.

2940- nm erbium:YAG laser versus 980- nm diode laser in the treatment of multiple seborrheic keratoses: A prospective comparative randomized study.

J Cosmet Dermatol

Seborrheic keratoses (SKs) are the most common benign epithelial tumors encountered in clinical practice. Complications associated with traditional treatments of SKs, urge the scientists to seek alternative treatment modalities.

To compare the efficacy and safety of 2940 -nm erbium- doped yttrium aluminum garnet (Er:YAG) laser versus 980- nm diode laser both clinically and dermoscopically for the treatment of seborrheic keratosis.

Thirty subjects with multiple SKs were randomized to receive two sessions of either Er:YAG laser (n=15) or diode laser (n=15) and were followed-up for 2 weeks after each session, and at 3 and 6 months after the second session.

Both lasers exhibited significant clearance of SKs with no significant difference in clinical and dermoscopic improvement between the two systems. However, Er:YAG laser showed shorter total downtime but more serious erythema, while scarring and hyperpigmentation were observed in diode laser group. No recurrence was detected in both groups at 6 months follow-up.

Er:YAG and diode lasers both are effective, non- invasive and well-tolerated techniques in treatment of SKs.

Super-selective intra-arterial dissolution therapy for lingual artery occlusion resulting due to the use of hyaluronic acid for chin augmentation: The first reported case.

J Cosmet Dermatol

As a consequence of the current trend of performing minimally invasive surgery, the use of injectable fillers has progressively increased in aesthe...

Clinical Outcomes of Small Infantile Hemangiomas Treated With Pulsed Dye Laser.

Dermatol Surg

Infantile hemangioma (IH) often causes cosmetic disfigurement. Early intervention with propranolol for large, high-risk lesions is recommended in the American Academy of Pediatrics' Clinical Practice Guideline. Conversely, strategies for the management of small, low-risk lesions have not been established; however, pulsed dye laser (PDL) is often used to treat these lesions.

To investigate clinical outcomes of PDL in small IH lesions.

Fifty-three cases with 58 small IHs which did not meet the criteria for high-risk lesions in the guideline and were treated only with PDL were retrospectively reviewed. The characteristics of IHs and residual skin changes after treatment were evaluated.

Forty-seven lesions (81.0%) were superficial hemangiomas, whereas 11 (19.0%) were combined-type. The median maximum diameter was 10.0 mm. Forty-five lesions (77.6%) exhibited various residual skin changes after PDL treatment, including anetoderma (53.5%), telangiectasia and erythema (43.1%), hyperpigmentation (34.5%), redundant skin (3.4%), and fibrofatty tissue (3.4%). Of these, the incidence of anetoderma and fibrofatty tissue were significantly higher in the combined group than in the superficial group (p = .036 and .033, respectively).

Even small lesions, especially combined-type, often result in cosmetic problems after PDL treatment.

Update on Exosomes in Aesthetics.

Dermatol Surg

In dermatology, exosomes have been leveraged given their roles in wound healing, cell migration, extracellular matrix reconstruction, and angiogenesis.

The purpose of this article is to review the literature investigating the use of exosomes in skin rejuvenation and hair regeneration.

The PubMed database was searched for studies published through October 2021.

Early preclinical studies in aesthetics have demonstrated promising effects of exosomes on skin rejuvenation and hair growth in in vitro and murine models. Despite this, only 1 clinical study has been published to date, and there are no FDA-approved products on the market.

Variation in purification techniques and practical issues surrounding isolation, storage, scalability, and reproducibility of an exosome product represent ongoing hindrances to the movement of exosomes into the clinical sphere.

Viability and Cosmesis of Right Angle and Vertical Paramedian Forehead Flaps Are Equivalent: A Retrospective Quantitative Study.

Dermatol Surg

Paramedian forehead flaps (PMFFs) are commonly used for reconstruction of nasal defects. The classic PMFF is vertically oriented while the modified PMFF is designed with a 90-degree angle. No study has compared outcomes between these PMFF designs.

To compare and quantify viability and cosmesis of 90-degree and vertical PMFF.

Retrospective chart review of 70 consecutive patients with a vertical or 90-degree PMFF design for nasal repairs after Mohs micrographic surgery (MMS). Cosmetic outcome was assessed on a 10-cm, 100-point, visual analog scale (VAS) by an independent observer using standardized 3-month postoperative photographs. Flap viability was assessed using standardized 3-week postoperative photographs. Descriptive statistics, t-test, and Mann-Whitney test were used for statistical analysis.

Forty-eight patients were repaired with a vertical PMFF and 22 using the 90-degree PMFF. The mean defect area of vertical and 90-degree designs was equivalent (7.7 ± 4.0 cm2 vs 8.1 ± 4.0 cm2, p = .70). There was no significant difference in cosmetic outcome (75.9 ± 9.4 vs 72.9 ± 6.8, p = .19) or flap viability (3.8% ± 11.6 vs 2.6% ± 7.9, p = .67) between vertical and 90-degree designs.

Vertical and 90-degree PMFF designs for nasal repairs after MMS are equivalent in cosmetic outcome and viability.

Combining the use of two non-invasive instruments to confirm that a formula can improve skin luminance while respecting constitutive melanogenesis.

J Cosmet Dermatol

Skin radiance products achieve perceivable benefits with different sort of mechanism of action.

To use two non-invasive instrumental devices to evaluate the effectiveness of a cosmetic formula designed to improve skin reflectance while respecting skin integrity.

Subjects (N=43) aged 18 to 50 years old had healthy skin of phototype V to VI and Individual Typology Angle between -10° and -50°. The treatment was applied twice weekly for 4 weeks on a delineated area of the back and an adjacent area was left untreated. Instrumental and clinical scoring assessments of treated and untreated skin were performed at baseline and Day 26.

Between baseline and Day 26, reflectance (Delta L*) increased by 1.27 points and was considered as clinically relevant. Dermatologist clinical scoring of radiance significantly improved from 2.6 to 3.6 after 4 weeks of treatment and the Skin Color Chart Clarity level significantly decreased from a score of 15.5 to 14.3, representing a skin reflectance improvement. Conversely, the change between baseline and Day 26 in Mexameter Melanin Density was not clinically different for treated skin versus untreated skin (difference of 2.54). At Day 26, changes from baseline for Mexameter Melanin Density and Delta L* parameters appeared to be uncorrelated (r=-0.036).

This combination of two non-invasive devices can be useful to confirm that a product can modulate skin reflectance without modifying constitutive pigmentation. The formula tested in this study did not interfere with constitutive melanogenesis.

Anatomic Update on the 3-Dimensionality of the Subdermal Septum and its Relevance for the Pathophysiology of Cellulite.

J Cosmet Dermatol

Cellulite is an aesthetic condition affecting the appearance of skin in specific body regions. When reviewing past literature, a 2-D image of a subdermal septum was created most likely due to the applied cross-sectional investigative methodology. Despite practitioners are aware of the 3-D nature of the subdermal architecture, this is not reflected in the present scientific literature. The aim of this anatomic review is to summarize the past literature and to provide an update on the 3-dimensionality of a subdermal septum with specific focus on the pathophysiology of cellulite.

This review is based on the literature search performed in the PubMed database using the keywords: cellulite (n = 777), cellulite AND pathophysiology (n = 53). The articles obtained were screened and those focusing on "cellulitis" or other non-cellulite related topics were additionally excluded resulting in a total of n = 38 relevant articles which were evaluated for the purpose of this anatomic review.

The skin is comprised of two fat layers (superficial and deep), separated by the superficial fascia. The dynamic 3-D interplay between retinacula cutis, fascia, and fat, with anatomic differences between men and women, highlights a complex anatomic construct with direct implications for the formation and treatment of cellulite.

The 3-dimensionality of a subdermal septum provides important clinical clues to understanding the underlying mechanisms and pathogenesis of cellulite. The 3-D approach, in contrast to the past 2-D models, presents a robust foundation for understanding and developing future cellulite therapeutic strategies.