Mesotherapy with hyaluronic acid (HA) is a treatment approach currently used for skin rejuvenation. High-frequency ultrasound (20–100 MHz) is a non-invasive technique that has been used to evaluate ...age-related dermal changes. The presence and the degree of a typical subepidermal low-echogenic band (SLEB) are photoaging related: the lower the SLEB echogenicity, the higher the photoaging. The aim of this trial was to evaluate, through ultrasound imaging, the long-term effects of microinjections of HA on SLEB echogenicity. Twenty-two women with clinical and ultrasound signs of moderate photoaging were enrolled in the study. Treatment consisted of multiple microinjections of HA salts of biotechnological origin on the dorsum of one hand, once weekly for 4 weeks and, successively, once monthly for 4 months (group A) or 9 months (group B). The dorsum of the other hand of each subject was injected with saline solution and used as a control. In all subjects, high-frequency ultrasound (22 MHz) was performed to evaluate SLEB echogenicity changes during treatment. Eighteen out of 22 patients completed the study. At the end of 4 weeks, an ultrasound increase of dermal echogenicity was observed in 13 subjects (seven of group A and six of group B), which we considered as “responders”. In these patients, the Student’s
t-
test showed a significant increase from baseline of SLEB pixel numbers of +24 % (
P
< 0.01) versus +6 % with placebo. In the same subjects, after an additional 4 months of monthly injections, the mean increase was +18 % (
P
< 0.05) versus +4 % with placebo. In patients from group B that completed 10 months of treatment, the increase from baseline of SLEB pixel numbers was +18 % (
P
< 0.05) versus 0 % with placebo. Our study suggests that mesotherapy with HA may effectively improve skin aging and photoaging, as supported by quantifiable ultrasound data showing significant changes in SLEB density over time.
Level of Evidence II
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.
Background
Acquired lymphangiectasias represent cystic dilatations of the cutaneous lymphatic vessels resulting from damage and/or obstruction of previously normal lymphatics, usually secondary to ...surgery, radiotherapy, and/or infections.
Materials and Methods
The clinical, dermoscopic, and confocal microscopy features of three cases of acquired lymphangiectasias occurring after breast surgery are described along with histopathological correlations.
Results
Polarized dermoscopy revealed in all lesions the presence of well‐circumscribed, white‐yellowish lacunae surrounded by pale septa. In addition, some lesions showed scattered reddish areas and red lacunae. Confocal microscopy showed in the upper dermis numerous, roundish dark cavities separated by thin septa. These features corresponded histopathologically to saccular dilations and ectatic lymphatic vessels lined by a single layer of endothelial cells in the papillary/reticular dermis.
Conclusion
The use of non‐invasive diagnostic techniques may be addressed to an enhanced non‐invasive diagnosis of acquired lymphangiectasias by showing peculiar features, thus avoiding the need for skin biopsy.
Clinical evidences of urea at medium concentration Dall’Oglio, Federica; Tedeschi, Aurora; Verzì, Anna Elisa ...
International journal of clinical practice,
December 2020, 2020-Dec, 2020-12-00, 20201201, Letnik:
74, Številka:
S187
Journal Article
Recenzirano
Odprti dostop
Urea‐based topical compounds at medium concentrations (15%‐30%) represent useful dermatological agents for their humectant and keratolytic effects by enhancing stratum corneum hydration and by ...loosening epidermal keratin, respectively. The aim of this paper is to review the clinical evidences of the use of 15%‐30% urea as single topical agent. Although limited evidence supports the use of these concentrations of urea in skin disorders characterised by xerosis and hyperkeratosis, in clinical practice they are largely used especially in xerosis of limited skin areas, in which the side effects are tolerable, or hyperkeratosis involving large or more sensitive (eg, face, genital region, etc) areas, in which higher concentration may be irritant. In addition, urea at medium concentrations is used in combination with other substances including topical antifungals as penetration enhancer.
Background
Topical azelaic acid (AzA) is a common treatment for mild/moderate inflammatory rosacea.
Aims
To assess the efficacy and tolerability of a novel formulation cream containing 15% AzA ...(anti‐inflammatory/anti‐oxidant/anti‐microbial agent) combined with 1% dihydroavenanthramide D (anti‐inflammatory/anti‐itch) in inflammatory rosacea using clinical/instrumental evaluation.
Methods
In this multicentre, prospective, open‐label trial, 45 patients with mild/moderate inflammatory rosacea enrolled at the Dermatology Clinic of the University of Catania, Naples, and Rome (Italy) were instructed to apply the cream twice daily for 8 weeks. Clinical evaluation was performed at baseline (T0) and at 8 weeks (T1) by (1) Investigator Global Assessment (IGA) score based on a 5‐point scale (from 0 = clear/no erythema/papules/pustules to 4 = severe erythema/several papules/pustules) and (2) inflammatory lesions count. Instrumental evaluation of erythema degree was performed by erythema‐directed digital photography (EDDP) by a 5‐point scale (from 0 = no redness to 4 = severe redness) at all time points. Tolerability was assessed by a self‐administered questionnaire at 8 weeks. Statistical analysis was performed using SAS version 9.
Results
Forty‐four patients completed the study. At week 8, a significant decrease in baseline of IGA scores median from 3 (T0) to 1 (T1) and inflammatory lesions count median from 8 (T0) to 1 (T1) was recorded along with a significant reduction of erythema scores median from 2 (T0) to 1 (T1). No relevant side effects were recorded.
Conclusions
Our results suggest that this new non‐irritating product represents a valid therapeutic option for mild/moderate inflammatory rosacea, and EDDP is able to provide a more defined evaluation of erythema changes.
Background
Cradle cap is a benign and self‐limiting variant of seborrheic dermatitis (SD) that can be distressing for parents.
Aims
To assess by clinical/laboratory/instrumental evaluation the ...efficacy/tolerability of a gel cream containing piroctone olamine (antifungal), biosaccharide gum‐2 (antifungal), stearyl glycyrrhetinate (anti‐inflammatory), and zinc l‐pyrrolidone carboxylate (zinc‐PCA) (antiseborrheic) in the treatment of mild/ moderate cradle cap.
Methods
In this prospective, open‐label trial, 10 infants, with mild/moderate cradle cap enrolled at the Dermatology University Clinic of Catania (Italy) used the tested gel cream twice daily for 30 days. Degree of erythema was evaluated clinically by a 5‐point severity scale (from 0=no erythema to 4=severe erythema), at baseline, at 15 and 30 days. Desquamation was rated by dermoscopy evaluation using a 5‐point scale (from 0=no desquamation to 4=severe/many large adherent white flakes), at all time points. An Investigator Global Assessment (IGA) using a 6‐point scale (from −1=worsening to 4=complete response/clear) was also performed at 30 days. Five subjects, randomly selected, underwent double microbiological evaluation for bacteria and yeasts by cultures of cotton swabs at baseline and at 30 days. Tolerability/acceptability was evaluated on a 4‐point scale (from 0=very poor to 3=excellent) at 15 and 30 days. Data were processed using SAS version 9.
Results
At baseline, a significant colony‐forming unit (CFU) count for Malassezia furfur and Staphylococcus aureus was detected in 4 out of 5 selected patients. After 15 and 30 days, a statically significant reduction from baseline in erythema and desquamation severity was observed, along with a reduction in CFU count for Malassezia furfur and Staphylococcus aureus from baseline. No signs of local side effects were documented.
Conclusions
Our results indicate that the tested gel cream may represent a valid option to treat mild‐to‐moderate forms of cradle cap and support its antifungal and antibacterial properties.
Topical cosmetic agents if correctly prescribed and used may improve outcomes in acne therapy. The aim of this study was to assess the efficacy and tolerability of a new daily cosmetic regimen in the ...treatment of mild facial acne.
A multicenter, prospective, observational, clinical study was conducted on 91 adult patients with mild acne. Subjects were instructed to apply a fluid containing Licochalcone A/Salicylic acid/L-Carnitine in the morning and a cream with Licochalcone A/Hydroxy-Complex 10% at bedtime for 8 weeks. The efficacy was clinically evaluated by Global Acne Grading System (GAGS) score and by comedones/papules lesions count and by instrumental assessment (Sebutape
and Reveal Photo Imager/VISIA-CR™ imaging) at baseline, at 4 and 8 weeks.
At 4 weeks a statistically significant reduction from baseline of GAGSwas observed. In addition, the mean total count of comedones and papules was significantly reduced by 41% and 45%, respectively, from baseline along with a significant reduction of mean sebum of 47%. At 8 weeks, a further statistically significant reduction from baseline of GAGS, total count of comedones and papules (64% and 71%, respectively), along with an additional sebum reduction of about 52% was also recorded.
Our results suggest that the daily regimen based on Licochalcone A with Salicylic acid/L-Carnitine as fluid or with Hydroxy-Complex 10% as cream represent an interesting cosmetic approach for treating mild acne.
Effectiveness of a new cosmetic treatment for melasma Berardesca, Enzo; Rigoni, Corinna; Cantù, Alessandra ...
Journal of cosmetic dermatology,
July 2020, 2020-Jul, 2020-07-00, 20200701, Letnik:
19, Številka:
7
Journal Article
Recenzirano
Background
Melasma treatment is difficult due to extended treatment periods, suboptimal adherence, inconsistent results, and frequent relapses. Kojic acid has been shown to be effective in reducing ...melasma severity and is now increasingly used in cosmetic treatments.
Aims
The purpose of the present study was to evaluate the effectiveness of a new cosmetic treatment for melasma at 45 and 90 days.
Methods
Multicenter prospective study across 20 dermatology clinics/ambulatories. One hundred patients with mild‐to‐moderate melasma were evaluated. The primary endpoints were changes in mean modified melasma area and severity index (mMASI) score and patient‐reported satisfaction at 45 and 90 days.
Results
The mean age of patients was 45.19 ± 11.5 years. Most patients were female and Caucasian. Patients presented mixed (65%), epidermal (26%), and dermal (4%) types of melasma. Triggering factors were hormonal contraception (33%), pregnancy (31%), and pharmacological treatment (11%); mean disease duration was 6.7 ± 6.8 years. Overall, a statistically significant decrease in mean mMASI scores was seen at 45 (2.19 ± 0.182 vs 3.29 ± 0.267, P < .0001) and 90 days (1.27 ± 0.128 vs 3.29 ± 0.267, P < .00001). The highest reduction in mMASI scores was observed in patients with dermal melasma. IGA scores showed a statistically significant improvement in pigmentation at 90 days (P < .00001).
Conclusion
The novel cosmetic treatment was associated with the improvement of melasma, as assessed by mMASI.
Clinical and Ultrasonographic Correlation of Acne Scars Lacarrubba, Francesco; Verzì, Anna Elisa; Tedeschi, Aurora ...
Dermatologic surgery,
November 2013, 2013-Nov, 2013-11-00, 20131101, Letnik:
39, Številka:
11
Journal Article
Recenzirano
Background
Consensus concerning nomenclature and classification of acne scars is lacking. Classification based solely on clinical examination represents an unmet need that could be improved with the ...use of objective, reproducible assessments.
Objective
To assess clinical and ultrasound morphologic features in 41 patients with scars resulting from moderate to severe acne and to determine whether correlation exists.
Materials and Methods
Eighty‐one lesions clinically identified as boxcar, ice pick, rolling, hypertrophic, or keloidal were evaluated using high‐frequency ultrasound (22 MHz).
Results
Ultrasound results generally correlated with clinical appearance. Eight scars clinically classified as ice pick showed a typical boxcar morphology upon ultrasound examination. Ultrasound showed that ice pick and boxcar scars were the deepest, with 95.8% between 0.2 and 0.5 mm.
Conclusions
High‐frequency ultrasound is a noninvasive technique that is useful in the evaluation and correct classification of acne scars. It represents an important adjunct to clinical examination, because it provides reliable objective and reproducible information useful to the selection of the best treatment option specifically customized to each individual patient's needs.
To evaluate if nonprescription topical agents may provide positive outcomes in the management of mild-to-moderate facial seborrheic dermatitis by reducing inflammation and scale production through ...clinical evaluation and erythema-directed digital photography.
Open-label, prospective, not-blinded, intra-patient, controlled, clinical trial (target area).
Twenty adult subjects affected by mild-to-moderate facial seborrheic dermatitis were enrolled and instructed to apply the study cream two times daily, initially on a selected target area only for seven days. If the subject developed visible improvement, it was advised to extend the application to all facial affected area for 21 additional days.
Efficacy was evaluated by measuring the grade of erythema (by clinical examination and by erythema-directed digital photography), desquamation (by clinical examination), and pruritus (by subject-completed visual analog scale). Additionally, at the end of the protocol, a Physician Global Assessment was carried out.
Eighteen subjects completed the study, whereas two subjects were lost to follow-up for nonadherence and personal reasons, respectively. Day 7 data from target areas showed a significant reduction in erythema. At the end of study, a significant improvement was recorded for erythema, desquamation, and pruritus compared to baseline. Physician Global Assessment showed improvement in 89 percent of patients, with a complete response in 56 percent of cases.
These preliminary results indicate that the study cream may be a viable nonprescription therapeutic option for patients affected by facial seborrheic dermatitis able to determine early and significant improvement. This study also emphasizes the advantages of using an erythema-directed digital photography system for assisting in a simple, more accurate erythema severity grading and therapeutic monitoring in patients affected by seborrheic dermatitis.
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