You searched for hyaluronidase | JCAD | The Journal of Clinical and Aesthetic Dermatology

Guideline for the Safe Use of Hyaluronidase in Aesthetic Medicine, Including Modified High-dose Protocol

August 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(8):E69–E75. Download a PDF of this guideline here by Gillian Murray, MPharm, PG Dip Clin Pharm, INP; Cormac Convery, MB ChB, MSc, MASLMS; Lee Walker, BDS, MFDS, RCPSG, MJDF, RCS, ENG; and Emma Davies, RN INP Ms. Murray is with Clinical Academic Kings College in London, England. Dr. Convery is with The Ever Clinic in Glasgow, Scotland. Dr. Walker is with B City Clinic in Liverpool, England. Ms. Davies is Clinical Director of Save Face in Cardiff, United Kingdom. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC). FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. ABSTRACT: Vascular occlusions can occur with injection of dermal fillers, causing devastating outcomes for the patient. Hyaluronidase is an enzyme that was first used in general medicine in 1949, but has gained widespread use in aesthetic medicine to dissolve hyaluronic acid (HA)-based dermal fillers. Knowledge of this drug and its use for other aesthetic indications is evolving, and there is often anxiety attached to the administration of animal-derived product due to fears of an allergic reaction.This paper provides guidance on

Intravenous Hyaluronidase for Visual Loss Secondary to Filler Injection: A Novel Therapeutic Approach

December 1, 2019 No Comments

J Clin Aesthet Dermatol. 2019;12(12):25–27 by Melissa McCann, BPharm, MBBS, FRACGP Dr. McCann is with Whitsunday Family Practice and Cosmetic Skin Clinic in Cannonvale, Australia. FUNDING: No funding was provided for this study. DISCLOSURES: The author has no conflicts of interest relevant to the content of this article. ABSTRACT: Despite the establishment of international expert consensus groups, peer-reviewed guidelines, and evidence-based protocols for both reducing the risk of arterial embolization of hyaluronic acid filler from aesthetic injection and promptly treating complications, perhaps the most devastating complication of visual loss remains largely irreversible. This article examines the novel therapeutic approach of using high-dose intravenous hyaluronidase when other attempts to restore vision have failed. Evidence for the safety of the proposed dosing in an emergency setting has been demonstrated in previous papers investigating the use of hyaluronidase for myocardial infarction in the 1970s. This approach has the advantage of reducing the time delay and risks associated with retrobulbar injection. Though rare, the risk of anaphylaxis must be able to be managed. KEYWORDS: Complications of filler, hyaluronic acid, hyaluronidase, facial filler injection, iatrogenic vision loss, retinal artery occlusion While rare, increasing case reports of visual loss following aesthetic facial injections have prompted reviews

This Month’s Guideline: The Use of Hyaluronidase in Aesthetic Practice (v2.4)

June 1, 2018 No Comments

J Clin Aesthet Dermatol. 2018 Jun; 11(6): E61–E68. By Martyn King, MD, Cormac Convery, MD, and Emma Davies, RN, NIP BACKGROUND Hyaluronic acid (HA)-based dermal fillers are the most commonly used fillers in the aesthetics market.1 A glycosaminoglycan and a chief component of the extracellular matrix, HA is mainly responsible for maintaining hydration in the dermis. HA is a linear polysaccharide chain with the alternating monosaccharides d-glucuronic acid and N-acetyl-d-glucosamine.2 Hyaluronidases are enzymes (endoglycosidases) that can depolymerise HA, leading to its degradation3 by hydrolyzing the disaccharides at hexosaminidic ?-1through ?-4 linkages.4 Hyaluronidase is licensed in the United Kingdom for enhancing permeation of subcutaneous or intramuscular injections, local anaesthetics, and subcutaneous infusions, and to promote resorption of excess fluids and blood.5 There is considerable evidence for the off-label use of hyaluronidase for managing vascular compromise due to inadvertent intravascular injection or external compression,6 over-correction, asymmetry, and lumps and nodules7 caused by the injection of HA filler. There are several sources of hyaluronidase, and they are generally divided into three subgroups: mammalian (obtained from the testes); hookworm or leech; and microbes.8 Recombinant human hyaluronidase (Hylenex®, Halozyme Therapeutics, San Diego, California) has a purity 100 times higher than some of the bovine preparations.9 There is no longterm data for this product yet, but

Selected Poster Abstracts From Symposium for Cosmetic Advances & Laser Education (SCALE) 2024

September 1, 2024 No Comments

J Clin Aesthet Dermatol. 2024;17(9 Suppl 2):S11–S27. A message from the Guest Editors and SCALE Program Directors Dear Colleagues: The 2024 Symposium for Cosmetic Advances & Laser Education (SCALE), held in Nashville, Tennessee on May 15 to 19, 2024, saw a variety of clinical and scientific data presented, but not just at the podium; clinically relevant material was also presented in poster format. For those of you who were unable to participate in the meeting or were not able to attend the poster sessions, we have compiled abstracts from a select group of research posters presented during the 2024 meeting. It is our hope that you will find the highlighted research informative and thought provoking. Michael Gold, MD, and Brian Biesman, MD SCALE 2024 Program Directors; Guest Editors, The Journal of Clinical and Aesthetic Dermatology Content Acne Improvement in skin moisturization and lack of barrier damage with clascoterone cream 1% treatment: Results of a randomized, single-blind, split-face study in acne-prone individuals Aesthetic Practice Insights Aesthetic concerns regarding body skin quality: Results from a large survey of aesthetically-inclined adults in the United States Aesthetic concerns regarding facial skin quality: Results from a large survey of aesthetically-inclined adults in

Microinjection Technique: A Novel and Comprehensive Approach for Nose Reshaping with Hyaluronic Acid Fillers

April 29, 2024 No Comments

J Clin Aesthet Dermatol. 2024;17(5):43–47. by Cemre Busra Turk, MD; Bugra Burc Dagtas, MD; Neslihan Fisek Izci, MD; and Gonca Gokdemir, MD Dr. Turk is with the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, Massachusetts, and Department of Dermatology at Harvard Medical School in Boston, Massachusetts. Dr. Dagtas is with the University of Health Sciences at the Istanbul Training and Research Hospital and Dermatology Clinic in Istanbul, Turkey. Dr. Izci is with the Faculty of Medicine and Department of Dermatology at Bahcesehir University in Istanbul, Turkey. Dr. Gokdemir is with Prof. Dr. Gonca Gokdemir Clinic in Istanbul, Turkey. FUNDING: No funding was provided for this article. DISCLOSURES: The authors have no conflicts of interest relevant to the contents of this article. ABSTRACT: Nose reshaping with hyaluronic acid (HA) fillers, also known as medical rhinoplasty, is an increasingly popular, minimally invasive aesthetic procedure. As the demand for nasal reshaping continues to rise, it is essential to develop safe and efficient injection techniques and assess satisfaction to ensure optimal outcomes and patient-centered care. Objective. This study aims to evaluate patient and physician satisfaction with hyaluronic acid filler applications using microinjection technique for nasal reshaping. Methods. The study included healthy

Clinical Evaluation of Next-generation, Multi-weight Hyaluronic Acid Plus Antioxidant Complex-based Topical Formulations with Targeted Delivery to Enhance Skin Rejuvenation

April 1, 2024 No Comments

J Clin Aesthet Dermatol. 2024;17(4):12–16. by Edward Lain, MD, MBA; Kavita Mariwalla, MD; Joshua Zeichner, MD; Frank Kirchner, PhD; Eduardo Ruvolo, MS; and Zoe D. Draelos, MD Dr. Lain is with Sanova Dermatology in Austin, Texas. Dr. Mariwalla is with Mariwalla Dermatology in West Islip, New York. Dr. Zeichner is with the Department of Dermatology at Mount Sinai Hospital in New York, New York. Dr. Kirchner and Mr. Ruvolo are with Beiersdorf Inc. in Florham Park, New Jersey. Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. FUNDING: Funding for this article was provided by Beiersdorf Inc. DISCLOSURES: Dr. Lain has served as a clinical trial investigator, consultant, advisor, and/or speaker for Beiersdorf, Pierre Fabre, L’Oreal, AbbVie, Galderma, Kenvue; Dr. Mariwalla has served as a consultant for Beiersdorf. Dr. Zeichner has served as a consultant for Beiersdorf. Mr. Kirchner and Dr. Ruvolo are employees of Beiersdorf. Dr. Draelos has served as a trial investigator, consultant, advisor and/or speaker for Aveda, Beiersdorf, Estee Lauder, Galderma, La Roche Posay, L’Oreal, and SkinCeuticals. ABSTRACT: Introduction: Hyaluronic acid (HA) has become a commonly used ingredient in many topical products due to its strong humectant properties and essential role in skin hydration;

Evaluation of Antioxidants’ Ability to Enhance Hyaluronic-acid Based Topical Moisturizers

March 1, 2024 No Comments

J Clin Aesthet Dermatol. 2024;17(3):48–51. by Joshua Zeichner, MD; Edward (Ted) Lain, MD, MBA; Kavita Mariwalla, MD; Tanja Bußmann, Dr; Julia M. Weise, Dr; Elisabeth Maaß; Andrea Krüger; Anne-Kathleen Schade; Frank Kirchner; and Zoe D. Draelos, MD Dr. Zeichner is with the Department of Dermatology at Mount Sinai Hospital in New York, New York. Drs. Bussmann and Weise, Ms. Maass, Ms. Krüger, and Ms. Schade are with Research and Development at Beiersdorf AG in Hamburg, Germany. Dr. Lain is with Sanova Dermatology in Austin, Texas. Dr. Mariwalla is with Mariwalla Dermatology in West Islip, New York. Mr. Kirchner is with Beiersdorf Inc. in Florham Park, New Jersey. Dr. Draelos is with Dermatology Consulting Services, PLLC in High Point, North Carolina. FUNDING: Funding for this article was provided by Beiersdorf. DISCLOSURES: Dr. Zeichner has served as a consultant for Beiersdorf; Dr. Bussmann, Dr. Weiss, Ms. Maass, Ms. Krüger, Ms. Schade, and Mr. Kirchner are employees of Beiersdorf; Dr. Lain has served as a clinical trial investigator, consultant, advisor, and/or speaker for Beiersdorf, Pierre Fabre, L’Oreal, AbbVie, Galderma, Kenvue; Dr. Mariwalla has served as a consultant for Beiersdorf; Dr. Draelos has served as a trial investigator, consultant, advisor and/or speaker for Aveda, Beiersdorf,

Evaluation of Current Literature on Complications Secondary to Lip Augmentation Following Dermal Filler Injection

July 1, 2023 No Comments

J Clin Aesthet Dermatol. 2023;16(7):26–33. by Zoya Diwan, MBBS, BSc, PG Dip Clinical Dermatology; Sanjay Trikha, MBBS, BSc; Sepideh Etemad-Shahidi, BDS, BSc, RCSEng; Nina Parrish, BSc; and Christopher Rennie, MBBCh, MRCS Dr. Diwan is the President of Academic Aesthetics Mastermind Group and the Medical Director at Trikwan Aesthetics in London, United Kingdom. Dr. Trikha is the Vice President of Academic Aesthetics Mastermind Group and the Director at Trikwan Aesthetics in London, United Kingdom. Dr. Etemad-Shahidi is a member at Academic Aesthetics Mastermind Group and a Practitioner at Medicetics in London, United Kingdom. Dr. Rennie is a member of the Academic Aesthetics Mastermind Group and a Director at Romsey Medical Aesthetics in Winchester, United Kingdom. Ms. Parrish is a member of the Academic Aesthetics Mastermind Group and Trikwan Aesthetics in London, United Kingdom. FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. ABSTRACT: Background. The current popularity of dermal filler treatments as an alternative to invasive surgical cosmetic procedures has led to an increase in filler-related complications. Lip filler treatments are among the most sought-after injectable treatments and a thorough understanding of the complications of lip filler injections,

The Effects of a Non-crossed-linked Hyaluronic Acid Gel on the Aging Signs of the Face versus Normal Saline: A Randomized, Double-blind, Placebo-controlled, Split-faced Study

February 1, 2023 No Comments

J Clin Aesthet Dermatol. 2023;16(2):29–36. by Luc Duteil, PhD; Catherine Queille-Roussel, MD; Hanane ISSA, PhD; Natalia Sukmansaya MD; Jane Murray, BSc; and Ferial Fanian, MD, PhD; Drs. Duteil, Queille-Roussel, and Ms. Murray are with the Center of Clinical Pharmacology Applied to Dermatology at L’Archet 2 Hospital in Nice, France. Drs. Fanian, Issa, and Sukmansaya are with FILLMED Laboratories in Paris, France. ABSTRACT: Background. Skin bio-revitalization improves skin quality globally; it permits the rejuvenation of the skin by increasing hydration and by reconstructing an optimal physiological environment for the skin cells together with a micro-filling effect. Objective. To assess the comparative efficacy of a non-cross-linked hyaluronic acid (NCHA) preparation (M-HA®10, FILLMED Laboratories, France) on fine lines reduction and on skin hydration, radiance and mechanical properties, after three sessions of multiple intradermal injections, active versus placebo, on the face of subjects presenting aging signs. Methods. Thirty healthy subjects received filler injections on one side and a control solution (saline) on the contralateral side of the face. Fine lines depth, skin hydration, and mechanical properties were evaluated using instrumental methods. Skin radiance, cheek fold and crow’s feet were scored clinically. In addition, Investigator and subject satisfaction rates were evaluated by the Global Aesthetic Improvement Scale and

A Retrospective Review of the Safety and Efficacy of Low-dose Triamcinolone Mixed with Hyaluronic Acid Fillers to Reduce Post-injection Infraorbital Swelling

April 1, 2022 No Comments

J Clin Aesthet Dermatol. 2022;15(4):13–19. by Robyn Siperstein, MD; Jose Raul Montes, MD; and AnnMari Speranza, MS Dr. Siperstein is with the University of Miami in Miami, Florida. Dr. Montes is with the Ophthalmology Department at the University of Puerto Rico in San Juan, Puerto Rico. Dr. Speranza is with the University of Tampa in Tampa, Florida. FUNDING: Funding for editorial assistance was provided by X-Medica, LLC. DISCLOSURES: Dr. Siperstein is a paid consultant, trainer, and recipient of research grants from Allergan & Galderma. Dr. Montes is a speaker and trainer for Allergan/Abbvie, Galderma and MERZ. Ms. Speranza does not have any conflicts to disclose. ABSTRACT: Objective. This retrospective review assesses the efficacy and safety of low-dose triamcinolone (1mg/cc) added to hyaluronic acid fillers to decrease swelling after infraorbital injection. Methods. This retrospective analysis includes 447 patients who underwent 706 infraorbital hyaluronic acid filler treatments from April 2013 to March 2020 by a single injector. Short-term post-procedural swelling (less than or greater to 2 weeks) was assessed through follow-up phone calls, which were documented in patient charts. The effect of triamcinolone, filler type, volume, and patient characteristics on the rate of post-procedure swelling were analyzed. Results. Swelling after infraorbital hyaluronic acid filler

Doppler Ultrasound in the Management of Vascular Complications Associated with Hyaluronic Acid Dermal Fillers

February 1, 2022 No Comments

J Clin Aesthet Dermatol. 2022;15(2):40–43. by; Marco Antonio Munia, MD, PhD; Christine Guarnieri Munia, MD; Meire Brasil Parada, MD; Jose Ben-HurFerraz Parente, MD, PhD and Nelson Wolosker, MD, PhD All authors are with Hospital Moriah in São Paulo, Brazil. FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. Facial injections with hyaluronic acid (HA) dermal fillers have become increasingly common. Hyaluronic acid is currently the most frequently used dermal filler. When compared to collagen for the treatment of nasolabial folds, HA not only produces similar cosmetic results with smaller doses but also lasts longer. Our objective was to evaluate the results of 10 patients with vascular complications associated with HA fillers treated with ultrasound-guided injection of hyaluronidase (HYAL) according to the Brazilian Society of Dermatology guidelines. Admission clinical evaluation revealed that the most frequent signs were: livedo reticularis (100% of the patients), hypoesthesia (50%) and local pain (20%). Although 80% of the patients complained of local pain during HYAL injection, none of them persisted with pain after the procedure ended. The total dose of injected HYAL per patient ranged from 300 to 750 IU (mean 500

Radial Sound (Shockwave) Therapy Resolves Delayed-onset Nodules Following Injection of Hyaluronic Acid Dermal Filler: A Case Study

December 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(12 Suppl 1):S15–S17 by Laura Ostezan, MD, and Jenna Peck, RN, MSN, WHNP-BC Dr. Ostezan is a board-certified dermatologist who practices aesthetic dermatology in Reno, Nevada. Ms. Peck is an advanced practice, board-certified Womens’ Health Nurse Practitioner and Aesthetic Medicine Specialist who practices cosmetic medicine in Gardnerville, Nevada. FUNDING: No funding was provided for the preparation of this article. DISCLOSURES: Assistance with manuscript preparation was provided by Lynda Seminara, CMPP, of ClearView Medical Communications, LLC, and was funded by a publication grant from Allergan (now AbbVie). Allergan (AbbVie) had no role in the design or conduct of the research. ABSTRACT: Delayed-onset nodules, a potential complication of injectable hyaluronic acid (HA) fillers, can be distressing to both patient and clinician. Current treatment options, including oral corticosteroids and antibiotics, have potential side effects and may be ineffective or contraindicated in some patients. Hyaluronidase is an enzyme used to degrade HA fillers. Although it is generally effective for resolving such nodules, it can interfere with the favorable aesthetic effects of filler treatment. This report describes a novel and successful method of treating delayed-onset nodules in facial tissue. Radial sound (shockwave) therapy was used to treat multiple delayed-onset facial nodules

Facial Vascular Events and Tissue Ischemia: A Guide to Understanding and Optimizing Wound Care

December 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(12 Suppl 1):S39–S48 by Astra Farmer, RN, NMP; Gillian Murray, MPharm, PG Clin Pharm INP; Brittony Croasdell, NP, ARPN, CANS; Emma Davies, RN, INP; Cormac Convery, MB ChB, MSc; and LEE WALKER, BDS, MFDS, RCS Ms. Farmer is with Devon and Cornwall Aesthetics Academy in Exmouth, England. Ms. Murray is with the Clinical Academic Kings College, London in London, England. Ms. Croasdell is Clinical Director at The Fitz® in Chicago, Illinois, United States. Ms. Davies is Clinical Director of Save Face UK in Bath, England. Dr. Convery is with the Ever Clinic Glasgow in Glasgow, Scotland. Dr. Walker is with B City Clinic in Liverpool, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC). FUNDING: No funding was provided for the preparation of this article. DISCLOSURES: The authors have no conflicts of interest relevant to the content of this article. ABSTRACT: The Complications in Medical Aesthetics Collaborative (CMAC) is a nonprofit organization established to promote best patient outcomes through educating clinicians in the prevention, diagnosis, and management of complications that can arise following nonsurgical cosmetic procedures. The organization is a global community sharing information, learning, experience, and data to promote best

Consensus Opinion for The Management of Soft Tissue Filler Induced Vision Loss

December 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(12):E84–E94. by Lee Walker, BDS, MFDS, RCPSG, MJDF, RCS, ENG; Cormac Convery, MB ChB, MSc, MASLMS; Emma Davies, RN, INP; Gillian Murray, MPharm, PG Dip Clin Pharm, INP; and Brittony Croasdell, MS,FNP-BC, APRN CANS Dr. Walker is with B City Clinic in Liverpool, England. Dr. Convery is with The Ever Clinic in Glasgow, Scotland. Ms. Davies is Clinical Director of Save Face in Cardiff, United Kingdom. Ms. Murray is with Clinical Academic Kings College in London, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC). FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. There are multiple treatment strategies proposed for the management of vision loss related to the injection of soft tissue fillers. Currently, there is no internationally accepted consensus on the immediate management of soft tissue filler induced vision loss (STFIVL). A recent systematic review of the literature concluded that there is not enough evidence to support retrobulbar hyaluronidase, and alternative treatments require exploration. The available literature demonstrates the inconsistent and unproven success of retrobulbar and peribulbar hyaluronidase in reversal of soft filler induced

Letters to the Editor: October 2021

October 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(10):16–18. Medical Photography in the Age of Smartphone Cameras Dear Editor: Immortalizing disease images, first by moulages and later by photography, has been a critical part of dermatology since before we were a formal specialty. At its peak in the 20th century, many departments had staff medical photographers, while others had official “department cameras” to capture a variety of skin findings. True democratization of image capture began in the mid-2000s with inexpensive camera phones that made image capture and storage simple and inexpensive. This “dumbing down,” making digital photography available worldwide, in our opinion has been associated with a loss of basic photographic principles for clinical photography, including non-distracting backgrounds, “standardized” views for reproducibility over time, and good lighting. The latter is most critical, as removal of backgrounds can be performed by apps and online services. Lighting, from the perspective of good color reproduction by choosing an appropriate light source, and short exposure with a small aperture to give good depth of field and not have movement-related blurs, is critical to good quality images. At present, there are many LED light sources, in the shape of rings or circles, that clip onto cell phones, giving a

Delayed-onset Nodules (DONs) and Considering their Treatment following use of Hyaluronic Acid (HA) Fillers

July 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(7):E59–E67. by Cormac Convery, MB ChB, MSc; Emma Davies, RN, INP; Gillian Murray, MPharm, PG Clin Pharm INP; and Lee Walker BDS, MFDS, RCS Dr. Convery is with The Ever Clinic Glasgow in Glasgow, Scotland. Ms. Davies is the Clinical Director of Save Face UK. Ms. Murray is with the Clinical Academic Kings College London in London, England. Dr. Walker is with B City Clinic in Liverpool, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC). FUNDING: No funding was provided. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. ABSTRACT: Delayed-onset nodules (DONs) represent a poorly understood and generally neglected group of complications. It is not a diagnosis. The underlying pathologies and their incidences are largely unknown due to the lack of specificity in clinical signs and the challenges in accessing diagnostic tests, cost implications, or reluctance from patients to undergo them. A lack of presumptive clinical diagnosis, coupled with management ranging from “scatter-gun” polypharmacy to clinical inertia, is believed to result in chronicity and increased morbidity. This paper provides guidance on the identification and understanding of the underlying pathologies and encourages the increased utilization

Guideline for the Management of Hyaluronic Acid Filler-induced Vascular Occlusion

May 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(5):E61–E69. by Gillian Murray, MPharm, PG Dip Clin Pharm, INP; Cormac Convery, MB ChB, MSc, MASLMS; Lee Walker, BDS, MFDS, RCPSG, MJDF, RCS, ENG; and Emma Davies, RN INP Dr. Murray is with Clinical Academic Kings College in London, England. Dr. Convery is with The Ever Clinic in Glasgow, Scotland. Dr. Walker is with B City Clinic in Liverpool, England. Ms. Davies is Clinical Director of Save Face in Cardiff, United Kingdom. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC). FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. ABSTRACT: Vascular occlusions can occur with injection of dermal fillers causing devastating outcomes for the patient. The occurrence, and subsequent management, of these negative outcomes is a source of significant stress to the aesthetic clinician. Complications management is an essential component of clinical practice and professionals must develop competence and confidence in the identification and effective treatment of a vascular occlusion. The relatively rare occurrence of a vascular occlusion mandates that learning must be largely through the study of theory in addition to the sharing of learning experiences within

Treatment of Small Keloids Using Intralesional 5-fluorouracil and Triamcinolone Acetonide versus Intralesional Bleomycin and Triamcinolone Acetonide

March 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(3):17–21. by Saurabh Sharma, MD, DNB, MNAMS; Kajal Vinay, MD; and Roopam Bassi, MD Drs. Sharma and Vinay are with the Department of Dermatology, Venereology, and Leprosy at the Sri Guru Ram Das Institute of Medical Sciences & Research in Amritsar, Punjab, India. Dr. Bassi is with the Department of Physiology at the Sri Guru Ram Das Institute of Medical Sciences & Research in Amritsar, Punjab, India. FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. ABSTRACT: Background. The aberration of wound healing leads to scar formation in the form of hypertrophic scars and keloids. Various modalities with variable results have been used in the treatment of keloids. Objective. We sought to evaluate outcomes in the treatment of small keloids with the combination of intralesional 5-fluorouracil (5-FU) and triamcinolone acetonide versus intralesional bleomycin and triamcinolone acetonide. Design. Sixty clinically diagnosed keloid lesions in 40 patients aged 18 to 60 years were divided equally into Groups A (n=30) and B (n=30). The combination of intralesional 5-FU and triamcinolone acetonide (TAC) was given to Group A and the combination of intralesional bleomycin and triamcinolone acetonide

Pretibial Myxedema in a Euthyroid Patient

January 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(1):21–23 by Stephen Ansah-Addo, MD, and Andrew F. Alexis, MD, MPH Mr. Ansah-Addo is with the Albert Einstein College of Medicine in the Bronx, New York, New York. Dr. Alexis is with the Department of Dermatology at Mount Sinai St. Luke’s and Mount Sinai West in New York, New York. FUNDING: No funding was provided for this article. DISCLOSURES: Dr. Alexis has received grant/research support from Leo, Novartis, Almirall, Bristol-Myers-Squibb, Celgene, Menlo, Galderma, SkinMedica, and Valeant (Bausch Health) and is a consultant for Leo, Novartis, Menlo, Galderma, Pfizer, Sanofi-Regeneron, Dermavant, Unilever, Celgene, Beiersdorf, Valeant, L’Oreal, BMS, Menlo, Scientis, Valeant. Mr. Ansah-Addo reports no conflicts of interest relevant to the content of this article. ABSTRACT: Pretibial myxedema (PM) is a rare extrathyroid condition seen in about 0.5 to 4.3 percent of individuals with hyperthyroidism due to Graves’ disease, often presenting with associated thyroid orbitopathy. In most cases, patients with PM have elevated levels of thyroid antibodies, such as thyroid peroxidase (TPO), thyroglobulin, and—most especially—thyroid-stimulating hormone receptor antibodies. We present a rare case of biopsy-proven PM in a euthyroid patient with no history of Graves’ disease or Hashimoto’s disease. TPO and thyroglobulin antibody counts were slightly elevated but

Septal Ulcer After Nasal Filling with Hyaluronic Acid

January 1, 2021 No Comments

J Clin Aesthet Dermatol. 2021;14(1):24–26. by Bruna Souza Felix Bravo, MD; Camila Roos Mariano da Rocha, MD; Leonardo Gonçalves Bravo, MD; Raquel de Melo Carvalho, MD; and Lucia Joffily, MD Drs. B. S. F. Bravo, Mariano Da Rocha, L. G. Bravo, and De Melo Carvalho are Clínica Bravo in Rio de Janeiro, Brazil. Dr. Joffily is with Universidade Federal do Estado do Rio de Janeiro in Rio de Janeiro, Brazil. FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. ABSTRACT: Nonsurgical rhinoplasty is a good treatment choice when surgery is not a viable option. However, serious complications, including blindness or cerebral ischemia, can occur given this area is one of external and internal carotid anastomosis. Here, we describe a case of a patient with a septum ulcer secondary to local ischemia postnasal filling with hyaluronic acid without skin lesion. Due to the rarity of the condition, her diagnosis was made late, but she was treated with hyaluronidase and showed total resolution. KEYWORDS: Hyaluronidase, fillers, liquid rhinoplasty, septum ulcer Hyaluronic acid is a widely popular dermal filler as a result of its safety profile. Recently, there has

Search Posts and Page Results