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3.
JAMA Dermatol ; 159(11): 1277-1279, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37728912

RESUMO

This report evaluates the use of timolol in 2 patients with long-term hydroxyurea use and lower-extremity ulcers resistant to other treatments.


Assuntos
Hidroxiureia , Úlcera da Perna , Humanos , Hidroxiureia/efeitos adversos , Úlcera , Timolol/efeitos adversos , Úlcera da Perna/induzido quimicamente
4.
Cutis ; 111(3): 143-145, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37224502

RESUMO

Dermatologists are at risk for blood-borne pathogen (BBP) exposures. We conducted a retrospective review of incidence reports to identify the incidence of BBP exposures in dermatologic procedures. Secondary aims included identification of the type of exposure, type of procedure associated with each exposure, anatomic locations of exposures, and instruments involved in each exposure. Data were obtained at 3 Mayo Clinic sites in Scottsdale, Arizona; Jacksonville Florida; and Rochester, Minnesota, from 2010 to 2021. Two hundred twenty-two exposures were identified over an 11-year period. Results indicated that quality improvement measures should focus on training all dermatologic staff to reduce BBP exposures.


Assuntos
Patógenos Transmitidos pelo Sangue , Melhoria de Qualidade , Humanos , Florida , Minnesota/epidemiologia
8.
Dermatol Surg ; 48(5): 551-555, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35170541

RESUMO

BACKGROUND: In total, 2.7 million injectable filler treatments were performed in 2019 in the United States. Although generally considered to be a safe treatment modality, adverse events may occur in rare situations. OBJECTIVE: Analyze serious adverse events from injectable filler treatments, including infections, cutaneous necrosis, blindness, or delayed-onset nodule formation, spanning 11 years for 3 board-certified dermatologists and review their incidence, management, and outcomes. MATERIALS AND METHODS: A retrospective analysis was performed of injectable filler treatments spanning 11 years at a multipractitioner outpatient clinic. Serious adverse events were identified, and treatment measures were documented. A literature search was performed to determine recent trends and outcomes for comparison. RESULTS: Between January 2009 and August 2020, 18,013 mL of injectable filler was administered to 7,659 patients. Of the 18,013 mL administered, 74.1% comprised hyaluronic acid derivatives, 19.19% poly-l-lactic acid, and 6.71% calcium hydroxylapatite. Four serious adverse events were identified. Three events were delayed-onset skin nodule formation. One adverse event was related to vascular compromise and subsequent cutaneous necrosis. After appropriate treatment, all adverse events resolved without significant long-term sequelae. CONCLUSION: Serious adverse events associated with injectable fillers, when performed by board-certified dermatologists, are extremely rare and can be successfully managed with appropriate treatment.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Durapatita/efeitos adversos , Humanos , Ácido Hialurônico/efeitos adversos , Necrose/induzido quimicamente , Estudos Retrospectivos , Estados Unidos
9.
Dermatol Surg ; 48(1): 76-81, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33731569

RESUMO

INTRODUCTION: Jawline augmentation with calcium hydroxylapatite has not yet been evaluated in a prospective study with a split-face design. This study aims to perform the first randomized controlled, split-face study on the efficacy and safety of calcium hydroxylapatite for jawline augmentation using the needle and cannula technique. OBJECTIVE: To perform the first randomized controlled, split-face study on the efficacy and safety of calcium hydroxylapatite for jawline augmentation using the needle and cannula technique. MATERIALS AND METHODS: This is a single-site, randomized, evaluator-blind trial enrolling a total of 10 healthy subjects with at least Grade 1 (mild) on a 4-point Jawline Scale. One side of the face was randomized to receive 1 to 2 syringes of calcium hydroxylapatite with lidocaine (total of 3 mL) for correction of wrinkles and folds along the jawline using both the cannula and needle method, and a balancing treatment will be performed 1 month later. Blinded investigator and subject evaluations will be performed immediately after treatment and at the 30-, 60-, and 90-day visits. RESULTS: Ten subjects were enrolled and completed the trial. There was a improvement in the degree of wrinkling and skin sagging in the 4-point Jawline Scale, with an average of a 1.3-point improvement in the scale on the day of treatment and at the Day 30 visit, which remained improved greater than baseline after 3 months as graded by blinded investigators. The Clinician Global Aesthetic Improvement Score for the treated side versus control, as assessed by blinded investigators, demonstrated a improvement with a 2.3-point improvement on the 5-point scale, and by the final visit on Day 90, most patients had a much improved appearance from baseline. CONCLUSION: This study demonstrates that calcium hydroxylapatite is effective and safe for restoration and augmentation of the jawline using the unique needle and cannula technique.


Assuntos
Preenchedores Dérmicos/administração & dosagem , Durapatita/administração & dosagem , Ritidoplastia/métodos , Envelhecimento da Pele/efeitos dos fármacos , Adulto , Idoso , Cânula , Preenchedores Dérmicos/efeitos adversos , Durapatita/efeitos adversos , Estética , Feminino , Voluntários Saudáveis , Humanos , Injeções Subcutâneas/instrumentação , Injeções Subcutâneas/métodos , Lidocaína/administração & dosagem , Lidocaína/efeitos adversos , Masculino , Pessoa de Meia-Idade , Agulhas , Satisfação do Paciente , Projetos Piloto , Estudos Prospectivos , Ritidoplastia/efeitos adversos , Resultado do Tratamento , Adulto Jovem
10.
J Drugs Dermatol ; 20(6): 666-670, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34076399

RESUMO

BACKGROUND: Current treatments for acne are often accompanied by undesirable side effects and contribute to antibiotic resistance. Gold and silver nanoparticles are an emerging treatment method with potentially fewer adverse effects. OBJECTIVE: To evaluate current literature discussing the various uses of gold and silver nanoparticles in the potential treatment of acne vulgaris. MATERIALS AND METHODS: A search of PubMed, EMBASE, and SCOPUS databases was conducted through April 22, 2020 to identify studies using gold or silver nanoparticles in the treatment of acne vulgaris. RESULTS: 16 original articles were identified in the systematic review including clinical studies, case reports, and in vitro publications. The available evidence found gold nanoparticles to be effective when combined with phototherapy to target overactive sebaceous glands and bacteria, or to mediate localized, targeted drug release. Silver nanoparticles have primarily been studied for their antibacterial properties. CONCLUSION: This review found gold and silver nanoparticles to be a promising treatment for acne vulgaris. Further randomized controlled studies are needed to determine clinical efficacy and the role of gold and silver nanoparticles in the treatment algorithm for acne. J Drugs Dermatol. 2021;20(6):666-670. doi:10.36849/JDD.5762.


Assuntos
Acne Vulgar , Nanopartículas Metálicas , Acne Vulgar/diagnóstico , Acne Vulgar/tratamento farmacológico , Antibacterianos/uso terapêutico , Ouro , Humanos , Prata
11.
J Cosmet Dermatol ; 20(10): 3190-3192, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33877741

RESUMO

INTRODUCTION: Adverse effects from dermal fillers are uncommon. We report a case of filler-induced xanthelasma at the bilateral infraorbital region in a 43-year-old woman after multiple injections of hyaluronic acid to correct tear trough depression. MATERIAL AND METHODS: We report a case of a 43-year-old woman with a chief complaint of skin discoloration of the bilateral lower eyelids. Her history was significant for ten sessions of hyaluronic acid filler for tear trough deformity between December 2008 and May 2016. On clinical examination, she exhibited thin, soft, and yellow papules to her lower medial infraorbital hollows. A punch biopsy showed foamy histiocytes with a background of hypervascularization and focal extracellular lipid in the superficial dermis, consistent with xanthelasma. RESULTS: Xanthelasma was treated with multiple passes of Er:YAG laser (Sciton Contour TRL) with a 4 mm spot size, fluence 7.5 J/cm2, and ablate/coagulate 50/50 at 6 Hz until clearance occurred. The perilesional skin was treated with 1-2 passes, fluence 7.5 J/cm2, ablate/coagulate 50/0 to blend in the cosmetic unit. Six-month follow-up showed notable improvement of all lesions. DISCUSSION: There is a paucity of treatments described for filler-induced xanthelasma reaction. While broad conclusions cannot be drawn from one case, our experience indicates that complete resolution can be achieved with Er:YAG ablation. We hypothesize that this laser is an optimal treatment, as it can vaporize the lipid contents while minimizing adverse effects, such as scars and hyperpigmentation.


Assuntos
Ácido Hialurônico , Xantomatose , Adulto , Pálpebras , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Injeções , Xantomatose/induzido quimicamente , Xantomatose/tratamento farmacológico
12.
Dermatol Surg ; 47(6): 762-766, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33899795

RESUMO

BACKGROUND: Aging of the face and upper neck is a complex process characterized by loss of collagen and elastic fibers, resulting in clinical skin laxity. Noninvasive interventions such as monopolar capacitively coupled radiofrequency (MRF) have gained popularity, offering a safer and more convenient alternative to traditional surgical face lift. The latest MRF device features larger tips, vibration, cooling, and impedance matching. OBJECTIVE: We performed the first open-label clinical trial, measuring the efficacy, safety, and patient satisfaction of this device for noninvasive lifting and tightening of the face and upper neck. MATERIALS AND METHODS: Forty subjects 30 to 60 years of age with mild/moderate skin laxity of the face and upper neck were enrolled. After pretreatment with ketorolac 60 mg intramuscular injection, subjects underwent treatment with MRF. Follow-up evaluations were performed on Days 30, 60, and 180. RESULTS: Our study demonstrated that the newest generation MRF produced statistically significant improvement in skin laxity 6 months post-treatment, especially in the jowls and melolabial folds. According to the Investigator Global Aesthetic Improvement Score, 73% of subjects had improvement at 6 months post-treatment. Subject satisfaction and improvement questionnaires supported these findings. CONCLUSION: Our data coupled with the excellent adverse effect profile validates MRF as an attractive treatment modality for facial and upper neck skin laxity.


Assuntos
Técnicas Cosméticas/instrumentação , Terapia por Radiofrequência/instrumentação , Ritidoplastia/instrumentação , Adulto , Técnicas Cosméticas/efeitos adversos , Estética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Satisfação do Paciente , Terapia por Radiofrequência/efeitos adversos , Terapia por Radiofrequência/métodos , Ritidoplastia/efeitos adversos , Ritidoplastia/métodos , Envelhecimento da Pele/efeitos da radiação , Resultado do Tratamento
17.
J Drugs Dermatol ; 19(11): 1044-1048, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33196737

RESUMO

BACKGROUND: Laser resurfacing is the gold standard procedure for photodamage, but is not without downtime and risk. Use of periprocedural products containing stem cell conditioned media may improve results and optimize healing. STUDY DESIGN: This was a prospective, randomized controlled, double-blind study, evaluating the efficacy and tolerability of red deer umbilical cord-derived stem cell conditioned media (USCCM) cream and serum pre- and post- ablative facial resurfacing. METHODS AND MATERIALS: Twenty patients with moderate to severe photodamage were randomized to receive vehicle or USCCM cream and serum pre- and post- ablative resurfacing of the face. Blinded investigators rated healing, tolerability, and efficacy, while subjects rated post-procedure symptoms, tolerability, and satisfaction. RESULTS: Both the active and vehicle pre-procedure cream were soothing, calming and easy to use by all patients. There was a trend towards decreased facial erythema and crusting in the active versus vehicle group. A greater improvement in wrinkling occurred in the active group. The majority of subjects were very satisfied with the active products. There were no serious adverse events. CONCLUSION: Red deer umbilical cord-derived stem cell conditioned media (USCCM) is well tolerated, safe and efficacious for use pre- and post- facial laser resurfacing.J Drugs Dermatol. 2020;19(11): 1044-1048 doi:10.36849/JDD.2020.5246.


Assuntos
Técnicas Cosméticas/efeitos adversos , Meios de Cultivo Condicionados/efeitos adversos , Terapia a Laser/métodos , Envelhecimento da Pele , Células-Tronco/metabolismo , Adulto , Idoso , Animais , Terapia Combinada/efeitos adversos , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Cervos , Método Duplo-Cego , Face , Feminino , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/instrumentação , Lasers de Gás/efeitos adversos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Rejuvenescimento , Creme para a Pele/administração & dosagem , Creme para a Pele/efeitos adversos , Resultado do Tratamento , Cordão Umbilical/citologia
18.
J Drugs Dermatol ; 19(11): 1050-1055, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33196756

RESUMO

Laser resurfacing has progressed since the 1980s to treat a variety of medical and aesthetic indications with ever-evolving safety parameters. While laser technology has evolved to provide a more favorable safety profile and decrease wound healing time, advances in post-procedure healing agents have also helped to mitigate adverse effects, such as persistent erythema, dyspigmentation, acneiform eruptions, dermatitis, infections, and scarring. We reviewed the evidence of growth factors, stem cells, silicone and silicone polymers, botanical based treatments, fatty acids, probiotics, and closed dressings on post-ablative laser skin resurfacing. All reviewed agents demonstrated some evidence in improving post-procedure outcomes, albeit mixed in many cases. Additionally, these studies contain small numbers of participants, vary in type, strength, and clinical indication for which the resurfacing laser was used, and have differing postprocedural evaluation protocols and assessments. This highlights a need for standardization of clinical studies and the importance of choosing an optimal postprocedural skincare plan depending on every unique clinical scenario. J Drugs Dermatol. 2020;19(11):1050-1055. doi:10.36849/JDD.2020.5386.


Assuntos
Técnicas Cosméticas/efeitos adversos , Terapia a Laser/efeitos adversos , Complicações Pós-Operatórias/terapia , Envelhecimento da Pele , Ferida Cirúrgica/terapia , Erupções Acneiformes/etiologia , Erupções Acneiformes/terapia , Cicatriz/etiologia , Cicatriz/terapia , Ensaios Clínicos como Assunto , Dermatite/etiologia , Dermatite/terapia , Eritema/etiologia , Eritema/terapia , Estética , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/administração & dosagem , Transtornos da Pigmentação/etiologia , Transtornos da Pigmentação/terapia , Complicações Pós-Operatórias/etiologia , Probióticos/administração & dosagem , Silicones/administração & dosagem , Transplante de Células-Tronco , Ferida Cirúrgica/etiologia , Resultado do Tratamento , Cicatrização
19.
Dermatol Surg ; 46(12): 1715-1720, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32947299

RESUMO

BACKGROUND: Foam sclerotherapy is a common treatment of lower extremity reticular veins. The effect of different liquid-gas ratios on foam stability and efficacy has been controversial. OBJECTIVE: To evaluate the use of 2 different polidocanol (POL) to air ratios for the treatment of reticular veins of the lower extremities. METHODS AND MATERIALS: Patients with lower extremity reticular veins were randomized to foam sclerotherapy with POL mixed with 4 mL of room air for one lower extremity or 2 mL for the other lower extremity. All telangiectasias were treated with glycerin immediately after treatment of the reticular veins. Adverse events (AEs) and efficacy were evaluated by both subject and blinded investigator. RESULTS: Thirty subjects completed the study. No statistically significant difference was seen in AEs between the 2 different POL to air ratios by subject questionnaire and blinded investigator scores at all time points. Subjects and blinded investigator reported a mean improvement between 0% and 50% at Day 21 and 26% to 75% at Day 90, which was not significantly different between groups. CONCLUSION: Two different POL to air ratios, 1:2 versus 1:4, were similarly safe and efficacious for the treatment reticular veins of the lower extremities.


Assuntos
Polidocanol/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Escleroterapia/métodos , Doenças Vasculares/terapia , Veias/efeitos dos fármacos , Adulto , Idoso , Ar , Método Duplo-Cego , Composição de Medicamentos/métodos , Feminino , Humanos , Injeções Intravenosas , Extremidade Inferior/irrigação sanguínea , Pessoa de Meia-Idade , Polidocanol/efeitos adversos , Polidocanol/química , Estudos Prospectivos , Soluções Esclerosantes/efeitos adversos , Soluções Esclerosantes/química , Resultado do Tratamento
20.
Dermatol Surg ; 46(12): 1623-1627, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32852426

RESUMO

BACKGROUND: Skin laxity of the upper knee and lower thigh is a common complaint among patients. OBJECTIVE: This is a randomized, double-blinded, split-body, placebo-controlled study to evaluate the safety and efficacy of poly-L-lactic acid (PLLA) for treatment of upper knee skin laxity. MATERIALS AND METHODS: Twenty female subjects between the ages of 30 and 65 years with upper knee laxity were enrolled. The patients were randomized to receive 3 treatments of PLLA in 1 knee, whereas the other knee received 3 treatments of bacteriostatic water. RESULTS: Statistically significant improvement as rated on the physician global aesthetic improvement scale was seen at Day 56 after final treatment in the active knee when compared with the placebo knee. This improvement was sustained at Day 84 and Day 168 after final treatment visits. No statistically significant difference was seen between the active and placebo knees on the subject global aesthetic score or the subject satisfaction scale. CONCLUSION: Based on our study, PLLA may be a safe and effective modality in addressing upper knee skin laxity. Larger studies with longer follow-up times and a validated knee laxity scale are needed to further determine if and how much improvement can be achieved.


Assuntos
Técnicas Cosméticas/efeitos adversos , Poliésteres/administração & dosagem , Envelhecimento da Pele/efeitos dos fármacos , Idoso , Método Duplo-Cego , Estética , Feminino , Seguimentos , Humanos , Joelho , Pessoa de Meia-Idade , Satisfação do Paciente , Fotografação , Placebos/administração & dosagem , Placebos/efeitos adversos , Poliésteres/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Pele/diagnóstico por imagem , Pele/efeitos dos fármacos , Resultado do Tratamento
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