Does electrophysical agents work for cellulite treatment? a systematic review of clinical trials.

Cellulite, a perceived alteration in skin topography, is predominantly found in adipose tissue-rich body regions such as the hips, buttocks, thighs, and abdomen. Contrary to common belief, the etiology and pathophysiology of cellulite are not well-established or universally agreed upon. This lack of understanding about the actual etiology of cellulite directly influences the selection of suitable treatments that can address both the aesthetic and inflammatory aspects of the condition. Various treatment methods, including electrophysical agents like electric currents, radiofrequency, ultrasound, and photobiomodulation, have been tested. However, the questionable methodological quality of many studies complicates the determination of effective treatments for cellulite. In this study, we conducted a systematic review of clinical studies that utilized electrophysical agents in cellulite treatment. METHODS: We employed the PICO (population, intervention, control, and outcome) process to develop our search strategy and establish inclusion/exclusion criteria. We searched five databases: Medline, Central, Scopus, Lilacs, and PEDro, for studies conducted between 2001 and July 2021 that involved cellulite treatment with electrophysical agents. To ensure systematicity and guide study selection, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. RESULTS: Our initial search yielded 556 articles: 379 from Medline, 159 from Central, and 18 from Lilacs. After applying our inclusion criteria, only 32 studies remained. Of these, only two (6.2%) were evaluated as having strong and good methodology via the QualSyst tool. CONCLUSIONS: Our findings indicate that the quality of evidence from clinical studies on the use of electrophysical agents for cellulite treatment remains subpar. Further studies with robust experimental designs and more precise assessment techniques are necessary. While our study does not refute the effectiveness of the techniques used for cellulite treatment, it underscores the need for additional well-designed trials.

Safety and Efficacy of Diluted Calcium Hydroxylapatite for the Treatment of Cellulite Dimpling on the Buttocks: Results from an Open-Label, Investigator-Initiated, Single-Center, Prospective Clinical Study.

BACKGROUND: Cellulite is a condition characterized by dimpling and contour irregularities in the gluteal and thigh regions, affecting an estimated 80-98% of postpubertal women. Innovative treatments for cellulite dimpling in the buttocks have gained popularity in recent years, seeking new solutions for a historically challenging condition. In this open-label, investigator-initiated, single-center, prospective clinical study, the authors sought to evaluate the safety and efficacy of diluted calcium hydroxylapatite (CaHA; Radiesse®, Merz Aesthetics, Raleigh, NC) for the treatment of cellulite dimpling in the buttocks of adult women. METHODS: Subjects underwent three treatment sessions, receiving a total of 12 syringes of 1:1 diluted CaHA administered using a cannula-based subcision technique. Endpoints included the cellulite severity scale (CSS), the global aesthetic improvement scale (GAIS), subject satisfaction measured on a 5-point scale, and three-dimensional imaging analysis via the Quantificare 3D Track®. RESULTS: Twenty-four subjects completed the study (mean age, 35 years; mean BMI, 26.88 kg/m2; mean body fat percentage, 31.29%), and no serious complications were reported. Quantitative analysis at week 14 revealed a mean reduction of 54.0% in the number of visible dimples and 50.09% in dimple depth compared to baseline. The mean CSS score decreased by 4.29 points, representing a 43.92% improvement in cellulite severity from baseline (p < 0.0001). Both physician-assessed and subject-assessed GAIS ratings also demonstrated significant improvement, with 91.6% of subjects rating their cellulite appearance as "improved" or greater. CONCLUSION: The results of this study support the safety and efficacy of diluted CaHA for treating cellulite dimpling in adult women. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 . CLINICAL TRIALS REGISTRATION: This study is registered with clinicaltrials.gov (ID: NCT05885035) and can be found at this link: https://clinicaltrials.gov/study/NCT05885035 .

Safety and Efficacy Study of the Application of Redensified Cross-Linked Hyaluronic Acid for Filling Gluteal Volume and Cellulite Depressions.

PURPOSE: To test the efficacy and safety of cross-linked hyaluronic acid application for filling buttocks and cellulite depressions and its permanence over time. METHODS: For a period of a year, 25 patients were applied redensified cross-linked hyaluronic acid in the gluteal area. These patients were all 23-45-year-old women with little fat to be removed. The product used is composed of hyaluronic acid with high cross-linking and redensification which allows it to maintain shape and durability over time. All patients underwent tumescent anesthesia with neuroleptic sedation in the operating room. The procedure was regarded as minimal (container, sterile gloves, and surgical field). The amount applied for gluteal augmentation varied from 50 to 100 ml per application area and according to the patient's needs. For the filling of cellulite depressions, the application was up to 3 cc per depression and up to a total of 40 ml. The maximum volume used per patient in the buttocks did not exceed 200 ml, and it did not exceed 40 ml in cellulite depressions. RESULTS: A group of patients was treated in the upper and middle third of the buttocks in superficial and deep subcutaneous layers and in cellulite depressions. Very good results have been obtained without any major complications. CONCLUSIONS: The use of redensified cross-linked hyaluronic acid of non-animal origin is therefore an option for gluteal augmentation and cellulite depressions. Although the product degrades over time, after 12 months, 44% of treated patients rated their results as highly or very much improved, 36% as improved, 16% rated the improvement as poor, and one patient (4%) was dissatisfied. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Clinical and Ultrasound Efficacy of Topical Hypertonic Cream (Jovita Osmocell®) in the Treatment of Cellulite: A Prospective, Monocentric, Double-Blind, Placebo-Controlled Study.

Background and Objectives: Cellulite, or edemato-fibro-sclerotic panniculopathy (EFP), is characterized by dermal and hypodermal changes leading to adipose tissue accumulation and compromised venous circulation. This study investigates the efficacy of a hypertonic cream containing concentrated sodium chloride (Jovita Osmocell®) in addressing water retention and structural alterations in adipose tissue, aiming to interrupt the cellulite formation process. Materials and Methods: A 12-week, prospective, monocentric, double-blind, placebo-controlled study enrolled 30 female subjects with grade II or III cellulite. Patients were randomized to receive hypertonic cream or a placebo. Thigh circumference, ultrasound evaluations, and standardized photographs were collected at baseline, intermediate, and endpoint visits. Adverse events were monitored. Results: After 84 days, the hypertonic cream group exhibited a significant reduction in thigh circumference compared to the placebo group (p = 0.0037). B-mode ultrasound examinations revealed significant changes in the parameters studied, such as the thickness of the subcutaneous tissue. No statistically significant changes were noticed in the placebo group. Volunteers reported the investigational product's pleasantness and good anti-cellulite activity, with no reported adverse events. Conclusions: The hypertonic cream demonstrated efficacy in reducing thigh circumference, addressing water retention and structural alterations in adipose tissue. The proposed mechanism involves osmosis, releasing accumulated fluids between fat cells, supporting drainage, and reducing inflammation. This study supports the efficacy and safety of hypertonic sodium chloride emulsions in cellulite treatment and confirms safety and user satisfaction.

A pilot study on the efficacy of a seaweed mud application in the treatment of cellulite.

BACKGROUND: Cellulite represents a common multi-factorial condition that affects nearly all women and is now recognized as a clinical condition associated with systemic factors and negative psychological effects. Several noninvasive and minimally invasive treatments were developed during the last few years, but limited evidence supports many of them due to lack of evidence, insufficient participants, and potential adverse effects. METHODS: This study aimed to evaluate the efficacy of a seaweed mud application in improving both the structure and function of tissues affected by cellulite. Sixty women with cellulite underwent 4-week applications of seaweed mud on the buttocks and thighs. The following assessments were performed at baseline and after the last treatment: photographic, clinical, and anthropometric evaluation; tests for elasticity and hydration; ultrasonography of cellulite nodules; and cellulite biopsies in the trochanteric region. Patient satisfaction was assessed using a 5-point Likert-scale questionnaire. RESULTS: The treatment resulted in a significant improvement in the severity of cellulite severity between the initial assessment and the 4-week follow-up, with enhanced structure, elasticity, and hydration of the affected tissues. Microscopic analysis of the cellulite biopsies revealed a significant restoration of dermal organization with induced collagen synthesis and reduced inflammation, edema, and lipid deposition following the 4-week seaweed mud applications. Additionally, the treatment led to a remarkable improvement in comfort and satisfaction as well as a reduction in body circumferences. CONCLUSIONS: The cosmetic application of seaweed mud has proven to be a safe, non-invasive treatment for improving the tissue alterations characteristic of cellulite.

Untargeted metabolomics-based molecular networking for chemical characterization of selected Apiaceae fruit extracts in relation to their antioxidant and anti-cellulite potentials.

Stress, obesity, hormonal changes, and aging have been connected to cellulite aggravation resulting in skin dimpled appearance, a very common painless skin disorder with a female preponderance. Several Apiaceae plants have been traditionally used for cosmetic applications. However, their screening for anti-cellulite potential has not been deeply investigated. In this work, UPLC-HRMS/MS coupled with molecular networking was employed to glean a holistic overview of the chemodiversity of the metabolome of nine Apiaceae fruits. Additionally, the extracts were screened for in vitro antioxidant and anti-cellulite activities. Apium graveolens and Petroselinum crispum revealed excellent free radical scavenging activity, remarkably increased lipolysis, and decreased adipogenesis. Furthermore, apigenin and its glycosides were identified to be the major components in both extracts, which might be responsible for the antioxidant activity and anti-cellulite potential. Conclusively, these results signify the potent antioxidant and anti-cellulite properties of A. graveolens and P. crispum fruit extracts, holding potential for the development of plant derived products for cellulite management.

Body contouring effects of at-home beauty device equipped with suction, radiofrequency, and electrical muscle stimulation functions.

BACKGROUND: With the rise in interest and demand for body contouring, beauty devices have continuously developed. Suction can aid in increasing the rate of fat breakdown by inducing a massage-like effect, thereby increasing blood flow. Moreover, radiofrequency (RF) can boost fibroblast activity and help reduce cellulite. In addition, electrical muscle stimulation (EMS) can use electrical stimulation to induce muscle contraction, leading to an athletic, and skin elasticity-increasing effect. AIMS: This study aimed to assess the effects of body contouring, such as cellulite and swelling, in healthy Korean women to objectively prove the efficacy of an at-home beauty device equipped with suction, RF, and EMS functions. METHODS: For 8 weeks, 21 participants used the at-home beauty device 3 days a week on their abdomen, thighs, and left calf. Validity assessments and subjective surveys were conducted at 4 and 8 weeks, including the first visit. RESULTS: The results of the validity assessments revealed that cellulite, swelling, elasticity, femoral skin texture, and dermal density were significantly (p < 0.05) improved in the experimental group compared with those at the baseline. CONCLUSIONS: The results of this study demonstrate that the combination of suction, RF, and EMS function is effective for body skin, fat, and body shape management. For better body-contouring effects, combining the beauty device with regular exercise and healthy eating habits is recommended.

Enfermedad invasiva por Streptococcus pyogenes con celulitis de manos bilateral: A propósito de un caso / Invasive Streptococcus pyogenes disease with bilateral cellulitis of the hands: A case report

El Streptococcus pyogenes o estreptococo B hemolítico Grupo A (EßHGA) suele ser una causa poco habitual de enfermedad invasiva en pediatría, la cual ha presentado un aumento en su incidencia en los últimos años. Se define como cualquier infección asociada al aislamiento de dicha bacteria de un sitio normalmente estéril y cuya presentación más frecuente es la bacteriemia. Los pacientes con EßHGA habitualmente se presentan con un sindrome febril asociado a manifestaciones clínicas relacionadas con el sitio primario de infección. Se presenta el caso de una paciente de 10 años, sin comorbilidades, que desarrolló enfermedad invasiva por EßHGA con bacteriemia e impacto secundario de piel y partes blandas resultando en una celulitis de manos bilateral

Streptococcus pyogenes or Group A Streptococcus (GAS) is an infrequent cause of invasive disease in pediatrics. Its incidence has increased in the last few years. It is defined as any infection associated with the isolation of GAS in a normally sterile site and its most frequent presentation is bacteremia. Patients with GAS bacteremia usually present with a febrile syndrome associated with clinical manifestations related to the primary site of infection. We present the case of a previously healthy, 10-year-old patient, who developed an invasive disease due to GAS with bacteremia and secondary impact of skin and soft tissues that developed in bilateral cellulitis of the hands

Síndrome larva migrans cutánea en pediatría / Cutaneous Larva Migrans Syndrome in Pediatrics

La dermatosis denominada larva migrans cutánea: (LMC) es una infección cutánea secundaria a infestación parasitaria por la migración de larvas de anquilostomas animales a la epidermis humana, frecuentemente por contacto directo con suelos contaminados, especialmente en zonas tropicales. Se caracteriza por la aparición de lesiones induradas, eritematosas con patrón irregular o serpiginoso acompañado de prurito. Describimos un caso de LMC en una niña, adquirido durante unas vacaciones en Colombia y tratado inicialmente como celulitis con antibióticos (AU)

Cutaneous larva migrans (CLM) is an infection secondary to parasitic infestation due to the migration of animal hookworm larvae into the human skin, frequently by direct contact with contaminated grounds, especially in the tropics. Clinically, it is characterized by the appearance of indurated, erythematous lesions with irregular or "creeping eruption" pattern and pruritus. This article describes a case of CLM infection in a pediatric patient, it was acquired during the holidays in Colombia, diagnosed as cellulitis and treated accordingly with antibiotics without success (AU)

Infecciones graves de huesos, articulaciones y tejidos blandos adquiridas en la comunidad / Severe community-acquired bone, joint, and soft tissue infections

Introducción: Las infecciones de huesos, articulaciones y partes blandas, no solo han tenido una incidencia creciente en los últimos años en el Hospital Pediátrico Universitario Paquito González Cueto de Cienfuegos, sino también una evolución más grave. Objetivo: Describir aspectos clínicos y epidemiológicos de las infecciones graves de tejidos blandos, huesos y articulaciones. Métodos: Se revisó la base de datos computadorizada del Departamento de Estadística del Hospital Pediátrico Paquito González, para identificar todos los egresos de la Unidad de Cuidados Intensivos Pediátricos, con diagnóstico de celulitis o absceso de tejidos blandos, fascitis, miositis, osteomielitis, sepsis severa y shock séptico, en el periodo de enero de 2009 a diciembre de 2019. Se estudiaron las siguientes variables: localización de la infección de piel y tejidos blandos, grupo de edad, año del egreso y sitio de origen de la sepsis. Resultados: No hubo diferencias en la incidencia entre los grupos de edad. La celulitis de los miembros fue la forma clínica más frecuente. Se encontró una incidencia creciente de las infecciones de tejidos blandos. Las infecciones de huesos y articulaciones, representaron el segundo sitio de origen más frecuente de sepsis grave y el shock séptico. Conclusiones: Ha habido un aumento de las infecciones de piel y tejidos blandos que requieren ingreso en la unidad de cuidados intensivos del citado hospital en los últimos 11 años. Estas infecciones de conjunto con las infecciones de huesos y articulaciones, constituyen un problema de salud puesto que provocan sepsis grave y shock séptico con una incidencia significativa(AU)

Introduction: Infections of bones, joints and soft parts have not only had an increasing incidence in recent years at ¨Paquito González Cueto¨ University Pediatric Hospital in Cienfuegos, but also a more serious evolution. Objective: Describe clinical and epidemiological aspects of severe soft tissues, bones and joints infections. Methods: The computerized database of the Department of Statistics of ¨Paquito González¨ Pediatric Hospital was reviewed to identify all discharges from the Pediatric Intensive Care Unit with a diagnosis of cellulite or soft tissue abscess, fasciitis, myositis, osteomyelitis, severe sepsis and septic shock, in the period from January 2009 to December 2019. The following variables were studied: location of skin and soft tissue infection, age group, year of discharge, and sepsis origin location. Results: There were no differences in the incidence between age groups. Limb cellulite was the most common clinical form. An increasing incidence of soft tissue infections was found. Bone and joint infections represented the second most frequent origin location of severe sepsis and septic shock. Conclusions: There has been an increase in skin and soft tissue infections that require admission to the intensive care unit of the aforementioned hospital in the last 11 years. These infections, together with bone and joint infections, constitute a health problem since they cause severe sepsis and septic shock with a significant incidence(AU)

Celulitis disecante del cuero cabelludo a propósito de un caso clínico / Dissecting cellulitis of the scalp a clinical case report

Celulitis disecante del cuero cabelludo (CDC) es una enfermedad inflamatoria crónica neutrofilica, clasificada dentro las alopecias cicatriciales, su etiopatogenia es desconocida, se manifiesta por nódulos en el cuero cabelludo de predominio en región occipital y vértice, si es muy extensa puede confluir y formar fistulas, predomina en descendientes afroamericanos, es de difícil tratamiento.

Dissecting cellulitis of the scalp (DCS) is a chronic inflammatory primary neutrophilic scarring alopecia, and its etiopathogenesis is yet only partly understood. DCS manifests with inflammatory nodules on the occipital scalp or vertex that may evolve to extensive confluent boggy plaques with sinus tract formation¹. predominantly affects young Afro-descendent men.Therapeutic management of DCS is often challenging1,6.

Erisipela e celulite: diagnóstico, tratamento e cuidados gerais / Erysipela and cellulitis: diagnosis, treatment and general care

Objetivo: sumarizar o diagnóstico, o tratamento e os cuidados gerais prestados aos pacientes acometidos por erisipela ou celulite, conforme a literatura científica. Métodos: Artigo de revisão integrativa, realizada por meio de buscas na Biblioteca Virtual em Saúde e na Pubmed, nas bases de dados Medline e Scopus. Os critérios de inclusão foram: artigos publicados em português, inglês e espanhol, cujosassuntosabordadosforamas manifestações clínicas, os exames e os cuidados prestados a pacientes com erisipela oucelulite publicados nos últimos oito anos. Foram excluídos os artigos duplicados nas bases buscadas e que não tratavam do tema. Nove artigos fizeram parte da análise crítica e da sumarização dos dados. Resultados:A erisipela e a celulite são infecções da pele que ocorrem em estágios diferentes. O diagnóstico é baseado nas alterações clínicas e o tratamento é basicamente farmacológico, terapia nutricional e cuidados de enfermagem. Considerações finais: O diagnóstico é puramente clínico e não há como sempre diferenciar erisipela de celulite, já que as manifestações clínicas são semelhantes. O tratamento é feito, principalmente, com a penicilina e seus derivados, e os cuidados gerais incluíram hidratação e nutrição adequadas, redução do edema e cicatrização das lesões de pele. São necessários mais estudos originais.

Objective: summarize the diagnosis, treatment and general care provided to patients affected by erysipelas or cellulitis, according to the scientific literature. Methods: Integrative review article, performed through searches on the Virtual Health Library and on Pubmed, as well as on the Medline and Scopus databases. The inclusion criteria were: articles published in Portuguese, English and Spanish, where the addressed topic consisted of clinical manifestations, exams and care provided to patients with erysipelas and cellulite, published in the last eight years. We excluded duplicate articles in the searched databases and that did not address the theme. Nine articles made up the critical analysis and data summarization.Results:Erysipelas and cellulite are infections of the skin that occur at different stages. The diagnosis is based on clinical changes and treatment is basically pharmacological, nutritional therapy and nursing care.Final considerations: The diagnosis is merely clinical and there is no way to always differentiate erysipelas from cellulite, since the clinical manifestations are similar. Treatment is mainly performed with penicillin and its derivatives, and general care included appropriate hydration and nutrition, reduction of edema and healing of skin lesions. Further original studies should be performed.

Effects of multi-directional oscillatory vibration in the treatment of cellulite and body remodeling / Efeitos da terapia vibro-oscilatória multidirecional no tratamento da celulite e remodelamento corporal

Abstract Introduction: Several technologies have been developed and optimized for the treatment of unaesthetic disorders. Among them is the oscillatory vibration therapy, a novel form of treatment based on the mechanical and physiological fundamentals of the vibration platform. Objective: The present study evaluated the efficacy of the oscillatory vibration therapy in the improvement of body contour remodeling and in the aspect of cellulite in women. Methods: This is a prospective longitudinal comparative study, in which the following evaluation tools are used: anthropometry, perimetry, adipometry, evaluation of skin viscoelasticity with Cutometer®, evaluation of the thickness of the hypodermis with diagnostic ultrasound and analysis of severity of cellulite (CSS). The evaluations occurred at the start and 1 week after the end of ten oscillatory vibration therapy. The results were analyzing using a paired student's t-test with interval confidence of 95% (PValue <0.05). Results: Thirty women took part in the research, with age of 33 ± 9 years, weight of 62 ± 11 kg, height of 1.66 ± 0.06 m, BMI of 22 ± 2 kg/m2. The measurements of perimetry, adipometry, analysis of subcutaneous tissue thickness by means of diagnostic ultrasound and analysis of skin viscoelasticity did not present significant alterations. However, the CSS variable of the right gluteus (7.3 ± 1.8 to 5.8 ± 1.6 ≤ 0.0001), left gluteus (7.2 ± 1.9 to 5.8 ± 1.6= 0.0001), right thigh (6.9 ± 1.9 to 5.6 ± 1.4 = 0.0004), left thigh (6.9 ± 1.9 to 5.6 ± 1.3 = 0.0004) and Celluqol® (59 ± 16 to 49 ± 16 = 0.022) presented significant difference. Conclusion: The multi-directional oscillatory vibration therapy is an effective and efficient therapy for the treatment of cellulite; however, for the treatment of body remodeling, it must be further evaluated and studied. (AU)

Introdução: Várias tecnologias vêm sendo desenvolvidas e otimizadas para o tratamento das afecções inestéticas. Dentre elas está a terapia vibro-oscilatória, uma nova forma de tratamento baseada na fundamentação mecânica e fisiológica da plataforma vibratória Objetivo: O presente estudo avaliou a eficácia da terapia vibro-oscilatória para melhora do remodelamento corporal e aspecto de celulite em mulheres. Métodos: Trata-se de um estudo clínico longitudinal prospectivo e comparativo, no qual se utilizaram as seguintes ferramentas de avaliação: antropometria, perímetria, adipometria, avaliação da viscoelasticidade da pele com Cutometer®, avaliação da espessura da hipoderme com ultrassom diagnóstico e análise da escala de severidade da celulite (CSS). As avaliações ocorreram no início e após 1 semana de término das dez sessões da terapia vibro-oscilatória. As análises estatísticas foram realizadas com o software Bioestat 5.0, utilizando o teste de normalidade de Lilliefor (P-valor > 0,05), teste paramétrico e teste T-Student da amostra pareada. Resultados: Trinta mulheres participaram da pesquisa, com média de idade de 33 ± 9 anos, peso médio de 62 ± 11 kg, altura média de 1,66 ± 0,06 metros, IMC médio de 22 ± 2 kg/m2 . As medidas de perímetria, adipometria, análise da espessura do tecido subcutâneo por meio de ultrassom diagnóstico e análise da viscoelasticidade da pele não apresentaram alterações significativas. Entretanto as variáveis de CSS glúteo direito (7,3 ± 1,8 para 5,8 ± 1,6 ≤ 0,0001), glúteo esquerdo (7, 2 ± 1,9 para 5,8 ± 1,6 = 0,0001), coxa direita (6,9 ± 1,9 para 5,6 ± 1,4 = 0,0004), coxa esquerda (6.9 ± 1,9 para 5,6 ± 1,3 = 0,0004) e Celluqol® (59 ± 16 para 49 ± 16 = 0,022), apresentaram diferença significativa. Conclusão: A terapia vibro-oscilatória multidirecional é uma terapia efetiva e eficaz para o tratamento da celulite, porém para o tratamento de remodelamento corporal ela deve ser mais bem avaliada e estudada. (AU)

Estudo comparativo entre carboxiterapia e plasma rico em plaquetas em pacientes com fibroedema geloide / Comparative study between carboxitherapy and platelet-rich plasma in patients with cellulite

Introdução: O plasma rico em plaquetas (PRP) e a carboxiterapia são recursos que melhoram a circulação sanguínea e linfática favorecendo a reorganização do colágeno, e ambos são usados para tratar distúrbios como o fibroedema gelóide (FEG). Objetivo: Comparar a influência da carboxiterapia e do PRP sobre o FEG. Métodos: 20 voluntárias de idade média de 35,7 anos com FEG em graus III e IV na região posterior da coxa abaixo do glúteo foram divididas em grupos: Grupo carboxiterapia (GC) que recebeu a aplicação do gás de dióxido de carbono em via subcutânea e o grupo plasma rico em plaquetas (GPRP). As voluntárias coletaram 40 ml de sangue do membro superior para a preparação e coleta do PRP seguido de aplicação na área tratada bilateralmente, totalizando 6 sessões, duas vezes na semana, e avaliadas por questionário de satisfação e registro fotográfico. Resultados: Na análise qualitativa no grupo GPRP houve melhora da FEG, relevo cutâneo e aspecto da pele se comparado ao grupo GC. Na análise quantitativa houve maior satisfação com o corpo e conscientização alimentar em ambos os grupos. Conclusão: Apesar de o grupo GPRP ter diminuição do grau do FEG mais evidente, ambos os recursos mostraram melhora do aspecto da pele, influenciando na autoestima. (AU)

Introduction: Platelet rich plasma (PRP) and carboxytherapy are features that improve blood and lymphatic circulation, favoring the reorganization of collagen, and both are used to treat disorders such as cellulite. Objective: To compare the influence of carboxytherapy and PRP on EGF. Methods: 20 volunteers with an average age of 35.7 years old with cellulite levels III and IV in the posterior region of the thigh below the gluteus were divided into groups: Group of the carboxitherapy (CG) receiving carbon dioxide gas in subcutaneous route and platelet-rich plasma group (PRPG). The volunteers collected 40 ml of blood from the upper limb for preparation and collection of PRP followed by application to the bilaterally treated area, totaling 6 sessions twice a week, being evaluated by satisfaction questionnaire and photographic register. Results: In the qualitative analysis the PRPG group improved cellulite, cutaneous relief and skin appearance when compared to the CG group. In the quantitative analysis there was greater satisfaction with the body and food awareness in both groups. Conclusion: Although the PRPG group decreased more evidently the degree of EGF, both features showed an improvement in the skin appearance, influencing the self-esteem. (AU)

Eficácia da massagem mecânica motorizada associada a cosmecêuticos no remodelamento corporal e aspecto da celulite / Efficacy of motorized mechanical massage associated with derma-cosmeceuticals in body remodeling and aspect of cellulite

Gordura localizada e celulite são as afecções estéticas que mais incomodam as mulheres nos dias atuais e as levam a busca de tratamentos estéticos. Por essa razão, o objetivo do presente estudo foi avaliar a associação da massagem mecânica motorizada com cosmecêuticos no tratamento da gordura localizada e celulite. Métodos: Trata-se de um estudo clínico longitudinal prospectivo e comparativo. Trinta e duas mulheres foram incluídas no presente estudo seguindo os critérios de elegibilidade e inelegibilidade, todos foram avaliados e reavaliados após dez sessões do protocolo de tratamento. Para análise dos dados foram utilizados testes Lilliefor's, teste t-student bicaudal pareado, teste t-student bicaudal para amostras heterocedásticas. Resultados: Trinta mulheres finalizaram o protocolo de tratamento. Obteve-se redução das medidas, de abdome superior (p < 0,032) e abdome inferior (p < 0,004) na adipometria; medidas de cintura (p < 0,008) e abdome inferior (p < 0,022) avaliadas pela perimetria; na análise do ultrassom houve redução da medida de abdome superior (p < 0,004), flancos (p < 0,021), posterior de coxa região de prega glútea (p < 0,006) e posterior de coxa região inferior (p < 0,0001). Conclusão: Diante dos resultados, conclui-se que o protocolo de tratamento com a associação da massagem mecânica motorizada e cosmecêuticos foram eficazes para a melhora do contorno corporal e a aparência da celulite. (AU)

Localized fat and cellulite are the aesthetic conditions which disturb women the most, in current times, and therefore lead them to search esthetic treatments. For this reason, the objective of this study was to evaluate the association of motorized mechanical massage with derma cosmeceuticals in the treatment of localized fat and cellulitis. Methods: This is a clinical prospective longitudinal study. Thirty-two women were included in the present study, following the criteria of eligibility and ineligibility, and they were all evaluated and re-evaluated after ten sessions of the treatment protocol. For data analysis, we used Lilliefors t-student tests, paired two-tailed test, for heteroscedastic samples. Results: Thirty women finalized the treatment protocol, and reduction of measures was obtained in the upper abdomen (p < 0.032) and lower abdomen (p < 0.004) in adipometry; waist measures (p < 0.008) and lower abdomen, (p < 0.022) evaluated by perimetry: in the ultrasound analysis, there was reduction of the upper abdomen measure (p < 0.004), flanks (p < 0.021), upper posterior thigh area (p < 0.006) and posterior thigh distal area (p < 0.0001). Conclusion: We concluded that the treatment protocol with the association of motorized mechanical massage was efficient in the improvement of the body contour and the aspect of cellulitis. (AU)

Histoplasma panniculitis in a patient with systemic lupus erythematosus

Abstract: Histoplasmosis usually presents primarily as lung infection. Occasionally, mainly in immunocompromised hosts, it can spread and cause systemic manifestations. Skin lesions have been reported in 10 to 15 percent of cases of disseminated histoplasmosis, and panniculitis has been described as an unusual form of presentation in affected patients. We present the case of a patient with systemic lupus erythematosus who presented cellulitis due to disseminated histoplasmosis.

Guía de Práctica Clínica para el Diagnóstico y Manejo de las Infecciones de Piel y Tejidos Blandos en Colombia / Clinical Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections in Colombia

Las infecciones de piel y tejidos blandos (IPTB) representan la tercera causa de consulta por enfermedad infecciosas a los servicios médicos, después de las infecciones respiratorias y urinarias. Se presenta una guía de práctica clínica (GPC) con 38 recomendaciones basadas en la evidencia, graduadas bajo el sistema SIGN, para el diagnóstico y tratamiento de pacientes adultos con IPTB en el contexto colombiano, posterior a un proceso de adaptación de GPC publicadas y la búsqueda sistemática y síntesis de literatura para la actualización de la evidencia científica. Además, se realizó un consenso de expertos para la evaluación de las potenciales barreras para la implementación de las recomendaciones y la evaluación del grado de recomendación en el contexto local.

Skin and soft tissue infections (SSTI) represent the third leading cause of infectious disease consultation for medical services after respiratory and urinary tract infections. This document generates a clinical practice guideline with 38 recommendations based on evidence, graduated under the SIGN system for the diagnosis and treatment for SSTI infections in adult patients in Colombia, following a process of adaptation of guidelines published, and the systematic search and synthesis of literature for the updating of scientific evidence. In addition, a consensus of experts was made for the evaluation of the potential barriers for the implementation of the recommendations and the evaluation of the degree of recommendation in the local context.

Nanoemulsion containing caffeine for cellulite treatment: characterization and in vitro evaluation

The Ginoide Hydrolipodystrophy (GHLD), commonly known as cellulite, occurs in 80-90% of the female population after the puberty period and comes from a metabolic modification in the cutaneous adipose tissue. Caffeine has been used in topical formulations due to its lipolytic action. We studied a nanoemulsion (F3) containing caffeine with two surfactants (oleth-3 and oleth-20) by emulsification method by phase inversion temperature inversion (PIT). The polydispersion indices (PDI) showed the reduced deviation of 0.1. The mean droplet size was ~ 40 nm. The evaluated constant of Ostwald, in the refrigerator condition was the most favorable during the stability test. In the In Raman spectroscopy assay, the caffeine bands found in F3 were compatible with those found in the caffeine solution (1337, 652.5 and 558.2 cm-1). There was no interaction of caffeine anhydrous with other ingredients in nanoemulsion. In the in vitro safety assay the result of 1.4 ranked the F3 as slightly irritating. In the natural membrane, cutaneous permeation test (human skin) permeate concentrations did not exceed the saturation concentration of the PBS buffer (48.96 µg/3 mL). The caffeine solution and F3 permeated statistically equal, but the nanoemulsion visually and sensorially improved the caffeine precipitation.

Rol de los estreptococos del grupo Streptococcus anginosus en infecciones de piel y partes blandas: reporte de 3 casos / Role of streptococci of the Streptococcus anginosus group in skin and soft tissue infections: report of 3 cases

Los estreptococos del grupo Streptococcus anginosus (GSA) comprenden uno de los grupos que conforman el grupo viridans de estreptococos y son parte de la microbiota humana habitual de la cavidad oral, del tracto respiratorio superior y del tracto gastrointestinal. Pueden producir colecciones purulentas de órganos sólidos, abscesos cutáneos y celulitis, entre otras infecciones. Este grupo posee numerosos factores de virulencia como hialuronidasa, adhesinas, enzimas extracelulares y hemolisinas. El objetivo de este trabajo fue presentar tres casos clínicos de infecciones asociadas a traumatismos vinculados con la cavidad oral como golpes de puño o mordeduras humanas. En todos ellos, los GSA desarrollaron como germen único, lo que pone de manifiesto su importante rol en este tipo de infecciones.

The Streptococcus anginosus group (SAG) is part of the viridans group streptococci and they belong to the normal human microbiota of the oral cavity, the upper respiratory tract and the gastrointestinal tract. It can produce purulent collections of solid organs, cutaneous abscesses and cellulitis, among other infections. This group has numerous virulence factors such as hyaluronidase, adhesins, extracellular enzymes and hemolysins. The objective of this work is to present three clinical cases of infections associated with trauma related to the oral cavity such as fist bumps or human bites. In all of them, the SAG developed as a single organism, which highlights its important role in this type of infection.

Os estreptococos do grupo do Streptococcus anginosus (GSA) são parte de um dos grupos que constituem o grupo viridans e fazem parte da microbiota normal da cavidade oral, do trato respiratório superior e do trato gastrointestinal dos seres humanos. Podem produzir coleções purulentas de órgãos sólidos, abscessos cutâneos e celulite, entre outras infecções. Este grupo possui numerosos fatores de virulência, como hialuronidases, adesinas, enzimas extracelulares e hemolisinas. O objetivo desse trabalho foi apresentar três casos clínicos de infecções associadas a traumatismos associados à cavidade oral, decorrentes de socos ou mordidas humanas. Em todos eles os GSA se desenvolveram como germe único, o que põe de manifesto seu papel importante nesse tipo de infecções.

Correlación de colonización de Staphylococcus aureus en mucosa nasal e infecciones faciales de origen no odontogénico / Corelation between Staphylococcus aureus colonization in nasal mucosa and facial infections from non-odontogenic origin

En la actualidad, las tasas que se conocen de colonización de piel y mucosa por el staphylococcus aureus están incrementando día a día. Se ha encontrado una fuerte correlación de la invasión de estos en otras partes del cuerpo (zona axilar, mucosa nasal, entre otras) con la aparición de celulitis y/o abscesos faciales. Se demostró que la flora nasal es muy diversa, encontrándose patógenos como streptococcus viridans, staphylococcus aureus, staphylococcus coagulasa negativa y Corynebacterium sp, pero sin posibilidad de definir con exactitud cuál es la constancia de los mismos pudiendo presentarse variaciones de esta. A su vez, esto se ve agravado por la falta de adherencia al tratamiento por parte de los pacientes y de otras condiciones como, el mismo contagio o predisposición del medio (sudoración, altas temperaturas, mala higiene, etc.), que facilitan la capacidad de dicho microorganismo de tornarse más resistente, incrementar su población y aumentar así la patogenicidad a través de la codificación de una exotoxina llamada Pantón Valentín (SAMR). Se demostrará entonces, la metodología que se llevó a cabo a través de un análisis descriptivo transversal de los casos tratados en el Hospital Mariano y Luciano de La Vega, con el fin de correlacionar causalidad y efecto (AU)

At present, the rates known for skin and mucosa colonization by Sthapylococcus aureus are increasing day by day. A strong correlation has been found of the invasion of these in other parts of the body (axillary area, nasal mucosa, among others, being the latter the most representative), with the appearance of cellulite and/or facial abscesses. It was shown that the nasal flora is very diverse, finding pathogens such as Streptococcus Viridans, Staphylococcus aureus (S aureus), coagulase negative Staphylococcus and Corynebacterium sp, but that has not been defined exactly the constancy of the same, can be presented variations of this. In turn, this is aggravated by the lack of adherence to treatment by patients and other conditions such as the same contagion or predisposition of the medium (sweating, high temperatures, poor hygiene, etc.), which facilitate the capacity of said Microorganism to become more resistant, increase its population and thus increase the pathogenicity through the codification of a exotoxin called Valentín Panty. To prove the methodology that was carried out through a transversal descriptive analysis of the cases treated at the Mariano Hospital and Luciano de La Vega in order to fulfil the objective of correlating causality and Effect (AU)