Comparative Results in Treatment of Keloids With Intralesional 5-FU/Kenalog, 5-FU/Verapamil, Enalapril Alone,Verapamil Alone, and Laser: A Case Report and Review of the Literature.

BACKGROUND: The pathogenesis of keloids involves a hyperproliferative state due to molecular abnormalities, cellular driving pathways, such as TGF, VEGF, and the inactivation of proapoptotic genes. We reviewed the literature and compared various treatment combina- tions in the treatment of keloids in a one patient observation. METHODS AND MATERIALS: Treatment modalities consisted of: intralesional 5- uorouracil (5-FU)/triamcinolone (TMC), 5-FU/verapamil, enal- april alone, verapamil alone, and fractional carbon dioxide laser. Size, height, and softness of the keloid, pain, itching, and pain were assessed. RESULTS: 5-FU based treatments proved to be more ef cacious than the other modalities. 5-FU + TMC demonstrated the largest reduc- tion in keloid height and rmness. The greatest degree of scar softening and average size reduction was achieved with 5-FU/ TMC (80% and 70% reduction, respectively), followed by 5-FU/verapamil (50% and 33% reduction, respectively). The same combinations led to the greatest reduction in scar height (70% and 33%, respectively). All treatments led to resolution of pain and itching in the keloid. CONCLUSION: The favorable effects of the 5-FU + verapamil combination are new and deserve further exploration. J Drugs Dermatol. 2016;15(11):1442-1447..

Twelve-month prospective study of polymethylmethacrylate/collagen dermal filler for volume loss of the dorsal of hands.

BACKGROUND: Dermal fillers have been used safely and effectively to revolumize aging hands. We assess the effectiveness of polymethylmethacrylate (PMMA) to treat the volume loss of photoaged dorsal hands for up to 12 months. METHODS: In a 12-month prospective study, 15 subjects were treated with PMMA filler in the bilateral dorsal hands. PMMA was injected 4 weeks after an initial screening visit, and touch-up treatments were provided if needed 4 weeks later. Effectiveness was assessed by the provider using the validated Merz Hand Grading Scale (MHGS) and the Global Aesthetic Improvement Scale (GAIS). Subjects completed the Subject GAIS and the Subject Satisfaction Survey. RESULTS: All subjects had at least 1 point of improvement on the MHGS starting from 1 month to 12 months after treatment. 75% of subjects had a 2-point improvement at 12 months. Investigators reported that 92% of subjects had some degree of improvement at 12 months, while 75% of subjects self-reported some degree of improvement. Approximately 75% of the subjects reported that they were satisfied with the treatment. Adverse events were minor and limited to swelling. CONCLUSION: PMMA is a safe and effective treatment for volumizing the dorsal hands with improvement that is sustained for up to 12 months.

Novel topical dermal repair: A clinical analysis.

BACKGROUND: There is an increasing interest in and demand for noninvasive anti-aging treatments, and cosmeceuticals are an effective adjunct treatment to in-office cosmetic treatments. OBJECTIVE: This study evaluates the short-term cosmetic benefits of a topical anti-wrinkle cream (Ultrascript Dermal Regenesis, Montclair, NJ) and a topical evening DNA repair serum (Dermal DNA Repair Serum with the active ingredient AC-11 from Optigenex INC). METHODS: Fourteen women of all Fitzpatrick skin types were randomized to receive either the topical anti-wrinkle cream (AM cream) only or the AM cream and the topical evening DNA repair serum (PM serum) for 16 weeks. Subjects noted their subjective improvement in wrinkles, pore size, hyperpigmentation, and overall skin quality. Two blinded physicians evaluated the appearance of wrinkles pre- and postapplication of the AM cream. RESULTS: Participants who applied the AM cream only reported subjective improvement in wrinkles and overall quality of their skin. Immediate improvement of wrinkles was seen after the application of the AM cream. Subjects who applied both the AM cream and PM serum noted improvement in pore size. CONCLUSION: This novel anti-wrinkle cream is a safe and effective topical treatment for the immediate, but short-term improvement of wrinkles. Prolonged use of the cream and continued follow-up may show additional long-term benefits.

Comparison of a novel wound dressing vs current clinical practice after laser resurfacing.

BACKGROUND: There are many postprocedure skin care options, but no consensus on the best formulation to optimize healing. Silicone gels have only been used to treat keloids and hypertrophic scars and typically applied after the wound has healed. This study compared the healing response after fractional ablative erbium laser resurfacing with a petrolatum-based ointment and a silicone gel. METHODS: A randomized, open-label, split-face study was performed. Ten subjects underwent Erbium:YAG (Sciton) fractional laser resurfacing. Patients were randomized to apply a petrolatum-based gel or a silicone gel (Stratacel® ; Stratpharma) on either the right or left side of the face. Subjects applied the products twice a day for 7 days and were evaluated in person 7, 30, and 60 days postprocedure. Subjects reported on the overall general aesthetic outcome, perceived pain, itch, and tightness via questionnaires using the Global Aesthetic Improvement Scale and the Wrinkle Severity Rating Scale (WSRS). RESULTS: All subjects healed without complications. By day 60, there was no difference in signs and symptoms of healing between the two different dressing approaches. However, patients treated with the silicone gel had less post-treatment erythema and hyperpigmentation. CONCLUSIONS: A novel silicone gel resulted in reduced signs of erythema and hyperpigmentation postprocedure, without an increase in adverse events. Additionally, the silicone gel dries to form a thin, full contact film and can be covered with sunscreen or cosmetics once dry. This new silicone gel presents a good option for postprocedure care after ablative fractional laser resurfacing.