Preclinical and Clinical Studies on the Use of Extracellular Vesicles Derived from Mesenchymal Stem Cells in the Treatment of Chronic Wounds.

To date, the widespread implementation of therapeutic strategies for the treatment of chronic wounds, including debridement, infection control, and the use of grafts and various dressings, has been time-consuming and accompanied by many challenges, with definite success not yet achieved. Extensive studies on mesenchymal stem cells (MSCs) have led to suggestions for their use in treating various diseases. Given the existing barriers to utilizing such cells and numerous pieces of evidence indicating the crucial role of the paracrine signaling system in treatments involving MSCs, extracellular vesicles (EVs) derived from these cells have garnered significant attention in treating chronic wounds in recent years. This review begins with a general overview of current methods for chronic wound treatment, followed by an exploration of EV structure, biogenesis, extraction methods, and characterization. Subsequently, utilizing databases such as Google Scholar, PubMed, and ScienceDirect, we have explored the latest findings regarding the role of EVs in the healing of chronic wounds, particularly diabetic and burn wounds. In this context, the role and mode of action of these nanoparticles in healing chronic wounds through mechanisms such as oxygen level elevation, oxidative stress damage reduction, angiogenesis promotion, macrophage polarization assistance, etc., as well as the use of EVs as carriers for engineered nucleic acids, have been investigated. The upcoming challenges in translating EV-based treatments for healing chronic wounds, along with possible approaches to address these challenges, are discussed. Additionally, clinical trial studies in this field are also covered.

A systematic review of procedural modalities in the treatment of notalgia paresthetica.

BACKGROUND: Notalgia paresthetica (NP) is a rare condition characterized by localized pain and pruritus of the upper back, associated with a distinct area of hyperpigmentation. Given the lack of standardized treatment and the uncertain efficacy of available options, applying procedural methods is of growing interest in treating NP. AIMS: We sought to comprehensively evaluate the role of procedural treatments for NP. METHODS: We systematically searched PubMed/Medline, Ovid Embase, and Web of Science until November 14th, 2023. We also performed a citation search to detect all relevant studies. Original clinical studies published in the English language were included. RESULTS: Out of 243 articles, sixteen studies have reported various procedural modalities, with or without pharmacological components, in treating NP. Pharmacological procedures, including injections of botulinum toxin, lidocaine, and corticosteroids, led to a level of improvement in case reports and case series. However, botulinum toxin did not show acceptable results in a clinical trial. Moreover, non-pharmacological procedures were as follows: physical therapy, exercise therapy, kinesiotherapy, acupuncture and dry needling, electrical muscle stimulation, surgical decompression, and phototherapy. These treatments result in significant symptom control in refractory cases. Physical therapy can be considered a first-line choice or an alternative in refractory cases. CONCLUSION: Procedural modalities are critical in the multidisciplinary approach to NP, especially for patients who are refractory to topical and oral treatments. Procedural modalities include a spectrum of options that can be applied based on the disease's symptoms and severity.

Treatment of horizontal neck wrinkles by Endolift laser: Biometric measurement.

BACKGROUND: One of the common esthetic complaints of patients is horizontal neck wrinkles that have limited treatment modality. AIM: In the present study, we evaluated the efficacy of the Endolift laser on the horizontal neck wrinkles. METHODS: Totally, 10 healthy female and male patients suffering horizontal neck wrinkles were joined in this study. All patients are treated with Endolift laser. The effect of the Endolift methods on the horizontal neck wrinkles was evaluated by biometric parameter changed results with Cutometer, Visioface, and the Skin Ultrasound Imaging system. Also, three blinded dermatologists and patients' satisfaction were evaluated. RESULTS: The Visoface results showed that the Endolift laser treatment significantly decline the depth and area of horizontal neck wrinkle. The skin ultrasonography results reported the epidermis and dermis density and thickness were significantly increased. Also, the cutometer outcomes displayed that the Endolift laser treatment can increase skin elasticity. Also, significantly a greater number of patients were well satisfied with the technique. CONCLUSION: In conclusion, Endolift laser is a safe and effective method for decreasing the horizontal neck wrinkles and improving the appearance of the neck. This procedure does not require general anesthesia and recovery time.

Evaluation of the effects of adding an adipose tissue-derived stromal vascular fraction to platelet-rich plasma injection in the treatment of androgenetic alopecia: A randomized clinical trial.

BACKGROUND: Stromal vascular fraction (SVF) cells derived from adipose tissue and platelet-rich plasma (PRP) are among novel treatments for androgenetic alopecia (AGA). We aimed to investigate the effect of adding SVF to PRP and compare it to administering PRP injection alone. METHODS: Eighteen patients were randomly divided into two groups of nine. The PRP group was treated with PRP at all three visits at 1-month intervals, while the SVF-PRP group received an SVF injection on the first visit and a PRP injection on the second and third visits. Each group was evaluated at baseline and 20 weeks after the therapy's initiation. RESULTS: Changes in mean hair diameter and hair count compared to baseline were significant in both groups. The PRP group experienced a greater increase in mean hair count than the SVF-PRP group, and the SVF-PRP group had a marginally greater increase in hair diameter than the PRP group. These differences were not statistically significant compared to each other. The patient and physician assessment scores exceeded the mean (on a scale from 0: poor to 3: excellent) in both groups. CONCLUSION: Adding one SVF injection to two PRP treatment sessions versus three PRP injections alone had no significant difference in evaluated variables. If additional research demonstrates the same results, we suggest that multiple SVF injection sessions may be required to produce a statistically significant difference compared to PRP injection alone. Moreover, considering lower cost and greater accessibility of PRP, it can be used before SVF in the treatment of AGA.

The investigation and comparison of the efficacy and safety of stromal vascular fraction (SVF), platelet rich plasma (PRP), and 1064-nm Q-switched Nd:YAG laser in reducing nanofat treated infraorbital dark circles and wrinkles: A controlled blinded randomized clinical trial.

BACKGROUND: To evaluate the efficacy and safety of stromal vascular fraction (SVF), platelet rich plasma (PRP), and 1064-nm Q-switched Nd:YAG laser in reducing nanofat treated dark circles and wrinkles under the eyes. METHOD: This study was a single-blinded randomized clinical trial conducted on patients with suborbital darkening under the eyes that randomly divided into control and case groups. In the control group, 15 patients were treated with one session of nanofat injection only, and five patients of each intervention groups received one session of nanofat+SVF injection, nanofat+PRP injection, and nanofat injection+Nd:YAG laser, respectively. Assessments methods were (1) evaluation of the degree of darkness and repair under the eyes by a blinded dermatologist based on clinical photographs, (2) investigating patient satisfaction, (3) using biometric variables for color, thickness, and density of the skin (only 3 months after the treatment), and (4) recording the possible adverse effects. CONCLUSION: In terms of the extent of reduction in the intensity of darkness under the eyes, the combined treatment of nanofat injection together with SVF, PRP, and Nd:YAG laser had a much greater therapeutic effect than nanofat injection alone. In all three groups of combined treatments, patients were 100% satisfied. In terms of biometric variables, amount of changes in colorimeter, complete and dermal thickness, complete and dermal density, between the different groups was statistically significant. The use of combined treatments including nanofat with SVF injection, PRP, and 1064 Q-switched Nd:YAG laser may be more effective than nanofat alone, in reducing infraorbital dark circles and wrinkles.

Efficacy and safety of radiofrequency in the treatment of hidradenitis suppurativa; a systematic review.

BACKGROUND AND AIMS: Hidradenitis suppurativa (HS) is an inflammatory skin disease affecting apocrine gland-bearing sites of the body. Radiofrequency (RF) is a minimally invasive method that acts by minimizing thermal damage to the dermis, resulting in collagen synthesis and scar improvement. We systematically reviewed the efficacy and safety of RF in treating HS. METHODS: A systematic search was performed up to November 18th, 2023, in PubMed/Medline, Ovid Embase, and Web of Science. Clinical studies with English full texts were included. The National Institute of Health (NIH) Quality Assessment Tool for clinical trials and Methodological quality and synthesis of case series and case reports by Murad et al. were utilized for critical appraisal. RESULTS: Out of 55 identified studies, 11 met our inclusion criteria with 167 subjects who underwent RF therapy alone or combined with an intense pulsed laser (IPL), known as LAight®. LAight® significantly improved clinical outcomes in mild-to-moderate HS patients based on the Dermatology Life Quality Index (DLQI), International Hidradenitis Suppurativa Score System (IHS4), Pain-Numerical Rating Scale (NRS), and Hidradenitis Suppurativa Clinical Response (HiSCR). Moreover, RF therapy alone significantly alleviated the clinical manifestations in patients with mild-to-moderate HS. Additionally, fractional microneedling RF significantly decreased HS-associated inflammatory markers. RF was found to be safe with limited adverse events. However, in moderate-to-severe HS, RF has failed to yield satisfactory results. CONCLUSION: RF is a safe energy-based method with promising outcomes, especially for long-term application in mild-to-moderate HS. In moderate-to-severe cases, RF should be combined with a systemic medication for further beneficial impacts.

The Endo-lift Laser (Intralesional 1470 nm Diode Laser) for Dermatological Aesthetic Conditions: A Systematic Review.

BACKGROUND: The prominence of minimally invasive aesthetic approaches has become increasingly pivotal. The endo-lift laser method is an intralesional 1470 nm diode laser connected to a fiber that serves both therapeutic and aesthetic properties. We sought to evaluate the efficacy and safety of the endo-lift laser method for dermatological aesthetic applications. METHODS: PubMed, Ovid-Embase, and Web of Science were systematically searched up to November 5th, 2023. A citation search was also performed. The National Institute of Health (NIH) Quality Assessment Tool was used to evaluate the quality of the studies. RESULTS: Out of 339 articles, twenty-three relevant studies were included in the current review. Applying the endo-lift laser method for rejuvenation, including face and neck lifting, enhancing skin laxity, and disappearing wrinkles, folds, and lines, demonstrated favorable efficacy and safety profile. Moreover, most studies have shown that the endo-lift laser method is promising in eliminating the adipose tissue in the jowl, abdomen, thighs, and arms. The endo-lift laser technique was also efficacious in nose remodeling and blepharoplastic procedures, including treating eyelid and eyebrow ptosis, eye bag, eyebrow position, and eyelid laxity. Patients who suffer from several diseases, such as hidradenitis suppurativa, progressive lipodystrophy, acne vulgaris, scars, and keloids, benefit from procedural treatment with the endo-lift laser technique. Across all studies, the adverse events were mild and self-limiting. Investigating the endo-lift laser method in all aesthetic and therapeutic indications resulted in high patient satisfaction rates. CONCLUSION: The endo-lift laser technique has therapeutic effects and is recommended for various dermatological aesthetic indications. Further clinical studies with control groups and larger sample sizes are needed to acquire more reliable evidence. LEVELS OF EVIDENCE III AND 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 .

A systematic review of interleukin-31 inhibitors in the treatment of prurigo nodularis.

BACKGROUND: Prurigo nodularis (PN) is a neuroimmunological skin disease. Severe itching is the most challenging symptom which affects patients' quality of life. T helper 2-derived cytokines, such as interleukin-31 and oncostatin M (OSM), play a crucial role in PN pathogenesis. Nemolizumab and vixarelimab are two biologics acting as IL-31 inhibitors. Vixarelimab also suppresses the OSM activity. This systematic review evaluates the efficacy and safety of nemolizumab and vixarelimab in PN management. METHODS: A systematic search was conducted in PubMed/Medline, Ovid Embase, and Web of Science up to September 17th, 2023. Clinical trials and cohort studies published in English were included. RESULTS: Among a total of 96 relevant records, five were included. The results of four studies with 452 patients using nemolizumab showed that a significantly higher percentage of patients treated with nemolizumab demonstrated a reduction in peak pruritus numerical rating scale (PP-NRS) and investigator's global assessment along with improved sleep disturbance (SD) and quality of life than the placebo group. Moreover, one study administered vixarelimab to 49 PN patients, and their finding illustrated a higher rate of subjects who received vixarelimab experienced ≥ 4-point diminution in worst itch NRS, visual analog scale, healing of representative lesions, and SD quality compared to the placebo group. CONCLUSIONS: IL-31 inhibitors suggest distinct advantages in improving pruritus, sleep quality, and overall quality of life in subjects with moderate-to-severe PN. Further clinical studies are recommended to compare the effectiveness of these biologics to other therapeutic choices.

Efficacy evaluation of endolift laser for treatment of nasolabial folds and marionette lines.

BACKGROUND: The nasolabial folds are the most marked sign of aging. Endolift laser was used for the treatment of nasolabial folds and marionette lines (one of the facial danger zones). METHODS: Ten female subjects were engaged in this study. Patients underwent Endolift laser for nasolabial folds and marionette lines treatment. The efficacy of the Endolift technique on the nasolabial folds and marionette lines was evaluated by biometric assessment with Cutometer, Visioface, and the Skin Ultrasound Imaging system. Also, patient's satisfaction and blinded dermatologists' assessment were assessed. RESULTS: The Visoface results displayed that the Endolift laser treatment significantly declined the depth and area of the nasolabial wrinkles. The skin ultrasonography results reported that the epidermis and dermis density and thickness were significantly increased. Also, the cutometer outcomes showed that the Endolift laser treatment can increase skin elasticity. The results showed that a large number of patients were very satisfied with the technique. CONCLUSION: In conclusion, Endolift laser has an effective technique for decreasing the nasolabial folds, marionette lines, and improve the appearance of the face without any sever side effect. This technique does not need general anesthesia and recovery time.

Treatment of periorbital hyperpigmentation using sublative fractional radiofrequency (SFR).

BACKGROUND: Periorbital hyperpigmentation (POH) is a common cosmetic concern. Numerous techniques of treatment have been assessed with variable results. AIM: The purpose of this research is to assess the efficacy of non-ablative radiofrequency, Sublative fractional Radiofrequency (SFR) on POH treatment. METHODS: In this research study, nine patients with POH and the age range of 25-57 years, were enrolled. The patients were treated by non-ablative radiofrequency SRF. The outcomes were assessed by biometric assessment. The skin lightness and melanin content of the periorbital skin were assessed by colorimeter and Mexameter. Skin elasticity was assessed by Cutometer. The skin ultrasound imaging system was used to evaluate the diameter and density of the epidermis and dermis. Visioface was used to evaluate the skin color and wrinkles. Also, patient's satisfaction and physician's assessment were assessed. RESULTS: The results showed that the lightness and elasticity of the periorbital skin were significantly increased after treatment. Also, the melanin content of the skin was decreased. The denser skin layers were seen in both dermis and epidermis. The Visioface results displayed the reduction in the percent change of the skin color and wrinkle (p < 0.05). Similarly, the physician and patients' assessment confirmed the outcomes. No serious adverse effect was reported. CONCLUSION: In conclusion, the SFR technique is an effective and satisfactory therapeutic choice for treatment of POH.

Treatment of superficial and deep partial width second degree burn's wound with allogeneic cord blood platelet gel.

BACKGROUND: Burns are caused by a variety of mechanisms, including flames, hot liquids, metallurgy, chemicals, electric current, and ionizing and non-ionizing radiation. The most significant burn wound management involves complete repair and regeneration as soon as possible while minimizing infection, contraction, and scarring in the damaged tissue area. Some factors such as delivery of nutrients, growth factors, and oxygen are essential to promote and stimulate the wound healing progress in the burns area. When these factors are not provided, the burn wound undergoes a physiological crisis. The use of growth factors is a promising approach to overcoming this limitation. Umbilical cord blood platelet concentrates are a rich natural source of growth factors. METHODS: This clinical trial used growth factors released from the lysis of umbilical cord blood platelet concentrates that have a key role in promoting re-epithelization and regeneration of damaged tissues by forming a fibrin network. This study evaluated the effectiveness of allogeneic cord blood platelet gel topical dressing in a group of patients diagnosed with superficial and deep partial thickness (second-degree) burn wounds. Clinical outcomes were compared between the intervention group and a control group of patients with superficial second-degree burn wounds who received the standard routine treatment including paraffin gauze wound dressing and silver sulfadiazine ointment. RESULTS: The study's results showed that the increased rate of recovery and tissue granulation completely promoted to wound healing and burn wound closure, decreased the recovery time, and reduced inflammation and scars caused by burn injuries. However, the use of cord blood platelet gel topical dressing is not currently a routine treatment method in patients suffering from burn wounds. However, the study's results showed that allogenic cord blood platelet gel could be used to treat superficial and deep second-degree burns as a routine treatment. It was also shown that allogenic cord blood platelet gel topical dressing could be a candidate for autograft or after autograft skin transplantation surgery (in donor and recipient sites) instead of skin surgery in some patients. CONCLUSION: Allogeneic topical wound dressing provides an effective treatment that offers a faster rate of epithelialization and healing of wounds and also decreases patients' scar and inflammation level as well as the length of recovery time. This, finally, leads to better burn wound management and the improved quality of burn wound treatment.

Endolift laser an effective method for the lower eye bag treatment: a case series study.

Numerous individuals suffer from the lower eye bag. Lower eye bag treatment is a challenge that might require new methods. Depending on the cause, there are different treatment approaches to reduce puffiness under the eyes. In this pilot study, 9 patients with lower eye bags received Endolift therapy (200-300-nm fiber) and were followed up for 6 months. The patients were evaluated according to biometric characteristics. Additionally, outcomes were evaluated by three blinded dermatologists, and patients' satisfaction was assessed. The obtained biometric results showed that Endolift laser treatment could increase both the dermis and epidermis of the skin and skin elasticity in this area. Furthermore, the results indicated that Endolift therapy showed good and very good improvement in about 90% of patients. Photographic data evaluation indicated a 90% improvement in the appearance of eye bags (P < 0.05). Endolift laser seems to be a safe and effective method for lower eye bag treatment. It is a noninvasive treatment with satisfactory results with minimal downtime and side effects. Endolift therapy significantly reduces the appearance of eye bags and wrinkles and increases skin elasticity under the eyes; therefore, it is an effective method for lower eye bag treatment. The method is pain-free, bloodless, and without the need for stitches. Endolift therapy allows the patient to avoid surgery.

Endolift laser for jowl fat reduction: clinical evaluation and biometric measurement.

Recently, jawline rejuvenation and jowl fat treatment methods have received a lot of attention. Many people are extremely upset and complain about the excess fat under the chin or neck and jowl. The study suggests a new procedure for targeting the jowl fat using Endolift laser, highlighting on the feasibility, convenience, and safety of the technique. Nine patients with pinchable fat on the jawline were enrolled in the study. The Endolift laser was performed for jowl fat treatment for each patient. The results of the treatment were measured by biometric assessment. Also the results were evaluated by 3 board-certified dermatologists (blind). Furthermore, patients' satisfaction was appraised at the end of the treatment. The biometric results showed that Endolift laser can increase the thickness, density, and elasticity of the skin in the jowl area. The patients' satisfaction results showed good and very good improvement in all of the patients (90%). The results by the dermatologist displayed good and very good improvement in about 90% of the patients. The outcomes of this experience displayed that Endolift laser is a safe and effective nonsurgical method for jowl reduction.

Role of Cultured Skin Fibroblasts in Regenerative Dermatology.

The skin, as the largest organ, covers the entire outer part of the body, and since this organ is directly exposed to microbial, thermal, mechanical and chemical damage, it may be destroyed by factors such as acute trauma, chronic wounds or even surgical interventions. Cell therapy is one of the most important procedures to treat skin lesions. Fibroblasts are cells that are responsible for the synthesis of collagen, elastin, and the organization of extracellular matrix (ECM) components and have many vital functions in wound healing processes. Today, cultured autologous fibroblasts are used to treat wrinkles, scars, wounds and subcutaneous atrophy. The results of many studies have shown that fibroblasts can be effective and beneficial in the treatment of skin lesions. On the other hand, skin substitutes are used as a regenerative model to improve and regenerate the skin. The use of these alternatives, restorative medicine and therapeutic cells such as fibroblasts has tremendous potential in the treatment of skin diseases and can be a new window for the treatment of diseases with no definitive treatment. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description ofthese Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Efficacy of allogeneic cord blood platelet gel on wounds of dystrophic epidermolysis bullosa patients after pseudosyndactyly surgery.

Epidermolysis bullosa (EB) is a rare genetic disorder characterized by the formation of blisters and wounds in skin and mucous membranes; it is classified into four types and has various methods of treatment. Management of previous wounds and prevention of formation of new lesions are the most important strategies in the course of therapy to improve patient's quality of life; lack of wound management can lead to further complications such as infection. The current study investigated the therapeutic effects of allogeneic platelet gel (prepared from umbilical cord blood) in a group of children diagnosed with dystrophic epidermolysis bullosa (DEB) eligible for surgical correction of pseudosyndactyly in the hand. The post-surgical clinical outcome in this group was compared with the clinical outcomes of DEB patients receiving the standard treatment (paraffin gauze wound dressing and topical antibiotics) after corrective surgery. The current study results showed an increase in the rate of recovery and promotion of tissue granulation, complete wound healing, and a decrease in pain level and treatment period. The application of cord blood platelet gel topical dressing was not a conventional method of treatment in patients with DEB wounds and blisters. However, the current study results demonstrated that this gel dressing could effectively accelerate epithelialization and healing of the wounds and decrease patients' pain and post-surgical recovery period, which altogether leads to improvements in patients' overall quality of life.

Comparison of carboxy therapy and fractional Q-switched ND:YAG laser on periorbital dark circles treatment: a clinical trial.

Treatment of the periorbital dark circles (PDCs) is a current challenge, with most treatment methods failing to yield promising results. The effectiveness of two common methods for periorbital dark circle treatment was compared in 28 patients with PDC. The patients were randomly divided into two groups of equal numbers: the first group received carboxy therapy, and the second group fractional 10,64 nm Q-switched Nd:YAG laser. In the carboxy therapy group, the treatment was performed six times, with 1-week intervals between sessions. In the group treated by Nd:YAG laser, the treatment was conducted in four sessions, with 1-month intervals between sessions. The results were evaluated through biometric evaluation, scoring on the visual analog scale (VAS) by both physicians and patients, and patients' satisfaction. Side effects of the treatments were also evaluated. The results showed that both carboxy therapy and Nd:YAG laser are effective in the treatment of periorbital dark circles, but carboxy therapy is significantly more effective. An increase in the skin lightness and a decrease in the melanin content of the periorbital skin was observed in the group receiving carboxy therapy, and these changes were more pronounced in this group compared to the group of Nd:YAG laser. In addition, side effects, such as erythema and post-inflammatory hyperpigmentation, were less in carboxy therapy than in Nd:YAG laser. Furthermore, the procedure was less expensive and easier to perform compared to Nd:YAG laser. Carboxy therapy is significantly more effective than Nd:YAG laser in PDC treatment.Trial registration: IRCT20080901001159N24.

Comparing cannula-based subcision with the common needle method: A clinical trial.

OF TRIAL DESIGN: Treatment of depressed acne scars requires multiple modalities. Although needle subcision is a valuable method, it exhibits mild to moderate efficacy in treatment of deep acne scars owing to the high recurrence rate and other side effects. A total of 100 patients with rolling acne scars were randomly treated using the standard technique of 18 gauge cannula and 27 gauge needle subcision in two parallel groups, and the effect of cannula subcision instead of needle subcision was evaluated in the treatment of rolling acne scars. METHODS: A total of 100 patients were randomly treated using the standard technique of 18 gauge cannula and 27 gauge needle subcision. The outcomes of these procedures were assessed by three blinded dermatologists and by patients' satisfaction. RESULTS: Subcision using the cannula showed good and very good improvement in about 83% of patients (n = 50, P < .05) based on dermatologists investigation and almost no side effects were observed in compared with needle subcision. The response rate was significantly different while using cannula subcision. CONCLUSION: Cannula subcision appears to be a safe and practical technique that can enhance the efficacy of subcision without considerable complications.

Biometric changes of skin parameters in using of microneedling fractional radiofrequency for skin tightening and rejuvenation facial.

BACKGROUND: Fractional radiofrequency (RF) has been used for skin rejuvenation and tightening by dermatologists and cosmetic surgeons in recent years. METHODS: Twenty female patients (mean age of 51.9 years) with Fitzpatrick III to VI skin phototypes who desired to undergo skin lift/tightening received six sessions of fractional microneedle RF treatment and were assessed at baseline and then 3 months after the last session for biometric characteristics using a Colorimeter, Visioface 1000D, Tewameter, Cutometer, Mexameter, and Sebumeter and a skin ultrasound imaging system to evaluate the transepidermal water loss (TEWL), skin pores, color, melanin content, erythema, sebaceous content, and thickness and density of the epidermis and dermis. Patient satisfaction with visual analog scale (VAS) was also measured. RESULTS: The results showed that skin pores and spots decreased significantly. TEWL also decreased significantly (by 18.44%). Meanwhile, skin density increased significantly (R7, by 44.41%). The ultrasonographic assessments showed that both the density and thickness of the dermis and epidermis were increased. The changes in the other parameters were not significant. CONCLUSION: FR increases the density and thickness of the dermis and thus also increases the collagen content and decreases skin pores and TEWL.

Maintaining Hair Inductivity in Human Dermal Papilla Cells: A Review of Effective Methods.

The dermal papilla comprises mesenchymal cells in hair follicles, which play the main role in regulating hair growth. Maintaining the potential hair inductivity of dermal papilla cells (DPCs) and dermal sheath cells during cell culture is the main factor in in vitro morphogenesis and regeneration of hair follicles. Using common methods for the cultivation of human dermal papilla reduces the maintenance requirements of the inductive capacity of the dermal papilla and the expression of specific dermal papilla biomarkers. Optimizing culture conditions is therefore crucial for DPCs. Moreover, exosomes appear to play a key role in regulating the hair follicle growth through a paracrine mechanism and provide a functional method for treating hair loss. The present review investigated the biology of DPCs, the molecular and cell signaling mechanisms contributing to hair follicle growth in humans, the properties of the dermal papilla, and the effective techniques in maintaining hair inductivity in DPC cultures in humans as well as hair follicle bioengineering.

A comparative study of the efficacy of fractional neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy alone and in combination with erbium:YAG laser therapy: tracing and objective measurement of melanin index in macular amyloidosis.

Macular amyloidosis (MA) is a common form of primary localized cutaneous amyloidosis, characterized by the eruption of brown pigments of the skin with a rippled pattern. MA can be of cosmetic concern for patients, and its treatment is challenging. In this study, we aimed to find new effective approaches for MA treatment. A total of 39 patients with the clinical diagnosis of MA were treated with two types of laser therapy, and the effectiveness of each approach was examined. Fractional Q-switched 10.64 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy was compared with a combination of fractional Q-switched 10.64 nm Nd:YAG laser and long-pulsed fractional erbium:YAG laser therapy. Melanin biometric measurements were performed using a Mexameter, objective image-based evaluation was carried out, and the itching score and patient satisfaction were examined. Mexameter-based analysis showed that both types of laser therapy were effective in the treatment of MA, causing a significant decrease in the amount of melanin in the treated areas (P < 0.05). Also, combination of two types of laser therapy was significantly more effective than one type alone (P < 0.05). The itching score significantly decreased in patients undergoing a combination of laser therapies. Also, a positive correlation was observed between the amount of melanin and degree of itching in the treated areas. Moreover, analysis of patient satisfaction showed that more than 90% of patients had excellent satisfaction with combination laser therapy. The results confirmed the significant positive effects of both fractional Nd:YAG laser alone and in combination with fractional erbium:YAG laser therapy considering the reduction in melanin content; however, combination of two types of laser therapy was more effective than one type alone. Trial registration: IRCT20080901001159N23.