ABSTRACT
Nodule formation can be a potentially disfiguring adverse event of soft tissue fillers. Limited treatment consensus exists regarding the optimal approach for addressing recurrent and persistent nodules. Here we describe two challenging cases of nodules that developed following injection with Restylane and Juvéderm Voluma. We review suspected pathophysiology and discuss our treatment approach. J Drugs Dermatol. 2018;17(5):580-581.
Subject(s)
Cosmetic Techniques/adverse effects , Dermal Fillers/adverse effects , Face , Hyaluronic Acid/analogs & derivatives , Skin Aging , Skin Diseases/diagnosis , Aged , Diagnosis, Differential , Female , Humans , Hyaluronic Acid/adverse effects , Injections, Subcutaneous , Skin Diseases/chemically inducedSubject(s)
Dermatologic Surgical Procedures/methods , Neoplasm Recurrence, Local/epidemiology , Neoplasm Staging , Skin Neoplasms/surgery , Adult , Female , Humans , Incidence , Male , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/surgery , Neoplasm, Residual , Prospective Studies , Reoperation , Skin Neoplasms/diagnosis , United States/epidemiologyABSTRACT
A 48 year-old woman with a history of fibroids presents with asymptomatic skin lesions. Biopsy reveals cutaneous leiomyomas and subsequent genetic evaluation confirms the diagnosis of hereditary leiomyomatosis and renal cell cancer. In this report, we review the typical presentation of the syndrome as well as recommendations for surveillance.
Subject(s)
Kidney Neoplasms/diagnosis , Leiomyoma/genetics , Leiomyomatosis/diagnosis , Sarcoma/diagnosis , Skin Neoplasms/diagnosis , Uterine Neoplasms/diagnosis , Female , Humans , Kidney Neoplasms/genetics , Leiomyoma/diagnostic imaging , Leiomyoma/pathology , Leiomyomatosis/genetics , Middle Aged , Neoplastic Syndromes, Hereditary , Sarcoma/genetics , Skin Neoplasms/genetics , Ultrasonography , Uterine Neoplasms/geneticsSubject(s)
Carcinoma, Basal Cell/surgery , Nasal Obstruction/etiology , Nose Neoplasms/surgery , Rhinoplasty , Surgical Flaps , Suture Techniques , Sutures , Aged , Carcinoma, Basal Cell/pathology , Humans , Male , Mohs Surgery/methods , Nose Neoplasms/pathology , Postoperative Care , Quality of Life , Respiration , Rhinoplasty/adverse effects , Rhinoplasty/methods , Suture Techniques/adverse effects , Treatment OutcomeSubject(s)
Nose Deformities, Acquired/surgery , Nose Neoplasms/surgery , Rhinoplasty/methods , Skin Neoplasms/surgery , Squamous Cell Carcinoma of Head and Neck/surgery , Surgical Wound/surgery , Aged , Humans , Male , Mohs Surgery/adverse effects , Nose Deformities, Acquired/etiology , Surgical Flaps , Surgical Wound/etiologyABSTRACT
Insulin is secreted from the islets of Langerhans in coordinated pulses. These pulses are thought to lead to plasma insulin oscillations, which are putatively more effective in lowering blood glucose than continuous levels of insulin. Gap-junction coupling of ß-cells by connexin-36 coordinates intracellular free calcium oscillations and pulsatile insulin release in isolated islets, however a role in vivo has not been shown. We test whether loss of gap-junction coupling disrupts plasma insulin oscillations and whether this impacts glucose tolerance. We characterized the connexin-36 knockout (Cx36(-/-)) mouse phenotype and performed hyperglycemic clamps with rapid sampling of insulin in Cx36(-/-) and control mice. Our results show that Cx36(-/-) mice are glucose intolerant, despite normal plasma insulin levels and insulin sensitivity. However, Cx36(-/-) mice exhibit reduced insulin pulse amplitudes and a reduction in first-phase insulin secretion. These changes are similarly found in isolated Cx36(-/-) islets. We conclude that Cx36 gap junctions regulate the in vivo dynamics of insulin secretion, which in turn is important for glucose homeostasis. Coordinated pulsatility of individual islets enhances the first-phase elevation and second-phase pulses of insulin. Because these dynamics are disrupted in the early stages of type 2 diabetes, dysregulation of gap-junction coupling could be an important factor in the development of this disease.