Tofacitinib for managing granuloma formation after dermal filler injection: three case reports and literature review.

BACKGROUND: Granuloma formation is an uncommon and persistent skin inflammatory condition caused by the injection of dermal fillers. The exact cause of this reaction is not well understood, but it may be associated with irritating components or abnormal immune function. Treating granulomas can be difficult. However, recent research has shown that Janus kinase (JAK) inhibitors hold promise as a potential therapy for refractory granulomatous diseases. OBJECTIVES: The aim was to evaluate the efficacy and safety of tofacitinib as a treatment for granulomas secondary to filler injection and the possible mechanisms were discussed and summarized. METHODS: This study focuses on three cases of patients who experienced granuloma formation after receiving filler injections and were subsequently treated with tofacitinib. The efficacy and safety of the treatment were evaluated using parameters such as photographs and monitoring for any adverse reactions. In addition, a literature review was conducted to explore the underlying mechanisms and potential effects of tofacitinib. RESULTS: All three cases recovered from swelling and nodules without side effects through the off-label use of oral tofacitinib. Existing data review reveals some approaches for cutaneous granulomatous disorders like inhibiting macrophage activation and downregulation of the JAK-STAT pathway. CONCLUSION: This report emphasizes the effectiveness of JAK inhibitors in treating granulomas caused by filler injections. Recent advancements in understanding the underlying mechanisms of granulomatous reactions have paved the way for JAK inhibitors to be regarded as a promising treatment choice. However, further research is necessary to fully assess the safety and long-term effectiveness of using tofacitinib for granuloma treatment.

A magnesium screw with optimized geometry exhibits improved corrosion resistance and favors bone fracture healing.

Stress-induced corrosion impairs the mechanical integrity of magnesium (Mg) and its alloys as potential orthopedic implants. Although there has been extensive work reporting the effects of stress on Mg corrosion in vitro, the geometric design principles of the Mg-based orthopedic devices still remain largely unknown. In this work, a numerical simulation model mimicking fractured bone fixation and surgical animal models were applied to investigate the effects of the geometric design of Mg screws on the stress distribution and the stress-induced degradation behavior. Finite element (FE) analysis was used for calculation of stress concentrations around the Mg screws, with different thread type, thread pitch, and thread width. Afterward, the Mg screws of the pre-optimization and post-optimization groups exhibiting the highest and lowest stress concentrations, respectively, were implanted in the fractured distal femora and back subcutaneous tissue of rabbits. Encouragingly, there was a significant difference between the pre-optimization and the post-optimization groups in the degradation rate of the stressed screw parts located around the fracture line. Interestingly, there was no significant difference between the two groups in the degradation rate of the non-stressed screw parts. Consistently, the Mg screw post-optimization exhibited a significantly lower degradation rate than that pre-optimization in the back subcutaneous implantation model, which generated stress in the whole screw body. The alteration in geometric design did not affect the corrosion rate of the Mg screws in an immersion test without load applied. Importantly, an accelerated new bone formation with less fibrous encapsulation around the screws was observed in the Mg group post-optimization relative to the Mg group pre-optimization and the poly (lactic acid) group. Geometry optimization may be a promising strategy to reduce stress-induced corrosion in Mg-based orthopedic devices. STATEMENT OF SIGNIFICANCE: Stress concentrations influence corrosion characteristics of magnesium (Mg)-based implants. The geometric design parameters, including thread type, thread pitch, and thread width of the Mg screws, were optimized through finite element analysis to reduce stress concentrations in a fractured model. The Mg screws with triangular thread type, 2.25 mm pitch, and 0.3 mm thread width, exhibiting the lowest maximum von Mises stress, showed a significant decrease in the volume loss relative to the Mg screws pre-optimization. Compared with the Mg screw pre-optimization and the poly(lactic acid) screw, the Mg screw post-optimization favored new bone formation while inhibiting fibrous encapsulation. Collectively, optimization in the geometric design is a promising approach to reduce stress-induced corrosion in Mg-based implants.

High incidence of HPV infection in minors with oral squamous cell carcinoma.

BACKGROUND: Oral squamous cell carcinoma in minors is considered to be a distinct entity from OSCC in older patients, with an uncertain etiology. Human papillomavirus (HPV) infection may trigger the initiation and promote the progression of OSCC, but these roles have not been firmly established.We aimed to explore the correlation between HPV infection and the development of oral squamous cell carcinoma in minors and know the characteristics of OSCC in young patients more thoroughly. METHOD: From January 2013 to December 2022,6 cases of OSCC aged < 15 years were selected from the Department of Oral Pathology, Peking University School of Stomatology, Beijing, China. All cases underwent testing for high-risk HPV mRNA infection using the RNA scope technique, and immunohistochemical staining was performed to investigate the expression of p16, pan-cytokeratin (CK), CK5/6, CK7, CK8/18, epidermal growth factor receptor (EGFR), p53, and Ki-67. Furthermore, we reviewed the literature on OSCC in patients aged < 21 years. CONCLUSIONS: Minors OSCC is associated with HPV infection, and that p16 can serve as an immunohistochemical marker of HPV positivity.

Clinical efficacy of intense pulsed light combined with low-dose intralesional corticosteroids in treating noninfectious granulomas after mesotherapy: A case series analysis.

BACKGROUND: Mesotherapy is a popular cosmetic procedure for localized delivery of substances. However, due to the lack of standardized processes, there are potential risks of adverse reactions. Granulomas formation is one of the chronic reactions which impose significant physical and mental burdens on patients. OBJECTIVES: The aim of this analysis is to evaluate the safety and feasibility of combining intense pulsed light (IPL) with intralesional corticosteroids for treating noninfectious granulomas after mesotherapy. METHODS: This retrospective observational case series included patients who suffer from noninfectious granulomas after mesotherapy and received combination of IPL and intralesional corticosteroids treatment between October 2021 and December 2022 at Peking University Shenzhen Hospital, Shenzhen, China. The process and effect were analyzed and summarized. RESULTS: Among the seven patients, five expressed extreme satisfaction with the efficacy, while two was slightly satisfied. The physicians believed that all patients had shown significant improvement. No adverse reactions or recurrences were observed during follow-up. CONCLUSION: Based on this analysis, the application of the combined treatment in patients suffering from noninfectious granuloma due to mesotherapy demonstrates good clinical efficacy and safety, making it worth considering as a treatment option.