Coupled blue and red light-emitting diodes therapy efficacy in patients with rosacea: two case reports.

BACKGROUND: Rosacea is a common inflammatory skin condition affecting approximately 5% of the world population. Therapeutic approaches to rosacea are focused on symptom suppression by means of anti-inflammatory agents. More recently, photodynamic therapy, especially light-emitting diodes, has been introduced as a valid alternative to conventional therapy. CASE PRESENTATION: In the present work, we reported the efficacy and safety of light-emitting diodes therapy combining blue (480 nm) and red (650 nm) light for the treatment of two patients with papulopustular rosacea: a 22-year-old Caucasian woman and a 68-year-old Caucasian man. CONCLUSIONS: This kind of treatment could represent an effective, safer, and well-tolerated approach for the treatment of such conditions.

Clinical and Videodermoscopic Evaluation of the Efficacy, Safety, and Tolerability of a Shampoo Containing Ichthyol, Zanthalene, Mandelic Acid, and Honey in the Treatment of Scalp Psoriasis.

PURPOSE OF THE STUDY: The aim of the present prospective multicenter open study was to clinically and instrumentally evaluate the efficacy, safety, and tolerability of a shampoo, Mellis Cap® shampoo, containing ichthyol, zanthalene, mandelic acid, and honeydew honey in the treatment of mild to moderate scalp psoriasis. PROCEDURES: Thirty subjects with mild to moderate psoriasis applied the shampoo three times a week for 12 weeks. The outcome was evaluated at 30 days (T1), 60 days (T2), and 90 days (T3) of treatment, comparing it to baseline (T0) by means of clinical and patients' evaluation, digital photographs, and videodermoscopy. RESULTS: Clinical and patients' evaluation showed improvement of scalp psoriasis and itching. This was confirmed by videodermoscopy analysis with a significant reduction of scalp psoriasis severity at T2 and T3 compared to baseline. No side effects were observed or reported. CONCLUSIONS: Study treatment was well tolerated and showed significant clinical and instrumental improvement of scalp psoriasis. Mellis Cap® shampoo is a good alternative to other medicated shampoos in the treatment of mild to moderate scalp psoriasis.

A Single-Arm, Open-Label, Phase IV Study to Evaluate the Efficacy of a Topical Formulation for Hyperkeratotic Actinic Keratosis Lesions.

INTRODUCTION: Actinic keratosis (AKs) are epidermal lesions that commonly occur in skin exposed to chronic cumulative UV irradiation. Untreated AK lesions can advance to squamous cell carcinoma. Current treatments of AK have many shortcomings; for instance, not all treatments can be used for the hyperkeratotic form of AK. The aim of this study was to test the efficacy and tolerability of a topical product containing 2,4,6-octatrienoic acid and urea for the treatment of hyperkeratotic AK lesions. METHODS: Forty male and female subjects with at least two hyperkeratotic AK lesions were enrolled in this single-arm, open-label phase IV study. The product was applied twice daily for two consecutive months. The efficacy endpoints were the reductions in the mean number of AK lesions per subject from baseline (T0) to the end of the trial (T1) and to three months after the end of the treatment period (T2). RESULTS: At T0, the mean (SD) number of lesions per subject was 3.65 (1.25). At the end of the treatment period (T1), this number had dropped (significantly, p < 0.0001) by 83.56%. The mean number of lesions per subject then decreased by 41.47% (p < 0.0001) between T1 and the three-month follow-up visit (T2). Complete elimination of lesions had occurred in 57.5% of the subjects at T1, and 82.5% (55% who had remained completely clear of lesions since T1, and 27.5% who had fully eliminated their lesions during the period from T1 to T2) at T2. No side effects were reported. CONCLUSION: The application of a topical combination of 2,4,6-octatrienoic acid and urea twice daily for 60 consecutive days is a safe and effective treatment for hyperkeratotic AK lesions. FUNDING: Giuliani SpA.

Confocal microscopy and imaging profilometry: A new tool aimed to evaluate aesthetic procedures.

According to the American Academy of Aesthetic Plastic Surgeons, more than 11 million cosmetic surgical and nonsurgical procedures were performed by board-certified plastic surgeons, dermatologists and otolaryngologists in the United States, totaling more than 12 billion dollars. We performed a retrospective observational multi-centric study on patients treated with a non-animal origin cross-linked hyaluronic acid with different molecular weights for nasolabial folds, evaluating through a new imaging system, profilometric techniques with the confocal microscopy, the durability, the efficacy and the safety of this product. From 25 patients, 150 silicone casts were obtained: 75 casts of the right nasolabial fold and 75 casts of the left nasolabial fold. Roughness arithmetical average of the right fold at T2 decreased by 50% versus T0 and by 40% compared to T1; at T2, it decreased by the 45% versus T0 and by 35% compared to T1. No side effects were reported. Results proved that the analysis of the skin microreliefs through confocal microscopy is a new imaging system that allows to evaluate with precision and safety the results of aesthetic treatments such as fillers objectively.

Percutaneous collagen induction: an effective and safe treatment for post-acne scarring in different skin phototypes.

BACKGROUND: Atrophic scars can complicate moderate and severe acne. There are, at present, several modalities of treatment with different results. Percutaneous collagen induction (PCI) has recently been proposed as a simple and effective therapeutic option for the management of atrophic scars. OBJECTIVE: The aim of our study was to analyze the efficacy and safety of percutaneous collagen induction for the treatment of acne scarring in different skin phototypes. METHODS & MATERIALS: A total of 60 patients of skin types phototype I to VI were included in the study. They were divided into three groups before beginning treatment: Group A (phototypes I to II), Group B (phototypes III to V), and Group C (phototypes VI). Each patient had three treatments at monthly intervals. The aesthetic improvement was evaluated by using a Global Aesthetic Improvement Scale (GAIS), and analyzed statistically by computerized image analysis of the patients' photographs. The differences in the GAIS scores in the different time-points of each group were found using the Wilcoxon's test for nonparametric-dependent continuous variables. Computerized image analysis of silicone replicas was used to quantify the irregularity of the surface micro-relief with Fast Fourier Transformation (FFT); average values of gray were obtained along the x- and y-axes. The calculated indexes were the integrals of areas arising from the distribution of pixels along the axes. RESULTS: All patients completed the study. The Wilcoxon's test for nonparametric-dependent continuous variables showed a statistically significant (p < 0.05) reduction in severity grade of acne scars at T5 compared to baseline (T1). The analysis of the surface micro-relief performed on skin replicas showed a decrease in the degree of irregularity of skin texture in all three groups of patients, with an average reduction of 31% in both axes after three sessions. No short- or long-term dyschromia was observed. CONCLUSION: PCI offers a simple and safe modality to improve the appearance of acne scars without risk of dyspigmentation in patient of all skin types.

Chemical peels: what's new and what isn't new but still works well.

Chemical peeling is becoming increasingly popular for the treatment of skin rejuvenation where it can improve damaged skin and fine wrinkles. The basic procedure aims at obtaining a controlled chemical burn of the epidermis and/or dermis. This results in epidermal regeneration and postinflammatory collagen neoformation with remodeling of collagen and elastic fibers and deposition of glycosaminoglycans in the dermis. Various chemicals have been used as peeling agents, of which the most used are the alpha-hydroxy acids, such as glycolic acid, or beta-hydroxy acids, such as salicylic acid. The choice of the compound is linked to the different indications and to the depth of the desired peeling. Phenol is still the best agent for deep peeling but requires specific indications, prescription, and post-peeling care. Combination of different compounds is one innovation in the field of chemical peelings. Further controlled studies are necessary to set up specific guidelines.

Tratamento de rugas periorbitais por terapia de indução de colágeno / Periorbital wrinkles treatment using collagen induction therapy

Introducão: Rugas periorbitais sao pregas cutaneas muito comuns que se desenvolvem na area periocular. O tratamento das rugas varia de acordo com o grau de ravidade. Um tratamento relativamente novo, denominado terapia de inducao de colageno (TIC), parece apropriado para o tratamento destas rugas. Objetivo: Confirmar a utilidade da TIC no tratamento de rugas periorbitais. b>Pacientes e métodos: Foram incluidos 20 pacientes (12 mulheres e oito homens com idades entre 50 e 65 anos) com rugas periorbitais. Cada paciente foi tratado com um aparelho especifico em duas sessoes. A avaliacao foi feita a partir de fotografias tiradas em camera digital, para avaliar a profundidade das rugas, e de moldes de borracha de silicone, para imprimir o microrrelevo das rugas. Os dados fotograficos foram analisados com o teste estatistico de sinal (ƒ¿ < 0,05), e o conjunto de dados sobre a pele foi avaliado por meio da analise de imagens computadorizadas. Resultados: A analise das fotografias dos pacientes, apoiada pelo teste do sinal, e o grau de irregularidade do microrrelevo da superficie, apoiado pela transformacao rapida de Fourier e pelo processamento da imagem das rugas, mostraram que, depois de apenas duas sessoes, o grau de gravidade das rugas diminuiu consideravelmente na maioria dos pacientes. Conclusões: O presente estudo sugere que a TIC possa ser uma tecnica adequada para melhorar as rugas periorbitais.

Introduction: Periorbital wrinkles are very common and permanent cutaneous folds that develop on the periocular area. The treatment for wrinkles varies with the degree of severity. A relatively new treatment, called collagen induction therapy (CIT), seems to be appropriate for the treatment of periorbital wrinkles. Objective: To confi rm the usefulness of CIT in periorbital wrinkles treatment. Patients and methods: In total, 20 patients (12 females, 8 males; between 50-65 years of age) with periorbital wrinkles were included. Each patient was treated with a specifi c tool in two sessions. Using digital cameras, photos of all patients were taken to evaluate wrinkles' depth, and silicone rubber was used to make a microrelief impression of the wrinkles. The photographic data were analysed by using the sign test statistic (α < 0.05). Skin layer data were analysed by computerized image analysis. Results: Analysis of the patient photographs, supported by the sign test, and the degree of irregularity of the surface microrelief, supported by Fast Fourier Transform and by wrinkle's image processing, showed that, after only two sessions, the wrinkles' severity grade in most patients was greatly reduced. Conclusion: The present study suggests that CIT can be a suitable technique to improve periorbital wrinkles.

Biorejuvenation: theory and practice.

The aim of mesotherapy for skin rejuvenation is to increase the biosynthetic capacity of fibroblasts, inducing the reconstruction of an optimal physiologic environment, the enhancement of cell activity, and the synthesis of collagen, elastin, and hyaluronic acid. The desired final effect is a firm, bright, and moisturized skin, and the injection in the superficial dermis of suitable products--perfectly biocompatible and totally absorbable--can achieve these results. In addition to a daily sunscreen application and nonsmoking, mesotherapy is another antiaging strategy helping to maintain a globally firm and bright skin, protecting it from the environmental contributors to aging.