577-nm high-power optically pumped semiconductor laser is safe and effective in the treatment of inflammatory acne: a prospective, single-center, split-face comparative study.

OBJECTIVE: This study aimed to appraise the efficacy of a 577-nm high-power optically pumped semiconductor laser (HOPSL) for the treatment of inflammatory acne. METHODS: The study included 50 patients with acne vulgaris (inflammatory type), 14 men, and 36 women; patient ages ranged from 16 to 35 years. The left side of the face was treated with a single pass of a 577-nm high-power optically pumped semiconductor laser (HOPSL) every 2 weeks for 3 sessions. The severity of acne examined prior to the first session and 4 weeks after the last session (Investigator's Global Assessment of acne severity, IGA; single lesion count). RESULTS: At baseline, no statistically significant difference in the severity of inflammatory acne lesions between both sides was observed. One month after the final session, a significant improvement (IGA reduction of > 50%) of the overall severity of acne was observed in 49 patients (98%) on the laser-treated side versus 41 (82%) the control side of the face (P < .05). Hence, we found a significant reduction in the mean percentage of inflammatory papules, pustules, and nodules on the laser-treated versus the control side (79.33 vs 56.92, 78.04 vs 43.33, 64.85 vs 21.93%, respectively) (P < 0.05). Side effects in the form of erythema and irritation during sessions were transient and tolerated by the patients. CONCLUSION: The 577-nm high-power optically pumped semiconductor laser is effective and safe for the treatment of inflammatory lesions (papules, pustules, and nodules) in acne patients.

Efficacy of non-ablative fractional 1440-nm laser therapy for treatment of facial acne scars in patients with rosacea: a prospective, interventional study.

Acne scarring is one of the most common facial skin disorders. The appropriate treatments for acne scars in patients with rosacea have not been studied. This study was designed to evaluate the efficacy and safety of non-ablative fractional 1440-nm laser (1440-nm NAFL) therapy for treatment of atrophic acne scars in patients with rosacea. In this prospective, interventional study, 32 patients with rosacea and acne scars underwent three sessions of 1440-nm NAFL therapy. Therapy efficacy, epidermal barrier function, and side effects were evaluated. Thirty patients completed and the median acne scar scores significantly reduced from 45 (30, 50) to 15 (15, 30) after three treatments (P < 0.001). The improvement score of acne scars was 2.7 ± 0.7; 22 (73.3%) were satisfied or highly satisfied. The rosacea erythema scores changed from 2.1 ± 0.4 to 1.9 ± 0.5 (P = 0.326), and flushing, burning, and stinging were not worse. The oil content after treatments was significantly reduced (P < 0.001), while there was no significant difference in other indicators of skin barrier function. The quality-of-life score decreased from 17.5 ± 3.8 to 14.1 ± 3.0 (P < 0.001). No serious side effects were observed. The 1440-nm NAFL therapy is effective in the treatment of acne scaring in patients with rosacea with little damage to the skin barrier.

1064-nm Q-switched fractional Nd:YAG laser is safe and effective for the treatment of post-surgical facial scars.

Post-surgical facial scars are often associated with unaesthetic outcome. Treatment of these scars using various lasers could be beneficial; however, the use of the Q-switched fractional (QSF) 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has yet to be evaluated for this indication. Our objective was to determine the safety and efficacy of a QSF-Nd:YAG laser for the treatment of post-surgical facial scars. Eleven (5 male, 6 female) patients who underwent facial surgery with significant scarring were treated using the QSF-Nd:YAG laser. Scars were exposed to 600-1200 mJ/stacked pulses (12-24 mJ per pixel), emitted at a rate of 10 Hz for up to 2 passes per treatment session, receiving overall 3-6 treatments. Patient follow-up was 3 months. Scars' photographs were blindly assessed by two dermatologists, who graded them on a scale of scar severity from 1 to 5 (1 = least severe, 5 = most severe) before and after treatment. A blinded before/after recognition of these photographs was also performed. Patient satisfaction was assessed 3 months post-treatment and graded on a scale of 1-5 (1 = not satisfied, 5 = very satisfied). Pain perception and adverse effects were also evaluated. Patients demonstrated a decrease in scar severity score by a mean of 1.57 points (p = 0.0005). A blinded before/after recognition was correct in 86.5% of the cases. Pain and adverse effects were mild and transient. Patient satisfaction was high (4.2). QSF-Nd:YAG laser is a safe and effective modality for the treatment of post-surgical facial scars.

The efficacy of a single-session pro-yellow laser in the treatment of facial telangiectasia.

Facial telangiectasia (FT) is a condition in which small dilated vessels visibly protrude on the surface of the skin. The aim of this study was to evaluate the efficacy and safety of a single-session pro-yellow laser in the treatment of FT and spider angioma (SA) to compare it with a limited number of studies conducted on this subject. In this pilot study, we reviewed 41 patients who admitted to our dermatology clinic with FT and SA and were treated by using pro-yellow laser. The efficacy of the treatment was evaluated using the recorded clinical information and digital camera images. The improvement was graded as complete (90-100%), very good (75-89%), good (50-74%), moderate (25-49%), and weak (< 25%). Of the 41 patients included in the study, 37 (90.2%) had FT and four (9.8%) had SA. Twenty-two patients were female and 19 were male. Pro-yellow laser therapy was generally well tolerated by patients, and minimal pain occurred during the application. In 1-month follow-up, good, very good, or complete recovery was achieved in 51.4% of the FT patients. The new pro-yellow laser only has a yellow light wavelength. Its unique wavelength at 577-nm yellow light is ideal for vascular lesions. In this study, 51.4% of the patients with FT achieved good, very good, or complete improvement after a single session of 577-nm pro-yellow laser, and complete improvement was achieved in all the four patients with SA.

Effect of a Face-Aging Mobile App-Based Intervention on Skin Cancer Protection Behavior in Secondary Schools in Brazil: A Cluster-Randomized Clinical Trial.

Importance: Because exposure to UV radiation early in life is an important risk factor for melanoma development, reducing UV exposure in children and adolescents is of paramount importance. New interventions are urgently required. Objective: To determine the effect of the free face-aging mobile app Sunface on the skin cancer protection behavior of adolescents. Design, Setting, and Participants: This cluster-randomized clinical trial included a single intervention and a 6-month follow-up from February 1 to November 30, 2018. Randomization was performed on the class level in 52 school classes within 8 public secondary schools (grades 9-12) in Itauna, Southeast Brazil. Data were analyzed from May 1 to October 10, 2019. Interventions: In a classroom seminar delivered by medical students, adolescents' selfies were altered by the app to show UV effects on their future faces and were shown in front of their class, accompanied by information about UV protection. Information about relevant parameters was collected via anonymous questionnaires before and 3 and 6 months after the intervention. Main Outcomes and Measures: The primary end point of the study was the difference in daily sunscreen use at 6 months of follow-up. Secondary end points included the difference in daily sunscreen use at 3 months of follow-up, at least 1 skin self-examination within 6 months, and at least 1 tanning session in the preceding 30 days. All analyses were predefined and based on intention to treat. Cluster effects were taken into account. Results: Participants included 1573 pupils (812 girls [51.6%] and 761 boys [48.4%]; mean [SD] age, 15.9 [1.3] years) from 52 school classes. Daily sunscreen use increased from 110 of 734 pupils (15.0%) to 139 of 607 (22.9%; P < .001) at the 6-month follow-up in the intervention group. The proportion of pupils performing at least 1 skin self-examination in the intervention group rose from 184 of 734 (25.1%) to 300 of 607 (49.4%; P < .001). Use of tanning decreased from 138 of 734 pupils (18.8%) to 92 of 607 (15.2%; P = .04). No significant changes were observed in the control group. The intervention was more effective for female students (number needed to treat for the primary end point: 8 for girls and 31 for boys). Conclusions and Relevance: These findings suggest that interventions based on face-aging apps may increase skin cancer protection behavior in Brazilian adolescents. Further studies are required to maximize the effect and to investigate the generalizability of the effects. Trial Registration: ClinicalTrials.gov Identifier: NCT03178240.

Facial treatment with acoustic wave therapy for improvement of facial skin texture, pores and wrinkles.

BACKGROUND: A frequent demand among the female and male population is the reduction of facial wrinkles and pores, and additionally, the improvement of the facial skin texture preferentially achieved by noninvasive treatments. AIMS: The objective of this study was to demonstrate the efficacy and safety of acoustic wave therapy (AWT) and extracorporeal pulse activation therapy (EPAT) technology using mechanical waves in the treatment of facial skin. METHODS: Treatment was performed on the face of 12 patients, with the D-ACTOR 200 (Storz Medical AG) using radial acoustic wave technology, EPAT. Within 6 weeks, six acoustic wave treatment sessions have been performed. A follow-up visit was performed 6 weeks after the last treatment. RESULTS: Measurements with the 3D camera system clearly and objectively demonstrate a significant diminution in facial wrinkles and pores. Additionally, an improvement in skin texture was recognized. CONCLUSIONS: This study, although performed on a small number of patients, tends to show the safety and efficacy of radial AWT in treating facial wrinkles, skin texture, and pores and in a noninvasive way.

Short pulse intense pulsed light versus pulsed dye laser for the treatment of facial redness.

Treating diffuse facial redness with an intense pulsed light (IPL) source usually requires multiple sessions and may not achieve complete clearance. The 595 nm pulsed dye laser (PDL) enjoys a good reputation for reducing facial redness with non-purpuric settings. The objective of this study was to compare facial redness reduction using these two devices. After establishing the lowest light dose able to achieve transient purpura for the same pulse width of 1,5 ms with each technology, right and left sides of the face were randomly assigned for each type of treatment. There were two treatment sessions 4 weeks apart and the final evaluation was performed 8 weeks after thesecond treatment. Four blinded experienced dermatologists analyzed pre and post-treatment photographs, which demonstrated an average of 60% improvement on the segment treated with the IPL as opposed to 45% on the other segment. Pain level was described as mild and the procedure was well tolerated for both types of treatment. In this study we showed that short-pulsed intense pulsed light and PDL are similar in decreasing facial redness when non-purpuric low fluence settings are used. The IPL was faster and did not have consumables.

Systematic review and meta-analysis of safety and efficacy of high-intensity focused ultrasound (HIFU) for face and neck rejuvenation.

High-intensity focused ultrasound (HIFU) is widely used for skin rejuvenation and tightening. The aim of this study was to determine the safety and efficacy of HIFU for face and neck rejuvenation. A systematic search of peer reviewed articles published before December 2017 was performed using Medline, Web of Science, and Scopus databases. Retrieved studies were screened, and clinical trials or follow-up studies which were evaluated the effect of HIFU on rejuvenation treatments of face and neck area were included. Risk of bias for each study was assessed and was reported. Safety and efficacy variables, which were reported more often in papers, were included in meta-analysis. Seventeen studies involving 477 participants were included in the analysis. Meta-analysis showed moderate improvement as scores of 2.74 (95% CI 2.06-3.43) and 2.68 (95% CI 1.92-3.45), out of 5 maximum score, for objective improvement score and subjective satisfaction score, respectively. Meta-analysis of mean pain score, assessed by a 0-10 Likert score, was 4.2 (95% CI 4.27-5.19). Edema and erythema showed considerable heterogeneity, and no hyperpigmentation was reported by included studies. Included studies used multiple and different outcome variables with different scoring at various time points. Long follow-up was not reported by majority of studies. HIFU is safe procedure in short term and has a moderate effect on rejuvenation of face and neck areas.

Face and neck rejuvenation using an improved non-ablative fractional high power 1064-nm Q-switched Nd:YAG Laser: clinical results in 16 women.

OBJECTIVE: To evaluate the safety and efficacy of a specific treatment protocol using a new and improved non-ablative fractional high-power 1064-nm Q-switched Nd:YAG laser for face and neck rejuvenation. METHODS: Sixteen women, aged 30 to 60 years old, were selected to undergo three consecutive treatment sessions with this new laser at maximum energy (2,400 mJ/pulse, Clear Lift laser®-Harmony XL-Pro, Alma Lasers Ltd.). Face and neck were treated in eight patients, respectively. Each treatment used the same protocol. The efficacy was evaluated by the therapist (TS), the patient (PS), and two separate independent experts who were blind to the study (E1 and E2). RESULTS: According to E1 and E2, the mean reduction in signs of skin aging on a Global Esthetic Improvement Scale was 30-40%. Using a 0-10 points scale, TS and PS mean (range) satisfaction rates were 9.0 (8-10); 9.2 (6-10) for the face and 8.7 (8-10); 8.0 (3-10), for the neck, respectively. The procedure was practically painless, no significant adverse effects were observed, and the patients returned to their daily and work activities without downtime. CONCLUSION: This laser was safe and effective for face and neck minimally invasive rejuvenation, with excellent results using our usual routine use conditions.

Will Repeated Ablative Er:YAG Laser Treatment Sessions Cause Facial Skin Sensitivity? Results of a 12-Month, Prospective, Randomized Split-Face Study.

Whether multiple laser irradiations affect skin sensitivity is still elusive. We aimed to investigate if repeated ablative erbium:yttrium-aluminum-garnet (Er:YAG) laser therapy could cause or increase skin sensitivity in the treatment areas. Nineteen healthy females received three sessions of a randomized, split-face, Er:YAG laser treatment in a scanning ablative mode (MicroLaserPeel™), with a 6-mm spot size, 8-µm ablative depths, and 30% of pulse overlap first. The next round was conducted in the fractional mode (ProFractional™) at depths ranging from 100 to 150 µm, with one pass by at coverage of 11% in the coagulation mode. Objective biophysical parameters, including transepidermal water loss (TEWL), skin glossiness, epidermal and dermal thickness and density, sensory nerve current perception threshold (CPT), and local blood flow, were measured before and after treatment. Quantitative evaluation of the Er:YAG laser treatment's effect on skin sensitivity is presented. Seventeen volunteers completed a follow-up of 12 months. On days 1 and 3, skin TEWL and epidermal thickness increased, while glossiness decreased. On day 7, there was no significant difference in the skin barrier function between the treated and the control side. Similarly, there was no significant difference in CPT values or local microvascular blood flow between sides at any time point before or after treatment, except that the local microvascular blood flow on the treated side was higher on the first day post-treatment. Er:YAG laser treatment does not influence skin sensitivity in healthy subjects in a long-term follow-up.

Perception of the blue light effect on Korean women's faces using the blue pearl pigment.

BACKGROUND: Transparent-looking skin is an objective of facial makeup products. However, this effect of makeup products has not been investigated to Korean women's faces. MATERIALS AND METHODS: We investigated the perception of blue light on women's faces using the blue pearl pigment. We compared colors and/or spectra of naked skin, standard makeup powder foundation (standard foundation), and test makeup powder foundations containing the blue pearl pigment 10% (w/w) (pearl foundation) or (ultramarine blue) blue pigment 0.2% (w/w) (pigment foundation) on real women's faces (n = 6) using spectrophotometry and facial image analysis. A self-administered questionnaire showed facial images (n = 3) with applied makeup powder foundations on computer monitor (n = 35); evaluated items were blooming, transparency, smoothness, gloss, and vitality. RESULTS: In vivo, the pearl foundation showed significantly lower b* values (degree of yellowness) than did naked skin, and pigment foundation and the samples also showed significantly higher reflection of blue light (410-490 nm) than did naked skin, standard foundation, or pigment foundation. In image analysis, the image with the pearl foundation showed significantly lower quasi-b* value. On the self-administered questionnaire, the results showed that the pearl foundation had a significantly higher grade than did naked skin, standard foundation, or pigment foundation at all evaluation items: blooming, transparency, smoothness, gloss, and vitality. CONCLUSION: Blue pearl pigment creates the perception of blue light effect, including transparency and gloss in Korean women.

Split-face comparison of the picosecond 1064-nm Nd:YAG laser using a microlens array and the quasi-long-pulsed 1064-nm Nd:YAG laser for treatment of photoaging facial wrinkles and pores in Asians.

Skin photoaging manifests deeper wrinkles and larger pore size. Various lasers have been tried for rejuvenation of photoaging skin, and the quasi-long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is one promising treatment option. New types of laser device are emerging, including devices operating with picosecond pulse duration combined with a microlens array, which are regarded as a new breakthrough for skin rejuvenation. We aimed to evaluate the clinical effectiveness and safety of the picosecond 1064-nm Nd:YAG laser using a microlens array compared with the quasi-long-pulsed 1064-nm Nd:YAG laser in a split-face design. We designed a split-faced, prospective study and enrolled 25 subjects with photoaging facial wrinkles and enlarged pores. Each facial area was randomly assigned to undergo treatment with either the picosecond 1064-nm Nd:YAG laser (Pico-arm) or the quasi-long-pulsed 1064-nm Nd:YAG laser (Quasi-arm). We performed five laser sessions at 2-week intervals, and final results were assessed after 20 weeks after the initial laser session. We used a five-point global assessment scale, wrinkle and pore index derived from 3D camera analysis. We enrolled a total of 25 subjects (24 females and 1 male) with Fitzpatrick skin types III to IV and a mean age of 63.8 ± 5.7 years. After treatment, 54.2% of subjects in the Pico-arm reported at least moderate improvement in visible pores compared with 41.7% of the Quasi-arm (P = 0.001). A total of 12.5% of subjects in the Pico-arm showed moderate improvement in wrinkles versus 4.2% of the Quasi-arm (P = 0.125). There was a 41.3% reduction in the pore index in the Pico-arm compared to a 3.9% increase in the Quasi-arm (P = 0.048). There was a 16.4% reduction in the wrinkle index in the Pico-arm compared with a 0.5% reduction in the Quasi-arm (P = 0.01). Pain assessment score was higher in the Pico-arm than the Quasi-arm (3.65 ± 1.70 vs 1.28 ± 1.28, P = 0.001). No serious adverse events occurred during the study. Our findings suggest that the picosecond 1064-nm Nd:YAG laser with a microlens array is as effective as the quasi-long-pulsed 1064-nm Nd:YAG laser for treatment of photoaging wrinkles and pores.

Comparison of efficacy and safety of fractional radiofrequency and fractional Er:YAG laser in facial and neck wrinkles: Six-year experience with 333 patients.

Lasers and other light sources are popular treatment options for facial rejuvenation in recent years. In this study, we aimed to compare the efficacy and safety of fractional radiofrequency (RF) and fractional Erbium: YAG (Er:YAG) laser for facial and neck skin wrinkles, objectively. Three hundred and thirty-three patients treated with fractional RF and fractional Er:YAG laser were evaluated by two blinded dermatologists. Fractional Er:YAG laser was more effective for the periorbital area; whereas fractional RF treatment was more effective for perioral, nasolabial and jawline areas. There was no statistically significant difference in side effects between two treatment groups. In conclusion, both modalities significantly improve skin wrinkles; however, it should be considered that there may be regional differences between the treatment outcomes of them.

Clinical impacts of sun exposures on the faces and hands of Japanese women of different ages.

OBJECTIVE: To assess the impacts of sun exposures on some skin signs on the faces and hands of differently aged Japanese women, according to their distinct behaviours towards vis à vis sun exposure. METHODS: Two comparable cohorts of Japanese women (aged 18-83 years) were created according to their usual behaviour towards sun exposure i.e. non-sun-phobic (N = 495) and sun-phobic (N = 516) and through their regular use(s) of a photo-protective product. Standard photographs (full-face and 45° lateral) allowed to focus on 18 facial signs that were graded by 15 experts, using a referential skin ageing Atlas. From these two cohorts, two sub-cohorts (114 and 122 women) were created with regard to the similar clinical aspects of the dorsal side of their hands (Left vs. Right) that were further graded. Absolute differences in the scores of each sign were used (non-sun-phobic minus sun-phobic), by age-ranges, to better ascertain the impact of sun exposures and photo-protection. RESULTS: Facial signs related to skin wrinkles/texture and pigmentary spots were found significantly more accentuated among non-sun-phobic women and show an early onset (20-30 years). Facial sagging and crow's feet wrinkles appear delayed (30-40 years). The severity of vascular disorders was found to be similar in the two cohorts. The absolute differences in the grading's of almost all signs were unsurprisingly found increased with advancing ages, illustrating the combination of chronological and photo-ageing processes. With regard to hands, differences in skin texture and pigmentary disorders are of a late onset (40-50 years) and were found much increased at older ages. The cutaneous signs of the hands of Japanese women can hardly be taken as reliable markers of their photo-ageing status. CONCLUSION: The present work illustrates, for the first time, some specificities of the impact of sun exposures on the facial skin of Japanese women, pinpointing the fact that some facial signs are of an early onset. Results significantly confirm the importance of both sun avoidance coupled with photo-protective measures.

OBJECTIF: D'évaluer les impacts de l'exposition solaire sur plusieurs signes du visage et des mains de femmes Japonaises d'âge différents, selon leurs différents comportements vis-à-vis de l'exposition solaire. MÉTHODES: Deux cohortes comparables de femmes Japonaises (âgées de 18 à 83 ans) ont été créées selon leur comportement habituel vis à vis de l'exposition solaire, phobique (N = 516) ou non (N = 495) et selon leur utilisation(s) régulière(s) de produits photo-protecteurs. Des photographies standardisées du visage de face et latérales (45°) ont permis de se focaliser sur 18 signes cliniques du visage dont la sévérité a été quantifiée par 15 experts, utilisant un Atlas de référence du vieillissement cutané. De ces deux cohortes, deux sous-cohortes ont été extraites (114 et 122 femmes) par les aspects cliniques similaires de la face dorsale de leurs mains (Gauche vs. Droite) pour être ensuite quantifiées. Les différences absolues de chaque signe (non-phobiques moins phobiques), par tranches d'âges, ont été utilisées pour mieux déterminer l'impact des expositions solaires et des routines de photo-protection. RÉSULTATS: Les signes du visage liés à la texture cutanée/rides et aux taches pigmentaires ont été trouvés significativement aggravés chez les femmes non-phobiques de l'exposition solaire et d'apparition précoce (20-30 ans) tandis que la ptose du visage ou les rides de la patte d'oie apparaissent plus tardivement (30-40 ans). La sévérité des désordres vasculaires du visage a été trouvée similaire dans les deux cohortes. Les différences absolues dans la sévérité de la plupart des signes ont été logiquement trouvées accrues avec l'âge, illustrant la combinaison du vieillissement chronologique et de celui photo-induit. Concernant les mains, les différences dans la texture cutanée et les désordres pigmentaires apparaissent significativement tardives (40-50 ans) et augmentent à des âges plus avancés. Les signes cutanés des mains des femmes Japonaises ne semblent donc pas être des marqueurs fiables du vieillissement photo-induit. CONCLUSION: La présente étude illustre, pour la première fois, quelques spécificités des impacts de l'exposition solaire sur les signes faciaux de femmes Japonaises, pointant le fait que certains sont d'apparition précoce. Les résultats confirment de manière significative l'importance d'éviter les expositions solaires et de recourir à des mesures photo-protectrices.

"I don't mind being ugly but I don't wanna have skin cancer": A qualitative study of attitudes to UV exposure and a facial morphing intervention in men 35 years and older.

Objectives: Skin cancer is a growing problem globally. Older men have been largely ignored in previous research, even though men may generally be prone to riskier exposure to the sun than women. Past research suggests that appearance-focused techniques such as facial morphing can increase motivations to use sun protection among women of all ages, and younger men.Design: was qualitative, consisting of individual interviews.Methods: were semi-structured interviews with 25 older men, to examine attitudes to UV exposure and reactions to a facial morphing intervention. Interviews were subjected to thematic analysis.Results: Three themes were constructed: masculine UV exposure; appearance that's accepted; personal responsibility. The men did not identify gaps in their sun protection behaviour and demonstrated a lack of concern about ageing and appearance. These attitudes translated into a lack of motivation for behaviour change due to ageing acceptance. However, motivation to change behaviour came from health concerns resulting from the intervention.Conclusions: The men experienced different motivations and barriers for sun protection use than women of similar ages. Facial morphing can be effective with older men but may need to be reframed to focus on health implications and personal choice.

Comprehensive Treatment of Facial Deformity Due to Radiotherapy in Rhabdomyosarcoma Patients: Distraction Osteogenesis and Free Flaps Surgical Technique.

Radiotherapy is essential for achieving and maintaining local control in head and neck rhabdomyosarcoma patients. However, radiotherapy may cause outgrowth disturbances of facial bone and soft tissue, resulting in facial asymmetry.Several studies have shown that the management of irradiated bones still remains challenging. The possibility of obtaining functional and aesthetic results when managing facial deformities due to radiation therapy with distraction osteogenesis combined with free flaps reconstruction is not common and not well documented in recent literature.In this report, we present the long-term results of distraction osteogenesis and soft tissue reconstruction via microvascular free flap to correct the facial hypoplasia of a young patient who underwent radiation therapy for rhabdomyosarcoma.This is the first presentation of 26 years long-term results in a patient who also underwent free flaps reconstruction as ancillary surgery for esthetic good results.

The skin rejuvenation associated treatment-Fraxel laser, Microbotox, and low G prime hyaluronic acid: preliminary results.

Minimally invasive facial rejuvenation procedures reached an all-time high in the 2016. This reveals a growing interest in a smoother, younger, and tighter look accessible using the esthetic medicine tools like botulinum toxin and dermal filler injections, laser, and microdermabrasion. Forty-five patients from 35 to 52 years old (medium age 43.8), 38 women and 7 men underwent 5 sessions of Fraxel laser, 1 session of very low G prime HA, and Microbotox injection treatments from January 2016 and January 2017, were included in this study. In this study, we demonstrated that the usage of three treatments together, like mBTX, Volite, and Fractional laser, have a better result despite every single technique alone. The clinical result showed 98% (44 patients, 6 males, 38 females) of the patients had a smoother skin surface, brighter, more hydrated, and elastic skin; 68% of our patients (31 patients, 5 males, 26 females) showed less skin defects and staining as well as less small wrinkles, thanks to Fraxel laser treatment; 98% (44 patients, 6 males, 38 females) showed tighter skin with less sebaceous gland secretion. The aim of this study was to demonstrate that the combination of three techniques acts better and faster than single treatment to contrast facial aging and to improve skin texture and quality.

Characterization and Etiology of Swollen Muzzles in Irradiated Mice.

Several investigators performing bone marrow transplantation studies have previously reported sporadic increases in mortality that were associated with pronounced swelling in the face, head and neck of mice. Over the past few years, we and others have noted an increasing number of experiments in which mice that have received total-body irradiation (TBI) or partial-body irradiation (PBI) develop swollen muzzles, drastic thickening of the upper lip and redness, bruising and/or swelling around the nose and muzzle and sometimes over the top of the head. We refer to this rapid and extreme swelling after irradiation as swollen muzzle syndrome (SMS). The development of SMS postirradiation is associated with morbidity that occurs earlier than would be expected from the traditional hematopoietic acute radiation syndrome (H-ARS), and has impeded studies in several laboratories attempting to evaluate medical countermeasures (MCM) against radiation. However, little has been done to characterize this somewhat unpredictable radiation effect. To investigate the cause and etiology of SMS, data from three different laboratories collected over a seven-year period from 100 MCM 30-day survival studies using mice from different vendors were retrospectively analyzed to determine the time of onset, progression and incidence of SMS in male and female mice exposed to various doses of ionizing radiation. An additional study compared incidence and etiology of SMS in mice from two different vendors (identified as vendors A and B) after exposure to the LD50/30 (X rays). Mice presenting with SMS, as well as non-SMS (irradiated) control mice, were necropsied to determine microbial status of the blood, heart, spleen, liver, kidney and muzzle tissue. Only mice from vendor A (20%) developed SMS. While the number of bacterial species isolated from various tissues of SMS and non-SMS mice was not different, the number of tissues positive for bacteria was significantly greater in SMS mice. At least one tissue in 83% of SMS mice from vendor A tested positive for Streptococcus agalactiae [group B beta Streptococcus (GBS)], compared to 25% of non-SMS mice from vendor A, and 0% of non-SMS mice from vendor B. In addition, all mice from vendor A with SMS had at least one tissue with >104 CFU/g, with GBS as the predominant bacterium, compared to only 25% of non-SMS mice from vendor A, and 0% of non-SMS mice from vendor B. The incidence and magnitude of GBS growth in cultures correlated with the onset of SMS; the earliest and heaviest infections occurred in mice presenting with SMS on days 5-6 postirradiation. The majority of SMS mice (5 out of 6) had positive blood cultures, with the same bacterial strain isolated from other tissues, suggesting systemic translocation via the bloodstream. We propose that testing of mice and the identification of the microorganisms frequently associated with SMS may provide guidance for selection of antimicrobials for use by other investigators in studies evaluating potential MCM, and for the ordering, handling and care of immunodeficient mice or mice that are to be rendered immunodeficient after acute irradiation.

Efficacy and safety of picosecond 755-nm alexandrite laser with diffractive lens array for non-ablative rejuvenation in Chinese skin.

BACKGROUND AND OBJECTIVES: The picosecond alexandrite laser with diffractive lens array (DLA) offers the dual advantages of a picosecond pulse duration and the fractionated delivery of laser energy. This study explores the efficacy and safety of the DLA for treatment of multiple aesthetic concerns associated with photoaging of the face including skin texture irregularities, dyspigmentation, enlarged pore size, rhytides, and skin laxity. METHODS: This prospective, evaluator-blinded trial enrolled Fitzpatrick skin type III-IV patients with mild to moderate signs of facial photoaging. Patients received six full face treatments at 4 week intervals for a total of 107 treatments. Standardized photography was obtained at baseline and at 1, 2, and 3 month follow-up visits. Two independent blinded evaluators rated each of the five signs of photoaging on a 10-point visual analog scale (VAS) at each follow-up visit compared to baseline. A global aesthetic improvement score was also assigned at each follow-up visit. Secondary outcomes included patient-rated pain and heat sensation on a 10-point VAS, and overall satisfaction. Adverse events were noted after each treatment and at each follow-up visit. RESULTS: A total of 18 Chinese patients age 35-59 completed the study. A statistically significant improvement in skin texture and dyspigmentation scores was noted at the 1 month follow-up that was sustained at 3 months. No significant improvements wer--e observed in pore size, rhytides, or skin laxity. The mean pain score was 5.1 ± 2 and mean heat sensation was 3.6 ± 2.1. Expected transient erythema and edema occurred in 95.3% (102/107) and 1.9% (2/108) of treatments, respectively, and resolved in hours. No incidences of post-inflammatory hyperpigmentation (PIH) were noted at the 1, 2, and 3 month visits. CONCLUSION: The 755-nm picosecond laser with DLA is a safe and effective non-ablative modality for targeting facial skin texture irregularities and dyspigmentation in Chinese skin. Patients tolerated the treatment well with adverse effects limited to transient erythema and edema. Lasers Surg. Med. 51:8-13, 2019. © 2018 Wiley Periodicals, Inc.