Prospective evaluation of incobotulinumtoxinA in the management of the masseter using two different injection techniques.

BACKGROUND: IncobotulinumtoxinA (Xeomin Cosmetic®) has been used previously in the management of masseteric hypertrophy. However, a standardized injection technique has not been established. The goal of the present study was to evaluate the efficacy and safety of two injection techniques in the management of masseteric hypertrophy using incobotulinumtoxinA. METHODS: Thirty female patients with masseteric hypertrophy were recruited and evenly randomized to receive bilateral treatments of either a single-injection technique (SIT) or a multiinjection technique (MIT). Improvement of masseteric hypertrophy was assessed at week 16 using standardized measurements and photographs. Patients completed a 5-point satisfaction questionnaire while physicians completed the Global Aesthetic Improvement Scale (GAIS) and 10-point photonumeric masseter prominence rating scale. RESULTS: There were no significant differences in physician ratings on the photonumeric scale and GAIS between the SIT and MIT groups. Results of the standardized measurements also revealed no significant difference between injection techniques. Majority of patients at every visit reported being "satisfied" with treatment results. Clinically, the number and severity of adverse events were similar between groups. CONCLUSION: This study supports the noninferiority of both SIT and MIT with regard to efficacy and safety in the management of masseteric hypertrophy, using incobotulinumtoxinA.

A Pharmacogenetic Study of Psoriasis Risk Variants in a Greek Population and Prediction of Responses to Anti-TNF-α and Anti-IL-12/23 Agents.

INTRODUCTION: Psoriasis is a highly divergent disease with many disease phenotypes, but there are currently no established biomarkers to predict the therapeutic outcomes of systemic treatments. With the introduction of biologic therapies during the last decade and with new treatments constantly emerging, there is a great need to validate biomarkers that have been reported to be associated with treatment response, and to introduce new biomarkers of possible clinical value. METHODS: In the current study, we aimed to investigate the association of psoriasis-related polymorphisms that have previously been reported to effect the anti-tumor necrosis factor alpha (anti-TNF-α) therapies (etanercept, adalimumab, and infliximab) and anti-interleukin-12/23 (anti-IL-12/23) biologic therapy (ustekinumab) in a Greek cohort of psoriasis patients. RESULTS: Rs10484554 in the HLA-C gene showed an association with a good response to anti-TNF-α agents but not to ustekinumab, while rs151823 and rs26653 in the ERAP1 gene showed associations with a good response to anti-IL-12/23 therapy. CONCLUSION: This study is the first in the field of pharmacogenetics in Greek psoriasis patients. Further, larger studies are required to validate our findings and replicate them in various populations.

Childhood and adolescent psoriasis in Greece: a retrospective analysis of 842 patients.

BACKGROUND: Childhood and adolescent psoriasis is not an uncommon disease, but epidemiological information from a large series of studies is still lacking. OBJECTIVE: Our purpose was to present the demographics, clinical features, and outcome of psoriasis appearing in Greek patients from infants up to adolescents. METHODS: We conducted a retrospective analysis of 842 children and adolescents who diagnosed with psoriasis over a period of twenty years. RESULTS: The mean age of psoriasis onset was 7.33 years, and the sex distribution was equal between boys and girls. Plaque-type psoriasis was the most frequent type (82.1%), followed by perianal, inverse, and guttate. The limbs and the scalp were the main body areas affected. The affected body surface area (BSA) was more than 10% in only 1.7% of patients, and the overall disease manifestations were considered to be mild. Psoriatic nails were detected in 11.8% of patients, while psoriatic arthritis in only six (0.7%) patients. An additional autoimmune disease was present in 3.8% of patients, and 16.7% had a positive family history for first-degree relatives. The main choice of therapy was topical treatment. CONCLUSION: Gender distribution, type of psoriasis, and body area affection is almost the same as in adults. Most of the patients presented with mild disease of little extent, possibly indicating the favorable effect of sun in a Mediterranean country. The most often prescribed treatment for the majority of patients was topical.