INDIVIDUAL ARTICLE: Real-World Patient Cases Using Triple Lipid-Containing Cream for Cutaneous Healing Post Laser or Microneedling Radiofrequency Treatment.

Lipids play an essential role in skin barrier health. With age, there is a natural reduction of physiological lipids such as fatty acids, ceramides, and cholesterol. The triple lipid restore cream is a moisturizer that contains an optimized lipid ratio for aging skin. The cream contains a 2:4:2 ratio of ceramides, cholesterol, and fatty acids that have been shown to best support aging skin. The triple lipid restore cream has been used in combination with energy-based procedures, to provide patients with comprehensive integrated skincare regimens. With limited clinical data and guidelines available in regenerative medicine, real-world cases serve as an invaluable guide for patients and dermatologists in navigating rejuvenation treatment plans. J Drugs Dermatol. 2024;23:9(Suppl 1):s3-14.

Advances in the Management of Localized Scleroderma: A Systematic Review of Laser Therapy and Injectable Filler Approaches.

Localized scleroderma (LS), commonly known as morphea, presents a significant clinical challenge due to its chronic, inflammatory nature affecting the skin and potentially underlying tissues. This systematic review explores the innovative approach of combining laser therapy and injectable fillers, specifically hyaluronic acid, for the treatment of LS. We conducted a comprehensive literature review following PRISMA guidelines, examining articles from MEDLINE/PubMed to assess the combined efficacy of these treatments in improving both esthetic and functional outcomes for LS patients. The search yielded 64 articles, with six selected for in-depth analysis for a total of nine patients, covering a range of patient demographics and treatment types. Our review highlights cases where fractional CO2 laser therapy promoted long-term tissue remodeling and instances where hyaluronic acid fillers effectively addressed skin atrophy and volume loss, enhancing both immediate and long-lasting esthetic improvements. The synergy between these treatments suggests a promising dual approach, aiming to maximize esthetic outcomes and to improve the quality of life for LS patients. This review underscores the necessity of further research to establish a comprehensive, evidence-based clinical pathway integrating both treatments for managing LS, thereby enhancing patient satisfaction and addressing the multifaceted nature of this challenging dermatological condition.

Dupilumab as Therapeutic Option in Polysensitized Atopic Dermatitis Patients Suffering from Food Allergy.

IgE-mediated food allergy is characterized immunologically by a type 1 immune response triggered upon exposure to specific foods and clinically by a broad range of manifestations and variable severity. Our understanding of food allergy within the allergic march of atopic dermatitis (AD) is still incomplete despite the related risk of unpredictable and potentially severe associated reactions such as anaphylactic shock. The aim of this pilot study was to investigate the effects of dupilumab, an IL-4/IL-13 monoclonal antibody approved for AD, on the allergic sensitization profile of patients with AD and type 1 hypersensitivity-related comorbidities, including oral allergy syndrome, anaphylaxis, and gastrointestinal disorders. We conducted an observational pilot study with a longitudinal prospective design, enrolling 20 patients eligible for treatment with dupilumab. Laboratory exams for total serum IgE, specific IgE, and molecular allergen components were performed at baseline and after 16 weeks of therapy. Our results demonstrate a statistically significant decrease in molecular components, specific IgE for trophoallergens, and specific IgE for aeroallergens following treatment with dupilumab. We suggest that modulating type 2 immunity may decrease IgE-mediated responses assessed with laboratory exams and therefore could minimize allergic symptoms in polysensitized patients. Upcoming results of randomized controlled trials investigating dupilumab in food allergy are highly anticipated to confirm its potential effect in the treatment of IgE-mediated food allergies.

Interleukin-13 Inhibitors in the Treatment of Atopic Dermatitis: The Role of Tralokinumab.

INTRODUCTION: The advent of biotechnological drugs has significantly changed the management of atopic dermatitis (AD) and the approach to the moderate-to-severe form of this chronic relapsing disease. OBJECTIVES: The aim of our review is to summarize the current literature on anti-interleukin (IL)-13 in atopic dermatitis. METHODS: A literature search was organized and a systematic review was performed to summarize the most recent evidence supporting the efficacy and safety of tralokinumab. RESULTS: Tralokinumab (anti-IL-13) 300 mg every 2 weeks subcutaneously has proven effective in several clinical trials in adults and adolescents with moderate to severe atopic dermatitis inadequately controlled with other topical or systemic therapies. Tralokinumab was found to be significantly superior in terms of efficacy in reducing Investigator's Global Assessment (IGA), Eczema Area and Severity Index (EASI) -75, Numeric Pain Rating Scale (NRS) pruritus, and Dermatology Life Quality Index (DLQI) scale numbers. During follow-up, tralokinumab was well tolerated with limited severity of adverse events. CONCLUSIONS: Tralokinumab leads to statistically significant improvements in disease severity and outcome scores. It represents an effective treatment option for adults with moderate to severe AD, but further large-scale studies are needed to verify long-term superiority over other treatments.

Evaluating the Impact of Oleocanthal and Oleacein on Skin Aging: Results of a Randomized Clinical Study.

The prevalence of skin aging and the request for effective treatments have driven dermatological research towards natural solutions. This study investigates the anti-aging efficacy of two bioactive natural polyphenols, Oleocanthal and Oleacein, in a skincare formulation. A single-blind, randomized clinical trial involved 70 participants, using a comprehensive exclusion criterion to ensure participant safety and study integrity. Participants applied the Oleocanthal and Oleacein 1% serum formulation twice daily for 30 days. The efficacy was objectively assessed using the VISIA® Skin Analysis System at baseline, after 15 days, and after 30 days. Results indicated significant wrinkle reduction in most groups. For women aged 45-79 years, the mean change was -33.91% (95% CI: -46.75% to -21.07%). For men aged 20-44 years, it was -51.93% (95% CI: -76.54% to -27.33%), and for men aged 45-79 years, it was -46.56% (95% CI: -58.32% to -34.81%). For women aged 20-44 years, the change was -25.68% (95% CI: -63.91% to 12.54%), not statistically significant. These findings highlight the potential of EVOO-derived polyphenols in anti-aging skincare, particularly for older adults. This research paves the way for further exploration into natural compounds in dermatology, particularly for aging skin management.

Clinical and Ultrasound Efficacy of Topical Hypertonic Cream (Jovita Osmocell®) in the Treatment of Cellulite: A Prospective, Monocentric, Double-Blind, Placebo-Controlled Study.

Background and Objectives: Cellulite, or edemato-fibro-sclerotic panniculopathy (EFP), is characterized by dermal and hypodermal changes leading to adipose tissue accumulation and compromised venous circulation. This study investigates the efficacy of a hypertonic cream containing concentrated sodium chloride (Jovita Osmocell®) in addressing water retention and structural alterations in adipose tissue, aiming to interrupt the cellulite formation process. Materials and Methods: A 12-week, prospective, monocentric, double-blind, placebo-controlled study enrolled 30 female subjects with grade II or III cellulite. Patients were randomized to receive hypertonic cream or a placebo. Thigh circumference, ultrasound evaluations, and standardized photographs were collected at baseline, intermediate, and endpoint visits. Adverse events were monitored. Results: After 84 days, the hypertonic cream group exhibited a significant reduction in thigh circumference compared to the placebo group (p = 0.0037). B-mode ultrasound examinations revealed significant changes in the parameters studied, such as the thickness of the subcutaneous tissue. No statistically significant changes were noticed in the placebo group. Volunteers reported the investigational product's pleasantness and good anti-cellulite activity, with no reported adverse events. Conclusions: The hypertonic cream demonstrated efficacy in reducing thigh circumference, addressing water retention and structural alterations in adipose tissue. The proposed mechanism involves osmosis, releasing accumulated fluids between fat cells, supporting drainage, and reducing inflammation. This study supports the efficacy and safety of hypertonic sodium chloride emulsions in cellulite treatment and confirms safety and user satisfaction.

Melasma and reflectance confocal microscopy: from baseline to treatment monitoring.

Melasma is a frequent condition worldwide, and it represents one of the most challenging disorders to treat in cosmetic dermatology. One of the critical factors for treatment prognosis is the assessment of the depth and distribution of pigment within the hyperpigmented area. Nowadays, non-invasive skin imaging techniques, such as reflectance confocal microscopy (RCM), have been used to estimate pigment distribution and depth within different skin layers. This article aims to provide a systematic review of RCM applications in melasma, providing terminology and investigating characteristics of melasma at baseline and after medical and laser treatment. Our results support the recognition of two main types of melasma, epidermal and mixed type, thanks to the role of RCM in highlighting the precise pigment depth location in the skin non-invasively. RCM treatment monitoring enables the objectification of pigment variations after treatment and the identification of prognostic factors for different treatment modalities. After the era of the application of RCM as a technique applied strictly to skin cancers, additional cosmetic applications are emerging, such as the application of melasma treatment monitoring.

An Innovative Dual-Wavelength Laser Technique for Atrophic Acne Scar Management: A Pilot Study.

Background and Objectives: Acne scars are one of the most disturbing and long-term symptoms of acne vulgaris, having a negative impact on a person's physical, emotional, and social well-being. Aim: the purpose of the study was to evaluate the efficacy and post-treatment outcomes of a dual-wavelength system combining the irradiation of two wavelengths at 10,600 nm and 1540 nm in the management of facial atrophic acne scars. Materials and Methods: Four healthy adult volunteers aged 24-53 years were enrolled. The areas treated were the full face (two patients), cheeks (one patient), and forehead (one patient). A dual-wavelength system (1540 nm and 10,600 nm) was used for this study. Patients underwent 2-4 treatment sessions, and the treatments were performed once every 45-90 days. All possible side effects such as burning sensation, dyschromia, mild to moderate post-treatment erythema, bleeding, itching, edema, and crusting were checked. The index to assess edema and erythema was based on a four-point scale (none, mild, moderate, and severe) and was applied before and at 3-month follow-up (3 MFU) after the last treatment session. In addition, a patient assessment was conducted before treatment and at 3 MFU after the last treatment session. Results: For all patients examined, the edema index was mild, while for the erythema index, 3/4 patients experienced moderate and 1/4 patients experienced mild symptoms. The mean patient downtime was 5.8 ± 0.5 days. Concerning the patient assessment, 2/4 subjects showed excellent improvement, 1/4 patients showed good improvement, and 1/4 patients showed slight improvement. As shown by the photographic assessment, a noticeable improvement in skin texture and a substantial reduction in acne scars were observed at the end of treatment. Conclusions: This dual-wavelength laser technology has the potential to be an interesting and safe approach for acne scar treatment, with a low risk of scarring/hypopigmentation and a shorter healing time.

Laser Impacts on Skin Rejuvenation: The Use of a Synergistic Emission of CO2 and 1540 nm Wavelengths.

Background and Objectives: For nearly 15 years, carbon dioxide (CO2) laser has been the gold standard in skin rejuvenation. Aim: The purpose of this study was to assess the efficacy of a new laser device which combines CO2 and 1540 nm wavelengths in wrinkles reduction, using a recently developed scanning unit named the µScan DOT scanner. Materials and Methods: A total of 20 female patients underwent from two to four laser treatment sessions performed once every 45-90 days. Wrinkles reduction was evaluated using the Fitzpatrick Wrinkle Classification System (FWCS). Evaluations of five-point Global Patient's Assessment (PGA) and an Oedema and Erythema index based on a four-point scale were carried out. A careful photographic evaluation was performed to observe the patients' aesthetic improvements. All the assessments were performed before and at 3 months follow up (3 MFU) after the last treatment session. Results: The mean FWCS score significantly (p < 0.01) decreased from 5.45 ± 2.21 at baseline to 3.3 ± 1.78 at 3 MFU after the last treatment session. In total, 8/20 (40%) subjects reported excellent improvement, 7/20 (35%) subjects showed good improvement, 5/20 (25%) subjects showed slight improvement, and 0/20 (0%) subjects showed no improvement. Concerning the Oedema index, 15/20 subjects experienced a mild one, 5/20 subjects experienced a moderate one, and none of 20 experienced a severe one, while for the Erythema index, 1/20 patients experienced mild, 18/20 patients experienced moderate, and only 1/20 patient experienced severe erythema. No severe adverse events were observed. Conclusions: This dual-wavelength laser technique may become a promising new option for safe, nonsurgical improvement for skin rejuvenation with an extremely low risk of scarring or hypopigmentation and shorter healing times.

Laser Treatment Monitoring with Reflectance Confocal Microscopy.

Laser treatments have become popular in Dermatology. In parallel to technologic development enabling the availability of different laser wavelengths, non-invasive skin imaging techniques, such as reflectance confocal microscopy (RCM), have been used to explore morphologic and qualitative skin characteristics. Specifically, RCM can be applied to cosmetically sensitive skin areas such as the face, without the need for skin biopsies. For these reasons, apart from its current use in skin cancer diagnosis, our systematic review reveals how RCM can be employed in the field of laser treatment monitoring, being particularly suitable for the evaluation of variations in epidermis and dermis, and pigmentary and vascular characteristics of the skin. This systematic review article aims to provide an overview on current applications of RCM laser treatment monitoring, while describing RCM features identified for different applications. Studies on human subjects treated with laser treatments, monitored with RCM, were included in the current systematic review. Five groups of treatments were identified and described: skin rejuvenation, scar tissue, pigmentary disorders, vascular disorders and other. Interestingly, RCM can assist treatments with lasers targeting all chromophores in the skin and exploiting laser induced optical breakdown. Treatment monitoring encompasses assessment at baseline and examination of changes after treatment, therefore revealing details in morphologic alterations underlying different skin conditions and mechanisms of actions of laser therapy, as well as objectify results after treatment.

TFOS Lifestyle: Impact of cosmetics on the ocular surface.

In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.

Blue light-emitting diodes for the treatment of localized vitiligo: A retrospective study.

BACKGROUND: Vitiligo is an autoimmune dermatological disease characterized by hypopigmented macules. Treatments include topical agents, phototherapy, and laser therapies. Different lasers should be individually chosen regarding location, extent, activity of the disease. AIMS: This article aims to demonstrate how blue LED is effective and safe, as its wavelength is very close to the UV spectrum (415 nm vs. 400 nm), but, unlike UV therapy, blue LED have not shown any long-term cancerogenic side effects. PATIENTS/METHODS: We treated 30 patients affected by vitiligo localized on different anatomical areas with blue light-emitting diodes. RESULTS: Complete repigmentation occurred in 75.33% of treated patients (22 out of 30 patients, 14 males, and 8 females). Partial repigmentation occurred in the remaining patients. CONCLUSIONS: Blue LED light may be a safe and well-tolerated way to induce repigmentation in patients affected by vitiligo.

Fractional Q-Switched 1064 nm Laser for Treatment of Atrophic Scars in Asian Skin.

Background and Objectives: Asian patients with Fitzpatrick skin type III-IV are a less studied subtype of patients in the medical literature. Q-Switched, 1064 nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser with a fractionated beam profile (QSF) is a new modality that was reported to be effective in the treatment of scars. This study aims to evaluate the efficacy and safety of QSF Nd: YAG laser in treating scars in Asian patients. Materials and Methods: A total of 29 Subjects were treated with 1064 nm QSF laser. Each patients had three treatments with a fractionated microlens array handpiece every 8 weeks). Efficacy of treatment was evaluated using the Goodman and Baron's quantitative grading scale before and 3 months after the last treatment. Results: All 29 patients treated had significant improvement of acne scars according to Goodman and Baron's Quantitative Global Acne Scarring Grading System. No side effect has been observed except some minor erythematous reactions in three patients. Conclusions: Our results confirm that the 1064 nm QSF Nd: YAG laser is a safe and effective technique for treating scars in Asians.

Comparing Traditional and in Motion Nd:YAG Laser in Hair Removal: A Prospective Study.

Background and Objectives: Hair removal is a common cosmetic problem interesting more and more patients nowadays. Various laser treatments are currently available. Alexandrite and Nd:YAG laser are the most effective procedures in lighter and darker skin phototypes, respectively. Materials and Methods: A total of 40 patients seeking hair removal in one or more body areas with skin phototypes 2-6 was recruited to perform this study. Patients were divided into two groups. One group was treated with the standard Nd:YAG hair removal procedure, while the other group was treated with a new "in motion" Nd:YAG technology. Results and hair removal rates were evaluated six months after the last treatment. Results: Out of 40 patients treated, all patients experienced hair reduction. No statistically significant difference in hair removal was noted between the two groups; however, a statistically significant reduction in pain during the procedure was observed in the group treated with the "in motion" technique. Conclusions: While traditional and "in motion" Nd:YAG techniques have similar result outcomes in hair removal, the "in motion" technology seems to guarantee a better safety profile compared with the traditional technique. A more extensive clinical study will be necessary to confirm our study's results.

Synergistic Sequential Emission of Fractional 10.600 and 1540 nm Lasers for Skin Resurfacing: An Ex Vivo Histological Evaluation.

Background: Fractional ablative and non-ablative lasers are useful treatments for skin rejuvenation. A procedure that provides the sequential application of fractional ablative followed by non-ablative laser treatment may reduce patients' downtime and deliver better cosmetic results than with either laser alone. Objective: The purpose of the current study was to demonstrate the ameliorative and therapeutic effects in skin remodeling of the synergistic use of the two laser wavelengths (fractional ablative CO2 and non-ablative 1540 nm) with three different types of pulse shapes, S-Pulse (SP), D-Pulse (DP) and H-Pulse (HP), through which the CO2 laser can emit, performing an ex vivo histological evaluation. Methods: In this prospective study, ex vivo sheep inner thigh skin was chosen due to its similarity to human skin tissue, and a histological evaluation was performed. Three irradiation conditions, using all of the three CO2 pulse shapes (alone or averaged), were investigated: (1) 10.600 nm alone, the sequential irradiation of the two wavelengths in the same perfectly controlled energy pulses (DOT) for the entire scan area; ((2) 10.600 nm followed immediately by 1540 nm; and (3) 1540 nm followed immediately by 10.600 nm). Results: When comparing ablative to sequential irradiations, the synergy of the two wavelengths did not alter the typical ablative pulse shape of the 10.600 nm laser alone. With the same CO2 pulse shape, the lesion depth did not vary with the synergy of the two wavelengths, while thermal lesion width increased compared to CO2 alone. The ablation rate was achieved, while the total thermal lesion coverage in the scanning area of CO2 - 1540 lasers was greater than when using CO2 alone and then the other sequential irradiation. Conclusions: This study provides important preclinical data for new and early uses of the novel 10.600/1540 nm dual-wavelength non-ablative fractional laser. The synergy of the two wavelengths enhanced all the benefits already available when using CO2 laser systems both in terms of tone strengthening, thanks to a greater shrinking effect, and in terms of stimulation and collagen remodeling thanks to a greater volumetric thermal effect.

Management of patients with giant basal cell carcinoma during SARS COV2 outbreak in Italy.

Basal cell carcinoma (BCC) is the most frequently occurring type of all cancers, and represents 80% of all skin cancer. The estimated lifetime risk for BCC in the white population is between 33% and 39% for men and 23% and 28% for women. Its incidence doubles every 25 years and is increasing in the young population. Death is uncommon and seems to decrease in the last years, probably due to early and better diagnosis. BCC arises from abnormal and uncontrolled growth of basal cells. It is a slow-growing tumor, therefore usually curable at an early stage with surgery or alternative treatment, such as cryotherapy, laser, photodynamic therapy, retinoids and topical agent like 5-Fluorouracil cream, imiquimod cream, and so forth. Topical treatment of superficial basocellular carcinoma is a viable option, when surgery is not an advisable treatment, especially in the case of giant basocellular carcinoma. In this subtype, imiquimod 5% cream can be a safe and effective treatment, but there are few reports in available literature. We present our case series of eight patients with superficial giant basocellular carcinoma successfully treated with imiquimod 5% cream, which showed clinical improvement after 8 weeks of treatment.

Satisfaction in Social Roles and Physical Function in Immune-mediated Inflammatory Diseases: A Cross-Sectional Study.

BACKGROUND: Although mood disorders have been well characterized in Immune-mediated inflammatory diseases, physical function and satisfaction in social roles have not yet been defined as independent domains. OBJECTIVE: The study aims to assess satisfaction in social roles and physical function alterations in an Immune-mediated inflammatory diseases population and identify associated characteristics. METHODS: Physical function and social roles satisfaction were evaluated through the Patient-Reported Outcomes Measurement System. Besides comparisons between groups, univariate and multivariable logistic regression were performed to identify independent predictors. RESULTS: Two hundred sixty-five Immune-mediated Inflammatory Diseases patients and 206 controls were recruited. Compared with controls, Inflammatory Bowel Diseases patients had impaired physical function (p<0.001), while Inflammatory Arthritis patients reported impairment in both domains (p<0.001, each). In the univariate logistic regression, gender, high school educational level, physical activity and occupation were positively associated with physical function and social role satisfaction (p<0.001; p=0.001; p<0.001; p=0.001 and p<0.001; p=0.012; p=0.008; p=0.004, respectively). Active disease and steroids were inversely associated with physical function and social roles satisfaction (p=0.033; p=0.022 and p=0.002; p=0.038, respectively). Further associations were found between age and physical function (p=0.002); biological treatment and ESR with social roles satisfaction (p<0.001; p=0.043; respectively). In the multivariable regression, gender remained associated with physical function (p<0.001) and social roles satisfaction (p=0.003). Negatively associated factors were biological treatment for satisfaction in social roles (p<0.001) and steroids for physical function (p=0.021) and social roles satisfaction (p=0.018). CONCLUSION: Immune-mediated Inflammatory diseases determine alterations in physical function and social life satisfaction. Gender and treatment are independent associated factors. Patient-Reported Outcomes should be considered in clinical management to define patients' real needs.