Prospective Evaluation of the Safety and Efficacy of Thermomechanical Fractional Injury for Perioral Rhytides.

BACKGROUND: Perioral rhytides can be treated with laser and energy-based devices. More recently, a novel fractional thermomechanical skin rejuvenation system was developed to cause controlled thermal injury through direct heat transfer. OBJECTIVE: A prospective clinical trial evaluated the safety and efficacy of a thermomechanical fractional injury device (Tixel 2, Novoxel, Netanya, Israel) for perioral rhytides. MATERIALS AND METHODS: Subjects with moderate-to-severe perioral rhytides were enrolled and underwent 4 monthly treatments. RESULTS: Twenty-three subjects were enrolled and completed all study visits. Mean age was 62.5 years, and 100.0% were women. Fitzpatrick Skin Types I-IV were included. For Fitzpatrick Wrinkle Classification System (FWCS), mean baseline score was 6.9. Per investigator, there was a mean 1.9-grade improvement in FWCS at 3-month follow-up ( p < .0001). At 3-month follow-up, 8.7% (n = 2) of subjects had a 3-grade improvement, 69.6% (n = 16) had a 2-grade improvement, and 21.7% (n = 5) had a 1-grade improvement. For physician Global Aesthetics Improvement Scale at 3-month follow-up, 69.6% (n = 16) had 76% to 100% improvement, 13.0% (n = 3) had 51% to 75% improvement, and 17.4% (n = 4) had 26% to 50% improvement. There were no severe adverse events, and subjects experienced minimal pain. CONCLUSION: A novel device using thermomechanical fractional injury was demonstrated to be safe and effective in the treatment of perioral rhytides.

Direct-to-consumer dermatology-related advertising differs in magazines targeted to women of color: A cross-sectional analysis of top-circulating consumer magazines.

BACKGROUND: Advertisements for dermatology-related products in consumer magazines serve as a potential source of health literacy, which varies by demographic group. OBJECTIVE: This study sought to examine differences in advertisements for dermatology-related products in the top U.S. consumer magazines targeted at women of color compared with three other demographic groups: teenagers, adult women, and adult men. METHODS: Dermatology advertisements in the most circulated U.S. consumer magazines targeting these four demographic groups were analyzed. Descriptive statistics were obtained. Simple logistic regressions were used to compare the product indications, language used, and the sex, age, ethnicity, and skin type of models between magazine categories. Limitations of this study included that certain magazines could not be included due to a lack of accessibility, and subjective assessments were made when necessary because not all data collected were explicitly stated. RESULTS: Significant differences exist in print media advertising for women of color in comparison with other demographic groups, including skin-of-color magazines having an increased number of darker-skin models, more advertisements related to products that target pigmentation, and differences in advertisement word choices. CONCLUSION: The differences in print media advertising for women of color in comparison with other demographic groups may influence the dermatologic concerns of this population, including their dermatology-related knowledge base, grooming practices, beauty perceptions, and utilization of dermatology as a specialty.

Lichen sclerosus among women in the United States.

BACKGROUND: Vulvar lichen sclerosus (LS) is a chronic dermatosis for which the true prevalence is not well established. LS remains an underrecognized and undertreated disease, and treatment patterns and differences among various specialties that care for patients with LS are largely unknown. OBJECTIVE: This study sought to determine the prevalence of diagnosed vulvar LS, demographic characteristics, and diagnostic and treatment patterns in the United States. METHODS: A database comprising >21.7 million women with commercial insurance in the United States was analyzed, and the largest cohort of patients with LS in the United States to date was identified. RESULTS: We found that obstetricians/gynecologists are diagnosing and managing approximately half of women with LS, and regardless of specialty, the majority of providers are appropriately prescribing high-potency topical steroids. CONCLUSION: Our results suggest that LS may truly be underrecognized and underdiagnosed, especially in younger women.

Camouflaging vitiligo using a spray tan.

Vitiligo is a depigmenting skin disorder that can cause significant patient distress. Treatment of vitiligo is challenging and should address patient's concern for cosmetic treatment. Herein, we report the case of a 60-year-old patient who achieved temporary improvement in pigmentation using a spray tan. Camouflaging vitiligo using a spray-tan is a reasonable, safe, and effective mechanism for management of vitiligo.

Comparison between organismal staining on histology and tissue culture in the diagnosis of cutaneous infection: A retrospective study.

BACKGROUND: In instances of suspected cutaneous infection, the standard of care includes obtaining skin biopsy specimens for histology and tissue culture. Few studies have compared the clinical utility of each test. OBJECTIVE: To assess the concordance of results between tissue culture and histology, as well as the clinicopathologic features that may influence the diagnostic yield of each test. METHODS: A retrospective review of all patients who underwent skin biopsy for histology and tissue culture at New York University from 2013 through 2018. RESULTS: Of 179 patients, 10% had positive concordance, 21% had positive tissue culture only, and 7% had positive histology only. We calculated a kappa correlation coefficient of 0.25 between histology and tissue culture (reference, 0.21-0.39 indicates minimal agreement). Histology exhibited higher sensitivity in detecting fungi, whereas tissue culture was more sensitive in identifying Gram-negative bacteria. Antimicrobial use before biopsy led to significantly fewer positive cultures (37.5% vs 71%; P = .023) in patients ultimately diagnosed with infection. LIMITATIONS: This study was conducted at a single institution, thereby restricting its broad applicability. The lack of a validated criterion standard to diagnose infection also limits interpretation of the results. CONCLUSION: Tissue culture and histopathology often yield discordant results. Dermatologists should recognize specific limitations, yet high clinical utility in special circumstances, of tests when approaching cases of suspected infection.