The evaluation of hyaluronic acid, with and without lidocaine, in the filling of nasolabial folds as measured by ultrastructural changes and pain management.

BACKGROUND: Pain management is an important objective in procedures involving dermal fillers composed of hyaluronic acid (HA). OBJECTIVE: To compare the 1-year clinical results of filling the nasolabial fold with 2 types of filler: large-gel particle HA and large-gel particle HA plus 0.3% lidocaine (HA+L). We compared the level of pain during treatment and 10 minutes after treatment and assessed the safety and efficacy profile, satisfaction, and histological findings (using reflectance confocal microscopy [RCM]). MATERIALS AND METHODS: We performed a comparative, parallel-group, double-blind trial with an external observer (blinded to the type of treatment administered). The filler was applied to the nasolabial fold in 119 patients (HA in 62 patients and HA+L in 57). Patients were followed at months 3, 9, and 12. Pain was evaluated using a visual analog scale. Efficacy and satisfaction were evaluated using the Wrinkle Severity Rating Scale and the Global Aesthetic Improvement Scale. RCM images (n=32) were taken at baseline and at months 3 and 12. RESULTS: Pain: The severity of pain was decreased in patients treated with HA+L on application (P <.001) and 10 minutes later ( P=.008). Efficacy and satisfaction: No significant differences existed between the 2 groups at months 3, 9, and 12. RCM: Skin rejuvenation occurred with a 32% increase in the height of the dermoepidermal junction at month 12 (P <.001), which was similar in both groups. Adverse events: At month 3, the most common adverse events (AEs) were erythema (68%) and hematoma (11%). No AEs were recorded at months 9 or 12. CONCLUSION: The use of HA+L provides pain relief without affecting efficacy, satisfaction, safety, or the duration of results. RCM showed that the changes in the dermoepidermal junction represented a histological improvement in the skin with similar results in both groups.

Distrofia simpática refleja: descripción de un caso con lesiones cutáneas / Reflex sympathetic dystrophy: description of a case with skin lesions

La algodistrofia simpática refleja es un síndrome mal definido en el que el paciente desarrolla un dolor desproporcionado a la causa. Se incluye dentro de los síndromes dolorosos regionales complejos. Los síntomas comienzan ante un traumatismo previo, en ocasiones trivial, y consisten en dolor urente, edema, cambios en el color de la piel, alteraciones en la vascularización, cambios de temperatura, hiperhidrosis y alteraciones cutáneas que consisten principalmente en cambios atróficos. Se han descrito otras manifestaciones cutáneas menos frecuentes en pacientes con este síndrome consistentes en pápulas, ampollas, lesiones inflamatorias e hiperpigmentación de aspecto reticulado. Presentamos el caso de un paciente con algodistrofia simpática refleja que tenía úlceras superficiales en la extremidad afectada que parecía una dermatitis artefacta

Reflex sympathetic dystrophy or algodystrophy is a poorly defined syndrome in which the patient develops pain disproportionate to the cause. It is included among the complex regional pain syndromes. The symptoms are triggered by some type of trauma, at times trivial, and consist of burning pain, edema, changes in skin color, alterations in vascularization, temperature changes, hyperhidrosis and skin disorders, which primarily consist of atrophic changes. Other less frequent cutaneous manifestations have been described in patients with this syndrome. These include papules, blisters, inflammatory lesions and reticulated hyperpigmentation. We discuss the case of a patient with reflex sympathetic dystrophy who presented with superficial ulcers on the affected limb, which mimicked dermatitis artefacta

Síndrome de Buschke-Ollendorff familiar / Family Buschke-Ollendorff syndrome

El síndrome de Buschke-Ollendorff es un trastorno de herencia autosómica dominante que cursa clínicamente con nevos elásticos y osteopoiquilia. Histológicamente la mayoría de los casos presentan en las lesiones cutáneas una cantidad normal de colágeno y aumento de fibras elásticas, aunque se han descrito formas abortivas con afectación cutánea, con disminución de fibras elásticas y ausencia de alteraciones óseas. Se describe el caso de una mujer de 41 años con criterios de síndrome de Buschke-Ollendorff y el de su hija de 2 años que podría presentar una forma de Buschke-Ollendorff abortiva

Buschke-Ollendorff syndrome is an autosomal dominant disorder whose clinical course includes elastic nevi and osteopoikilosis. Histologically, most cases present with a normal amount of collagen in the skin lesions and an increase in elastic fibers, although abortive forms with skin involvement have been described, with a decrease in elastic fibers and an absence of bone alterations. We describe the case of a 41-year-old woman with Buschke-Ollendorff syndrome criteria, and that of her 2-year-old daughter who might present an abortive form of Buschke-Ollendorff

Eczema alérgico de contacto profesional en auxiliar de odontología / Occupational allergic contact eczema in a dental assisstant

La frecuencia de eczemas de contacto profesional es muy elevada en auxiliares de dentistas. Se presenta el caso de una mujer de 46 años con lesiones pruriginosas eritematoedematosas, escamosas, de límites imprecisos en dorso y laterales de dedos de manos de varios meses de evolución. Las pruebas epicutáneas realizadas con la batería estándar del GEIDC, la dental de Chemotechnique y sus productos propios demostraron positividades para sulfato de níquel, cloruro de cobalto, dicromato potásico, tiosulfato sódico de oro, eugenol, el líquido de endodoncia denominado «eugenol», mezcla de fragancias y colofonia. El eugenol es un producto perfumado que se emplea en cementos y sellantes de endodoncia y periodontología. Hay cinco artículos con casos de eczema alérgico de contacto profesional por este producto en dentistas o enfermeras y auxiliares que trabajan en clínicas dentales

Occupational contact eczemas are very frequent in dental assistants. We present the case of a 46-year-old woman with pruritic, flaky, erythematous-edematous lesions, with indistinct borders, on the backs and sides of the fingers, which had been developing for several months. The skin tests performed with the GEIDC (Spanish Contact Dermatitis Research Group) standard battery, the Chemotechnique dental screening series and her own products showed positivity to nickel sulfate, cobalt chloride, potassium dichromate, gold sodium thiosulfate, the liquid used in endodontics known as «eugenol,» fragrance mix and colophony. Eugenol is a perfumed product that is used in cements and sealants for endodontics and periodontology. There are 5 articles regarding cases of occupational allergic contact eczema from this product in dentists or nurses and assistants who work in dental clinics

[Reflex sympathetic dystrophy: description of a case with skin lesions]. / Distrofia simpática refleja: descripción de un caso con lesiones cutáneas.

Reflex sympathetic dystrophy or algodystrophy is a poorly defined syndrome in which the patient develops pain disproportionate to the cause. It is included among the complex regional pain syndromes. The symptoms are triggered by some type of trauma, at times trivial, and consist of burning pain, edema, changes in skin color, alterations in vascularization, temperature changes, hyperhidrosis and skin disorders, which primarily consist of atrophic changes. Other less frequent cutaneous manifestations have been described in patients with this syndrome. These include papules, blisters, inflammatory lesions and reticulated hyperpigmentation. We discuss the case of a patient with reflex sympathetic dystrophy who presented with superficial ulcers on the affected limb, which mimicked dermatitis artefacta.

[Family Buschke-Ollendorff syndrome]. / Síndrome de Buschke-Ollendorff familiar.

Buschke-Ollendorff syndrome is an autosomal dominant disorder whose clinical course includes elastic nevi and osteopoikilosis. Histologically, most cases present with a normal amount of collagen in the skin lesions and an increase in elastic fibers, although abortive forms with skin involvement have been described, with a decrease in elastic fibers and an absence of bone alterations. We describe the case of a 41-year-old woman with Buschke-Ollendorff syndrome criteria, and that of her 2-year-old daughter who might present an abortive form of Buschke-Ollendorff.

[Occupational allergic contact eczema in a dental assistant]. / Eczema alérgico de contacto profesional en auxiliar de odontología.

Occupational contact eczemas are very frequent in dental assistants. We present the case of a 46-year-old woman with pruritic, flaky, erythematous-edematous lesions, with indistinct borders, on the backs and sides of the fingers, which had been developing for several months. The skin tests performed with the GEIDC (Spanish Contact Dermatitis Research Group) standard battery, the Chemotechnique dental screening series and her own products showed positivity to nickel sulfate, cobalt chloride, potassium dichromate, gold sodium thiosulfate, the liquid used in endodontics known as "eugenol," fragrance mix and colophony. Eugenol is a perfumed product that is used in cements and sealants for endodontics and periodontology. There are 5 articles regarding cases of occupational allergic contact eczema from this product in dentists or nurses and assistants who work in dental clinics.