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Background: Microfocused ultrasound with visualization (MFU-V) and calcium hydroxylapatite (CaHA) filler are modalities for improving skin laxity. Their use in combination on body sites other than the face is expanding. Objective: To investigate the effectiveness and safety of combination MFU-V and dilute CaHA (dCaHA) for lower anterior thigh and knee laxity over 12 and 24 weeks. Methods: Twenty women (40-71 years) with moderate to severe laxity of the anterior thigh and knee were enrolled in this split-body trial. Subjects received dual-depth (3.0mm, 1.5mm) or triple-depth MFU-V (4.5mm, 3.0mm, 1.5mm) to the inferior anterior thigh (127-381 lines) along with dCaHA (1:1 normal saline) injection (0.5-3mL). Clinical effectiveness was monitored using photography, qualitative clinician and subject assessments, and quantitative analysis of skin topography by three-dimensional imaging and dermal thickness by optical coherence tomography. Results: At 12 and 24 weeks, the treated thigh and knee experienced significant improvement in qualitative clinician scales (p<0.01), with subjective improvement on photography and subject-reported assessments; no significant changes were noted by quantitative measures. Adverse events were reported in 68 percent of patients, including mild bruising (n=12) and swelling (n=10). Conclusion: Combining MFU-V and dCaHA is safe and results in clinical improvement of anterior thigh and knee laxity.
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INTRODUCTION: While autoimmune comorbidities are common in alopecia areata, little is known about comorbid cardiovascular disease. The purpose of this study was to evaluate the incidence of bradyarrhythmia in patients with alopecia areata. METHODS: Retrospective review of electrocardiograms of 124 patients with [Formula: see text] 50% scalp hair loss (severe alopecia areata) was conducted and compared to National Health and Nutrition Examination Survey (NHANES) data. RESULTS: The prevalence of bradycardia in females with alopecia areata was 24.3% (95% CI, 14.5-34.1%) and in those age 40 years or older was 40.8% (95% CI, 22.2-53.5%) compared to 19.5% in the NHANES III population. The prevalence of bradycardia in males with alopecia areata was 36.0% (95% CI, 22.7-49.3%) and in those age 40 years or older was 50.0% (95% CI, 21.7-78.3%) compared to 26.9% in the NHANES III population. CONCLUSION: The potential association between bradycardia and alopecia areata merits further investigation.