The effect of narrowband ultraviolet B phototherapy on antinuclear antibody status: A case-control study.

BACKGROUND: Narrowband ultraviolet B (NB-UVB) phototherapy has become a widely used, standard treatment modality in dermatology. The effect of 8-methoxypsoralen plus ultraviolet A on antinuclear antibody (ANA) formation has been investigated extensively, but there are very scarce data about the potential risk of NB-UVB phototherapy inducing production of ANAs. The aims of this study were evaluation of ANA status before and after NB-UVB treatment and comparison of ANA status with the healthy control group. METHODS: Phototherapy unit database was used to identify patients who had received whole body NB-UVB treatment. Analyses of ANA were performed twice in the study group that were before initiation of the NB-UVB phototherapy and after cessation of the therapy. Also, ANAs were screened in the control group. RESULTS: A total of 95 patients (50 males and 45 females; mean age: 43.03 ± 13.40) treated with NB-UVB radiation and 90 age- and sex-matched controls were included in the study. Thirteen patients (13.7%) were found to develop ANAs at the end of the treatment. ANA positivity was significantly more common in patients after phototherapy than in patients before phototherapy and than in the control group. None of the patients in the positive ANA group was diagnosed with any connective tissue diseases. CONCLUSION: This study revealed that ANA positivity increased after NB-UVB phototherapy. However, it did not provide evidence for increased connective tissue disease risk. Therefore, ANA might not need to be routinely checked before treatment unless the patients have signs and symptoms indicating autoimmune diseases.

Which factors influence Demodex mite density in standardized superficial skin biopsy in patients with rosacea? A prospective cross-sectional analysis.

Rosacea is a chronic cutaneous disease that manifests with facial erythema, telangiectasia, papules and pustules on the central face. Although the pathogenesis is not well established, rosacea appears to have a close relationship with Demodex mites. The aim of the study was to elucidate the factors influencing Demodex mite density by standardized superficial skin biopsy (SSSB) in patients with rosacea. This prospective, cross-sectional study included 200 patients with rosacea. Clinical characteristics of the patients were recorded and SSSB was used to measure Demodex density (Dd). If Dd was < 5 D/cm2 in the first SSSB, SSSB was repeated 4 more times to avoid false negative results. Of 200 patients, 152 (76%) were females and 48 (24%) males with a mean age of 43.47 ± 11.87 years. Ninety-nine patients (49.5%) had erythematotelangiectatic (ETR) and 101 patients (50.5%) had papulopustular (PPR) subtype of rosacea. Among 200 patients, the ratio of cumulative positive results of the consecutive SSSBs were as follows: 1st SSSB = 125 (62.5%), 2nd SSSB = 155 (77.5%), 3rd SSSB = 170 (85%), 4th SSSB = 173 (86.5%) and 5th SSSB = 174 (87%). The ratio of detecting Demodex infestation in the first SSSB was significantly lower in patients with PPR (55/101, 54.5%) than in patients with ETR (70/99, 70.7%). Median total Demodex mite density and D. folliculorum density were significantly higher in the ETR group than in the PPR group. There was a statistically significant relationship between density of Demodex tails in dermoscopy and positive/negative results of Demodex infestation in SSSB. As a conclusion, Demodex mite density by SSSB was influenced by various factors such as subtypes of rosacea, types of Demodex species, and dermoscopic findings.

Functional and esthetic effects of botulinum toxin injection into the masseter muscles: evaluation of 80 patients from a dermatological perspective.

BACKGROUND: Masseter muscle hypertrophy is characterized by a symmetrical or asymmetrical increase in muscle volume. Although it can be asymptomatic, it may be associated with bruxism. Therefore, patients may seek intervention for esthetic and/or functional concerns. This study aimed to establish patient characteristics, purpose of undergoing botulinum toxin injection into the masseter muscles, efficacy, and side effects of the procedure at a dermatology clinic. METHODS: A retrospective chart review was carried out over a period of one year from January 2022 to January 2023 for the patients who underwent botulinum toxin injection into the masseter muscles. The general characteristics of patients, the purpose of botulinum toxin treatment, relief levels regarding bruxism according to the Visual Analog Scale (VAS), side effects, and complications were recorded. RESULTS: The study group comprised 74 female and 6 male patients with a mean age of 31.20 ± 6.71 years. Eighteen (22.5%) patients were treated only for narrowing the lower face contour, 28 (35%) patients were treated only for the relief of bruxism, and 34 (42.5%) patients were treated for both indications. Fifteen (18.8%) patients experienced 16 treatment-related side effects, including two (2.5%) with smile asymmetry and two (2.5%) with paradoxical bulging. CONCLUSIONS: Botulinum toxin injection into the masseter muscles with the intention of lower face contouring and/or relieving bruxism offers a minimally invasive, safe, and effective treatment option. Although it has a favorable safety profile, the risks of significant side effects or complications remain.

Is it possible to obtain long-lasting results with thread lift in the brow region? Introduction of a new suspension technique and evaluation of 50 patients.

BACKGROUND: Eyebrow region is a dynamic region, and it has a thinner skin prone to wrinkles and sagging. Descended brows could be repositioned immediately with fewer complications by the use of the threads. Despite all its advantages, the main drawback of absorbable thread lift is its short duration of lifting effect. AIMS: This report aims to describe our thread lift technique we have implemented to counteract the descent of the brows and evaluate our results in 50 patients. PATIENTS/METHODS: A retrospective chart review was carried out over a period of 1 year from September 2019 to 2020 for the patients who underwent thread lifting for eyebrows in a private clinic in Ankara. Complications after the procedure, durability of the results, global esthetic improvement scale (GAIS) score, and patient satisfaction survey scores were recorded. RESULTS: The study group was composed of 50 female patients with a median age of 34 years. The median duration of the procedure is 15 months. Nine (18%) patients experienced complications related to the procedure including ecchymosis, edema, erythema, skin dimpling, and pain. Three weeks after the procedure, the position of the eyebrows of eight (16%) patients were improved, 18 (36%) patients were much improved, and 24 (48%) patients were very much improved according to GAIS. CONCLUSIONS: So far, the most disappointing feature of the threads was the poor long-term sustainability of the outcomes. Our thread lift technique for brows offers a significant improvement in the position of the eyebrows in a short time with decreased downtime. More importantly, it can be possible to improve the longevity of the results with this approach.

Evaluation of inflammatory status in blood in patients with rosacea.

Rosacea is a chronic inflammatory skin disease that is characterized by recurrent episodes of erythema, telangiectasia and papulopustular lesions. Although the pathogenesis is not well established, growing knowledge suggests that multiple etiological factors play a role resulting in inflammation. The aim of the present study is to investigate inflammatory status of patients with rosacea by evaluating CBC parameters and systemic immune inflammation (SII) index and compare these parameters with control group. Thus, it is aimed to understand the role of systemic inflammation in the pathogenesis of the disease. This retrospective, case-control study included 100 patients with rosacea and 58 sex- and age-matched controls. Laboratory examinations including CBC, ESR, CRP, HDL, LDL, and triglyceride levels were recorded and neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR), monocyte-to-high-density lipoprotein ratio (MHR) and SII index were calculated. Monocyte and platelet count, SII index, ESR and CRP were significantly higher in patients with rosacea than in the control group. No statistically significant difference was found in other parameters. There was no significant correlation between disease severity and ESR, CRP, and SII index. The findings of this study suggest that apart from the inflammatory pathways at the level of skin, there is an inflammatory state in the blood of patients. Rosacea is a skin disease, but it may have systemic implications and/or associations that need to be clarified completely.

Autologous blood injection for treatment of steroid atrophy: A case report.

BACKGROUND: Intramuscular corticosteroid injections are frequently used for a variety of conditions in dermatology practice. Unfortunately, many complications are associated with systemic and local administration of corticosteroids. Localized subcutaneous lipoatrophy is among the most common adverse effects that can lead to permanent disfigurement. Autologous blood is collected from peripheral veins and injected immediately to the affected tissue with the intention of stimulating the body's own tissue-healing mechanisms through cellular and humoral mediators. AIMS: Although platelet-rich plasma therapy, produced by centrifugation of autologous blood, is very popular in dermatology practice, autologous blood injection (ABI) is not routinely preferred. With this case, it was aimed to report that ABI can be a safe and effective option in the treatment of steroid atrophy. PATIENTS/METHODS: A case of steroid atrophy in a female patient treated successfully with ABI was presented. RESULTS: A 17-year-old female patient presented with epidermal/dermal atrophy, depigmentation, and subcutaneous fat atrophy after intramuscular corticosteroid injection. ABI treatment was initiated because there were no signs of spontaneous improvement after 6 months. 4 cc autologous blood was injected in small volumes into the superficial, middle, and deep parts of the atrophic tissue. After 2 sessions of ABI, the size and depth of the atrophy were markedly improved and depigmentation was resolved. CONCLUSION: There are several treatment options for localized steroid atrophy with varying success rates. This is the first report that shows ABI is a simple, effective, and safe procedure for correction of corticosteroid-induced cutaneous and subcutaneous atrophy with satisfying results.

A new three-point filler technique to maximize safety for the correction of glabellar rhytids: Evaluation of 50 patients.

BACKGROUND: Hyaluronic acid (HA) fillers have been widely used for reversing the signs of the aging face. Injectable fillers are particularly effective in treating vertical glabellar wrinkles. AIMS: The aim of this study was to share our own safe glabella filling technique and to evaluate our results in 50 patients with facial rejuvenation. METHODS: A total of 50 patients consisting of women and men with moderate to severe glabellar rhytids were enrolled in the study. Patients were evaluated before the injection procedure and 2 weeks after the procedure by using the Rao-Goldman scale. We have described a new three-point filler technique. RESULTS: Of 50 patients, 39 were females and 11 males, and the mean age was 39.82 ± 6.44 years. The mean volume of HA that was injected into the glabellar wrinkles was 0.61 ± 0.12 mL. Eight patients had experienced mild complications related to the procedure. None of the patients had experienced skin necrosis and visual impairment. CONCLUSION: Our technique is a simple and safe procedure to correct glabellar rhytids. Practitioners should be aware of the safe injection techniques, potential complications, and management of these complications for a good clinical practice.

Chin augmentation with the use of cannula from a single, midline entry point: Evaluation of 50 patients.

BACKGROUND: A chin that is of right size, shape, and contour plays a crucial role in overall facial balance and esthetically harmonious appearance. Dermal fillers have been widely used for correcting mild to moderate chin retrusion and resorption. AIMS: The aim of this study was to share our preferential technique for chin augmentation and to evaluate our results in 50 patients. METHODS: A total of 50 patients consisting of females who received hyaluronic acid injection for chin augmentation and rejuvenation were enrolled in the study. We have described chin augmentation technique with the use of cannula from a single, midline entry point. RESULTS: The study included 50 female patients, and the mean age was 37.56 ± 8.84 years. The median injected filler volume for augmentation of the mental area was 2.25 mL (minimum = 1, maximum = 4 mL). Four (8%) patients had ecchymosis related to the procedure. CONCLUSION: Chin has a profound effect on the perception of attractiveness and is an area of concern for rejuvenation of the lower third of the face. Our preferential technique allows the practitioners to increase the likelihood of a satisfactory esthetic outcomes and minimize the risks of the procedure.

Evaluation of serum uric acid levels in patients with rosacea.

Rosacea is an inflammatory skin disease with a chronic course. Although the pathogenesis of rosacea is not completely understood, it is regarded as an inflammatory process. The aim of the present study was to evaluate uric acid (UA) levels in patients with rosacea and to detect the correlation of UA levels with disease activity. A total of 61 patients with rosacea and 64 sex- and age-matched controls were included in the study. Demographic characteristics, medical history, and dermatological examination of the patient and control groups were recorded. Concentrations of serum UA and C-reactive protein (CRP) were evaluated and compared in both groups. This study included 61 patients with rosacea (39 females, 22 males, median age = 30 years) and 64 age- and sex-matched controls. Metabolic syndrome was significantly more common in patients with rosacea than in the control group. Patients with rosacea had significantly higher body mass index (BMI) values compared with those of controls. Serum UA and CRP values were significantly higher in the rosacea group than values in the control group. There was no statistically significant correlation between serum UA level and clinical rosacea severity. This study suggests that rosacea is not only a skin-related disease but also an inflammatory disease that can be related to higher uric acid levels, BMI values, and metabolic syndrome. It may be recommended that clinicians pay careful attention to the clinical follow-up of these patients to avoid missed associated comorbidities.

A cross-sectional analysis of skin cancer risk in patients receiving narrow-band ultraviolet B phototherapy: an evaluation of 100 patients.

Narrow-band ultraviolet B (NB-UVB) phototherapy is an effective and widely used treatment modality for psoriasis and other inflammatory skin diseases. The carcinogenic effect of PUVA treatment has been investigated extensively, but there is very scarce data about the role of NB-UVB in the development of skin cancer. The aim of this study was to investigate the potential carcinogenic risk of NB-UVB therapy in various skin disorders. In this cross-sectional study, we evaluated 100 patients who had received whole-body NB-UVB treatment and 100 age- and sex-matched controls. Phototherapy unit database was used to identify patients. A total of 100 patients (53 males and 47 females) treated with NB-UVB and 100 controls were included in the study. The patient group revealed no cases of melanoma or non-melanoma skin cancer, while ten of them were found to have solar lentigines. Basal cell carcinoma in a patient and nine patients with solar lentigines were detected in the control group. There was no statistically significant difference between patient and control groups in terms of skin cancer and solar lentigines. This study does not provide evidence for an increased skin cancer risk in patients treated with NB-UVB phototherapy. However, we have detected the occurence of 10 cases of solar lentigines. Still, definitive prospective longitudinal studies with a greater number of patients and prolonged follow-up are required to specifically address skin cancer risk in relation to NB-UVB phototherapy.