George KROUMPOUZOS's informes (107)

Nonsurgical Rhinoplasty: A Modified Rino-4-Puntos Technique With Hyaluronic Acid Improves the Appearance of Nasal Septal Deviation.

May, 2025

Recently, we introduced the Rino-4-Puntos (R4P) nonsurgical rhinoplasty technique using hyaluronic acid (HA), which effectively addresses nose shape issues. However, no nonsurgical rhinoplasty procedure has been explicitly tested for improving the appearance of nasal septal deviation (NSD). This study aimed to evaluate the aesthetic outcome, longevity of results, safety, and patient satisfaction of the modified R4P (mR4P) technique, designed to address nose shape issues related to NSD. leer más

Plastic and reconstructive surgery. Global open

Innovations in maternal-fetal dermatology: A focus on artificial intelligence-driven diagnostics, global disparities, and transformative care.

May, 2025

Pregnancy-associated dermatologic conditions emerge from intricate hormonal, immunologic, genetic, and environmental changes, often complicating maternal and neonatal outcomes. Such changes can also impact the course of preexisting skin disease during gestation. There are persistent gaps in clinical research, including the underrepresentation of pregnant patients, limited therapeutic options, and health disparities, that continue to challenge optimal care. Recent advances in artificial intelligence offer promising opportunities for early diagnosis, enhanced risk assessment and drug safety, and expanded care access, particularly in underserved populations. Cultural, demographic, and genetic factors critically shape dermatologic presentations and outcomes, whereas inequities in data representation, algorithmic bias, and health care accessibility remain significant barriers. By integrating interdisciplinary innovations with culturally sensitive strategies, we propose a framework to optimize and globalize maternal-fetal dermatologic care. leer más

Clinics in dermatology

Exploring Nonresponse to Botulinum Toxin in Aesthetics: Narrative Review of Key Trigger Factors and Effective Management Strategies.

Apr, 2025

Nonresponse to botulinum toxin type A (BoNT-A) has been reported in both medical and aesthetic applications. Secondary nonresponse (SNR) occurs when BoNT-A is initially effective before failure commences at a later point. Most reported cases involve SNR in aesthetics. Several aspects of this complication remain elusive or controversial. leer más

JMIR dermatology Ver más  

Balancing AI and human interaction in aesthetic dermatology.

Feb, 2025

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Archives of dermatological research

Large Language Models in Cosmetic Dermatology.

Feb, 2025

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Journal of cosmetic dermatology

Botulinum toxin treatment of refractory vaginismus: a prospective study.

Dec, 2024

Vaginismus is a common sexual dysfunction. A few studies have indicated that botulinum neurotoxin type A (BoNTA) can help treat refractory vaginismus by alleviating muscle tension. However, such studies did not use standardized methodology and BoNTA dosage. leer más

International journal of women's dermatology

Opt for Methotrexate Before Biologics in the Treatment of Recalcitrant Delayed-Onset Reactions to Dermal Fillers.

Oct, 2024

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Journal of drugs in dermatology : JDD

Advancing Care for Psychocutaneous Disorders: The Role of Artificial Intelligence and Virtual Reality.

Sep, 2024

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Clinics in dermatology

Nonsurgical Rhinoplasty: Results from a Retrospective Study of Rino-4-Puntos Technique with Hyaluronic Acid.

Jul, 2024

Nonsurgical rhinoplasty (NSR) utilizing hyaluronic acid (HA) filler injections is increasingly used to address nose shape issues. While refinements have been proposed, the technique lacks standardization. leer más

Aesthetic plastic surgery

Frontal fibrosing alopecia-A new absolute contraindication for deep chemical peels.

Jun, 2024

Frontal fibrosing alopecia (FFA) is characterized by a receding hairline in the frontotemporal region due to the gradual loss of hair follicles and then follicular stem cells and follicular fibrosis. Follicular stem cells are crucial in skin healing after chemical peeling and other resurfacing procedures. Although there is a possible association of FFA with a history of facial and scalp surgical procedures, there is no information on the safety of cosmetic procedures in patients with FFA. We report five patients with FFA who experienced unusual and complicated outcomes after undergoing a deep chemical peel (phenol and croton oil). As the prevalence of FFA continues to increase globally, it is essential to raise awareness about the potential incompatibility of this dermatologic disorder with specific cosmetic procedures, such as deeper peels and other resurfacing modalities. leer más

Clinics in dermatology

Rare and novel complications of botulinum neurotoxin type A and dermal filler injections.

Jun, 2024

Botulinum neurotoxin type A (BoNTA) and filler injection procedures usually provide predicted outcomes with a low incidence of complications. Most of the complications after these procedures have been extensively discussed. In this study, we report on these injectables' less well-known, recently reported, and novel complications and attempt to clarify the underlying mechanisms. Counterfeit or mishandled BoNTA has been associated with botulism. BoNTA has been linked to uncommon complications, including morphea-like lesions, nontuberculous mycobacterial infections, vascular occlusion, and pseudoaneurysm of the superficial temporal artery. Unusual complications from filler injection include nonscarring alopecia, intraoral necrosis, nontuberculous mycobacterial infections, xanthelasma-like reactions, intracranial perforation, and pneumosinus dilatans. Post-BoNTA injection nodules and filler infection from bone destruction due to cocaine use are new complications. These complications pose a challenge for diagnosis and treatment. This publication aims to assist in promptly identifying and managing these rare and novel complications when necessary. leer más

Clinics in dermatology

ULTRASONOGRAPHIC FEATURES OF NON-VASCULAR COMPLICATIONS OF HYALURONIC ACID FILLERS: A RETROSPECTIVE STUDY AT A REFERENCE CENTER FOR DERMATOLOGIC ULTRASONOGRAPHY.

May, 2024

Hyaluronic acid (H.A.) filler injections have been associated with early, temporary, and delayed-onset onset complications. High-resolution ultrasound (HRUS) with Doppler analysis has been increasingly used to detect and identify such complications. We describe comprehensively the most common ultrasonographic findings of non-vascular complications associated with H.A. filler injections. This retrospective, cross-sectional observational study was conducted at a reference center for dermatologic ultrasound in Bogotá, Colombia. Ultrasound reports documented the ultrasonographic findings of non-vascular complications of H.A. filler injections. Fifty-two complications were documented in a cohort of 50 patients (women, 88%). The infraorbital region was the most common site affected (23%), followed by the nasolabial (22%). The Tyndall effect was the most common complication (25% of all), followed by changes in rheology (21%) and pseudo-sarcoidal (foreign body granuloma) reaction (15%). The Tyndall effect stood out for its distinctive ultrasonographic characteristics. We discuss the ultrasonographic findings and pathogenesis of other complications, including filler migration, early hypersensitivity, aseptic abscess, overcorrection, and filler material interaction. The clinical presentation of H.A. filler complications can be confusing, delaying timely diagnosis and treatment. HRUS with Doppler analysis is a valuable tool for avoiding unnecessary treatments and ensuring timely diagnosis and treatment. leer más

Clinics in dermatology

Educational Strategies to Combat Harmful Cosmetic Dermatology Trends in Generations Alpha and Z.

May, 2024

This article argues in favor of implementing comprehensive educational strategies to combat the harmful effects of social media (SM) on body image and self-perception among generations Alpha and Z. These generations are often exposed to unattainable beauty standards that can lead to distorted self-perceptions and body image disorders such as Zoom dysmorphia. To address this issue, we propose embedding health education, critical media literacy, and active parental involvement in educational curricula. The goal is to help young individuals develop the skills necessary to critically evaluate and navigate the pressures of SM. We believe that incorporating health education, critical media literacy, and active parental engagement into school programs is urgently needed to counteract the adverse effects of SM on body image and self-perception. These initiatives will equip young people with the necessary tools to evaluate SM content critically, navigate SM influences more safely and effectively, and develop a more resilient and informed perspective. This proactive educational approach is vital for improving mental health outcomes and mitigating the psychological impacts of digital media. Ultimately, we hope that this comprehensive strategy will help future generations face SM pressures with confidence and critical awareness. leer más

Clinics in dermatology

Hyaluronidase for Dermal Filler Complications: Review of Applications and Dosage Recommendations.

Jan, 2024

Hyaluronidase (Hyal) can reverse complications of hyaluronic acid (HA) fillers, which has contributed substantially to the popularity of such procedures. Still, there are differing opinions regarding Hyal treatment, including dosage recommendations in filler complication management. leer más

JMIR dermatology

Complications of fillers in the lips and perioral area: Prevention, assessment, and management focusing on ultrasound guidance.

Sep, 2023

An ever-increasing interest in perioral rejuvenation with dermal fillers reflects the esthetic importance of this region. However, filler injections in the lips and perioral area have been associated with various complications. Such complications are classified according to severity (mild, moderate, severe) or by the time of onset: immediate (within 24 h after injection), early (24 h to 4 weeks post-procedure), and late or delayed (>4 weeks after injection). While most complications are mild and manageable, vascular compromise, infections, and the development of delayed-onset nodules may significantly undermine the ultimate esthetic outcome and cause substantial morbidity. These more serious complications often require more invasive treatment modalities. This article details the prevention and management of such adverse events and discusses safe filler injection principles, including safety recommendations for the lips. Lastly, we highlight the use of ultrasound guidance in complication prevention (vascular mapping, filler identification, location, and extent), assessment (identification of intravascular embolus or external vascular compression by the filler implant), and management (real-time imaging of hyaluronidase or other drug injection in the affected area). Esthetic practitioners should be versed in injection anatomy, and the prevention, recognition, and management of filler complications in the perioral area. leer más

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

A Screening Proposal for Zoom Dysmorphia in Virtual Settings.

Aug, 2023

Zoom dysmorphia (ZD) is a facial dysmorphia that is triggered or aggravated by frequent virtual meetings. The frequent use of videoconferencing platforms has been linked to a distorted perception of facial images as individuals have an increased awareness of their appearance, given constant video feedback. As a result, dysmorphic concerns can develop. It is crucial to identify ZD as this condition interferes with an individual's life and can trigger or aggravate body dysmorphic disorder (BDD). A standardized approach for screening ZD in non-psychiatric settings has yet to be defined. We discuss the features of ZD and the challenges of screening for ZD in a virtual setting. To facilitate the recognition of ZD in telehealth consultations, we propose a comprehensive ZD screening questionnaire that includes questions related to typical ZD features and a BDD-focused question. The questionnaire is concise and allows the identification of individuals with a potential ZD. A BDD assessment in such individuals should follow. leer más

Life (Basel, Switzerland)

Annular Basal Cell Carcinoma Expanding Around Central Hypertrophic Scarring: A Case Report.

Mar, 2023

A case of annular basal cell carcinoma (BCC) with central atrophic scarring that developed secondary to spontaneous regression has been reported. We present a novel case of a large, expanding nodular and micronodular BCC with annular morphology with central hypertrophic scarring. A 61-year-old woman presented with a two-year history of a mildly itchy lesion on the right breast. Previously diagnosed as an infection, the lesion persisted after treatment with topical antifungal agents and oral antibiotics. Physical examination revealed a 5x6 cm plaque consisting of a pink-red arciform/annular edge with an overlying scale crust and a large, centrally positioned, firm, alabaster-colored portion. A punch biopsy of the pink-red rim revealed nodular and micronodular BCC features. A deep shave biopsy of the central bound-down plaque showed histopathology of scarring fibrosis with no findings of BCC regression. The malignancy was treated with two sessions of radiofrequency destruction, which led to the resolution of the tumor with no recurrence to date. Contrary to the previously reported case, BCC in our case was expanding, associated with hypertrophic scarring, and showed no signs of regression. We discuss several possible etiologies of the scarring centrally. With further awareness of this presentation, more such tumors can be detected at early stages to facilitate prompt treatment and prevent local morbidity. leer más

Cureus

Erosive Pustular Dermatosis: Delving into Etiopathogenesis and Management.

Dec, 2022

Erosive pustular dermatosis (EPD) is a chronic inflammatory skin disorder that usually affects mature individuals. It predominantly affects the scalp and can lead to scarring alopecia. Risk factors include actinic damage and androgenetic alopecia. A traumatic insult to the skin is considered a vital trigger of the condition. EPD is a diagnosis of exclusion; thus, several neoplastic, infectious, vesiculobullous, and inflammatory conditions should be ruled out. Biopsy and clinicopathologic correlation are required to differentiate between EPD and these entities. A dysregulated, chronic immune response is considered central to the etiopathogenesis of EPD. We performed an evidence-based systematic review of the management options. There were predominantly studies with level IV and V evidence and only two with level III. Despite the responsiveness of EPD to potent topical steroids, such as clobetasol propionate, recurrence occurs after treatment withdrawal. With the available data, tacrolimus 0.1%, curettage-assisted aminolevulinic acid-photodynamic therapy, and systemic retinoids can be considered second-line options for EPD with a role in maintenance regimens. However, controlled data and more powerful studies are needed to make solid recommendations. leer más

Life (Basel, Switzerland)

Nonmelanoma skin cancer in the setting of erosive pustular dermatosis of the scalp: A case series and comment on management implications.

Jul, 2022

Erosive pustular dermatosis of the scalp (EPDS) is an inflammatory cutaneous disorder typically affecting sun-damaged skin of mature individuals. Clinical features of EPDS include sterile pustules and chronic crusted erosions that can be hyperkeratotic and lead to scarring alopecia, atrophy, and telangiectasia. While the condition occurs on sun-damaged skin, a relationship with non-melanoma skin cancer (NMSC) has not been investigated. leer más

Dermatologic therapy

Hormonal Therapies in the Management of Acne Vulgaris.

Jun, 2022

Acne vulgaris is a multifactorial chronic disorder of the pilosebaceous unit. Established treatments include topical retinoids, antibiotics in mild cases, and oral antibiotics and isotretinoin in moderate to severe cases. Anti-androgens and other hormonal therapies constitute another group of drugs in the armamentarium of acne management. These can be used in patients who do not respond to the aforementioned treatments or when other systemic drugs cannot be tolerated. Recent approval of topical androgen receptor blocker is an additional armamentarium for the management of acne. Considering limited systemic exposure and good efficacy, it has potential for wide usage in patients with acne. In this article, we critically review currently available hormonal treatment options based on published literature search of an electronic database (MEDLINE/PubMed) performed through June 2021. J Drugs Dermatol. 2022;21(6):618-623. doi:10.36849/JDD.6494. leer más

Journal of drugs in dermatology : JDD

Rosacea management: A comprehensive review.

May, 2022

Rosacea is a chronic cutaneous disorder affecting primarily the face, characterized by erythema, transient or persistent, telangiectasia, and inflammatory lesions including papulo-pustules and swelling. The essential component of the disease is the persistent erythema of facial skin. Episodes of flushing (acute-subacute intermittent vasodilation) are common. Swelling and erythema of the nose along with dilatation of the pilosebaceous poral orifices, known as rhinophyma, can be noted in chronic cases. Rosacea affects up to 10% of the world population and is especially noted in fair-skinned individuals aged 35-50. Women are affected more often than men. Several treatment modalities including topical medications, systemic drugs, lasers, and light-based therapies have been used for the management of rosacea with variable results. Topical medications such as azelaic acid, metronidazole, and sulfacetamide/sulfur, oral antibiotics such as tetracyclines, and oral retinoids alone or, most commonly, in combination form the mainstay of treatment. Light therapies such as intense pulsed light and pulsed dye laser are best used for the erythemato-telangiectatic type. Topical brimonidine, oxymetazoline, ivermectin, tacrolimus, pimecrolimus, low-dose modified-release tetracyclines and botulinum toxin are the new additions to the therapeutic armamentarium. This article provides a comprehensive review of the various therapies used for rosacea. leer más

Journal of cosmetic dermatology

Critical Review of the Sentinel Lymph Node Surgery in Malignant Melanoma.

05, 2022

Malignant melanoma is one of the most aggressive solid tumors but has low morbidity if treated at an early stage. Over the past decade, the advent of targeted therapy and immunotherapy have productively enriched the treatment options for advanced melanomas and further improved the prognosis. The treatment of melanoma is a rapidly evolving field. In patients with sentinel lymph node (SLN)-positive (SLN+) melanoma, the role of complete lymph node dissection (CLND) is still a matter of debate. Sentinel lymph node biopsy (SLNB) is a staging procedure for melanoma that is routinely offered to patients with tumor thickness ≥1 mm or ≥0.8 mm with additional risk factors and is widely accepted as an important diagnostic and prognostic tool, since SLN+ patients can receive adjuvant targeted treatment or immunotherapy. Currently, the role of CLND has largely been replaced by often recommended adjuvant therapies since their approval. This article provides an overview of sentinel lymph-node surgery in cutaneous melanoma. J Drugs Dermatol. 2022;21(5):510-516. doi:10.36849/JDD.6198. leer más

Journal of drugs in dermatology : JDD

Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review.

Mar, 2022

Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines worldwide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer-BioNTech), and AZD1222 (AstraZeneca-Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination. leer más

Microorganisms

Incorporation of social media questions in body dysmorphic disorder scales: a proposed revision.

Feb, 2022

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Clinics in dermatology

Efficacy and Toxicity of Classical Immunosuppressants, Retinoids and Biologics in Hidradenitis Suppurativa.

Jan, 2022

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the apocrine glands characterized by recurrent episodes. Although several therapies exist, none is completely curative. Several immunosuppressives have been studied with encouraging results and targeted approaches. In this review, we highlight the various immunosuppressives used in this condition along with their salient features to enable physicians to choose the correct therapy for their patients. The search of the peer-reviewed literature included clinical trials, scientific reviews, case series, case reports, and guidelines. The literature was identified from electronic databases (MEDLINE and PubMed) through November 2021; additional articles were included from the references of the identified articles. leer más

Journal of clinical medicine

Dermatology in a multidisciplinary approach with infectious disease and obstetric medicine against COVID-19.

Dec, 2021

The care for patients infected with COVID-19 requires a team approach, and dermatologists may collaborate with other specialties, especially infectious disease (ID) medicine and obstetrics and gynecology (ObGyn), at every stage of the infection process. A broad spectrum of cutaneous manifestations may occur early in COVID-19 infection, making appropriate dermatologic identification critical for an early diagnosis. There is prognostic value in appropriately identifying different types of COVID-19-associated skin manifestations, which have been linked to disease severity. Such observations emanated from dermatology research, especially large series and international registries of cutaneous manifestations relating to COVID-19, and impact COVID-19 care provided by most health care providers. Also, research based on international registries of skin reactions from the COVID-19 vaccines has an impact across disciplines. An increased risk for severe illness from COVID-19 is encountered during pregnancy, and dermatologists' role is to urge ObGyn and other clinicians to monitor and educate pregnant patients about the potential for eruptions as a manifestation of COVID-19. ID and ObGyn experts indicate that teledermatology enhanced the interaction among health care providers and improved COVID-19 care. More than 40% of all dermatology consultations at a tertiary care hospital were done via teledermatology. Future collaborative research involving dermatology and specialties, such as ID and ObGyn, could help delineate guidelines for dermatology consultations in patients infected with COVID-19 and determine cases appropriate for teledermatology. leer más

International journal of women's dermatology

Light-Based Devices for the Treatment of Facial Erythema and Telangiectasia.

Dec, 2021

Facial erythema is one of the most common outpatient complaints in dermatology. There are various causes of facial erythema and several devices are available for its treatment. Pulsed dye laser (PDL) and intense pulsed light (IPL) are the two common light devices used for these conditions. In this review, we evaluated the literature to assess efficacy of IPL versus PDL in facial erythema and telangiectasia. We searched published articles including clinical trials or reviews articles, case series, and case reports. Electronic databases (MEDLINE and PubMed) were searched to retrieve the articles. Reference lists of selected articles were also considered for the review. Articles published in English language until June 2021 were considered for this review. leer más

Dermatology and therapy

Extensive ecchymosis and edema associated with injection of human hyaluronidase in the periorbital area: A report of three cases.

11, 2021

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Dermatologic therapy

Deoxycholic Acid (ATX-101) for Fat Reduction.

11, 2021

Excess, unwanted fat in submental and other body areas has been a focus of new modalities in aesthetics. Invasive and, more recently, non-invasive modalities for removal of unwanted fat have been on an increase. ATX-101 (deoxycholic acid injection) is the only injectable drug approved in the United States and Canada for reduction of moderate or severe submental fat in adults, with ongoing trials testing its efficacy in body contouring and lipomas. It has proven efficacy in submental fat reduction with a good safety profile. This article reviews the pharmacology, mechanism of action, clinical effects and adverse effects of ATX-101. It emphasizes on careful patient selection and advises on appropriate volume administration, number of treatments, and injection technique. The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till December 2019 and reference lists of respective articles. Only articles published in English language were included. J Drugs Dermatol. 2021;20(11):1169-1173. doi:10.36849/JDD.3936. leer más

Journal of drugs in dermatology : JDD

Nocturnal pruritus and sleep disturbance associated with dermatologic disorders in adult patients.

Sep, 2021

Nocturnal pruritus (NP) is a relatively common reason for dermatologic consultation. Its pathophysiology is partially understood. Skin conditions such as atopic dermatitis, psoriasis, urticaria, and prurigo nodularis are well-described causes of NP. The most distressing sequela of NP is sleep deficit, which can lead to physical and mental disturbances (e.g., daytime somnolence and fatigue) and negative emotional states that profoundly affect quality of life. However, this aspect of NP is often overlooked by dermatologists. It is essential to assess sleep quality in such patients and adopt appropriate measures to arrest the problem at an early stage. We conducted an evidence-based literature review to highlight the pathogenetic mechanisms of NP, identify dermatologic etiologies, and explore methods that have been used to assess the quality of sleep. Furthermore, we performed a systematic review of studies on sleep disturbance relevant to NP in patients with dermatologic conditions. Finally, we discuss the evidence on treatment options for NP and indicate therapies that may target both NP and sleep disturbance. leer más

International journal of women's dermatology

New Coronavirus (SARS-CoV-2) Crossing Borders Beyond Cities, Nations, and Continents: Impact of International Travel.

07, 2021

The third outbreak of coronavirus in the form of the COVID-19 infection started in Wuhan, China, in December 2019. The early and rapid spread of this infection across borders can be largely attributed to international air travel that has become a part of modern globalization. In this article, we analyze the spread of the novel coronavirus (SARS-CoV-2) along the routes of international travel, both by air and by sea. Pitfalls of various screening methods used at the airports and the importance of optimal aircraft ventilation are discussed. Also, we suggest measures that can be taken to reduce the risk of transmission associated with air travel. leer más

Balkan medical journal

Complications of Botulinum toxin A: An update review.

Jun, 2021

Cosmetic surgery procedures have increased manifolds all over the world owing to the ever-increasing demand of people to look beautiful and young. Injectable treatments like botulinum toxin are becoming more popular owing to their rapid, well-defined, and lasting results for the reduction of facial fine lines, wrinkles, and facial rejuvenation. These emerging treatments are quite safe but can have certain adverse effects. In this article, we have highlighted the complications and side effects of botulinum toxin based on the anatomical location. The possible causes and precautions to prevent these complications are also discussed. The search of literature included peer-reviewed articles including clinical trials and scientific reviews. Literature was identified from electronic databases (MEDLINE/PubMed) through January 2021 and references of respective articles and only the articles published in English language were included. leer más

Journal of cosmetic dermatology

Transcutaneous Temperature-Controlled Radiofrequency Treatment: Improvement in Female Genital Appearance, Sexual Dysfunction, and Stress Urinary Incontinence.

Apr, 2021

Transcutaneous temperature-controlled radiofrequency (TTCRF) is an emerging modality for vulvovaginal rejuvenation. Still, the clinical experience with this modality is limited. leer más

Aesthetic surgery journal

Cutaneous manifestations of COVID-19: An unusual presentation with edematous plaques and pruritic, erythematous papules, and comment on the role of bradykinin storm and its therapeutic implications.

Mar, 2021

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Dermatologic therapy

Noninvasive diagnostic techniques of port wine stain.

Mar, 2021

Port-wine stain (PWS) is a benign capillary malformation that most commonly occurs in the head and neck. It is present at birth and progresses over time. It is formed by progressive dilatation of post-capillary venules and is associated with hypertrophy and nodularity with increasing age, leading to cosmetic disfigurement and psychological aggravation. It is caused by genetic mosaicism in GNAQ and GNA11 genes. Histopathology is the gold standard for assessment of PWS but it is invasive and may cause scarring. Inadequate characterization of the lesions may predispose to inadequate treatment protocols as well as higher treatment dosages. Clinical evaluation of treatment efficacy is subjective and may not be a representative of actual results. Therefore, an objective visualization modality is required. With evolving technology, numerous optical instruments have been developed for objective evaluation and visualization of subsurface structures. These include VISIA-CR™ system, videodermoscopy, high-frequency ultrasound (HFUS), laser speckle contrast imaging (LSCI), reflectance spectrophotometers and tristimulus colorimeter, laser Doppler flowmetry (LDF), cross-polarized diffuse reflectance imaging system (CDR), reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and spatial frequency domain imaging (SFDI). These semi-quantitative modes of diagnosis are complementary to each other. Some can be used in the clinical setting while others, due to high instrument cost, are limited to the research settings. In this review, we bring to you a brief overview of noninvasive diagnostic modalities in PWS. leer más

Journal of cosmetic dermatology

Idiopathic guttate hypomelanosis: Presentation and Management.

Feb, 2021

Idiopathic guttate hypomelanosis (IGH) is a benign, typically asymptomatic, acquired leukoderma characteristically affecting mature individuals. Although the etiopathogenesis is unclear, chronic sun exposure and senile degeneration are important triggers. Researchers have been engaged in a continuous effort to unveil the gray areas encompassing different aspects of IGH pathogenesis. IGH is a clinical diagnosis; however, histopathology and dermoscopy may aid in quetionable cases. Patients often seek cosmetic treatment. There has been no standard therapy for this condition. Newer treatment modalities range from topical agents to procedure-based therapies and have enhanced the therapeutic armamentarium. Here we discuss the pathogenesis, presentation, and management of IGH. leer más

Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology

Assessment of prurigo of pregnancy in patients without atopic background.

Dec, 2020

Prurigo of pregnancy (PP), a specific pregnancy dermatosis, has been associated with atopic background in the patient and/or the patient's family. However, this association was not validated in some studies, and cases without atopic background have been reported. leer más

International journal of women's dermatology

Impact of covid-19 pandemic on dermatology practice: results of a web-based, global survey.

Oct, 2020

The spectrum and magnitude of changes in dermatology practice induced by the COVID-19 pandemic have not been adequately studied. leer más

International journal of women's dermatology

COVID-19 and alcohol use.

Sep, 2020

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Drug and alcohol review

Mental distress in dermatologists during COVID-19 pandemic: Assessment and risk factors in a global, cross-sectional study.

Aug, 2020

There is a sparsity of data regarding the mental health status of dermatologists during COVID-19 pandemic. Evaluate the effects of pandemic on mental health of dermatologists on a large scale and identify risk factors for mental distress. 733 dermatologists were included in this cross-sectional, web-based survey. Mental distress was reported by 77.2% of responders. Considerable percentages of participants experienced stress (73.9%), irritation (33.7%), insomnia (30%), or depression (27.6%), and 78.6% were overwhelmed with the amount of pandemic information they were receiving. Mental distress was significantly associated with practice years, volume of patients seen per week before pandemic, personal protective equipment availability at hospital (P = .001 for each), practice location (continent; P < .001), and participant's assessment that the healthcare system was not equipped for the pandemic (P = .003). Stress was associated with hospital service (P = .003), and depression with being overwhelmed with the amount of pandemic information received (P = .004). In a logistic model, teledermatology use was the most powerful predictor of mental distress (OR, 1.57 [95% CI, 1.07-2.32]). Mental distress was common among dermatologists during this pandemic. Teledermatology use was the most powerful predictor of mental distress. Preventative strategies and psychosocial interventions should be implemented. leer más

Dermatologic therapy

Role of music therapy in reducing the burden of dermatological diseases during COVID-19.

Jul, 2020

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Dermatologic therapy

Hand eczema due to frequent hand washing in combat with COVID-19.

Jul, 2020

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Journal of cosmetic dermatology

COVID 19 and its impact on cosmetic dermatology.

Jun, 2020

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Dermatologic therapy

Virtual conferences of dermatology during the COVID-19 pandemic.

Jul, 2020

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Dermatologic therapy

Safety measures in dermatology help minimize spread of COVID-19.

Jul, 2020

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Dermatologic therapy

Protection comes at a cost: Doctor's life inside personal protection equipment.

Jul, 2020

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Dermatologic therapy

Subcorneal pustular dermatosis: Comprehensive review and report of a case presenting during pregnancy

06, 2020

Subcorneal pustular dermatosis (SPD), also known as Sneddon-Wilkinson disease, is a rare, relapsing, sterile pustular eruption of unknown etiology that develops most commonly in middle-aged or mature women. This article reviews the presentation, associations, and management of the condition and highlights advances in pathophysiology. Onset of SPD during pregnancy has not been reported. Herein, we report a case of SPD that developed during pregnancy. The patient was treated with dapsone without complications for her or the fetus. An association between T helper (Th) 17 and Th2 environments in the development of SPD has been advocated. Pregnancy is characterized by a predominance of Th2 responses and increased interleukin-17 levels and thus may favor the development of the condition. leer más

International journal of women's dermatology

Update in minimally invasive periorbital rejuvenation with a focus on platelet-rich plasma: A narrative review.

May, 2020

The periorbital region is among the first areas to be affected by the process of aging, which is influenced by genetic and constitutional factors. As the region plays an important role in overall facial appearance, rejuvenation of the area has immense cosmetic benefit and various treatment modalities have been used to achieve the same. leer más

Journal of cosmetic dermatology

Mental health status of dermatologists during the COVID-19 pandemic: A technology-based therapy.

Jul, 2020

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Dermatologic therapy

Where do we stand as dermatologists in combat with COVID-19.

Jul, 2020

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Dermatologic therapy

Dermatologic treatments in the era of COVID-19 pandemic-Data and Hypothesis.

Jul, 2020

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Dermatologic therapy

Effects of 5-alpha reductase inhibitors on lung function: A reason for discontinuation during COVID-19 pandemic?

07, 2020

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Dermatologic therapy

Use of face masks in dermatology department during the COVID-19 outbreak.

May, 2020

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Dermatologic therapy

Update on COVID-19 effects in dermatology specialty.

Jul, 2020

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Dermatologic therapy

Employing dermatologists on the frontline against COVID-19: All hands on deck.

Apr, 2020

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Dermatologic therapy

5-Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety.

05, 2020

Androgenetic alopecia (AGA) is a multifactorial disease that carries a significant psychological burden with it. Dihydrotestosterone, the main pathogenic androgen in AGA, is produced by conversion of testosterone, which is catalyzed by the 5-alpha reductase (5-AR) isoenzyme family. Finasteride and dutasteride are inhibitors of these enzymes. Finasteride, which is a single receptor 5-alpha reductase inhibitor (5-ARI), acts by blocking dihydrotestosterone (DHT). Dutasteride, a dual receptor DHT blocker, has a higher potency than its predecessor, finasteride. This review corroborates the evidence of superiority of dutasteride over finasteride, and its comparable safety profile concerning fertility, teratogenicity, neurotoxicity, and hepatotoxicity. leer más

Dermatologic therapy

COVID-19: A relationship to climate and environmental conditions?

Jul, 2020

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Dermatologic therapy

Efficacy of 595- and 1319-nm pulsed dye laser in the treatment of acne vulgaris: a narrative review.

Apr, 2020

Acne is one of the commonest problems of adolescence with almost half of the patients experiencing persistence into adulthood. Pulsed dye lasers (PDL) with wavelengths of 585 and 595 nm targeting hemoglobin have been used for the treatment of this condition and its sequelae. Recent introduction of PDL with a higher wavelength of 1319 nm has been reported to offer some benefit to acne patients. We reviewed the literature on the use of 595-nm and 1319-nm PDL in the management of acne. A PubMed literature search for search terms "pulsed dye laser," "acne laser therapy," "light therapy for acne," "595 nm and acne," "1319 nm and acne" was done. Studies, series and case reports were included. These lasers were compared to other lasers and light sources such as 532-nm Potassium Titanyl Phosphate laser, 585-nm PDLs, 1450-nm diode laser, 1540-nm erbium glass laser, intense-pulsed light (IPL), photodynamic therapy, red and blue light and short-pulsed 1064 nm laser utilized in acne management regarding their efficacy. Improvement in acne grading, scale severity or reduction in lesion count indicated substantial efficacy of the laser system utilized. leer más

Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology

COVID-19 in the pediatric population.

Jul, 2020

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Dermatologic therapy

Pharmaceutical promotion and guided-prescription in low- and middle-income countries: A need for new regulations.

03, 2020

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Dermatologic therapy

Complications of botulinum toxin and fillers: A narrative review.

Mar, 2020

Cosmetic surgery and esthetic procedures have become a billion dollar industry owing to the ever-growing demand of the population to stay young. The injectable treatments including fillers and botulinum toxin have become highly popular because of their quick, predictable and lasting results in the management of facial wrinkles and rejuvenation. Although these treatment modalities are relatively safe, they are associated with certain side effects. leer más

Journal of cosmetic dermatology

Solidarity and transparency against the COVID-19 pandemic.

Jul, 2020

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Dermatologic therapy

Skin disease related to metabolic syndrome in women.

Sep, 2019

Sex hormones are involved in pathways of metabolic syndrome (MetS), an observation supported by animal studies. The relationships of sex hormones with components of MetS, such as insulin resistance and dyslipidemia, have been studied in pre- and postmenopausal women. High testosterone, low sex hormone-binding globulin, and low estrogen levels increase the risks of MetS and type 2 diabetes in women. Cutaneous diseases that are sex hormone mediated, such as polycystic ovary syndrome, acanthosis nigricans, acne vulgaris, and pattern alopecia, have been associated with insulin resistance and increased risk for MetS. Furthermore, inflammatory skin conditions, such as hidradenitis suppurativa and psoriasis, increase the risk for MetS. Patients with such skin conditions should be followed for metabolic complications, and early lifestyle interventions toward these populations may be warranted. leer más

International journal of women's dermatology

Combination therapy using subcision, needling, and platelet-rich plasma in the management of grade 4 atrophic acne scars: A pilot study.

Aug, 2019

Multimodality therapies including minimally invasive modalities are increasingly used in atrophic scarring. leer más

Journal of cosmetic dermatology

Travelers' tropical skin diseases: Challenges and interventions.

07, 2019

Tropical regions receive a significant part of the traveling population. It is very important that health professionals are familiar with the main tropical skin diseases and able to advice patients appropriately. This article reviews the main tropical diseases of travelers, with an emphasis on diagnosis, management, and prevention. Among others, cutaneous larva migrans, myiasis, tungiasis, Chagas disease, Dengue fever, African trypanosomiasis, filariasis, and leishmaniasis are discussed. Increasing awareness among travelers and health care professionals can help reduce morbidity and mortality. Continued research on new drugs and vaccines is needed to reduce the risks of tropical diseases. leer más

Dermatologic therapy

Vaginal rejuvenation: From scalpel to wands.

Jun, 2019

Vaginal rejuvenation procedures are increasing in popularity in terms of types of treatment offered, number of patients undergoing them, clinical studies, and in the controversy surrounding them. Both non-invasive and invasive solutions are being developed by pharmaceutical and technological companies. Radiofrequency devices and lasers are spearheading the energy-based device space, and fillers and platelet-rich plasma are used to address several concerns surrounding vaginal health. In this review, an overview of the growing field of vaginal rejuvenation is presented, as well as the authors' personal view and analysis of this clinical space. leer más

International journal of women's dermatology

Erosive Pustular Dermatosis of the Scalp Treated With Aminolevulinic Acid Photodynamic Therapy and Postprocedure Silicone Gel.

05, 2019

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Ethics of esthetic procedures in pregnancy.

Dec, 2018

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International journal of women's dermatology

Acne Scarring Management: Systematic Review and Evaluation of the Evidence.

Aug, 2018

Modalities for atrophic acne scarring can be classified depending upon the needs they satisfy; that is, resurfacing, lifting/volumization, tightening, or surgical removal/movement of tissue that is required for correction. A plethora of treatment options have resulted from the need to treat various acne scar types, variability of responses noted in various skin types, and increasing popularity of minimally invasive modalities. Still, there is a lack of consensus guidelines on treatment or combination therapies for various clinical scenarios. leer más

American journal of clinical dermatology

Skin excoriations: picking apart the picker.

Aug, 2018

Management of patients who pick at their skin can be challenging. Etiologies and maintaining factors of skin picking are often unclear. Significant psychiatric overlay is often present, and the clinician is left with an overwhelming differential diagnosis and poorly focused management plans which can result in suboptimal clinical outcomes. The purpose of this article is to provide a conceptual framework for the evaluation and treatment of a patient presenting with excoriations. Ten diagnostic categories of pickers are described, and specific suggestions for treatment are offered. leer más

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia

Psychopharmacology.

Aug, 2018

Most dermatologists evaluate and treat patients with psychological or psychiatric issues related to their skin disease. These patients often require psychopharmacologic therapies. Therefore, it is important for dermatologists to be familiar with psychopharmacologic treatments for diseases that fit into the overlap between psychiatry and dermatology. This review aims to provide a concise overview of psychopharmacology as it applies to dermatology. Psychotropic medications commonly used in psychodermatology, including antidepressants, antipsychotics, and anxiolytics, are reviewed; safety profile and dosing recommendations are discussed. leer más

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia

Body dysmorphic disorder in the cosmetic practice.

Aug, 2018

Body dysmorphic disorder (BDD) is a preoccupation with a slight or imagined flaw in appearance that causes significant distress and impairment in daily functioning. The disease is more prevalent among patients who seek aesthetic procedures as compared with population standards or individuals that are not interested in aesthetic surgery. Several studies have indicated that BDD symptoms typically worsen after an aesthetic procedure because the preoccupation shifts to a different body area. This review discusses the demographic and clinical features, psychiatric comorbidity, assessment, differential diagnosis, and management of BDD. Components of the assessment include the interview, patient observation in the office, and questionnaires. The article includes a detailed discussion on questionnaires, especially those that are most useful in the dermatology or cosmetic practice. Ethical considerations in the management of BDD are discussed. BDD should not be missed by health providers because of the associated high morbidity that includes an increased suicidality. The cosmetic provider's approach should motivate BDD patients to participate in treatment, a combination of psychotherapy and pharmacotherapy. leer más

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia

Approach to a psychodermatology patient.

Aug, 2018

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Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia

Onychophagia and onychotillomania can be effectively managed.

11, 2017

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Journal of the American Academy of Dermatology

Amoxicillin-induced generalized eruption associated with Epstein-Barr virus reactivation in pregnancy.

Jul, 2017

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International journal of dermatology

Striae gravidarum: Risk factors, prevention, and management.

Jun, 2017

Striae gravidarum (SG) are atrophic linear scars that represent one of the most common connective tissue changes during pregnancy. SG can cause emotional and psychological distress for many women. Research on risk factors, prevention, and management of SG has been often inconclusive. leer más

International journal of women's dermatology

Psychocutaneous disease: Pharmacotherapy and psychotherapy.

May, 2017

Building a strong therapeutic alliance with the patient is of utmost importance in the management of psychocutaneous disease. Optimal management of psychocutaneous disease includes both pharmacotherapy and psychotherapy. This article reviews psychotropic medications currently used for psychocutaneous disease, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics, with a discussion of relevant dosing regimens and adverse effects. Pruritus management is addressed. In addition, basic and complex forms of psychotherapy, such as cognitive-behavioral therapy and habit-reversal training, are described. leer más

Journal of the American Academy of Dermatology

Psychocutaneous disease: Clinical perspectives.

May, 2017

Psychocutaneous disease, defined in this review as primary psychiatric disease with skin manifestations, is commonly encountered in dermatology. Dermatologists can play an important role in the management of psychocutaneous disease because patients visit dermatology for treatment of their skin problems but often refuse psychiatric intervention. This review describes common psychocutaneous syndromes, including delusional, factitious, obsessive-compulsive and related, and eating disorders, as well as psychogenic pruritus, cutaneous sensory (pain) syndromes, posttraumatic stress disorder, and sleep-wake disorders. The updated classification of these disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition is included. Strategies for management are reviewed. leer más

Journal of the American Academy of Dermatology

A review of the safety of cosmetic procedures during pregnancy and lactation.

Mar, 2017

The safety of cosmetic procedures in patients who are pregnant and/or lactating is a complex clinical question surrounded by uncertainty. Our objective is to consolidate data on the safety of commonly requested cosmetic procedures during pregnancy and lactation after a systematic review of the current literature to guide evidence-based care in the future. A systematic search of the PubMed database was conducted for articles on cosmetic procedures during pregnancy and lactation. Due to a lack of controlled trials, case reports and series were considered. Minor procedures such as shave, punch, snipping, and electrocautery are considered safe. With respect to chemical peels, glycolic and lactic acid peels are deemed safe; however, trichloracetic and salicylic acid peels should be avoided or used with caution. Although safety data on botulinum toxin A is insufficient, the procedure may be safe because systemic absorption and placental transfer are negligible. Sclerotherapy can be safe during pregnancy but must be avoided during the first trimester and after week 36 of the pregnancy. Laser and light therapies have been considered generally safe for patients with granulomatous conditions and condylomata. Epilation should be limited to waxing, shaving, and topical treatments instead of permanent procedures. In patients who are lactating, most therapies discussed above are safe but fat transfer, sclerotherapy, and tumescent liposuction are not recommended. Better evidence is needed to make concrete recommendations on the safety of cosmetic therapy during pregnancy and lactation but preliminary evidence suggests excellent safety profiles for many commonly requested cosmetic procedures. leer más

International journal of women's dermatology

Severe, ulcerative, lichenoid mucositis associated with secukinumab.

Sep, 2016

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JAAD case reports

Aminolevulinic Acid Photodynamic Therapy in the Treatment of Erosive Pustular Dermatosis of the Scalp: A Case Series.

06, 2016

Erosive pustular dermatosis of the scalp (EPDS) is an inflammatory skin condition that develops on sun-damaged skin in older individuals. Patients with EPDS present a therapeutic challenge because medical treatments and surgical modalities have met with limited success. Methyl aminolevulinate photodynamic therapy has been effective in 1 case but induced the disease in others. leer más

JAMA dermatology

Melasma Improving Spontaneously upon Switching from a Combined Oral Contraceptive to a Hormone-releasing Intrauterine Device: A Report of Four Cases.

May, 2015

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Acta dermato-venereologica

Psychology of aesthetics: Beauty, social media, and body dysmorphic disorder.

2023

The perception of beauty is fluid within society and can morph based on cultural practices and societal interaction, such as social media exposure. The exposure to digital conference platforms has increased significantly, leading users to check their appearance constantly and find flaws in their perceived virtual appearance. Studies have shown that frequent social media use may lead to unrealistic body image ideals, a significant concern with appearance, and anxiety. Also, social media exposure can worsen body image dissatisfaction, social networking site addiction, and comorbidities of body dysmorphic disorder (BDD) such as depression and eating disorders. Additionally, excessive social media use can increase preoccupation with imagined image defects among BDD patients leading them to pursue minimally invasive cosmetic and plastic surgery procedures. This contribution aims to provide an overview of the evidence surrounding the perception of beauty, cultural aspects of aesthetics, and social media's consequences, especially on BDD's clinical specifics. leer más

Clinics in dermatology

Through the looking glass: Skin signs that help diagnose eating disorders.

2023

Eating disorders (EDs) such as anorexia nervosa and bulimia nervosa have a plethora of skin manifestations. They can be categorized into skin signs of self-purging, skin signs of starvation, skin signs related to drug abuse, skin signs of psychiatric comorbidity, and miscellaneous signs. "Guiding signs" are valuable because they are pointers to the diagnosis of an ED. They include hypertrichosis (lanugo-like hair), Russell's sign (knuckle calluses), self-induced dermatitis, and perimylolysis (tooth enamel erosion). Practitioners should recognize such skin signs promptly, as this helps to diagnose early, which may improve the prognosis of ED. Management requires a multidisciplinary approach that focuses on psychotherapy combined with attention to medical complications, nutritional needs, and nonpsychiatric findings such as cutaneous manifestations. Psychotropic medications that are currently used in EDs include pimozide and atypical antipsychotic agents, such as aripiprazole and olanzapine, fluoxetine, and lisdexamfetamine. leer más

Clinics in dermatology

The role of lipids in vitiligo and schizophrenia.

2023

The pathogenesis of vitiligo and schizophrenia has not been adequately clarified. We explore the role of lipids in these diseases. Both conditions have been associated with stress in several observations and studies. Research data indicate complex interactions between oxidative stress and metabolic syndrome-with lipid abnormalities being a significant component of the latter-in these diseases. The impaired membrane lipid homeostasis mechanism is related to the increased phospholipid remodeling caused by excessive oxidative stress in schizophrenia. We indicate that sphingomyelin is possibly involved in the pathogenesis of these diseases. Statins have anti-inflammatory and immunomodulating effects and an effect against oxidative stress. Preliminary clinical studies show that these agents may be beneficial in both vitiligo and schizophrenia, but their therapeutic value should be studied further. leer más

Clinics in dermatology

Body dysmorphic disorder: A critical appraisal of diagnostic, screening, and assessment tools.

2023

Body dysmorphic disorder (BDD) is a psychiatric condition characterized by profound concern about a minor or imagined defect in the appearance of individuals and increased preoccupation with the imagined/perceived defect. Individuals with BDD often undergo cosmetic intervention for the perceived imperfection but rarely experience improvement in their signs and symptoms after such treatment. It is recommended that aesthetic providers evaluate individuals face-to-face and screen for BDD with approved scales preoperatively to determine the candidate's suitability for the procedure. This contribution focuses on diagnostic and screening tools and measures of disease severity and insight that providers working in nonpsychiatric settings can use. Several screening tools were explicitly developed for BDD; others were designed to evaluate body image/dysmorphic concern. The BDD Questionnaire (BDDQ)-Dermatology Version (BDDQ-DV), BDDQ-Aesthetic Surgery (BDDQ-AS), Cosmetic Procedure Screening Questionnaire (COPS), and Body Dysmorphic Symptom Scale (BDSS) have been developed explicitly for BDD and validated in cosmetic settings. The limitations of screening tools are discussed. Given the increasing use of social media, future revisions of BDD instruments should consider incorporating questions relevant to patients' behaviors on social media. Current screening tools can adequately test for BDD despite their limitations and a need for updates. leer más

Clinics in dermatology

Psychocutaneous medicine: A psychopathology-based, problem-focused approach.

2023

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Clinics in dermatology

Beauty perception: A historical and contemporary review.

2023

The power of beauty influences many aspects of modern society and daily life-perceptions surrounding beauty date back to ancient philosophers and have evolved significantly throughout history. Still, there appear to be universally accepted physical characteristics of beauty that span different cultures. Human beings have an inherent ability to distinguish between attractive and nonattractive based on physical features that include facial averageness, symmetry, skin homogeneity, and sexual dimorphism (sex-typical characteristics). Although beauty standards have changed over time, youthful appearance has remained a permanent influential component of facial attractiveness. Each person's perception of beauty is influenced by environment and perceptual adaptation, an experience-based process. Perception of beauty varies by race and ethnicity. We discuss typical features of White, Asian, Black, and Latino beauty. We also review the effects of globalization on spreading foreign beauty culture and discuss how social media change traditional beauty stereotypes within the different races and ethnicities. leer más

Clinics in dermatology

Atypical Clinical Presentation of Hidradenitis Suppurativa in a Patient with Severe Mannose-Binding Lectin Deficiency.

2020

Mannose-binding lectin (MBL) deficiency is associated with recurrent infections, autoimmune and inflammatory skin disease, and vascular complications. MBL deficiency is not a recognized comorbidity in hidradenitis suppurativa (HS); the latter is associated with the group of autoinflammatory disorders. A 32-year-old woman presented with a history of recurrent painful, deep-seated abscesses and pustular lesions since the age of 13 years. Lesions were noted predominantly in HS distribution, i.e., submammary, inguinal, and perianal areas were affected. However, unusual locations (jawlines, neck) were also affected. The patient fulfilled the clinical criteria for HS but the presentation was atypical because lesions were noted in unusual locations, most lesions were in Hurley stage 1 (sparsity of sinus tracts and scarring), and most cultures from abscesses and pustular lesions were negative. The excruciating pain caused by constantly developing abscesses had a profound impact on the patient's quality of life. Laboratory workup showed an exceptionally low serum MBL level. Treatment was challenging with only a temporary, mild response to oral antibiotic therapy and no response to immunosuppressive and hormonal therapies. This atypical HS presentation may reflect an enhancement of proinflammatory mechanisms. Health care providers should be aware of this clinicopathologic presentation so that the establishment of HS diagnosis is not delayed and the patient receives appropriate counseling. leer más

Case reports in dermatology

Carboxytherapy in dermatology.

2022

Carboxytherapy is a medical technique during which a sterile gas-carbon dioxide-is injected into the subdermal tissue. The utility of carbon dioxide injections has enhanced the practical relevance of carboxytherapy as a method for the management of multiple disorders. We have evaluated its use in the treatment of dermatologic conditions by searching electronic databases (ie, MEDLINE and PubMed) for contributions in the English language through January 2021. Carboxytherapy provides an attractive aesthetic option in skin rejuvenation, atrophic scars, striae distensae (stretch marks), cellulite-fibrolipodystrophy adhesions after liposuction, and certain types of alopecia. We discuss the drawbacks of the procedure including inadvertent lipolysis, long-lasting emphysema, and suboptimal outcomes. leer más

Clinics in dermatology

Evaluating resurfacing modalities in aesthetics.

2022

Skin resurfacing for cutaneous rejuvenation has evolved with the development of a plethora of nonsurgical and minimally invasive modalities. We have highlighted the advances in laser therapy, chemical peels, radiofrequency, microneedling, and platelet-rich plasma therapy. We have also included studies providing head-to-head comparisons between procedures and discussed relevant debates in the field. We have examined additionally combination treatments and resurfacing in acne scars, melasma, and skin of color. leer más

Clinics in dermatology

Aminolevulinic Acid-Photodynamic Therapy for Erosive Pustular Dermatosis of the Scalp: Comparison of Two Treatment Protocols and Participant Satisfaction.

2022

Treatment of erosive pustular dermatosis of the scalp (EPDS) is challenging. Topical and systemic medications have achieved limited success, and destructive modalities have been associated with EPDS recurrence because of the tendency of the condition to recur after any treatment that induces trauma to the skin. Our group has have recently reported two series of EPDS treated with aminolevulinic acid-photodynamic therapy (ALA-PDT). Here, we aimed at comparing the protocols utilized in those series regarding efficacy, cost, and patient satisfaction. The first protocol included one visit for curettage of the hyperkeratosis and a second one for ALA-PDT. The revised (second) protocol included all procedures (curettage and ALA-PDT) in one visit. A novel silicone gel was applied immediately after completion of PDT, and patients were instructed to apply it twice daily over the treated areas until their follow-up visit. Both protocols were efficacious and provided similar length of remission. The second protocol was less costly. Patients treated using the second protocol were more satisfied due to the ease of treatment completion in one visit and better postoperative healing. (. 2022;20:107-112). leer más

Skinmed

Optoacoustic imaging and potential applications of raster-scan optoacoustic mesoscopy in dermatology.

2022

Optoacoustic imaging (OAI) is a hybrid imaging modality that integrates the benefits of optical contrast and ultrasound detection. Raster-scan optoacoustic mesoscopy (RSOM) is an emerging OAI method that provides information about several dermatological conditions' structural, functional, and molecular features. We searched PubMed and Google Scholar databases through September 2021 for contributions relevant to OAI in the English language. This review contains 32 studies and other relevant literature. Several studies indicate that RSOM is helpful in inflammatory skin conditions such as psoriasis and eczema, especially as it allows more accurate quantification of inflammation-related alterations such as changes to the dermal vasculature. In psoriasis, RSOM can provide objective early diagnosis and monitoring of disease activity and treatment efficacy. Multispectral RSOM, a method in which skin is lightened at more than a single wavelength, is beneficial in diagnosing and monitoring hypoxia-associated conditions, such as systemic sclerosis and chronic wounds. OAI techniques can visualize the pathologicvascularization of skin cancers and quantify their oxygenation status which helps differentiate them from normal skin. Also, they can measure the depth of malignant melanoma and detect the metastatic spread of melanoma cells to sentinel lymph nodes. As demonstrated in this contribution, there is a large spectrum of potential applications of OAI imaging, especially RSOM, in diagnosing, treating, and managing skin diseases. leer más

Clinics in dermatology

Global impact on dermatology practice due to the COVID-19 pandemic.

2021

This contribution focuses on the effects of coronavirus disease 2019 (COVID-19) on dermatology practice. We discuss the impact on practice volume and procedures and on the considerable increase in teledermatology use. We also describe the important roles that dermatologists have played in enhancing infection prevention and on the frontline. During the crisis, dermatologists have faced the challenge of a shortage of resources, such as personal protective equipment, in the health care system. In addition, they have been involved in managing cutaneous manifestations related to COVID-19 and occupational disease caused by personal protective equipment. Dermatologists have made a diligent effort to identify melanoma and to ensure the treatment of high-risk skin cancers. Safety guidelines have been suggested to minimize the potential risks associated with the systemic use of immunosuppressant agents and immunomodulators in patients with severe inflammatory skin disease during the pandemic. Finally, social distancing necessitated that dermatology conferences take place virtually and teaching via e-learning increased. leer más

Clinics in dermatology

Virtual conferences and e-learning in dermatology during COVID-19 pandemic: Results of a web-based, global survey.

2021

During the pandemic, virtual conferences became the norm. We conducted a cross-sectional global study to assess dermatologists' responses to virtual conference and e-learning program attendance, as well as to discuss the status of such events during the pandemic. This web-based, global survey included 733 dermatologists. Primary outcomes are percentages of responders answering questions. Assessment of the relationship between two categorical variables was performed with the chi-square test. A substantial percentage of responders were willing to attend a virtual meeting (70.6%) or webinar (80.2%), or to conduct a webinar (47.3%). Among participants who provided resident or fellow training before the pandemic, 38% responded that they did not have any teaching systems in place during the pandemic. Virtual conference attendance was significantly associated with video conference attendance before the pandemic, webinar attendance, teledermatology (TD) use during the pandemic, future TD use, having training systems in place for residents or fellows (P < .001 for each), and North American location of participant (P = .001). Webinar attendance was associated with North American location, conducting webinars (P < .001 for each), and future TD use (P = .024). This pandemic has had a profound effect on dermatology conferences and e-learning programs. Attending video conferences and webinars or other online training was associated with TD use and future use, which indicates that these technologies are all here to stay. leer más

Clinics in dermatology

Availability of personal protective equipment among dermatologists in the COVID-19 pandemic: Assessment and risk factors in a web-based, global study.

2021

The availability of personal protective equipment (PPE) among dermatologists during the Coronavirus Disease 2019 (COVID-19) pandemic has not been studied. leer más

Clinics in dermatology

Genital diseases in the mature woman.

2018

Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. Similarly, the incidence of vulvovaginal malignancies, such as squamous cell carcinoma and extramammary Paget disease, rises exponentially after 65 years of age. Early diagnosis of these malignancies is of utmost importance. Lichen sclerosus et atrophicus and vulvovaginal candidosis are among the most common postmenopausal vulvovaginal conditions. Lichen sclerosus et atrophicus is associated with significant morbidity, and its management can be challenging. The incidence of vulvovaginal candidosis increases in patients on estrogen replacement therapy. leer más

Clinics in dermatology

Gynecologic and andrologic dermatology and the metabolic syndrome.

2018

The relationship of sex hormones to obesity and inflammation has been extensively studied. Research on endogenous and exogenous sex steroids, including studies on animal models of metabolic syndrome (MetS), has indicated that sex hormones are involved in metabolic pathways relevant to MetS. Lower testosterone levels in men and higher levels in women increase risks of MetS and type 2 diabetes mellitus (T2DM). Lower levels of sex hormone-binding globulin increase risks of MetS and T2DM in both sexes. Skin diseases that are sex hormone mediated, such as polycystic ovary syndrome, acanthosis nigricans, acne vulgaris, and pattern alopecia, have been associated with insulin resistance. Insulin resistance increases the risk for metabolic and potentially cardiovascular complications, and patients with such skin diseases should be followed for a prolonged time to determine whether they develop these complications. Early intervention may help delay or prevent the onset of T2DM and decrease cardiovascular risks. leer más

Clinics in dermatology

Bipolar disorder in patients with psoriasis and the impact of lithium therapy on psoriasis.

2025

There is a significant amount of research examining the link between psoriasis and common mental health disorders; however, studies on less common psychiatric disorders, such as bipolar disorder (BD), remain limited. We conducted a systematic review of studies in the PubMed and Cochrane databases that explored the relationship between BD and psoriasis. In addition, we evaluated the impact of lithium on psoriasis in patients with BD and included a quality assessment of all the studies. This review covers five studies that addressed the connection between psoriasis and psychiatric disorders, three studies on medical conditions in patients with BD, and four studies examining the effects of lithium intake on psoriasis in BD patients. We found substantial evidence supporting a link between psoriasis and BD, suggesting that psoriasis is an independent risk factor for BD. Patients with psoriasis are also more likely to use psychotropic medications. A limited number of studies indicate that lithium therapy may trigger or worsen psoriasis. We also explore the mechanisms of lithium-induced or lithium-aggravated psoriasis, highlighting the intricate interplay between lithium treatment, inositol depletion, and psoriasis in patients with BD. In a placebo-controlled, randomized study, inositol supplementation could mitigate psoriasis in patients taking lithium. Additional research is needed to evaluate the efficacy of inositol supplementation for patients with psoriasis who need to continue lithium treatment for their BD. leer más

Clinics in dermatology

Cosmetic Procedures in Pregnancy: A Reappraisal.

2017

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Skinmed

Drug safety: Pregnancy rating classifications and controversies.

2016

This contribution consolidates data on international pregnancy rating classifications, including the former US Food and Drug Administration (FDA), Swedish, and Australian classification systems, as well as the evidence-based medicine system, and discusses discrepancies among them. It reviews the new Pregnancy and Lactation Labeling Rule (PLLR) that replaced the former FDA labeling system with narrative-based labeling requirements. PLLR emphasizes on human data and highlights pregnancy exposure registry information. In this context, the review discusses important data on the safety of most medications used in the management of skin disease in pregnancy. There are also discussions of controversies relevant to the safety of certain dermatologic medications during gestation. leer más

Clinics in dermatology

Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: Facts and controversies.

2016

Prurigo (PP) and pruritic folliculitis of pregnancy (PFP) are poorly characterized entities. Traditionally classified under specific dermatoses of pregnancy, they were reclassified under a new umbrella entity, atopic eruption of pregnancy (AEP), which also includes atopic dermatitis (AD) that can worsen or present for the first time in pregnancy. Still, several aspects of AEP have not been adequately elucidated. It needs to be clarified whether it is the intrinsic ("nonallergic" or "atopiform dermatitis") or extrinsic (immunoglobulin E-associated) AD that is affected by pregnancy. Future studies need to examine the postpartum prognosis of AD that develops for the first time during gestation. A revision of diagnostic criteria of AEP will allow a more accurate estimate of its prevalence, as well as clarification of the relationship between AD and specific dermatoses, such as PP and PFP. In this context, this review discusses the history, epidemiologic data, clinicopathologic features, and management of these entities. leer más

Clinics in dermatology

Oral Methotrexate Treatment of Delayed-Onset Inflammatory Reactions to Dermal Fillers.

2024

In aesthetic practice, delayed-onset (late) inflammatory reactions (DIRs) to dermal fillers are encountered. The treatment of DIRs can be challenging, with a response to established therapies, including oral antibiotics, intralesional and oral steroids, and hyaluronidase injection, occasionally reported as unsatisfactory. leer más

Aesthetic surgery journal. Open forum

A critical review of COVID-19 course and vaccination in dermatology patients on immunomodulatory/biologic therapy: recommendations should not differ between non-pregnant and pregnant individuals.

2023

COVID-19 can have detrimental effects on immunosuppressed patients. Here, we evaluate the evidence regarding continuing immunomodulatory/biologic (IMBI) therapy in pregnant dermatology patients during the COVID-19 pandemic. Also, we discuss the risks of COVID-19 vaccination in pregnant dermatology patients on IMBI therapy. As indicated in this review, regarding continuing IMBI therapy in pregnant dermatology patients during the pandemic, there is no compelling reason for treating them differently than non-pregnant. The body of evidence indicates that mRNA COVID-19 vaccines are safe during pregnancy. Studies on rheumatology patients, a group that overlaps significantly with the dermatology group, provided essential findings. IMBI in a non-pregnant rheumatology patient was not associated with COVID-19 mortality (except for rituximab), and vaccination of the rheumatology patient during pregnancy improved the obstetric outcomes compared to the unvaccinated patient. Based on this data, it can be stated that after weighing the benefit-risk profile of the available COVID-19 vaccines, the recommendation for the pregnant dermatology patient speaks in favor of the COVID-19 vaccination. COVID-19 vaccine recommendations in pregnant dermatology patients on IMBI should not differ from those for their non-pregnant counterparts. leer más

Frontiers in medicine

Scalp Ulcer due to Intralesional Corticosteroid Injection.

2023

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Skinmed

Idiopathic Acroosteolysis: A Novel Cutaneous Sign Can Help Identify the Condition Early.

2023

Acroosteolysis (AO) is a rare condition characterized by resorption of the distal phalanges of the fingers and/or toes. It can be familial, idiopathic (IAO), occupational, or secondary. Other authors suggest a classification into primary (genetic disorders, lysosomal storage disorders) or secondary AO. Various skin and nail changes have been reported in this condition. However, the cutaneous change on the affected digit(s)/toe(s) during the natural course of AO has been poorly documented. A 5-year-old girl presented with a 3-month history of a distinct transverse boundary between normal skin proximally and affected crusted skin overlying osteolysis distally ("split" sign) on the plantar surface of the third toe. This boundary gradually elongated circumferentially to involve the dorsal surface. The mother gave a similar history of a delimitation line on the 2nd, 4th, and 5th toes of the right foot with durations of 3 months, 1 year, and 2 years, respectively, that disappeared before she noticed a shortening of those toes. X-rays revealed partial resorption of the terminal phalanx of the third toe and several lytic changes in the middle and terminal phalanx of the second, fourth, and fifth toes. The clinical features, radiology findings, and a workup that helped rule out conditions associated with AO (secondary AO) helped establish the diagnosis of IAO in our patient. This case study highlights that the natural course of IAO includes distinct skin findings, such as the "split" sign that we describe. This sign can help identify the condition early. leer más

Case reports in dermatology