{"title":"Introduction to the Potpourri III Issue","authors":"Faraz Yousefian","doi":"10.1002/der2.70087","DOIUrl":"https://doi.org/10.1002/der2.70087","url":null,"abstract":"","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148752663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exosomes: Biology, Sources and Isolation Techniques","authors":"Aseem Sharma, Rajiv Kaul, Neha Akhoon","doi":"10.1002/der2.70086","DOIUrl":"https://doi.org/10.1002/der2.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Exosomes are nanosized extracellular vesicles of endosomal origin that mediate intercellular communication through the transfer of proteins, lipids, nucleic acids, metabolites, and other bioactive cargo. Their ability to regulate immune responses, tissue repair, angiogenesis, extracellular matrix remodeling, and cellular homeostasis has generated substantial interest in their diagnostic and therapeutic applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To provide a comprehensive overview of exosome biology, molecular cargo, cellular sources, isolation and characterization methodologies, dermatologic applications, and emerging translational strategies relevant to regenerative medicine and dermatology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative review of contemporary literature was performed to summarize current evidence regarding exosome biogenesis, cargo sorting, cellular sources, isolation and characterization techniques, storage considerations, engineered therapeutic approaches, and clinical applications in dermatology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Exosomes are generated through the endosomal pathway and contain selectively packaged proteins, lipids, DNA, messenger RNAs, microRNAs, and other regulatory molecules that reflect the biological state of the parent cell. Mesenchymal stem cells, adipose-derived stem cells, umbilical cord-derived mesenchymal stem cells, platelets, fibroblasts, and keratinocytes have emerged as important exosome sources for regenerative applications. Advances in isolation technologies, including ultracentrifugation, size-exclusion chromatography, immunoaffinity capture, and microfluidic platforms, have improved extracellular vesicle characterization and translational research. In dermatology, exosomes have demonstrated promising applications in wound healing, skin rejuvenation, hair regeneration, scar modulation, pigmentary disorders, inflammatory dermatoses, and cutaneous oncology. Furthermore, bioengineering approaches have enabled the development of exosome-based drug delivery systems, targeted therapeutics, and hydrogel-assisted delivery platforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Exosomes represent a rapidly evolving platform for precision diagnostics, regenerative medicine, and targeted therapeutics. Their unique biological properties, favorable safety profile, and cell-free therapeutic potential position them as promising candidates for future dermatologic applications. However, challenges related to standardization, l","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148615516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabrina Fabi, John Fezza, Jeremy B. Green, Jean Carruthers, Nazanin Ashourian, Elena Dimitrijevic, Steven Yoelin
{"title":"Expert Treatment Considerations for Lower Face and Neck Rejuvenation","authors":"Sabrina Fabi, John Fezza, Jeremy B. Green, Jean Carruthers, Nazanin Ashourian, Elena Dimitrijevic, Steven Yoelin","doi":"10.1002/der2.70083","DOIUrl":"https://doi.org/10.1002/der2.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The lower face and neck are essential to overall facial harmony and a balanced appearance. Although most nonsurgical treatments have focused on the upper and midface, a variety of minimally invasive options are now available for treating the lower face and neck that target different aesthetic concerns and provide welcome alternatives to surgery. This review offers guidance for clinicians treating the lower face and neck, including a description of the interactions among different facial layers and their contributions to esthetic concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PubMed database was searched for original studies and review articles related to anatomical tissue layers of the lower face and neck and minimally invasive treatments for lower face and neck aesthetic, preferentially considering randomized controlled trials. We synthesized the literature into this narrative review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patient assessment should encompass the entire face and neck, even when aesthetic concerns relate primarily to a single area, and should involve physical examination and photos at rest and during animation. Due to interactions among facial layers, an important goal of assessment is to determine the contribution of bone, fat, muscle, glands, and skin to patients' aesthetic concerns. Minimally invasive treatments for the lower face and neck considered here include fillers, neuromodulators, adipocytolysis, and energy-based devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Minimally invasive treatments can lead to notable improvement in individual aesthetic concerns of the lower face and neck that serve to highlight their importance in overall appearance. This paper recommends careful patient selection and management of expectations, along with suggestions for combining and sequencing various minimally invasive treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148615240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Longevity in Aesthetic Dermatology: Review of the Literature","authors":"Zachary Sone, David Goldberg","doi":"10.1002/der2.70084","DOIUrl":"https://doi.org/10.1002/der2.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aesthetic dermatology is increasingly framed within a skin longevity paradigm that emphasizes sustained skin quality and functional preservation rather than short-term cosmetic change alone. This review looks at evidence relevant to skin longevity, integrating biologic mechanisms of skin aging, approaches to outcome measurement, exosomes and lifestyle contributors, as well as key safety and regulatory considerations. Most outcomes discussed reflect surrogate, short-term, or cosmetic measures rather than validated indicators of long-term skin health, and this limitation is discussed explicitly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a narrative (non-systematic) review; a targeted PubMed/MEDLINE search (January 2015–May 2026) and a validated evidence-grading framework (GRADE) were used, as detailed in the Methods. Extracellular matrix remodeling and collagen depletion, oxidative stress, chronic low-grade inflammation, cellular senescence, and reduced reparative capacity consistently link to clinical dyspigmentation, photodamage, textural change, laxity, and dermal thinning and/or volume loss. Skin healthspan is measured across studies, using approaches that include photoaging scales, standardized photography, patient and investigator assessments, and objective measures such as hydration, transepidermal water loss, and elasticity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Interventions are reviewed, including prevention, topical therapies, energy-based devices, injectables, and emerging regenerative or biologic approaches, with the most consistent evidence supporting prevention and well-studied topicals. Procedural and regenerative modalities show greater variability in durability, safety, and evidentiary maturity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on the integrated literature, a phenotype-guided approach may help operationalize skin longevity in clinical practice. Patients can be stratified according to dominant aging patterns, including photodamage, texture change, laxity, or volume loss, with interventions selected to address both upstream drivers and downstream structural consequences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Hammock Hypothesis: An Integrative Conceptual Framework for Facial Aging","authors":"Chuan-Yuan Lin, Jui-Yu Lin, Konstantin Frank, Sachithevi Sivananthan, Vanravi Vachatimanont, Carmelo Crisafulli, Fowzieh Rasras, Razan Kadry, Hala Alsadik, Lehavit Ackerman, Phuong Nguyen Ngoc Dong, Lukas Prantl","doi":"10.1002/der2.70085","DOIUrl":"https://doi.org/10.1002/der2.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Facial aging is a multilayered and regionally heterogeneous process involving coordinated changes in the facial skeleton, fat compartments, retaining structures, fascial continuity, mimetic activity, and skin. Existing anatomical models have advanced understanding of age-related facial change, but may not fully explain how interactions across tissue layers and neighboring regions become expressed as recognizable surface phenotypes. This narrative review examines current concepts of facial aging and proposes the Hammock Hypothesis as an integrative structure–function framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Relevant literature was synthesized thematically across six domains: skeletal remodeling; superficial and deep fat-compartment change; retaining ligaments and septal support; superficial musculoaponeurotic system, fascial planes, and soft-tissue continuity; skin envelope and dermal aging; and dynamic influences. These concepts were organized into four interrelated dimensions of facial support behavior.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Hammock Hypothesis interprets visible facial aging as progressive disequilibrium within a mechanically coupled multilayer support system. The four proposed dimensions are: support base and foundational projection; anchoring and suspensory restraint; load transmission and dynamic redistribution; and surface deformation and visible expression. This framework relates whole-face support behavior to regional manifestations including tear trough prominence, midfacial flattening, nasolabial fold accentuation, jowl formation, marionette change, and temporal hollowing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Hammock Hypothesis is not intended to replace existing anatomical models, but to provide an integrative conceptual framework for clinical interpretation. It should be regarded as a heuristic and hypothesis-generating model requiring validation through imaging, biomechanical analysis, and phenotype-based clinical studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghada Farouk Mohammed, Mohammed Saleh Al-Dhubaibi, Lina Mohammed Atef, Saleh Salem Bahaj, Ahmed Mohammed Al-Dhubaibi, Nada Sameh Aziz, Tarek Ragab Ali Mohammed, Sameh Saad Aziz
{"title":"Exploring the Role of Poly-L-Lactic Acid in Dermatology","authors":"Ghada Farouk Mohammed, Mohammed Saleh Al-Dhubaibi, Lina Mohammed Atef, Saleh Salem Bahaj, Ahmed Mohammed Al-Dhubaibi, Nada Sameh Aziz, Tarek Ragab Ali Mohammed, Sameh Saad Aziz","doi":"10.1002/der2.70079","DOIUrl":"https://doi.org/10.1002/der2.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The rising demand for non-invasive cosmetic procedures has led to increased use of biocompatible dermal fillers like Poly-<span>l</span>-Lactic Acid (PLLA), a synthetic, biodegradable polymer known for stimulating neocollagenesis and providing gradual, sustained volumization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To comprehensively examine PLLA's development, properties, clinical efficacy, safety, and potential future directions in dermatological and aesthetic applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and comparative clinical evaluation were conducted on PLLA's stereochemical structure, biostimulatory mechanisms, and outcomes. Comparisons with hyaluronic acid and calcium hydroxylapatite (CaHA) fillers were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Studies revealed a 30% increase in collagen types I and III within 3 months post-treatment. Around 80% of patients reported improved skin texture and volume. Mild adverse events (swelling, bruising) were reported in 35% of cases, while serious complications remained rare (0.4%). Advanced techniques—such as cannula use and microjet injection—have reduced complications, with nodule formation rates < 0.5% when proper protocols are followed. Compared to hyaluronic acid and calcium hydroxylapatite, PLLA provides superior long-term aesthetic outcomes with minimal adverse effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PLLA offers a promising, long-term alternative for skin rejuvenation. Continued innovation in formulation and delivery systems is expected to expand its dermatologic applications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Secondary Intention Healing and Re-Volumization After Mohs Surgery With a Collagen-Mānuka Honey-Hydroxyapatite Dressing: A Prospective Study","authors":"Karen Montecinos, David J. Goldberg","doi":"10.1002/der2.70076","DOIUrl":"https://doi.org/10.1002/der2.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Secondary intention healing (SIH) after Mohs micrographic surgery (MMS) is often limited by delayed closure, infection risk, and infrequent follow-up. Traditional surface-area assessments overlook wound depth. Re-volumization, wound depth restoration, may better indicate healing progress. A novel, patient-administered collagen–Mānuka honey–hydroxyapatite dressing (CHD) has demonstrated benefits in reducing pain and progressing healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluate efficacy, safety, and satisfaction of CHD in at-home SIH after MMS, emphasizing re-volumization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Materials</h3>\u0000 \u0000 <p>In this IRB-approved prospective study, 10 adults with full-thickness post-MMS wounds applied CHD daily for 2 months via a durable medical equipment (DME) model. Wounds assessed by area, volume, photography, scar scales, and satisfaction. Safety monitored via adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline wound area and volume averaged 2.99 cm² and 2.35 cm³. Wound area decreased linearly; volume decreased exponentially, with 50% achieving full re-volumization within 1 month and 90% achieving > 90% by 2 months. Investigators rated healing speed 8.0/10; patients rated 8.67/10. Pain was minimal, scar appearance favorable, and satisfaction high (8.25/10). Dressing was simple to use, empowering independent at-home healing. One withdrew due to secondary adhesive irritation; no serious adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CHD is a suitable, affordable, patient-administered option for SIH after MMS, demonstrating rapid re-volumization, minimal pain, and high satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Glucuronyl Glucosyloleanolate: Discovery and Evaluation of a Skin Depigmenting Compound","authors":"Yannick Quesnel, Michael Gold","doi":"10.1002/der2.70074","DOIUrl":"https://doi.org/10.1002/der2.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Growing regulatory and safety limitations of established tyrosinase inhibitors create an unmet need for safer, mechanistically distinct depigmenting agents. Glucuronyl Glucosyloleanolate (GGO), a natural saponin, was identified through an AI-enabled discovery platform integrating public compound databases with in silico physicochemical and toxicity predictions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>GGO was evaluated in normal human epidermal melanocyte (NHEM) models for melanin inhibition and tyrosinase activity. Ex vivo activity was assessed in UV-stimulated NativeSkin human skin explants. Safety was evaluated by semi-occlusive patch test (<i>n</i> = 12) and a validated GARDskin assay (OECD 442E). Clinical efficacy was assessed in a randomized, single-blind, placebo-controlled trial (<i>n</i> = 60; 84 days; 0.01% twice-daily application), stratified by Fitzpatrick phototype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GGO inhibited melanin production by up to 86% at 2 µg/mL in NHEMs, outperforming hydroquinone, kojic acid, niacinamide, and tranexamic acid. GGO did not directly inhibit tyrosinase, indicating a distinct mechanism. In UV-stimulated explants, melanin content decreased 45% and tyrosinase expression by 2.4-fold. No irritation (mean irritation index 0.00) or sensitization potential was detected. Clinically, GGO produced statistically significant increases in Individual Typology Angle (ITA°) from Day 21: 11% in phototype III, 14% in phototype IV, and 24% in phototype V at Day 84.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GGO is a safe and effective depigmenting ingredient with a differentiated, multi-target mechanism of action. These data support its use as a clinically validated cosmetic active for skin brightening and hyperpigmentation management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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