Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Topical <i>Garcinia Mangostana</i> Pericarp Extract Attenuates TPA-Induced Cutaneous Inflammation and Oxidative Stress in Mice: Preclinical Implications for Tumor Promotion-Related Inflammatory Mechanisms.","authors":"Siswanto Wahab, Khairuddin Djawad, Nuril Ilmi, Upik Anderiani Miskad, Nasrum Massi","doi":"10.2147/CCID.S638847","DOIUrl":"10.2147/CCID.S638847","url":null,"abstract":"<p><strong>Purpose: </strong>Persistent cutaneous inflammation and oxidative stress drive the promotion stage of skin carcinogenesis. Most evidence for <i>Garcinia mangostana</i> pericarp comes from purified α-mangostin tested in vitro or given systemically. We evaluated whether a standardized crude <i>G. mangostana</i> pericarp extract (GMPE) applied topically produces concentration-related anti-inflammatory and antioxidant effects in acute 12-<i>O</i>-tetradecanoylphorbol-13-acetate (TPA)-induced skin inflammation in mice.</p><p><strong>Methods: </strong>Thirty-five male Swiss albino mice were randomized to seven groups (n = 5): negative control, TPA control, TPA + vehicle cream, TPA + 1% hydrocortisone, and TPA + GMPE cream at 2.5%, 5%, and 10%. GMPE was standardized for α-mangostin by ultra-performance liquid chromatography. Cutaneous tumor necrosis factor-alpha (TNF-α; ELISA) and malondialdehyde (MDA; TBARS assay) were measured, and epidermal thickness, neutrophil infiltration, and immunohistochemical TNF-α and MDA expression (immunoreactive score, IRS) were assessed by a blinded observer.</p><p><strong>Results: </strong>GMPE contained 17.54 ± 0.03% (w/w) α-mangostin. TPA raised TNF-α from 22.03 ± 11.43 to 77.03 ± 17.50 pg/mL and MDA from 0.48 ± 0.13 to 0.92 ± 0.10 nmol/mL, increased epidermal thickness fivefold, and induced neutrophil infiltration (all p < 0.001). GMPE 10% lowered TNF-α to 24.81 ± 11.85 pg/mL and MDA to 0.48 ± 0.10 nmol/mL, values not different from healthy skin or from hydrocortisone, and restored epidermal thickness (50 ± 20 µm). Immunohistochemistry confirmed these changes. A linear concentration-response was significant for MDA (p = 0.001).</p><p><strong>Conclusion: </strong>In this experimental animal study, topical GMPE exerted concentration-related anti-inflammatory and antioxidant effects in acute TPA-induced skin inflammation, and the 10% cream performed comparably to 1% hydrocortisone. Because signaling pathways and tumor endpoints were not measured, GMPE may serve as a promising preclinical candidate for mechanistic and long-term chemoprevention studies rather than a proven modulator of tumor promotion.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"638847"},"PeriodicalIF":2.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omalizumab in Refractory Adult-Onset Facial Atopic Dermatitis: A Case Report.","authors":"Yixuan Liu, Yiqiong Zhang, Yuehong Guo, Zhanchao Zhou, Yang Xu","doi":"10.2147/CCID.S591497","DOIUrl":"10.2147/CCID.S591497","url":null,"abstract":"<p><strong>Purpose: </strong>Adult-onset facial atopic dermatitis (AFAD) is a distinct subtype of atopic dermatitis that predominantly affects the face and is frequently misdiagnosed as rosacea or other facial dermatoses. The management of AFAD is challenging, particularly in patients who respond poorly to conventional therapies. At present, reports on the use of anti-immunoglobulin E (IgE) therapy in AFAD are limited. Herein, we report a case of AFAD with markedly elevated serum IgE levels that showed a favorable response to omalizumab.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on the clinical characteristics, laboratory findings, treatment course, and therapeutic outcomes of a patient with AFAD. Pruritus severity was assessed using a visual analog scale (VAS, 0-10). Facial erythema and skin dryness were evaluated using the objective sign components of the SCORAD index. Clinical photographs and objective assessment results were recorded during follow-up.</p><p><strong>Results: </strong>A 41-year-old woman presented with a 10-year history of recurrent facial erythema accompanied by pruritus and burning sensations, with poor responses to multiple conventional systemic and topical treatments. Total serum IgE levels were markedly elevated. The patient received subcutaneous omalizumab at a dose of 300 mg every 4 weeks for a total of three injections. During treatment, facial erythema, scaling, pruritus, and burning sensations gradually improved. Symptom-related scores decreased, and no adverse events were observed in this case.</p><p><strong>Conclusion: </strong>This case suggests that even in the absence of a typical atopic history, omalizumab may represent a potential therapeutic option for patients with adult-onset facial atopic dermatitis who exhibit elevated serum IgE levels and poor responses to conventional treatments.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"591497"},"PeriodicalIF":2.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Insight into Acne Pathogenesis: Multi-Omics Links a Metabolite to <i>C. acnes</i> Expansion and Lipid Accumulation.","authors":"Xiaojing Song, Junyou Chen, Hung Chan, Feiyan Lin, Xuan Wang, Chenwei Zhu, Mohammad Hassan Heidari, Lingjun Liu, Chengyi Li, Zhenfeng Liu, Qing Li, Bin Yang","doi":"10.2147/CCID.S641284","DOIUrl":"10.2147/CCID.S641284","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiota dysbiosis is implicated in dermatoses, including acne vulgaris. However, gut microbial and metabolomic profiles in acne remain uncharacterized.</p><p><strong>Methods: </strong>We performed metagenomic and metabolomic analyses on fecal samples from 29 acne patients and 20 healthy controls. Functional annotations utilized multiple databases. Integrated metagenomic-metabolomic analysis was conducted to identify metabolites, and their effects were subsequently validated in a mouse acne model. Finally, a five-fold cross-validated random forest model evaluated discriminatory capacity of microbial, metabolic, and multi-omics signatures for acne and its subtypes.</p><p><strong>Results: </strong>Acne patients exhibited reduced gut microbial diversity and decreased abundance of beneficial genera (eg, <i>Blautia, Faecalibacterium</i>) and species (eg, <i>Anaerotardibacter muris, Firmicutes bacterium CAG:321, Clostridium sp. CAG:245, Ruminococcus sp. OM06-36AC</i>). Differentially enriched microbial pathways involved amino acid metabolism. Integrated analysis revealed positive correlations between the key microbes driving the selected pathways and the associated metabolites which promoted the growth of <i>C. acnes</i>. The integrated multi-omics model yielded high diagnostic accuracy (validation AUC=0.921, test AUC=0.915), outperforming single-omic models, showed optimal gender discrimination (test AUC=1.00) and subtype-specific predictive efficacy, with key microbial and metabolite biomarkers identified for acne subtype classification and disease progression regulation.</p><p><strong>Conclusion: </strong>Acne vulgaris demonstrates distinct gut microbiota and metabolite signatures. Our integrated data suggest that gut microbiota may influence acne development via metabolic changes, and some of these metabolites might possess acne‑promoting properties.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"641284"},"PeriodicalIF":2.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Real-World Retrospective Cohort Study Evaluating Clinical Effects and Safety of Radiofrequency Microneedling for the Treatment of Rosacea.","authors":"Ji Young Um, Han Bi Kim, Hye One Kim, Valerie D Callender, Narendra Kumar","doi":"10.2147/CCID.S625777","DOIUrl":"10.2147/CCID.S625777","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency Microneedling (RFMN) targets vascular, inflammatory, and dermal remodeling pathways in rosacea; however, evidence from routine practice remains limited.</p><p><strong>Objective: </strong>To evaluate the clinical effects and safety of POTENZA^® RFMN in adults with rosacea in a real-world setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 50 adults with clinically diagnosed rosacea treated with RFMN at a dermatology center (Hallym University Kangnam, Seoul, Republic of Korea). Severity was assessed longitudinally using the Rosacea Area and Severity Index (RASI) and erythema index from standardized photographs and the medical records. Missing data were addressed using multiple imputation and linear mixed-effects models. A substantial proportion of patients (68%) received concomitant oral antibiotics, and severity scoring relied on retrospective evaluation of photographs and medical records. Safety outcomes included adverse events, pain scores, lesion fading, texture improvement, and patient-reported satisfaction.</p><p><strong>Results: </strong>Fifty patients (80% women; median age, 33 years) were included. The median rosacea duration was 54 months (IQR 24-81), and most had Fitzpatrick phototype III (76%). Missingness was consistent with a missing-at-random mechanism, as patients lost to follow-up had lower baseline disease severity. The mean RASI decreased from 11.9 to 9.08 (difference -2.79; 95% CI -3.48 to -2.11; p<0.001). The mean erythema index decreased from 2.48 to 1.58 (difference -0.90; 95% CI -1.14 to -0.66; p<0.001). Lesion fading occurred in 80% of the patients, and texture improvement occurred in 72%. Mild adverse events occurred in three patients (6%) and resolved within 96 hours.</p><p><strong>Conclusion: </strong>RFMN (POTENZA®) was associated with significant longitudinal improvements in rosacea severity and erythema, with favorable tolerability. Given the retrospective design, concomitant antibiotic use, and photographic scoring, these findings should be considered hypothesis-generating and warrant confirmation in prospective controlled studies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"625777"},"PeriodicalIF":2.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative Network Toxicology Identifies NFKB1 and KIF11 as Candidate Genes Associated with 2-Hydroxyphenanthrene in the Context of Psoriasis.","authors":"Haixia Shi, Yuan Guo, Haochen Yuan, Liya Wang, Yun Zhang, Yanhua Li","doi":"10.2147/CCID.S628973","DOIUrl":"https://doi.org/10.2147/CCID.S628973","url":null,"abstract":"<p><strong>Background: </strong>2-Hydroxyphenanthrene (2-PHE), a polycyclic aromatic hydrocarbon metabolite, has been implicated in immune and inflammatory dysregulation, yet its potential toxicological contribution to psoriasis remains unclear. This study aimed to identify candidate genes and pathways through which 2-PHE might influence psoriasis using a network toxicology framework.</p><p><strong>Methods: </strong>Differentially expressed genes (DEGs) were identified from the psoriasis dataset GSE30999 and intersected with 2-PHE-predicted targets obtained from SEA, SuperPred, and TargetNet. Functional enrichment, protein-protein interaction (PPI) analysis, and topological algorithms were used to define hub genes. Two-sample Mendelian randomization (MR) was performed to explore suggestive associations with psoriasis. Tissue-classification performance was evaluated by ROC analysis in GSE30999 and GSE41662 for distinguishing lesional from non-lesional skin, while GSEA characterized pathway involvement. Molecular docking simulations assessed potential binding modes between 2-PHE and key proteins.</p><p><strong>Results: </strong>A total of 4,185 psoriasis-associated DEGs and 219 2-PHE targets yielded 55 overlapping genes enriched in NF-κB signaling, apoptosis, insulin resistance, and AGE-RAGE pathways. PPI analysis identified 13 hub genes, with NFKB1 and KIF11 showing nominally significant associations with psoriasis in MR analyses. Both NFKB1 and KIF11 showed strong capacity to discriminate lesional from non-lesional tissue and were enriched in inflammatory, immune, and cell-cycle-related pathways. Docking predicted favorable binding energies of 2-PHE to NFKB1 (-5.9 kcal/mol) and KIF11 (-9.0 kcal/mol) in silico.</p><p><strong>Conclusion: </strong>This integrative network toxicology study suggests that NFKB1 and KIF11 are candidate genes potentially involved in the association between 2-PHE and psoriasis, linking environmental exposure to immune activation and cell-cycle dysregulation. However, the genetic evidence remains preliminary, and the lack of colocalization support and the nominal nature of MR findings underscore the need for further validation through functional experiments and larger genetic studies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"628973"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative Aesthetics: Shaping the Emerging Frontier of Modern Aesthetic Medicine.","authors":"Kate Goldie, Mayoni Gooneratne, Joleen P Z Goh, Niamh Corduff","doi":"10.2147/CCID.S618850","DOIUrl":"https://doi.org/10.2147/CCID.S618850","url":null,"abstract":"<p><p>Aesthetic medicine is moving beyond an appearance-centered focus toward approaches that also prioritize long-term skin and underlying tissue health. Skin health and systemic health are now widely recognized as closely interconnected through shared mechanisms of aging biology, yet a practical clinical construct for translating this understanding into aesthetic practice remains to be established. In this conceptual review article, we propose Integrative Aesthetics (IA) as a clinically grounded framework that positions aesthetic and systemic health improvement as coequal, mutually reinforcing clinical goals, organized through 2 interconnected layers: local tissue optimization and systemic health optimization. These aims are operationalized through 3 synergistic pillars: i) conventional aesthetic interventions, ii) regenerative therapies, and iii) functional medicine. Conventional aesthetic interventions provide direct structural and surface-level correction; regenerative therapies support tissue quality by modulating the local microenvironment and repair pathways; and functional medicine addresses modifiable upstream determinants of tissue responsiveness, including nutrition, mitochondrial function, endocrine status, lifestyle, and broader biological aging processes. By integrating local and systemic strategies, IA proposes a mutually reinforcing model in which improved systemic health enhances procedural readiness, recovery, and remodeling, while improved skin and supporting tissue health, and the visible aesthetic benefits they produce, may support broader patient engagement in long-term health optimization. IA therefore offers a practical framework for reorienting aesthetic medicine toward a more whole-person, multidisciplinary, and health-focused model of care.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"618850"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Resistance as a Potential Predictor of Post-Inflammatory Hyperpigmentation After CO₂ Laser Resurfacing: A Real-World Study of a Dual Technique Protocol (Maghreb Experience).","authors":"Sihem Benosman, Qiaofeng Zhao, Yuping Ran, Xueqin Huang, Alberto Leguina-Ruzzi","doi":"10.2147/CCID.S643348","DOIUrl":"https://doi.org/10.2147/CCID.S643348","url":null,"abstract":"<p><strong>Purpose: </strong>Laser-assisted skin regeneration is a cornerstone of modern dermatologic practice; however, post-inflammatory hyperpigmentation (PIH) remains a major limiting complication of CO₂ laser treatments. Risk has traditionally been attributed to darker phototypes, particularly in high ultraviolet (UV) exposure settings. Emerging evidence suggests that metabolic factors, especially insulin resistance measured by HOMA-IR, may influence pigmentary responses. This study evaluated a Dual Technique CO₂ laser protocol designed to enhance skin regeneration while reducing the number of treatment sessions and explored the association between PIH and metabolic status.</p><p><strong>Patients and methods: </strong>A prospective, non-randomized, real-world study included 45 patients treated in a private practice in the Maghreb region, characterized by high UV exposure and predominantly medium-to-high phototypes. The Dual Technique combined ablative fractional vaporization with subablative thermal stimulation. Skin quality was assessed using the Vancouver Scar Scale (VSS), and PIH severity using the Dermal Pigmentation Area and Severity Index (DPASI). Outcomes were analyzed in relation to phototype, HOMA-IR, and polycystic ovary syndrome (PCOS).</p><p><strong>Results: </strong>Significant clinical improvement was observed across indications following treatment, typically within two sessions. PIH occurred in 15/20 (75%) patients with Fitzpatrick phototypes I-III compared with 9/25 (36%) patients with phototypes IV-VI (p = 0.0092). PIH severity showed a strong positive correlation with HOMA-IR (Spearman <i>ρ</i> = 0.8624, p < 0.0001). PCOS prevalence did not differ significantly between phototype groups (p = 0.8). PIH improved significantly following standardized management.</p><p><strong>Conclusion: </strong>The Dual Technique CO₂ laser protocol was associated with favorable clinical outcomes using relatively few treatment sessions. In this cohort, higher HOMA-IR was strongly associated with greater PIH severity, suggesting that insulin resistance may represent an additional factor associated with individual PIH susceptibility. These findings are hypothesis-generating and require confirmation in larger, controlled studies before metabolic assessment can be recommended for routine laser-treatment risk stratification.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"643348"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota in Psoriasis: Evidence for Dysbiosis, Pathological Mechanisms, Causality, and Therapeutic Implications.","authors":"Nana Zhao, Wenbin Cao, Weijia Liu, Liping Wu, Rongzhong Huang","doi":"10.2147/CCID.S630661","DOIUrl":"https://doi.org/10.2147/CCID.S630661","url":null,"abstract":"<p><p>Psoriasis is a chronic inflammatory skin disease driven by genetic susceptibility, environmental triggers, and immune dysregulation, with a global prevalence of approximately 2%-3%. In recent years, the gut microbiota has garnered increasing attention as a key interface linking environmental factors to host immunity in the pathogenesis of psoriasis. A growing body of research has revealed significant gut dysbiosis in patients with psoriasis, characterized by reduced microbial diversity, depletion of specific beneficial bacteria, and enrichment of opportunistic pathogens. Mechanistically, the gut microbiota participates in the pathological process of psoriasis through modulation of the Th17/IL-23 axis, induction of regulatory T cell dysfunction, disruption of the intestinal barrier leading to bacterial translocation, and imbalance of microbial metabolites. Regarding causal evidence, germ-free animal models, fecal microbiota transplantation experiments, and Mendelian randomization studies have provided multi-level support for causal relationships between specific microbial taxa and psoriasis. Therapeutically, microbiota-targeting strategies including probiotics, prebiotics, dietary interventions, and fecal microbiota transplantation have shown potential to ameliorate psoriasis severity in preclinical and preliminary clinical studies. This review systematically synthesizes the above evidence, delineates the characteristics of dysbiosis, pathological mechanisms, the causal evidence chain, and therapeutic translation prospects, and highlights current limitations and future directions.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"630661"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multimodal Approach to Extended Periorbital Rejuvenation: Clinical Outcomes and Time Course in a Prospective Single-Centre Study.","authors":"Konstantin Frank, Michael Alfertshofer, Nhung Dinh, Valentina Prinz, Michelle Friedrich, Jacqueline Johanna Gerassimoff, Mia Cajkovsky","doi":"10.2147/CCID.S642570","DOIUrl":"https://doi.org/10.2147/CCID.S642570","url":null,"abstract":"<p><strong>Background: </strong>The periorbital region is characterized by early visible signs of aging, including wrinkles, fine lines, and skin laxity. While surgical procedures such as blepharoplasty have traditionally been used to address these changes, minimally invasive aesthetic treatments such as polynucleotides (PNs), botulinum toxin, and hyaluronic acid (HA) fillers are increasingly preferred due to lower risks and shorter recovery times. Although these treatments are widely used, real-world data on the efficacy and safety of such combination protocols remain limited.</p><p><strong>Objective: </strong>To assess the time course and safety of a comprehensive holistic rejuvenation procedure using highly crosslinked HA-based fillers, PNs, and letibotulinumtoxinA in the extended periorbital region.</p><p><strong>Materials and methods: </strong>In this prospective, non-interventional study, 34 participants with a mean age of 41.2 ± 11.4 years received an extended periorbital treatment comprising injections of an HA-based filler at Visit 1, polynucleotide at Visit 1, 2 and 3 and letibotulinumtoxinA at Visit 3 (Week 6). A mean total of 1.38 ± 0.37 cc HA-based filler was administered per patient. Skin wrinkling in the periorbital region was assessed using VISIA skin analysis, while glabellar line severity and midface volume deficit were evaluated using the Facial Wrinkle Scale (FWS) and Midface Volume Deficit Severity Scale (MVDSS), respectively. Assessments were performed by the principal investigator at baseline, week 8, and week 22.</p><p><strong>Results: </strong>VISIA analysis showed no statistically significant change in periorbital wrinkling at Week 8 (+1.6% vs baseline) and by Week 22 (-5.1%). Mean FWS scores improved from 2.9 at baseline to 1.6 at Week 8 and 2.4 at Week 22, while MVDSS scores improved from 2.6 at baseline to 1.1 at Week 8 and remained improved at 1.3 at Week 22; all changes from baseline were statistically significant. Two non-serious injection site reactions (5.9%) were reported.</p><p><strong>Conclusion: </strong>This study describes the real-world time course of a multimodal approach targeting muscle activity, volume loss, and skin quality in the extended periorbital region. Larger, longer and ideally controlled studies are required to characterize the safety and efficacy of such staggered multimodal treatment approaches.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"642570"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Intensity Focused Ultrasound for the Treatment of Infraorbital Fat Protrusion: A Preliminary Case Series.","authors":"Hyoung Moon Kim, Seung Min Oh, Myungjune Oh, Tatsuro Kamakura, Jean D A Carruthers, Eunsoo Park","doi":"10.2147/CCID.S643854","DOIUrl":"https://doi.org/10.2147/CCID.S643854","url":null,"abstract":"<p><p>Infraorbital fat (IOF) protrusion is a common feature of periorbital aging and is commonly managed with lower blepharoplasty. Although surgical approaches can provide predictable aesthetic outcomes, there remains interest in minimally invasive treatment options for appropriately selected patients. This preliminary case series evaluated the feasibility, short-term tolerability, and clinical outcomes of high-intensity focused ultrasound (HIFU) for the treatment of IOF protrusion. Three Korean patients (two female and one male; mean age, 48 years) underwent HIFU treatment using LinearZ device at focal depths of 4.5 and 9.0 mm following pre-treatment ultrasonography. Each treatment session delivered 0.6 J per shot in DOT mode under local anesthesia. Clinical photographs, patient satisfaction, and Global Aesthetic Improvement Scale (GAIS) scores were assessed three months after the final treatment session. All three patients showed clinically observable improvement in infraorbital bulging and lid-cheek contour, with high patient satisfaction. GAIS scores were 4, 5, and 4, respectively. Treatment was well tolerated, with transient erythema and edema reported and no major adverse events observed during follow-up. Given the very small sample size, absence of a control group, subjective and non-blinded outcome assessment, lack of systematic post-treatment imaging or quantitative fat measurements, and short follow-up, these findings should be considered preliminary and hypothesis-generating. Larger controlled studies incorporating objective outcome measures are warranted to establish efficacy, durability, and optimal treatment parameters of HIFU for IOF protrusion.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"643854"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}