Dermatologic Surgery最新文献

{"title":"Why Does an \"Avatar Nose\" Appear After Dermal Filler Injection? Insights From a Cadaveric Study on the Nasofrontal Ligament.","authors":"Jovian Wan, Gi-Woong Hong, Raymond Wu, Kar Wai Alvin Lee, Lisa Kwin Wah Chan, Deborah Chua, Hugues Cartier, Soo-Bin Kim, Kyu-Ho Yi","doi":"10.1097/DSS.0000000000004534","DOIUrl":"10.1097/DSS.0000000000004534","url":null,"abstract":"<p><strong>Background: </strong>Nonsurgical rhinoplasty (NSR) with dermal fillers has gained popularity because of its immediate and visible results, minimal downtime, and long-lasting effects. However, complications such as filler migration can lead to the development of the \"Avatar nose,\" a condition where the nose appears unnaturally wide and bulbous in the nasion area, disrupting facial harmony. This phenomenon is often exacerbated by the presence of a taut nasofrontal ligament, which tethers the periosteum to the dermal layer and influences nasal contour.</p><p><strong>Objective: </strong>This study aims to introduce and define the nasofrontal ligament, a previously unrecognized anatomical structure identified during cadaveric dissection, and to measure the penetration force required to traverse this ligament in the context of NSR. By exploring these aspects, the study seeks to enhance the understanding of nasal anatomy and improve the precision and outcomes of filler-based NSR.</p><p><strong>Methods: </strong>The study involved the dissection of 2 fresh-frozen human cadaveric specimens, during which the nasofrontal ligament was identified. Penetration force was measured using a motorized force tester, with a standardized cannula depth of 5 mm. The force required to traverse the nasofrontal ligament was compared with a control point devoid of ligaments and muscles.</p><p><strong>Results: </strong>The nasofrontal ligament required a significantly higher penetration force compared with the control point, highlighting its structural integrity and potential impact on filler migration. These findings suggest that subcision of the ligament could prevent the development of the \"Avatar nose\" and improve the outcomes of NSR.</p><p><strong>Conclusion: </strong>This study introduces the nasofrontal ligament as a key anatomical structure in NSR and demonstrates its influence on filler migration. Subcision of this ligament may enhance filler stability and aesthetic outcomes. However, the study's limitations, including a small sample size and the exclusive use of Korean cadavers, suggest the need for further research across diverse populations to validate these findings and refine NSR techniques.</p>","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"493-496"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatologist Characteristics Associated With Outlier Performance of Destruction for Benign Lesions.","authors":"Brad R Woodie, Andrew Nicholas, Alan B Fleischer","doi":"10.1097/DSS.0000000000004526","DOIUrl":"10.1097/DSS.0000000000004526","url":null,"abstract":"<p><strong>Background: </strong>Destruction of a benign skin lesion should not be billed to Medicare if the lesion is solely a cosmetic concern. Reducing unnecessary benign destructions could lower Medicare costs.</p><p><strong>Objective: </strong>Evaluate benign destruction rates relative to premalignant destruction rates and identify factors associated with frequent benign destruction among dermatologists.</p><p><strong>Methods: </strong>This study analyzed 2022 Medicare benign and premalignant destructions procedure counts for dermatologists.</p><p><strong>Results: </strong>Of the included 5,605 dermatologists, 180 (3.2%) were outliers, performing benign destructions at a rate exceeding 1.18 per premalignant destruction. Forty-nine (0.9%) were extreme outliers, with ratios above 1.76. Dermatologists with over 26 years of practice were more likely to be outliers or extreme outliers, whereas those in the West had lower odds. Reducing outlier benign destruction rates to the 80th percentile could save Medicare $1.17 million, with potential savings of up to $10.3 million if applied broadly.</p><p><strong>Conclusion: </strong>A small number of dermatologists bill for benign destructions at high rates. Targeted educational interventions may reduce unnecessary Medicare expenditures.</p>","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"475-479"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Axillary Syringoma: A Diagnostic and Therapeutic Challenge.","authors":"Zhenzhen Li, Chong Zhang","doi":"10.1097/DSS.0000000000004529","DOIUrl":"10.1097/DSS.0000000000004529","url":null,"abstract":"","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"555-557"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of 730-nm Picosecond Laser for the Treatment of Acquired Bilateral Nevus of Ota-like Macules.","authors":"Rui Han, Yifang Sun, Mingshan Su","doi":"10.1097/DSS.0000000000004545","DOIUrl":"10.1097/DSS.0000000000004545","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness and safety of 730-nm picosecond laser for treating acquired bilateral nevus of Ota-like macules remain uncertain.</p><p><strong>Objective: </strong>This study aims to evaluate the potential benefits and risks of using the 730-nm picosecond laser for ABNOM removal.</p><p><strong>Methods: </strong>This is a retrospective review of patients who were presented to the clinic between January 2020 and January 2024 for the treatment of ABNOM with 730-nm picosecond laser alone. The efficacy of the laser was assessed based on the Quartile Improvement Scale, using high-resolution photographs evaluated by blinded dermatologists.</p><p><strong>Results: </strong>A total of 72 Chinese participants with Fitzpatrick skin types III to IV were included in the study. The overall effective rate of the treatment was 75%, achieved after an average of 2.42 ± 0.75 sessions. A subgroup analysis of 41 patients who completed 3 treatment sessions showed statistically significant differences in outcomes across the sessions. The mean improvement scores for sessions 1, 2, and 3 were 1.63 ± 1.04, 2.66 ± 1.22, and 3.29 ± 1.17, respectively ( p < .01). No cases of hypopigmentation were observed. The incidence of postinflammatory hyperpigmentation was 5.56%.</p><p><strong>Conclusion: </strong>The 730-nm picosecond laser is a safe and effective treatment for ABNOM in Chinese patients.</p>","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"485-489"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yellow Is the New Red: Clearance of a Yellow Microbladed Tattoo With a 532-nm Picosecond Laser.","authors":"Ritu N Swali, Anisha Guda, Paul M Friedman","doi":"10.1097/DSS.0000000000004513","DOIUrl":"10.1097/DSS.0000000000004513","url":null,"abstract":"","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"559-561"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimbursement Trends in the Top 5 Most Commonly Performed Dermatologic Procedures.","authors":"Lily Park, Eli Saleeby, Eduardo Weiss, Terrance A Cronin, Patrick K Lee","doi":"10.1097/DSS.0000000000004519","DOIUrl":"10.1097/DSS.0000000000004519","url":null,"abstract":"","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"569-572"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Botulinum Toxin Type A Treatment on Clinical and Biophysical Parameters in Patients With Erythematotelangiectatic Rosacea: A Prospective, Randomized, Controlled, Double-Blind Study.","authors":"Buğra Burç Dağtaş, Ozan Erdem, Tuğba İlter Güneç, Elif Bal Avcı, Vildan Manav, Ayşe Esra Koku Aksu","doi":"10.1097/DSS.0000000000004528","DOIUrl":"10.1097/DSS.0000000000004528","url":null,"abstract":"<p><strong>Background: </strong>Erythematotelangiectatic rosacea (ETR) lacks a gold-standard treatment. Recent studies show that intradermal Botulinum Toxin-A (BoNT-A) is effective for erythema, though objective data are limited.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy and tolerability of intradermal BoNT-A in patients with ETR.</p><p><strong>Methods: </strong>In this randomized, double-blind, split-face study, 30 patients were enrolled. One side of the face received 15 units of BoNT-A, reconstituted in 10 mL of saline, while the control side received saline injections. Assessments were made at baseline and 1-month posttreatment. Clinician's Erythema Assessment (CEA) scale and Patient Self-Assessment (PSA) scores were recorded. Erythema and Melanin Index measurements using a Mexameter. Background erythema was assessed through dermatoscopy, while vascular structure and density were evaluated using Investigative Global Assessment (IGA) scores through videocapillaroscopy.</p><p><strong>Results: </strong>The BoNT-A-treated side demonstrated significant reductions in CEA scores, Erythema Index, and dermatoscopic background erythema, while no significant changes were observed on the saline control side. IGA scores indicated a significant response to treatment on the BoNT-A side. Patient Self-Assessment scores improved on both sides. No serious adverse events requiring hospitalization were reported.</p><p><strong>Conclusion: </strong>Intradermal BoNT-A effectively reduces erythema and vascular density in patients with ETR and is well-tolerated.</p>","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"515-521"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Microneedling in Treating Primary Hyperhidrosis: A Systematic Review and Meta-Analysis.","authors":"Mayuri H Vaish, Edward Hadeler, Anisha Guda, Heather Goff","doi":"10.1097/DSS.0000000000004532","DOIUrl":"https://doi.org/10.1097/DSS.0000000000004532","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency microneedling (RFM) is a potential treatment for primary hyperhidrosis. However, its efficacy is unclear, and treatment parameters and outcomes vary across studies.</p><p><strong>Objective: </strong>To understand the effect of RFM on treating primary hyperhidrosis, as measured by changes in the Hyperhidrosis Disease Severity Score (HDSS) before and after treatment, and to clearly define treatment settings most likely to optimize results.</p><p><strong>Materials and methods: </strong>A systematic literature search utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted across PubMed, EMBASE, MEDLINE, Web of Science, and the Cochrane Library. Studies were evaluated for risk of bias via the ROBINS-I tool and Levels of Evidence/GRADE criteria. A random forest model identified RFM settings that predict HDSS score decrease.</p><p><strong>Results: </strong>Six publications met inclusion criteria. The level of evidence was classified as Grade B, indicating moderate quality. RFM intervention resulted in a mean HDSS score decrease of 1.63 (52% reduction, p < .05). The strongest predictors for HDSS score decrease were dwell time, energy, and depth, with feature importances of 0.43, 0.19, and 0.15 respectively.</p><p><strong>Conclusion: </strong>Radiofrequency microneedling treatment significantly reduces HDSS scores in patients with primary hyperhidrosis. Moving forward, it would benefit physicians to standardize objective protocols in reporting RFM parameters and measuring outcomes.</p>","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":"51 5","pages":"480-484"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixed Drug Eruption-Induced Hyperpigmentation Treated With High-Fluence Picosecond Alexandrite Laser.","authors":"Koya Sonoda, Jun Omatsu, Kentaro Ishii","doi":"10.1097/DSS.0000000000004530","DOIUrl":"10.1097/DSS.0000000000004530","url":null,"abstract":"","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"557-559"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenol Dilution With Saline Solution Versus Alcohol in Partial Matricectomy for Onychocryptosis.","authors":"Joaquín Espiñeira Sicre, Lucía García Sirvent, Juan Ruiz Sánchez, Pedro Álvarez Chinchilla, Laura García Fernández, Julia Miralles Botella","doi":"10.1097/DSS.0000000000004541","DOIUrl":"10.1097/DSS.0000000000004541","url":null,"abstract":"<p><strong>Background: </strong>Onychocryptosis significantly impacts quality of life. Chemical partial matricectomy with phenol is a common surgical treatment. The use of alcohol as a solvent during this procedure has been controversial. In vitro studies suggest that physiologic saline solution (PSS) may be a more effective solvent for phenol.</p><p><strong>Objective: </strong>To evaluate the in vivo efficacy of PSS as a phenol solvent, in terms of postoperative outcomes, compared to alcohol.</p><p><strong>Methods: </strong>A retrospective unicentric cohort study was conducted on patients who underwent partial chemical matricectomy with phenol for onychocryptosis. Sociodemographic and clinical variables were collected and compared between the alcohol and PSS groups. Clinical staging followed Martinez Nova and colleagues' classification. Patients were followed up over a 12-month period to assess postoperative complications.</p><p><strong>Results: </strong>The study population demonstrated typical characteristics of onychocryptosis, with a median age of 20 years. No statistically significant differences were found between the groups in terms of pain, infections, or bleeding postoperatively. There were also no differences in terms of recurrence, days of analgesic use, or need for antibiotic therapy ( p > .05).</p><p><strong>Conclusion: </strong>The results suggest that PSS is as effective and safe as alcohol as a solvent for phenol in chemical partial matricectomy.</p>","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":" ","pages":"527-531"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}