Journal of Cosmetic Dermatology最新文献

{"title":"Treatment of Porphyria Cutanea Tarda Scarring With Combination Laser Treatment and a Pilot Use of Artificial Intelligence to Quantify Laser Results","authors":"Chelsea E. Kesty,&nbsp;Katarina R. Kesty","doi":"10.1111/jocd.70056","DOIUrl":"https://doi.org/10.1111/jocd.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Porphyria cutanea tarda (PCT) is the most common subtype of porphyria and results from a deficiency of the enzyme uroporphyrinogen decarboxylase. Even after successful treatment, patients can be left with significant scarring, and there is little published data on the safety and efficacy of light-based or laser-based therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This report examines a case of a 47-year-old male with PCT secondary to HCV, treated with a combination of fractionated erbium-doped yttrium-aluminum-garnet (Er:YAG), intense pulsed light (IPL), and carbon dioxide (CO₂) lasers to address significant scarring and residual skin damage. An artificial intelligence model was used to quantify the results of the laser procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After combination laser treatment, the patient exhibited marked improvements in skin texture, reduction in scar visibility, and diminished hyperpigmentation. The artificial intelligence algorithm quantified the laser results and showed improvements in the scores used in the large language model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this patient, customizing a combination of lasers to target different layers of the skin to achieve comprehensive improvement: erbium primarily addressed superficial irregularities and pigmentation, while CO₂ promoted deeper collagen remodeling. The use of artificial intelligence to quantify the positive results in this case is in line with the clinical evaluations and photos.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741001","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":"Efficacy and Safety of Oxymetazoline 1% Cream for the Treatment of Mild to Moderate Facial Rosacea","authors":"Fatemeh Sajdeh,&nbsp;Aniseh Samadi,&nbsp;Atefeh Naeimifar,&nbsp;Taraneh Yazdanparast,&nbsp;Maryam Ahmadi,&nbsp;Fatemeh Amiri,&nbsp;Martin Kassir,&nbsp;Alireza Firooz,&nbsp;Saman Ahmad Nasrollahi","doi":"10.1111/jocd.16782","DOIUrl":"https://doi.org/10.1111/jocd.16782","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Rosacea is a common skin condition that affects the physical and mental health of the patient. The objective of this study was to evaluate the efficacy and safety of oxymetazoline 1% cream, a specific α1A-adrenoceptor agonist, for the treatment of mild to moderate facial rosacea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In phase II of the before–after study, 15 patients with mild to moderate rosacea were enrolled and treated with oxymetazoline 1% cream twice daily for 4 weeks. The clinician's erythema assessment (CEA) and patient's self-assessment (PSA), as well as the skin biometric parameters (transepidermal water loss, sebum, stratum corneum hydration, temperature, erythema, melanin, and pH), dermal and epidermal thickness and echo-density, and capillaroscopic pattern were assessed and compared before and after treatment. <i>p</i>-Value &lt; 0.05 was considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CEA and PSA indexes decreased significantly 2 and 4 weeks after the treatment (<i>p</i>-value: 0.001). The erythema index also decreased significantly in both 2 weeks (<i>p</i>-value: 0.001) and 4 weeks (<i>p</i>-value: 0.001) after the treatment. The capillaroscopic pattern of lesions showed a decrease in telangiectasia and a reddish background of skin. No side effects of treatment were experienced by any of the patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Oxymetazoline 1% cream was safe and effective in treating mild to moderate facial rosacea. The reduction in the skin's vascularity was also objectively confirmed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.16782","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740974","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":"Successful Treatment of Mesotherapy Induced Granuloma Annulare With Baricitinib","authors":"Li Wang,&nbsp;Shang Shen Chen,&nbsp;Ming Yuan Xu,&nbsp;Ye Qiang Liu,&nbsp;Jun Ting Tang","doi":"10.1111/jocd.70162","DOIUrl":"https://doi.org/10.1111/jocd.70162","url":null,"abstract":"&lt;p&gt;Mesotherapy is a dermatological treatment that involves injections into the dermal layer to achieve effects such as pore reduction, enhanced hydration, improved skin tone, and wrinkle removal [&lt;span&gt;1&lt;/span&gt;]. Although generally regarded as safe, its widespread use and the absence of standardized procedures have led to various adverse reactions, including granuloma formation, infections, fat necrosis, and abscesses. Systemic corticosteroids are considered the primary treatment; however, consensus is lacking regarding alternative therapeutic options [&lt;span&gt;2&lt;/span&gt;]. Granuloma annulare is a benign inflammatory condition associated with various comorbidities, including thyroid disease, malignancy, trauma, diabetes mellitus, and HIV infection [&lt;span&gt;2&lt;/span&gt;]. While systemic corticosteroids are effective in managing granuloma annulare, the condition frequently recurs following the cessation of treatment. Baricitinib, an inhibitor of the Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway, exhibits promising therapeutic effects on granuloma annulare (GA). In this context, we report on a patient with Mesotherapy-induced Granuloma Annulare whose lesions significantly improved with the administration of the JAK1/2 inhibitor, Baricitinib.&lt;/p&gt;&lt;p&gt;A 32-year-old female exhibited diffuse red papules and nodules on her face following mesotherapy injections intended for facial aesthetic enhancement with one-week history. The injectant, hyaluronic acid, was procured by the patient and administered using a handheld needle. Verification of the substance's nature and chemical composition was not feasible. A skin biopsy was obtained from a singular lesion on the forehead.&lt;/p&gt;&lt;p&gt;Upon physical examination, diffuse papules and subcutaneous nodules were observed bilaterally on the cheeks, forehead, and lower jaw, aligning with the mesotherapy injection sites (Figure 1a,b). Dermoscopic examination revealed multifocal yellow-orange areas along with several globular white regions, indicative of the histologic subtype of granuloma (Figure 1d). Histopathological examination showed accumulation of palisading granuloma, which was characterized by histiocytes and lymphocytes surrounding irregular zones of altered collagen and deposited mucus in the dermis; no obvious foreign body deposition was found (Figure 1e,f). Positive for Alcian blue staining (Figure 1g). These findings supported a diagnosis of granuloma annulare, grounded on characteristic clinical and pathological features.&lt;/p&gt;&lt;p&gt;The initial treatment regimen included doxycycline, administered orally at 100 mg twice daily for 1 month, and intramuscular administration of 7 mg betamethasone was performed once monthly, totaling two injections. However, these measures resulted in minimal improvement. Subsequently, the patient commenced treatment with oral baricitinib at a dose of 2 mg/day. A marked reduction in lesions was noted 1 month post-initiation, with near-complete resolution observe","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741380","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":"The Kesty Redness Scale: A Pilot Validation Study for a Novel Tool for Evaluating Facial Redness in Cosmetic and Clinical Dermatology","authors":"Chelsea E. Kesty,&nbsp;Katarina R. Kesty","doi":"10.1111/jocd.70039","DOIUrl":"https://doi.org/10.1111/jocd.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Facial redness is a common concern in dermatology, affecting patients with conditions such as rosacea, post-inflammatory erythema, and other vascular irregularities. Despite its prevalence, existing tools for quantifying facial redness are limited in their clinical utility and ease of use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To develop a high-performing redness scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study introduces the Kesty Redness Scale (KRS), outlines its development and validation process, and discusses its potential clinical applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The investigators rated the scale as useful and easy to use, and the majority stated they would use it in clinical practice to document patient characteristics. The results of the evaluation utilizing Gwet's AC2, Kendall's W, Spearman's ρ, Weighted Cohen's kappa, and Bland–Altman analysis —showcasing strong ordinal agreement, robust rank concordance, and negligible bias—demonstrate that this new rating system is both reliable and valid for measuring skin hyperpigmentation on a 0–3 scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The KRS is a reliable, easy-to-use tool that enhances the assessment of facial redness in dermatology. Its validation through expert evaluation and statistical analysis underscores its potential to improve clinical practice and research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740973","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":"Influential Factors in the Efficacy and Safety of Hemoporfin-Mediated Photodynamic Therapy for Facial Port-Wine Stains","authors":"Ruixuan You,&nbsp;Yixin Tan,&nbsp;Xueqin Zhang,&nbsp;Lu Li,&nbsp;Ting Zeng,&nbsp;Yixin Zhou,&nbsp;Yaqian Shi,&nbsp;Yongqi Shao,&nbsp;Hongxia Yan,&nbsp;Rong Xiao,&nbsp;Xiangning Qiu","doi":"10.1111/jocd.70153","DOIUrl":"https://doi.org/10.1111/jocd.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a novel and promising treatment for port-wine stains (PWS); however, the factors affecting the efficacy and safety are controversial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In this study, the relationship between influential factors and the efficacy and safety of HMME-PDT for facial PWS was clarified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, 155 patients suffering from facial PWS who underwent HMME-PDT at 2–3 months interval were included. The efficacy was evaluated by the facial PWS area and severity index (FSASI) scoring system based on pre- and post-treatment photographs of the lesion. The demographic characteristics, lesion patterns, treatment history, number of treatment sessions, and adverse events were also recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After the first and second sessions of HMME-PDT, 61.9% and 92.9% of patients responded, respectively. The lesion subtype, degree of lip involvement, and number of HMME-PDT sessions were associated with the efficacy of HMME-PDT (<i>p</i> = 0.014, <i>p</i> = 0.034, <i>p</i> &lt; 0.001, and respectively). Logistic regression analysis confirmed that the patients with red-type PWS (<i>p</i> = 0.019) and more HMME-PDT sessions (≥ 2) (<i>p</i> &lt; 0.001) showed an association with a better response to HMME-PDT. The response rate was higher for lesions on the mandibular prominence area than that on the forehead area (<i>p</i> = 0.031). No photosensitivity or systemic adverse reactions were reported. Most adverse effects were well tolerated in all patients. Furthermore, the severity of crust was found positively associated with the efficacy (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HMME-PDT is an effective and safe treatment approach for treating facial PWS. Patients who had red-type, nonforehead area, and more treatment sessions showed an association with better efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741381","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":"Navigating the Intersection of Lasers and the Skin Microbiome: A New Frontier in Esthetic Dermatology","authors":"Diala Haykal,&nbsp;Marco Rocha","doi":"10.1111/jocd.70150","DOIUrl":"https://doi.org/10.1111/jocd.70150","url":null,"abstract":"&lt;p&gt;Advances in esthetic dermatology have increasingly emphasized the role of laser technologies in achieving precise, non-invasive, and highly effective treatments for various skin concerns. Lasers have become a cornerstone of modern dermatological care, offering solutions for conditions such as acne scars, hyperpigmentation, and skin laxity [&lt;span&gt;1&lt;/span&gt;]. While the immediate therapeutic benefits of laser treatments are well-documented, a significant gap remains in understanding their broader systemic effects, particularly on the skin microbiome [&lt;span&gt;2&lt;/span&gt;]. This oversight is critical because the skin microbiome functions as an integral component of skin health, influencing everything from immune defense to wound healing [&lt;span&gt;3, 4&lt;/span&gt;]. By intentionally disrupting the skin's structure to stimulate repair and rejuvenation, laser treatments may inadvertently affect this vital ecosystem [&lt;span&gt;5, 6&lt;/span&gt;]. Despite the increasing integration of microbiome research into dermatology, there remains limited direct clinical evidence demonstrating long-term microbiome disruption following laser procedures. While some hypotheses suggest that ablative lasers could alter microbial populations, no large-scale studies confirm an increased risk of infection or impaired healing due to microbiome dysbiosis. Instead, the skin's regenerative mechanisms often restore its microbial equilibrium post-treatment. Nevertheless, understanding how different laser modalities interact with the skin microbiome is an area requiring further investigation to optimize treatment protocols and improve patient outcomes. The question of how to balance therapeutic goals with microbiome preservation is now at the forefront of esthetic medicine. The skin microbiome plays a pivotal role in maintaining immune defense, skin barrier function, and overall dermatological health [&lt;span&gt;7-9&lt;/span&gt;]. Recent studies underscore its vulnerability to various interventions, including laser treatments, highlighting the need for microbiome-conscious strategies. This commentary aims to bridge the gap between laser advancements and their impact on the microbiome, underscoring the importance of integrating microbiome-friendly practices into dermatology.&lt;/p&gt;&lt;p&gt;The skin microbiome operates as a dynamic and adaptive interface between the body and its external environment [&lt;span&gt;10&lt;/span&gt;]. Its primary function is to protect the skin from pathogenic invasion by outcompeting harmful microbes and producing antimicrobial peptides. Beyond this, the microbiome also modulates local immune responses, preventing unnecessary inflammation that could damage skin tissues [&lt;span&gt;11&lt;/span&gt;]. For example, commensal bacteria like &lt;i&gt;Staphylococcus epidermidis&lt;/i&gt; and Cutibacterium acnes play critical roles in maintaining skin equilibrium. Cutibacterium acnes also contributes to maintaining the skin's acidic pH by metabolizing sebum triglycerides into short-chain fatty acids, such as propionic acid, which help sus","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741384","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":"The Kesty Hyperpigmentation Scale: A Study to Validate a New Tool for Assessing Facial Hyperpigmentation","authors":"Chelsea E. Kesty,&nbsp;Katarina R. Kesty","doi":"10.1111/jocd.70055","DOIUrl":"https://doi.org/10.1111/jocd.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Facial hyperpigmentation due to sun damage, post-inflammatory hyperpigmentation, and other factors is a common complaint of patients. While lasers and topical treatments are frequently used to manage hyperpigmentation, a standardized way of measuring response to treatment is difficult.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The Kesty Hyperpigmentation Scale (KHS) is a novel clinical instrument created to provide a consistent approach for evaluating facial hyperpigmentation in both cosmetic dermatology and broader medical settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study introduces the KHS, describes the process of its creation and validation, and examines its practical uses in clinical settings. Statistical analysis included Gwet's AC2, Kendall's <i>W</i>, Spearman's <i>ρ</i>/rho, weighted Cohen's kappa, and Bland–Altman analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings of the statistical analysis included high ordinal agreement, strong rank concordance, and minimal bias. This supports the conclusion that the novel rating approach is both reliable and valid for assessing skin hyperpigmentation on the given 0–3 scale. The KHS offers an objective framework to measure the severity of hyperpigmentation, helping clinicians track patient progress after cosmetic treatments, and fostering improved communication with patients. Participants in this study found the scale to be user-friendly, and the majority expressed interest in incorporating it into their practices to document patient conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The KHS is an effective and user-friendly tool for evaluating facial hyperpigmentation, addressing a significant need within dermatology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741383","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":"Methodological Considerations in PRP Treatment for Lichen Planopilaris: Addressing Potential Bias","authors":"Mathias Willaert,&nbsp;DirkJan Hijnen,&nbsp;Rick Waalboer-Spuij","doi":"10.1111/jocd.70157","DOIUrl":"https://doi.org/10.1111/jocd.70157","url":null,"abstract":"&lt;p&gt;We are writing in response to the recent publication titled “Platelet-Rich Plasma as a New and Successful Treatment for Lichen Planopilaris: A Controlled Blinded Randomized Clinical Trial” by Behrangi et al. (2024) in the &lt;i&gt;Journal of Cosmetic Dermatology&lt;/i&gt;. The study contributes valuable data on the use of platelet-rich plasma (PRP) for lichen planopilaris (LPP); however, we wish to address a significant methodological issue related to performance bias that could have influenced the study's outcomes.&lt;/p&gt;&lt;p&gt;The study design involved a single-blinded approach, where only the outcome assessor was blinded to the treatment groups. Nonetheless, the participants were aware of whether they were receiving PRP in addition to clobetasol or clobetasol alone. This lack of blinding among participants introduces a risk of performance bias. This type of information bias is particularly significant in a condition like LPP where subjective symptomatology—such as pruritus, pain, and burning—plays a crucial role in outcome assessment.&lt;/p&gt;&lt;p&gt;Patients aware of receiving what is perceived as a more novel or advanced treatment (in this case, PRP) might expect greater improvement and report better outcomes. This expectation can influence their subjective reporting of symptoms, potentially leading to an overestimation of the treatment's effectiveness. Conversely, patients in the control group might report less improvement because of lower expectations, even if they experience similar physiological benefits. The psychological impact of knowing one's treatment group can significantly affect patient-reported outcomes, which are central to studies involving chronic conditions with a subjective symptom burden.&lt;/p&gt;&lt;p&gt;Moreover, the Lichen Planopilaris Activity Index (LPPAI) used in this study, which heavily relies on patient-reported symptoms, is particularly vulnerable to such bias. The differences in symptom reporting between the PRP and control groups could skew the perceived efficacy of PRP, thereby complicating the interpretation of the study's findings. The study's conclusion that PRP is superior to clobetasol in managing LPP might be partially attributable to this bias rather than the treatment's inherent efficacy.&lt;/p&gt;&lt;p&gt;To mitigate performance bias, a double-blinded design where both participants and assessors are unaware of the treatment allocation would address this issue. This approach would reduce the influence of patient expectations on symptom reporting, providing a clearer picture of the true efficacy of PRP in treating LPP.&lt;/p&gt;&lt;p&gt;In light of these concerns, we recommend that future studies on PRP for LPP or similar conditions employ a double-blinded methodology to ensure more reliable and unbiased results. Such a design would enhance the validity of the findings and support more robust conclusions about the efficacy of PRP in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Mathias Willaert:&lt;/b&gt; conceptualization, methodology, writing – original draft preparation. &lt;b&gt;DirkJan H","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741382","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":"Clinical Management of Poly-D,L-Lactic Acid Nodules: A Guideline With Diagnostic and Treatment Flowchart","authors":"Fabiano Nadson Magacho-Vieira,&nbsp;Eliza Porciuncula Justo Ducati","doi":"10.1111/jocd.70158","DOIUrl":"https://doi.org/10.1111/jocd.70158","url":null,"abstract":"&lt;p&gt;Safety is of critical importance in aesthetic treatments. There are currently two distinct varieties of poly-lactic acid (PLA)-based fillers available on the market: poly-L-lactic acid (PLLA) and poly-D,L-lactic acid (PDLLA). Both materials have been widely utilized in the field of aesthetic dermatology, primarily due to their capacity to induce a sub-clinical inflammatory tissue response that causes an increase in the content of type I collagen at the injection site.&lt;/p&gt;&lt;p&gt;PDLLA has demonstrated a favorable safety profile [&lt;span&gt;1&lt;/span&gt;]. However, although side effects are typically mild and transient, there are rare reports of more significant issues, such as nodules or granulomas. Unlike hyaluronic acid nodules, which can be readily dissolved with hyaluronidase injections that result in filler degradation, PDLLA nodules do not respond to straightforward enzymatic treatment, requiring a more intensive approach. Moreover, the biostimulatory nature of PDLLA (which promotes collagen production) may result in a more prolonged tissue response, potentially complicating the resolution of nodules and making it necessary to extend the treatment period. This can be a challenging scenario from a clinical perspective. Consequently, the formulation of a structured treatment-focused guideline can assist dermatologists in optimizing treatment protocols for each individual case by following a series of diagnostic steps that ultimately lead to the formulation of corresponding therapeutic recommendations. Figure 1 illustrates a step-by-step guide for diagnosis and treatment, developed by integrating the authors' extensive clinical experience with a comprehensive review of the medical literature to create an evidence-based, yet practical framework for managing these cases.&lt;/p&gt;&lt;p&gt;It is important to note that other pathologies that manifest as free, hardened nodules in the skin or subcutaneous tissue (such as cutaneous calcinosis, small epidermoid cysts, nodular basal cell carcinomas, or pseudolymphomas) may present in a similar manner to PDLLA nodules, thus underscoring the necessity for an initial differential diagnosis [&lt;span&gt;2&lt;/span&gt;]. The multiplicity of potential etiologies highlights the importance of a comprehensive history, clinical examination, and diagnostic imaging for the appropriate management of these cases. Imaging is of significant value, particularly ultrasound (US), due to its superior accessibility and ability to characterize fillers and complications, while other techniques, such as magnetic resonance imaging (MRI) or computed tomography (CT), can provide valuable information in scenarios where sonographic findings are inconclusive or further anatomical detail is required [&lt;span&gt;3&lt;/span&gt;]. In rare cases where history and imaging still render an inconclusive diagnosis, histopathological evaluation may be necessary.&lt;/p&gt;&lt;p&gt;As part of the consent process, patients must be informed about the potential risks and the importance of promptly notifyi","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741620","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 Comparative Study on the Sensitivity of Establishing Melasma-Like Models in Different Strains of Mice","authors":"Xiaojie Sun,&nbsp;Wenzhu Wang,&nbsp;Hedan Yang,&nbsp;Yunyao Liu,&nbsp;Hui Ding,&nbsp;Xiaoli Zhang,&nbsp;Xiuzhen Li,&nbsp;Siqi Tan,&nbsp;Xing Liu,&nbsp;Yin Yang,&nbsp;Xu Chen,&nbsp;Tong Lin","doi":"10.1111/jocd.70155","DOIUrl":"https://doi.org/10.1111/jocd.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Melasma is a common disease that is difficult to treat, with no recognized animal model for mechanism research or drug screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a novel, standardized mouse model of melasma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Three different strains of mice (C57BL/6J, BALB/c, and KM) were used to create a melasma-like model across various body regions. The skin of the mice was removed on Day 28 and subjected to staining to examine histopathological changes. Data were analyzed using SPSS19.0 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with KM and BALB/c mice, C57BL/6J mice were identified as the ideal strain for demonstrating hyperpigmentation more sensitively. The head and ear were identified as more appropriate irradiation sites. Furthermore, a lower irradiation dose was determined to be appropriate for modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The C57BL/6J mouse model more accurately simulates the clinical phenotype of melasma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741619","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}