Journal of Cosmetic Dermatology最新文献

{"title":"Sonoanatomy of the Nasal Ala for Botulinum Neurotoxin Injection","authors":"Kyu-Ho Yi,&nbsp;Soo-Bin Kim,&nbsp;Hyewon Hu,&nbsp;Konstantin Frank,&nbsp;Hugues Cartier,&nbsp;Sebastien Garson,&nbsp;Hee-Jin Kim","doi":"10.1111/jocd.70035","DOIUrl":"https://doi.org/10.1111/jocd.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The nasal ala region significantly affects facial aesthetics and function. Botulinum toxin injections may enhance nasal appearance, but their precise impact on underlying muscles remains unexplored. Understanding the muscular anatomy and behavior in this area is crucial for optimizing toxin application and achieving desired outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to ultrasonographically assess and characterize the muscular architecture of the nasal ala region in 32 participants, with the primary objective of delineating the specific muscles involved in nasal aesthetics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Materials</h3>\u0000 \u0000 <p>This cross-sectional study included 32 participants (15 females and 17 males, aged 20–65) with no history of nasal surgery or botulinum toxin injections in the nasal region. Ultrasonographic evaluation was performed to assess the superficial and deep muscular layers in the nasal ala region, using ultrasonography to visualize the targeted muscles and measure their depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ultrasonographic analysis revealed distinct muscular structures in the nasal ala region among participants. Simultaneous movements of the associated muscles were observed, exhibiting diverse depths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ultrasonographic evaluation in our study population elucidated the anatomical nuances of the underlying muscles involved in nasal anatomy. These findings establish a foundation for a more targeted and precise approach in administering botulinum toxin injections, potentially optimizing nasal aesthetics outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717273","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":"Treatment of Port-Wine Birthmarks Using a Large-Spot, Variable Sequenced, Long-Pulsed KTP-Laser—A Retrospective Analysis","authors":"Lynhda Nguyen,&nbsp;Stefan W. Schneider,&nbsp;Katharina Herberger","doi":"10.1111/jocd.70152","DOIUrl":"https://doi.org/10.1111/jocd.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pulsed-dye lasers (PDLs) are currently regarded as the gold standard for treating port-wine birthmarks (PWBs). Recently, the large-spot, variable-sequenced, long-pulsed potassium titanyl phosphate laser (KTP) has been introduced as a promising alternative for addressing dermatologic vascular lesions. Despite its growing use, data on the efficacy and safety of this technology in treating PWBs over an extended period remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of a large-spot, variable-sequenced, long-pulsed KTP in the treatment of PWBs over 3 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on PWB patients treated with the KTP between October 2021 and October 2024. Treatment outcomes were assessed using colorimetric analysis based on the CIE L*a*b* color space system and by measuring the surface area of the lesions. All adverse events (AEs) were documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 69 patients were included, with a mean age of 36.5 ± 15.6 years. 59.4% were female. Colorimetric analysis revealed an average lightening of PWBs by 75.7% ± 36.1%. Additionally, the surface area of the lesions decreased by 25.3% ± 24.4%. No severe AEs, such as post-inflammatory hyperpigmentation or scarring, were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the potential of large-spot, variable-pulsed KTP as a safe and effective alternative for treating PWBs, demonstrating significant lesion lightening and surface area reduction. With no severe AEs observed, the findings suggest that this technology could complement or serve as an alternative to PDLs. Further prospective studies are warranted to optimize treatment protocols and evaluate long-term outcomes compared to PDL and other vascular treatment options.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717274","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":"Perceptions and Management of Pregnancy-Related Skin Changes: A Cross-Sectional Study on Knowledge, Practices, and Use of Skincare Product","authors":"Safwan Aladwan,&nbsp;Reem Issa,&nbsp;Wala'a Al. Safadi,&nbsp;Lilian Alnsour,&nbsp;Lidia Kamal Al-Halaseh","doi":"10.1111/jocd.70132","DOIUrl":"https://doi.org/10.1111/jocd.70132","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Hormonal, metabolic, and immunologic factors may cause several skin changes during pregnancy. Therefore, it is important for pregnant women to be aware of these expected changes in their skin appearance in order to prevent unwanted effects and to choose the appropriate preventive or treatment measures via trustable sources of information.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study would highlight the most common normal and abnormal physiological skin changes mothers usually complain about before or after pregnancy. The most commonly used skin care products, their sources of knowledge, information, perception, and experiences on these problems and products were also considered. In addition, patient satisfaction levels and their sources and types of knowledge were also investigated.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Across sectional survey was distributed among women who met the inclusion criteria and were citizens in the Hashimate Kingdom of Jordan. This survey was composed of a number of questions used for investigating participant's socio-demographic characteristics, during and post-pregnancy characteristics and medications used, comparison of skin related complains reported by these women, in addition to their use of skin care products. Women's knowledge, perception, and experience regarding their use of skin care products were also included.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of the 337 participants in this study, 6.5% and 6.8% of women were using thyroid medications and antihypertensive agents. An increase of around 3% in pregnancy-related skin changes, such as hyperpigmentation, hair loss, cellulite, and wrinkles, was predominant among women. Despite the prevalence of hyperpigmentation, only 4% and 17% of women used depigmentation and sunblock products. Moreover, women declare that their information about the use of skin care products was mainly via social media or self-experience. A low rate of consultation with dermatologists and the reliance on self-diagnosis or non-professional advice were shown.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study suggests a lack of awareness about effective preventive measures for skin-related disorders commonly occurring during pregnancy, potentially exacerbated by reliance on unverified sources of information, such as social media. Therefore, incorporating education about skin changes into routine prenatal care could ","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707295","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 Impact of Acoustic Wave Therapy on Viability and Differentiation Capacity of Human Adipose Stem Cells","authors":"Sheila Veronese,&nbsp;Riccardo Ossanna,&nbsp;Sara Ghazanfar Tehrani,&nbsp;Paolo Bernardi,&nbsp;Sima Khabouri,&nbsp;Velia Cannone,&nbsp;Maria Maddalena Nicoletti,&nbsp;Mario Goisis,&nbsp;Andrea Sbarbati","doi":"10.1111/jocd.70142","DOIUrl":"https://doi.org/10.1111/jocd.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acoustic Wave Therapy (AWT) is a particular shock wave treatment that combines focused and radial shock waves, resulting in particular efficiency in the body's superficial layers. Its application before fat grafting has the potential to enhance it, favoring a better result of the graft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study was to analyze the effects of AWT on fat tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Histological analysis of fat harvested from the abdomen of 40 subjects was evaluated. Twenty subjects had been pre-treated with AWT, while 20 had not. Extraction and characterization of adipose-derived stem cells (ADSCs) were performed for all. The multilineage differentiation capacity of extracted ADSCs and exosome extracellular vesicles' production from the fat samples were analyzed in both groups of specimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All 40 specimens presented both preservation of the structure of the tissue and of the cells, particularly of adipocytes. The cell growth resulted higher for pre-treated samples. All ADSCs from all the samples were able to differentiate along adipogenic, chondrogenic, and osteogenic lineages. In particular, for pre-treated samples, in the adipogenic lineage, a more advanced maturation phase was observed, and in the chondrogenic lineage, a chondroid matrix was evident around chondrocyte aggregates. All the samples reacted with exosome extracellular vesicles' production to stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results highlighted that AWT aligns with the in-force minimal manipulation regulations, as the tissue and cells' structure and functionality were preserved. The types of differentiation observed permitted us to speculate about possible new applications in aesthetic and regenerative medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707296","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":"Treatment of Solar Lentigines: A Systematic Review of Clinical Trials","authors":"Ghazal Mardani,&nbsp;Mohammad Javad Nasiri,&nbsp;Nastaran Namazi,&nbsp;Mehdi Farshchian,&nbsp;Fahimeh Abdollahimajd","doi":"10.1111/jocd.70133","DOIUrl":"https://doi.org/10.1111/jocd.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Solar lentigines, resulting from chronic UV exposure, are early signs of photoaging and can significantly affect individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This systematic review evaluates the efficacy, safety, and tolerability of treatments for solar lentigines in light of a lack of conclusive evidence regarding optimal therapy options.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed/Medline, EMBASE, Cochrane Library, and clinicaltrials.gov was conducted to identify relevant clinical trials published up to December 7, 2023. Inclusion criteria encompassed studies with patients diagnosed with solar lentigines, employing clinical trial methodologies and reporting clinical outcomes. Study quality was assessed using the Cochrane tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-one clinical trials involving 3234 patients aged 24–92 years were included. The most common effective topical treatment was a combination of mequinol 2% and tretinoin 0.01%, achieving efficacy rates between 52.6% and over 80%, particularly for facial lesions. Laser therapies demonstrated promising results: pulsed dye laser (27%–57% success), intense pulsed light (74.6%–90%), Q-Switched laser (36.36%–76.6%), picosecond laser (67.9%–93.02%), and fractional CO₂ laser (8%–23%). Cryotherapy yielded success in 37%–71.4%, while chemical peels with trichloroacetic acid achieved 12%–46%. Most adverse events were mild and transient, with local irritation from topical agents and mild pain from therapies being common. Pulsed dye and intense pulsed light lasers were less associated with post-inflammatory hyperpigmentation, whereas cryotherapy was linked to more severe side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Laser therapy appears more effective than other modalities, with an acceptable safety profile. Combining lasers with specific topical agents may further improve outcomes and reduce PIH. However, additional large-scale randomized trials are required to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707629","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 Efficacy of CGF Combined With Periodic Supramolecular Salicylic Acid in the Treatment of Chloasma","authors":"Ge Su,&nbsp;Qiang Fu,&nbsp;Xun Zhou","doi":"10.1111/jocd.70146","DOIUrl":"https://doi.org/10.1111/jocd.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the clinical efficacy of CGF combined with supramolecular salicylic acid cycle injection for melasma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty patients with chloasma admitted to our hospital were selected and treated with CGF facial injection. After each CGF injection, supramolecular salicylic acid was given once. After one cycle of treatment, the severity of melasma and skin parameters before and after treatment were compared using the modified melasma Area and Severity index (MASI) and VISIA facial image analysis system, respectively. At the same time, the patients' self-satisfaction was investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total effective rate of CGF combined with supramolecular salicylic acid in the treatment of chloasma was 95%. Compared with before treatment, the VISIA scores in spots, UV spots, brown spots, red areas, wrinkles, texture, pore and porphyrins scores were significantly increased after treatment. After CGF combined with supramolecular salicylic acid treatment, the MASI score of chloasma patients was significantly reduced (4.70 ± 2.47 vs. 15.30 ± 4.01, <i>p</i> &lt; 0.001). The results showed that the total satisfaction of patients with facial skin improvement after CGF combined with supramolecular salicylic acid treatment was 95.00%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CGF combined with supramolecular salicylic acid has an obvious effect on the comprehensive overall improvement of melasma and facial aging patients, and can effectively accelerate the speed of skin lesion repair and pigment elimination, which is worthy of clinical promotion and application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698796","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":"Adipogenic Effect of Magnolol in Primary Human Pre-Adipocytes With Potential Skin Health and Volumizing Effect","authors":"Alan D. Widgerow,&nbsp;Nava Dayan,&nbsp;Mary E. Ziegler,&nbsp;Faiza Shafiq","doi":"10.1111/jocd.70066","DOIUrl":"https://doi.org/10.1111/jocd.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aging is associated with fat atrophy and fibrosis with loss of adipocyte differentiation from preadipocytes. New approaches to this loss involve agents that can renew the proliferative and differentiative capacities of preadipocytes with the aim of creating new healthy adipose tissue that secrete adipokines that positively impact on skin health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material &amp; Methods</h3>\u0000 \u0000 <p>We investigated the effect of Magnolol (ML), a naturally derived compound, on human primary pre-adipocyte viability and proliferation as well as adipogenic gene expression and increase in lipid production. Cell proliferation was assessed using fluorescent signaling, and adipocyte differentiation was monitored by following morphological and microscopic changes. RNA purification and real-time PCR were undertaken to examine gene expression changes, and Oil red O staining was used to confirm adipose cell transformation. Adipokine expression, in particular adiponectin quantification, was also undertaken.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Magnolol, at a relatively low concentration, demonstrated clear adipogenic activity: with a significant increase in preadipocyte proliferation after 48 h and a significant accumulation of adipocytes as demonstrated by oil red staining. Increased gene expression of PLN1 and FABP4 and a significant increase in adiponectin protein expression was demonstrated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Magnolol stimulates preadipocyte proliferation and conversion to adipokine-producing adipocytes. This has the potential for a positive skin health and volumizing effect if used in a topical formulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698794","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 Case of Forehead Subcutaneous Fat Atrophy Following Botulinum Toxin Injection","authors":"Wen Xu,&nbsp;Lijun He,&nbsp;Yeqin Dai","doi":"10.1111/jocd.70140","DOIUrl":"https://doi.org/10.1111/jocd.70140","url":null,"abstract":"&lt;p&gt;Botulinum toxin (BTX) is a cornerstone of minimally invasive cosmetic procedures, widely employed for dynamic wrinkle treatment due to its efficacy and favorable safety profile [&lt;span&gt;1&lt;/span&gt;]. However, complications, though rare, can significantly affect patients both clinically and psychologically. Here, we report a case of forehead subcutaneous fat atrophy following BTX injection in an Asian female, shedding light on a rare complication and emphasizing the importance of precision in dosing and injection technique.&lt;/p&gt;&lt;p&gt;A 40-year-old Asian female developed progressive left forehead concavity 8 weeks post-BOTOX (onabotulinumtoxinA, Allergan) treatment (Figure 1). Initial therapy delivered 2U (0.05 mL/site) of BTX-A (100U/2.5 mL saline; 4U/0.1 mL) across five standard forehead sites. At 1-week follow-up for transient left frontal protrusions, she received a targeted 3U booster injection (0.075 mL) exclusively at the original left frontal site. The 1.2 × 1.4 cm paramedian depression emerged at 2 months, correlating with the secondary injection locus. Forehead kinematics remained intact with no neurologic sequelae. No interim interventions were reported.&lt;/p&gt;&lt;p&gt;Ultrasound imaging revealed significant alterations in tissue structure, with reduced subcutaneous fat thickness (0.8 mm vs. 2.0 mm in the unaffected region) and thickening of the dermis (1.8 mm vs. 1.4 mm) and frontalis muscle, and the subfrontal space (0.9 mm vs. 0.4 mm) (Figure 2). These findings confirmed localized atrophy and structural changes in the affected area.&lt;/p&gt;&lt;p&gt;Fat atrophy remains uncommon in aesthetic BTX applications at therapeutic doses. This case highlights critical considerations for patients with anatomical predispositions, particularly the thinner subcutaneous fat layers prevalent in Asian populations. The localized nature of atrophy—without systemic symptoms or bilateral involvement—excludes metabolic etiologies, reinforcing localized neuro-adipose disruption as the likely mechanism.&lt;/p&gt;&lt;p&gt;The observed fat loss aligns with Lim &amp; Seet's hypothesis of chemodenervation-induced lipolysis via BTX diffusion into adipose innervation [&lt;span&gt;2&lt;/span&gt;]. This contrasts sharply with BTX's protective role in fat graft survival through mechanical stress reduction [&lt;span&gt;3&lt;/span&gt;], and differs from Fortuna et al.'s chronic intramuscular fat replacement in denervated muscles [&lt;span&gt;4&lt;/span&gt;]. Although intestinal BTX accelerates gut transit to reduce fat absorption systemically [&lt;span&gt;5&lt;/span&gt;], this case aligns with anatomical stratification of BTX effects: superficial neuro-adipose disruption precipitating lipolysis versus deeper mechanical protection preserving fat viability, underscoring the critical role of injection depth in predisposed populations.&lt;/p&gt;&lt;p&gt;In conclusion, this case highlights the necessity of precision in dosing and technique to minimize complications. Clinicians should maintain a high index of suspicion for rare adverse effects, particularly in demographi","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698797","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":"Impact of Vitamin D Injection on Keloids and Hypertrophic Scars","authors":"Amel R. Hassan,&nbsp;Ammena Y. Binsaleh,&nbsp;Samar M. El-Tahlawi,&nbsp;Azza M. El-Amir,&nbsp;Mary M. Ishak,&nbsp;Nawal Alsubaie,&nbsp;Thanaa A. El-Masry,&nbsp;Mostafa M. Bahaa,&nbsp;Mamdouh Eldesoqui,&nbsp;Marwa Kamal","doi":"10.1111/jocd.70118","DOIUrl":"https://doi.org/10.1111/jocd.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hypertrophic scars and keloids are human cutaneous fibroproliferative conditions that develop after burns, trauma, surgery, and inflammation. Vitamin D inhibits keloid fibroblast proliferation by reducing TGF-β-induced extracellular matrix formation, boosting matrix metalloproteinase activity, and reducing inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To study the effect of intralesional and systemic Vitamin D3 injection on hypertrophic scars and keloids and whether vitamin D3 deficiency increases scarring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This study included 30 hypertrophic scars and keloid patients divided into groups depending on serum vitamin D levels. Every patient was tested for vitamin D using ELISA. Group I: patients with vitamin D deficiency or insufficiency received a systemic injection of vitamin D (cholecalciferol 200 000 I.U.) once monthly for 3 months with a calcium oral supplement and intralesional vitamin D injections on hypertrophic scars and keloids. Group II: patients with sufficient vitamin D received only intralesional vitamin D injections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vitamin D deficiency did not affect scar formation or severity (total Vancouver scar scale before assessment) with a <i>p</i> value &gt; 0.05. All instances showed a substantial drop in vascularity, pliability, and total Vancouver scale score (<i>p</i> value &lt; 0.05) following intervention, but no change in scar pigmentation or height. Scar assessment following intervention did not significantly differ between research groups (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Injection of vitamin on hypertrophic scars and keloids enhances vascularity and pliability in patients with sufficient serum vitamin D levels and those with deficient or insufficient serum vitamin D levels after improving them by systemic injection of vitamin D without any effect on height and pigmentation of scars.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>NCT06301178</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698798","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":"Artificial Intelligence Predicts Fitzpatrick Skin Type, Pigmentation, Redness, and Wrinkle Severity From Color Photographs of the Face","authors":"Rachel L. Draelos,&nbsp;Chelsea E. Kesty,&nbsp;Katarina R. Kesty","doi":"10.1111/jocd.70050","DOIUrl":"https://doi.org/10.1111/jocd.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Due to high patient demand, increasing numbers of non-dermatologists are performing skin assessments and carrying out laser interventions in medical spas, leading to inferior outcomes and higher complications. A machine learning tool that automatically analyzes patient skin has the potential to aid non-dermatologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To develop a high-performing machine learning model that predicts Fitzpatrick skin type, hyperpigmentation, redness, and wrinkle severity simultaneously.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed the SkinAnalysis dataset of 3662 images, labeled by a dermatologist across five skin scales. We trained and evaluated machine learning models across 15 different configurations, including three neural network architectures and two loss functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The best-performing model was an EfficientNet-V2M architecture with a custom cross entropy loss. This model's mean test set accuracy across all labels was 85.41 ± 9.86 and its mean test set AUROC was 0.8306 ± 0.09599. An interesting trend emerged in which machine learning model performance was higher at the extremes of the scales, suggesting greater clinical ambiguity in the middle of the scales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Machine learning models are capable of predicting multiple skin characteristics simultaneously from color photographs of the face. In the future, similar models could assist non-dermatologists in patient skin evaluation to enhance treatment planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698793","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}