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BACKGROUND HU-014, a newly introduced botulinum toxin type A, has not been investigated for its efficacy and safety in crow’s feet line (CFL) treatment. OBJECTIVE Here, we compared the efficacy and safety of HU-014 and onabotulinumtoxinA in CFL treatment. METHODS This was a randomized, double-blind, active drug–controlled, multicenter, 16-week, Phase I/III study designed to determine the noninferiority of HU-014 compared with onabotulinumtoxinA in moderate-to-severe CFL treatment. In the Phase III study, 290 subjects were randomized at a 1:1 ratio to receive a single treatment of HU-014 or onabotulinumtoxinA. The primary endpoint was the proportion of subjects achieving Grade 0 or 1 in the facial wrinkle scale on maximum smile at Week 4. RESULTS The primary endpoint was achieved by 72% of the subjects with HU-014 and onabotulinumtoxinA treatments, supporting the noninferiority of HU-014 compared with onabotulinumtoxinA. All secondary efficacy outcomes were achieved by the subjects. The 2 groups showed no significant differences in the safety analysis. CONCLUSION HU-014 has noninferior efficacy and safety compared with onabotulinumtoxinA in the treatment of CFL. [ABSTRACT FROM AUTHOR]

BACKGROUND Recently, the safety of a new botulinum toxin (HU-014) was confirmed through animal experiments. The evaluation of the efficacy and safety of this newly introduced botulinum toxin is required considering the risk of adverse events (AEs) and need for standardization before its universal use. OBJECTIVE The aim of this multicenter, double-blind, randomized, parallel, active-controlled phase III clinical trial was to investigate the noninferiority of HU-014 versus existing onabotulinumtoxin A for the treatment of moderate to severe glabellar lines. METHODS In total, 267 subjects were randomized to either the test (HU-014) or control (onabotulinumtoxin A) group. At the baseline and at weeks 4, 8, 12, and 16, investigator’s live assessment, independent photographic assessment, subjects’ improvement assessment, subjects’ satisfaction assessment, and safety assessment were performed. RESULTS At week 4, the response rate was 90.15% and 92.31% in the test and control groups, respectively, as per investigator’s live assessment while frowning, without a significant difference. Both groups also showed no significant differences in response rates in the other assessments. In addition, no serious AEs were reported. CONCLUSION HU-014 was noninferior to existing onabotulinumtoxin A in the treatment of glabellar lines at a 1:1 dose ratio, and both products were well tolerated. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 45-year-old woman diagnosed with erythematous protruding mass in left temporal area. The study discussed the medical history of the patient, her treatment option through total thread removal, the chronic inflammation reactions during the procedure, disease complication, and the clinical outcomes of the treatment.

Background: Various modalities have been used to treat acne scars, but limited efficacy and considerable side effects have restricted their proper use. Recently, a new-generation fractional photothermolysis modality has been introduced that has deeper penetrating ability; however, a 1540 nm fractional photothermolysis study has not yet been performed. Objectives: To evaluate the efficacy and safety of 1540 nm fractional photothermolysis for the treatment of acne scars in Asian skin. Methods: Sixteen volunteers (Fitzpatrick skin types III–IV) with mild to moderate acne scars were enrolled. Acne scar lesions were treated with 1540-nm fractional photothermolysis (Starlux™ 1540). Three treatment sessions were performed for each patient 4 weeks apart. Outcome assessments included the following four methods: (1) clinical evaluation of the photographs that were taken before and after the treatment; (2) comparison of the quality of life (QOL) of the patients before and after the treatment; (3) patients' satisfaction with the treatment; and (4) comparison of the quantity of collagen and elastic fibers in the skin biopsies before and 12 weeks after the last treatment. Results: A mild to moderate clinical improvement was observed in most of the patients. Moreover, the QOL of all the patients improved, and all of them were satisfied with the results of the treatment. Significant collagen and elastic-fiber increases were also observed after the treatment, and side effects were limited to transient erythema and edema, which occurred in 50% of the patients. No severe side effect was observed. Conclusions: 1540 nm fractional photothermolysis is an effective and safe method for improving acne scar, even in Asian skin. [ABSTRACT FROM AUTHOR]

BACKGROUND Despite the widespread use of botulinum toxin (BTX) injection for the treatment of masseter muscle hypertrophy (MMH), there is no standard treatment option. OBJECTIVE We report the efficacy and safety for BTX in MMH over a period of 48 weeks. METHODS In double-blinded, placebo-controlled phase 3 trials, 180 patients (randomized 1:1) received treatment with placebo (normal saline) or prabotulinumtoxinA (48 units). Masseter muscle thickness (at maximal clenching and resting positions), 3D imaging analysis, and masseter muscle hypertrophy scale grades were analyzed at each time point. After the 24-week CORE study, all patients who met the same criteria of the CORE study at week 24 (n 5 114) received only prabotulinumtoxinA, regardless of previous treatment, for an additional 24 weeks (48 weeks in total) for the open-label extension study. RESULTS The largest differences in mean and percent changes from baseline in masseter muscle thickness were observed at 12 weeks, and there were significant differences between the 2 groups at all time points (all p, .001). The effect was independent of the number of injections. No serious adverse event was observed. CONCLUSION PrabotulinumtoxinA could effectively ameliorate MMH without major complications. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the administration of fractional photothermolysis laser to treat patients with alopecia areata (AA) is presented.

The article presents an analysis regarding effective treatment modalities for depressed facial scars in regenerating dermal matrix and in minimizing downtime. It cites a case of a Korean man with an ipsilateral atrophic resulting from herpes zoster. He was given a monthly application of subdermal minimal-surgery technology for six months. It concludes that dermal edema with nanobullets containing hyaluronic acid particles might facilitate wound-healing processes.

Background Vitamin C has been used for the treatment of hyperpigmented diseases. However, there is no study available on hypopigmenting effect of multivitamin. Objectives To investigate the inhibitory effects of multivitamin and vitamin C on melanogenesis. Methods We assessed the effect of multivitamin and vitamin C on cell viability, melanogenesis, and mushroom tyrosinase. The antioxidant activity of multivitamin and vitamin C was measured. We performed the Western blot analysis to study the effect of multivitamin and vitamin C on the expression of tyrosinase, microphthalmia-associated transcription factor (MITF), extracellular signal-regulated kinase (ERK), and Akt/protein kinase B. In a clinical trial, 20 melasma patients were treated with split face iontophoresis using either multivitamin or vitamin C. We evaluated the hypopigmenting effects of multivitamin and vitamin C through colorimetric measurement. Results Both vitamin C and multivitamin inhibited melanogenesis with low cytotoxicity. Multivitamin reduced melanin contents greater than vitamin C. However, the effects of vitamin C are greater than those of multivitamin on mushroom tyrosinase inhibition and antioxidation. In the Western blot, the reduced tyrosinase expression and MITF level were observed only in multivitamin-treated group, and not in vitamin C-treated group. No changes of ERK and Akt activation were observed in both multivitamin and vitamin C-treated groups. After 12 weeks of treatment with iontophoresis, both multivitamin and vitamin C were effective for melasma. Conclusions Multivitamin has shown more anti-melanogenic effect than vitamin C via the downregulation of MITF. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease-2019 (COVID-19) outbreak has presented unique dermatologic challenges due to respiratory protective equipment (RPE)- related skin conditions. Objective: To objectively evaluate the effects of RPE including medical masks and respirators on the skin barrier by measuring various physiological properties of the skin. Methods: A cross-sectional study was designed. Twenty healthy healthcare workers were included in this study. Skin parameters including skin hydration, transepidermal water loss (TEWL), erythema, sebum secretion, pH, and skin temperature were measured in the RPE-covered and RPE-uncovered areas of the face 4 and 8 hours after wearing RPE and 14 hours after not wearing RPE. Results: Skin hydration, TEWL, erythema, pH, and skin temperature increased in the RPE-covered areas after wearing RPE for 4 and 8 hours. By contrast, in the RPEuncovered areas, skin hydration decreased and TEWL, erythema, and pH showed minimal changes over time. Based on the repeated-measure analysis, the changes in skin physiological properties over time were significantly different between RPEcovered and RPE-uncovered areas. Conclusion: We observed that skin physiological characteristics change with the prolonged use of RPE such as medical masks and respirators. These changes may lead to various adverse skin reactions after long-term use. [ABSTRACT FROM AUTHOR]

Stichopus japonicus has been used as a folk medicine and as an ingredient in traditional food in East Asian countries. In recent years, the bioactive compounds found in S. japonicus have been reported to possess efficacy in wound healing and may be of potential use in the cosmeceutical, pharmaceutical and biomedical industries. Although the components and their functions require further investigation, S. japonicus extracts exhibit anti-inflammatory properties, and may be used for cancer prevention and treatment. Although several reports have examined different aspects of S. japonicus, the effects of S. japonicus extract on melanogenesis in the skin has not been reported to date. Therefore the present study aimed to investigate the effects of S. japonicus extract on melanogenesis. Treatment with a mixture of S. japonicus extracts (MSCE) reduced melanin synthesis and tyrosinase (TYR) activity in mouse melanocyte cells lines, B16F10 and Melan-A. In addition, MSCE treatment reduced the protein expression levels of TYR, tyrosinase-related protein-1 and tyrosinase-related protein-2. The reduced protein levels may be the result of decreased microphthalmia-associated transcription factor (MITF) expression, which is an important regulator of melanogenesis. The reduced expression level of MITF was associated with delayed phosphorylation of extracellular signal-regulated kinase (ERK) induced by MSCE treatment. A specific MEK inhibitor, PD98059, significantly blocked MSCE-mediated inhibition of melanin synthesis. In conclusion, these results indicate that MSCE may be useful as a potential skin-whitening compound in the skin medical industry. [ABSTRACT FROM AUTHOR]

Background/Aims: This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. Methods: We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week. Results: In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively. Conclusions: A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori. [ABSTRACT FROM AUTHOR]