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Laser skin resurfacing is a common procedure in aesthetic surgery. The safety of facial laser skin resurfacing among immunocompromised and diabetic patients has not been scientifically assessed. The purpose of this investigation was to evaluate for differences in adverse events among immunocompromised patients and diabetic patients following laser skin resurfacing. A retrospective review of all patients who underwent fractionated ablative laser skin resurfacing at between 2010 and 2019 was performed. Infectious and dermatologic complications within the first 3 months after surgery were recorded and compared between immunocompetent, immunocompromised, and diabetic patients. A total of 525 cases were identified, including 22 immunocompromised, 21 diabetic, and 482 immunocompetent cases. Patient demographics were similar between groups. Infectious complications occurred in 15 (2.9%) patients: 1 (4.5%) among immunocompromised cases, 1 (4.8%) among diabetic cases, and 13 (2.7%) among immunocompetent cases, with no significant difference in incidence (P = 0.35). Fourteen infections (93.3%) occurred within the first 2 weeks of laser resurfacing. The rates of other adverse dermatologic events such as prolonged erythema, post-inflammatory hyperpigmentation, and scarring were similar between groups (P = 1.00, 0.21, 1.00, respectively). Compared to non-diabetic immunocompetent patients, no significant difference in rates of infection following laser skin resurfacing in immunocompromised patients or diabetic patients was observed. Level of evidence: Level III, risk / prognostic study.

Aim: The physiological ageing process causes significant changes in the extracellular matrix (ECM) of the neck skin, which are the first signs of ageing witness for women. We are inspired by a young woman, who suffers from a rare genetic disorder called pseudoxanthoma elasticum (PXE), which manifests irregular, thickened, fragmented and haphazardly orientated elastic fibers. We herein present a combination of three different therapies (laser skin resurfacing, type I horse collagen boosters and platelet rich plasma)as an approach to ameliorate neck skin sagging. Methods: A 28-year-old Roma woman with a clinically diagnosed PXE, verified by ophthalmologic evidence and skin biopsy, underwent 3 sessions of this combined protocol every 3 weeks. One month after the last treatment session, a new biopsy was taken. During this period, the patient was encouraged for daily topical application of collagen mousse and vitamin C combined with sun block SPF50, along with limited exposure to sunlight. Results: Clinical assessment supported by photographic documentation was performed at each session. Severe changes in hydration and tightening of the neck skin were obvious 3 weeks after the second session, although the verification of the results was substantiated with the pathology of the post treatment skin biopsy obtained 1 month following the completion of the protocol. The elastic fibers in the mid-dermis were dense, non-fragmented and parallel oriented. The aesthetic performance was evident until the final follow-up visit. Conclusions: Nowadays, the primary goal of aesthetic medical research is oriented to the dermis bio-reconstruction, where specific treatments try to improve the dermis quality from the inside to repair imperfections of skin ageing. The key of success is attributed to the best possible treatment combination capable of fibroblast stimulation.

The epidermis forms an essential barrier against a variety of insults. The overall goal of this study was to shed light not only on the effects of accidental epidermal injury, but also on the mechanisms that support laser skin resurfacing with intra-epidermal focal laser-induced photodamage, a widespread medical practice used to treat a range of skin conditions. To this end, we selectively photodamaged a single keratinocyte with intense, focused and pulsed laser radiation, triggering Ca2+ waves in the epidermis of live anesthetized mice with ubiquitous expression of a genetically encoded Ca2+ indicator. Waves expanded radially and rapidly, reaching up to eight orders of bystander cells that remained activated for tens of minutes, without displaying oscillations of the cytosolic free Ca2+ concentration (${[ {{\rm{C}}{{\rm{a}}^{2 + }}} ]_c}$). By combining in vivo pharmacological dissection with mathematical modeling, we demonstrate that Ca2+ wave propagation depended primarily on the release of ATP, a prime damage-associated molecular patterns (DAMPs), from the hit cell. Increments of the ${[ {{\rm{C}}{{\rm{a}}^{2 + }}} ]_c}$ in bystander cells were chiefly due to Ca2+ release from the endoplasmic reticulum (ER), downstream of ATP binding to P2Y purinoceptors. ATP-dependent ATP release though connexin hemichannels (HCs) affected wave propagation at larger distances, where the extracellular ATP concentration was reduced by the combined effect of passive diffusion and hydrolysis due to the action of ectonucleotidases, whereas pannexin channels had no role. Bifurcation analysis suggests basal keratinocytes have too few P2Y receptors (P2YRs) and/or phospholipase C (PLC) to transduce elevated extracellular ATP levels into inositol trisphosphate (IP3) production rates sufficiently large to sustain ${[ {{\rm{C}}{{\rm{a}}^{2 + }}} ]_c}$ oscillations.

Background Laser and energy-based devices may be used for many cutaneous indications, including facial resurfacing, improving skin conditions, and reducing signs of photoaging. Currently, no consensus papers or guidelines exist concerning peri-operative agents and specifically their use for laser skin resurfacing and their potential/possible role in prevention or treatment of side effects. Aim To explore current practice using laser and energy devices, a survey was developed to identify the trends in pre- and postprocedural treatment measures. Methods The survey was sent out digitally to 300 randomly selected US dermatologist and plastic surgeon physicians practicing medical esthetics using laser and other energy devices treatment for facial rejuvenation. The survey gathered information on demographics, types of devices used in the clinic and pre-/postprocedural measures for facial laser, and other energy-based devices treatment. Results The survey was active from June 15, to July 15, 2018, and fifty-eight dermatologists and plastic surgeons completed the survey (19.3% response rate, 58/300). The results showed inconsistency in skin preparation strategies and postprocedure wound care. The majority of survey participants (55/58 [96%]) reported prophylactic oral antiviral use pre- and post-treatment; however, there was inconsistency about when to start and when to stop the use. A similar inconsistency existed in the recommended period of post-treatment sun protection before and after treatment. Conclusion The results of the survey confirmed the lack of consistency in the types and duration of pre- and postprocedural measures-emphasizing the need for evidence-based recommendations to optimize outcomes, prevent infection, enhance comfort, and reduce downtime.

BACKGROUND Many modalities have been described for the treatment of periorbital wrinkling. AIMS The purpose of this study is to quantify the improvement of periorbital wrinkling achieved by current nonablative modalities, using a fractional 1565 nm Er:glass fiber laser. METHODS Our study is a retrospective two-center case series including 16 patients treated with nonablative laser for periorbital wrinkling at the Tel-Aviv Sourasky Medical Center in Israel and Laserplast Aesthetic Medicine Center in Italy between 2017 and 2019. Patients were assessed for objective and subjective improvement, patient satisfaction, side effect profile, and downtime. RESULTS Improvement in average Fitzpatrick Wrinkle Scale scores (from 4.3 to 2.7 by ranking physician 1 and 3.8 to 2.4 by ranking physician 2, P

Laser resurfacing procedures have become increasingly popular as more and more patients are seeking out aesthetic treatments that produce dramatic results. Considered the gold standard procedure for atrophic acne scarring and skin regeneration, laser resurfacing achieves more superior results than chemical peels and has a safer profile than more traditional methods such as dermabrasion. In this article, the author will differentiate between the various laser resurfacing technologies available, describe the mechanisms of action for ablative and non-ablative lasers in both fractionated and unfractionated modalities, explore the expected treatment outcomes, and outline the short-term and long-term complications associated with each procedure.

Introduction: Greater demand for noninvasive techniques to reduce cellulite and contour the body has led to the growth of electromagnetic and radiofrequency devices. In this study, we aimed to char...

To assess current practice patterns for management of upper and lower eyelid blepharoplasty by active American Society of Ophthalmic Plastic and Reconstructive Surgery members. An invitation to participate in a web-based anonymous survey was sent to the active American Society of Ophthalmic Plastic and Reconstructive Surgery membership via email. The survey consists of 34 questions, both multiple choice and free response, regarding upper and lower eyelid blepharoplasty surgery. Practice patterns for both aesthetic and functional blepharoplasty are assessed. Thirty-four percent (161/472) of American Society of Ophthalmic Plastic and Reconstructive Surgery members polled responded to the survey. Members perform an average of 196 upper eyelid, 46 lower eyelid, and 53 four-eyelid blepharoplasty procedures per year, with 70% of cases being functional and 30% purely aesthetic. Most members prefer monitored care (71%) to local (21%) or general (8%) anesthesia. Eighty-nine percent of surgeons use topical antibiotics after surgery, erythromycin being the most common (51%). Fourteen percent of members use postoperative oral antibiotics, with cephalexin (81%) being most common. In upper eyelid blepharoplasty, orbicularis muscle is excised by 86% of respondents. Orbital fat is excised, when deemed appropriate, in 97% of cases, with nasal fat excised most commonly (88%). Less commonly, fat repositioning (36%) and adjunctive fat grafting (33%) are performed. In lower eyelid blepharoplasty, surgeons report using one or more of the following approaches: transconjunctival (96%), transcutaneous (82%), and both transconjunctival and transcutaneous (51%). Common adjunctive procedures include orbital fat excision (99%), fat repositioning (80%), and lateral canthal suspension (96%). Less common adjunctive procedures include laser skin resurfacing (36%) and chemical peels (29%). This report outlines contemporary practice patterns among active American Society of Ophthalmic Plastic and Reconstructive Surgery members in the management of upper and lower eyelid blepharoplasty. It is important to quantify such data periodically to update the membership as to how this common surgical procedure is approached. This also allows eyelid surgeons to compare their practice patterns with a national group specializing in such surgery.

The request for skin rejuvenating techniques is increasing. The concept of nonsurgical skin rejuvenation has been developed through the introduction of laser skin resurfacing. Laser resurfacing for skin rejuvenation was first introduced in the 1980s through the ablative carbon dioxide (CO2) laser. However, first devices showed an imbalanced risk-benefit ratio was for the high rate of adverse events and downtime. Therefore, technological evolution has led to the development of new devices, optimizing results with a reduced downtime. In detail, non-ablative and ablative fractional lasers, based on the fractional photothermolysis principle, have been introduced. The concept is based on fractional thermal damage of the skin while the undamaged surrounding tissue allows tissue repair, thus optimizing results and reducing downtime. An analysis of the main sources for laser resurfacing is herein presented as well as perioperative management advices and specific indications.

Laser resurfacing is an excellent modality in the treatment of the aging skin. This chapter includes patient evaluation, the authors’ preferred laser technique, and both preoperative and postoperative care recommendations. The chapter is supplemented with case presentations.

Facelift surgery is a popular treatment but exhibits high variation among practitioners in terms of both core technique and adjunctive measures. This review identified significant evidence addressing the role of pre-infiltration, drains, fat grafting, fibrin tissue adhesives, hilotherapy, and other miscellaneous adjuncts. Based on the authors' assessment of the current literature, there is reasonable supportive evidence for pre-infiltration, fat grafting and laser skin resurfacing, which appear to be safe and effective in appropriately selected patients. Drain use is not mandatory but may confer some benefit. Conversely the evidence for the use of fibrin tissue adhesives and hilotherapy is not compelling.

Background: Skin cancer can affect the lips and Mohs micrographic surgery is the ideal mode of removal. However, how are post-Mohs defects affecting the vermillion border approached by a clinic with both a plastic surgeon and Mohs surgeon team? Method: A cross-sectional study was designed of 8 consecutive Mohs cases with a post- Mohs defect affecting the vermillion border in a practice with a Mohs surgeon and plastic surgeon. These were the only vermillion defects out of 358 consecutive Mohs procedures. The participants ranged in age from 30-82 years of age. Their post-Mohs defects were between 1-3.5 cm in greatest diameter, but 2.5 cm was the mean diameter. The surgical procedures were performed by a two-surgeon team for post-Mohs defects. For each case, information was gathered, including patient age, type of tumor, tumor location, greatest diameter of the tumor, Mohs stages for clear margins, and the greatest diameter of the final wound size. Also, the techniques used in the defect repair were documented. The one patient who needed more than one repair technique was assessed. Results: Basal cell carcinoma (BCC) was the only tumor that affected thee vermillion border. The defects were closed primarily by advancement flaps. The philtrum defect that involved the vermillion was closed primarily with an advancement flap. The greatest number of defects affected the left upper lip, and the areas were closed equally by an advancement flap, an island pedicled flap, a full thickness skin graft (FTSG), and a myocutaneous flap. The right lower lip was not affected in our patient pool. Men outnumbered women in BCC of the vermillion border. The combined closure of the lip involved the left upper lip and consisted of an island pedicled flap and a FTSG. Conclusion: Men and overwhelmingly affected with BCC of the vermillion border and advancement flap is the most common closure technique.

Serious scientific Research in the field of cosmetics has speared headed the growth of cosmetic industry which adds undeniable credibility to the products Many a time a clinically simple non invasive dermatological technique is required to study the effect of the products in real time Raman spectroscopy can be employed in his regard as it is a versatile technique which can be employed to study the nature and effects of these cosmetic products In this short communication we are reporting the study on the effect of fairness creams available in the market for the general Indian populace using Raman spectroscopy

Dermatophytosis acquired from pets has been increasing Dogs cats and rodents are the more related animals with these superficial fungal infections Microsporum canis and Trichophyton spp are the most common species involved in zoophilic dermatophytosis We report three cases of dermatophytic infections acquired from infected pets and their etiological agents

Purpose The purpose was to evaluate the clinical outcomes of laser skin resurfacing using an ultra-pulse carbon dioxide (CO2) laser and manual dermabrasion with a medium-grit drywall sand screen for scar revision in adults with Fitzpatrick skin type III to V. Materials and Methods A total of 20 postsurgical and post-traumatic scars in individuals with Fitzpatrick skin type III to V were included in this study. Preoperative evaluation of the scars was performed by 3 blinded observers using the Manchester scar rating scale. Each scar to be treated was divided into 2 equal halves, and each half was randomly allotted to either ultra-pulse CO2 laser resurfacing (group A) or manual dermabrasion (group B). Postoperative clinical evaluation was performed by the same observers using the Manchester scar rating scale at the end of the first month, third month, and sixth month. Results This study showed that both methods were effective in improving the appearance of the postsurgical and post-traumatic scars. No significant difference was found between them (P = .978). Hyperpigmentation occurred in 4 scars in both the half treated with manual dermabrasion and the half treated with laser resurfacing; however, it had resolved by the end of the sixth month in all 4 scars. Conclusions CO2 laser resurfacing and manual dermabrasion are equally efficacious and safe methods for scar resurfacing in adults with Fitzpatrick skin type III to V.

Removing children traumatic scars, resulting from various injuries and surgeries, is still actual problem. Unlike conventional laser skin resurfacing removal of sizeable amount of tissue is required for such treatment. To decrease the injury rate a special laser with the pulse duration below 20 μs was used. The data of 6 years successful method application are presented (over 250 patients).