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Background: There has been a significant increase in submissions to scientific journals addressing a broad spectrum of medical and surgical conditions in subjects grouped under the classification of "Skin of Color." Authors, reviewers, and editors have struggled with accurate terminology., Objective: To update the Fitzpatrick scale to make it more accurate in stratifying various shades of skin color., Materials and Methods: A thorough literature review was performed using PubMed and Embase to assess existing skin color scales, and an extensive internet search was conducted using makeup foundation ranges as a starting point for skin tone matching., Results: The research resulted in a consensus that Fitzpatrick types 4 and 5 ratings were the most confusing in that these included a broad range of skin types with different responses to solar radiation, lasers, surgery, and cosmetic products. The authors reached a consensus that subdividing skin types 4 and 5 into "A" and "B" better defined them. The new scale that resulted was labeled the SCE scale (for Skin Color Ethnicity)., Conclusion: This new updated SCE scale should assist authors in better reporting scientific data in skin of color., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Effacement of horizontal forehead lines (FHL) with onabotulinumtoxinA has not been investigated in prospective Phase 3 studies., Objective: To evaluate safety and efficacy of onabotulinumtoxinA treatment of FHL together with glabellar lines (GL)., Materials and Methods: A 12-month, Phase 3 study randomized subjects with moderate-to-severe FHL and GL to onabotulinumtoxinA 40 U or placebo, distributed between the frontalis (20 U) and glabellar complex (20 U). After Day 180, subjects could receive up to 2 additional open-label onabotulinumtoxinA treatments. Efficacy was assessed using the Facial Wrinkle Scale (FWS) and Facial Line Outcomes questionnaire., Results: The intent-to-treat (ITT) population included 391 subjects, and the modified ITT (mITT) population (subjects with psychological impact) included 254 subjects. After 30 days, onabotulinumtoxinA significantly improved the investigator- and subject-assessed appearance of FHL severity by at least 2 FWS grades in 61.4% of ITT subjects versus 0% of placebo subjects (p < .0001). In the mITT population, 94.8% of onabotulinumtoxinA subjects and 1.7% of placebo subjects achieved investigator- and subject-assessed FWS ratings of none/mild (p = .0003). Patient-reported outcomes were consistent with FWS ratings. OnabotulinumtoxinA was well tolerated., Conclusion: OnabotulinumtoxinA 40 U distributed between the frontalis and glabellar complex was safe and effective for treatment of moderate-to-severe FHL.

Background: Demand for nonsurgical esthetic body procedures has led to the development of noninvasive techniques for reducing localized subcutaneous adipose tissue., Objective: This study assessed multiple treatments with nonthermal focused ultrasound for noninvasive abdominal treatment of excess fat deposits., Materials and Methods: Subjects were randomly assigned to Group 1 for a 4-week control phase before undergoing 3 abdominal fat reduction treatments, at 2-week intervals, or to Group 2 for immediate treatment. Weight, abdominal circumference, tolerability to treatment, subject satisfaction, and adverse events were recorded., Results: Weight remained stable in the 126 participants. Mean reduction in midline circumference was 2.5 ± 2.1 cm in the Group 1 and 3.5 ± 2.7 cm in the Group 2 at Week 22. The effect of multiple treatments was cumulative with a steady decrease in abdominal circumferences during the study. Erythema was observed in 28% of treatments but was mild and transient in nature. Subjects tolerated the treatments well and were satisfied with treatment outcome., Conclusion: The study demonstrated the efficacy and safety of multiple nonthermal focused ultrasound treatments of excess abdominal fat deposits. Although the remodeling effect is minor compared with traditional surgical procedures, successive focused ultrasound treatments significantly reduced treatment area circumference, while avoiding invasive techniques and their associated disadvantages.