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A double-blind, randomized multi-centre study was performed to evaluate the efficacy of a 4%, erythromycin and zinc combination (Zineryt®) versus 2%, erythromycin (Eryderm®). One- hundred and twenty-two patients suffering from acne vulgaris were treated with either Zineryt® lotion or 2%, erythromycin lotion. Acne grading arid lesion counts for comedones, papules, pustules, nodules and macules were performed at each visit at 0, 1, 2, 4, 8 and 12 weeks. Treatment with Zineryt® lotion was found to be more effective than with 2%, erythromycin as regards the reduction in number of the acne lesions and the seventy grade of the acne. [ABSTRACT FROM AUTHOR]

In a randomised study the clinical efficacy of ciprofloxacin was compared with that of doxycycline administered in two different dosage schemes to male patients suffering from non-gonococcal urethritis. Fourteen days after completion of therapy (day 21) pyuria was absent in 30 of 100 patients in the ciprofloxacin group; Chlamydia trachomatis was isolated from five and Ureaplasma urealyticum from eight patients. In the 100 mg doxycycline group (n=60) pyuria was absent in 36 patients (60 %) and Ureaplasma urealyticum was isolated from six patients on day 21. In the 200 mg doxycycline group (n=45) pyuria was absent in 18 patients (40 %) and Ureaplasma urealyticum was isolated from two patients on day 21. Side-effects were mild and transient in all groups. It is concluded that ciprofloxacin given in a dosage of 1 g for seven days is not effective in the treatment of non-gonococcal urethritis. [ABSTRACT FROM AUTHOR]

Clinical Implications: The present data contribute to the specialties of Sports Dentistry and Implantology, offering scientific evidence of the importance of a mouthguard to provide the best protection for athletes rehabilitated with dental implants.

Background: Lipedema is a chronic, progressive disorder of subcutaneous adipose tissue that usually affects the lower extremities of women. Also known as "two-body syndrome," the fat accumulations in lipedema are unsightly and painful. The disorder is well-known in Europe but is largely unrecognized and underdiagnosed in the United States., Objective: To hold the First International Consensus Conference on Lipedema with the purpose of reviewing current European guidelines and the literature regarding the long-term benefits that have been reported to occur after lymph-sparing liposuction for lipedema using tumescent local anesthesia., Methods: International experts on liposuction for lipedema were convened as part of the First International Congress on Lipedema in Vienna, Austria, June 9 to 10, 2017., Results: Multiple studies from Germany have reported long-term benefits for as long as 8 years after liposuction for lipedema using tumescent local anesthesia., Conclusion: Lymph-sparing liposuction using tumescent local anesthesia is currently the only effective treatment for lipedema.

Background: There is an increasing demand for safety standards for cosmetic treatments. With regard to liposuction, interdisciplinary consensus is lacking, especially regarding treatment setting and physician specialty., Objective: A solid, independent interpretation of scientific data on safety requires a systematic approach, which is the aim of this study., Methods: A systematic literature search was conducted for safety studies about liposuction through April 2017. Fatalities and/or reported serious adverse events served as outcome measures for safety., Results: Twenty-four studies were included. Factors that contributed to increased serious complication and mortality risk were: use of the (super)wet technique; use of systemic anesthetics, especially general anesthesia and intravenous sedation; execution by a plastic surgeon; execution in an operating room; and combination with other procedures., Conclusion: Liposuction using tumescent local anesthesia has been shown to be the safest method of fat removal, especially if no or only minimal systemic anesthesia is used. Performance of this technique in an office-based setting has been proven to be safe beyond doubt. When systemic anesthesia is used, an outpatient or ambulatory surgery facility seems also safe. Regardless of the physician specialty, knowledge and training on the execution of the tumescent procedure are vital to ensure optimal safety.

The neck is one of the most common areas treated by liposuction. Neck liposuction decreases fat volume, causes skin contraction, and restores a more youthful appearance. We present a large case series (n=987) performed by three dermatologic surgeons. Five patients developed temporary post-operative marginal mandibular dysfunction, one patient had submandibular gland ptosis and one patient had arterial bleeding. Seroma, skin necrosis, scarring, and hyperpigmentation did not occur following neck liposuction. Neck liposuction performed with tumescent local anesthesia is a safe procedure associated with a low incidence of nerve injury and other complications.

J Drugs Dermatol. 2018;17(1):30-34.

Recently, the unregulated use of untested synthetic alpha-melanocyte-stimulating hormone (α-MSH) analogues, commonly known as melanotan I and II, appears to have increased. These analogues are primarily used for their tan-stimulating effects. Dermatologists see many patients in their clinic who tan. This review provides an overview of the risks of the unregulated use of these substances. Other topics discussed here include the history and safety of afamelanotide, which is the only α-MSH analogue that is approved for use in a limited number of medical indications. Although afamelanotide has been thoroughly tested and deemed safe, illegal melanotans are likely risky for several reasons. There are questions regarding the preparation, administration, and dosage of these substances. In addition to these general risks, increasing numbers of case reports indicate that the unregulated use of both melanotan I and II is associated with cutaneous complications, particularly melanocytic changes in existing moles and newly emerging (dysplastic) nevi. Four case reports have described melanomas emerging from existing moles either during or shortly after the use of melanotan. Although conclusive evidence linking these phenomena is lacking, publications have stressed the importance of awareness that melanotan is a part of a 'tanning culture' in certain subpopulations. Multiple national health organizations have issued safety warnings regarding the use of melanotan I and II., (© 2017 The International Society of Dermatology.)

We demonstrate the efficacy of a novel minimally invasive nonthermal skin rejuvenation technique for wrinkle and fine-line reduction based on laser-induced optical breakdown. The optical breakdown caused by tightly focused near-infrared laser pulses creates a grid of intradermal lesions without affecting the epidermis, leading to skin rejuvenation. The pilot in vivo efficacy test performed on five subjects successfully demonstrates wrinkle and fine-line reduction, and improvement of other skin features without pain or any other unpleasant sensations or any social downtime associated with the treatment. The efficacy is evaluated objectively and subjectively by assessing the improvement of wrinkles and/or fine lines or skin texture after the treatment. The treatment is safe without side effects or social downtime, and all test subjects reported that the treatment is "perceptible but not painful." Four out of the five subjects who participated in this pilot study were assessed to have "minor" to "significant" improvements of wrinkles and fine lines by the professional panels. The results of this clinical study are expected to bring a paradigm shift in the present laser- and light-based skin rejuvenation methods by introducing a safe treatment procedure without damaging the epidermis, with no or little social downtime and with an efficacy that might be comparable to ablative techniques.

We describe a novel, minimally invasive laser technology for skin rejuvenation by creating isolated microscopic lesions within tissue below the epidermis using laser induced optical breakdown. Using an in-house built prototype device, tightly focused near-infrared laser pulses are used to create optical breakdown in the dermis while leaving the epidermis intact, resulting in lesions due to cavitation and plasma explosion. This stimulates a healing response and consequently skin remodelling, resulting in skin rejuvenation effects. Analysis of ex-vivo and in-vivo treated human skin samples successfully demonstrated the safety and effectiveness of the microscopic lesion creation inside the dermis. Treatments led to mild side effects that can be controlled by small optimizations of the optical skin contact and treatment depth within the skin. The histological results from a limited panel test performed on five test volunteers show evidence of microscopic lesion creation and new collagen formation at the sites of the optical breakdown. This potentially introduces a safe, breakthrough treatment procedure for skin rejuvenation without damaging the epidermis with no or little social down-time and with efficacy comparable to conventional fractional ablative techniques., (Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: Liposuction for female breast reduction is a new treatment modality that has many advantages over the generally accepted procedure of excision, which can damage glandular tissue and impair breastfeeding capacity., Objective: To assess any potential damage to glandular tissue caused by liposuction of the female breast., Methods: Specimens of the aspirate from 61 consecutive female patients who underwent liposuction of the breast using tumescent local anesthesia (TLA) and powered cannulae (PCs) were sent for histologic evaluation., Results: In all cases, fat tissue was the main component observed in the breast aspirate specimens. In 58 cases, fragments of fibrotic tissue were found. In nine cases, minor fragments of the smallest glandular tissue ductuli were detected. In no case was there any sign of larger glandular structures., Conclusions: Histologic evaluation of 61 specimens of the aspirate obtained from breast liposuctions using TLA and PCs showed only minor signs of damage to glandular tissue in a small minority of patients. There was no indication that lactation might be impaired using this procedure. The authors have indicated no significant interest with commercial supporters., (© 2010 by the American Society for Dermatologic Surgery, Inc.)

Background: Many surgeons consider liposuction using tumescent local anesthesia (TLA) to be a safe technique, but when TLA has been combined with other techniques, such as general anesthesia or intravenous medication, or when the guidelines associated with TLA have been violated, serious complications and deaths have occurred. This has resulted in uncertainty concerning the safety of liposuction using TLA, which this article seeks to resolve., Objective: To investigate whether liposuction using TLA is a safe procedure., Methods: The same surgeon performed liposuction using exclusively TLA in 3,240 procedures. Detailed records were kept of the complications that occurred., Results: In a series of 3,240 procedures, no deaths occurred, and no complications requiring hospitalization were experienced. In nine cases, complications developed that needed further action., Conclusions: Liposuction using exclusively TLA is a proven safe procedure provided that the existing guidelines are meticulously followed.

Background: Having large, heavy breasts can be a problem for women. The widely accepted method of breast reduction is excision, but this procedure often leads to a large number of unwanted side effects and complications. There is, therefore, a need for an effective technique that produces fewer of these undesirable features., Objective: A study was conducted to evaluate the safety and efficacy of liposuction using tumescent local anesthesia (TLA) and powered cannulas., Methods: One hundred fifty-one women were treated. Exact measurements of volume and ptosis were performed before the procedure and at intervals of 6 weeks and 4 months after the procedure., Results: The average volume of the breast removed was 53%. Fat was abundant in elderly women and more easily removed because of the progressive fatty involution of the breast. Ptosis reduction was sufficient in women of all ages, with an average of 3.0 cm achieved after 4 months. Patient satisfaction was high, no serious complications were seen, and down-time was minimal. Pre- and postoperative mammograms were taken 1 year after the procedure and showed no new calcifications., Conclusion: Liposuction using TLA and powered cannulas is a safe and effective treatment modality for breast reduction.

Preventing patient dissatisfaction is a primary goal when performing botulinum toxin-A injections. By taking the correct approach with careful patient selection, ensuring safety and minimizing the risk of complications and side effects, the practitioner can largely eliminate patient dissatisfaction with this therapy. Basic understanding of facial esthetics and concepts of beauty are helpful to optimize patient satisfaction.

n-Docosanol has been shown to have antiviral activity. To demonstrate the efficacy of n-docosanol 10% cream in the treatment of recurrent herpes labialis, a randomised, double-blind, parallel group, placebo-controlled study was undertaken in 63 patients. In a crossover extension, 22 of the patients used the alternative treatment for a further episode. A total of 98 episodes were evaluated. Application of n-docosanol 10% cream early in the prodromal or erythema stage of a recurrent episode of herpes labialis shortened mean healing time by approximately 3 days, as compared to late treatment with n-docosanol 10% cream and early or late treatment with the placebo. The crossover study revealed that late treatment with n-docosanol 10% cream significantly reduced mean healing time compared to placebo. Treatments were well tolerated.

The Clearview Chlamydia test (CV; Unipath Ltd., Bedford, United Kingdom), the Magic Lite Chlamydia test (ML; CIBA Corning, Medfield, Mass.), a polymerase chain reaction (PCR), and cell culture (CC) were evaluated for detection of Chlamydia trachomatis in urogenital specimens. Specimens were collected from 283 men and 724 women visiting the outpatient clinic for Sexually Transmitted Diseases at the University Hospital Rotterdam, Rotterdam, The Netherlands. ML, PCR, and CC were all performed on the same sample to prevent swab-to-swab variability. CV was performed on a separate sample. Analysis of discordant results was performed by application of the following confirmatory assays: first, PCR on the CC, second, ML was repeated, and third, PCR was repeated by using a different DNA extraction protocol. If more than one test was positive, the sample was considered true positive. If only one test was positive, which was confirmed by the confirmatory assay, the sample was also considered true positive. By using these interpretations, the following results were obtained. The sensitivity and specificity of CV for samples from men were 60.4 and 86.3%, respectively. For samples from women, these values were 62.3 and 99.7%, respectively. The low specificity for samples from men was caused by unidentified substances in the swab that was used. The use of CV on samples from men is not recommended by the manufacturer. For samples from women, the specificity of CV was high, but the low sensitivity of CV limits its use for diagnostic purposes. The sensitivities of ML were low for samples from both men and women (68.8% and 50.9% respectively), while specificities were excellent for samples from both groups (100 and 99.9%, respectively). The low sensitivity of ML limits its diagnostic value. The PCR technique was highly specific for samples from both men (99.6%) and women (99.9%). The sensitivity of PCR, however, was unexpectedly low for samples from both groups (men, 87.5%; women, 79.2%), most likely because of the sample treatment method used. The sensitivity and specificity values of CC for samples from men were 95.8 and 100%, respectively. For samples from women, these values were 100 and 99.9%, respectively. In the present study, CC was the most reliable technique for the detection of C. trachomatis.

The Gen-Probe PACE 2 assay (GP), a nonisotopic DNA probe, was evaluated by using cell culture as the method of reference. Specimens were collected from 260 men and 482 women visiting the outpatient department for sexually transmitted diseases at the University Hospital in Rotterdam, The Netherlands. The prevalences of Chlamydia culture-positive men and women were 13.2 and 8.6%, respectively. Sensitivity values for the male and female patients were 70.6 and 92.7%, respectively. Specificity values for these groups were 98.2 and 97.7%, respectively. Sensitivity was significantly lower when the number of inclusions in cell culture was low. Samples which showed a discordance between cell culture and GP results were retested by the polymerase chain reaction. If the results of the polymerase chain reaction were considered as the points of reference, the sensitivity and specificity of both GP and cell culture could be calculated. The performance of GP for females was comparable to that of cell culture. In males, the sensitivity of GP was considerably lower than that of cell culture (77.2 versus 91.4%), while specificity was somewhat higher (99.6 versus 99.1%). Compared with cell culture, the GP is a relatively simple and rapid test that is suitable for diagnosing Chlamydia infections in urogenital specimens.

Clinical and pathologic findings are described in a seven-month-old boy who suffered from persistent truncus arteriosus and suddenly developed signs of respiratory distress. Bronchial compression in patients with persistent truncus arteriosus has only rarely been reported.