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A 19-year-old woman experienced recalcitrantpsoriasis after streptococcal pharyngitis. Multipletreatment regimens were employed, but results werepoor until after the patient underwent tonsillectomy.

Superficial morphea, a rare variant of morphea, ischaracterized by hypopigmented to hyperpigmentedskin lesions located predominantly in a symmetricfashion at intertriginous sites. These patches andplaques typically lack the significant induration,contractures, and atrophy seen in other subtypesof morphea. Histologic examination is key foraccurate diagnosis considering the number of similarconditions which may clinically mimic superficialmorphea. Herein, we present a case of a 25-year-oldwoman who re-presented for consultation in ourclinic after gradual progression of her skin lesions. Inaddition, we review dermatologic look-alikes, as wellas the pathophysiology and treatment options forsuperficial morphea.

BACKGROUND Acne scarring is an unfortunate sequela affecting up to 95% of patients with acne and carries profound psychosocial impact. Both nonablative fractional lasers (NAFL) and microneedling with radiofrequency (MNRF) have demonstrated comparable efficacy in the treatment of atrophic acne scars. OBJECTIVE To determine whether alternating NAFL and MNRF is superior to NAFL alone in the treatment of atrophic acne scars. METHODS AND MATERIALS This was a prospective, single-center, double-blinded, split-face clinical trial. Twenty patients with atrophic acne scars who had their facial halves randomized to receive either NAFL alone or NAFL alternating with MNRF. Patients received 4 total treatments at 4-week intervals. RESULTS Ninety days after the final treatment, both facial halves demonstrated a significant improvement in the mean global échelle d'évaluation clinique des cicatrices d'acné (ECCA) score from baseline (p < .001 for both halves). The average percentage improvement at the final end point was 20% to 30% from baseline. No significant difference was noted between facial halves for mean global ECCA score or percentage improvement at any time point. CONCLUSION Although both NAFL and MNRF are safe and effective in the treatment of atrophic acne scars, alternating NAFL and MNRF does not seem to be superior to NAFL alone. [ABSTRACT FROM AUTHOR]

BACKGROUND Cosmetic facial tattoos have proven difficult to remove despite advancements in laser technology. OBJECTIVE Review safety and efficacy of picosecond laser removal of cosmetic facial tattoos. METHODS & MATERIALS Retrospective chart review from January 2015 to January 2022 of patients undergoing tattoo removal of facial cosmetic tattoos. RESULT A total of 33 patients were included in the review. The average number of treatments to obtain satisfactory results was 3. Sixty 6 percent of subjects were rated as "very much improved" with 76% to 100% of the tattoo removed and 34% of subjects were rated "much improved" with 51% to 75% of the tattoo removed. Thirty percent of subjects experienced unexpected changes in the tattoo color after initial treatment with 1,064-nm picosecond laser. CONCLUSION Picosecond laser is an effective and safe treatment for cosmetic tattoos, and it highlights the underreported unmasking of an orange color postlaser treatment that can be successfully treated with a 532-nm PS laser. [ABSTRACT FROM AUTHOR]

The patient ultimately healed with a multimodal approach including intralesional hyaluronidase, oral prednisone, oral aspirin, intralesional STS, and HBO therapy. We report a case of a 29-year-old woman who presented 1 day after calcium hydroxylapatite (CaHA) injections at a medispa with purpuric, reticulate patches involving the left lower eyelid and anterior cheek (). The patient was instructed to add oral aspirin 81 mg and warm compresses to her regimen, and hyperbaric oxygen (HBO) therapy was prescribed daily for 5 days. [Extracted from the article]

Background: Injectable poly-l-lactic acid (PLLA-SCA) increases extracellular matrix to improve skin quality. The hip dell is an underappreciated element of gluteal aesthetics. Adipose tissue has roles in aesthetics and skin functioning., Objective: To investigate the efficacy of PLLA-SCA treatment to induce adipogenesis and volumize the hip dell., Materials and Methods: This was a double-blinded, split-body trial of 15 women with hip dell volume deficits. Each subject was randomized to have 1 hip dell treated with 150 mg of PLLA-SCA while the contralateral hip dell received the equivalent volume of saline. Subjects received 3 treatments at 1-month intervals and were followed for 9 months. Assessments included physician global aesthetic improvement scale, ultrasonography, and histologic examination., Results: Blinded investigators rated PLLA-SCA-treated hip dells as improved and much improved. The dermis and adipose layers increased in thickness by 26.1% and 27%. These measures, in addition to collagen and elastic fiber quality, were significantly improved compared with saline-treated hip dells, which did not change from baseline. Subject satisfaction was also significantly greater on the PLLA-SCA-treated side. No subject experienced significant adverse effects., Conclusion: Poly-l-lactic acid is a safe and effective method for durable volumization and aesthetic improvement of the hip dell. PLLA-SCA may promote adipogenesis and elastogenesis., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Defensins recruit leucine-rich repeat-containing G protein-coupled receptor 6 positive (Lgr6+) stem cells which ultimately regenerate new basal stem cells, healthy keratinocytes, and nascent hair follicles. Thus, defensins are an exciting, novel therapy for the reversal of skin aging., Methods: This is a multicenter, prospective, open-label clinical trial. Twenty healthy subjects, aged 45-80, with Fitzpatrick skin types II-IV were enrolled in the study. A skin care regimen containing alpha-defensin 5 and beta-defensin 3 were applied to the face twice daily for 12 weeks. This skin care regimen contains a greater percentage of defensins than that already studied.7 All participants underwent imaging at baseline, day 30, day 60, and day 90. Primary endpoints included investigator scoring on the Fitzpatrick-Goldman wrinkle scale and percent improvement in periorbital wrinkles, laxity, pigmentation, erythema, texture, and radiance. Secondary endpoints were investigator Global Aesthetic Improvement Score (GAIS), subject GAIS, and investigator assessment of tolerability. A final subject questionnaire was completed on day 90.&nbsp; Results: Based on the Fitzpatrick-Goldman wrinkle scale, a statistically significant improvement was noted in both wrinkling and elastosis from baseline to day 90. 30% of subjects were rated as much improved and 50% of subjects were rated as improved on the physician GAIS at the 90 day follow up. Improvements were noted in all aspects of skin quality including wrinkles, laxity, dyschromia, erythema, texture, and radiance.&nbsp; Conclusion: The enhanced formula containing increased concentrations of alpha-defensin 5 and beta-defensin 3 is a safe and efficacious topical therapy for the treatment of periorbital rhytids., Citation: Hartman N, Loyal J, Taub A, et al. Clinical trial of alpha and beta defensin skin care regimen for improvement of periocular wrinkles. J Drugs Dermatol. 2023;22(9):874-880. doi:10.36849/JDD.7184.