Pressure- and dose-controlled transcutaneous pneumatic injection of hypertonic glucose solution for the treatment of atrophic skin disorders

Background: Needleless transcutaneous pneumatic injections (TPIs) are a minimally invasive way to deliver the solution into the skin for therapeutic purposes. The suggested action mechanisms of TPI therapy include mechanical stimulation, immediate tissue shrinkage and late wound healing. Methods: Thirteen Korean patients were treated with TPI for atrophic skin disorders, including acne scars, striae albae, post-furuncle, or carbuncle scars, and horizontal wrinkles with lipoatrophy. At each TPI treatment session, a single pass was made along with the atrophic skin lesions without overlapping. Thereafter, two dermatologists objectively evaluated the clinical improvement in the lesions in the photographs via the global aesthetic improvement scale (GAIS). Results: One month after the final treatment, the overall mean GAIS score was 2.3 ± 0.8. Six of the 13 (46.2%) patients exhibited clinical improvement of grade 3, five (38.5%) patients grade 2 and two (15.4%) patients grade 1. The overall mean subjective satisfaction score with the TPI treatment was 2.3 ± 0.9. Six of the 13 (46.2%) patients achieved subjective satisfaction of grade 3, six (46.2%) patients grade 2 and one (7.7%) patient grade 0. Conclusions: The present study demonstrated that the TPI treatment is effective and safe for treating atrophic skin disorders of varying causes in Korean patients.     

Silicone gel enhances the efficacy of Er:YAG laser treatment for atrophic acne scars: A randomized,split-face,evaluator-blinded,placebo-controlled,comparative trial

Background: The effect of topical silicone gel has been studied to prevent scars from burn, postoperative wound and to treat hypertrophic scars. No previous studies have been done to evaluate the efficacy of topical silicone gel on atrophic acne scars. Material and methods: Nineteen patients were treated with three sessions of ablative Er:YAG laser with 1-month intervals. Following each laser treatment, the randomlyassigned silicone gel or placebo was applied in split-face manner. Objective assessments, which included roughness, smoothness, hydration, transepidermal water loss were measured at baseline and prior to each treatment. Subjective assessments by dermatologists and subjects were done at baseline and 1 month after last laser treatment. Results: The laser treatments were well tolerated and resulted in clinical improvements. Topical silicone gel treatment resulted in significantly less roughness at weeks 4 and 12 compared with placebo (p < 0.05). Conclusion: Adding topical silicone gel to ablative Er:YAG laser treatment may provide additional benefits in improving acne scars.     

A clinical study on the usefulness of autologous plasma filler in the treatment of nasolabial fold wrinkles

Background: Recently, the efficacy of autologous plasma filler for the reduction of facial wrinkles has been demonstrated. Objective: The aim of our study is to validate the efficacy and safety of autologous plasma filler in treating nasolabial fold wrinkles. Material and methods: Twenty Korean patients with moderate-to-severe nasolabial fold wrinkles were enrolled. The patients were treated with one session of autologous plasma filler. The wrinkle improvement effects were evaluated at 1-week, 4-week, 8-week, and 12-week after the treatment. Three assessment methods were applied. First, two independent dermatologists assessed cosmetic results using a 5-point wrinkle assessment scale. Second, global aesthetic improvement score was used for assessment of the final cosmetic results. Third, patient satisfaction was surveyed. Also, the adverse effects associated to treatment were observed. Results: Mean age of the patients was 44.5 years. The average 5-point wrinkle assessment scale score was significantly improved at 1, 4, 8, and 12 weeks after treatment, comparing to before treatment (p < 0.01). The patients’ average global aesthetic improvement score also indicated better cosmetic outcomes. Conclusion: The clinical improvement with sufficient patients’ satisfaction and no significant adverse events demonstrated that novel autologous plasma filler could be considered as efficient and safety treatment option for nasolabial fold wrinkles.     

The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation

Objective: To evaluate the effects of conditioned medium of adipose-derived stem cells (ADSC-CM) on efficacy and side effects after fractional carbon dioxide laser resurfacing (FxCR) when treating subjects with facial atrophic acne scars or with skin rejuvenation needs. Materials and methods: Twenty-two subjects were enrolled in the study and divided into two groups. Nine subjects were included in skin rejuvenation group and thirteen subjects were included in acne scar group, and all subjects underwent three sessions of FxCR. ADSC-CM was applied on FxCR site of one randomly selected face side. Evaluations were done at baseline, 1 week after first treatment, and 1 month after each treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), and the erythema and melanin index. Biopsies taken from one subject in skin rejuvenation group were analyzed using hematoxylin and eosin, Masson's Trichrome, and Gomori's aldehyde fuchsin staining. Results: ADSC-CM combined with FxCR increased subject satisfaction, elasticity, skin hydration, and skin elasticity and decreased TEWL, roughness, and the melanin index in both acne scars and skin rejuvenation groups. Histologic analysis showed that ADSC-CM increased dermal collagen density, elastin density, and arranged them in order. Conclusion: ADSC-CM with FxCR is a good combination therapy for treating atrophic acne scars and skin rejuvenation.

Trial registration: JSPH2012-082 – Registered 14 Feb 2012     

Efficacy and Safety of Treatment with Fractional 1,064-nm Picosecond Laser with Diffractive Optic Element for Wrinkles and Acne Scars: A Clinical Study

BackgroundFractional picosecond lasers is effective for the treatment of wrinkles or acne scars.ObjectiveTo investigate the safety and efficacy of treatment with a fractional 1,064-nm picosecond laser with a diffractive optic element for facial wrinkles and acne scars.MethodsThis prospective open-labeled trial comprised 22 subjects with facial wrinkles or acne scars. Subjects received three laser treatments with a fractional 1,064-nm picosecond laser at 3-week intervals. The efficacy and safety were evaluated at every visit and 2 months after the final treatment (14 weeks from the first treatment session). Global photographic assessments were performed by three blinded dermatologists and the subjects. Skin profilometry was performed using three-dimensional digital photographs; viscoelasticity was measured.ResultsThe overall mean global improvement scores assessed by the dermatologists at weeks 3, 6, and 14, were 1.8±1.46, 2.5±1.88, and 3.5±1.84, respectively, and those assessed by the subjects were 2.7±2.08, 4.1±2.24, and 5.0±2.52, respectively. Skin profilometry showed significant improvements in the skin wrinkles, texture, depressions, and pores. The gross elasticity and skin firmness significantly improved by 10.96% and 9.04%, respectively. The major adverse reactions were erythema, pruritus, and petechiae, which disappeared within 2~3 days.ConclusionThe fractional 1,064-nm picosecond laser is an effective and safe therapeutic modality for skin rejuvenation.     

Treatment of atrophic facial acne scars with fractional Er:YAG laser in skin phototype III–IV: A pilot study

Background: Fractional ablative lasers have recently been used for the treatment of skin scars. The objective of this study was to assess the efficacy and safety of the fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser (2940 nm) in the treatment of skin scars. Materials and methods: A total of 9 patients (8 female, 1 male) with Fitzpatrick skin types III and IV suffering from atrophic facial acne scars were treated with a fractional Er:YAG laser for 2–5 (mean 3.3) sessions 4–6 weeks apart. One independent investigator assessed the efficacy, using standardized photographs, before and 1 month after the last treatment. The patients’ satisfaction rate was also evaluated. Results: The treatment was well tolerated by all patients without any anesthesia. The downtime was 2–3 days. All patients showed improvement in scars: excellent in 1, good in 1, and fair in 7 patients. Six patients were highly satisfied and 3 were satisfied with treatment. No adverse effect was noted. Conclusion: A fractional Er:YAG laser can deliver an effective and minimally invasive treatment for acne scars.     

The self-recovery of facial skin barrier and erythema after nanochip treatment

Objective: To determine the degree of acute skin damage and the time required for the recovery of facial skin barrier function after the skin was treated with micro-needles and nanochips of various tip lengths. Methods: For this split face comparative study, a total of 16 subjects were enrolled and randomly divided into 2 groups. In the first group, one of the facial side of each subject was treated with 0.25-mm long nanotips for a total of 6 times while the other facial side was treated with 0.25-mm traditional micro-needles with a straight blade for a total of 6 times. In the second group, one of the facial side was treated with 0.5-mm nanotips for a total of 6 times while the other facial side was treated with 0.5-mm traditional micro-needles with a straight blade for a total of 6 times. Evaluations for trans-epidermal water loss (TEWL), skin hydration and erythema were carried out at baseline, 0, 4, 8, 24, 48 and 72 hours after the treatment. Results: There was no significant difference in TEWL, skin hydration and erythema between the two facial sides of the subjects in the Group one who were treated with 0.25 mm nanochips and traditional micro-needles. However, in the subjects of the Group two, the mean TEWL of the facial side treated with 0.5 mm nanochips was relatively lower than that of the 0.5 mm traditional micro-needles treated facial side at 0, 4, 8 and 24 hours after the treatment. Mean erythema of the facial side treated with 0.5-mm nanochips micro-needles was also relatively lower than that of the 0.5-mm traditional micro-needles treated facial side at 8 hours after the treatment. Rapid recovery of skin barrier function was observed within 4–8 hours after treatment with various lengths of nanochips while it took at least 48–72 hours for recovery of skin barrier function after treatment with various lengths of traditional micro-needles as measured by TEWL. Conclusion: The skin disruption caused by nanotips treatment recovers quicker than the traditional microneedle treatment at equal lengths.     

Safety and efficacy of hybrid energy and trifractional technologies in the treatment of acne scars: An open-label clinical trial

Introduction: This study determines the safety and efficacy of a novel device—Surgen that utilizes hybrid energy (HE) technology and trifractional (TF) technology in the treatment of acne scars in Filipino patients. Methods: Open-label clinical trial on eight subjects who underwent 4 weekly HE treatments followed by 2 TF treatments spaced 3 weeks apart. Efficacy was evaluated by dermatologists’ (investigator and two blinded dermatologists) and patients’ assessment and grading of post-treatment digital photographs. Subjects also reported level of satisfaction and comfort. Adverse events were recorded. Results: Dermatologists’ grading of acne scars improvement—58.3% of subjects showed slight to moderate improvement, 8.3% showed marked improvement, and 33.3% was graded as unchanged after HE treatments. After 2 additional TF treatments grades improved further, with 37.5% showing mild to moderate improvement, 37.5% showing marked improvement, and 25% graded as unchanged. Dermatologist's scoring using the global acne scoring system resulted in improvement of 75% of patients after 4 HE sessions and 100% after TF treatments. Subjects’ grading showed a similar trend: 75% of subjects reported that they were satisfied and 25% slightly satisfied after the complete protocol. Conclusion: A treatment protocol combining HE and TF technology is safe, effective, and comfortable in the treatment of acne scars.     

Prognosis for cutaneous melanoma according to surgical department: comparative study at a tertiary care hospital

IntroductionSurgical treatment of melanoma is performed by dermatologists and general or plastic surgeons. It is not known whether the type of specialist treating the melanoma results in a different prognosis for these patients.Material and methodsA retrospective study was carried out on the epidemiological, clinical/histological and evolutional characteristics of all patients diagnosed with melanoma at Hospital Gregorio Marañón over a 10-year period (1994--2003). The differences by hospital department where the patients were treated (dermatology, general surgery and plastic surgery) were noted.ResultsOver 90 % of the patients with melanoma were treated by the Dermatology Department. The thickness of the tumors and the presence of histologic ulceration were significantly higher in the melanomas treated by general and plastic surgeons (p < 0.05). The differences in overall average survival (105, 55 and 77 months) and disease-free time (88, 24 and 51.3 months) in the melanomas operated on by dermatologists, general surgeons and plastic surgeons, respectively, were significant (p < 0.001).ConclusionsThis study confirms that there are significant differences in the clinical and histological characteristics and the life prognosis of patients with cutaneous melanoma treated by different specialists. The melanomas treated by general or plastic surgeons have usually been developing for a longer time, and therefore are thicker and more often ulcerated than those treated by dermatologists, resulting in a lower survival period. With appropriate medical and surgical training, dermatologists are the most suitable specialists for early diagnosis and treatment.     

The Important Factors Associated with Treatment Response in Laser Treatment of Facial Scars: A Single-Institution Based Retrospective Study

BackgroundThere is increased interest in laser treatment of facial scars.ObjectiveTo determine the factors associated with treatment response.MethodsWe conducted an institution-based retrospective study by including the patients treated with laser for facial scars from 2012 to 2015. Treatment methods were determined with an algorithm according to individual scar characteristics. In each treatment session, either a 595-nm pulsed-dye laser or a non-ablative fractional laser was used, often in combination with a corticosteroid injection. We evaluated treatment responses based on the number of treatment sessions required to reach the treatment endpoint. Data were analyzed using multinomial logistic regression analysis to examine the association between treatment response and various factors of the scar.ResultsA total of eighty-four scars were analyzed. The onset of treatment (defined as the period between the injury and treatment initiation), used laser modality, and the location of the scar were all found to be significantly associated with treatment responses. Early implementation was more likely to provide better treatment response. Scars on the perioral area were more likely to be associated with worse treatment response.ConclusionThe important factors for the treatment response in facial scars were the location of the scar and the timing of the initiation of treatment. Such information can be used to predict treatment response and tailor the treatment plan to the patient, depending on scar characteristics.     

A novel fractional micro-plasma radio-frequency technology for the treatment of facial scars and rhytids: A pilot study

Abstract

Introduction: Fractional ablative and non-ablative lasers have gained popularity in the treatment of acne scars and rhytids due to their efficacy and improved tolerability. Plasma and radio frequency (RF) have also emerged as methods for ablative or non-ablative energy delivery. We report preliminary experience with a novel fractional micro-plasma RF device for the treatment of facial acne scars and rhytids. Methods: Sixteen patients with facial acne scars or rhytids were treated at 4-week intervals. Treatment parameters were titrated to an immediate end point of moderate erythema. The clinical end point for cessation of treatment was the attainment of satisfactory clinical results. Results were monitored photographically up to 3 months after treatment. Results: Acne scars showed marked improvement after two to four treatments. Facial rhytids demonstrated reduced depth after two treatments and marked improvement after four treatments. Treatment was well tolerated by all participants, with transient erythema and short downtime. These results provide initial evidence for the safety and effectiveness of fractional micro-plasma RF as a low-downtime and well-tolerated modality for the treatment of acne scars and facial rhytids.     

Combined use of microfocused ultrasound and a calcium hydroxylapatite dermal filler for treating atrophic acne scars: A pilot study

Background: An unfortunate consequence of severe acne is scarring, which can have serious psychosocial consequences. Available methods for treating acne scars have varying degrees of effectiveness. Objective: This nonrandomized, retrospective pilot study assessed the safety and effectiveness of combining microfocused ultrasound with visualization (MFU-V; Ultherapy^®) and a calcium hydroxylapatite dermal filler (CaHA; Radiesse^®) for treating atrophic acne scars. Methods: Healthy subjects 35–55 years old with moderate-to-severe facial acne scars were enrolled. MFU-V was applied bilaterally using two transducers with focal depths of 3.0 and 1.5 mm. Using a cross-hatch pattern, 75 treatment lines were applied 2–3 mm apart. Immediately afterward, the same areas were injected with 1.5 mL of CaHA diluted with 1.5 mL of lidocaine 2% without epinephrine. Scar severity changes were assessed by two independent physicians using the Goodman Acne Scar Scale at post-treatment Day 90. Subject satisfaction was assessed with a questionnaire. Results: Treated subjects (N = 10) achieved significant overall improvement in baseline acne scar severity (P = 0.002). When stratified by severity, a clear trend was apparent with the greatest improvement observed among subjects with severe scars. Subjects were very satisfied (n = 9) or satisfied (n = 1) with their aesthetic results. No adverse events were observed. Conclusions: Combining MFU-V and diluted CaHA is effective for treating atrophic acne scars.     

Efficiency and safety of microneedling fractional radiofrequency in the treatment of Chinese atrophic acne scars: A retrospective study of 3 consecutive treatments with 1-month intervals

Background

Atrophic acne scars (AAS) impact the aesthetic appearance, inducing social and psychological problems. Effective and safe therapy for AAS is urgently needed now. Microneedling fractional radiofrequency (MFRF) has emerged as a minimal invasive alteration for treating AAS lately, while the existing data on Chinese population was few.

Aims

We aimed to explore the effectivity and safety of MFRF in Chinese patients with facial AAS and analyze the response of different subtypes to MFRF treatment.

Methods

We conducted a retrospective analysis using data from medical records and clinical photographs of 40 Chinese patients with AAS with Fitzpatrick skin type III-IV, all of them had received 3 MFRF treatments with 1-month intervals and were followed up 3 months after the last treatment. The clinical severity was assessed through échelle d'évaluation clinique des cicatrices d'acné (ECCA) score at each visit. Clinical photographs were taken by VISIA. Patients were asked to evaluate their satisfaction of the treatment using a 5-point Likert scale at the last visit.

Results

ECCA score decreased more than a half at the last visit based on the baseline. Among the three types of AAS, the M-shaped scars respond most quickly to MFRF and the U-shaped scars improved the most after 3 months follow-up. A significant improvement was seen in clinical appearance, parallel to the change of ECCA, indicating the remarkable improvement of AAS after the MFRF treatment. Concomitant active acne was controlled along with the improvement of AAS. Statistics from VISIA showed excellent improvement in pores and texture as well. Side effects including pain and erythema were transient and mild. The number of MFRF treatment sessions was positively associated with the degree of improvement. Of the total 39 patients who had given a score of satisfaction, more than 89% (35 patients) were very satisfied or satisfied with the outcome.

Conclusions

To sum up, our study reveals that MFRF provides high efficiency in treating Chinese AAS patients with high satisfaction and low risk of adverse effects. M-shaped scars are the most sensitive type to the treatment, but the U-shaped scars improve most at the last visit. The simultaneous minimization of pores and improvement of skin texture imply the increased collagen stimulated by MFRF. Regular MFRF should be considered a good choice in treating AAS.     

点阵式Er：YAG激光治疗痤疮瘢痕及毛孔粗大的疗效观察

目的 探讨点阵式掺铒钇铝石榴石（Er:YAG）激光对于面部凹陷性痤疮瘢痕及毛孔粗大的疗效。方法 轻至中度凹陷性痤疮瘢痕41例,予中长脉宽、能量800 ～ 1200 mJ、定点连续发射4 ～ 8个脉冲。毛孔粗大23例,予中脉宽、能量800 ～ 1000 mJ、定点连续发射2 ～ 4个脉冲。疗程为3 ～ 5次,每次间隔1个月。由医生对治疗后皮损改善程度进行评价,由患者对疗效进行满意度评价。应用三维皮肤成像仪获取皮肤立体图像,评价治疗对皮肤粗糙度的影响。结果 医生评估痤疮瘢痕患者皮损改善程度为82.93%,毛孔粗大患者皮损改善程度为86.96%;两种皮损患者满意率分别为88.80%和91.30%;与治疗前相比,治疗后表示粗糙度的Ra值及Rz值分别下降18.74%和21.01%（P < 0.001）。结论 点阵式Er:YAG激光可有效改善面部轻中度凹陷性痤疮瘢痕及毛孔粗大。     

Early propranolol treatment of infantile hemangiomas improves outcome

BackgroundInfantile hemangiomas (IH) are the most common soft tissue tumors of childhood. Although most of these tumors are not worrisome, some IH may be life or function-threatening, can lead to permanent disfigurement, or have associated structural congenital anomalies, requiring early recognition and referral to specialists for treatment consideration. Since 2008, oral propranolol has been widely considered to be the first-line treatment for IH.ObjectivesTo evaluate aesthetic and functional outcome in propranolol-treated infantile hemangiomas according to the age of treatment onset.MethodsRetrospective, observational study of infantile hemangioma patients under 4 years of age at the time of diagnosis, treated with oral propranolol. Evaluated parameters included: pre and post-treatment morphologic/aesthetic aspects of the hemangioma, total resolution rate, degree of functional compromise of affected areas and its evolution. Two independent pediatric dermatologists evaluated all cases reviewing clinical data from medical records and comparing clinical photographs taken at initiation and at the end of treatment of each patient. Data were analyzed with STATA 13.0 program.ResultsThe cohort included 138 patients, with a female predominance. The median age at therapy onset was 3 months. The morphological/aesthetic improvement rate was 99% (95% CI 96‒99), the total resolution rate was 48% (95% CI 44‒60) and the functional improvement rate reached 100%. When comparing total resolution outcome versus age when treatment started, the improvement was larger in younger patients (3.5 vs. 4.9 months, p = 0.01). When comparing the total resolution rate in those younger or older than 3 months at treatment initiation, the percentage of total resolution in the younger group was 57% vs. 40% in the older one (p = 0.05).Study limitationsRetrospective design; patients photographs were the sole indicators used to measure regression rates. Visual assessment is subjective.ConclusionThe present results strongly suggest that early (before 3 months of age) initiation of treatment of infantile hemangiomas with propranolol results in significantly higher aesthetic and functional improvement rates and a higher percentage of total resolution.     

Vacuum and electromagnetic field in synergy for skin rejuvenation: A retrospective study on 217 patients

Background

There are many aesthetic treatments aimed at combating aging. In the most common and frequently used ones there are often side effects, albeit minor ones. However, sometimes it is necessary to use medications before or after treatments.

Objectives

To evaluate the anti-aging efficacy and application safety of a therapy based on the combination of vacuum and electromagnetic fields (EMFs).

Methods

A retrospective study was conducted to evaluate the aesthetic effects of the treatment on 217 subjects. Before treatment (T0) and after the last session (T1), skin hydration levels, the amount of sebum present and the pH were measured. The presence of discomfort during the sessions and side effects at T1 was verified. At T1, the levels of satisfaction of the patients and of the doctors who performed the treatment were assessed. At 3 and 6 months of follow-up the aesthetic results were re-evaluated.

Results

For all treated subjects, an evident qualitative improvement was observed in the quality of the skin of the neck and face, with an increase in tone and a reduction in wrinkles. The instrumental tests highlighted a normalization of skin hydration, pH, and sebum values. High levels of satisfaction at T0 and good stability of results up to 6 months of follow-up were reported. No discomfort was referred during the treatment sessions, nor any side effects after the entire treatment.

Conclusions

The treatment that exploits the synergy between vacuum and EMFs is very promising given the effectiveness and safety of the technique.     

Correction of nasolabial folds wrinkle using intraoral non-ablative Er:YAG laser

Background: The accentuated nasolabial folds (NLFs) is the most pronounced sign of aging. Non-ablative erbium:yttrium aluminum garnet laser (ER:YAG), Smooth mode was used for the treatment of mucosal tissue. It was reported that it is effective in facial rejuvenation.

Aim: To assess the safety and the effectiveness of intraoral ER:YAG Smooth mode laser in the treatment of NLFs wrinkle. Materials and methods: A total of 20 patients with different grades of NLFs wrinkle treated with 2940 nm Er:YAG laser intraorally. Six sessions were done every 2 weeks. The efficacy was assessed by two blinded dermatologists. Photographs were taken at the baseline, end of treatment and 6 months after the final session to document visible changes in NLFs wrinkle. The assessment was based on Modified Fitzpatrick Wrinkle Scale (MFWS) and by comparing the photographs. Patient’s self-assessment and patient’s satisfaction were used for assessment of final results and any side effects associated to treatment were observed. Results: There was significant reduction of the NLFs wrinkle. The MFWS was significantly improved 6 months after treatment compared to before treatment (p < 0.001). At the end of the follow-up period, there was improvement in overall appearance of the wrinkles. Patient’s self -assessment and satisfaction demonstrated better cosmetic outcomes. Conclusion: Intraoral Er:YAG laser is safe, painless, and effective treatment option for NLFs wrinkle.     

Effect of mesotherapy with nanochip in the treatment of facial rejuvenation

ABSTRACT

Objective: To observe the clinical effect of mesotherapy with nanochip for facial rejuvenation.

Methods: 24 volunteers with aging skin were treated with a polycomponent formulation – NCTF® BOOST 135 HA for 5 times (once weekly for 3 times and successively biweekly for 2 times). Photographs were taken by VISIA at baseline, and after 1, 4, 10 weeks, while global scores for photoaging (GSP), improvement scores, volunteers’ satisfaction, parameters describing the properties of the skin, and adverse effects were assessed during each follow-up period.

Results: Total 20 volunteers completed the treatment. Evaluation of the whole face showed that GSP, skin texture (ophthalmic wrinkles, dermal thickness, and intensity of collagen fibers of skin), and skin brightness (Lab value) significantly improved at 4 weeks compared to baseline, while the difference between 4 and 10 weeks was not statistically significant. No evident improvement was observed in pigmented spots, telangiectasia, skin tightening, trans-epidermal water loss (TEWL), and skin hydration. Slight erythema, pain was the most common side effect.

Conclusion: Mesotherapy with nanochip can improve skin texture and brightness, but the effect is not permanent. It is recommended that the treatment be used as a complementary method for patients with facial rejuvenation needs.     

Physician and patient perception of disease severity, quality of life, and treatment satisfaction in psoriasis: an observational study in Spain

ObjectivesThe aims of this study were to determine the impact of psoriasis on patient quality of life, to analyze differences in perception between patients and physicians regarding quality of life, treatment satisfaction, and patient needs, and to assess the physician–patient relationship.Material and methodsA multicenter, observational, cross-sectional study was undertaken in which a representative group of dermatologists—working in hospitals and outpatient clinics throughout Spain—and their patients with a diagnosis of psoriasis completed specifically designed questionnaires. The questionnaires covered patient demographics, disease characteristics, impact of the disease on quality of life, treatment of psoriasis, and the relationship between patient and dermatologist.ResultsA total of 151 dermatologists from throughout Spain included a mean of 5 patients each. The analysis included 771 questionnaires completed by dermatologists and 732 completed by patients. Two-thirds of patients had moderate-to-severe psoriasis with a major impact on quality of life, particularly in relation to emotional wellbeing. Nevertheless, quality of life was only assessed routinely and systematically by 19.9% of dermatologists. Overall, 47% of patients reported being quite satisfied or very satisfied with the treatment they received. No significant differences were observed between patients and dermatologists on the aspects analyzed.ConclusionsOur results highlight the substantial impact of psoriasis on patient quality of life and the consequent need for systematic quality-of-life assessment in affected patients. Patients reported a high level of satisfaction with the care provided by dermatologists and the treatment received. There was good agreement between patients and dermatologists in their assessment of the variables analyzed.     

Design and validation of a questionnaire to measure treatment satisfaction in patients with moderate-to-severe psoriasis: the NEODERMA study

Background and objectivesthe aim of this study was to design and assess the validity, reliability, and sensitivity to change of the Spanish Satisfaction With Treatment of Psoriasis Questionnaire (SSTPQ) for use in patients with moderate-to-severe psoriasis.Patients and methodsa prospective, multicenter, observational, naturalistic study was designed. The instrument consisted of 12 items scored on a 5-point Likert scale with scores from 0 (very satisfied) to 5 (very unsatisfied), generating a total score of 0 to 48. Patients completed the questionnaire at baseline and then at 3-, 6-, 9-, and 12-month follow-up. At each visit, data were also collected on the Psoriasis Area and Severity Index (PASI), treatment adherence (Morisky-Green questionnaire), and overall treatment satisfaction on a Visual Analogue Scale (VAS) from 0 to 100.Resultsa total of 423 patients were included in the study and 68% completed 12 months of follow-up. Responses were provided to all items in 98.8% of cases. There was a weak correlation between changes in treatment satisfaction on the SSTPQ and changes in PASI score (r = 0.38 to 0.33); in contrast, there were strong correlations with changes in the VAS score for overall treatment satisfaction (r = –0.75 to –0.81). Good internal consistency was observed (Cronbach α = 0.92). The intraclass correlation coefficient was 0.89, with a mean difference in score at 3- and 6-month follow-up of 0.07.ConclusionsThe results obtained suggest that the SSTPQ is a feasible, valid, and reliable tool for the assessment of treatment satisfaction in patients with moderate-to-severe psoriasis.