Psychosocial issues and body dysmorphic disorder in aesthetics: Review and debate

Body dysmorphic disorder (BDD) is a serious and debilitating psychiatric condition that disproportionately presents in dermatologic and cosmetic surgery patients. BDD is currently underrecognized in cosmetic medical settings and is thought to be underdiagnosed by behavioral health professionals. The significant comorbidities associated with this disorder, as well as potential harm done to both patient and physician, raise ethical and medicolegal concerns regarding its treatment. Although cosmetic interventions have historically been discouraged in BDD, recent studies have provided controversial evidence of benefit in certain cohorts. The rise of “snapchat dysmorphia” and the proposed explanatory phenomenon of perception drift have generated further debate around the de novo development or unmasking of BDD. We critically review and summarize existing debates around the treatment of BDD in cosmetic medicine. We provide guidance for screening, clinical interviewing, and the provision of psychoeducation in cases of suspected BDD.     

Isolation and determination of lipophilic mycochemicals from a New Zealand edible native mushroom Hericium novae-zealandiae

Hericium novae-zealandiae is a native mushroom consumed by indigenous Māori people in New Zealand. The lipophilic mycochemicals of the mushroom were isolated using a normal column chromatography combined with a preparative HPLC. Structural characterisation based on spectroscopic methods, namely UV, MS, NMR and single crystal XRD have identified three lipophilic compounds as hericene B (a compound unique to Hericium), ergosterol and ergosterol peroxide. Following this, an HPLC-DAD method was developed and validated to quantify the hericene B and ergosterol. The method showed excellent selectivity, linearity, precision, accuracy and robustness. The content of hericene B was determined as 28.53 mg/g by dry weight of H. novae-zealandiae (approximately 3%). This discovery indicates the potential utilisation of H. novae-zealandiae as a natural source of hericene B. Current research revealed for the first time, the lipophilic constituents of H. novae-zealandiae and the method development for quantification of hericene B in the above species.     

Comparing performance of Chromameter®, Mexameter® and full‐field laser perfusion imaging for measurement of ultraviolet B light‐induced erythema

Erythema induced by ultraviolet (UV)B light is a common skin reaction. Currently, three techniques, the Chromameter^® CR‐400, the Mexameter^® MX16 and full‐field laser perfusion imaging (FLPI), are widely used for dermatological evaluation of UVB‐induced erythema. However, there is little known about the comparative performance of these three techniques. This study was therefore designed to evaluate the effectiveness of the three techniques. Our findings showed that the performance of Chromameter and Mexameter for measurement of UVB‐induced erythema was very similar, while FLPI indicated acute erythema at D1 with the greatest fold change. Further studies of UVB dose‐dependence need to be carried out.     

South‐East Asia study alliance guidelines on the management of acne vulgaris in South‐East Asian patients

The management of acne in South‐East Asia is unique, as Asian skin and local variables require a clinical approach unlike that utilized in other parts of the world. There are different treatment guidelines per country in the region, and a group of leading dermatologists from these countries convened to review these guidelines, discuss current practices and recent advances, and formulate consensus guidelines to harmonize the management of acne vulgaris in the region. Emphasis has been placed on formulating recommendations to impede the development of antibiotic resistance in Propionibacterium acnes. The group adopted the Acne Consensus Conference system for grading acne severity. The group recommends that patients may be treated with topical medications including retinoids, benzoyl peroxide (BPO), salicylic acid, a combination of retinoid and BPO, or a combination of retinoids and BPO with or without antibiotics for mild acne; topical retinoid with topical BPO and a oral antibiotic for moderate acne; and oral isotretinoin if the patient fails first‐line treatment (a 6‐ or 8‐week trial of combined oral antibiotics and topical retinoids with BPO) for severe acne. Maintenance acne treatment using topical retinoids with or without BPO is recommended. To prevent the development of antibiotic resistance, topical antibiotics should not be used as monotherapy or used simultaneously with oral antibiotics. Skin care, comprised of cleansing, moisturizing and sun protection, is likewise recommended. Patient education and good communication is recommended to improve adherence, and advice should be given about the characteristics of the skin care products patients should use.