Evaluation of inflammatory status in blood in patients with rosacea

Rosacea is a chronic inflammatory skin disease that is characterized by recurrent episodes of erythema, telangiectasia and papulopustular lesions. Although the pathogenesis is not well established, growing knowledge suggests that multiple etiological factors play a role resulting in inflammation. The aim of the present study is to investigate inflammatory status of patients with rosacea by evaluating CBC parameters and systemic immune inflammation (SII) index and compare these parameters with control group. Thus, it is aimed to understand the role of systemic inflammation in the pathogenesis of the disease. This retrospective, case-control study included 100 patients with rosacea and 58 sex- and age-matched controls. Laboratory examinations including CBC, ESR, CRP, HDL, LDL, and triglyceride levels were recorded and neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR), monocyte-to-high-density lipoprotein ratio (MHR) and SII index were calculated. Monocyte and platelet count, SII index, ESR and CRP were significantly higher in patients with rosacea than in the control group. No statistically significant difference was found in other parameters. There was no significant correlation between disease severity and ESR, CRP, and SII index. The findings of this study suggest that apart from the inflammatory pathways at the level of skin, there is an inflammatory state in the blood of patients. Rosacea is a skin disease, but it may have systemic implications and/or associations that need to be clarified completely.

Is it possible to obtain long-lasting results with thread lift in the brow region? Introduction of a new suspension technique and evaluation of 50 patients

BACKGROUND

Eyebrow region is a dynamic region, and it has a thinner skin prone to wrinkles and sagging. Descended brows could be repositioned immediately with fewer complications by the use of the threads. Despite all its advantages, the main drawback of absorbable thread lift is its short duration of lifting effect.

AIMS

This report aims to describe our thread lift technique we have implemented to counteract the descent of the brows and evaluate our results in 50 patients.

PATIENTS/METHODS

A retrospective chart review was carried out over a period of 1 year from September 2019 to 2020 for the patients who underwent thread lifting for eyebrows in a private clinic in Ankara. Complications after the procedure, durability of the results, global esthetic improvement scale (GAIS) score, and patient satisfaction survey scores were recorded.

RESULTS

The study group was composed of 50 female patients with a median age of 34 years. The median duration of the procedure is 15 months. Nine (18%) patients experienced complications related to the procedure including ecchymosis, edema, erythema, skin dimpling, and pain. Three weeks after the procedure, the position of the eyebrows of eight (16%) patients were improved, 18 (36%) patients were much improved, and 24 (48%) patients were very much improved according to GAIS.

CONCLUSIONS

So far, the most disappointing feature of the threads was the poor long-term sustainability of the outcomes. Our thread lift technique for brows offers a significant improvement in the position of the eyebrows in a short time with decreased downtime. More importantly, it can be possible to improve the longevity of the results with this approach.

Autologous blood injection for treatment of steroid atrophy: A case report

BACKGROUND

Intramuscular corticosteroid injections are frequently used for a variety of conditions in dermatology practice. Unfortunately, many complications are associated with systemic and local administration of corticosteroids. Localized subcutaneous lipoatrophy is among the most common adverse effects that can lead to permanent disfigurement. Autologous blood is collected from peripheral veins and injected immediately to the affected tissue with the intention of stimulating the body's own tissue-healing mechanisms through cellular and humoral mediators.

AIMS

Although platelet-rich plasma therapy, produced by centrifugation of autologous blood, is very popular in dermatology practice, autologous blood injection (ABI) is not routinely preferred. With this case, it was aimed to report that ABI can be a safe and effective option in the treatment of steroid atrophy.

PATIENTS/METHODS

A case of steroid atrophy in a female patient treated successfully with ABI was presented.

RESULTS

A 17-year-old female patient presented with epidermal/dermal atrophy, depigmentation, and subcutaneous fat atrophy after intramuscular corticosteroid injection. ABI treatment was initiated because there were no signs of spontaneous improvement after 6 months. 4 cc autologous blood was injected in small volumes into the superficial, middle, and deep parts of the atrophic tissue. After 2 sessions of ABI, the size and depth of the atrophy were markedly improved and depigmentation was resolved.

CONCLUSION

There are several treatment options for localized steroid atrophy with varying success rates. This is the first report that shows ABI is a simple, effective, and safe procedure for correction of corticosteroid-induced cutaneous and subcutaneous atrophy with satisfying results.

The effect of narrowband ultraviolet B phototherapy on antinuclear antibody status: A case-control study

BACKGROUND

Narrowband ultraviolet B (NB-UVB) phototherapy has become a widely used, standard treatment modality in dermatology. The effect of 8-methoxypsoralen plus ultraviolet A on antinuclear antibody (ANA) formation has been investigated extensively, but there are very scarce data about the potential risk of NB-UVB phototherapy inducing production of ANAs. The aims of this study were evaluation of ANA status before and after NB-UVB treatment and comparison of ANA status with the healthy control group.

METHODS

Phototherapy unit database was used to identify patients who had received whole body NB-UVB treatment. Analyses of ANA were performed twice in the study group that were before initiation of the NB-UVB phototherapy and after cessation of the therapy. Also, ANAs were screened in the control group.

RESULTS

A total of 95 patients (50 males and 45 females; mean age: 43.03 ± 13.40) treated with NB-UVB radiation and 90 age- and sex-matched controls were included in the study. Thirteen patients (13.7%) were found to develop ANAs at the end of the treatment. ANA positivity was significantly more common in patients after phototherapy than in patients before phototherapy and than in the control group. None of the patients in the positive ANA group was diagnosed with any connective tissue diseases.

CONCLUSION

This study revealed that ANA positivity increased after NB-UVB phototherapy. However, it did not provide evidence for increased connective tissue disease risk. Therefore, ANA might not need to be routinely checked before treatment unless the patients have signs and symptoms indicating autoimmune diseases.

A new three-point filler technique to maximize safety for the correction of glabellar rhytids: Evaluation of 50 patients

BACKGROUND

Hyaluronic acid (HA) fillers have been widely used for reversing the signs of the aging face. Injectable fillers are particularly effective in treating vertical glabellar wrinkles.

AIMS

The aim of this study was to share our own safe glabella filling technique and to evaluate our results in 50 patients with facial rejuvenation.

METHODS

A total of 50 patients consisting of women and men with moderate to severe glabellar rhytids were enrolled in the study. Patients were evaluated before the injection procedure and 2 weeks after the procedure by using the Rao-Goldman scale. We have described a new three-point filler technique.

RESULTS

Of 50 patients, 39 were females and 11 males, and the mean age was 39.82 ± 6.44 years. The mean volume of HA that was injected into the glabellar wrinkles was 0.61 ± 0.12 mL. Eight patients had experienced mild complications related to the procedure. None of the patients had experienced skin necrosis and visual impairment.

CONCLUSION

Our technique is a simple and safe procedure to correct glabellar rhytids. Practitioners should be aware of the safe injection techniques, potential complications, and management of these complications for a good clinical practice.

A cross-sectional analysis of skin cancer risk in patients receiving narrow-band ultraviolet B phototherapy: an evaluation of 100 patients

Narrow-band ultraviolet B (NB-UVB) phototherapy is an effective and widely used treatment modality for psoriasis and other inflammatory skin diseases. The carcinogenic effect of PUVA treatment has been investigated extensively, but there is very scarce data about the role of NB-UVB in the development of skin cancer. The aim of this study was to investigate the potential carcinogenic risk of NB-UVB therapy in various skin disorders. In this cross-sectional study, we evaluated 100 patients who had received whole-body NB-UVB treatment and 100 age- and sex-matched controls. Phototherapy unit database was used to identify patients. A total of 100 patients (53 males and 47 females) treated with NB-UVB and 100 controls were included in the study. The patient group revealed no cases of melanoma or non-melanoma skin cancer, while ten of them were found to have solar lentigines. Basal cell carcinoma in a patient and nine patients with solar lentigines were detected in the control group. There was no statistically significant difference between patient and control groups in terms of skin cancer and solar lentigines. This study does not provide evidence for an increased skin cancer risk in patients treated with NB-UVB phototherapy. However, we have detected the occurence of 10 cases of solar lentigines. Still, definitive prospective longitudinal studies with a greater number of patients and prolonged follow-up are required to specifically address skin cancer risk in relation to NB-UVB phototherapy.