Efficacy of Fractional Co2 Laser and Human Lyophilized Growth Factors in the Treatment of Stretch Marks: A Clinical and Histopathological Study

Background Striae distensae are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The natural evolution of striae is from red or purple, raised wavy lesions (striae rubra) to white atrophic lesions with wrinkly surface (striae alba). Objectives The present study was designed to compare the efficacy of fractional CO2 laser alone or combined with lyophilized growth factors or to its efficacy alone in the treatment of striae distensae. Patients and Methods The present study included 20 female patients with SD; they were all recruited from Dermatology Outpatient Clinic, Ain Shams University from may 2017 to march 2018. An informed consent for treatment, photography and punch biopsy was taken before enrollment and the study was approved by Dermatology Research Ethical Committee. Results The present study showed statistically significant clinical and histopathological improvement in areas A and B after treatment. This impronment was in rubra more than alba. Area C showed no clinical and histopathological improvement. Area B showed better results than area A.We propose that LGF alone did not show clinical or histopathologiacl improvement. Treatment was tolerated well by all patients where side effects were minimal in the form of transient PIH that resolved after using bleaching creams. There was no statistically sgnificant difference in the incidence of PIH between areas A& B. Conclusion We concluded that fractional CO2 alone is effective in treatment of SD especially stria rubra in skin type III and IV.

Cutaneous manifestations in overweight and obese children and adolescent

Background: Obesity currently is regarded as universal disease of epidemic prevalence and known as the evil of the twentieth century. The last 3 decades we have seen an unprecedented increase in the prevalence of obesity throughout the world including India. Overweight and obesity are the fifth leading risks of global deaths worldwide. However, despite all above mentioned problems, the impact of obesity on the skin has received minimal attention though it can be a window for obesity markers.Methods: It was a cross-sectional descriptive observational study. A total of 131 patients of age 5 to 18 years with BMI greater than 85 percentiles for age and sex and those willing to give consent for participation in the study were selected.Results: Maximum number of patients were obese with their BMI (body mass index) range falling between 95-99 percentile; according to IAP guidelines obese were 83 (63.35%), followed by overweight 27 (20.61%) and 21(16.03%) patients were severely obese. Acanthosis nigricans was the major cutaneous finding seen in 100% cases. Other common manifestations were striae distensae, acrocordons, hyperhidrosis, miliaria, frictional dermatitis and intertrigo, acne vulgaris, atopic dermatitis and hypertrichosis.Conclusions: Obesity is associated significantly with certain dermatoses in children as well as in adults. Skin care of obese patients deserves particular attention, not only because of the high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated which may improve patient’s quality of life.

Effect of Purple Passion Fruit Extract Cream (Passiflora edulis Sims var. Edulis) 6% against Striae Distensae

ABSTRACT Background: Striae distensae is a skin disorder that causes cosmetic and psychological problems. Purple passion fruit (Passiflora edulis Sims var. Edulis) is widely cultivated, especially in North Sumatra. The seeds are abundant and unused industrial waste. Purple passion fruit seeds contain piceatannol, ascorbic acid, flavonoids, resveratrol, hydroalcohols and sterols which play a role in the repair of striae distensae through anti-inflammatory mechanisms, increase fibroblast proliferation and collagen production, increase crosslinking between collagen fibers and moisturizers. Objective: To determine the effect of 6% purple passion fruit (Passiflora edulis Sims var. Edulis) seed extract cream on striae distensae. Subjects and Methods: This study is a pre-experimental clinical trial with a pretest-posttest research design on 40 subjects with striae distensae. Diagnosis was confirmed by history and clinical evaluation using the Manchester scar scale before and after administration of 6% purple passion fruit extract cream at weeks 0, 2, 4, 6, 8. Adverse effects were recorded during the study and satisfaction levels were assessed at the end. Results: The majority of subjects' ages ranged from 29 to 39 years (72.5%). There was a significant reduction in Manchester scar scale in striae distensae, both after being given a 6% purple passion fruit extract cream or a combination of 1% tretinoin cream for 8 weeks, with a mean reduction of 25% (p = 0.000). Striae distensae after being given 6% purple passion fruit extract cream compared to 6% purple passion fruit extract cream combined with 1% tretinoin cream, there was no significant difference (p = 0.791). From a total of 40 subjects, none experienced side effects (0%). As many as 57.5% of the subjects showed a good level of satisfaction. Conclusion: The use of 6% purple passion fruit seed extract cream can improve the appearance of striae distensae without side effects and the level of satisfaction is good.

Treatment of striae distensae: recent conceptions

Stretch marks (striae distensae) are linear areas of cutaneous atrophy that appear in regions of greatest stretch of the skin. Their formation is a complex multifactorial process, its etiopathogenesis has not been fully understood yet. Aesthetic correction of stretch marks is an urgent problem of modern dermatocosmetology due to their widespread prevalence and pronounced negative impact on the patient’s quality of life. The aim of this paper was to provide a review of the literature on current reported treatment options for stretch marks. The principles of the effect of various methods of treatment, their classification and data from clinical trials are considered.

Platelet-rich plasma in interventional dermatology and trichology: How far have we come?

Platelet-rich plasma (PRP) contains several growth factors and cellular adhesion molecules which promote wound healing, angiogenesis and accelerate the rejuvenation of skin and hair follicles. With its proven regenerative and regrowth potential in a plethora of conditions, PRP has been deemed as the “futuristic elixir.” Current evidence suggests that PRP effectively stimulates angiogenesis, collagen as well as elastin regeneration, and is a safe, easy to prepare, minimally invasive technique with limited downtime, and negligible risk of allergic/hypersensitivity reactions owing to its autologous nature. It has shown excellent results when utilized as monotherapy or in combination with microneedling or ablative lasers in acne scars, post-burn or post-traumatic scars, melasma, striae distensae, chronic ulcers, and lichen sclerosus. PRP injections or PRP combined with microneedling are increasingly being utilized for skin rejuvenation and recently have been utilized to provide non-invasive face lifts. A novel technique combining non-cultured epidermal cell suspension suspended in PRP results in superior repigmentation outcomes in case of vitiligo. Use of PRP alone or in combination with hair transplant in androgenetic alopecia is another well-researched indication and its use has been successfully extrapolated to indications such as alopecia areata, chronic telogen effluvium, and cicatricial alopecia. In spite of its established efficacy in such a vast number of indications, PRP should be used with utmost caution. These growth mediators exert their own endocrine, paracrine, and enzymatic effects, the complete influence of which still remains a mystery and only years of experience, in the times to come will unravel the absolute power of our “mighty dragon warrior.”