Wounding Therapies for Prevention of Photocarcinogenesis

The occurrence of non-melanoma skin cancer (NMSC) is closely linked with advanced age and ultraviolet-B (UVB) exposure. More specifically, the development of NMSC is linked to diminished insulin-like growth factor-1 (IGF-1) signaling from senescent dermal fibroblasts in geriatric skin. Consequently, keratinocyte IGF-1 receptor (IGF-1R) remains inactive, resulting in failure to induce appropriate protective responses including DNA repair and cell cycle checkpoint signaling. This allows UVB-induced DNA damage to proliferate unchecked, which increases the likelihood of malignant transformation. NMSC is estimated to occur in 3.3 million individuals annually. The rising incidence results in increased morbidity and significant healthcare costs, which necessitate identification of effective treatment modalities. In this review, we highlight the pathogenesis of NMSC and discuss the potential of novel preventative therapies. In particular, wounding therapies such as dermabrasion, microneedling, chemical peeling, and fractionated laser resurfacing have been shown to restore IGF-1/IGF-1R signaling in geriatric skin and suppress the propagation of UVB-damaged keratinocytes. This wounding response effectively rejuvenates geriatric skin and decreases the incidence of age-associated NMSC.

Efficacy of acupuncture for melasma: a protocol of systematic review and meta-analysis

Review question / Objective: How effective is acupuncture in treating melasma compared to conventional treatment？ Condition being studied: Melasma is a common acquired hyperpigmentation of the skin. The clinical manifestations are light brown or dark brown patches symmetrically distributed on the cheeks, forehead and mandibular with different shades and unclear borders. Melasma particularly affects women during menstruation, especially in thirties and forties Asian women. The incidence of Asian women of childbearing age is as high as 30%. Current treatments for melasma include topical drugs, chemical peeling agents, laser and light treatments, and systemic drugs. Despite the strong demand for treatment, the treatment of melasma is still very challenging, the results are inconsistent, and the recurrence rate is almost constant.

Fingertip Necrosis due to Chemical Burn from Glacial Acetic Acid: A Case Report

Glacial acetic acid is a high-purity acetic acid that is mainly used as a solvent in chemical production and for various purposes in the food and pharmaceutical industries. It is safe enough to be used for chemical peeling when diluted, and has been used in folk remedies for warts, athlete’s foot, and eczema. Indeed, such conditions are the most common reason for exposure to glacial acetic acid. In the present report, we describe the case of a 10-year-old girl who presented with pain and necrosis of the distal phalanx of her left index finger. Two days prior, her fingers had been wrapped overnight with a paste of flour mixed with glacial acetic acid to treat warts. We irrigated the affected area with normal saline, applied a mupirocin ointment, and administered prostaglandin E1. However, the necrosis progressed rapidly. After 10 days, the girl’s fingertip was amputated, and a hypothenar free flap was performed. The case represents a severe chemical burn resulting from the misuse of glacial acetic acid, requiring surgical treatment.

Peeling with 30% Salicylic acid in the treatment of facial skin photoaging

Introduction: Chemical peeling consists of the application of one or more chemical ablative agents to the surface of the skin to induce keratolysis or keratocoagulation, with subsequent regeneration, achieving improved texture and pigmentation. It is currently a popular tool in the dermatology therapeutic arsenal, however, few studies objectively evaluate its efficacy. Objective: To evaluate the efficacy and safety of the 30% salicylic acid peeling in the treatment of facial skin rejuvenation. Method: An observational, analytical and longitudinal study was carried out in 280 patients from two hospitals (Surgical Clinic: “Hermanos Ameijeiras” and General Teaching: “Enrique Cabrera”), in the period between January 2010 and January 2020. Treatment It was applied monthly for 6 months. The final evaluation was carried out 3 months after the end of the treatment. Results: 256 women and 24 men were treated with an average age of 34.2 (± 6.3) years. After treatment, there were significant changes in the Glogau Photo Damage Scale (P = 0.015), in the Global Aesthetic Improvement Scale (P = 0.023) and in the Lemperle Wrinkle Assessment Scale (P = 0.017). The adverse events found were burning, inflammation and scaling. The degree of satisfaction reported by the patients was good (6.4%) and very good (93.5%) (P = 0.001). Conclusions: The 30% salicylic acid peel proved to be effective and safe to reduce the signs of facial skin aging, associated with a high degree of patient satisfaction.

Comparison of safety and efficacy of 20% salicylic acid with Jessner’s solution in chemical peeling for melasma in asian skin

Background: Treatment of melasma is a challenging job for dematologists. Different modalities are in practice with variable results. Superficial chemical peeling is a newly introduced way of treatment in this regard, in which a chemical solution is applied to the skin that causes exfoliation and peeling. Methods: Sixty patients of either sex, with melasma of any type having Fitzpatrick skin type 4 to 6 were enroled from outpatient department. Patients in group A were treated with 20% salicylic acid solution and in group B were treated with Jessener’s solution. Baseline melasma area and severity index (MASI) scoring was done. Result: Both the peeling agents produced a drop in MASI score, but the mean reduction compared in both the groups was not statistically significant (p>0.05). Conclusion: Both salicylic acid and Jessner’s solution are effective and safe peeling agents in treatment of melasma in Asian skin types, giving comparable results

Chemical Peeling: Indications, Side-Effects and Outcome among Patients at a Private Clinic in Port Harcourt

Background: Chemical peeling is a technique that aims to achieve rejuvenation of the skin by application of chemical peels. The technique dates back to several decades, yet little is known about the indication, side-effects and outcome among a Nigerian population. Purpose: The aim of the study was to assess the type of chemical peels, their indication, side –effects and outcome among patients at a private dermatology clinic. Materials and Methods: This was a retrospective study, which employed a pro forma to obtain data required to attain the objectives. Data were obtained from all patients who underwent chemical peeling. Chi square and student t test were determined at a statistically significant level of 0.05. Results: The study had a total of twenty-seven patients, comprising of 7 (25.9%) males, and 20 (74.1%) females, who underwent chemical peeling. Superficial chemical peel was the most dominant peel method (81.5%). Among the superficial peel, mandelic peel, salicylic peel and glycolic peel were commonly. Five of the patients (18.5%) received medium depth, and none (0%) received deep chemical peel. The most frequent indication among the patients in the study was Acne Vulgaris (55.6%), followed by Melasma (14.8%). The comparison of treatment outcome on clinical improvement by age, sex and category of chemical peel revealed no significant differences. Two of the patients reported side-effects (7.4%) namely skin dryness and hyperpigmentation. Conclusion: Chemical peeling among Nigerian population has few side-effects and is effective. Acne is the most common indication for chemical peel. There is a need for further studies employing analytic study designs and involving a larger population.

Formulasi dan Uji Stabilitas Fisik Gel AHA (Alpha Hydroxy Acid) Kombinasi BHA (Beta Hydroxy Acid) Sebagai Ekspolieting dalam Penanganan Melasma

Melasma adalah hiperpigmentasi simetris kelainan dengan etiopatogenesis multifaktor diduga akibat interaksi antara faktor genetik, lingkungan, dan juga fototipe kulit. Terapi yang sering digunakan dalam penangganan melasma salah satunya yaitu chemical peeling. Penelitian ini bertujuan untuk memformulasi AHA (Alpha Hydroxy Acid) Kombinasi BHA (Beta Hydroxy Acid) dalam sediaan gel dan untuk mengetahui stabilitas gel selama penyimpanan pada suhu 40±2o C. Penelitian ini menggunakan metode eksperimen. AHA yang digunakan Glycolic Acid 10% dan BHA yang digunakan adalah Salicylic Acid 1% diformulasi menjadi sediaan gel dengan basis karbopol. Sediaan gel dilakukan uji stabilitas selama 21 hari dan dilakukan stabilitas dipercepat metode cycling test dengan menyimpan sediaan gel pada suhu 5±2 oC selama 24 jam, lalu dipindahkan ke dalam oven yang bersuhu 40±2oC selama 24 jam. Perlakuan ini terhitung 1 siklus dan dilakukan sebanyak 6 siklus (12 hari). Selanjutnya dilakukan pengamatan organoleptik, homogenitas, daya sebar, daya lekat, daya tercuci dan viskositas. Hasil uji stabilitas menunjukkan sediaan gel kombinasi AHA dengan BHA baik secara fisik, homogenitas, daya sebar, daya tercuci, viskositas dan pH selama 21 hari penyimpanan, tetapi tidak stabil pada pengujian cycling test karena terjadi perubahan stabilitas sediaan pada parameter viskositas dan pH. Pengaruh kombinasi konsentrasi pada sediaan gel terhadap stabilitas sediaan gel mempengaruhi pH dan viskositas.