High Resolution Ultrasound of Fillers and Their Implications in Aesthetic Medicine: A Study in Human Cadavers

The use of fillers for cosmetic or therapeutic purposes is very common and it’s increasing daily. Although it’s true that in most cases the results are as expected, the use of these substances is not free from the development of complications, even when it’s performed by highly trained medical physicians. On the other hand, these substances can be used indiscriminately by untrained personnel leading to a serious public health complication known as iatrogenic allogenosis, which leads to problems related to malpractice. Most of the time, professionals are consulted for a second opinion regarding the use of these substances, because use of these substances might be unknown due to the patients denying or forgetting the use of these. The presence of a previous unknown filler in aesthetic areas that require treatment may trigger severe or irreversible reactions, especially if non-absorbable fillers were injected. High resolution ultrasound is an extremely useful diagnostic tool for the identification of fillers. In this paper we will describe the ultrasound appearance of hyaluronic acid, calcium hydroxyapatite, liquid silicone, silicone oil, biopolymers, and Polymethylmethacrylate (PPMA) and then we compare it with it’s reported appearance in previous studies. The injection of the substances was carried out in human cadavers with the intention of gathering ultrasound images as similar to the imaging behavior of these substances in vivo. The obtained images can be used as precise references in the ultrasound evaluation, diagnosis, follow-up and behavior of the filler materials in the benefit of a comprehensive approach in the management of patients.

Nodular fasciitis on the arm

A 20-year old female with no trauma history presented to our department of dermatology with a 6-month history of a painful tumor of the arm. Physical examination revealed a 5-cm hard-elastic and friable tumor, which were movable and unattached to the underlying tissues. Surgical excision of the tumor was performed. Histopathologic examination concluded to nodular fasciits. Nodular fasciitis is a benign pseudosarcomatous tumour composed of a vascular and fibroblastic proliferation. Surgical excision is the gold standard treatment and recurrence is rare.

Il-18 Overproduction Associated with NLRP1 Single Nucleotide Polymorphisms Linked to Risk for Vitiligo

Background The NLRP1gene is central to the NLR inflammasome. Variants to the NLRP1 gene are associated with vitiligo and other autoimmune diseases. We examined the effects of two single nucleotide polymorphisms (SNP) son cytokine levels and NLRP1 gene expression in 50 human volunteers. Methods NLRP1 was genotyped at SNPs rs2670660 and rs12150220, and participants who were homozygous at one or more SNP were analyzed. Plasma IL-18 and IL-1β levels were quantified using ELISA. NLRP1 gene expression was measured using real-time PCR. Results Participants with the risk genotype had significantly higher levels of plasma IL-18 than participants with protective genotype (0.439 ng/µL compared to 0.152 ng/µL, p = 0.024). Genotypes rs2670660 and rs12150220 were strongly linked in this population (p = 2.33 x 10-13). Conclusions Increased production of IL-18, suggests that at least one of the AA variants of rs2670660 or rs12150220 increases NLRP1 activity. rs2670660 and rs12150220 are strongly linked.

Neurofibromatosis Type One and Two: Review On The Diagnosis Criteria

There are some neurocutaneous syndromes and neurofibromatosis is among them. This is a review on the diagnosis criteria of neurofibromatosis types one and two.

Acral Lentiginous melanoma arising in Brauer-Buschke-Fischer plantar keratoderma

Type I Punctuate palmoplantar keratoderma or Brauer-Buschke-Fischer keratoderma (BBFK) is a rare autosomal dominant keratinisation disorder with variable penetrance. \r\n The emergence of acral lentiginous melanoma on palmoplantar keratoderma is rarely reported. Herein, we present a case of a 53-year-old woman with a history of BBFK in both palms and soles, who developed an acral lentiginous melanoma. The clinical examination showed multiple tiny hyperkeratotic and translucent papules on both palms and soles. On the right sole, she developed an acral lentiginous melanoma over a hyperkeratoic area. This case presentation illustrates a rare association of malignant melanoma and BBFK and seeks to enhance further investigations to determine its pathophysiological mechanism.\r\n

Mutual Relationships of Environment and Migration: A Sociological Appraisal

Socio-industrial change in the past two centuries has widely affected the environment in various ways. In this process natural life has reversed ___ water resources, forests, agriculture, original foods, rural life, husbandry, access to fresh air and many more have changed face. Instead, chemicals, pollutants, transportation pollution, family networks, artificial food and many more have replaced the original/ natural characteristics of life and the original human values. Environmental change and degradation have widely caused migration in various forms. Currently, we can observe lots of climate refugees moving from one part to another. Such a situation leads to problems in the area of origin and in the destination area. When migration from a village takes place, agricultural production per head migrant is ceased/ suspended, and when the migrant is settled in a city, or another country, there would happen a pressure on resources there. Therefore, migration overall has its positive and negative effects. However, the phenomenon of migration brings many challenges and shortcomings for the host countries. Illegal immigrants who generally live unregistered on the outskirts of the city, they themselves cause environmental pollution, many social perversions, abnormalities (antisocial) behaviors, and the like.

Pityriasiform Eruption Post COVID Vaccine

COVID 19 pandemic appeared in the end of 2019 and swept throughout the world at a raging speed. Multiple vaccines have been rolled out to curb the spread of disease. We report a case of 43-year male whole developed a generalised eruption with a pityriasiform reaction on histology. The rash resolved with symptomatic treatment.

UV-protective Properties of Topical of Astaxanthin Half side Controlled Pilot Study

Background: Astaxanthin, a product of green algae, a naturally occurring reddish pigment from the carotenoid group, is known as a potent antioxidant reducing free radicals. Objective: The aim of this pilot clinical study is to determine whether astaxanthin in topical formulation has antiinflammatory and uv-protective Properties through its antioxidant potency. Material and Methods: The UV-protective effect of Astaxanthin AstaCos® OL50 versus a placebo tested in a half side controlled setting on 21 healthy volunteers Fitzpatrick skin type 2 or 3. A light testing system was used for irradiation of volar aspects of both forearms, one with Astaxanthin formulation, the other with placebo. Twenty four hours later photodocumentation and colormetric measurement of erythema values in all treated areas was performed. Results: After equal uv-exposure, the erythema value after 24 hours on the astaxanthin side is on average 25% lower than on the placebo side. Astaxanthin suppresses visual erythema formation in over 71.42% of cases. Discussion: Uv-exposure causes inflammation, accelerated skin aging and non melanoma skin cancer. Topical Astaxanthin reducing the inflammatory effects of uv-irradiation could prevent later stages of photoaging and malignant skin disease. Zusammenfassung Hintergrund: Astaxanthin, ein Produkt aus Grünalgen, ein natürlich vorkommendes rötliches Pigment aus der Gruppe der Carotinoide, ist als starkes Antioxidans bekannt, das freie Radikale reduziert. Zielsetzung: Das Ziel dieser klinischen Pilotstudie ist es, festzustellen, ob Astaxanthin in topischer Formulierung durch seine antioxidative Potenz uv-protektive Effekte hat. Material und Methoden: Die UV-schützende Wirkung von Astaxanthin AstaCos® OL50 im Vergleich zu einem Placebo wurde in einer halbseitigen kontrollierten Einstellung an 21 gesunden Probanden mit Fitzpatrick-Hauttyp 2 oder 3 getestet. Mit einem Lichttestsystem wurden die volaren Seiten beider Unterarme bestrahlt, einer mit der Astaxanthin-Formulierung, der andere mit Placebo. 24 Stunden später erfolgten Fotodokumentation, farbmetrische Messung der Erythemwerte in allen behandelten Bereichen. Ergebnisse: Nach gleicher uv-Belichtung ist der Erythemwert nach 24 Stunden auf der Astaxanthin-Seite im Durchschnitt 25% niedriger als auf der Placebo-Seite. Astaxanthin unterdrückt die visuelle Erythembildung in über 71,42% der Fälle. Diskussion: Uv-Exposition verursacht Entzündungen, beschleunigte Hautalterung und Nicht-Melanom-Hautkrebs. Die topische Anwendung von Astaxanthin, das die entzündlichen Effekte der UV-Bestrahlung reduziert, könnte spätere Stadien der Lichtalterung und bösartige Hauterkrankungen verhindern.

Efficacy and Safety of Autologous Platelet Concentrate in The Treatment of aging of The Neck.

Introduction: Neck rejuvenation has a certain degree of difficulty, both due to its location and mobility, as well as its anatomical characteristics. Objective: To evaluate the efficacy and safety of intradermal microinjection of autologous platelet concentrate (APC) in the treatment of signs of neck aging. Method: An observational, analytical and longitudinal study was carried out in 60 patients from the Hospital Clínico Quirúrgico: “Hermanos Ameijeiras”, in the period between March 1, 2017 and March 31, 2020. The treatment was applied monthly for 1 year. The final evaluation was carried out 3 months after the end of the treatment. Results: 60 women with an average age of 45 ± 4.3 years were treated. After treatment, there were significant changes in the Glogau Photo Damage Scale (P = = 0.024), in the Global Aesthetic Improvement Scale (P <0.002) and in the Allergan Neck Transverse Lines Scale (P = 0.013). The adverse events found were pain, inflammation and ecchymosis. The degree of satisfaction reported by the patients was good (10.0%) and very good (90.0%) (P < 0.0012). Conclusions: The autologous platelet concentrate proved to be effective and safe to reduce the signs of aging in the neck, associated with a high degree of patient satisfaction.

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.