Introduction: Bletilla Striata (Thunb. ex A. Murray) Rchb. f.) Is a native herb of the orchidaceae family. Modern pharmacological activity studies have shown that Bletilla striata mainly has pharmacological activities such as promoting blood circulation and hemostasis, promoting wound healing anticancer, anti-tumor disease-resistant pathogenic microorganisms, protecting mucosa, anti-ulcer, whitening and anti-oxygen, anti-aging, and immune regulation, which have been widely recognized and applied. Research on the efficacy of plant extracts mainly adopts in vitro testing methods, such as cell experiment and 3D skin model experiment. Objective: To evaluate the soothing effect of Bletilla striata extracton UVB-stimulated keratinocytes (HaCaT) and its barrier repair efficacy in Skinovo-Epi skin model. Methods: The soothing and barrier repairing effects of Bletilla striata extract were studied in vitro. The cytotoxicity of the sample was measured by MTT assay, and cytotoxicity to keratinocytes was evaluated by cell survival rate. The soothing effect was evaluated by detecting changes in inflammatory cytokines (IL-6, IL-1β, IL-8, TNF-α) secreted by UVB-stimulated keratinocytes with the sample treatment. Barrier repair efficacy was assessed in a Skinovo-Epi skin model by measuring changes in FLG (Filaggrin) and LOR (Loricrin) protein levels after topical application of the sample. Results: The sample showed low cytotoxicity on keratinocytes. The sample significantly reduced UVB-stimulated secretion of inflammatory cytokines in keratinocytes. Topical application of the sample increased FLG and LOR protein levels in the Skinovo-Epi skin model. Conclusions:Bletilla striata extract exhibits soothing and barrier repair activities in vitro. Bletilla striata extract reduces UVB-stimulated inflammation in keratinocytes and improves skin barrier function. The data provide novel experimental evidence supporting the innovative application of Bletilla striata for skin disorders. Bletilla striata has potential as a therapeutic herb for sensitive and damaged skin conditions.

Introduction: Over the last twenty years, dermal fillers have become the backbone for rejuvenating the perioral area, which is one of the most difficult areas to treat. Due to the development of highly sophisticated fillers with radically different rheological properties and innovating techniques, it has become possible to correct specific regions with more natural results than before. This four-center pilot study sought to investigate the efficacy and safety of MaiLi® Precise in correcting fine-line wrinkles of the perioral area. Material and Methods: MaiLi® Precise is a recently introduced Hyaluronic Acid (HA) filler, harnessing the OxiFree™ technology, for suppleness, flexibility, and high longevity. These properties were deemed particularly suitable for correcting fine-line perioral wrinkles. All injections were performed using intradermal injections, with the fluid HA injected in a very superficial manner, resulting in the formation of very small papules at the wrinkle, disappearing within 1-2 hours. Follow-up occurred at one (T1) and three months (T2) post-injection. Treatment effectiveness was evaluated using the Global Aesthetic Improvement Scale (GAIS), as was the satisfaction of the subjects and investigators. Adverse Events (AEs) were also reported. Results: Overall, 20 patients aged 56 years on average, from four centers, were injected MaiLi® Precise into the perioral area to correct perioral lines using intradermal injections. No specific safety concerns were detected, given that AEs remained mild, were almost all resolved by T1, and were completely absent by T2. Patient and physician satisfaction were both >90% during follow-up. All physicians attributed improved, much improved, or very much improved GAIS scores at T1 and T2, indicating a marked improvement in appearance after injection. Conclusion: Based on the current study results, MaiLi® Precise was shown to be safe and provided satisfactory results from both the patient and the physician’s points of view during a 3-month follow-up.

The author executed a series of self-biopsies following focused acoustic, and focused and radial acoustic wave therapy to examine the effectiveness of the two types of acoustic wave therapy and to identify and investigate mechanotransduction; the mechanism of action produced by acoustic wave therapy. A case of a 28-year-old patient’s acoustic wave therapy that improved a vascular malformation is reported as a successful example. The series of histopathologic examinations following acoustic wave therapy strongly suggest that mechanotransduction causes neither fatal damage nor critical degeneration of tissue, and rather create moderate changes; indicating that the treatment is safely effective. There are distinctive differences in histopathologic changes between the two types of acoustic waves; the combination of focused and radial acoustic wave therapy leads to a faster normalizing change with less infiltration of cells than that following only focused-acoustic wave therapy. Further research on the mechanism of acoustic wave therapy is awaited, and a clear elucidation of this mechanism will bring about widespread recognition of this modality as a promising treatment for skin tightening and rejuvenation.

Introduction: We present the long-term follow-up photographic and MRI data on 4 patients 42-44 months after cross-linked Hyaluronic Acid (HA) gel injection into the temple region. All injected HA gels were produced using the registered and patented “Inter Penetration Network Like®” (IPN-Like® cross-linking technology) (LABORATOIRES VIVACY, France). The initial results following injection and up to 24 months were previously reported [1,2]. Material and methods: Our study population comprised 4 Caucasian patients who were enrolled into our two previous studies that compared Stylage XL versus Stylage XL-Lido (incorporating lidocaine added at manufacturing) [1] and Stylage XL versus Stylage XXL [2]. Patients, radiologists and the independent evaluators were blinded to the type of product used. The 4 patients were each injected in both temporal fossae using the 2 different HA gels being compared (one on either side). All patients had their follow-up at month 42 after injection (M42) with the exception of one patent who her MRI and photographs taken at the same setting on month 44 (M44). Photographic assessments were undertaken by the injector and 2 independent experts using Merz-Analogic Scale® (MAS®) and the Global Aesthetic Improvement Scale (GAIS). Results: Except for participant 2 (Stylage® XL vs. Stylage® XL-Lido) on the Stylage® XL-Lido side, all the other participants were considered to have a degree of persisting improvement compared to baseline, according to experts scoring of photographs on MAS and GAIS, However, there was a gradual deterioration in the level of improvement compared to the other assessment time-points. MRI: Although the bolus of injected gel was spherical at D0, we observed a change in the shape of the implant over time on MRI, where it changed from a round to a “teardrop” shape. Slow resorption occurred from 18 months onwards. At M42-44, the gel appearance on MRI remained similar to that previously reported at M18. The MRI residual volume calculation showed persistent increased volume compared to the volume initially injected. The product location appeared stable. There were no radiological or clinical signs of inflammatory reaction in tissues adjacent to the gel. Conclusion: At long-term follow-up 42-44 months after initial injection there was still an improvement in the aesthetic appearance of the temporal fossa and the MRI images show the continued presence of the gel. We also noticed that Stylage®XL (without lidocaine) seemed to absorb more water than its counterpart with lidocaine. Likewise, Stylage® XL seemed to absorb more water than Stylage® XXL.

Introduction: The principal author was given the opportunity to assess new hyaluronic acid filler, first before its European Commission labeling during clinical investigations in France, and then after its European Commission labeling in his clinical practice in Geneva, Switzerland. This hyaluronic acid gel benefits from the world’s first patented OxiFree™ technology. This article sought to present preliminary safety and efficacy data from the first private patient series treated in Geneva with this cross-linked hyaluronic acid gel, called MaiLi. Material and methods: Like most of its competitors, MaiLi is available in various variants, including gel for filling fine wrinkles, for deeper wrinkles, folds, and for lip enhancement, in addition to gels for volumizing indications. This cohort study encompassed patients from the authors’ private esthetic clientele in Geneva, Switzerland. Depending on the indications, the injections were performed according to previously described techniques, ranging from the “blanching technique” to deeper injections. Results: Between January and November 2021, overall 45 patients aged 56 years on average were injected MaiLi gels, according to the areas they wished to be treated, with a follow-up period ranging from a few days to 12 months. Based on our current dataset, we confirm that MaiLi fillers have proven very safe, causing no unexpected undesirable effects. The gel’s hold over time related to its remarkable projection capacity was excellent, resulting in quite natural outcomes and a perfect integration into the tissues. These beneficial effects were still evident at 1-year follow-up. Conclusion: The MaiLi hyaluronic acid fillers proved to be well tolerated and safe, with long-lasting effects. Remarkable properties revealed in this follow-up were their projection capacity and suppleness, as well as their ease of use and longevity, resulting in full patient satisfaction. No relevant undesirable effects were observed. There were no edematous reactions following the injections, nor were there any lymphatic circulation disorders.

Introduction: Discoid lupus erythematosus is an autoimmune disease with mainly skin manifestations. Squamous cell carcinoma is a complication of discoid lupus on phototype VI and photoprotected area. We are reporting a case. Observation: It was a 52-year-old man, driver for 30 years, phototype VI, received for a budding lesion of the back evolving for 1 year on discoid lupus erythematosus followed for 10 years. On examination, there was a budding swelling with a bleeding surface of 5cm in diameter resting on a discoid lupus lesion in the lumbar region with discoid plates along the spine. Histology showed moderately differentiated tumor cells with volumeincreased nuclei; nucleolated. He benefited from a carcinological excision followed by chemotherapy and was then lost to follow-up. Discussion: Squamous cell carcinomas are rare on discoid lupus erythematous. The factors incriminated would be chronic inflammatory processes, atrophy, depigmentation, UV rays, microtrauma by friction related to the patient’s profession. Conclusion: Squamous cell carcinoma on discoid lupus erythematous remains a rare cancer in photo protected areas.

Melasma is one of the most prevalent acquired pigmentation disorders, especially among women due to its hormonal background. There is a wide variety of therapeutic alternatives available for its treatment given its multifactorial origin and complexity. Cosmetic protocols based on depigmenting agents remain one of the cornerstones of melasma treatment. Aim: To evaluate the efficacy and safety of a new cosmetic pigment correction protocol in the treatment of melasma in Caucasian women. Methods: A single-blind, prospective, single-center study was conducted in 20 women between 25 and 65 years of age, phototypes II-IV with mildmoderate facial melasma. For 90 days patients applied a sunscreen and moisturizing cream in the morning and a pigment correction protocol at night consisting of a skin retinization regime combining two formulations with Retinsphere® technology. (Neoretin DC Ultra emulsion and Neoretin DC transition cream). Treatment results were evaluated by clinical assessment, Observ® photography and non-invasive instrumental measurements such as the erythema and melanin index by Mexameter. The Melasma Area and Severity Index (MASI) were recorded, and patients completed both a quality of life questionnaire (MELASQoL) and a subjective evaluation. Results: MASI score was significantly reduced at all study visits, with a significant reduction in the area and severity of melasma already observed at 30 days and a 48% reduction at the end of treatment. In the opinion of the investigator and patients, some degree of improvement was reported in 95% of patients at the end of treatment and neither patients nor the investigator reported worsening of melasma at the end of treatment as compared to baseline. The degree of melasma improvement observed by patients increased progressively and significantly from day 45 onwards, reaching an improvement of almost 70% at the end of the treatment. The adverse effects evaluated, (peeling, erythema, burning, tightness, irritation, and itching) increased gradually, being higher at T45 and T60, coinciding with the greater frequency of application of the formulations. Effects were however transient and in no case reached statistical significance or required treatment discontinuation. Conclusion: The cosmetic pigment correction protocol under study appears to be an effective therapeutic option for the treatment of melasma. The retinization regime, which consisted in the gradual application of the more powerful formulation alternated with a transition formulation, made it possible to achieve both efficacy and good tolerability to the therapeutic regimen.

Introduction: Throughout the aging process, skin is subject to continuous structural, cellular and molecular modifications that affect not only its mechanical properties but also its biological and physiological functions, which clinically is manifested by dry skin, loss of elasticity and the consequent appearance of fine lines, wrinkles and creases, representing a therapeutic challenge with a difficult solution. Objective: to describe the superficial application technique of cohesive polydensified matrix hyaluronic acid (Belotero soft®) for the resolutive treatment of superficial perioral, periorbicular and lateral wrinkles and creases of the face. Conclusion: The superficial and transversal application technique showed to be ideal for the treatment of wrinkles and superficial creases, without description of important adverse effects or Tyndall effect with the cohesive polydensified matrix hyaluronic acid.

Background: Psoriasis is associated with cause specific ocular involvement, uveitis being the most serious. Severity of skin disease, presence of arthritis and HLA B27 positivity may be associated with higher incidence of uveitis.

Introduction: Although adding a local anesthetic is an effective way to reduce pain during intradermal Hyaluronic Acid (HA) injections, it is not clear if the pain control is as effective when performing injections close to the bone. The primary aim of these preliminary observations was to explore this issue. As a secondary aim, we wanted to assess if the addition of lidocaine alters the behavior of HA gel in the tissues over time. Subjects: Two women provided informed written consent to participate in the study. Participants were blind to the type of HA gel used for either temporal fossa. Methods: A cross-linked HA gel was used for the study. One side was injected with the gel with and the other without lidocaine, in no particular order. Photographs from the front, profile and three-quarter left and right and frontal MRI scans were taken before and just after the injections, then every 6 months for 2 years. Results: The side injected with the gel with lidocaine was significantly less painful than that injected without lidocaine. Both types of gel changed shape on MRI in the first 6 months but stayed stable thereafter till the end of our follow-up at 24 months. Based on MRI, patient reported outcomes and expert assessed aesthetic outcomes, using MAS® and the global aesthetic improvement scale, both types of gel were comparable. Conclusion: The addition of lidocaine to HA volumiser gels reduces pain to a remarkable degree.