Direct-to-consumer advertisements (DTCAs) in medical marketing serve as a prominent modality to deliver information to an increasingly diverse audience of consumers and increase prescription sales. In dermatology, advertisements have the potential to shape the public's opinions, aid in the understanding of skin conditions, and raise awareness of available treatments. To investigate and characterize the representation of skin tones in DTCAs. Nielsen ratings were utilized to identify the networks most watched by Black viewers in 2022. Programming on NBCUniversal, ABC, CBS, and FOX that aired in the District of Columbia, suburban Maryland, and Northern Virginia from June 2022 to July 2022 was reviewed for DTCAs. DTCAs were then analyzed to determine the skin tones of models and skin conditions depicted on models with darkly pigmented skin. Of the 106 DTCAs related to dermatologic conditions, there were 13 unique advertisements featuring 32 unique models. Four advertisements depicted the skin condition on darkly pigmented skin tones. Using the Monk Skin Tone (MST) scale to assess the 32 unique individuals, only 25% (n = 8) were rated at an MST 7 or above, and 6.25% (n = 2) were rated at an MST 10. This study has the limitation of only sampling DTCAs from Washington, District of Columbia which does not fully represent all dermatology-related DTCAs in the United States. Results of this content analysis demonstrate that the number of persons of color within dermatologic DTCAs is 23%, whereas there are 13.6% Black individuals in the 2021 US census. This suggests that DTCAs are becoming more diverse since 2018. However, findings also show that the vast majority of DTCAs do not include models with darkly pigmented skin, and there remains a lack of advertisements depicting skin disease among people of color. Given the role of DTCAs in informing and aiding patients' requests for prescription drugs, representation of all skin tones is essential for this communication to be effective, especially in the field of dermatology.

Skin of color in dermatology encompasses individuals of various ethnic backgrounds including Black or those of African descent, Hispanic or Latino, Asian, Native American, Pacific Islander, and those of mixed ethnicities. Because these populations continue to expand, more patients of color (POC) are seeking out cosmetic enhancements and treatments. Aside from cosmeceuticals, nonsurgical cosmetic rejuvenation options, such laser and light-based treatments, neurotoxins, soft tissue augmentation, and more recently body contouring and skin tightening, are becoming increasingly popular worldwide. This article examines risks of cosmetic enhancement procedures in POC and best practices to prevent adverse events.

Post-inflammatory hyperpigmentation is an extremely common disorder of pigmentation in skin of color. It most frequently and severely affects phototypes that are rich in melanin and often has a chronic and unpredictable course. It presents significant treatment challenges and often requires a multi-factorial approach. We review the literature available for the optimal use of laser-based devices in the treatment of post-inflammatory hyperpigmentation, particularly for Fitzpatrick skin phototypes III-VI. For the treatment of post-inflammatory hyperpigmentation in skin of color, lasers remain second line to topical agents based on the variable response, cost, and risk of complications with laser use. For post-inflammatory hyperpigmentation resistant to topicals, laser devices, particularly neodymium:yttrium-aluminum-garnet and fractional photothermolysis systems, can provide adjunctive treatment in skin of color patients when appropriate parameters are used. Future studies would benefit from an objective and consistent assessment to assist with a systematic analysis.

DaxibotulinumtoxinA for Injection (DAXI) is a novel botulinum toxin type A formulation approved for the treatment of glabellar lines. The efficacy, safety, and extended duration of response of DAXI 40 U for glabellar lines were demonstrated in 2 Phase 3, randomized, double-blind studies (SAKURA 1 and 2) and a Phase 3 open-label trial (SAKURA 3). The aim of this study was to evaluate the efficacy and safety of the first DAXI 40 U treatment received in SAKURA 1, 2, or 3 across age and race subgroups. Adults with moderate-to-severe glabellar lines (Investigator Global Assessment-Frown Wrinkle Severity [IGA-FWS] and Patient FWS [PFWS] scales) were evaluated for glabellar line severity for ≤36 weeks after the first DAXI treatment. Efficacy and safety were analyzed by age (18-45, >45-55, and >55 years) and race (Asian, Black and African American, and White). Overall, 2785 patients were included in the efficacy analysis. The proportion of patients achieving none or mild glabellar line severity at maximum frown (IGA-FWS) after DAXI treatment was high in all age and race subgroups (>96% at Week 4). Glabellar line severity of none or mild by composite IGA-FWS and PFWS rating was maintained for a median of 24.0 weeks in all age subgroups, and for 27.0, 25.3, and 24.0 weeks in the Asian, Black and African American, and White subgroups, respectively. Treatment-emergent adverse events were similar across all subgroups. Consistent with the overall study population, DAXI 40 U demonstrated a high response rate and duration of effect of ≥24 weeks across all age and race subgroups.

Recent years have brought forth the undeniable practice gap in dermatology concerning knowledge and experience of cosmetic procedures in people of color (POC). A paucity in the literature regarding evidence-based recommendations for the management of POC undergoing cosmetic procedures and the rise of cosmetic procedures in dermatology serves as a call to action to provide education regarding differences in skin of color that may impact the cosmetic outcomes. To mitigate the current practice gap on the safety, use, and benefits of cosmetic procedures in POC, part 2 will discuss the authors' recommendations and clinical pearls, as well as evidence-based management for neuromodulators, soft tissue augmentation, chemexfoliating agents, and laser hair reduction in POC undergoing cosmetic procedures.

The focus of this study is twofold; the first objective is to evaluate the resistance of veneer-retained anterior fixed partial dentures to compression testing. The second objective is to determine if veneer retainers with these axial grip extensions improve the restorations resistance to compressive forces as demand for biomaterial and access to care is often globally differentiated. Two maxillary typodont models with edentulous spaces in the left lateral incisor area were obtained. On each typodont model, the central incisor and canine neighbouring the edentulous space were given veneer-type preparations with a chamfer finish line. On one model, 2-mm axial grip extensions were added to the prepared facial surface of the abutment teeth. Metal duplicates of the prepared abutment teeth and edentulous spaces of each typodont model were produced using the lost wax casting technique. The two metal duplicates were scanned, and ten identical CAD/CAM restorations were produced for each metal duplicate. The restorations were cemented to metal duplicates and were subjected to compressive strength testing using a universal testing machine. Compressive forces were applied from the incisal margin towards the cervical in order to determine the force at which the restorations undergo debonding or fracture. Subject specimen N tested totalled 20. The veneer-retained restorations without axial grip extensions all underwent debonding but none fractured. In the veneer-retained restorations with axial grip extensions retention, nine cases of debonding (90%) were recorded and one case of fracture (10%) was recorded. The veneer-retained restorations with axial grip extensions (M = 302 N, SD = 79) compared to the restorations without axial grip extensions (M = 228 N, SD = 60) withstood significantly higher compressive forces (p < 0.05). This study shows that veneer-retained anterior fixed partial dentures with axial grip extensions can withstand higher compression forces than veneer-retained anterior fixed partial dentures without axial grip extensions. Veneer-retained anterior bridges can be useful in addressing esthetic concerns in a minimally invasive manner. This study shows that axial grip extensions can play a crucial and important role in addressing concerns about resistance and long-term success of this type of restoration. An important clinical relevance will be highlighted for endodontically treated dentition versus non-endodontic treated dentition. Additionally, there will be reporting on intersectional pending studies regarding custom geo-position of axial grip extensions preparation design.

Beyond submental fat reduction, injectable deoxycholic acid (DCA) has gained popularity in recent years for various minimally invasive lipolysis applications. To summarize and evaluate the evidence of off-label uses of injectable DCA. MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL were searched. The outcomes measured included applications of DCA, treatment regimen, and its efficacy. An overall success rate for each condition was calculated based on the improvement defined in the included studies. Eleven studies evaluated the cosmetic use of DCA for excess adipose tissue on various anatomical locations. The outcomes were evaluated at time points ranging from 1 to 21 months post-treatment, with overall success rates over 85%. Eight case reports and series reported the success of using DCA treating lipomas, xanthelasmas, paradoxical adipose hyperplasia, fibrofatty residue of infantile hemangioma, piezogenic pedal papules, and HIV-associated lipohypertrophy. Although the preliminary efficacies were high, the overall recommendations for off-label uses are weak because of the lack of high-level studies. The review emphasizes the diversity of injectable DCA as a minimally invasive technique for lipolysis. Further high-level studies demonstrating consistent treatment regimens and methods of evaluation are warranted to make more definitive recommendations regarding off-label DCA use.

What is known about this subject in regard to women and their families? • Porokeratoma is a rare lesion with distinct pathologic features that make diagnosis challenging. • Porokeratoma has historically been treated with excision. • In those who are cosmetically sensitive, particularly women, excision may not be a desirable treatment option. What is new from this article as messages for women and their families? • Porokeratoma can be successfully treated with topical 5% 5-fluorouracil (5-FU) cream. • Topical 5-FU is a safe and practical alternative to surgical intervention, especially in patients who are cosmetically sensitive. It is also useful in sites, such as the hands, where excision can compromise daily functioning and occupational activities.