Pre- and postprocedure skin care is crucial for patients undergoing energy-based device (EBD) treatments. A serum containing a proprietary blend of peptides to support extracellular matrix remodeling (TriHex Technology®) was developed to aid skin preparation and recovery following aesthetic procedures. This analysis evaluated the skin recovery effects and safety of this serum in Asian subjects following fractional CO2 laser (FCL) and radiofrequency microneedling (RFMN). Two prospective, randomized, evaluator-blind, split-face studies were conducted. In the FCL study (n = 26), subjects applied a reference moisturizer on the entire face and the serum on an assigned hemi-face for 2weeks preprocedure. Postprocedure, the serum and moisturizer were applied to opposite hemi-faces for 3 days, followed by the preprocedure regimen until day 14. In the RFMN study (n = 25), serum and moisturizer were applied to opposite hemi-faces immediately postprocedure for 3 days, followed by serum on the assigned hemi-face and moisturizer on the entire face until day 14. Blinded clinical evaluations, self-assessments, and skin measurements were performed on days 0, 1, 3, 7, and 14. All 26 subjects (18 female, 8 male) completed the FCL study and 25 (24 female, 1 male) completed the RFMN study. Overall, the serum-treated side showed superior or comparable recovery versus control across multiple parameters. The primary endpoint of investigator-assessed erythema showed significant within-side improvement on both sides in both studies, while between-side differences did not reach statistical significance. Among secondary endpoints, the serum-treated side showed significantly greater recovery that withstood multiplicity correction for transepidermal water loss (TEWL) at day 3, and edema, VISIA redness, and tactile roughness at day 14 in the FCL study, while crusting at day 3 showed numerical improvement. In the RFMN study, the serum-treated side showed significantly greater edema reduction at day 7 that withstood correction; numerical improvements were observed for pain and heat sensation at day 1 and for erythema and crusting at day 7. On day 14, significantly more subjects reported better recovery on the serum-treated side (FCL, 81.8%; RFMN, 100%; p < 0.05). Safety was favorable with few mild adverse events. In these two exploratory studies, the topical serum containing TriHex Technology® demonstrated superior or comparable recovery to a basic moisturizer across multiple parameters following FCL and RFMN in Asian subjects, with the most pronounced benefits in the early postprocedure period. These findings suggest that the serum may be a useful periprocedural adjunct, although further controlled studies are warranted. Chictr.org.cn identifiers: ChiCTR2400089516 and ChiCTR2400089424.

Facial expressions and movements, from a subtle and ephemeral grimace to vigorous and rapid chewing, offer direct insights into the moment-to-moment changes of neural and physiological processes. Mice, with discernible facial responses and evolutionarily conserved mammalian facial movement control circuits, provide an ideal model in which to unravel the link between facial movement and underlying states. However, existing frameworks lack the spatial or temporal resolution to sensitively track all movements of the mouse face because of its small and conical form factor. We introduce Cheese3D, a computer vision system that captures high-speed 3D motion of the entire mouse face (including ears, eyes, whisker pad and jaw, covering both sides of the face), using a calibrated six-camera array. The interpretable framework extracts dynamics of anatomically meaningful 3D facial features in absolute world units at sub-mm precision. The precise face-wide motion data generated by Cheese3D provides clear insights, as shown by proof-of-principle experiments predicting anesthetic depth from changing facial patterns, inferring tooth and muscle anatomy from fast ingestion motions across the entire face, measuring minute differences in movements evoked by brainstem stimulation and relating neural activity to spontaneous facial movements, including expressive features only measurable in 3D (for example, angles of ear motion). Cheese3D can serve as a discovery tool that renders subtle mouse facial movements as a highly interpretable readout of otherwise hidden processes.

Melasma is a multifactorial disorder, and while treatments aimed at suppressing melanin production and removing excess melanin have demonstrated some efficacy, no definitive therapy has yet been established. Dermal aging is widely recognized as a contributing factor in melasma, and previous studies have demonstrated that the presence of senescent fibroblasts reduces the efficacy of melasma treatments. Therefore, treatment strategies focused on reactivating fibroblast activity are anticipated to be effective against melasma. The objective of this study is to investigate the safety and efficacy of the Thermal-Thread Technique, which utilizes high-intensity, high-frequency parallel ultrasound beams for the treatment of melasma among Asian subjects. Patients diagnosed with melasma, regardless of disease type, duration, or Fitzpatrick skin type, underwent a single treatment session covering the entire face utilizing a high-intensity, high-frequency parallel ultrasound beam with Thermal-Thread Technique. High-resolution skin images were captured using a skin analyzer before treatment and six months after the treatment. Two independent evaluators assessed these images using the modified Melasma Area and Severity Index (mMASI) scoring system to objectively evaluate treatment efficacy. Statistical analyses of the mMASI scores were performed using paired t-tests. All potential side effects were carefully monitored both during and after the procedure. All patients (n = 20, female, mean age: 50.5 ± 5.7) completed the study. The distribution of Fitzpatrick skin types among participants was as follows: type II (n = 7), type III (n = 11), and type IV (n = 2). The mean mMASI score significantly decreased from 4.63 ± 1.66 at baseline to 1.69 ± 0.90 six months post-treatment (p = 1.53e-9; p < 0.001). No statistically significant difference was observed among FST groups (F(2,17) = 1.68, p = 0.216). No side effects were observed or reported during or after the treatment period. The improvement in mMASI scores observed with the Thermal-Thread Technique, utilizing a high-intensity, high-frequency parallel ultrasound beam, demonstrates its potential as an effective treatment for melasma. Further research is necessary to evaluate its efficacy in more severe cases, extend the observational period, and investigate the potential benefits associated with multiple treatment sessions.

A sheet face mask is a type of facial skincare cosmetic applied to the entire face to provide hydration, a refreshing sensation and skin tightening. A paradigm shift is now underway, fuelled by consumer concerns over the long-term safety of synthetic chemicals used in these products and the broader ecological footprint of cosmetic production. Consequently, κ-carrageenan is an alternative to these synthetic chemicals due to its natural origin, being free of harmful chemicals, gelling and hydration properties. The red seaweed, Kappaphycus alvarezii, the only seaweed species commercially cultivated in Sri Lanka is a rich source of κ-carrageenan, however, it has not yet been used locally to extract carrageenan and test its application in skincare cosmetics. Precipitation of κ-carrageenan using KCl is a critical step in carrageenan extraction process as it imparts strength to carrageenan gels. In this study, carrageenan was extracted using three concentrations of KCl and its suitability for a sheet face mask gel was tested across three carrageenan concentrations. The results showed that comparatively higher yields of 31.89±0.05 and 33.52±2.50 were obtained at 2.50% and 3.50% KCl concentrations, respectively. All tested characteristics for a leave-on sheet face mask gel were achieved at 1.00% carrageenan concentration prepared using carrageenan extracted at 3.50% KCl concentration. Notably, prepared carrageenan gels were able to moisturise the skin without altering skin oiliness.

The choice of appropriate treatment aids holds paramount significance in achieving optimum treatment outcomes. Rehabilitation of large craniofacial defects following conventional workflow is challenging and is influenced by the required material properties, operator's expertise and anatomical complexity. A woman in her early 30s was referred for the prosthetic rehabilitation of an extensive facial defect following traumatic avulsion from a fodder-cutting machine. The defect involved the frontal bone, orbit, cheek and upper lip on the right side, including complete nose. Analogue impressions were unsuccessful in recording the tissue bed accurately and in a resting state.A predominantly digital workflow was employed for prosthesis fabrication. Facial scanning using structured light technology obtained a precise and detailed three-dimensional (3D) model of the entire face including the defect. A computer-aided design software programme was used to duplicate and mirror the normal side of the face on the defect side. A hollow shim and three-part mould were digitally designed and 3D printed. The final prosthesis was processed conventionally using silicone and characterised with extrinsic staining. Eyebrows and eyelashes were sewn in the prosthesis using patient's hair. A combination of medical-grade adhesive and a customised hair wig was employed to achieve both aesthetic integration and functional stability.At 6 months, the prosthesis showed a stable fit and colour, with notable progress in the patient's confidence and social reintegration. The outcome achieved makes a strong case for integrating digital workflow not only for the rehabilitation of extensive facial defects but also in routine clinical practice.

Dear Editor, Vitiligo, the most common acquired pigmentary disorder, is marked by the loss of functional melanocytes and affects approximately 1%–2% of the global population.[1] In individuals with extensive disease who have not responded to medical treatments, and who experience significant cosmetic concern due to patchy residual pigmentation, depigmentation therapy may be considered. Although an ideal depigmenting agent is lacking, monobenzyl ether of hydroquinone remains the only US FDA-approved option, requiring several months to achieve depigmentation. However, its limited availability and potential for local side effects and repigmentation present challenges.[2] In view of these limitations and the potential depigmenting side effects of imiquimod,[3,4] we explored the use of topical imiquimod cream as an alternative depigmenting agent. A 34-year-old female presented to the dermatology outpatient department with extensive, rapidly progressive vitiligo for 6 years. On examination, diffuse depigmented macules were found on the trunk and extremities. On the other hand, islands of depigmented macules were noted in the background of variegated residual pigmented macules on the face [Figure 1a–c]. With the diagnosis of vitiligo vulgaris, the patient had received oral betamethasone pulse therapy for 6 months and tofacitinib for 1 year, with no stability. With the failed medical management, after 6 months off therapy, the patient requested depigmentation therapy for facial pigmented macules.Figure 1: Clinical image depicts pretreatment vitiligo vulgaris on face (a-c) and at 3 months after imiquimod peel (d-f)We initiated immunopeeling therapy using imiquimod 5% cream for 3 months. The patient was instructed to apply the contents of a single 250 mg sachet, containing 12.5 mg of imiquimod, to the entire face (approximately 600 cm²) on alternate days, along with strict adherence to physical photoprotection and the use of a sunscreen with sun protection factor 30. At 3-month follow-up, uniform pigmentation was noted, areas of depigmentation showed repigmentation, and variegated residual pigmented macules developed a light, homogeneous color [Figure 1d–f]. Three months after discontinuation of imiquimod therapy, the achieved pigmentation remained stable. Imiquimod is a topical immunomodulator that is commercially available in 2.5%, 3.75%, and 5% concentrations and is US FDA approved for the treatment of actinic keratosis, superficial basal cell carcinoma (less than 2 cm in diameter on the face and trunk), and genital warts. It exerts its immunomodulatory effects by activating toll-like receptors (TLRs) 7 and 8 on antigen-presenting cells, thereby regulating both innate and adaptive immune responses.[5] Interestingly, various TLRs, including TLR 2, 3, 4, 7, 9, 19, and 20, are expressed by human melanocytes, and their functional activity is influenced by the expression levels of these receptors.[6] Studies have shown that imiquimod may directly impact melanocyte biology through TLR activation. Specifically, Kim et al.[6] demonstrated that imiquimod induces apoptosis in human melanocytes, implicating its potential to cause melanocyte dysfunction or destruction. Furthermore, emerging evidence suggests that autophagy plays a key role in melanocyte function and melanin aggregation. In vitro studies assessing imiquimod’s effects on melanocytes have examined its influence on melanogenesis, autophagy, apoptosis, and the expression of TLR7 and TLR9, along with the production of inflammatory cytokines such as IL (interleukin)-8, IL-6, and soluble ICAM (intercellular adhesion molecule)-1.[7] While some reports paradoxically suggest that imiquimod may stimulate melanogenesis, the exact pathomechanisms remain unclear and are likely to be dose-dependent. The concept of ’immunopeeling’, originally described in the treatment of premalignant and malignant lesions in xeroderma pigmentosum, was adopted in our case to target islands of residual pigmentation.[8] Additionally, given the documented depigmenting effects of imiquimod reported in multiple case studies, its use was considered a rational therapeutic option in our patient.[3,4] However, we noted uniformity of skin tone at follow-up, that may be attributed to the relatively low-dose application of imiquimod, which may have been insufficient to exert its full depigmenting potential. Future studies are warranted to better understand the dose-dependent effects of imiquimod on melanocyte biology and its precise mechanism of action in vitiligo. In conclusion, we highlight the effectiveness of imiquimod immunopeel in promoting repigmentation and restoring uniform skin tone in islands of hyperpigmented macules, without any side effects. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Use of artificial intelligence (AI) The preparation of this manuscript was carried out entirely by the authors without the use of artificial intelligence technologies.

Second-degree facial burns in the pediatric population represent a therapeutic challenge due to their functional, aesthetic, and psychosocial impact. The use of biosynthetic dressings has emerged as an effective alternative in the conservative management of these injuries. We present the case of a 5-year-old male patient with superficial and deep second-degree facial burns involving the entire face, corresponding to 9% of the total body surface area, secondary to accidental exposure to hot liquid. The patient was managed conservatively with the application of Suprathel® following wound cleansing and atraumatic superficial debridement. At 72 hours of follow-up, adequate adherence of the material, a significant reduction in pain, absence of clinical signs of infection, and early signs of reepithelialization were observed, with no progression in burn depth or need for additional surgical interventions. Early clinical evolution was favorable, allowing continuation of conservative management. This case report suggests that Suprathel® as a biosynthetic dressing for partial-thickness facial burns in pediatric patients may be a safe and effective therapeutic option with encouraging early outcomes; however, studies with larger sample sizes and long-term follow-up are required to confirm its impact on functional and aesthetic outcomes.

The demand for remote biometric technologies to monitor drowsiness levels is expected to increase in the future of autonomous driving. Facial skin is constantly exposed to the outside world and its temperature is an autonomic index that can be measured while driving. Previous studies have attempted to estimate drowsiness from the facial skin temperature distribution (FSTD) using a convolutional neural network (CNN). However, only models specific to a single individual have been constructed. The objective of this study is to improve the generalization of drowsiness classification from the FSTD using data preprocessing in a CNN. The three main approaches of this study are as follows: 1) The input is not the entire face, but only the skin area without the background. 2) Input image preprocessing focuses on the spatial temperature gradient of facial thermal images. 3) Normalization methods are improved to emphasize the spatial variation of skin temperature. In this study, two and three levels of drowsiness were estimated, resulting in 83%–92% and 79%–85% accuracy, respectively. Thus, the generalization of drowsiness classification from the FSTD is considered to have improved.

It is becoming increasingly vital to assess the risks of geological disasters associated with mining activities. However, most existing methods solely evaluate the deformation of individual points in mining areas without accounting for the overall deformation of an entire working face; additionally, if decorrelation occurs, it can degrade the interferometric time-series InSAR measurements of existing models. To address these disadvantages, we introduce a novel velocity–neighborhood spatial algorithm to accurately predict mining deformation trends and build upon the precise extraction of surface deformations from mining areas. Initially, surface deformation data from the Yuka mining area in Qinghai Province were obtained using the LiCSBAS method and transformed into a graphical structure. Subsequently, the T-GCN model was used to predict deformation trends, and the results show that it improved upon the accuracy of traditional recurrent neural networks and machine learning algorithms by 4% with a 15% reduction in root mean square error, thus proving its substantive advantages in spatiotemporal deformation trend predictions. The proposed method provides a more accurate and comprehensive scientific basis for monitoring and controlling geological disasters in mining areas while showcasing the vast application prospects of the T-GCN model.

The eyes are the windows for humans to interact with the outside world and a prerequisite for the promotion of many applications. In gaze estimation, although the full-face image encompasses the eyes, when extracting gaze features, the network often comprehensively considers the information characteristics of the entire face and its interrelationships. This may lead to neglecting the delicate gaze-related information contained in the eye images. To improve the accuracy of gaze direction prediction, this study proposes a novel multi-stream binocular gaze estimation model named CO-Net, which takes facial and binocular images as input. First, we use facial and eye features to preliminarily estimate a primary gaze direction. Considering the differences that arise when observing objects with both eyes in an unconstrained environment, we utilize this characteristic to purify the gaze features. Finally, we use the purified features to linearly optimize the primary gaze direction. Experimental results demonstrate that our method reduces the mean angular error to 3.63 ∘ on MPIIGaze and 5.9 ∘ on RT-GENE, representing improvements of 7% and 10%, respectively, over the previous state-of-the-art.

Introduction: Tuberculosis continues to pose a considerable public health challenge in India. Although antitubercular drugs are vital for effective treatment, they can lead to significant adverse reactions, one of which is drug-induced erythroderma. This severe inflammatory skin disorder is marked by extensive erythema and scaling that can affect more than 80% of the body’s surface area. Case Presentation: We present a 75-year-old male who was admitted with a onemonth history of widespread skin redness and scaling, accompanied by loose stools for the past three days. He had been undergoing antitubercular treatment for tuberculosis for 5 months. A thorough cutaneous examination revealed numerous erythematous, hyperpigmented plaques exhibiting scaling and superficial fissures, affecting the entire face, with some lesions on the lower lip, as well as hyperpigmented patches on the buccal mucosa and lower extremities. The patient also reported experiencing itching for the last 20 days and complained of bleeding per rectum while passing stools over the past three days. Management and Outcome: Given the clinical findings and the patient’s history of antitubercular medication use a diagnosis of erythroderma, secondary to isoniazid was established after rechallenging. The patient’s antitubercular regimen was modified, and he received supportive treatment aimed at enhancing skin barrier function and reducing inflammation. Discussion and Conclusion: This case underscores the necessity of recognizing drug-induced erythroderma in patients undergoing antitubercular therapy who exhibit extensive skin involvement. Timely diagnosis and effective management of the underlying condition, along with supportive care, are essential for enhancing patient outcomes.

Background: Breast cancer, the second most common oncological disease in Brazil, is estimated to have approximately 73,000 new cases in the Brazilian female population in the 2023-2025 triennium. Considering the treatments offered, physiotherapy emerges as a tool in the treatment of various conditions, such as musculoskeletal disorders and pain resulting from traditional antineoplastic therapies, with resources such as laser therapy available for this management. Objective: To establish a physiotherapeutic intervention protocol, based on scientific evidence, for women with breast cancer. Method: This is a physiotherapeutic protocol that is part of a randomized, placebo-controlled, double-blind clinical trial, approved by the Research Ethics Committee of SCS/UFPR (CAAE: 71033323.9.0000.0102), to evaluate the effects of photobiomodulation on breast cancer. The study will recruit 60 women with breast cancer, aged between 21 and 60 years, who are undergoing active antineoplastic treatment. The developed protocol consists of four physiotherapeutic techniques: cervical pompage associated with breathing exercises, kinesiotherapy, and clay therapy. Clay therapy consisted of applying white clay to the entire face of the participant, lasting approximately 15 minutes. Kinesiotherapy included range of motion exercises of rotation, inclination, flexion, and extension of the cervical spine, in a prescription of 2 sets of 10 repetitions, in addition to static stretching of the upper limbs, in 2 sets of 60 seconds. The pompage and breathing exercises combined cervical rotation with pursed-lip breathing, lateral cervical inclination with diaphragmatic breathing, and the pranayama surya bedhana technique with the pompage of the pectoralis major. Conclusion: The proposed protocol is expected to be an efficient resource for managing the well-being of study participants during Modified Intravascular Laser Blood Irradiation applications, potentially providing comfort associated with the therapeutic application of the laser.

An 84-year-old female patient initially presented to the general ophthalmology outpatient clinic with a complaint of a mass on the left lower eyelid. At that time, only the eyelid lesion was noted. Upon referral to the oculoplastic unit, an expert oculoplastic surgeon identified, in addition, multiple lesions on the left nasal alar rim. The patient was subsequently referred to the Department of Otorhinolaryngology. Incisional biopsies confirmed basal cell carcinoma in both sites. Under general anesthesia, the ophthalmology and otorhinolaryngology teams performed simultaneous resections and reconstructions in a single operative session. The lower eyelid tumor was excised with tumor-free margins confirmed by frozen section and reconstructed with a Hughes flap. The nasal alar rim lesion was excised with safe margins and repaired with a Rieger flap. Histopathology confirmed nodular and adenoid BCC in both specimens, with all margins clear. The postoperative course was uneventful, and no recurrence was observed during the follow-up. This case highlights 3 key points: ophthalmologists should extend their examination beyond the periocular region to include the entire face; simultaneous multidisciplinary surgery can eliminate the need for additional anesthesia, procedures, and costs; and, to our knowledge, this is the first reported case of synchronous lower eyelid and nasal alar BCCs managed with concurrent Hughes and Rieger flap reconstructions.

Thick hard roof with high strength, large breaking step and strong mine pressure is one of the major problems in coal mine safety production. Aiming at the problems of large thickness, high strength and difficult collapse of the roof slab of Yadian Coal Mine in Binchang Mining Area, we integrated theoretical analysis, UDEC numerical modeling, and engineering validation to mechanistically analyze the overlying rock structure. We proposed a regionalized control method using high-low three-dimensional synergistic directional hydraulic fracturing, simulated its effect via UDEC, and conducted large-scale industrial tests at the ZF1407 working face (strike length 1602 m; burial depth 634–794 m). Seven directional boreholes achieved 3381 m3 fracturing volume with 141 segments. The average spacing of the fracturing holes was 24 m, and the total number of fracturing segments was 141, which realised the coverage of the entire working face by the fracturing and reforming area. The applicability and effectiveness of the directional hydraulic fracturing technology for thick hard roofs were verified by monitoring means such as microseismic, transient electromagnetic and ground sound monitoring. On-site monitoring results show that: through the implementation of hydraulic fracturing measures on the thick hard roof of the working face, the thick hard roof rock layer has been effectively weakened; the number of microseismic events has been significantly reduced, and the number of microseismic events in the middle and late stages of fracturing has been reduced by 77.0% and 78.5% respectively compared with the number of events in the pre-fracturing stage, and the microseismic activities before and after the fracturing have been developed in the direction of low-energy, low-frequency from high-energy, high-frequency; and the distribution of the electrical resistivity contours in the thick hard rock layer has been changed from a smooth layer distribution to an irregular distribution. The distribution of resistivity contours of thick hard rock formations changed from the smooth layer distribution before fracturing to irregular distribution, and the resistivity of rock formations increased by about 50%, and the local resistivity was as high as 90 due to the large number of cracks generated in the rock formations after fracturing. The ground sound energy in the fracturing process can better reflect the energy release of rock formation rupture and crack extension through the high-pressure water. The results of the study can provide a reference for solving the disaster control of mine pressure caused by the structural instability of multi-layer thick and hard rock formations in the roof of similar longwall workings.

ABSTRACTBackgroundIn recent years, treatments using energy‐based devices (EBDs) aimed at skin quality improvement have become widely adopted. However, it has been pointed out that treatments using EBDs alone show limited durability of effects and variability in patient‐perceived improvements. Therefore, we evaluated skin quality improvement resulting from a combination therapy involving cross‐linked hyaluronic acid (CL‐HA) filler and EBD treatments tailored to patients' chief concerns.ObjectiveTo assess the efficacy and safety of combined CL‐HA filler and EBD therapies in treating facial skin quality improvement among Asian subjects.MethodsIn this prospective, evaluator‐blinded study, 18 participants aged 32–59 years with decreased skin elasticity, fine wrinkles, uneven texture, pore enlargement, pigmentation, and sagging were enrolled. CL‐HA filler (VYC‐12L) was injected intradermally into the entire face. One month later, according to each patient's primary concerns and symptoms, EBD treatment (either high intensity, high frequency parallel ultrasound beam [PUB], picosecond alexandrite laser [PSAL], and sequential monopolar bipolar pulsed radiofrequency [SMBPRF]) was administered to the entire face. Evaluations were conducted at three time points: baseline (T0), 4 weeks post‐CL‐HA injection (T1), and 8 weeks post‐EBD treatment (T2). Subjective assessment was performed using the FACE‐Q | Aesthetics—Satisfaction with Skin scale. Objective assessment was independently conducted by a dermatologist utilizing three‐dimensional image analysis and skin diagnostic imaging with the Global Aesthetic Improvement Scale (GAIS).ResultsAll participants completed the study. Pairwise comparisons of the FACE‐Q skin satisfaction scores demonstrated statistically significant improvements at all time points: from T0 to T1 (p < 0.05), from T0 to T2 (p < 0.001), and from T1 to T2 (p < 0.001). Objective assessment with the GAIS showed improvement in all cases: very much improved (2 cases), much improved (9 cases), improved (7 cases), no change (0 cases), and worsened (0 cases). Regarding safety, no severe adverse events were reported, and only minor transient post‐treatment reactions were observed.ConclusionsThe combination of CL‐HA filler and EBD represents a safe and effective therapeutic approach for enhancing facial skin quality in Asian subjects.

The facial injuries occur more frequently among young male adult, resulting from varied etiology, such as automobile accidents and interpersonal violence. The lesions predominantly affect the frontal region or the facial subunits, reaching hemiface or the entire face, with various levels of severity. This study aims to report a case of severe facial tissues injury involving hemiface and ear avulsion, including the immediate emergency treatment with suture and flap rotation, collagenase use, complementary treatments such as the use of low intensity CO2 laser, hyaluronic acid and botulin toxin. The patient had a satisfactory evolution in a six-year follow-up. Thus, a well-planned treatment for facial restorations and an appropriated combined therapy may bring positive results.

The bite of spiders of the Loxosceles genus causes loxoscelism. It can occur in cutaneous-necrotic, cutaneous-visceral, or predominantly edematous cutaneous loxoscelism forms. This last form is a rare variant characterized by edema without necrosis with a frequency of 5% of all cases of loxoscelism. A 6-year-old girl presented edema in the eyelid that progressively increased and spread to the entire face. The relative reported that this event occurred after a spider bite. Physical examination revealed a bite-type lesion on the lower left eyelid, generalized edema throughout the face, and dysphonia. The tests showed elevated creatinine and bilirubin; the rest were normal. Initially, she received corticosteroids, antihistamines, and adrenaline. Due to the persistence of edema, we administrated anti-loxosceles serum and continued with corticosteroids and antibiotics. After 48 hours, edema decreased, and on the seventh day, it was almost entirely resolved, so the patient was discharged without complications. Predominantly edematous cutaneous loxoscelism is a rare variant. It can mimic other diseases like cellulitis or anaphylaxis in the emergency room. Supportive treatment is essential to avoid complications in children.

The non-ablative fractionated erbium glass laser (NAFL) 1540 nm combined with topical tranexamic acid (TXA) is a novel therapeutic approach for melasma. However, the efficacy and safety of this combination remain controversial. This study aims to evaluate the effectiveness and safety of NAFL combined with TXA in treating melasma. A randomized controlled trial with a split-face design was conducted on 27 participants with symmetric melasma. All participants applied 5% TXA topically twice daily to their entire face. One side of the face underwent three NAFL sessions combined with TXA at 4-week intervals, while the opposite side, treated with TXA alone, served as the control. Outcomes were assessed using the modified melasma area and severity index (m-MASI), physician global assessment (PGA), and participant satisfaction at the end of treatment, and at one and 3 months after the final laser session. Both facial sides showed significant m-MASI score improvement at the end of treatment (p < 0.001); however, a significant recurrence was noted in both groups during follow-up. The reduction in m-MASI scores was significantly greater for the NAFL plus TXA group than for TXA alone at the end of treatment (p = 0.029). However, no significant difference was observed between the groups at the 1- and 3-month follow-ups (p = 0.33 and 0.31, respectively). NAFL plus TXA led to significantly better PGA scores at Week 12 (p < 0.001), but this improvement was not sustained during follow-up (p = 0.06 and 0.07, respectively). Participant satisfaction was consistently higher in the NAFL plus TXA group (p = 0.001). The combination of NAFL and topical TXA provides significant short-term clinical benefits in treating melasma, likely by enhancing TXA penetration into target tissues and improving pigmentary clearance. However, its efficacy diminishes over time due to the inevitable recurrence of melasma, necessitating further investigation into long-term maintenance strategies.

Abstract We develop a novel approach to performing precision inference on tidally perturbed dwarf galaxies. We use a Bayesian inference framework of implicit likelihood inference, previously applied mainly in the field of cosmology, based on forward simulation, data compression, and likelihood emulation with neural density estimators. We consider the case of NGC 205, a satellite of M31. NGC 205 exhibits an S-shape in the mean line-of-sight velocity along its semimajor spatial axis, suggestive of tidal perturbation. We demonstrate that this velocity profile can be qualitatively reproduced even if NGC 205 was in a spherically symmetric and isotropic state before its most recent pericenter passage. We apply our inference method to mock data and show that the precise shape of a perturbed satellite’s sky-projected internal velocity field, mapped across its entire face, can be highly informative of both its orbit and total mass density profile, even in the absence of proper motion information. For NGC 205 specifically, our method is hampered because the available data only covers a line along its semimajor axis. This shortcoming could be addressed with another round of observations.

Skin ageing is a complex process influenced by various factors. Personal care products claim to address ageing signs, yet clinical efficacy tests lack standardised regulations. Niacinamide (NIA) is known for skin benefits, including managing hyperpigmentation and enhancing the barrier function. The 5 MHz unfocused ultrasound (5-US) is a technological intervention for cutaneous ageing, lacking sufficient literature. This study aimed to clinically assess a topical formulation with NIA, combined with facial application of unfocused 5-US. Sixty-seven female subjects (30-60 years) with signs of aged skin participated in the study. They were enrolled and randomised into four groups: (A) placebo formulation, (B) cosmetic formulation, (C) placebo formulation plus 5-US, and (D) cosmetic formulation plus 5-US. Groups C and D performed the aesthetic procedure of 5-US on the entire face, in a total time of 20 minutes per session, once per week (eight total sessions). Clinical, instrumental, and subjective assessments were performed before (T0) and during the eighth week (T8) of the study. The formulation with NIA improved stratum corneum aqueous content and reduced transepidermal water loss. Sebum reduction was observed in groups utilising the formulation. Consumer evaluations indicated improvements in appearance, firmness, elasticity, and reduced wrinkles, notably in Groups C and D. Sensory analysis indicated overall product acceptability. The formulation with NIA improved skin hydration and reduced sebum content in mature skin, while subjective evaluations indicated qualitative improvements in skin appearance. Although 5-US alone did not show instrumental improvements, protocol adjustments and longer study periods may yield better results. The comprehensive approach provides an innovative perspective into potential synergies, suggesting future directions for anti-ageing interventions in skin care. RBR-2zkkxr3.