Facial Side Research Articles

Normal Facial Function in the Sunnybrook Facial Grading System: Is the 100% Score too Restrictive?

The primary objective of this study was to describe the distribution of the Sunnybrook Facial Grading System scores in the general population. Secondary objectives included analyzing the effects of age, gender and facial side on these scores. Two speech therapists specializing in facial motor skill assessment evaluated the healthy participants using the Sunnybrook Facial Grading System, first with the right hemiface as a reference and then with the left hemiface as a reference. The study was conducted in our ENT department from September 2022 to June 2023. One hundred eleven healthy participants were included (57 women and 54 men), aged 18 to 79 years. SFGS composite scores (SFGS-Total) and sub-scores at rest (SFGS-Rest) and in movement (SFGS-Movement) were studied according to three age categories (18-39 years) (40-59 years) and (60-79 years) and gender. Inter-rater reliability was collected between the two evaluators with Cronbach's alpha. Taking the right hemiface as a reference, SFGS-Total scores ranged from 65% to 100% (median = 96, IQR [91-100]). When the left hemiface was considered as the reference, scores ranged from 78% to 100% (median = 95; IQR [90-100]). Right and left SFGS-Total scores showed high inter-rater reliability (respectively α = 0.953 and α = 0.926). There was a slight negative correlation between age and SFGS-Total scores. By embracing a more realistic approach that acknowledges natural variations and asymmetry in facial movements, we can enhance patient care and promote a more holistic understanding of facial rehabilitation outcomes.

Fractional Ablative Carbon Dioxide Laser versus Fractional Non-Ablative 1410 nm Diode Laser in the Treatment of Acne Scars: A Clinical and Immunohistochemical Study

Background: Effectively managing acne scars while minimizing consequences is still a challenging task. The primary determinant in selecting and continuing therapy for a specific device is stimulating collagen production and dermal remodeling with the fewest possible complications. Objective: To evaluate the clinical and immunohistochemical results of ablative fractional carbon dioxide (FCO2) laser versus fractional non-ablative diode laser for treating facial acne scars. Methods and Materials: Thirty patients with atrophic acne scars were included in a split-face comparative study. Right and left facial sides received three sessions of FCO2 and diode laser, respectively, at one-month intervals. One month after the third session, patients were evaluated using photographs, the Goodman and Baron qualitative and quantitative global scarring grading system, the investigator’s global assessment, and patient satisfaction. A sample was collected from the area that had been treated, and the tissue was examined using hematoxylin and eosin (H–E) staining and immunohistochemistry staining for collagen I. Results: Goodman and Baron global scores showed a statistically significant difference compared to baseline on both sides of the face. However, there was no statistically significant difference between the two treatment modalities. Biopsy specimens showed an increased deposition of collagen I by both laser devices, which was validated and described by immunohistochemistry staining. Conclusion: Both FCO2 and fractional non-ablative diode lasers proved their efficacy in treating different types of acne scars. For patients who are interested in no downtime and no complications, fractional non-ablative diode laser is recommended as an efficient alternative modality.

A randomized, controlled, split-face, double-blind comparison of a multimodality pigment-correcting serum containing lotus sprout extract versus hydroquinone for moderate to severe facial hyperpigmentation, including melasma, in a diverse population

BackgroundHyperpigmentation results in uneven skin tone, with darker skin types disproportionately affected. ObjectiveAssess efficacy and safety of a novel, hydroquinone (HQ)-free, multimodal pigment-correcting serum (ABT) versus 4% HQ in moderate to severe hyperpigmentation, including melasma. MethodsIn this split-face study, ABT and 4% HQ were applied topically on randomly assigned facial sides twice daily for 12 weeks. Hyperpigmentation, skin tone evenness, Modified Melasma Area and Severity Index (mMASI), Melasma Quality of Life Questionnaire (MelasQoL), self-assessment questionnaires, and tolerability were assessed. ResultsSubjects (n=113; melasma subgroup, n=44) were Asian (22%), Black/African American (27%), Hispanic (22%), and White/Caucasian (28%). ABT achieved comparable results to 4% HQ. ABT was well tolerated and resulted in improvement versus baseline at all visits in mean overall hyperpigmentation (−11.7% at week 12; p ≤ .001), skin tone evenness (−8.8%, p ≤ .005), and, in the melasma subgroup, mMASI (−50.6%; p ≤ .011) and MelasQoL scores (33.0 vs 46.6 for week 12 vs baseline, respectively; p ≤ .011), with similar results across racial subgroups. ABT was preferred over 4% HQ, with high satisfaction rate (≥89%). LimitationsQuality-of-life improvements per treatment were not evaluated separately. ConclusionEfficacy and safety of ABT is comparable to 4% HQ in individuals with facial hyperpigmentation, including melasma, across multiple racial/ethnic backgrounds.

Analysis of anatomical variations in the frontal and maxillary sinuses and their relevance in dentistry

Introduction: Paranasal sinuses can be defined as air-filled cavities lined with mucosa. Although there is a limited number of previous studies that have addressed the relationship between anatomical variations in these sinuses and dentistry, it is essential to emphasize the significance of morphofunctional knowledge of the maxillary sinus (MS) and frontal sinus (FS) for various dental specialties. Objectives: To investigate and analyze anatomical variations in selected paranasal sinuses (MS and FS) from the embryonic period to advanced age, and to correlate them with their diverse applications in dental practice. Methods: Electronic databases PubMed, Lilacs (via Bvsalud), and Scielo were consulted using the descriptors: "anatomical variation," "maxillary sinus," "frontal sinus," "dentistry," and their English counterparts. Initially, a total of 334 published articles were found, and after reading the abstracts and applying inclusion and exclusion criteria, 19 articles were analyzed. Results: The main morphological variations found included changes in dimension, number, characteristics of septations, and physiological pneumatization, which vary with age, sex, and facial sides. Among the dental implications, notable aspects include associated pathologies, techniques for maxillary sinus elevation in implantology, craniofacial profile relationships, connections with orthodontics and forensic dentistry, imaging techniques, and general surgical treatments. Conclusion: The literature reviewed suggests that the morphology of the sinuses analyzed directly influences dental practice, contributing to the improvement of clinical, forensic, surgical, and other procedures. However, studies involving the subject matter are still scarce, thus requiring further investigations.

A 595 nm pulsed dye laser as an adjuvant intervention for post-comedone extraction erythema and comedone reduction: A randomized, split-face controlled trial.

Comedone extraction provides greater satisfaction for acne treatment than conventional treatment alone; however, post-comedone extraction erythema (PCEE) remains a concern for patients. To evaluate the efficacy of pulsed-dye laser (PDL) in PCEE and comedone reduction. Mild-to-moderate acne patients were randomly allocated in split-face fashion. Three comedones were extracted on each facial side. On the PDL-treated side, 595-nm PDL was delivered to the entire side with an additional shot on three comedone-extracted sites. Erythema index (EI) and total acne lesion counts (TALC) were evaluated at baseline, week 2 and 4. The comprehensive acne severity scale (CASS) was assessed by three blinded independent pediatric dermatologists. Participant satisfaction surveys were completed at the end of the study. Thirty-five participants (age 12.9-24.2 years) showed no differences in the EI and TALC at baseline on both sides. At weeks 2 and 4, the EI on the PDL-treated side was significantly lower (p < 0.001) with a greater EI reduction (p < 0.001) when compared to the control side regardless of gender and menstruation. There was significantly lower TALC on the PDL-treated side at week 2 (p < 0.001) and week 4 (p = 0.02). No complications were noted with high participant satisfaction reported (median 8; IQR 7-9). PDL remained significantly associated with EI improvements after controlling for gender, menstruation cycle, and examination stress. PDL can be an adjunctive intervention for the treatment of PCEE and comedone reduction due to its effectiveness and high participant satisfaction.

Evaluation of nasolacrimal canal morphology in different facial skeletal relationships

BackgroundAbnormal morphological variations of nasolacrimal canal (NLC) and its lack of understanding contributes to acquired injuries during craniomaxillofacial surgical procedures which leads untoward postoperative complications like nasolacrimal obstruction (NLO) and epiphora. PurposeThe purpose of this study was to determine dimensional and volumetric morphological variations of nasolacrimal canal in various facial skeletal relationships which aid in performing a precise and safe surgery. Materials and methodsThis retrospective cohort study involved dimensional and volumetric analysis of nasolacrimal canal procured from computed tomography scans of 47 individuals grouped as ClassI, Class II and Class III, and unilateral cleft lip and palate (UCLP) groups. The outcome variables included length of NLC, volume of NLC, distance between the inferior orifice of the NLC to nasal floor, distance between inferior orifice of NLC to canine apex and distance between inferior orifice of NLC to central incisor apex. The objectives were to analyse morphological variation of NLC in different facial skeletal relationships and to evaluate the variation with change in facial sides and its relationship with surrounding structures. ResultsVolume of the NLC was found significant in Class I and UCLP population (p < 0.05) with the greatest volume in the UCLP group. The mean linear and volumetric measurements between the right and left sides were found insignificant among all groups. Inferior orifice of NLC from canine apex were farthest in Class III and nearest in the UCLP group (p < 0.05). There was no significant association between outcome variables and skeletal base configuration. ConclusionNLC demonstrates dimensional and anthropometric variations between different skeletal relationships and this study is inevitable in understanding the probability of NLC injury during maxillofacial surgeries.

Machine learning for distinguishing saudi children with and without autism via eye-tracking data

BackgroundDespite the prevalence of Autism Spectrum Disorder (ASD) globally, there’s a knowledge gap pertaining to autism in Arabic nations. Recognizing the need for validated biomarkers for ASD, our study leverages eye-tracking technology to understand gaze patterns associated with ASD, focusing on joint attention (JA) and atypical gaze patterns during face perception. While previous studies typically evaluate a single eye-tracking metric, our research combines multiple metrics to capture the multidimensional nature of autism, focusing on dwell times on eyes, left facial side, and joint attention.MethodsWe recorded data from 104 participants (41 neurotypical, mean age: 8.21 ± 4.12 years; 63 with ASD, mean age 8 ± 3.89 years). The data collection consisted of a series of visual stimuli of cartoon faces of humans and animals, presented to the participants in a controlled environment. During each stimulus, the eye movements of the participants were recorded and analyzed, extracting metrics such as time to first fixation and dwell time. We then used these data to train a number of machine learning classification algorithms, to determine if these biomarkers can be used to diagnose ASD.ResultsWe found no significant difference in eye-dwell time between autistic and control groups on human or animal eyes. However, autistic individuals focused less on the left side of both human and animal faces, indicating reduced left visual field (LVF) bias. They also showed slower response times and shorter dwell times on congruent objects during joint attention (JA) tasks, indicating diminished reflexive joint attention. No significant difference was found in time spent on incongruent objects during JA tasks. These results suggest potential eye-tracking biomarkers for autism. The best-performing algorithm was the random forest one, which achieved accuracy = 0.76 ± 0.08, precision = 0.78 ± 0.13, recall = 0.84 ± 0.07, and F1 = 0.80 ± 0.09.ConclusionsAlthough the autism group displayed notable differences in reflexive joint attention and left visual field bias, the dwell time on eyes was not significantly different. Nevertheless, the machine algorithm model trained on these data proved effective at diagnosing ASD, showing the potential of these biomarkers. Our study shows promising results and opens up potential for further exploration in this under-researched geographical context.

How to improve infraorbital hollows with neuromodulators-A clinical prospective interventional study about the application of facial biomechanics.

A previous injection algorithm termed the "Toxin Lift" was recently introduced and described volume increases in the midface following neuromodulator treatments of the jawline. Increase in midfacial volume due to soft tissue repositioning could also affect the severity of infraorbital hollows. The objective is therefore to evaluate whether the severity of infraorbital hollows can be improved by injecting neuromodulators in the supra-mandibular segment of the platysma. A total of 35 volunteers (11 males/24 females) with a mean age of 39.8 (9.6) years and a mean BMI of 25.2 (5.2) kg/m2 were investigated. Bilateral infraorbital regions were evaluated via clinical assessment and semi-quantitative 3D imaging. The applied injection technique targeted the platysma via four injection points administering 5 I.U. per injection point resulting in a total of 20 I.U. per facial side. Volume increase of the infraorbital region was 0.13 cc at 15 days (p = 0.001) and was 0.02 cc at 30 days (p = 0.452) whereas the skin displacement in cranial direction was 0.54 mm at 15 days (p < 0.001) and was 0.31 mm at 30 days (p < 0.001). Clinical evaluation revealed a highly statistically significant improvement of the tear trough, palpaebromalar groove, and of the lid-cheek junction when compared to baseline with all p < 0.001. The results of this clinical prospective interventional analysis revealed that the "Toxin Lift" injection technique is capable to improve the clinical appearance of infraorbital hollows. The effects can be explained by the concepts of facial biomechanics.

Assessment of the reproducibility and accuracy of the Visia® Complexion Analysis Camera System for objective skin analysis of facial wrinkles and skin age.

This study aimed to investigate the reproducibility and accuracy of the Visia® Complexion Analysis Camera System by Canfield Scientific for objective skin analysis. Nineteen participants underwent facial capture with the Visia® camera following a standardised protocol. During the first session, the participants sat down and positioned their faces in a capture rig, closed their eyes and had their faces captured from the left, front and right sides, with threefold repetition of the captures from the front side. After 4 weeks, the participants underwent recapture in a similar manner. Based on the frontal views, data for two measurement methods of the Visia® camera system, the absolute scores and the percentiles, were obtained with regard to the skin criterion wrinkles via automated software calculation. Means and standard deviations were evaluated. Based on the side views, the data for the Truskin Ages® were calculated by the Visia® camera system and compared with the calendrical ages, which served as the gold standard for comparison. In the assessment of the reproducibility of the data of the capture system the standard deviation from the frontal captures among all participants was about 3% when the absolute scores of the wrinkles were compared with each other; specifically, the average deviation was 3.36% during the first capture session and 3.4% during the second capture session. Meanwhile, the standard deviation of the measurements was about 9% when the percentiles were compared; specifically, the average deviation was 8.2% during the first capture session and 10.7% during the second capture session. In the assessment of the accuracy the correlation between the calendrical age and the calculated Truskin Age® for both facial sides was very high at a correlation coefficient rho value of >0.8 (right side: r=0.896; left side: r=0.827) and statistically significant at a p-value of <0.001. The average calendrical age and Truskin Age® deviated only slightly from each other and did not differ significantly (right side: p=0.174; left side: p=0.190). The Truskin Age® was slightly higher than the calendrical age by a mean value of 1.37 years for both facial sides. The analysis of the absolute differences revealed that in 50% of the cases, there was a maximum difference of 3 years, and in 75% of the cases, there were maximum differences of 4.5 years for the right side and 5.5 years for the left side. The assessment of the reproducibility and accuracy of the objective measurement method, the Visia® camera system, contributed to the validation of the system. The evaluation of the reproducibility revealed a satisfactory precision of the repeated captures when investigating facial wrinkles. Absolute scores should be preferred over percentiles owing to their better precision. The calculation of the accuracy of the Truskin Age® data from the Visia® camera system revealed only a slight deviation from the true calendrical ages. The correlation between both data groups was highly significant.

Investigating the effects of Argireline in a skin serum containing hyaluronic acids on skin surface wrinkles using the Visia® Complexion Analysis camera system for objective skin analysis.

To analyze the effects of Argireline on skin surface wrinkles using the Visia® camera system developed by Canfield Scientific Inc., U.S.A., for facial image capture. Nineteen female participants were recruited from a plastic surgery clinic. Initial facial images captured the left, front, and right sides of the participants' faces, which were documented as timepoint one. Following this, the participants immediately began to apply a facial skin serum containing triple hyaluronic acids produced by CNC cosmetic GmbH, Philippsburg, Germany. The serum was applied once in the morning and once in the evening. Participants received two identical containers labeled L for left and R for right, with each container to be used on the corresponding facial side, particularly around the eye area. One container contained Argireline, a synthetic hexapeptide, which previously was deemed to be a biosafe alternative to botulinum neurotoxin. The study was conducted as double-blind; neither the participants nor researchers knew which of the two containers contained Argireline. Participants were allowed to use their own cosmetic products throughout the study. After four weeks, the participants returned to have their faces recaptured using the Visia® camera, which was documented as timepoint two. The absolute scores of the wrinkles were noted, and results on both sides of the face were calculated and compared. The "TruSkinAge®" measurement provided by the Visia® camera was reviewed for each face side. Results between both time points and both sides of the face were compared. After the data analysis was complete, the company was contacted to determine which container contained Argireline. Nineteen participants returned for facial image capture. There were no significant adverse events, allergic reactions, or skin irritations. The investigation revealed that the wrinkle score slightly decreased for the right and left side of the face following four weeks of serum application. However, this decrease was not significant (p>0.05) based on the Wilcoxon matched pairs tests for the wrinkle scores (right side p=0.060 and left side p=0.176) and Truskin Ages® results (right side p=0.096 and left side p=0.489).Comparing the data from the right side with that from the left side of the face revealed that neither demonstrated a significant reduction in wrinkle score (p=0.829) or Truskin Ages® results (p=0.804). Argireline was included in the serum applied to the right side of the face. However, no statistical significance was seen in the results on this side of the face indicating any possible effects. Wrinkle scores and Truskin Ages® results were observed to decrease non-significantly following the application of a skin serum involving hyaluronic acid. The Visia® imaging method was used to analyze the data objectively. Differences between both sides of the face that were treated with and without Argireline were not statistically significant. Therefore, the effect of Argireline was not proven. While Argireline presented with low toxicity, its efficacy was found not to be significant. Therefore, it is not deemed to be an alternative treatment to botulinum toxin.

Comprehensive assessment of facial paralysis based on facial animation units.

Quantitative grading and classification of the severity of facial paralysis (FP) are important for selecting the treatment plan and detecting subtle improvement that cannot be detected clinically. To date, none of the available FP grading systems have gained widespread clinical acceptance. The work presented here describes the development and testing of a system for FP grading and assessment which is part of a comprehensive evaluation system for FP. The system is based on the Kinect v2 hardware and the accompanying software SDK 2.0 in extracting the real time facial landmarks and facial animation units (FAUs). The aim of this paper is to describe the development and testing of the FP assessment phase (first phase) of a larger comprehensive evaluation system of FP. The system includes two phases; FP assessment and FP classification. A dataset of 375 records from 13 unilateral FP patients was compiled for this study. The FP assessment includes three separate modules. One module is the symmetry assessment of both facial sides at rest and while performing five voluntary facial movements. Another module is responsible for recognizing the facial movements. The last module assesses the performance of each facial movement for both sides of the face depending on the involved FAUs. The study validates that the FAUs captured using the Kinect sensor can be processed and used to develop an effective tool for the automatic evaluation of FP. The developed FP grading system provides a detailed quantitative report and has significant advantages over the existing grading scales. It is fast, easy to use, user-independent, low cost, quantitative, and automated and hence it is suitable to be used as a clinical tool.

Third-Order Effects and Maxillary Incisor Control in Lingual Orthodontics – A Finite Element Study of a Ribbon Arch and Edgewise Straight Wire System

Introduction: The aim of the present study was to analyze the effects of retraction mechanics on torque control when retraction forces were applied on the maxillary anterior dentition in two distinct lingual appliance systems. Materials and Methods: A three-dimensional bilateral maxillary model was created where the first premolar extraction case was included. 150 g (1.47 N) of retraction force was applied on each side from canine (C) hook to molar for both edgewise straight wire system and ribbonarch appliances. Results: In the edgewise appliance, it was observed in the X-axis that there was less amount of tipping of the six anterior teeth of the canine and central incisor (CI) when compared with the lateral incisor (LI) at occlusal point. In the Y-axis, overall extrusion was observed. In the Z-axis, there was less lingual crown movement. In the ribbonarch appliance, it was observed in the X-axis that there was less tipping, prominently in the canine and CI than in the LI. In the Y-axis, overall extrusion was observed. In the Z-axis, there was less lingual crown movement, whereas the CI and canine showed less movement when compared with the LI. Conclusions: It was observed that there was greater torque loss and extrusion in the edgewise appliance along with greater maximum principal stress in the cervical half of the facial side in the periodontal ligament (PDL) and minimum principal stress on the cervical half of the palatal side in the PDL when compared with the ribbonarch appliance.

Simultaneous Reconstruction of a Subtotal Maxillectomy and Columella Deficit using Radial Forearm and Preauricular Free Flaps

Reconstruction of subtotal maxillectomy defects with columella deficit is challenging. We report a unique case of facial reconstruction using a free radial forearm flap and a free preauricular flap for the maxillectomy and columella deficit. A 73-year-old woman was diagnosed with recurrent sebaceous carcinoma of the nose. We performed wide excision, including areas of the right cheek, nose, upper lip, maxilla, and columella. The resultant subtotal maxillectomy defect was reconstructed using a three-dimensional flap. First, a free radial forearm flap was transfered to resurface the nasal, oral, and external facial side. Second, a preauricular flap was positioned into the columella defect and anastomosed with the distal portion of the radial forearm flap pedicle. The two flaps survived, and the patient recovered uneventfully. We believe the radial forearm and preauricular double free flaps with the pedicle connection method were effective in reconstructing the present case of subtotal maxillectomy defect.

Effectiveness of a Radiofrequency Device for Rejuvenation of Aged Skin at Home: A Randomized Split-Face Clinical Trial.

IntroductionSeveral techniques, including the use of radiofrequency (RF) devices, are currently utilized for the treatment of skin aging. This study aimed to evaluate the anti-aging effects imparted by a home-based RF beauty device and to compare these results with those of a marketed anti-aging cosmetic in vivo.MethodsThirty-three women aged 35–60 years were enrolled in this randomized, controlled, split-face trial. This study involved a 12-week trial with five repeated measurements (at baseline, 2, 4, 8 and 12 weeks). One side of the face was randomly selected to be part of the experimental group and treated with the RF beauty device, while the other side was considered as control and was treated with an anti-aging cosmetic. Treatment safety was evaluated. Skin wrinkles, hydration, radiance, elasticity, color and thickness were evaluated using noninvasive equipment.ResultsThirty-two participants completed the study; one withdrew for personal reasons. Compared with the anti-aging cosmetic-treated facial side, the experimental side showed statistically significant improvements in wrinkles, skin radiance, color and thickness (p < 0.05).ConclusionsThe home-based RF beauty device was safe and effective for rejuvenation. The device was more effective than the commercially available anti-aging cosmetics.

The Importance of Physical Therapy in the Treatment of Unilateral Congenital Bell Paralysis – A Case Report

Abstract Peripheral paralysis of facial nerve in the newly-born can be congenital and developed. In clinical sense, paralysis of facial nerve is characterised by paralysis of mimic face muscles that are controlled by a facial nerve. A female newly-born, delivered by caesarean section was clinically diagnosed weakness on the right side of the face. Thirteen days after the birth the newly-born was examined by a physiatrist for the first time due to the weakness of the right facial side. During the first year of life a severe congenital lesion of facial nerve was diagnosed. Rehabilitation treatments were administered during the first year of life, with partial clinical improvement. The seriousness of facial nerve lesion hasa significant influence on the degree of recovery. It is very important to identify the type of lesion by using efficient technology, since it is the only way to provide early and adequate therapy

Combined Protocol for Restoration and Repositioning of Natural Volumes of the Face in a Patient with Peripheral Hemiparesis of Right Facial Side

Combined Protocol for Restoration and Repositioning of Natural Volumes of the Face in a Patient with Peripheral Hemiparesis of Right Facial Side

PERIODONTAL APPROACH TO GINGIVITIS IN PATIENTS’ FIXED ORTHODONTICS APPLIANCES (PENDEKATAN PERIODONTAL UNTUK GINGIVITIS PADA PASIEN DENGAN PESAWAT ORTODONTI CEKAT)

Comprehensive care of a patient from multidisciplinary periodontics and orthodontic is found in gingivitis cases with patients that use fixed orthodontics appliances. Periodontal pathogenic bacteria were initiated to dental plaque formation, followed by predisposing factors such as fixed orthodontic appliance, orthodontic movement, and bad oral hygiene. This case report describes a female patient (23 years old) who needs treatment at the anterior mandibular region. Clinical examination explained crowding anterior 32, 31, 41, 42 and applied bracket on each tooth. Pocket depth on the facial side was average 6-5 mm, accompanied by bleeding on probing. Periodontal approach for gingivitis used gingivectomy and gingivoplasty with blade number 15c to eliminate gingival pocket on crowding teeth at anterior mandibular region. Evaluation results in one week and one month after surgery showed healthy gingiva with an average probing depth of 3mm. Gingivectomy is a periodontal approach for gingivitis in patients with fixed orthodontics appliances that could create healthy gingiva and follow excellent oral hygiene instructions.

Effectiveness of an epidermal growth factor-containing cream on postinflammatory hyperpigmentation after 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser treatment of acquired bilateral nevus of Ota-like macules (Hori's nevus) in Asians: A split-face, double-blinded, randomized controlled study.

Epidermal growth factor (EGF) may promote wound healing and decrease laser-induced postinflammatory hyperpigmentation (PIH). To evaluate the effectiveness of an EGF-containing cream on PIH, post-laser erythema, and transepidermal water loss (TEWL) after 1,064-nm Q-Switched Nd: YAG laser treatment of Hori's nevus. This is a split-face, double-blinded, randomized, controlled study conducted in 30subjects with bilateral Hori's nevus. After laser treatment, participants were randomized to apply EGF cream on one facial side and placebo on the other side for 8weeks. The incidence and intensity of PIH were assessed by photographs and melanin indexes (MIs) ratio at baseline, Week 2, Week 4, and Week 8. Post-laser erythema and TEWL were measured at baseline, Day 1, Day 3, and Day 7. Side effects and patient satisfaction score were evaluated. The incidence of PIH was 26.7% in EGF group compared to 20% in placebo. The intensity of PIH was 0.057 (0.033-0.086) and 0.045 (0.027-0.076) in EGF and placebo group, respectively. There was no significant difference in both incidence (p=0.5) and intensity of PIH (p=0.145). Post-laser erythema was not statistically different between groups. EGF could alleviate TEWL better than placebo but without statistical significance. Patient satisfaction score was significantly higher in EGF group compared to placebo (p<0.001). The EGF-containing cream could not prevent PIH. It may reduce laser-induced skin barrier damage. Future studies in more subjects are needed.

A Prospective, Randomised, Controlled, Split-Face Clinical Trial to Assess the Safety and the Efficacy of Cold Atmospheric Plasma in the Treatment of Acne Vulgaris

The increase in antibiotic resistance requires effective non-antibiotic therapies for acne. Cold atmospheric plasma (CAP) inactivates bacteria and improves wound healing, but its effect on acne has not been investigated. The objective of this controlled split-face study was to assess safety and efficacy of CAP in moderate acne. One side of the face received 8–10 treatments with cold helium plasma within 4–6 weeks; follow-up was two and four weeks thereafter. Acne lesions were counted, followed by global acne severity ratings. Of the 34 patients included, 29 completed the study. No serious adverse events occurred. The two facial sides did not significantly differ in the number of inflammatory and non-inflammatory lesions. An interaction effect of number and type of treatment was found for inflammatory lesions. Lesion reduction after 10 treatments was significantly higher on the treated than on the untreated side. Percentage of patients reporting improved aesthetics was higher for the treated than for the untreated side after treatment completion (79% vs. 45%) and at the two- (72% vs. 45%) and four-week follow-up (79% vs. 52%). In conclusion, CAP was safe with excellent tolerability, showed moderate reduction in acne lesions and led to higher patient-based ratings of aesthetics than non-treatment.

Parry Romberg Syndrome with contralateral iridocorneal endothelial syndrome: a unique case

Parry-Romberg syndrome (PRS) is a rare disorder which causes progressive hemifacial atrophy, with ocular manifestations like hypotony, enophthalmos and corneal edema on the ipsilateral atrophic side. This is a report of a unique case of PRS with contalateral manifestations like ectropion uvea, correctopia and endothelial deposits, along with polymegathism and pleomorphism seen on specular microscopy suggestive of Iridocorneal Endothelial (ICE) Syndrome. ICE syndrome and PRS have not been reported together in any literature so far. This case highlights the importance of a thorough glaucoma workup and corneal examination on the atrophic facial side as well as on the apparently normal side in all cases of PRS.