Dermatologic Procedures Research Articles

Investigating visual preferences of clinical mechanical anesthetic vibration: a cross-sectional image survey.

While mechanical vibration lessens discomfort associated with injection site pain (ISP), many local anesthetic injectors (LAIs) do not use vibratory anesthetic devices (VADs). Injector preference of vibration device is influenced by functional concerns, but qualitatively there is an element of adoption that is driven by visual feedback. We sought to capture operator preferences of vibration device design elements to further understand why injectors do not use these devices. We conducted a survey of image preferences among nurses and medical assistants employed at 8 dermatological clinics to investigate barriers to VAD use. Images were electronically modified with features distinct from the original device (a VAD commonly used in clinical practice). Participants rated their likelihood and comfort of use of each VAD represented in the images. Two-sample t-tests were used to compare the rating of the unmodified VAD to each modified VAD within participants. A response rate of 100% was achieved with 35 participants (average age, 38.5 years; 6 (17.1%) male, 29 (82.9%) female). Despite 28 (80%) participants knowing that mechanical vibration reduces ISP, only 16 (45.7%) endorsed ever using mechanical vibration as topical anesthetic. Images modified by pattern, color, and sterility covering were rated significantly lower than the original, unmodified VAD image (plain white VAD), confirming that visual feedback does impact adoption. Through independent comment categorization, aesthetics were found to be important to LAIs. Aesthetic preferences opposing functional concerns may factor into the lack of VAD use. Defining these visual preference barriers to adoption may help promote VAD use during dermatologic procedures.

Changing Dermatologic Procedural Patterns in the Medicare Population: A National Trend Analysis.

Dermatologists are trained in diagnostic and therapeutic procedures for cutaneous lesions, yet comparative trends for basic dermatologic procedures across dermatology providers are lacking at the national level. To trend common dermatologic procedures among general dermatologists, Mohs surgeons, primary care providers or primary care physicians (PCPs), and nonphysician clinicians (NPCs). Longitudinal analysis of 2016 to 2021 Medicare Public Use Files. Aggregate dermatologic procedural volume decreased 3.0%. Procedural volume declined among general dermatologists (-11.7%), Mohs surgeons (-16.7%), and PCPs (-41.7%) but increased among NPCs (+57.5%). The proportion of procedures by general dermatologists decreased substantially for premalignant destructions (-6.2%), skin biopsies and shave removals (-4.7%), and malignant excisions (-4.1%) and more notably in counties that were nonmetro (-7.1%), low in income (-6.1%), and with <4.0 dermatologists per 100,000 population (-7.0%). Aggregate procedural volume decreased across the study period with general dermatologists, Mohs surgeons, and PCPs performing a progressively smaller proportion. The increase in procedures by NPCs may help to address demand but underscores the value of formalized procedural training. The procedural decline by general dermatologists in rural and low-income counties and those with baseline dermatologist shortages may exacerbate existing unmet need. Primary limitation included lack of commercial data.

Facial Rejuvenation: A Global Trend of Dermatological Procedures in the Last Decade.

We aimed to track the global trend of cosmetic treatment outcomes for facial rejuvenation and the differences in modalities used in East Asian and Western populations. Articles reporting on facial rejuvenation procedures (invasive/noninvasive) were identified in PubMed from 2013 to March 2023 and bibliometrically analyzed for type of published document, citation frequency, authors with most articles, author's affiliation, and frequency distribution of keywords. From 553 articles, most were published in 2021 (n = 86, 15.6%). Western countries (n = 323, 58.4%) contributed more than East Asian (n = 230, 41.6%), with more invasive interventions (n = 355, 64.2%) than noninvasive techniques (n = 198, 35.8%). Numbers of invasive techniques in West versus East Asian countries were 225 (40.7%) versus 135 (24.4%). Main indications were the reduction of facial wrinkles and antiageing treatments. Hyaluronic acid, fillers, and botulinum toxin were the main hotspots for invasive treatments, whereas laser, platelet-rich plasma, and radiofrequency were for noninvasive treatments. Nasolabial folds (13.4%) and glabellar lines (12.4%) were the top research hotspots in the East Asian and Western regions. Common adverse events were pain, erythema, swelling, and bruising. Approximately, 89.3% of publications were from single countries, whereas 10.7% of publications were from international collaborations. Most articles (n = 387; 69.95%) presented their findings using level II evidence. Dermatological surgery (IF = 2.914) had the greatest number of publications (n = 109; 19.71%). The main hotspots were antiaging and youthfulness. This study provides a trend and a new perspective on the future research directions in the field of facial rejuvenation.

Management of edoxaban therapy in patients undergoing emergency/urgent procedures: a subanalysis of the global, prospective, observational, multinational EMIT-AF/VTE programme

Abstract Background Physicians are often unable to follow recommendations for preprocedural oral anticoagulant interruption before emergency/urgent (unplanned) procedures, which may lead to a higher incidence of adverse outcomes in these patients compared with those who undergo planned procedures. The Global EMIT-AF/VTE programme found low bleeding and thromboembolic event rates for patients receiving edoxaban who underwent diagnostic or therapeutic procedures. However, edoxaban management and clinical outcomes may differ among the subgroup of patients with emergency/urgent procedures. Purpose To describe periprocedural edoxaban management and clinical outcomes for patients in the EMIT-AF/VTE programme who underwent emergency/urgent procedures. Methods In this subanalysis, only physician-reported unplanned (emergency/urgent) procedures were included, of which dental and dermatological procedures were excluded. Only a patient’s first emergency procedure was included, with the exception of 3 patients having 2 procedures on the same day (in these cases the 2 procedures were combined). Procedure bleeding risk was classified according to EHRA criteria, and baseline characteristics and edoxaban interruption data were collected. Clinical event and procedure dates were compared to determine whether they were related. Results Among 156 patients undergoing emergency/urgent procedures, the mean ± standard deviation age at baseline was 74.5 ± 8.7 years, and the CHA2DS2-VASc score was 3.8 ± 1.6. Medical histories of hypertension and dyslipidaemia were reported in 84.0% and 40.4% of patients, respectively; approximately one-quarter of patients had diabetes mellitus (26.9%) or creatinine clearance ≤50 mL/min (24.4%). The most common procedure types were vascular access and transcatheter diagnostics/interventions (34.6%) and gastroenterological procedures (27.6%). Procedures were more often EHRA-classified as minor (35.9%) or low (35.3%) vs high risk (20.5%). Preprocedure edoxaban interruption rates ranged from 39.3%–50.9% across risk groups, with more than half of the procedures being performed with edoxaban interruption (53%–66%; Figure). By 20 days postprocedure, edoxaban therapy was resumed in approximately 86% and 88% of patients with minor- or low-risk procedures vs 70% with high-risk procedures. Overall, 33 clinical events were recorded, of which 18 (54.5%) preceded a procedure (Table). Five bleeding events and one thrombotic event occurred after and were caused by the procedure. Conclusions Edoxaban resumption was protracted after high- vs minor- or low-risk procedures. Bleeding and thrombotic events resulting from a procedure occurred in &amp;lt;4% of patients, indicating that postprocedure edoxaban therapy can be effectively tailored to optimise clinical outcomes.FigureTable

The Biological Role of Platelet Derivatives in Regenerative Aesthetics.

Bioproducts derived from platelets have been extensively used across various medical fields, with a recent notable surge in their application in dermatology and aesthetic procedures. These products, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), play crucial roles in inducing blood vessel proliferation through growth factors derived from peripheral blood. PRP and PRF, in particular, facilitate fibrin polymerization, creating a robust structure that serves as a reservoir for numerous growth factors. These factors contribute to tissue regeneration by promoting cell proliferation, differentiation, and migration and collagen/elastin production. Aesthetic medicine harnesses these effects for diverse purposes, including hair restoration, scar treatment, striae management, and wound healing. Furthermore, these biological products can act as adjuvants with other treatment modalities, such as laser therapy, radiofrequency, and microneedling. This review synthesizes the existing evidence, offering insights into the applications and benefits of biological products in aesthetic medicine.

An Over-the-Counter Healing Ointment: Benefits in Dry Skin and Wound Healing.

The use of ointments can be beneficial for dry, chapped, or cracked skin and also for supporting wound healing. We describe the results of 2 studies with an over-the-counter healing ointment (HO) to evaluate the effects on skin hydration and in the setting of wound healing after dermatologic procedures.&nbsp; Methods: Study 1 was a single-center, in-use study using HO on qualified areas at least once daily for 4 weeks in subjects with dry, cracked body skin and self-perceived sensitive skin. Study 2 was a multi-center study of wound healing in subjects using HO on a daily basis after having dermatologic surgical procedures.&nbsp; Results: In Study 1, there was a significant reduction in skin dryness after 1 and 4 weeks of HO use (P&lt;0.05). Image analysis of the skin revealed a significant increase in skin smoothness after the first application of HO in 100% of subjects (P&lt;0.05). Tolerability and safety were excellent, and HO was well-perceived by subjects throughout the study. In Study 2, HO improved clinical assessments at all time points compared with baseline with a decrease in erythema, edema, scabbing/crusting, and an improvement in overall wound appearance (P&lt;0.05). There was no worsening or significant increase in measures for tolerability parameters at any study visits. Additionally, HO achieved a favorable perception by study subjects.&nbsp; Conclusions: HO has a well-established safety profile and has been shown to improve both skin hydration and the overall wound healing process after dermatologic surgical procedures. J Drugs Dermatol. 2024;23(5):360-365. doi:10.36849/JDD.8224.

The Use of Virtual Reality to Reduce Anxiety and Pain in Pediatric Dermatologic Outpatient Procedures

The Use of Virtual Reality to Reduce Anxiety and Pain in Pediatric Dermatologic Outpatient Procedures

A Practical Algorithm for Integrating Skincare to Improve Patient Outcomes and Satisfaction With Energy-Based Dermatologic Procedures.

Medical aesthetic procedures for facial antiaging with laser and energy-based devices (EBDs) are rapidly increasing, but standards integrating skincare before, during, and after these treatments are lacking. The algorithm for integrated skin care for facial antiaging treatment with EBDs aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes. A panel of 8 global physicians employed a modified Delphi method and reached a consensus on the algorithm integrating skincare based on the best available evidence, the panel's clinical experience, and opinions. The algorithm has a pretreatment (starts 2 - 4 weeks before the procedure) and treatment (day of treatment) section, followed by care after the procedure (0 - 7 days) and follow-up care (1 - 4 weeks after the procedure or ongoing). Applying a broad-spectrum sunscreen with an SPF 50 or higher, combined with protective measures such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with skin of color (SOC). Clinicians may recommend skincare using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition. Medical aesthetic procedures for facial antiaging with EBDs integrating skincare or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone.&nbsp; J Drugs Dermatol. 2024;23(5):353-359.&nbsp; &nbsp;&nbsp; doi:10.36849/JDD.8092.

The influence of social media on public attitudes and behaviors towards cosmetic dermatologic procedures and skin care practices: A study in Saudi Arabia.

Social media has fostered a landscape where trends, ideals, and beauty standards have significantly proliferated. Images of flawless skin, sculpted features, and curated aesthetics inundate user feeds, potentially shaping their self-perceptions and aspirations. The rise of influencers, dermatologist social media engagement, and beauty campaigns sharing skincare routines and product recommendations wield substantial influence over individual appearance-related decisions. The main aim of this study is to determine the pattern of behavior in using social media to seek dermatological procedures and skin care routine. We conducted a nationwide, online cross-sectional study targeting the general Saudi population. Our survey aimed to understand participant social media behaviors and gather insights into skincare products, cosmetic procedures, and makeup habits. Gender-related differences emerged in seeking skincare advice. Females preferred dermatologists on social media (p < 0.001) and beauty influencers (p < 0.001), whereas men leaned towards pharmacists (p < 0.001). Women displayed stronger engagement with dermatologist social media reputation regarding non-cosmetic concerns (p < 0.001), education (p < 0.001), and social media impact on cosmetic decisions (p = 0.001). They frequently sought dermatologists on social media before appointments (p = 0.001), whereas men emphasized dermatologists' fame (p = 0.024). Common cosmetic barriers included high costs (62.5%), complications (40.3%), and trust issues (40.2%). Women underwent various cosmetic procedures (p < 0.05), influenced by social media in their decisions and skincare routines. Our study reveals significant gender-based disparities in seeking skincare advice. Women rely on social media, clinics, friends, and beauty influencers, whereas men prefer pharmacists. Additionally, women depend on dermatologists' social media reputation and conduct thorough pre-appointment research. Their heightened social media engagement links to skincare practices and influences cosmetic procedure considerations based on age and usage frequency.

Analysis of Pediatric Procedural Dermatology at a Tertiary Care Referral Hospital in Eastern India

Background: Pediatric procedural dermatology is a broad and emerging aspect in the field of dermatology. Pediatric procedures require great expertise, skill, empathy, and confidence on the part of the treating physician. The challenging factors such as parental anxiety and doubts, the child’s cooperation, and the risks versus benefits are further contributory. Objective: The objective of the study was to summarize the risks of intra- and postoperative complications/side effects during diagnostic and therapeutic procedure in the pediatric population. Materials and Methods: We conducted a retrospective study in our hospital. Patients were taken between ages 0 and 18 years who had attended the dermatology outpatient department from January 2019 to March 2022. Results: In a total of 527 outpatient department patients, 267 (50.66%) were males and 260 (49.33%) were females (male:female ratio 1.02:1). Out of diagnostic procedures, the most commonly performed procedures were punch biopsy (14.61%), followed by autologous serum skin test (11.81%) and slit-skin smear (1.90%). Out of 15 therapeutic procedures, intralesional steroids (21.34%) were the most frequently performed therapeutic procedure, followed by radiofrequency cauterization (16.51%), autologous skin therapy (6.98%), cryotherapy (8.76%), nail surgery (2.79%), chemical peeling (2.79%), comedone extraction (2.66%), chemical cauterization (2.54%), neodymium-doped yttrium aluminum garnet laser (2.16%), platelet-rich plasma therapy (1.39%), diode laser (1.27%), measles, mumps, and rubella vaccine injection (0.89%), fractional carbon dioxide laser (0.63%), suction blister epidermal grafting (0.63%), and platelet-rich fibrin therapy (0.25%). Conclusions: This study provided comprehensive data on the various dermatological procedures done for pediatric cases in a tertiary care teaching hospital. Both diagnostic and therapeutic procedures caused mild and transient side effects such as pain, edema, erythema, burning sensations, and irritation that did not affect the patient’s lifestyle.

Sedation of Pediatric Patients during Dermatosurgery

Executing dermatosurgical procedures can be a challenging task in the pediatric population due to their hyperreactive and hypermobile behavioral responses to discomfort posed by these procedures. Thus, most of the dermatological procedures are to be performed in minimal or moderate (conscious) sedation. The objective of this review is to compare the different sedative drugs used in pediatric patients to achieve cooperation during a standard dermatological procedure. Other traditional methods of ensuring compliance by feeding and distracting the patient will be discussed briefly to help or add on to current knowledge in sedation of children during dermatosurgery. While sedatives can be effective in managing anxiety and pain in pediatric dermatosurgery, their use should be carefully considered given the potential adverse effects and risks involved in indiscriminate use and the decision to use sedatives should be individually tailored, considering factors such as the child’s age, medical history, and the nature of procedure being performed.

A Practical Algorithm Integrating Skin Care With Nonenergy and Injectable Dermatologic Procedures to Improve Patient Outcomes and Satisfaction.

The most rapidly increasing medical aesthetic procedures for facial antiaging comprise nonenergy and injectable treatments. Currently, standards for skin care before, during, and after nonenergy and injectable treatments are lacking. The algorithm on supportive skin care for facial antiaging nonenergy and injectable treatments aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes.&nbsp; Methods: A panel of 7 global physicians employed a modified Delphi method and reached a consensus on an algorithm for supportive skin care for nonenergy and injectable antiaging treatments based on the best available evidence and the panel members&rsquo; clinical experiences and opinions. The algorithm has a pretreatment (starts 2 &ndash; 4 weeks before the procedure) and treatment or ongoing (day of treatment) section, followed by care after the procedure (0 &ndash; 7 days) and follow-up care (1 &ndash; 4 weeks after the procedure). Applying a broad-spectrum sunscreen with an SPF 30 or higher, combined with protective measures, such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with richly pigmented skin. Clinicians may recommend skin care using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients, such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition. Nonenergy and injectable procedures combined with skin care or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone.&nbsp; &nbsp; J Drugs Dermatol. 2024;23(4):&nbsp; &nbsp; &nbsp;doi:10.36849/JDD.7918.

The Origins and Development of Pre-emptive Dermatologic Anesthesia: A Systematic Review.

This study delves into the historical trajectory of dermatological anesthesia, tracing its roots from ancient civilizations to modern times. It emphasizes the relentless pursuit of pain relief in dermatologic procedures and the transformative impact of anesthesia on surgical practices. A comprehensive analysis was conducted through an extensive literature review, employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review model on the PubMed and Embase databases. A total of 1304 articles were initially identified, with six publications from these databases and 10 additional sources from the World Wide Web included in the study. This systematic approach allowed for a thorough examination of the historical journey of dermatological anesthesia.The historical trajectory outlined in this study highlights the progress in dermatological anesthesia, showcasing its impact on contemporary procedures with a continual emphasis on patient comfort and safety. As medical knowledge expands, the ongoing quest for enhanced pain control in dermatology remains a central focus.

Topical anaesthesia for invasive procedures in dermatology and cosmetology

Currently, in dermatology and cosmetology, the range of cosmetic procedures and minor invasive interventions, which use local anesthetics, is expanding. They are used alone or as part of an integrated anesthetic approach. Procedures such as mesotherapy, biorevitalization, contour plastic surgery, removal of skin tumors, and laser procedures require anesthesia in the form of local topical anesthesia. Local anesthetics have long been known and well-studied; they have many advantages, significantly increasing patient comfort during invasive procedures, but they also have some disadvantages, including the risk of toxicity. The purpose of using a local anesthetic is to increase the effectiveness of the procedure, convenience and comfort for the patient, minimize negative emotions associated with pain, and the ability to achieve local anesthesia without anatomical distortion of the tissue (i.e., without the use of infiltration anesthesia). Often, the severity of the pain experienced depends on the individual response of the patient. The characteristics of pain are subjective and can vary depending on the “pain threshold”, type of temperament, and previous negative experience. For some patients, sometimes minimal pain becomes a serious obstacle to performing a particular procedure. Some invasive, painful procedures that are performed on pediatric patients require a particularly careful approach to the choice of anesthesia drug and method of administration. In this article, we analyzed the mechanisms of pain pathogenesis, methods of local anesthesia, focused on the role of local anesthetics in cosmetology and dermatology, examined the features of using a cream for local and external use containing a combination of lidocaine 2.5% and prilocaine 2.5%, its therapeutic effectiveness, clinical recommendations for use in various procedures in dermatology and cosmetology. When choosing a drug for local anesthesia, safety is important for the doctor, when used correctly, a low level of side effects, timely pain relief, effectiveness, ease of use and accessibility.

Auto-Occlusive Lidocaine 7% and Tetracaine 7% Cream has Greater Pain Reduction Effects in Comparison with Lidocaine 4% Cream during Laser CO2 Dermabrasion Procedure in Preparation of Non-Cultured Autologous Epidermal Cell Grafting for Repigmentation in Vitiligo Subjects. An Intrasubject Pilot Evaluation Study

Introduction: Autologous non-cultured epidermal cell graft is a complex but promising technique in the treatment of vitiligo. Affected vitiligo areas should be de-epithelialized using an ablative Laser CO2 prior healthy epidermal cell inoculation. The dermabrasion (DA) procedure could be painful for the patient. To reduce the discomfort of this step topical anaesthesia is very often required. Topical anaesthetics available differ for composition, concentration of active anaesthetic molecules and methods of application (occlusion or not). An auto occlusive film-forming cream containing Lidocaine 7% and Tetracaine 7% (Pl-C) has shown in previous trials to be very effective in reducing discomfort during dermatological painful procedures like phototherapy, laser-conducted tattoo removal and laser resurfacing for skin ageing. Study Aim: To compare the clinical efficacy of Pl-C with Lidocaine 4% cream (As-C) in reducing the pain during Laser DA procedures in vitiligo subjects in preparation of autologous non-cultured epidermal transplantation. Subjects and Methods: We performed a prospective intra-subject randomized cases series in 7 subjects (4 men and 3 women) with segmental vitiligo with symmetrical lesions suitable for autologous non-cultured epidermal transplantation. Before the DA procedures the Pl-C or As-C were applied in a randomized fashion over the vitiligo areas to be treated. Pl-C was applied for 20 min without occlusion. The product was removed before the Laser procedure. As-C cream was applied for 30 min with occlusive band and then removed before the procedure. The treated skin regions had a mean area of 72±50 cm2; (range: 10 to 150 cm2). The primary outcome was the 100-mm Visual Analogue Scale (VAS) for patient-assessed pain evaluation with 0 mm value means no pain at all and 100 mm representing the worst possible pain. Results: Just after the Laser CO2 DA procedure the VAS score in PL-C area was 32±7 mm and 58±8 mm in As-C treated areas. This difference (-25±4 mm; 95% CI: from -16 to -35 mm) was highly statistically significant (p=0.0001) and clinically relevant (higher than the minimum clinically significant difference). Conclusion: The Lidocaine 7% and Tetracaine 7% auto occlusive cream is more effective than lidocaine 4% cream in reducing the pain associated with Laser CO2 DA procedures in preparation of skin autologous transplantation in vitiligo subjects.

“The hidden hues”- An analysis of public perspectives regarding intimate area depigmentation and its dynamic relationship with dermatological procedures

Objectives: The art of esthetic dermatology has reached its pinnacles in this generation providing treatments for almost all skin concerns. Throughout history a myriad of issues have risen, and one that is common to everyone is the pigmentation of their intimate areas. Many people, particularly women, lament that their dark underarm makes it impossible for them to wear their favorite sleeveless dress or that they must deal with their partner’s embarrassment due to this issue. Even though cosmetics have advanced and we now have answers for every issue, people are still hesitant to undergo these treatments, even though they want to get rid of these pigmentations. This study has multiple goals, it aims to determine the reasons behind people’s reluctance to undergo depigmentation procedures in intimate areas, the extent to which dermatology has advanced in society, and whether skincare is still taboo. Material and Methods: Using an online survey through Google Forms, we conducted a cross-sectional study dated from May 21, 2023, to July 05, 2023, collecting data from 112 people living in Tbilisi, Georgia. Most of the participants were in the 18–35 age range. Participants responded to 17 questions about their overall skincare routines, the amount of time and effort they put into skincare, and their thoughts on the depigmentation process in private areas. Results: From a total of 112 participants, 69.6% (n = 78) were female, and 30.4% (n = 34) were male, with the majority of participants from age group 18 to 24 [83% (n = 93)], followed by people who are 25–30 [16.1% (n = 18)], and 2% from age 31 to 40 [0.9% (n = 1)]. In that, 62.5% (n = 70) of the population was interested in receiving treatment, but they were hesitant for a variety of reasons where 47.3% (n = 53) reasoned the high cost. About 8.9% (n = 10) were also reluctant to expose their intimate areas during procedures. About 8.9% (n = 10) of people think that they are intrusive and refuse to have them done. About 2.7% (n = 3) refuse to get the treatment due to opposition from spouses and family. Varying opinions about skincare approaches were also recorded where 33% (n = 37) stated that they have never been to a dermatologist since they have not experienced any skin problems whereas 21.4% (n = 24) use homemade skin care products, whose efficacies are debatable. Conclusion: Our investigation emphasizes the blending of medical and cosmetic components of dermatology by demonstrating positive responses regarding depigmentation and dermatologic procedures. A greater demand for solutions to skin pigmentation problems in sensitive areas of the body is reflected in the growing popularity of intimate area depigmentation. Nonetheless, the choice to receive these treatments is kept private and is shaped by cultural conventions, society expectations, and individual preferences. Some desire depigmentation for greater comfort and confidence while others value natural beauty and self-acceptance. The two biggest obstacles to involvement are lack of information and financial limitations. To combat this, easily accessible skincare solutions that have been shown to work should be reasonably priced and come with easy-to-follow directions that will allay worries and promote making wise decisions.

Trends in dermatologic procedures performed by dermatologists and advanced practice clinicians among Medicare beneficiaries from 2012 to 2020

Trends in dermatologic procedures performed by dermatologists and advanced practice clinicians among Medicare beneficiaries from 2012 to 2020

A comprehensive review of the medical and cosmetic applications of exosomes in dermatology.

Exosomes are a subset of extracellular vesicles that are released by all cell types and are theorized to play a crucial role in intercellular communication. Ranging from 40 to 160 nm in diameter, exosomes contain a variety of genetic materials including DNA, RNA, mRNA, metabolites, proteins, and lipids depending on their cellular origin. Given that intercellular communication is abetted by the exchange of cellular components via exosomes, their applied use can have important implications for disease pathology and exosome-based therapeutics. We provide a comprehensive review of the current application of exosomes in medical (and skin) diseases and in cutaneous medical aesthetics. A literature search was conducted on PubMed reviewing exosomes and their application in medical and aesthetic fields. While the therapeutic use of exosomes in the treatment of medical and cosmetic dermatological procedures is promising, it is also important to note that most studies implementing exosomes as therapeutic agents have been conducted in preclinical models, thus highlighting the need for additional studies and clinical trials. One more important note in the aesthetic world associated with exosomes is that in the United States, at the time of this writing, exosomes may only be topically applied and not injected into the skin, as is done in many countries worldwide. There is a need for additional studies and clinical trials to evaluate the safety and therapeutic effect and safety of exosomes in medical and aesthetic fields.

Enhancing dermatology: the current landscape and future prospects of augmented and virtual reality technologies

This article aims to provide a comprehensive assessment of the current status and future potential of augmented and virtual reality (AR/VR) technologies in the field of dermatology. We conducted an extensive review of the existing literature, encompassing studies and case reports related to the utilization of AR/VR in dermatology. This analysis encompassed diverse applications, including medical education, diagnostics, and dermatologic surgery, to offer a holistic view of their current implementations. Despite the significant interest generated within the dermatological community, the integration of AR/VR technologies in dermatology has not advanced at the same pace as in surgery. Our review underscores the current applications of AR/VR, which encompass improving medical education through interactive simulations, enhancing diagnostic precision, and facilitating complex dermatologic surgical procedures. Additionally, we address the challenges and constraints associated with their practical implementation in clinical settings. Augmented and virtual reality technologies possess immense potential to transform the landscape of dermatology. While their adoption has been gradual, these technologies have showcased their ability to enhance medical education, diagnostics, and surgical interventions. The future holds promising prospects for further developments in AR/VR applications, positioning them as valuable assets for dermatologists and aspiring dermatologists alike. However, it is imperative to address issues related to accessibility, cost-effectiveness, and patient acceptance to foster their widespread integration into clinical practice.

Prevalence of Body Dysmorphic Disorder in the Spanish Population: Cross-Sectional Web-Based Questionnaire Study.

Body dysmorphic disorder (BDD) is defined as excessive concern with mild or nonexistent defects in personal physical appearance, which are not perceived by others. The worldwide prevalence of BDD ranges between 0.5% and 3.2%, with no differences across genders. The mean age of onset of BDD is 16.9 years. BDD is typically associated with young age, psychiatric disorders, and dermatological procedures. Patients with BDD typically display poorer mental health status than patients diagnosed with other mental disorders. The aim of this study was to estimate the prevalence of BDD in Spain and to identify the variables associated with BDD. We performed a cross-sectional descriptive study by collecting data through an anonymous web-based survey targeting the Spanish population aged 18 years or older. The measures in this study were (1) sociodemographic variables, (2) variables associated with dermatological and psychiatric disorders and cosmetic procedures, (3) scales measuring quality of life (12-item Short Form health survey, version 2) and (4) BDD (BDD Questionnaire). Statistical analysis was performed with SPSS software version 21. P values less than .05 were considered significant. Of the 2091 participants who took the survey, 322 (15.2%) met the criteria of having BDD. The mean age of the participants with BDD was 23.5 (SD 9.6) years. In terms of BDD prevalence, women accounted for 19.9% (284/1421), men accounted for 5.2% (34/653), and students accounted for 25.2% (263/1043). Approximately 46.6% (150/322) of the participants with BDD reported a history of psychiatric comorbidities, including anxiety disorders, depressive disorders, and eating disorders. BDD was significantly associated with female gender, younger age (18-24 years), students, monthly income of less than €500 (€1=US $1.11), and the presence of dermatological and some psychiatric disorders such as depression, anxiety, and eating disorders (P<.05). The number of body parts of concern in participants with BDD was significantly higher than that in those without BDD (4.6 vs 2.2, respectively; P<.001). Regarding the body parts of concern, body fat was the most common concern for both groups with BDD and without BDD, followed by thighs, face, hips, and skin in the BDD group and thighs, teeth, and hair in the non-BDD group. Participants with BDD showed a significantly poorer self-perception of their mental health, irrespective of the presence of any mental disorder (P<.001). Our findings showed that the prevalence of BDD in Spain was higher than expected. Further, BDD is frequently associated with other psychiatric disorders, particularly depressive disorder, anxiety disorder, and eating disorder. Participants with BDD had a poorer perception of quality of life associated with mental but not physical health problems. Finally, the perception of quality of mental health life in participants with BDD was independent of diagnosis of any mental disorder.