Scar Score Research Articles

Evaluation of different methods for optic port entry in the umbilical region in gynecologic laparoscopic operations

Background Scarring after surgery poses a significant concern for women, particularly for those in their youth. Aim Evaluate which method of vertical trans umbilical and tranverse supra umbilical entry approaches in laparoscopic surgeries ought to be prioritized regarding cosmetic, pain and infection. Patients and methods This prospective comparative study was performed on 50 individuals aged from 18 to 60 years old, both sexes, undergoing diagnostic or operative laparoscopy for infertility, ovarian torsion, or cystectomy, chronic pelvic pain and total laparoscopic hysterectomy. Participants divided in to two groups equally: group 1: Vertical trans umbilical incision. Group 2: Transverse supra umbilical incision. Results There were significantly lower pain scores and overall scar scores after 1 week, 1 month, and 3 months of the operation in individuals with vertical trans umbilical incision than in patients with transverse supra umbilical incision. A substantial variation existed among both groups as regard redness warmth, tenderness, and increased pain. There was significantly lower vascularity, pigmentation, pliability, thickness sub scale scores, and overall scar scores after 1 week, 1 month, and following 3 months of the operation in individuals with trans umbilical vertical incision than in patients with supra umbilical transverse incision (P<0.05). Lower painful, itchy, stiff, irregular, and hyperpigmented scar in vertical trans umbilical incision than patients with transverse supra umbilical incision however, this difference was significant in itching and irregular scar formation (P<0.05). Conclusion A vertical incision provides better cosmetic outcomes compared with a transverse incision one.

A case-control study evaluating single and dual layer dermal matrix in treating scar contractures using the Vancouver and POSAS scar scales, and correlations with retraction and function in treating scar contractures

IntroductionThe dermal matrix appeared in the late 1990s and became an important tool in burn treatment. Following its success, new matrices soon emerged and were employed to treat burn contracture, but few studies have compared the different types available. This study evaluated two different dermal regeneration matrices comprised of one (Matriderm) or two layers (Integra) according to the Vancouver and the Patient and Observer Scar Assessment (POSAS) evaluation scales with regard to treatment of burn scar contracture. MethodsIn this prospective, case-control study, 24 patients with impaired mobility secondary to burns were divided into two groups and treated with dual or single layer matrices. Data were collected for intraoperative and postoperative complications, percentage take for matrix and graft areas, Vancouver scar scale score, POSAS score for skin quality assessment, area of matrix take, and skin graft take, and degree of mobility. Results and conclusionBoth matrices produced significant improvement according to the Vancouver and POSAS assessments over 12 months, but the dual layer matrix yielded better results than the single layer matrix in terms of retraction of the grafted area at 12 months, functional improvement, and skin quality as measured by the Vancouver and POSAS scales. According to statistical analysis, with p<0.05.

EP.03B.01 The Genomic Scarring Score as a Biomarker for the Use of PARP Inhibitors in Early-Stage Non-Small Cell Lung Cancer

EP.03B.01 The Genomic Scarring Score as a Biomarker for the Use of PARP Inhibitors in Early-Stage Non-Small Cell Lung Cancer

Korean Medicine Subcision Therapies in Scar Treatment: A Retrospective, Multicenter Study at Network Clinics.

This study is a retrospective, multicenter research designed to report the efficacy of Korean medicine subcision therapies in scar treatment. Charts and photographs of 29 patients who received subcision treatment between May 2016 and June 2020 in four scar treatment network clinics were analyzed. The Qualitative Global Acne Scarring Grade System (QGASC) and the Stony Brook Scar Evaluation Scale (SBSES) were used to objectively measure scar scores. Except for 4 patients whose GASGS and SBSES scores remained unchanged, most patients' scars showed improvement from Visit 2 to about Visit 8. Furthermore, the degree of change for both scales was found to be statistically significant. Subcision therapy using acupuncture has been found to be an effective treatment for scar, with statistically significant improvements in patients' SBSES and QGASC scores.

Severity of Trachomatous Scarring among Adults in Trachoma-Endemic Amhara Region of Ethiopia.

Trachomatous scarring has been shown to progress regardless of active ocular Chlamydia trachomatis infection, indicating that scarring drivers may be unrelated to ongoing transmission. Although scarring prevalence is commonly associated with older age and female sex, less is known about other potential contributors to its development. This study identified and assessed risk factors associated with scarring magnitude in a trachoma-endemic setting, utilizing a five-point photographic scale (S0-S4). During 2017 trachoma surveys of Amhara, Ethiopia, photographers captured left and right conjunctival images of adults (ages 15 years and older) from 10 districts. Subsequently, two graders independently assessed photographs for scarring, with discrepancies adjudicated by an expert grader. Scarring scores for 729 individuals were aggregated from the eye level to the participant level, excluding 17 participants because of poor photograph quality. Among those with scarring, most cases (20.4%) were severe (S4, comprising more than 90% of the tarsal conjunctiva) compared with the prevalence of moderate S3-A/B (11.2%), S2 (8.3%), and mild S1 (19.2%). The youngest group (ages 15-19 years) exhibited all scarring stages. Older participants (60 years and older) experienced a greater burden of severe scarring (S4 prevalence: 32.6%) than their younger (15-19 years) counterparts (6.2%). Multivariate ordinal logistic regression models indicated female sex, increasing age, and district-level trachomatous follicular-inflammation prevalence were significant predictors of scarring severity. Trachomatous scarring and its progression to trichiasis, may prove a barrier to meeting WHO timelines for trachoma elimination and will necessitate ongoing surveillance and interventions after elimination thresholds have been met.

Application of modified Z-shaped cosmetic incision in parotid benign tumor resection

Objective:To explore the safety and aesthetic effect of modified Z-shaped cosmetic incision in parotid benign tumor resection. Methods:A prospective study was conducted. A total of 44 patients with benign parotid tumor resection were randomly divided into experimental group（n=22） and control group（n=22）. The experimental group underwent modified Z-shaped cosmetic incision, while the control group underwent the traditional S-shaped incision. The surgical duration, hospital stay, complications and maxillofacial aesthetics were compared between the two groups. Results:There was no significant difference in gender, age, surgical method, pathological type between the experimental group and the control group（P>0.05）. The maxillofacial aesthetics and surgical duration of the two groups was statistically significant（P<0.05）, while there was no statistically significant difference in terms of hospitalization days, surgical complications and Vancouver scar scale score （P>0.05）. Conclusion:The modified Z-shaped cosmetic incision has a better effect on improving the maxillofacial aesthetics after benign parotid tumor resection, and compared with the traditional S-shaped incision, the safety is consistent, so it is worthy of clinical promotion and application.

1233P Genomic scarring score as a criterion for PARP inhibitor administration in early-stage NSCLC

1233P Genomic scarring score as a criterion for PARP inhibitor administration in early-stage NSCLC

Comparative study in treatment of acne scars fractional carbon dioxide laser versus micro needling fractional radio frequency - A retrospective study.

Efficacy of fractional carbon dioxide laser and microfractional radiofrequency in treatment of acne scars is well substantiated. The objective of this study was to compare the efficacy and safety of carbon dioxide laser versus microfractional radiofrequency in treatment of acne scars in skin type 3,4. Thirty-two patients of skin types 3-4 with grade 3 and 4 atrophic acne scars, of which 16 were treated with fractional carbon dioxide (CO2) laser and 16 were treated with microfractional radiofrequency were retrospectively analyzed. All patients received either treatment 4 sessions at an interval of 4-6 weeks. Objective assessment was done with qualitative and quantitative Goodman and baron acne scar grading system by assessment of photographs at baseline and 3 months after last session. All the data collected were entered in a Microsoft Excel worksheet and analyzed using R Software R-4.2.1. The study variables acne scar grades were described using frequency with percentage, acne scar scores were described using Mean with Standard deviation, and Median with interquartile range (IQR) (Q1-Q3). Since the data were ordinal, which is non-normal, hence, non-parametric tests are applied. To compare grades between the groups, Mann-Whitney U-test was applied. There was no difference in the last session (after the treatment) between the groups, the Mann- Whitney U-test was 109.5 with P-value of 0.484 >0.05. Therefore, there was no statistically significant difference between the microfractional radiofrequency and carbon dioxide laser group. There were 2 (12.5%) cases reported with post-inflammatory hyperpigmentation in the CO2 laser group and zero cases in the microfractional radiofrequency group.

Using a Zipper Device to Minimize Scarring After Excision of Facial Nevi in Pediatric Patients.

This study aims to investigate the safety and effectiveness of using a zipper device to minimize scarring after facial nevi excision in pediatric patients. A total of 48 patients were included, with 23 in the control group and 25 in the zipper group. The zipper device was used immediately to equalize skin tension after facial nevi excision. The primary outcome was the scar width measured at 1, 3, 6, and 12 months postoperatively. The Vancouver Scar Scale (VSS) was used to assess patients' scars at postoperative 12 months as a secondary outcome. Two patients in the zipper group withdrew from the trial due to skin irritation. The symptom disappeared within a week after the zipper device was removed. The scar width in the zipper group was smaller than that in the control group at postoperative 1, 3, 6, and 12 months. In addition, the VSS scores for scarring also showed that patients in the zipper group had significantly better scar scores than those in the control group. At postoperative 6 months, scar morphology was essentially similar to that at post 12 months in both groups, and there was a significant positive correlation between scar morphology at the 2 time points. It is safe and effective to use this zipper device to minimize scarring after excision of facial nevi in pediatric patients, and we think it be a complementary therapeutic measure in pediatric patients after facial nevus excision. II.

Periareolar approach in video-assisted thoracoscopic surgery for right middle lobectomy: a novel technique

BackgroundUniportal thoracoscopic right middle lobectomy (RML) poses greater technical challenges than other lobectomies. Although two-port thoracoscopy offers convenience, it results in heightened surgical trauma and scarring. The periareolar incision is rarely used in lobectomy while known for its cosmetic advantages. This study presents the periareolar access (combining a periareolar port and a 1-cm port) for video-assisted thoracoscopic surgery (VATS) in RML, comparing it with the traditional uniportal technique in both male and female patients.MethodsEighty patients who underwent RML were randomly divided into two groups: the periareolar VATS (PV) approach (n = 40) and the uniportal VATS (UV) approach (n = 40) from August 2020 to February 2023. All patients were followed up for 1 year and clinical data were collected and analyzed.ResultsNo significant differences in complications, blood loss, duration of chest tube placement, and length of postoperative hospital stay were observed between two methods. However, the PV group exhibited significantly shorter operative time, reduced postoperative visible scarring and lower visual analogue scores (VAS) for postoperative pain (P < 0.05). Additionally, the PV group demonstrated significantly higher cosmetic and satisfaction scores at the 6-month postoperative assessment (P < 0.05). Notably, breast ultrasound follow-up revealed two cases injuries of the mammary glands in female patients, and sensory function of most nipple and areola remained intact except two cases in all PV group patients.ConclusionsPeriareolar VATS emerges as a promising alternative approach for RML, providing clear benefits in pain management and cosmetic outcomes, while maintaining safety and convenience.Graphical

Endoscopic assisted parathyroid surgery via a subclavian approach

Objective:To explore the safety and efficacy of airless endoscopic surgery in the treatment of parathyroid diseases. Methods:By retrospective comparison, clinical treatment of 26 patients with primary hyperparathyroidism admitted to the Department of Otolaryngology and Head and Neck Surgery of the Hospital, Sun Yat-sen University from January 2018 to January 2023 were collected. They were divided into traditional group（13 cases） and endoscopic group（13 cases） according to the surgical method. The traditional group underwent traditional open parathyroid surgery, and the endoscopic group underwent airless endoscopic surgery through the subclavian approach. The efficacy, postoperative incision pain, incidence of adverse events, and aesthetic effects of the two groups were evaluated. Results:A total of 26 patients were included, including 13 patients in the traditional group and 13 patients in the endoscopic group. There was no significant difference in the incidence of hypocalcemia and transient hypoparathyroidism on the first day after surgery between the two groups（P>0.05）. No patients with incision pain（>3 points） or swallowing pain were found in both groups after the operation, and they were afraid or unwilling to cough and expel phlegm. There were no significant differences in the amount of blood loss, duration of operation, incidence of temporary recurrent laryngeal nerve palsy and transient hypocalcemia, and postoperative pain score between the two groups. The endoscopic group's scar evaluation score and aesthetic effect satisfaction score at 6 months after surgery were higher than those of the traditional group（P<0.01）. Conclusion:Airless Endoscopic parathyroid surgery via the subclavian approach has good effectiveness and safety, which did not significantly increase the risk of surgery. It can safely remove the lesion and leave no surgical scar on the anterior neck, which has the advantage of a good cosmetic effect. It is a safe and feasible endoscopic parathyroid surgery and can be used as a new choice for patients undergoing parathyroid surgery.

Improvement in scar appearance with the usage of silicone gel containing vitamin C for pediatric Asian patients

Background Silicone gel has been introduced as a preventive measure for scarring, yet there is limited objective evidence supporting its effectiveness in the healing of pediatric traumatic scars. This study aimed to evaluate the impact of silicone gel enriched with vitamin C on facial scars in Asian pediatric patients.Methods Pediatric patients aged 3 months to 12 years who underwent debridement and primary repair for simple facial lacerations were included in this study. A topical silicone gel mixture containing vitamin C was applied from the time of stitch removal until 6 months post-operation. Scars were evaluated at baseline, 1-, 3-, and 6-month post-application using a simplified version of the Vancouver Scar Scale, which assessed vascularity, pigmentation, and height. Scar color and pigmentation were quantified using a spectrophotometer, with comparisons to the symmetrical area on the opposite side of the scar. Statistical analysis was conducted using the Student t-test and repeated-measures analysis of variance, with post hoc testing for pairwise comparisons.Results Of the participants, 33 were men, and 19 were women. By 6 months, there was a significant improvement in the scar score on the Vancouver Scar Scale across all parameters. The erythema index showed a statistically significant decrease at each timeline (P&lt;0.001). Similarly, the melanin index demonstrated a significant difference between the baseline and 6 months (P&lt;0.001).Conclusions The topical application of silicone gel containing vitamin C significantly improved the appearance of fine surgical scars on the face in Asian pediatric patients.

Evaluation of Ultrasound Changes With the Use of Microneedling Versus Fractional CO2 Laser in Atrophic Acne Scars.

Atrophic acne scarring, a common sequela of acne, can be treated by different interventions, including microneedling and laser resurfacing. We sought to evaluate the comparative efficacy of microneedling versus fractional CO2 laser in treating atrophic acne facial scars using imaging with high and ultra-high frequency ultrasound. Participants received 2 sessions, separated by 1 month, of microneedling on the left side of the face and fractional CO2 laser on the right. Color Doppler ultrasound evaluations (24 and 70 MHz) were conducted at baseline and 3 months after treatment. Each patient completed questionnaires on satisfaction, pain, and adverse effects. Nine subjects were enrolled. The frequency order of scar types was boxcar, ice-pick, and rolling. At 3 months, using the acne scar clinical evaluation scale, a decrease in scar scores of both methods was observed for total scars (P = 0.0005), ice-pick scars (P = 0.0128), and rolling scars (P = 0.0007). Twenty-two scars analyzed by ultrasound demonstrated a trend to decrease in size; however, no significant changes were observed for either microneedling or CO2 laser treatments. Moreover, there were no significant differences between these methods. Both treatments were rated as good or very good by patient assessments. There was a low frequency of pain and hyperpigmentation reported with both modalities, albeit somewhat higher with microneedling. Both microneedling and CO2 laser improved atrophic acne scars. Ultrasound did not show significant differences between these modalities.

Clinical effectiveness of transaxillary single-port endoscopic surgery in the treatment of breast benign tumor.

Benign breast lumps affect 10% of women in their lifetimes. Endoscopic surgery could be an alternative surgical technique for benign breast tumors because it is performed through small wounds hidden in inconspicuous areas. The aim of this study was to explore the safety and esthetic effects of endoscopic surgery in the treatment of benign breast disease. This retrospective cohort study analyzed 363 patients with benign breast tumors from August 2021 to December 2023 in the Sixth Affiliated Hospital of Sun Yat-Sen University, of whom 118 underwent transaxillary single-port endoscopic surgery and 245 underwent traditional open surgery. Clinicopathologic characteristics, surgery type, hospital stay, and complications were analyzed to assess the effectiveness of the procedure for benign breast tumors. Breast tumor resection was successfully performed in 363 patients by endoscopic surgery or traditional open surgery. Endoscopic procedures demonstrated longer durations of surgery (98.54±35.17min vs. 70.28±26.06min, p<0.01) and postoperative drainage (64.30±34.92mL vs.18.49±19.86mL, p<0.01), but there was less blood loss. The nipple-areolar complex of the patients who underwent endoscopic resection was significantly more sensitive than the traditional open surgery group. Patients in the endoscopic group reported higher satisfaction with surgical outcome (13.10±1.97 vs. 12.63±1.90, p<0.01). And there was a significant difference in the wound scar and cosmetic outcome total score between the two groups. Transaxillary single-port endoscopic surgery is effective and safe and improves postoperative nipple-areolar sensation and cosmetic outcome, as compared to the conventional technique.

Cell-intrinsic platinum response and associated genetic and gene expression signatures in ovarian cancer cell lines and isogenic models.

Ovarian cancers are still largely treated with platinum-based chemotherapy as the standard of care, yet few biomarkers of clinical response have had an impact on clinical decision making as of yet. Two particular challenges faced in mechanistically deciphering platinum responsiveness in ovarian cancer have been the suitability of cell line models for ovarian cancer subtypes and the availability of information on comparatively how sensitive ovarian cancer cell lines are to platinum. We performed one of the most comprehensive profiles to date on 36 ovarian cancer cell lines across over seven subtypes and integrated drug response and multiomic data to improve on our understanding of the best cell line models for platinum responsiveness in ovarian cancer. RNA-seq analysis of the 36 cell lines in a single batch experiment largely conforms with the currently accepted subtyping of ovarian cancers, further supporting other studies that have reclassified cell lines and demonstrate that commonly used cell lines are poor models of high-grade serous ovarian carcinoma. We performed drug dose response assays in the 32 of these cell lines for cisplatin and carboplatin, providing a quantitative database of IC 50 s for these drugs. Our results demonstrate that cell lines largely fall either well above or below the equivalent dose of the clinical maximally achievable dose (C max ) of each compound, allowing designation of cell lines as sensitive or resistant. We performed differential expression analysis for high-grade serous ovarian carcinoma cell lines to identify gene expression correlating with platinum-response. Further, we generated two platinum-resistant derivatives each for OVCAR3 and OVCAR4, as well as leveraged clinically-resistant PEO1/PEO4/PEO6 and PEA1/PEA2 isogenic models to perform differential expression analysis for seven total isogenic pairs of platinum resistant cell lines. While gene expression changes overall were heterogeneous and vast, common themes were innate immunity/STAT activation, epithelial to mesenchymal transition and stemness, and platinum influx/efflux regulators. In addition to gene expression analyses, we performed copy number signature analysis and orthogonal measures of homologous recombination deficiency (HRD) scar scores and copy number burden, which is the first report to our knowledge applying field-standard copy number signatures to ovarian cancer cell lines. We also examined markers and functional readouts of stemness that revealed that cell lines are poor models for examination of stemness contributions to platinum resistance, likely pointing to the fact that this is a transient state. Overall this study serves as a resource to determine the best cell lines to utilize for ovarian cancer research on certain subtypes and platinum response studies, as well as sparks new hypotheses for future study in ovarian cancer.

Investigating the Impact of Wound Edge Approximation with Skin Grafting on Hypertrophic Scar Reduction: A Randomized Controlled Clinical Trial.

In modern burn care, the focus extends beyond mere patient survival to encompass long-term functional and cosmetic outcomes. Research suggests that the technique and manner of suturing during skin grafting play a significant role in scar formation. This study aimed to explore the effectiveness of wound edge approximation with skin grafting compared to the conventional approach, where the graft edge exclusively interacts with the wound edge, in reducing hypertrophic scar development. Seventy-four burn unit patients eligible for grafting were randomly allocated into two groups: those receiving grafts with overlapping edges (Group A) and those receiving grafts with edges tailored to the burn wound (Group B). Evaluation of graft sites occurred immediately post-surgery and at 1 and 6 months post-operatively using the standardized Vancouver Scar Scale (VSS) administered by trained surgeons. The findings of this study revealed that there was no statistically significant difference between the two examined groups regarding the average duration of hospitalization and the mean thickness of wounds (P>0.05). Similarly, the mean scores for pain, vascular index, and pigmentation index immediately post-surgery, at 1 month, and 6 months later, as well as the scar height index and flexibility immediately and at 1 month post-surgery, and the Vancouver Scar Scale index at the study's conclusion, showed no significant variation between the two groups (P>0.05). However, at the 6-month follow-up, the mean scar height score (P=0.004) in the overlapping group and the mean flexibility score (P=0.017) in the non-overlapping group were significantly lower compared to the respective alternative group. This indicates a notable improvement in scar height and wound flexibility in the overlapping group over the non-overlapping group after 6 months.

Retrospective Analysis of the Effectiveness of Laser Therapy in the Treatment of Acne Scarring.

This retrospective analysis aimed to estimate the efficiency of laser therapy in the management of acne scarring, assessing changes in scar severity, patient satisfaction, and adverse events. A cohort of 150 subjects with clinically diagnosed acne scarring who underwent laser therapy. Data were extracted from electronic medical records, and baseline characteristics, scar types, and management parameters were analyzed. Outcome measures included changes in scar severity scores, patient-reported satisfaction, and documentation of adverse events. Statistical analyses were conducted using appropriate methods, with sub-group analyses based on scar type and laser modality. Following laser therapy, a statistically significant decrease in scar severity scores was seen across all scar types (P < 0.05). Patient satisfaction was high, with 75% reporting significant improvement. Adverse events were mild and transient, including erythema and post-inflammatory hyperpigmentation. Sub-group analyses did not reveal significant differences in management outcomes based on scar type or laser modality. Laser therapy demonstrates effectiveness in reducing acne scarring with a favorable safety profile. The research supports its role as a versatile management modality for diverse scar presentations, emphasizing the need for further research to optimize protocols and explore combination therapies.

Increased Synthetic Cytotoxicity of Combinatorial Chemoradiation Therapy in Homologous Recombination Deficient Tumors

BackgroundHomologous recombination deficient (HRD) tumors are exquisitely sensitive to platinum-based chemotherapy and when combined with RT, leads to improved overall survival in multiple cancer types. Whether a subset of tumors with distinct molecular characteristics demonstrate increased benefit from cisplatin and RT (c-RT) is unclear. We hypothesized that HRD tumors, whether associated with BRCA mutations or genomic scars of HRD, exhibit exquisite sensitivity to c-RT, and that HRD may be a significant driver of c-RT benefit. MethodsSensitivity to c-RT was examined using isogenic and sporadic breast cancer cell lines. HRD was assessed using four assays: RT-induced Rad51 foci, a DR-GFP reporter assay, a genomic scar (large scale state transitions, LST), and clonogenic survival assays (CSA). Whole genome sequencing of 4 breast tumors from a phase 2 clinical trial of neoadjuvant c-RT in triple negative breast cancer (TNBC) was performed and defined HRD utilizing HRDetect. ResultsBRCA1/2 deficient cell lines displayed functional HRD based on the Rad51 functional assay, with c-RT to RT or cisplatin interaction ratios (IR) of 1.11 and 26.84 for the BRCA1 isogenic pair at 2uM Cisplatin and 6Gy, respectively. The highest LST lines demonstrated HRD and synthetic cytotoxicity to c-RT with IR at 2Gy and Cisplatin 20uM of 7.50, and the lowest LST line with IR of 0.65. Of 4 evaluable patients on the Phase 2 trial, one achieved pathologic complete response (pCR) with corresponding HRD based on multiple genomic scar scores including HRDetect and LST scores, compared with patients without pCR. ConclusionsHRD breast cancers, whether identified by BRCA1/2 mutation status, functional tests or mutational signatures, appear to be significantly more sensitive to c-RT compared to isogenic controls or tumors without HRD mutational signature. HRD tumors may be exquisitely sensitive to c-RT and warrants further clinical investigation to guide a precision oncology approach.

Clinical and molecular significance of homologous recombination deficiency positive non-small cell lung cancer in Chinese population: An integrated genomic and transcriptional analysis.

The clinical significance of homologous recombination deficiency (HRD) in breast cancer, ovarian cancer, and prostate cancer has been established, but the value of HRD in non-small cell lung cancer (NSCLC) has not been fully investigated. This study aimed to systematically analyze the HRD status of untreated NSCLC and its relationship with patient prognosis to further guide clinical care. A total of 355 treatment-naïve NSCLC patients were retrospectively enrolled. HRD status was assessed using the AmoyDx Genomic Scar Score (GSS), with a score of ≥50 considered HRD-positive. Genomic, transcriptomic, tumor microenvironmental characteristics and prognosis between HRD-positive and HRD-negative patients were analyzed. Of the patients, 25.1% (89/355) were HRD-positive. Compared to HRD-negative patients, HRD-positive patients had more somatic pathogenic homologous recombination repair (HRR) mutations, higher tumor mutation burden (TMB) (P<0.001), and fewer driver gene mutations (P<0.001). Furthermore, HRD-positive NSCLC had more amplifications in PI3K pathway and cell cycle genes, MET and MYC in epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK) mutant NSCLC, and more PIK3CA and AURKA in EGFR/ALK wild-type NSCLC. HRD-positive NSCLC displayed higher tumor proliferation and immunosuppression activity. HRD-negative NSCLC showed activated signatures of major histocompatibility complex (MHC)-II, interferon (IFN)-γ and effector memory CD8+ T cells. HRD-positive patients had a worse prognosis and shorter progression-free survival (PFS) to targeted therapy (first- and third-generation EGFR-TKIs) (P=0.042). Additionally, HRD-positive, EGFR/ALK wild-type patients showed a numerically lower response to platinum-free immunotherapy regimens. Unique genomic and transcriptional characteristics were found in HRD-positive NSCLC. Poor prognosis and poor response to EGFR-TKIs and immunotherapy were observed in HRD-positive NSCLC. This study highlights potential actionable alterations in HRD-positive NSCLC, suggesting possible combinational therapeutic strategies for these patients.

Split face randomized, evaluator blinded study on the effect of multiple subcisions on rolling acne scars.

Acne scarring results from a common inflammatory condition present in many people. These scars can have an impact on quality of life by influencing self-esteem and social acceptance. Current acne scarring treatments, such as chemical peels and laser treatments, often have limited success due to their time-consuming nature and the variability of acne scar types. The subcision technique has shown promise for the treatment of rolling acne scars. There are few studies to date that examine the effects of multiple subcision treatments on rolling acne scars. We evaluated whether the use of multiple subcision treatments improved the appearance of rolling acne scars compared to no treatment. Five patients with rolling acne scars on both sides of their face who met inclusion and exclusion criteria were enrolled in the study. One side of the face was randomized to receive treatment, while the contralateral side of the face received no treatment. Subjects underwent five sequential subcision treatments, spaced 4 weeks apart, with two follow-up visits at weeks 20 and 36 from the 1st treatment. Photographs were taken before and after the initial treatment visit and at each subsequent visit. Acne scar appearance was evaluated by the subject, a blinded live rater, and two double-blinded dermatologist raters. Evaluations of treatment outcomes involved overall acne scar appearance on a 5-point scale, acne scar improvement on a percentage scale, a modified quantitative global scarring grading system, and potential treatment side effects. There was a greater decrease in global scarring scores in the multiple subcision side compared to the control side. There was a greater difference in the average acne scar appearance scores between the Week 36 follow-up visit and baseline for the multiple subcision side compared to that of the control side. 50% of patients reported being more satisfied with the treatment side compared to the control side in regard to overall improvement. The study results suggest that multiple subcision treatments may improve the appearance of rolling acne scars compared to no treatment.