Abdominoplasty for Removal of Skin Necrosis as Side Effect of Mesotherapy

Mesotherapy is one of skin rejuvenation methods and known to be effective for anti-aging, cosmetic treatment, and improvement of obesity. Furthermore, the side effect of mesotherapy has been known to be very little, therefore, it has been used widely. Because of these reasons, complication of mesotherapy has been disregarded. A 32-year-old woman visited a private clinic for improvement of obesity. The patient had placenta injection with aminophylline, lidocaine and epinephrine on abdomen for several times and she did not have any symptoms. However, placenta injection was carried out at the last time with aminophylline, lidocaine, epinephrine and dehydrated alcohol. Four days later, abdominal partial necrosis was developed. And she was refered to our department. Wound of the abdomen had eschar formation and reddish color change. So, debridement of necrotic skin, and immediate reconstruction using flap and cosmetic abdominoplasty were done immediately, and the patient was satisfied with results. Based on various circumstances, we concluded that one of the etiologies of necrosis might be dehydrated alcohol and epinephrine effect. The standard of materials that are mixed in mesotherapy has not yet been established. In fact, the safety of additives has not yet been verified. Therefore, more studies on the standard materials and safety are needed.

A Study for Verification of Hair Growth Effect of Azelaic Acid and Vitamin B6

PURPOSE: Interest in the augmentation of hair growth for functional and aesthetic purpose has increased dramatically in recent years. Many hair growth products have been released, but most of these have not been proven scientifically. This study aims to measure the hair growth effect of azelaic acid and vitamin B6, which have been known as hair growth materials, in animal models. METHODS: Six weeks old C57BL/6 mice were used in this study and hair of mice were removed by topical treatment. The mice were divided into five experimental groups according to the testing material such as saline (negative control), propylene glycol(vehicle control), azelaic acid, vitamin B6 and azelaic acid plus vitamin B6 in combination. Hair growth was documented photographically and histologically, and then analysed by the high quality hair analysis program system. The quantity of endocrine factors, IGF-I and TGF-beta1 in the skin of mice was measured by PCR analysis. RESULTS: The topical treatment of azelaic acid and vitamin B6 in combination for 2 weeks to dorsal skin accelerated hair regrowth more than other groups. The azelaic acid and vitamin B6-combined treatment also promoted hair follicle elongation and thickness compared to the others. Histologic studies showed increased number of basal cells in azelaic acid and vitamin B6-combined treatment. Furthermore, the azelaic acid and vitamin B6-combined group significantly increased the expression of IGF-I but decreased the expression of TGF-beta1 in the skin of mice compared to other groups. CONCLUSION: These results suggest that azelaic acid and vitamin B6, when used together, have an additive effect and might be used as hair growth materials.

The Usefulnesssof Cultured Allogenic Keratinocyte for Burn Treatment

PURPOSE: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. METHODS: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5-7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1-5), and degree of pain and patient satisfaction by visual analogue scale(0-10). RESULTS: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were 3.29+/-0.529(mean+/-S.D.). Without the application, the mean score of epithelization were 2.86+/-0.655(mean+/-S.D.). The degree of pain was 7.71+/-1.419(mean+/-S.D.) and 2.35+/-0.950(mean+/-S.D.) before and after the application, respectively. The patients' satisfaction score was 6.45+/-0.850(mean+/-S.D.) and 8.45+/-0.961(mean+/-S.D.) before and after the application, respectively. CONCLUSION: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.