Adipose tissue, fillers, and skin tightening.

The role of adipose tissue has long been underestimated in esthetic dermatology. With the development of liposculpture and lipolysis, subcutaneous adipose tissue has gained an increasing interest. Harvested tissue has been used for lipofilling. In recent years, a better understanding of adipocyte physiology and its role in aging opened a new road for targeted treatments. Subcutaneous adipose tissue is no longer an innocent bystander in the combat of aging and the correction in esthetics. Adipose tissue is of importance for metabolic function and thermoregulation. Adipose tissue is involved in inflammation. Adipose tissue is heterogeneous in sense of function, color and size of adipocytes. The tissue is an important source of somatic stem cells.

[Topical retinoids in acne--an evidence-based overview]. / Topische Retinoide bei Akne--eine evidenzbasierte Ubersicht.

Topical retinoids are important tools in the management of acne because they act against comedones and microcomedones and have direct anti-inflammatory effects. The substances approved for acne treatment comprise tretinoin (all-trans-retinoic acid), isotretinoin (13-cis retinoic acid) as well as the synthetic third-generation polyaromatic retinoids adapalene and tazarotene, the latter being approved for acne treatment in the US only. Retinaldehyde is used in cosmetic preparations against acne. All topical retinoids are effective as single agents in mild to moderate acne but differ in efficacy and tolerability. Tazarotene 0.1 % is more effective than tretinoin 0.025 % or 0.1 % microsphere gel or adapalene 0.1 % gel or cream (EBM-level 2c). Adapalene 0.1 % is equally effective to tretinoin 0.025 % or tretinoin microsphere 0.1 % gel or tretinoin 0.05 % cream or isotretinoin 0.05 % gel (EBM-level 2c). Adapalene 0.1 % gel is significantly better tolerated than tazarotene 0.1 % gel, tretinoin 0.025 % and tretinoin 0.05 % gel, tretinoin 0.05% cream, tretinoin microsphere 0.1 % gel or isotretinoin 0.05 % gel (EBM-level 2c).The safety profile of topical retinoids differs from their systemic counterparts and is related mainly to local adverse effects, such as erythema, dryness, itching and stinging. The currently available evidence justifies the use of topical retinoids in most types of acne and during maintenance treatment.

Topical retinoids in acne--an evidence-based overview.

Topical retinoids are important tools in the management of acne because they act against comedones and microcomedones and have direct anti-inflammatory effects. The substances approved for acne treatment comprise tretinoin (all-trans-retinoic acid), isotretinoin (13-cis retinoic acid) as well as the synthetic third-generation polyaromatic retinoids adapalene and tazarotene, the latter being approved for acne treatment in the US only. Retinaldehyde is used in cosmetic preparations against acne. All topical retinoids are effective as single agents in mild to moderate acne but differ in efficacy and tolerability. Tazarotene 0.1% is more effective than tretinoin 0.025% or 0.1% microsphere gel or adapalene 0.1% gel or cream (EBM-level 2c). Adapalene 0.1% is equally effective to tretinoin 0.025% or tretinoin microsphere 0.1% gel or tretinoin 0.05% cream or isotretinoin 0.05% gel (EBM-level 2c). Adapalene 0.1% gel is significantly better tolerated than tazarotene 0.1% gel, tretinoin 0.025% and tretinoin 0.05% gel, tretinoin 0.05% cream, tretinoin microsphere 0.1% gel or isotretinoin 0.05% gel (EBM-level 2c). The safety profile of topical retinoids differs from their systemic counterparts and is related mainly to local adverse effects, such as erythema, dryness, itching and stinging. The currently available evidence justifies the use of topical retinoids in most types of acne and during maintenance treatment.

Sequential immunohistochemical study of depigmenting and repigmenting minigrafts in vitiligo.

The initial steps of melanocytic dysfunction in vitiligo are hitherto not well understood. The aim of the present study was to examine the sequence of early events that occur in melanocytes after autologous minigrafting in patients with vitiligo, depending on their clinical response. Six patients with non-segmental widespread vitiligo were included in the study. Specimens of vitiliginous lesions were used as preoperative controls and sequential punch biopsies were taken from the grafted areas on days 14, 17, 21 and 28 after minigrafting. Immunohistochemical stains using the MoAbs HMB-45, CD4, CD8, ICAM-1, and LFA-1 were performed in all biopsies and the labelled cells were counted by a digital image analyser. Results obtained show that in vitiligo patients not responding to minigrafting, significant numbers of cytotoxic T-lymphocytes and LFA-1 positive infiltrating cells occur in early phases (p < 0.05), suggesting that a cell-mediated immune response takes place towards the grafted melanocytes. Possibly this cell-mediated mechanism causing unresponsiveness to minigrafts may also play a role in the pathogenesis of vitiligo.