ABSTRACT
BACKGROUND: The use of botulinum toxin has rapidly expanded into various aesthetic applications. Any guideline representing a consensus for aesthetic treatments using botulinum toxin type A (BTA) in Asians has not been published. OBJECTIVES: To provide consensus recommendations on common aesthetic problems which are treated by neurotoxin in Asians. METHODS: A panel of experienced Korean dermatologists was convened to develop a clinical consensus on common aesthetic problems involving the face, neck, and calves in Asians, based on their own extensive experience. RESULTS: The consensus recommendations address general questions regarding treatment and provide specific guidelines on each common aesthetic indication. The recommended final concentration of BTA was 50 U/mL after reconstitution with physiologic saline. For horizontal forehead lines, the members recommended nine injections in two rows into the frontalis with 1 U/point. For glabellar lines, the members recommended three injection points (a total of 8 U). For crow's feet, the members recommended three injections per side (7 U/side) at the lateral part of the orbicularis oculi. For infraorbital wrinkles, one to two points per side in the superficial subcutaneous space approximately 1 cm below the lash line were recommended (1-2 U/side). For nasal flare, one injection point in the middle of each ala nasi was recommended (a total of 2 U). For depressed nasal tip, a single injection deep within the columella was recommended, with a dose of 3 U. For benign masseter hypertrophy, the members recommended a six-point injection to the masseter (three points per side for a total of 50-60 U). For the treatment of calf hypertrophy, the members recommended a total dose of 100 to 120 U (50-60 U/side), divided between six injection points (approximately 8-10 U/point). CONCLUSION: This guideline provides a framework for physicians who wish to perform safe and efficacious injections of BTA in Asians.
Subject(s)
Asian People , Botulinum Toxins, Type A/therapeutic use , Consensus , Esthetics , Neuromuscular Agents/therapeutic use , Face , Humans , Leg , Neck , Republic of Korea , Skin Aging , Surveys and QuestionnairesABSTRACT
The skin shows an important "epidermal permeability barrier homeostasis" in response to barrier disruption. Calcium ion (Ca(2+)), a major regulator in keratinocyte differentiation and proliferation, plays a crucial role in skin barrier homeostasis. Acute barrier disruption induces an immediate depletion of both extra- and intracellular calcium ions in the epidermis, especially in the upper granular layers, and results in the loss of normal epidermal calcium gradient. Currently, we hypothesize that the change in the intracellular calcium ion concentration triggers the barrier repair responses, such as lamellar body (LB) secretion and increased lipid synthesis in the epidermis. In this article, we suggest that PKC-delta is a signaling mediator for the changes in extracellular and intracellular calcium ion concentration.
Subject(s)
Epidermis/physiology , Homeostasis/physiology , Protein Kinase C-delta/physiology , Animals , Calcium/physiology , Cell Membrane Permeability/physiology , Epidermal Cells , Humans , Signal Transduction , Skin Physiological PhenomenaABSTRACT
We describe a woman from Korea with pyodermatitis-pyostomatitis vegetans associated with ulcerative colitis. On immunofluorescence examination, she demonstrated in vivo bound and circulating IgG antibasement membrane zone antibodies. The immunoelectron microscopy and immunoblot analysis showed that the antibodies reacted with the bullous pemphigoid antigen 230. We consider that the circulating autoantibodies to the bullous pemphigoid antigen 230 in this patient were an epiphenomenon, resulting from epidermal damage induced by inflammation of pyodermatitis-pyostomatitis vegetans.
