Effectiveness and side effects of bipolar radiofrequency to treat submental laxity.

BACKGROUND: Submental skin laxity becomes a common cosmetic problem with age. Bipolar radiofrequency is a new, non-invasive procedure. Unlike the LASER, the radiofrequency (RF) device has no specific chromophore absorption. Thus, the device can be used on any skin type. OBJECTIVE: To evaluate the effectiveness and adverse effects of the bipolar RF for treatment of submental laxity and skin tightening. MATERIAL AND METHODS: Twenty-two patients with submental laxity were treated with Forma™ on both sides of the submental area. The patients underwent four sessions every 2 weeks for one and half months. Two blinded dermatologists evaluated the pre-treatment and post-treatment photographs at every visit. The three-dimensional photographs were recorded by Vectra® camera and determined the association. RESULTS: All 22 patients completed all the treatment sessions. The degree of improvement was statically significant after the third session based on the physical assessment scale and after the second session in terms of the submental laxity score. The fat volume reduction was statically significant from one week to six months from baseline. Almost all subjects developed transient erythema immediately after the treatment. No serious side effects were noted. CONCLUSIONS: The bipolar RF device is another potential choice for skin tightening due to its efficacy and safety profile. It can be used with any skin type and has few side effects.

New Donor Excision Design for Better Hair Alignment in Hair Restoration Surgery.

BACKGROUND: The linear scar and misalignment of hair follicles are disadvantages of the follicular unit transplantation (FUT) or strip technique. The most common misalignment is at the end of the strip. Although most surgeons try to match hair direction to achieve optimal hair alignment, their attempts are often unsuccessful. OBJECTIVES: We aimed to assess strip designs to improve hair alignment during hair transplantation. METHODS: We conducted a retrospective study of 157 patients who underwent hair transplantation with either the commonly used elliptical incision or our novel triangular flag-shaped designed incision on the donor strip tip. Two blind evaluators assessed the outcome of hair alignment using a 5-point visual analog scale. RESULTS: In total, 303 wounds on 157 patients were assessed. Overall, our triangular flag-shaped design (TFD) achieved better hair alignment than the common elliptical design (CED) (p=0.01). Patients with hair direction straight on the upper wound edge and hair direction inward on the lower wound edge showed improved outcomes with TFD, whereas patients with hair direction inward on both upper and lower wound edges showed better outcomes with CED. CONCLUSIONS: The TFD tip of donor strips achieved proper hair alignment for most hair transplant patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

High Sensitivity C-Reactive Protein Level and Psoriasis Severity in Thai Patients.

Background: Psoriasis vulgaris severity have been widely assessed by psoriasis area severity index (PASI) score. However, it may not be not the best measure because of the high variability and inability to tell the other aspect of the disease including co-morbidity and cardiovascular risk. Objective: To determine the correlation between high sensitivity C-reactive protein (hs-CRP) level and psoriasis severity and to determine co-morbidities of psoriasis patients. Material and Method: One hundred eighty psoriasis patients and thirty control patients were enrolled in the present cross-sectional study. Fasting venous blood were collected and analyzed for fasting plasma glucose, hemoglobin A1c, lipid profile, and hs-CRP. The psoriasis patients were assessed for skin severity by PASI scoring. The correlation was assessed by regression analysis. Results: The hs-CRP level was found significantly higher in the psoriasis group (p-value <0.001). The hs-CRP level significantly correlated with PASI score by using multivariate regression analysis. Conclusion: This correlation between hs-CRP level and the psoriasis severity has led to the proposition that hs-CRP be used as a biomarker for overall inflammation including skin severity and cardiovascular risk factor in psoriasis.