RESUMEN
BACKGROUND: The hollowing of the infraorbital area (tear trough) is anatomically complex, and complications are frequent with its treatment. A simplified, quantifiable, and reproducible technique should encourage more novice injectors to confidently address this region. AIMS: The aim of this study was to evaluate the efficacy of a simplified method of treating the tear trough by using BD insulin syringes with fixed 6 mm 31G needles. PATIENTS/METHOD: A total of 150 sequential patients were divided into Hirman's three grades of tear trough deformity and were injected with up to three small boluses of hyaluronic acid at three defined anatomical regions. The amount injected varied with the grade of volume loss but all injections were deep on periosteum and under the orbicularis oculi muscle. Patients photographs before and after were reviewed to assess the outcome. RESULTS: All patients at all time points (immediate, 1 week, 1, 3, 6, and 12 months) were improved by patient and physician assessment. Approximately 90% at all time points rated their results as "very" or "exceptionally" improved. Adverse events were short term and included swelling, redness, pain, and bruising. No adverse events seen after the 1-week visit. No Tyndall effect was noted throughout the study and no filler required removal. CONCLUSION: This interventional-observational study illustrates the value of a simplified and quantifiable injection technique with predictable and satisfactory outcome and a low complication rate. We propose a possible way forward for aspiring aesthetic physicians to treat tear trough with confidence to minimize complications and maximize the outcome.
Asunto(s)
Técnicas Cosméticas/efectos adversos , Rellenos Dérmicos/administración & dosificación , Párpados/efectos de los fármacos , Ácido Hialurónico/administración & dosificación , Inyecciones Subcutáneas/métodos , Adulto , Anciano , Rellenos Dérmicos/efectos adversos , Esquema de Medicación , Estética , Femenino , Humanos , Ácido Hialurónico/efectos adversos , Inyecciones , Inyecciones Subcutáneas/efectos adversos , Masculino , Persona de Mediana Edad , Seguridad del Paciente , Satisfacción del Paciente , Envejecimiento de la Piel/efectos de los fármacos , Resultado del Tratamiento , Adulto JovenRESUMEN
AIM: The objective of this study was to assess autologous serum skin test (ASST) vs autologous plasma skin test (APST) response in chronic spontaneous urticaria (CSU) patients and study the significance of intensity of positive responses in relation to clinicoepidemiological parameters. MATERIALS AND METHODS: One hundred CSU patients and 100 age and sex-matched controls were recruited. The demographic and clinical features were recorded in all patients and routine investigations were performed. ASST and APST tests were performed as per the standard guidelines. RESULTS: The mean duration of illness was 4.85 ± 5.07 years, 90% patients were APST (+), 68% ASST (+), and 22 patients were only APST (+). Positive predictive value (PPV) of ASST and APST was 90.7% and 95.7%, respectively. A significant inverse association was seen between thyroid status and serum IgE levels with APST and ASST positivity. CONCLUSION: APST appears to have better PPV and high intensity of positive response on autologous tests, and correlates with ANA positivity and angioedema.
RESUMEN
A venous lake, sometimes referred to as senile hemangioma of the lips is usually a solitary, non-indurated, soft, compressible, blue papule occurring due to dilatation of venules. It is commonly found on sun-exposed surfaces of the face and ears. We describe a 46 year-old male who presented with this clinical picture on the lower lip.