The Use of Autologous Serum in Dermatology.

Autologous serum is a component taken from patient's blood after centrifugation to be used for the same patient. Lately, growth factors (GF) found in platelet-rich plasma (PRP) has been widely used as an alternative therapeutic modality in various medical fields. The benefits of using autologous serum effectively include reduced risk of hypersensitivity or allergic reactions as well as the reduced risk of transmission of infectious diseases; however, in practice, the availability of products with GF is still limited. This study aimed to review the latest evidences of using autologous serum therapy in dermatology. We searched and screened the study papers of past 5 years (2015 - 2020) through Pubmed Medline for the following topic: "Risks and benefits of autologous serum in the field of dermatology." The initial search obtained 333 papers, of which only 14 met the inclusion criteria: these included five papers on dermatology, seven on ophthalmology, and one paper each on plastic surgery and orthopedics. PRP serum contains GF, vitamins, hormones, and other components. GF contained in PRP is an effective therapeutic modality to be used in dermatology for wound healing, skin rejuvenation, acne scar, and androgenic alopecia. (SKINmed. 2022;20:97-104).

Evaluating Oral Glutathione Plus Ascorbic Acid, Alpha-lipoic Acid, and Zinc Aspartate as a Skin-lightening Agent: An Indonesian Multicenter, Randomized, Controlled Trial.

CLINICALTRIALSGOV IDENTIFIER: NCT04105504. BACKGROUND: For Asians, especially women with darker skin tones (Fitzpatrick Skin Types IV and V), clear, bright skin is considered highly desirable, and various topical, oral, or injection-based cosmetic skin-lightening agents with different mechanisms of action are widely available across Asia. OBJECTIVE: We sought to investigate the efficacy and safety of an oral glutathione supplement comprising L-glutathione (fermentation), ascorbic acid, alpha-lipoic acid, and zinc (as zinc aspartate) as a skin-lightening agent. METHODS: This randomized, double-blind, controlled clinical trial was carried out at three teaching hospital-based dermatovenereology clinics in Indonesia. Participants were randomized to receive either the glutathione supplement or placebo capsules and were evaluated every four weeks over a 12-week study period. Total reduction in spot ultraviolet, spot polarization, and skin tone were measured and recorded using a Janus Facial Analysis System® (PIE Co., Ltd, Suwon-si, Gyeonggi-do, Korea). RESULTS: Eighty-three participants, aged between 33 and 50 years, completed the study. Reductions in spot ultraviolet in certain subgroups, spot polarization, and skin tone were greater in the glutathione supplement group than in the placebo group, but the difference was not statistically significant. Both the glutathione supplement and placebo groups experienced only mild side effects in the first four weeks. CONCLUSION: The oral glutathione supplement was slightly beneficial for skin lightening in particular subgroups, but the results were not statistically significant. Mild and temporary side effects were reported. Further research is required to more fully evaluate the efficacy of this glutathione supplement as a skin-lightening agent.

The Effectiveness of Galactomyces Ferment Filtrate, Dexpanthenol, and Centella Asiatica Combination Serum in the Treatment of Post-Acne Hyperpigmentation in Subjects with Skin of Color.

Post-acne hyperpigmentation (PAH) occurs secondary to acne vulgaris and may cause significant adverse effects. Although may occur in any skin types, PAH has been found to be more common and severe in people with colored skin. This study aimed to assess the effectiveness of combination serum containing galactomyces ferment filtrate (GFF), dexpanthenol, and Centella asiatica for treating PAH. This randomized controlled clinical trial involved Fitzpatrick skin type (FST) IV and V patients with PAH. Subjects were equally divided into treatment group, who received three drops of combination serum twice daily for 8 weeks, and placebo group. The melanin index (MI) and Lightness (L*) score were assessed every 2 weeks. Out of 51 subjects, the L* score of the treatment group in subjects with FST V was significantly higher on the 4th and 6th week compared to the placebo group (P ˂ 0.05). The MI of subjects with FST IV was significantly lower compared to the placebo group after 8 weeks (P ˂ 0.05). The treatment group showed consistent increasing and decreasing trend in L* score and MI, respectively (r ˃ 0.9, P ˂ 0.05). Combination serum containing GFF, dexpanthenol, and C. asiatica may be effective in treating PAH in subjects with colored skin by accelerating lessening of PAH.

Comparison of 2% deoxyarbutin and 4% hydroquinone as a depigmenting agent in healthy individuals: A double-blind randomized controlled clinical trial.

BACKGROUND: Hydroquinone, which is considered the gold standard skin depigmenting agent, has been associated with multiple side effects. Lately, deoxyarbutin has been suggested to be an alternative of hydroquinone with better safety profile. OBJECTIVE: To compare the depigmenting effect of 2% deoxyarbutin and 4% hydroquinone sera. METHODS: This double-blind randomized controlled study was done on the right and left arms of healthy participants. Subjects were instructed to apply either 2% deoxyarbutin or 4% hydroquinone serum on each arm, which were randomly labeled as group A and B, every day for 12 weeks. Chromameter and mexameter analysis were done every 2 weeks to assess the color change. Paired and independent t-tests were used to assess the color change within and between both groups, respectively. RESULTS: A total of 59 females participated in this study. Both groups showed significant improvement in skin depigmentation as shown by the chromameter (increase in L* value) and mexameter (decrease in melanin index) analysis at the end of the study (p < 0.05). No significant difference in both parameters was observed between both groups (p > 0.05). No side effects were reported in either groups. CONCLUSION: 2% deoxyarbutin and 4% hydroquinone sera showed comparable depigmenting efficacy.

Laser tattoo removal: Fundamental principles and practical approach.

Tattoos have long become a part of human civilization. However, as the number of people who get tattoos increases, so is the number of people who wish to have their tattoos removed. Compared to other methods, laser-based devices are associated with the best efficacy and least side effects in tattoo removal. Lack of understanding of the fundamental principles of laser and managing its parameters may result in suboptimal result and increased risk of side effects. Recognizing and mastering multiple factors including skin types, nature and color of tattoos, and proper selection of laser parameters such as wavelength, fluence, and pulse, are central in achieving an optimal tattoo removal outcome. This review provides a comprehensive overview on the fundamental principle of laser and practical approaches in tattoo removal.

Successful diagnosis and management of tuberculosis verrucosa cutis using antituberculosis therapy trial approach.

Tuberculosis verrucosa cutis is a paucibacillary form of cutaneous tuberculosis that often occurs in sensitized immunocompetent individuals due to exogenous reinfection. The diagnosis is often difficult because the clinical features are often not typical and acid-fast staining test often shows negative results. Therapeutic trial with antituberculosis therapy is justified if there is strong clinical suspicion in which diagnosis can be made based on the therapeutic response. We report a 46-year-old male with erythematous verrucous plaque on the right knee and crusted erythematous plaque on the left dorsal foot that had been present for 20 years. There were neither history of previous trauma nor tuberculosis treatment. Histopathology, culture, polymerase chain reaction (PCR), Mantoux test, and chest radiograph were negative for cutaneous tuberculosis. Gamma release interferon assay showed positive result. The patient was given category 1 antituberculosis treatment and showed improvement after three weeks. Treatment was continued for 6 months and the lesion significantly regressed.