Chart Review Presenting Safety of Injectable PLLA Used With Alternative Reconstitution Volume for Facial Treatments.

BACKGROUND: Since the approval of Sculptra Aesthetic, the amount of sterile water used to reconstitute the product has gradually increased in clinical practice. A retrospective chart review was conducted to evaluate patient safety associated with a larger reconstitution volume, and to investigate specific parameters for how Sculptra Aesthetic is used in a real-world clinical setting. OBJECTIVE: The primary objective of the study was to evaluate the safety of Sculptra Aesthetic when using a reconstitution volume of 7 to 10 mL, via collection of adverse events related to the product or injection procedure reported in medical records. METHODS: This was a multi-center, retrospective chart review conducted in the US. Medical records for subjects treated in the facial area with Sculptra Aesthetic reconstituted to 7–10 mL were reviewed to obtain information about demographics, treatment data, and adverse events. Each injector completed a questionnaire regarding reconstitution and injection procedures generally used. RESULTS: There were 4483 treatments performed in 1002 subjects; nearly half (48%) had 3 or 4 treatments during the studied period. Subjects most commonly received treatment in the midface/cheek area (97%), temple (94%), and jawline (54%). All injectors indicated adding lidocaine to the solution, resulting in total volumes of 8–10 mL. Adverse events were reported by 3.6% of subjects, all mild in intensity. Nodules were reported by 4 subjects (0.4%). CONCLUSION: The low number of AEs reported in this retrospective chart review suggests that facial aesthetic treatment with PLLA reconstituted to a final volume of 8–10 mL, including anesthetics, is associated with a favorable risk benefit ratio. J Drugs Dermatol. 2021;20(1):18-22. doi:10.36849/JDD.5631.

Kinetic energy-assisted delivery of hyaluronic acid for skin remodeling in middle and lower face.

BACKGROUND: Kinetic energy of a liquid jet has been demonstrated to achieve clinical efficacy by injecting hyaluronic acid for skin thickening and improving facial sagging. A pneumatically accelerated jet penetrates the epidermis leaving HA particles spherically spread in the dermis and initiating microtraumatic wound healing. METHOD: We reported retrospective analysis of our successful experience in improving rhytidosis and skin remodeling in the middle and lower facial regions by pneumatically administered HA filler. Subjects seeking correction of facial wrinkles in middle and lower face were treated in 3 monthly sessions with computerized jet-injection device and assessed 6 months thereafter for perception of the wrinkles, rhytidosis burden, and treatment satisfaction. RESULTS: Thirty-four female patients (average age 42 years) with age-related rhytidosis in perioral, cheek, and neck areas received the treatment. The treatments had short downtime, minimal pain, and no side effects. Mean Lemperle Rating Scale score decreased in all treated areas by one full degree and was maintained for 6 months after the treatments. Patients and investigators independently scored the wrinkles as "improved" per Global Aesthetic Improvement Scale. Mean treatment satisfactory score was 4.0 ± 1.4 (out of 5). CONCLUSION: Retrospective data showed successful implementation of liquid jet injections of HA in correction of aging middle and lower facial regions.

Evidence for restricted Vbeta usage in the leukemic phase of cutaneous T cell lymphoma.

Antibodies directed against the beta chain of the T cell receptor (anti-Vbeta antibodies) are useful to identify the Vbeta repertoire of T cells in various diseases and to quantify numbers of Vbeta-bearing T cells. The goals of this study were to identify Vbeta+ cases of leukemic phase cutaneous T cell lymphoma (CTCL) and to compare the percentage of positive calls with other measures of blood tumor burden, i.e., lymphocyte subsets with a CD4+CD7- and CD4+CD26- phenotype and Sezary cell counts. Thirty-three of 49 (67%) cases of leukemic CTCL reacted with an anti-Vbeta antibody. When combined with reports from the literature, the frequency of Vbeta5 (probably Vbeta5.1) usage was relatively high when compared with Vbeta2 that is also frequently expressed by normal CD4+ T cells. The percentage of Vbeta+ cells correlated to the percentage of CD4+CD7- and CD4+CD26- cells for cases in which the neoplastic cells were deficient in expression of CD7 and CD26, respectively, but not the Sezary cell count. We hypothesize that the increased Vbeta5.1 usage in CTCL may be the result of depletion of Vbeta2 and other Vbeta-bearing T cells by staphylococcal superantigens prior to neoplastic transformation, resulting in a relative increase in the frequency of Vbeta5.1 usage in CTCL.