Evaluation of effectiveness of tranexamic acid as mesotherapy in improvement of periorbital wrinkling in a trial study.

BACKGROUND: Tranexamic acid is used to treat pigmented disorder in dermatology for a long time however there are limited data for effectiveness of tranexamic acid for rejuvenation and improvement of wrinkle. Here we want to find the effectiveness of tranexamic acid as mesotherapy in improvement of periorbital wrinkle in a clinical trial study. METHODS: Patients with melasma who were treated with 4 session of tranexamic acid mesotherapy at intervals on 1 week were evaluated with Visioface device before starting and 1 month after last course of treatment. The outcomes including volume, area, area percent, and depth were measured by Visioface device. RESULTS: Mean of periorbital wrinkles volume before and after procedure were 89 271 and 74 639 pixel3 (px3 ), respectively. Very significant difference with p-value of <0.001 was detected at volume of patient wrinkles before and after treatment. Moreover, the mean of area (and area percent) of their periorbital wrinkles before and after therapeutic method were 8481 Px3 (1.131%) and 7184 Px3 (0.646%), respectively, with significant differences (both have p-value of <0.001).Mean of periorbital wrinkles depth at before and after treatment were 9.8 and 9.6, respectively, without remarkable difference (p-value was 0.257). CONCLUSION: Tranexamic acid mesotherapy significantly leads to reduced volume and area of wrinkles. Injection of tranexamic acid as mesotherapy seems to be effective in improvement of periorbital wrinkling.

Endovascular reconstruction of aortoiliac occlusive disease in a case with claudication and an ectopic pelvic kidney.

INTRODUCTION AND IMPORTANCE: Ectopic kidney is a rare anomaly with an incidence of about 1 in 2500 birth in the population. Concurrency of pelvic kidney and iliac occlusion is rare, and the treatment is challenging because the pelvic kidney is associated with an atypical blood supply. CASE PRESENTATION: We reported a 68-year-old man with aortoiliac stenosis, right pelvic kidney, and high-risk cardiovascular comorbidities. He presented with the right lower extremity claudication that has been present for four years. Computed tomography angiograms showed total occlusion of right common and external iliac arteries. CLINICAL DISCUSSION: The old method for treating iliac artery stenosis is open surgery, which needs cross-clamping of the aorta. During this procedure, the chance of renal thrombosis and ischemia is high. Thus, the patient underwent an endovascular angioplasty that was done successfully for the patient without any disturbances in kidney function. CONCLUSION: Traditional treatment of iliac artery stenosis, especially in patients with high-risk cardiovascular comorbidities, may be associated with complications. Endovascular intervention is a safe and effective approach for treating aortoiliac occlusion in patients with ectopic pelvic kidneys. More research and case series are needed to review the results and compare the success rate of this method versus open surgery.