Microinjection Technique: A Novel and Comprehensive Approach for Nose Reshaping with Hyaluronic Acid Fillers.

Introduction: Nose reshaping with hyaluronic acid (HA) fillers, also known as medical rhinoplasty, is an increasingly popular, minimally invasive aesthetic procedure. As the demand for nasal reshaping continues to rise, it is essential to develop safe and efficient injection techniques and assess satisfaction to ensure optimal outcomes and patient-centered care. Objective: This study aims to evaluate patient and physician satisfaction with hyaluronic acid filler applications using microinjection technique for nasal reshaping. Methods: The study included healthy adult patients who underwent medical rhinoplasty with the same HA filler using the microinjection technique. Patient satisfaction levels were evaluated at one and six months after the last injection using the Global Patient Satisfaction Scale (GPSS). Additionally, an independent dermatologist conducted a clinical evaluation for each patient by comparing before and after clinical pictures, using the Aesthetic Improvement Scale (AIS). Any side effects were recorded during each session and follow-up period for six months. Results: A total of 40 patients (37 women and 3 men) participated in the study. The most frequently targeted anatomical areas for filler injections were the nasal tip (100%), columella (100%), nasal prominence (100%), nasal dorsum (85%), and nasal root (82.5%). Injections distal to the nasolabial fold (NFL) were performed in 2.5 percent of patients. Patients expressed high satisfaction with the results at both one and six months after the procedure (mean GPSS, respectively; 4.65 and 4.47). Similarly, clinicians reported satisfaction with outcomes at the same time points (mean AIS, respectively; 1.7 and 1.4). Apart from mild pain during the procedure and transient erythema afterward, no side effects were recorded. Conclusion: Medical rhinoplasty with HA fillers using the microinjection technique is an effective and reliable procedure. This technique provides safe and aesthetically pleasing results from both patient and dermatologist perspectives, making it a favorable option for nasal reshaping with HA dermal fillers.

The Effects of Oral Isotretinoin on Atrophic Acne Scars Measured by Shear-wave Elastography: An Observational, Single-center Study.

Background: Although the effects of oral isotretinoin (OI) on acne vulgaris and preventing further acne scars have been well-documented, the specific impact of OI alone on pre-existing atrophic acne scars (AAS) remains unclear. No clinical study has objectively evaluated the effect of OI on AAS yet. Objective: We sought to investigate the OI effect on AAS quantitatively and reliably by shear-wave elastography (SWE). Methods: This work is a single-center, prospective and observational study. Thirty patients with moderate and severe acne vulgaris accompanied by AAS were included. We started the OI with a standard dose regime. On Days 0 and 90 of treatment, patients' global acne grading system (GAGS) and the Goodman and Baron's Qualitative Global Scar Rating System (GSRS) were evaluated. The dermal thickness, subcutaneous tissue thickness, scar size, and scar and subcutaneous tissue's elastic modules were measured on both cheeks of each patient by SWE. Results: The improvement in GSRS stages and GAGS scores in 90 days were statistically significant (respectively; p=0.029, <0.001). Scar size and dermal thickness decreased, while the subcutaneous tissue thickness and the elastic modulus of scar and subcutaneous tissue increased in bilateral cheeks. The thickness changes in the right side dermis, and subcutaneous tissue on both sides were noteworthy (p<0.05). Conclusion: Besides its well-known effect on acne vulgaris, OI also could be an effective treatment option for reducing scar size and severity while improving skin elasticity. SWE may help follow skin and scar properties.

A Screening Proposal for Zoom Dysmorphia in Virtual Settings.

Zoom dysmorphia (ZD) is a facial dysmorphia that is triggered or aggravated by frequent virtual meetings. The frequent use of videoconferencing platforms has been linked to a distorted perception of facial images as individuals have an increased awareness of their appearance, given constant video feedback. As a result, dysmorphic concerns can develop. It is crucial to identify ZD as this condition interferes with an individual's life and can trigger or aggravate body dysmorphic disorder (BDD). A standardized approach for screening ZD in non-psychiatric settings has yet to be defined. We discuss the features of ZD and the challenges of screening for ZD in a virtual setting. To facilitate the recognition of ZD in telehealth consultations, we propose a comprehensive ZD screening questionnaire that includes questions related to typical ZD features and a BDD-focused question. The questionnaire is concise and allows the identification of individuals with a potential ZD. A BDD assessment in such individuals should follow.

Body dysmorphic disorder: A critical appraisal of diagnostic, screening, and assessment tools.

Body dysmorphic disorder (BDD) is a psychiatric condition characterized by profound concern about a minor or imagined defect in the appearance of individuals and increased preoccupation with the imagined/perceived defect. Individuals with BDD often undergo cosmetic intervention for the perceived imperfection but rarely experience improvement in their signs and symptoms after such treatment. It is recommended that aesthetic providers evaluate individuals face-to-face and screen for BDD with approved scales preoperatively to determine the candidate's suitability for the procedure. This contribution focuses on diagnostic and screening tools and measures of disease severity and insight that providers working in nonpsychiatric settings can use. Several screening tools were explicitly developed for BDD; others were designed to evaluate body image/dysmorphic concern. The BDD Questionnaire (BDDQ)-Dermatology Version (BDDQ-DV), BDDQ-Aesthetic Surgery (BDDQ-AS), Cosmetic Procedure Screening Questionnaire (COPS), and Body Dysmorphic Symptom Scale (BDSS) have been developed explicitly for BDD and validated in cosmetic settings. The limitations of screening tools are discussed. Given the increasing use of social media, future revisions of BDD instruments should consider incorporating questions relevant to patients' behaviors on social media. Current screening tools can adequately test for BDD despite their limitations and a need for updates.

Clinical and Histopathological Evaluation of Forty-one Cases of Pediatric Granuloma Annulare.

INTRODUCTION: Granuloma annulare (GA) is a non-infectious granulomatous disease that can affect children and adults. Although many studies have been conducted in adult GA patients, the literature on pediatric GA cases is limited. OBJECTIVES: Therefore, this study aimed to examine the demographic, clinical, and pathological features of pediatric GA cases. METHODS: This study was performed retrospectively in a single-center tertiary dermatology hospital. Demographic characteristics and clinical and histopathological features were recorded. RESULTS: Forty-one participants were included in this study, of which 66% were females. The mean age was 3.8 ± 2.6 years, and the mean lesion duration was 7.5 ± 10.3 months. The involvement of 78% of the patients was localized, and the remaining 22% was generalized. Asthma (30%) was the most common comorbid disease. Histopathological examination was performed on 21 patients, and the infiltrate pattern was interstitial in 71% of the cases and palisadic in 29%. Generalized distribution, trunk involvement, and concomitant disease tended to be higher in patients with an interstitial pattern than in those with a palisadic pattern. CONCLUSIONS: Atopy and asthma should be questioned in pediatric GA cases. There are differences between involvement, distribution, concomitant disease, and histopathological patterns, which may indicate differences in pathogenesis.

Evaluation of the serum magnesium and vitamin D levels and the risk of anxiety in primary hyperhidrosis.

BACKGROUND: Excessive sweating is considered primary hyperhidrosis if it is triggered by emotional states without any thermogenic or other underlying disease from the eccrine glands. This may be due to dysfunction in the autonomic nervous system. AIMS: To investigate the relationship between Vitamin D and Mg deficiency and the risk of anxiety and depression in patients with primary hyperhidrosis. PATIENTS/METHODS: This cross-sectional, case-control study was conducted between July and October 2019. 49 primary hyperhidrosis patients in Group I and 47 age and gender matched healthy individuals in Group II were included in the study. RESULTS: The mean 25 (OH) D and Mg levels in Group I were statistically significantly lower than in Group II (p < 0.001 and p = 0.002, respectively). Statistically significant differences were found between the groups in terms of anxiety and depression (p < 0.001 and p = 0.033, respectively). There was no significant relationship between the HADS-A / HADS-D scores and the severity of primary hyperhidrosis (r = -0.131, p = 0.096; correlation coefficient = 0.232, p = 0.447). However, a significant correlation was observed between HADS-A scores and serum Mg levels (r = -0.439, p = 0.007). CONCLUSION: Anxiety and depression are common in patients with primary hyperhidrosis. As shown in this study, both anxiety and depression can be seen with low Mg levels in patients with primary hyperhidrosis. This could possibly be related to the pathological mechanism involving Vitamin D and Mg, which determines the common pathway affecting primary hyperhidrosis and anxiety/depression.