Center for Aesthetic Dermatology & Laser Surgery

The abstract presents a clinical case of simultaneous abdominaloplasty and cholecystectomy performed on a 45-year-old patient with stage 2 obesity and cholelithiasis. The author (Plastic Surgeon V.V. Panov) describes the historical significance of this surgery, which was performed in 1995 in Novosibirsk, when the combination of aesthetic and abdominal surgery was a groundbreaking approach.

Lichen planus pigmentosus (LPP) is a condition characterized by persistent and asymptomatic brownish-black–to-blue or purple-gray pigmentation, predominantly in the face and sun-exposed areas, commonly in dark-skinned individuals. Several clinical variants of LPP have been reported. However, the ichthyosiform type of LPP has not been reported. We present a 19-year-old male patient who presented with a 7-year history of asymptomatic grayish macules; patches with fine scales on the face, trunk, and upper extremities; and grayish plaques with thick “ichthyosiform” scales on the lower extremities. The diagnosis of LPP was proven by histopathological findings on both the macular and ichthyosiform plaques. Cluster differentiation (CD) 68 stain highlights the same density of pigment-laden macrophages in both the gray macule and the ichthyosiform plaque. The cause of LPP is unknown. Transcription factor anomalies may play a role in increased keratinization of lichen planus lesions. It can be assumed that the mechanism of the altered distribution of keratinization may occur on the ichthyosiform lesions in this patient. The terminology “ichthyosiform lichen planus pigmentosus” is hereby proposed to be added to the clinical variants of LPP.

Hyperpigmentation and solar damage remains a difficult problem to treat with topical agents. To evaluate a novel skin-lightening complex (SLC) comprising four actives targeting melanin formation at multiple levels, namely disodium glycerophosphate, L-leucine, phenylethyl resorcinol, and undecylenoyl phenylalanine, in an oil-in-water emulsion cream. Skin-lightening complex was evaluated in 80 female subjects of skin types I-III with at least moderate mottled hyperpigmentation. After a wash-out period of 1 month with a sunscreen, the subjects added a cream containing the SLC for 12 weeks twice daily to entire face and continued the sunscreen use. Whereas there was no significant change during the wash-out period, the primary endpoint mottled hyperpigmentation decreased by 32% after the 12-week treatment period with the SLC cream. Secondary endpoints such as severity and number of lentigines, skin tone, and skin brightness also improved. In all, 57% of the subjects showed at least a moderate response, 17% did not improve, and 3% got worse after the treatment. The SLC cream was well tolerated, in particular when comparing with exfoliating or peeling agent containing skin-lightening products. When used with a daily sunscreen, this study confirms that the SLC represents an alternative to hydroquinone, retinoids, and many other skin-lightening actives.

Patch testing is performed to evaluate suspected allergic contact dermatitis. Common wisdom suggests that various allergens cross-react but only a few larger studies have published confirmations of this. The purpose of our study was to identify significant correlations between positive test reactions in a screening series. A total of 1235 patients undergoing patch testing to the Hermal standard series at the Massachusetts General Hospital, Contact Dermatitis Clinic between 1990 and 2006 were investigated. Two or more positive reactions were seen in 411 patients (33.3%). Sensitizations to eight pairs of allergens were found to have significant correlation (P <or= 0.0001). A strong association was observed for cross reactions between formaldehyde and its releasers quaternium 15 and imidazolidinyl urea and between balsam of Peru and fragrance mix. Moreover, significant co-sensitization was identified for potassium dichromate and colophony. Three significant pairings in our study were associations between fragrances and metals. Our data confirm the previously published cross-reactions in the literature between fragrance components, and formaldehyde and formaldehyde-releasing preservatives. The increased numbers of patients with metal and fragrance sensitization can be considered as a random finding due to independent sensitization. Being aware of cross-reacting allergens is essential to success in resolving allergic dermatitis when counseling patients.

Peptide cosmeceuticals are one of the new, popular options to treat aging skin. There are three main categories of cosmeceutical peptides: signal peptides, neurotransmitter-affecting peptides and carrier peptides. Although their benefits currently may not be as rigorously tested as most FDA-regulated drugs, the evidence to support their use is growing. This article attempts to review the various current popular cosmeceutical peptides, the published studies on their theoretical effects, and their practical use in dermatology.

BACKGROUND: Propionibacterium acnes synthesize and store a large amount of porphyrins. Once the porphyrin is exposed to visible light it becomes chemically active and transfers to an excited state, resulting in the formation of singlet oxygen, which combines with cell membranes to destroy the P. acnes. This process is dependent on the rate of production of excited porphyrin molecules, which is influenced by the concentration of porphyrins, the concentration of photons, the temperature, and the wavelength of the photons.METHODS: Nineteen patients with mild to moderate acne underwent bi‐weekly treatments for 4 weeks using the ClearTouchTM system. During each treatment, pulses of light and heat were applied. Each pulse used an average energy density of 3.5 J/cm2, a pulse width of 35 ms, and a wavelength between 430 and 1100 nm.RESULTS: At the end of the eighth treatment, acne clearance for the non‐inflammatory and inflammatory lesions was 63±21% and 50±32%, respectively. One month after the last treatment, the acne clearance for non‐inflammatory and inflammatory lesions was 79±22% and 74±20%, respectively, with further improvement in acne clearance at 2 months after the last treatment (85±17% and 87±25%, respectively).CONCLUSION: ClearTouch pulsed light and heat energy (LHETM) technology is effective and safe for the treatment of acne vulgaris.