Soft-tissue filler–associated blindness: a systematic review of case reports and case series
As the use of dermal fillers increases worldwide, so has the number of serious adverse events, such as vascular compromise and blindness. The aim of this systematic review of case reports and case series was to assess the role of dermal filler procedures in causing blindness and examine the link between hyaluronic acid (HA) filler and blindness.
This study looked at 190 cases of reported blindness due to dermal fillers. Of the 190 cases, 90 were attributed to autologous fat and 53 cases were caused by HA. The rest of the cases were attributed to collagen, calcium hydroxylapatite and other fillers.
In conclusion to this study, the results showed that autologous fat was the most common filler associated with blindness, despite HA fillers being the most commonly used across the globe.
This review also identified cases of blindness from other products, such as soft-tissue fillers like collagen and calcium hydroxylapatite. This study concluded that through the review of cases, the treatment of HA-related blindness was likely to have better outcomes compared with other fillers, due to hyaluronidase use.
Incorporating three-dimensional scanning and printing to enhance dermatology education and teledermatology
The majority of skin lesions encountered in dermatology can easily be identified solely on the basis of visual morphology and careful palpation of a lesion. The diagnosing of lesions such as actinic keratoses or discoid lupus erythematosus is often based on texture.
When considering a diagnosis, it's fair to say that dermatologists benefit from being able to assess the tactile characteristics of a lesion.
With this in mind, the authors of this letter to the Editor of the Journal of the European Academy of Dermatology suggest that the use of three-dimensional (3D) scanning and 3D printing into dermatologic training, clinical practice and teledermatology would hugely benefit and provide numerous diagnostic and educational benefits.
Optimal sunscreen use, during a sun-holiday with a very high UV index, allows vitamin D synthesis without sunburn
As we know, the sun contains both UVA and UVB radiation. UVB is essential for vitamin D synthesis, but is also the main cause of sunburn and skin cancer. The use of sunscreen is advocated to reduce the sun's adverse effects on the skin, but this may also compromise vitamin D status.
The aim of this study was to assess the impact of sunscreens on vitamin D production. The study was conducted while on a 1-week holiday in Tenerife. Comparisons were made between two formulations, each with a sun protection factor of 15. The UVA protection factor was low in one case and high in the other.
In total, 20 healthy Polish volunteers were given the sunscreens and advised on the correct application method. Comparisons were also made with discretionary sunscreen use (n=22) and non-holiday groups (n=17) Sunscreen use in the intervention groups was measured. Behaviour, UVR exposure, clothing cover and sunburn were all monitored.
The results of this study showed that the use of Sunscreens may be used to prevent sunburn yet allow vitamin D synthesis. A high UVA sunscreen enables significantly higher vitamin D synthesis than a low UVA sunscreen because a high UVA sunscreen transmits more UVB than the than a low UVA sunscreen.
Concomitant use of hyaluronic acid and laser in facial rejuvenation
For many patients undergoing aesthetic treatments for facial ageing, they may require combined treatments for optimal results. The two most popular non-surgical procedures to treat age-related changes are botulinum toxin A injections and dermal filler injections.
The authors of this article concluded that there have not been many studies reporting the concomitant use of dermal fillers and laser technology for facial rejuvenation. The aim of this review was to use the experience and opinions of the authors and a literature search to assess the concomitant use of dermal HA fillers and laser technology, and provide some recommendations for concomitant use.
The authors found that the scientific evidence about the combined use of HA fillers and laser-radiofrequency-intense pulsed light (laser/RF/IPL) is limited and encompasses mainly small and non-randomized studies.
However, they recommend that if a combined procedure is to be performed on the same day, that the light treatments be carried out first. This will avoid skin manipulations after injecting HA. The authors also state that it is crucial to establish a precise diagnosis of the photodamage and loss of volumes suffered by the patient, in order to customise the treatment and therapeutic management.
It was found that the majority of studies found that the concomitant use of laser and HA fillers for facial rejuvenation represents an effective and safe strategy which improves clinical results and patient satisfaction. However, the authors state that more clinical studies are needed regarding the effectiveness and safety of combination filler/laser treatments.
Can we use psychoactive drugs to treat pruritus?
Pruritus is a common skin condition seen in dermatology and in general medicine. This condition has a complex and multifactorial pathogenesis, and the central nervous system is known to be involved in its development.
Psychoactive drugs is a term given to several therapeutic groups, which are mainly used in psychiatry. However, these drugs have on occasion been used in dermatologic practice to help alleviate pruritus in several cutaneous and extracutaneous disorders.
The authors of this review article summarise the role of H1-antihistamines, antidepressants, antipsychotics and antiepileptics in managing pruritis.
‘The old and the new’: an update on cosmetic allergy
In most of the cosmetics available on the market, there are several chemicals present. However, there are only a few ‘dominant allergens’, which are responsible for causing most cases of allergic contact dermatitis. These include fragrances, preservatives, dyes and nail varnish resins.
An increase in contact dermatitis over the past decade has necessitated change in the patch test screening for cosmetics. This article discusses newer patch test screening agents, such as ethylhexylglycerin, sodium benzoate and glucosides, as well as exploring the expanding use of sunscreen chemicals in everyday cosmetics.