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  • 机译 咪喹莫特2.5%和3.75%乳霜用于光损伤的治疗
    摘要:Background: Ad-hoc reports within clinical studies of imiquimod for the treatment of actinic keratosis (AK) have suggested the drug can improve both skin texture and overall signs of photodamage. Objective: We sought to assess the efficacy and tolerability of imiquimod 3.75% and 2.5% cream for the treatment of photodamage in patients with AK of the full face or balding scalp. Methods: A meta-analysis of four identical multicenter, randomized, double-blind, vehicle-controlled studies was conducted. The studies included a total of 969 adult subjects (aged 33–91 years) with 5 to 20 visible lesions or palpable AKs in an area exceeding 25cm2 on either the face or balding scalp. Patients were randomized to imiquimod 3.75%, imiquimod 2.5%, or vehicle cream (1:1:1). Up to two packets (250mg each) were applied per dose once daily for two two-week treatment cycles, separated by a two-week no-treatment interval. Photodamage improvement was assessed at study end based on subjects’ baseline assessments using a seven-point scale. Local skin reactions were recorded throughout the study. Results: Combined Investigator’s Global Integrated Photodamage (IGIP) score was “significantly” or “much” improved in 57.6 percent (n=175) of patients treated with imiquimod 2.5% cream and in 69.6 percent (n=208) of patients treated with imiquimod 3.75% cream versus in 25.7 percent (n=76) of patients treated with the vehicle. Mean IGIP scores at end of study were 1.67, 1.98, and 0.73, respectively (both actives P<0.0001 versus vehicle). Conclusion: Both imiquimod 2.5% and 3.75% creams showed a positive effect on photodamage when compared with the vehicle cream.
  • 机译 非热脉冲超声治疗可减少腹部脂肪
    摘要:Objective: Noninvasive fat reduction has become increasingly popular. This study evaluated the outcomes of multiple treatments with a nonthermal focused ultrasound device for the noninvasive removal of excess abdominal fat. Design: Participants underwent a total of three pulsed, focused ultrasound treatments spaced two weeks apart. Setting: This study took place in an outpatient dermatology office in a suburb of a major city. Participants: Ten healthy female subjects between 18 and 60 years of age with an abdominal thickness of at least 0.6cm and body mass index between 22 and 30kg/m2 were included. Measurements: Fat layer thickness was measured by ultrasound imaging and skin caliper and was compared with baseline at the four-, eight-, and 12-week follow-up visits after the final treatment session. Results: The study subjects underwent a total of 30 treatment sessions. Ultrasound imaging of the targeted fat layer decreased significantly by 13, 16, and 13 percent at the four-, eight-, and 12-week follow-up time points, respectively, while measurements of the fat layer as performed by skin caliper decreased by 12, 10, and 13 percent, respectively. All subjects noted improvement, while investigators noted significant improvement and expressed high satisfaction from the ultrasound treatment outcomes at the final visit. Treatments were well tolerated and no adverse events were recorded during the study period. Conclusion: Nonthermal pulsed focused ultrasound appears to be a safe and effective treatment option for the noninvasive removal of unwanted abdominal fat deposits. ClinicalTrials.gov:
  • 机译 持续消耗黑巧克力会刺激角质细胞脱皮并促进细菌定植,从而影响人的面部皮肤表面。
    摘要:Background: Nutrition can influence skin health. Dark chocolate possesses health promoting properties, but its consumption can exacerbate acne vulgaris in young people. Objective: We evaluated effects of continuous dark chocolate intake on morphological characteristics of the residual skin surface components (RSSCs) collected from the facial skin of young and middle-aged men. Methods: RSSC samples were taken from 17 young and 16 middle-aged men before and after a four-week consumption period of dark chocolate (10g per day). Lipid droplet size, corneocyte desquamation, and microbial presence levels were measured in the collected RSSC. The project was registered as ISRCTN89815519 in the ISRCTN registry (). Results: Chocolate consumption caused a significant increase in corneocyte desquamation only in the group of young men, whereas Gram-positive microorganism presence significantly increased in both the young and middle-aged men, though this effect was noticeably stronger in the young men. Conclusion: Dark chocolate consumption appears to affect the facial skin of young men by enhancing corneocyte desquamation and promoting bacterial colonization of the RSSC. These changes might potentially contribute to acne development.
  • 机译 美学,整形外科和皮肤病学重大会议的演讲者出版物简介
    • 作者:Ravi Jandhyala
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2018年第9期
    摘要:Background: Aesthetics remains a novel, poorly-regulated field of medicine. Objectives: This study compared the scientific backgrounds of speakers at major conferences related to aesthetic medicine. Methods: Records from conferences that took place in 2015 in aesthetics (Facial Aesthetic Conference and Exhibition [FACE]), plastic surgery (British Association of Aesthetic Plastic Surgeons [BAAPS]), and dermatology (British Association of Dermatologists [BAD]) were reviewed for professional backgrounds and publication histories of conference speakers. Results: FACE 2015 was the largest conference and included “aesthetics doctors” among speakers from diverse professional backgrounds. Speakers at BAD 2015 and BAAPS 2015 were mostly dermatologists and plastic surgeons. Overall and when grouped by profession, speakers at FACE 2015 had fewer authorships and were less likely to have authored any peer-reviewed papers. Only 17 percent of speakers at FACE 2015 had contributed to relevant publications. Aesthetics doctors only averaged 0.37 authorships versus plastic surgeons (6.76) and dermatologists (13.92). Conclusion: Most of the talks at FACE 2015 were presented by individuals with limited scientific backgrounds. The publication profiles of both FACE 2015 and aesthetic doctors were inconsistent with their fellow congresses and medical specialities. The results for aesthetic doctors might fall below the threshold deemed acceptable for doctors presenting themselves as experts in a branch of medicine, and might reflect a critical dearth of evidence-based practices in aesthetic medicine.
  • 机译 将外皮系统与艺术融合
    • 作者:Amit OmAnjali Om
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2018年第9期
    摘要:The objectives of this review are to demonstrate that portraits, in their visual reflections of subjects faces and expressions, offer significant representations relevant to the field of dermatology and bring attention to an underappreciated aesthetic of dermatological conditions. The review comprises paintings that purposefully or inadvertently depict dermatological conditions. The findings were substantiated by searching PubMed using the keywords art, painting, and dermatology, as well as combinations of these terms. The “Notable Notes” section of JAMA Dermatology proved especially useful. The review is subdivided by disease category, including portraits that display infectious diseases, neoplastic conditions, genetic dermatoses, rosacea and/or acne, and autoimmune disorders. The breadth of examples of dermatology represented in art suggest that portraits might serve as an unintentional atlas of dermatological conditions. By implication, it seems that the arts might be more interconnected to the sciences than traditionally acknowledged.
  • 机译 老年女性注射剂全脸应用的12点活化指南
    • 作者:Niamh Corduff
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2018年第8期
    摘要:Soft tissue filler augmentation for beautification is a common aesthetic request from women who wish to enhance facial features. These interventions are performed in both younger and older women and can result in exaggerated or over-augmented lips and cheeks. This unsatisfactory outcome in older women might be due to the inappropriate application of filler enhancement principles that are based the characteristics of a young face. These existing principles do not necessarily translate well to an older face due to underlying facial skeletal changes associated with aging. Mature women might prefer subtler corrections that do not significantly alter their faces, but rather refresh and revitalize their current appearance. Here, the author presents a 12-point revitalization guide, based on personal experience, as an approach for the pan-facial application of calcium hydroxylapatite and hyaluronic acid fillers specific to the aging female face that can result in an understated and age-appropriate appearance. Three illustrative cases are also presented.
  • 机译 胸罩扣是镍暴露的来源
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  • 机译 热带地区高比例阳光照射患者的维生素D缺乏症,皮肤照片类型,阳光指数和代谢风险
    摘要:Objective: We sought to evaluate serum 25-hydroxycholecalciferol (vitamin D [25-OHD]) levels, skin phototype, and sun index in a sample of patients to determine the association between these factors and metabolic risk. Design: This was a cross-sectional study involving 729 adults (50.2% male). Mean age was 65.13±9.18 years, sun index 5.71±5.06, body mass index (BMI) 27.60±5.34 kg/m2, and waist circumference 97.29±12.08cm. Hypertension, metabolic syndrome, and Type 2 diabetes were reported in 77.8, 74.5, and 38.9 percent, respectively; Fitzpatrick Skin Types III and IV were reported in 60.6 percent. Results: Mean serum 25-OHD was 25.72±10.91ng/mL; 31 percent of subjects had serum 25-OHD below 20ng/mL, and 63.1 percent had serum 25-OHD below 30ng/mL. Although there were no significant differences between the vitamin D deficient and sufficient groups regarding age, BMI, waist circumference, or presence of diabetes, in the group with 25-OHD less than 20ng/mL (sun index of 4.5±4.08), higher serum triglycerides and lower high-density lipoprotein cholesterol (HDL-C) levels were measured: triglycerides 179.14±103.53 versus 161.63±90.23mg/dL (p=0.029) and HDL-C 43.48±12.38 versus 45.94±14.14mg/dL (p=0.018) compared to the group with 25-OHD levels of 20ng/mL or higher (sun index: 6.25±5.36). Considering less than 25th percentile (25-OHD: 18.7ng/mL) and 75th percentile or higher (25-OHD: 30.8 ng/mL), the differences in serum triglycerides remained significant: 176.63±103.79 versus 157.47±80.49 (p=0.039). Conclusion: We found a high prevalence of vitamin D deficiency in individuals with high sun exposure, regardless of age, BMI, and waist circumference. This deficiency was associated with increased serum triglycerides and decreased HDL-C levels.
  • 机译 化学去皮的实用方法
    摘要:Background: Chemoexfoliation, also known as chemical peeling, is a method of targeted cutaneous ablation using specific caustic agents that allow for rapid, predictable, and uniform thickness of chemoablation to a desired cutaneous depth, ultimately resulting in an improved appearance of skin. Objective: In this review, we provide an up-to-date analysis of all currently available chemical peels for dermatologic use, as well as a step-by-step instructional protocol for an algorithmic approach to treatment. Methods: A comprehensive search of the Cochrane Library, MEDLINE, and PUBMED databases was performed to identify relevant literature investigating chemical peeling agents. In addition, a search of all commercially available, prescription-based peeling agents was performed to identify all products currently available in the United States market. Results and Conclusion: Chemical peels are the third most commonly performed noninvasive cosmetic procedure in the United States, with over 1,300,000 procedures performed in 2016 alone. There has been a paradigm shift in recent years, with lasers largely supplanting deep peels. Despite this shift, superficial peels have proliferated in both popularity and product diversity.When used for the appropriate indication and with proper technique, nearly all peeling agents have demonstrated excellent clinical efficacy and remain an indispensable cost-effective tool in the dermatologist’s aesthetic toolbox.
  • 机译 自动化微针设备改善皮肤老化迹象的安全性和有效性
    • 作者:Glynis Ablon
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2018年第8期
    摘要:Objective: The purpose of this study was to evaluate the efficacy and safety of an automated microneedling device (Exceed, Amiea Med, MT.DERM GmbH, Berlin, Germany) when used for the rejuvenation of facial skin, as well as to generate data for an FDA 510K submission for the device. Study design: This was an open-label, single-center study. Participants: Forty-eight subjects aged 35 to 75 years with signs of facial skin aging were recruited. After consenting and satisfying inclusion criteria, each subject underwent four microneedling sessions 30 days apart. Subjects were assessed at baseline and at 30, 60, 90, and 150 days after the first treatment. Measurements: Wrinkles were assessed using the Lemperle Grading Scale. Skin laxity and texture were assessed using a modified Alexiades-Armenakas Grading Scale. Digital fringe projection technology (PRIMOS) was used to determine skin topography of the periorbital and mesolabial areas. Results: Mean improvements in global wrinkle score (mean of nine facial area grades), skin laxity, and skin texture at Day 150, compared to baseline were 1.23 (99% confidence interval [CI]: 1.11, 1.34), 1.09 (99% CI: 0.93, 1.26), and 1.54 (99% CI: 1.33, 1.75), respectively. Statistically significant mean improvements in these three measures were also observed at Day 90. Improvements in wrinkle grading and skin texture were confirmed by the PRIMOS profilometry. The treatment was well tolerated with minimal pain, discomfort, and downtime. Side effects were minor and easily managed. Conclusion: This study demonstrates that four microneedling treatments of facial skin, spaced four weeks apart, significantly improve lines, wrinkles, skin laxity and skin texture, 90 and 150 days after the first treatment. The treatment was well tolerated with minimal pain, discomfort, and downtime. Side effects were minor and easily managed compared to other invasive technologies, such as laser ablation and radiofrequency.
  • 机译 非绝缘部分微针射频治疗,平滑电机插入,可减少痤疮疤痕,减少毛孔大小和改善皮肤纹理
    摘要:Background: Severe scarring caused by acne is associated with substantial physical and psychological distress, both in adolescents and adults. There are two basic types of scars: atrophic (depressed) and raised (hypertrophic). Microneedle fractional radiofrequency (MFRF) is a new technology that uses extra sharp microneedles to heat the depths of the dermis, which promotes dermal collagen remodeling. In this study, we used electronically controlled non-insulated microneedle radiofrequency treatment to treat atrophic acne scars, improve skin texture, and reduce pore size. Methods: Nineteen patients were enrolled in the study. The goal of the treatment was to improve acne scars and skin texture and to reduce pore size. Each patient received 2 to 6 treatments with one month intervals between treatments. Treated areas were visually assessed for skin response, including edema, erythema, and burns. We used the standard pain scale of 0 to 10 to assess pain during and after treatment. Results: All the patients completed a series of 2 to 6 treatments. No adverse events as burns, scarring, or hyper/hypopigmentation were reported. Subjective pain assessment was the average point of 1.5, as reported by the patients. The subjective and objective questionnaire revealed high satisfaction from the treatment. Conclusions: The presented study results show that the MFRF treatment provides a highly effective minimally invasive treatment for acne scars, skin texture improvement, and pore size reduction, with a short downtime and high subjective satisfaction rates.
  • 机译 局部氨苯砜7.5%凝胶治疗寻常性痤疮
    摘要:The majority of available data on the prevalence, grading, and management of acne vulgaris (AV) are based on studies that evaluate facial AV. Data are limited in all of these areas with truncal AV. This study evaluates the efficacy and safety of topical management of truncal AV involving the chest and back in a three-center, open-label, 16-week study. Enrolled subjects (N=20), 12 years of age or older, applied dapsone 7.5% gel once daily as monotherapy. The primary endpoint of the study was the percent of subjects who achieved a two-grade improvement and a rating of clear or almost clear based on the Investigator Global Assessment scale. Secondary endpoints included percent reductions of inflammatory, non-inflammatory (comedonal), and total lesions at Week 16 compared to baseline. Tolerability and safety were assessed over the duration of the study.
  • 机译 一种针对植物保湿,弹性,紧实度和脂肪团的局部植物性乳霜的随机,有效比较剂控制的临床试验。
    摘要:Background: The skin is where initial visual signs of aging manifest, including increased skin dryness and decreased firmness and elasticity. Cellulite, a skin condition characterized by changes in the skin morphology due to excessive lipid deposition in subcutaneous adipose tissue, is another characteristic of skin aging. Objective: We sought to assess the effectiveness of a topical botanical cream on cellulite, skin hydration, firmness, and elasticity after two, four, and eight weeks of use compared to an active comparator. Design: The study was a single-blind, randomized, controlled study conducted on subjects with mild-to-severe cellulite on the thighs. Subjects were treated with a topical botanical cream (UP1307) and an active comparator for eight weeks. A total of 44 women 18 to 59 years of age were enrolled. Test products were gently applied in a circular motion to the area identified by subjects as the target cellulite area twice per day. Measurements: Measurements using Corneometer® (for skin hydration) and Cutometer® (for skin elasticity and firmness) were carried out at each visit in addition to expert clinical grader evaluations for cutaneous changes and cellulite. Outcomes were also assessed by patients using subject questionnaires. Results: Patients reported significant improvement in skin hydration, firmness, and elasticity over time. Findings were corroborated with objective instrumental measurements. At Week 8, 44.4- and 42.7-percent improvement in appearance of cellulite was also observed for the UP1307 cream and the active comparator group, respectively. Conclusion: Use of UP1307 cream produced significant improvements in skin hydration, firmness, and elasticity, with associated improvement in cellulite appearance. There was overall superiority of UP1307 between groups. Progressive subject perceptions of product effects are reported.
  • 机译 皮肤在各个身体部位的可扩展性和总体弹性以及与病理性瘢痕形成的关系
    摘要:Objective: Pathological scars, including hypertrophic scars and keloids, have a strong predilection for specific regions of the body. Such site specificity might reflect regional differences in skin properties. Greater knowledge about the characteristics of the skin at various body regions can promote the development of clinical approaches to skin incision and flap design and reduce the formation of cutaneous scars. It could also help elucidate the etiology of pathological scar development and progression. Thus, we measured the distensibility and gross elasticity of the skin at various body sites. Methods: Five healthy adult volunteers were enrolled. In each, the cutaneous viscoelasticity at 16 sites (forehead, superior eyelid, lower jaw, earlobe, deltoid, outside and medial side of the upper arm, palm, scapular region, anterior chest, upper abdomen, lateral abdomen, lower abdomen, lateral thigh, anterior lower leg, and planta) was examined using a Cutometer MPA 580® (Courage Khazaka electronic GmbH, Cologne, Germany). Results: The skin was particularly distensible at the medial side of the upper arm, followed by the earlobe, lower jaw, upper abdomen, lateral abdomen, lower abdomen, and superior eyelid. It was poorly distensible at the planta, followed by the anterior lower leg, palm, and forehead. The skin was poorly elastic at the earlobe, superior eyelid, planta, and palm and highly elastic at the lateral and upper abdomen, scapular region, and deltoid. Conclusions: Except for the earlobe, all regions with poorly distensible and hard skin are not prone to pathological scarring. This association between these skin properties and abnormal scarring could be useful for skin surgeons.
  • 机译 本月的指南:在美容实践中使用透明质酸酶(v2.4)
    摘要:
  • 机译 评价中重度牛皮癣患者非酒精性脂肪肝患病率的病例对照研究
    摘要:Objective: International case-control studies have demonstrated that psoriasis is associated with an increased prevalence of nonalcoholic fatty liver disease (NAFLD). The purpose of the present study was to establish an association of psoriasis and NAFLD in patients attending a dermatology clinic center in the United States. Design: This was an observational, case-control study. Setting: The study setting was an outpatient dermatology clinic of the George Washington Medical Faculty Associates in Washington DC. Participants: One hundred fifty-one adult patients with psoriasis and 51 control subjects were recruited. Measurements: NAFLD was diagnosed by ultrasonography after excluding secondary causes of liver disease. Regression analysis was used to assess the associations between: 1) NAFLD and psoriasis and 2) metabolic syndrome components and NAFLD among psoriasis patients. Results: NAFLD was more prevalent in patients with psoriasis (21.2% vs. 7.8%, p<0.04). However, psoriasis was not associated with NAFLD when matching for age, sex, and body mass index (BMI) (odds ratio: 2.63, 95% confidence interval [CI]: 0.51–13.6; p=0.25). As compared to patients with psoriasis but without NAFLD, those with NAFLD were more likely to have obesity (BMI: 34.9 vs. 27.2, 95% CI: 32.4–37.5 vs. 25.9–28.5; p<0.01). NAFLD in patients with psoriasis was also associated with select components of metabolic syndrome, including hyperglycemia and hyperlipidemia. Conclusion: Our findings show there is an association of psoriasis with NAFLD. Our findings also suggest an increased presence of metabolic syndrome components in patients with psoriasis and NAFLD. Trial registry: .
  • 机译 新型无创超声人体雕刻设备的开放标签,单中心,前瞻性评估
    摘要:Objective: The goal of this study was to evaluate the safety and the efficacy of the SlimME™ (Lumenis AB, Lumenis, Israel) ultrasound device for noninvasive body contouring. Design: This was an open-label, single-arm, exploratory study. Participants: Twenty adult patients presenting with subcutaneous target region adipose fat thickness greater than 2.5cm were included in this study. Measurements: Responses to a single treatment session with the ultrasound device were assessed. Change from baseline in abdominal circumference was evaluated at one, two, and three months posttreatment. Before and after treatment, the physician scored improvements, patients completed a self-improvement assessment questionnaire, and photographs were evaluated by three blinded reviewers. Immediate skin responses were recorded for up to 30 minutes posttreatment, and adverse events were recorded throughout the study. Results: A statistically and clinically significant reduction in abdominal circumference was observed at three months posttreatment, with a mean of -2.19±1.95cm, -2.14±1.94cm, and -1.83±2.00cm reduction from baseline in the umbilicus, under the ribs, and anterior superior iliac spine (ASIS) circumference measurements, respectively. Physician-based assessments classified 89.5 percent of subjects as “improved” within three months of treatment, and 89.5 percent of patients indicated their conditions to be either improved or much improved within this same time period. Immediate skin reactions were all expected, short-term, and self-resolving. Conclusions: A single treatment session using the ultrasound study device appears safe and effective in achieving noninvasive body contouring. Trial registry:
  • 机译 具有抗衰老功效的成年女性痤疮治疗方案的功效和耐受性
    摘要:Objective: The objective of this study was to assess clinical safety and efficacy of a novel acne treatment regimen in adult women. Methods: Participants in the study included an ethnically diverse group of adult women (n=24) with mild-to-moderate acne who were treated twice daily with a topical regimen (cleanser, acne cream, and rebalancing gel) for eight weeks. Following baseline assessments, subjects returned to clinic at Weeks 2, 4, and 8 for clinical assessments and self-assessment questionnaires. Results: Twenty-one of the 24 enrolled women completed the eight-week clinical trial. Statistically significant clinical improvements were seen in both acne and aging parameters over time. The product regimen was well tolerated without adverse reactions commonly seen with topical acne products. Conclusion: The regimen demonstrated efficacy and tolerability in adult women with acne and signs of skin aging.
  • 机译 眉毛和睫毛的移植
    摘要:The objective of this systematic review was to investigate the etiologies of hair loss of the eyebrow and eyelash that required hair transplantation, the optimal surgical technique, patient outcomes, and common complications. A total of 67 articles including 354 patients from 18 countries were included in this study. Most patients were women with an average age of 29 years. The most common etiology requiring hair transplantation was burns, occurring in 57.6 percent of cases. Both eyebrow and eyelash transplantation use follicular unit transplantation techniques most commonly; however, other techniques involving composite grafts and skin flaps continue to be utilized effectively with minimal complication rates. In summary, many techniques have been developed for use in eyebrow/eyelash transplantation and the selection of technique depends upon the dermatologic surgeon’s preferences and the unique presentations of their patients.
  • 机译 使用透明质酸填充剂纠正巩膜显示
    摘要:Generally, the shape of women’s eyes are distinctly different in intercatal height from that in men. Ideally, in a woman, the lateral intercostal point is positioned above the medial intercostal point, which gives the eyes a cat-like appearance that culturally suggests youth and health. Because of aging and/or physiological changes, this area can be altered with the inversion of the lateral intercantal line lower than the medial intercantal line, producing a tired and/or sad looking appearance. Hyaluronic acid is a quick and safe method of elevating the lateral intercantal area of the eye. This article describes a technique for using hyaluronic acid for the treatment of scleral show.

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