Vol 3-1 Commentary

How to Reconstruct a Complex Multiunit Skin Defect: A Single-case Survey Study

Inge J. Veldhuizen1-2#, Frederieke F.M. Theelen1#, Maarten J. Ottenhof1, Rene R.J.W. van der Hulst2, Maarten M. Hoogbergen1*

1Department of Plastic and Reconstructive Surgery, Catharina Hospital, Eindhoven, the Netherlands

2Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, the Netherlands

#These authors contributed equally to this work and are co-first authors

DOI: 10.29245/2767-5092/2021/1.1133 View / Download Pdf
Vol 3-2 Mini Review Article

Vision Loss and Blindness Following Fillers

Ann Q. Tran, MD1, 2; Wendy W. Lee, MD, MS1

1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL

2Manhattan Eye Ear Throat Hospital, Northwell Health, New York, NY

Facial aging associated with volume loss can be addressed with soft tissue fillers. This minimally invasive technique has quickly gained popularity and is commonly performed in many outpatient settings. The composition of injectable dermal fillers includes marketed hyaluronic acid, calcium hydroxyapatite, polylactic acid, silicone and polymethylmethacrylate. Complications, such as vision loss, are rare, but can result in a devastating and irreversible sequala from iatrogenic vascular occlusion. Understanding the facial anatomy, specific filler characteristics, and having a safe injection technique is crucial to assure optimal aesthetics results while avoiding complications. Injectors need to be able to recognize early complications and treat them appropriately, especially if vision loss is encountered. This review will focus on vision loss from fillers, techniques to prevent such complications and possible treatment strategies.

DOI: 10.29245/2767-5092/2021/1.1134 View / Download Pdf
Vol 3-1 Original Research Article

In vitro Approach to Assess Local Tolerance of Ingredients Dedicated to Specific Topical Care Applications

Alicia Roso1, Mickael Puginier1*, Mathilde Bergal1, Frederic Nunzi2, Alain Alonso3

1Seppic, 50 boulevard National, CS 90020, 92257 La Garenne Colombes Cedex, France

2Groupe IDEA Lab - Site Montesquieu, 5 rue Jacques Monod, 33652 Martillac, France

3EPISKIN, 4 rue Alexander Fleming, 69007 Lyon, France

Considering all topical applications, products target very different body areas including mucosa, healthy or impaired skin with many specific characteristics in the epithelium composition, structure and barrier functionality. In vitro reconstructed human tissue models are recognized as being sensitive and reliable in preclinical studies. On top of validated methods for skin irritation, new and predictive experimental protocols can be designed to address specific applications. The objective of this study was therefore to investigate the behavior of ingredients with a well-known tolerance profile for specific applications using 3D human reconstructed models: gingival and vaginal focusing on mucosa tolerance, “immature” epidermis intended to be closer to baby skin, and a fourth epidermis model with a physically impaired barrier function. Ingredients with a key function were applied at usual doses and compared to controls and formulation benchmarks to challenge the predictivity of the models.

The analysis of the results of each in vitro model demonstrated their greater sensitivity compared to the standard reconstructed human epidermis, making it possible to evaluate the tolerance of ingredients and select a well-tolerated dosage according to the local application area. The multiparametric approach designed for the “immature” and “impaired” epithelia models enriched basic irritation information with cellular, morphological and functional effects evaluations. It was therefore possible to identify some infra-clinical reactions and study the ingredient mechanisms.

View / Download Pdf
Vol 3-2 Case Report

Pemphigus Vulgaris in a Black Patient: Early Recognition of Disease Saves Lives

María A. Rodríguez-Santiago*, Javier García-Marín, Alfredo Lamela-Domenech, María Vega-Martínez

Internal Medicine, School of Medicine, University of Puerto Rico, USA

There is a well-known shortage of racial diversity in medical textbooks and literature contributing to race-based health care inequalities1. We present the case of a black puertorrican 58-year-old female who developed a painful non-pruritic blistering ulcer in the inner oral mucosa with associated erythema six months prior to the evaluation. She was misdiagnosed on multiple occasions leading to a rapid progression of the disease, and subsequently, her death. Lack of images in medical textbooks and scarce literature describing initial presentation per-skin-tone of Pemphigus Vulgaris (PV) in patients with dark skin color led to misdiagnosis, delay in treatment, and thus, this catastrophic outcome. This case report describes the appearance of PV in patients with dark skin tone and serves as an educational resource by providing images of a rare skin disease in people with dark skin. The purpose of this case report is to fill major gaps in medical literature, highlight the importance of timely recognizing PV in patients with dark skin, and to create awareness among physicians.

DOI: 10.29245/2767-5092/2021/2.1137 View / Download Pdf
Vol 3-2 Mini Review Article

Pressure Injury Related to Friction and Shearing Forces in Older Adults

Vianna V. Broderick, Linda J. Cowan*

*James A. Haley Veterans Hospital and Clinics, 13000 Bruce B. Downs Blvd, Tampa, FL 33612, USA

DOI: 10.29245/2767-5092/2021/2.1136 View / Download Pdf