Abstracts

A summary of the latest clinical studies

Title: Fractional C02 Laser Plus Topical Antifungal Versus Fractional CO2 Laser versus Topical Antifungal in the Treatment of Onychomycosis Authors: Zaki A, Abdo H, Ebadah M. Published: Dermatologic Therapy, December 2019 Keywords: Onychomycosis, Tioconazole, Laser Abstract: Onychomycosis is an important medical disorder affecting both health and quality of life of patients. This study was done to compare the efficacy of CO2 laser in combination with topical tioconazole versus CO2 laser only versus topical tioconazole alone in onychomycosis. A total of 120 patients with onychomycosis were randomly assigned to three groups. Group A patients were treated with fractional CO2 laser followed by topical tioconazole 28% for five sessions with 3 weeks interval. Group B patients were treated with fractional CO2 laser for five sessions with 3 weeks interval. Group C patients were treated with only topical tioconazole 28% for 16 weeks. The clinical effect, KOH examination, and culture for the affected nails in the three groups were analysed. One month after the last session, regarding clinical response, 55% showed complete clinical improvement in Group A versus 30% in Group B versus 25% in Group C with a significant difference in between. There was a significant difference between the three studied groups as regard KOH test and culture after treatment. Fractional CO2 laser combined with topical antifungal is a safe and effective treatment for onychomycosis.

Title: Doppler Ultrasound-Guided Thread Lifting Authors: Lee W et al. Published: Journal of Cosmetic Dermatology, December 2019 Keywords: PDO threads, Ultrasound, Complication prevention Abstract: Although there are various techniques of thread lifting, most of these techniques require anchoring of the threads at the temple area. However, the frontal branch of the superficial temporal artery (FBrSTA) is located in the temple area and a detour pathway should be created for thread insertion to avoid vascular complications. We aimed to determine the relationship between the FBrSTA and the hairline using realtime Doppler ultrasound. Doppler ultrasound was used to detect the FBrSTA pathway, and the relationship between the hairline and the FBrSTA was analyzed. After confirming the arterial pathway, thread lifting was performed in patients, and complications related to the entry point and insertion of the threads were evaluated. Patient satisfaction was evaluated immediately after the procedure and 3 months later. This study included 50 patients (45 women and 5 men; age: 51 [range 26-71] years) who underwent thread lifting in a single institution from January to May 2019 after Doppler ultrasound-guided detection of the FBrSTA. No vascular complications were noted in all patients. Our findings suggest that Doppler ultrasound can be used to detect the FBrSTA at the temple area to avoid vascular complications during thread lifting. Title: Adipose-derived Stromal/Stem Cells Improve Epidermal Homeostasis Authors: Moriyama M et al. Published: Scientific Reports, December 2019 Keywords: Stem cells, Wound healing, Skincare Abstract: Wound healing is regulated by complex interactions between the keratinocytes and other cell types including fibroblasts. Recently, adipose-derived mesenchymal stromal/stem cells (ASCs) have been reported to influence wound healing positively via paracrine involvement. However, their roles in keratinocytes are still obscure. Therefore, investigation of the precise effects of ASCs on keratinocytes in an in vitro culture system is required. Our recent data indicate that the epidermal equivalents became thicker on a collagen vitrigel membrane co-cultured with human ASCs (hASCs). Co-culturing the human primary epidermal keratinocytes (HPEK) with hASCs on a collagen vitrigel membrane enhanced their abilities for cell proliferation and adhesion to the membrane but suppressed their differentiation suggesting that hASCs could maintain the undifferentiated status of HPEK. Contrarily, the effects of co-culture using polyethylene terephthalate or polycarbonate membranes for HPEK were completely opposite. These differences may depend on the protein permeability and/or structure of the membrane. Taken together, our data demonstrate that hASCs could be used as a substitute for fibroblasts in skin wound repair, aesthetic medicine, or tissue engineering. It is also important to note that a co-culture system using the collagen vitrigel membrane allows better understanding of the interactions between the keratinocytes and ASCs.

Title: The Structure and Classification of Botulinum Toxins Authors: Dong M and Stenmark P Published: Handbook of Experimental Pharmacology, December 2019 Keywords: BONT, Rejuvenation Abstract: Botulinum neurotoxins (BoNTs) are a family of bacterial protein toxins produced by various Clostridium species. They are traditionally classified into seven major serotypes (BoNT/A-G). Recent progress in sequencing microbial genomes has led to an ever-growing number of subtypes, chimeric toxins, BoNT-like toxins, and remotely related BoNT homologs, constituting an expanding BoNT superfamily. Recent structural studies of BoNTs, BoNT progenitor toxin complexes, tetanus neurotoxin (TeNT), toxin-receptor complexes, and toxin-substrate complexes have provided mechanistic understandings of toxin functions and the molecular basis for their variations. The growing BoNT superfamily of toxins present a natural repertoire that can be explored to develop novel therapeutic toxins, and the structural understanding of their variations provides a knowledge basis for engineering toxins to improve therapeutic efficacy and expand their clinical applications.