Chemical Peels as Field Therapy for Actinic Keratoses: A Systematic Review.

Background: Actinic keratoses (AKs) are a common premalignant cutaneous neoplasm and can progress to squamous cell carcinoma. A variety of treatment options are available for field therapy of diffuse AKs.

Objective: This review systematically analyzes the use of chemical peels for treatment of AKs.

Efficacy, Safety, and Subject Satisfaction After AbobotulinumtoxinA Treatment for Moderate to Severe Glabellar Lines.

Background: The aesthetic use of botulinum toxins is widely accepted in routine treatment of glabellar lines.

Objective: To strengthen existing efficacy and safety data, and examine subject satisfaction concerning abobotulinumtoxinA (ABO) treatment for moderate to severe glabellar lines.

Materials And Methods: A 150-day prospective, single-dose, multicenter, randomized, parallel-group, placebo-controlled, double-blind study of 300 subjects treated with ABO (50 Units [U]).

Treatment of Atrophic Facial Acne Scars With Microneedling Followed by Polymethylmethacrylate-Collagen Gel Dermal Filler.

Background: Microneedling and soft-tissue filler injections have been used independently to improve acne scarring. The effectiveness of a combined approach using microneedling followed by polymethylmethacrylate (PMMA)-collagen gel has not been carefully studied.

Objective: The goal of this study was to assess the effectiveness and safety of microneedling alone versus microneedling followed by injection of PMMA-collagen gel filler for correction of atrophic facial acne scars.

Noninvasive approach to treatment of submental fullness.

A recent survey done by the American Society for Dermatologic Surgery indicated that 67% of respondents were bothered by "excess fat under the chin/neck." Accumulation of fat in the preplatysmal compartment of the neck is a common cause for fullness in the submental area. In the past, surgical liposuction was the only option to remove fat in the submental area.

Histologic Accuracy of Mohs Micrographic Surgery.

Background: Mohs micrographic surgery enables the surgeon to maximize tumor removal while minimizing the amount of tissue being removed using advanced mapping techniques combined with microscopy. Interpretation of frozen section slides is vital to the success of Mohs micrographic surgery.

Objective: Evaluate and confirm the congruence of frozen section slide interpretation between fellowship-trained Mohs surgeons and dermatopathologists.

AbobotulinumtoxinA: A 25-Year History.

During the late 1960s and early 1970s, Alan Scott showed that intramuscular injections of botulinum toxin (BoNT) corrected nonaccommodative strabismus without resorting to surgery. The UK doctors who trained with Scott soon realized the significant potential offered by BoNT type A as a therapeutic option for several difficult-to-treat diseases. This led to a collaboration between these pioneering clinicians and the Centre for Applied Microbiology and Research at Porton Down, United Kingdom, and, in turn, to the development and commercialization of abobotulinumtoxinA as Dysport (Dystonia/Porton Down; Ipsen Biopharm Ltd.

Anatomy of the Cervicomental Region: Insights From an Anatomy Laboratory and Roundtable Discussion.

In 2015, ATX-101 (deoxycholic acid injection; Kybella in the United States and Belkyra in Canada; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) was approved as a first-in-class injectable drug for reduction of submental fat. Use of a pharmacologic/injectable therapy within the submental region requires a thorough understanding of cervicomental anatomy to ensure proper injection technique and safe administration.

Proper Technique for Administration of ATX-101 (Deoxycholic Acid Injection): Insights From an Injection Practicum and Roundtable Discussion.

ATX-101 (deoxycholic acid injection; Kybella in the United States and Belkyra in Canada; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) is the first aesthetic injectable approved for reduction of submental fat. In February 2014, an injection practicum was conducted in the anatomy laboratory at the University of Texas Southwestern Medical Center to explore the proper injection technique for ATX-101 and the importance of its appropriate, safe anatomical placement within the submental area.

Nonsurgical facial rejuvenation.

Facial rejuvenation has evolved from purely surgical to the use of nonsurgical techniques such as lasers and injectable fillers and toxins. This has occurred as a product of consumer demand for less down time and risk, as well as a new scientific knowledge of facial aging. A review of patient consultation evaluation and use of injectable products will be discussed in this chapter.

Understanding and use of the American Joint Committee on Cancer seventh edition guidelines for cutaneous squamous cell carcinoma: a survey of dermatologic surgeons.

Background: The seventh edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual was published in 2009, including an updated chapter on cutaneous squamous cell carcinoma (cSCC) and other cutaneous carcinomas. Notable improvements from the previous sixth edition include placement of Merkel cell carcinoma and cSCC of the eyelid in individual chapters, elimination of the 5-cm clinical breakpoint for T3, and addition of high-risk features for upstaging T1 to T2 independent of clinical tumor size. Despite these advances, several publications critical of the AJCC guidelines have surfaced in the literature since their release.

Comparison of a skin-lightening cream targeting melanogenesis on multiple levels to triple combination cream for melasma.

The safety and efficacy of a novel skin-lightening cream (SLC) with 4% hydroquinone (HQ), which additionally contains 4 skin-brightening actives, was compared with a triple combination cream (TCC) with 4% HQ, 0.05% tretinoin, and 0.01% fluocinolone acetonide for the treatment of melasma under measures of sun protection.

How many sections are required to clear a tumor? Results from a web-based survey of margin thresholds in Mohs micrographic surgery.

Background: Mohs micrographic surgery (MMS) offers an unparalleled cure rate for cutaneous malignancy. Its success hinges on achieving reliably negative histologic margins. When assessing margins, Mohs surgeons generally examine multiple histologic sections per Mohs stage.

Development and validation of a new clinically-meaningful rating scale for measuring lateral canthal line severity.

Background: Several scales have been employed for evaluating the effects of cosmetic treatments in the periorbital area. The Food and Drug Administration (FDA) has recently issued new recommendations specifying a rigorous process to validate new aesthetic scales.

Objectives: The authors describe and validate a new clinical rating scale: the Investigator's Global Assessment of Lateral Canthal Line (IGA-LCL) severity scale.

Results of a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of a botulinum toxin type A topical gel for the treatment of moderate-to-severe lateral canthal lines.

Background: Injections of botulinum toxin type A are commonly used to treat facial wrinkles; however, undesirable effects are associated with injections (e.g., pain, bruising, ptosis, immunogenicity, and needle aversion).

An overview of botulinum toxins: past, present, and future.

Although the mechanism of action of botulinum toxin (BTX) has been intensively studied, many unanswered questions remain regarding the composition and clinical properties of the two formulations of BTX currently approved for cosmetic use. In the first half of this review, these questions are explored in detail, with emphasis on the most pertinent and revelatory studies in the literature. The second half delineates most of the common and some not so common uses of BTX in the face and neck, stressing important patient selection and safety considerations.

Investigator global evaluations of efficacy of injectable poly-L-lactic acid versus human collagen in the correction of nasolabial fold wrinkles.

Background: Injectable poly-L-lactic acid (PLLA) is indicated in the United States for use in immune-competent patients for correction of shallow-to-deep nasolabial fold contour deficiencies and other facial wrinkles in which a deep dermal grid pattern injection technique is appropriate. It is also indicated for restoration and/or correction of signs of lipoatrophy in patients with human immunodeficiency virus.

Objective: The authors examine the efficacy of injectable PLLA for correction of nasolabial fold wrinkles, based on Investigator Global Evaluations (IGE).

Facial soft-tissue fillers conference: assessing the state of the science.

: The American Society of Plastic Surgeons and the American Academy of Dermatology, with the support of other sister societies, conducted the Facial Soft-Tissue Fillers: Assessing the State of the Science conference in December of 2009. The American Society of Plastic Surgeons and the American Academy of Dermatology established a panel of leading experts in the field of soft-tissue fillers-from researchers to clinicians-and other stakeholders for the conference to examine and discuss issues of patient safety, efficacy, and effectiveness in relation to the approved and off-label use of soft-tissue fillers, and other factors, including the training and level of experience of individuals administering fillers. This report represents the systematic literature review that examines comprehensively the available evidence and gaps in the evidence related to soft-tissue fillers, to inform and support the work of the state-of-the-science conference panel.

Facial Soft-Tissue Fillers conference: Assessing the State of the Science.

The American Academy of Dermatology and the American Society of Plastic Surgeons, with the support of other sister societies, conducted the Facial Soft-Tissue Fillers: Assessing the State of the Science conference in December of 2009. The American Academy of Dermatology and the American Society of Plastic Surgeons established a panel of leading experts in the field of soft-tissue fillers-from researchers to clinicians-and other stakeholders for the conference to examine and discuss issues of patient safety, efficacy, and effectiveness in relation to the approved and off-label use of soft-tissue fillers, and other factors, including the training and level of experience of individuals administering fillers. This report represents the systematic literature review that examines comprehensively the available evidence and gaps in the evidence related to soft-tissue fillers, to inform and support the work of the state-of-the-science conference panel.