References

Kapoor KM, Kapoor P, Heydenrych I, Bertossi D. Vision loss associated with hyaluronic acid fillers: a systematic review of literature. Aesthetic Plast Surg. 2019; https://doi.org/10.1007/s00266-019-01562–8

Claudel JP, Auffret N, Leccia MT, Poli F, Dréno B. Acne from the young patient's perspective. J Eur Acad Dermatol Venereol. 2019; https://doi.org/10.1111/jdv.16067

Löwa A, Graff P, Kaessmeyer S, Hedtrich S. Fibroblasts from atopic dermatitis patients trigger inflammatory processes and hyperproliferation in human skin equivalents. J Eur Acad Dermatol Venereol. 2020; https://doi.org/10.1111/jdv.16240

Du-Harpur X, Watt FM, Luscombe NM, Lynch MD. What is AI? Applications of artificial intelligence to dermatology. Br J Dermatol. 2020; https://doi.org/10.1111/bjd.18880

Avila C, Massick S, Kaffenberger BH, Kwatra SG, Bechtel M. Cannabinoids for the treatment of chronic pruritus: a review. J Am Acad Dermatol. 2020; https://doi.org/10.1016/j.jaad.2020.01.036

RESEARCH ROUNDUP

02 March 2020
Volume 9 · Issue 2

Abstract

In this regular feature, aesthetic nurse Claudia McGloin presents a brief synopsis of a range of recently published articles on medical aesthetics. Research roundup aims to provide an overview, rather than a detailed summary and critique, of the papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided at the end of each study summary

One study reviewed the role of hyaluronic acid fillers in causing loss of vision

Vision loss associated with hyaluronic acid fillers: a systematic review of literature

As the use of dermal filler injections increases worldwide, as are the cases of serious adverse events, such as loss of vision and skin ischemia, being reported.

The aim of this article was to review the role that hyaluronic acid (HA) fillers may play in causing vision loss and to further explain the outcomes vision loss caused by HA fillers.

There was a total of 29 articles used for this study, which showed 60 distinctive cases of HA filler causing loss of vision. There were also 26 articles with details of 44 cases that were included in this study.

Most of these vision loss cases were seen among women aged 20–40 years and the majority of these cases were reported in Korea and China.

The results of this study showed that nearly 50% of these cases reported visual complications and had partial loss of sight, therefore, the terms ‘partial vision loss’ and ‘complete vision loss’ were used to describe the differences between the degrees of vision loss. The study also showed that most of the cases were unilateral, with visual signs and symptoms beginning immediately.

The areas that were injected and caused vision loss were the nose, glabella and forehead. There were no reported cases of HA filler vision loss from the lower face, including the chin, jawline, and lips. The study also showed that partial vision loss after HA filler was a better diagnosis rather than complete vision loss. The injected volumes of HA filler were as little as 0.2 ml and even this can cause permanent and complete vision loss. After ophthalmic artery occlusion and central retinal artery occlusion, branch retinal artery occlusion was the most commonly involved arterial obstruction patterns.

In conclusion to this study, HA filler vision loss is mostly of immediate onset, while there are better outcomes for post-HA filler partial vision loss, with the involvement of smaller branches of the retina, other than central retinal artery or ophthalmic artery.

Acne from the young patient's perspective

Acne can considerably influence the self-esteem and quality of life of anyone suffering with this skin condition.

The aim of this study was to provide an overview of acne and to discuss the risk factors in adolescents and young adults.

To conclude this study, the authors conducted a PubMed literature review of results from patient surveys that were published between 2007 and 2018. There were two different types of survey used in this study: validated or specifically developed questionnaires.

The results of the study showed that acne affected the female patients psychologically more than the male patients affected. The majority of patients had consulted with their medical professionals to get further information on acne and all the surveys used in this study had pointed out that specific treatment programs would act to increase the likelihood of acne awareness.

The study found that there are a lot of causes that can impact the perception and treatment choices for acne globally, ranging from traditions to economic factors.

In conclusion to this study, the authors state that a young person's wellbeing can be improved by identifying, considering and managing the patient's concerns about acne, thus decreasing additional healthcare expenses for emerging psychological comorbidities. The authors suggest that this can be achieved by creating extensive and structured awareness by using local and global information campaigns via medical professionals, the internet and education.

Fibroblasts from atopic dermatitis patients trigger inflammatory processes and hyperproliferation in human skin equivalents

Atopic dermatitis is an extremely complicated and heterogenic skin disease. Its underlying pathomechanism is still not fully understood by medics.

The studies available that intended to show the disease mechanism focused on the contribution of keratinocytes and the immune system. Very little is understood about the impact of fibroblasts on atopic dermatitis. The authors of this study examined the role of atopic dermatitis patient-derived fibroblasts on tissue homeostasis and inflammation in human skin equivalents.

What is AI? Applications of artificial intelligence to dermatology

To make a correct dermatological diagnosis, clinicians will need experience and skill, as well as having treated thousands of patients.

Artificial intelligence (AI) has made huge developments the past few years, particularly in image classification in dermatology. These advancements have led to scientists specialising in computers to apply these techniques and develop algorithms that are able to recognise skin lesions, in particular, melanoma.

Numerous studies over the past few years have assessed the accuracy of these algorithms, with some reporting that accuracy matches or surpasses that of a dermatologist.

Developments in artificial intelligence are proving beneficial for dermatology

The aim of this article was to explain AI, machine learning, neural networks and deep learning, and then to explore how these tasks are completed.

The authors reviewed available studies and evaluated each one that assessed the efficacy of these methods to discuss restrictions and any possible ethical issues.

In conclusion, skin cancer diagnoses are rapidly increasing in Western societies, with major repercussions for dermatology. The authors agree that AI has the possibility to aid in the diagnosis of skin lesions in dermatology and could have value at the interface between primary and secondary care. The developing technology presents new opportunities and developments for dermatologists and medical professionals working with skin.

Cannabinoids for the treatment of chronic pruritus: a review

Patients in the US are widely using medical marijuana and, as recreational marijuana is now legalised in many states, there is now an increase in patient interest to treat various conditions.

The endocannabinoid system has a key part in treating skin conditions such as pruritus, inflammation and immune reactions.

Various studies are available showing how it is possible for cannabinoid modulation to help with pruritus. The most evidence available is showing neuronal modulation of both peripheral itch fibers and centrally acting cannabinoid receptors. Furthermore, studies show constant significant reductions in both scratching and symptomatology in chronic pruritus. Clinical studies have demonstrated a reduction in pruritus in several dermatologic (atopic dermatitis, asteatotic eczema, psoriasis and prurigo nodularis) and systemic (uremic pruritus, cholestatic pruritus) diseases.

The authors have stated that these studies require further controlled trials to confirm the benefit of cannabinoids for the treatment of pruritus and to set gold standards for treatment protocols, as well as clinical indications. In conclusion, the use of endocannabinoid system plays an active role in the skin and cannabinoid products are an emerging consideration for skin therapy, particularly for itches.