Daily Cosmetic Research Analysis

BACKGROUND: Women with cosmetic implants have lower rates of future breast cancer than the general population. The authors hypothesized that the implant foreign body response could induce a local protective anticancer immunosurveillance. The authors expanded on their previous finding, which showed that women with breast implants have elevated antibody responses to certain breast cancer proteins. METHODS: Blood samples and breast tissue were collected from women undergoing first time breast augmentation (implant-naive [IN]) and revision breast augmentation (implant-exposed [IE]). Sera were collected and antibody levels to common breast cancer proteins were quantified by enzyme-linked immunosorbent assay. Reverse transcriptase-polymerase chain reaction was performed on breast tissue samples to quantify immune-related gene expression levels between IN and IE patients. Bulk RNA sequencing was performed to identify differentially expressed genes and altered signaling pathways in the breasts of IN patients versus IE patients. RESULTS: In total, 188 patients were recruited (IN, n = 117; IE, n = 71). Data demonstrated that IE patients had higher levels of antibodies to mucin-1, estrogen receptor-α, and mammaglobin A compared with IN patients. Mucin-1 expression was found to be higher in IE compared with IN breast tissue. RNA- sequencing analysis demonstrated up-regulated pathways in IE breast tissue for B-cell activation and development, T-helper cell type 2-related genes, T-cell activation, chemotactic factors, and responses to estrogen. CONCLUSIONS: This is the first study to demonstrate that periimplant inflammation extends beyond the implant capsule to the breast parenchyma. Women with breast implants have more activated B cells in the breast parenchyma and elevated antibody responses to breast cancer antigen. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

BACKGROUND: Treatment with fluocinolone acetonide, hydroquinone, and tretinoin cream is the gold standard for melasma; however, the effects of this treatment in the Chinese population remain unclear. Due to the differences between Chinese and Caucasian subjects, further clinical trials in Chinese patients with melasma are needed. AIM: To evaluate the efficacy and safety of fluocinolone acetonide, hydroquinone, and tretinoin creams in Chinese patients with moderate-to-severe melasma. METHODS: We recruited 53 patients who received a generic formulation (triple combination cream, TCC), brand formulation (TRI-LUMA), or placebo once daily for 8 weeks. In weeks 4 and 8, efficacy was evaluated based on the Melasma Severity Scale and Melasma Area and Severity Index. In addition, safety was assessed based on the incidence and severity of treatment-emergent adverse events. RESULTS: The generic TCC group achieved 52.2% efficacy compared to 57.1% in the TRI-LUMA group. There was no significant difference in the incidence of adverse effects between the TCC and TRI-LUMA groups (69.6% and 90.5%, respectively; p > 0.05). The incidence of adverse events in the placebo group was 0%. CONCLUSION: Generic TCC was as effective as TRI-LUMA and had a similar safety profile in this study of Chinese subjects with moderate-to-severe melasma.

BACKGROUND: Ellanse is a polycaprolactone-based collagen stimulator that is rarely associated with the formation of palpable nodules. The current management of palpable nodules include triamcinolone injection, consumption of oral methotrexate, and surgical excision. The absence of an effective reversal agent that is safe has limited the popularity of Ellanse as a facial rejuvenation modality. OBJECTIVE: This article presents a dual focus (1) a case series demonstrating the efficacy of the iCare technique in treating 10 nodules from Ellanse M treatment in three patients and (2) an experimental study investigating the in vitro and in vivo dissolution of Ellanse M aliquots. In the case series, nodules, which have persisted for an average of 2 years following initial Ellanse M treatment, are effectively managed with the iCare technique. The iCare technique of dissolution involves injecting a collagenase mixture that is five times the initial injected volume of Ellanse. The case series finding demonstrates the iCare technique as a viable solution in managing Ellanse-associated nodules. An allergy test is also conducted prior to injection of collagenase mixture to demonstrate the safety of collagenase mixture. EXPERIMENTAL STUDY: An experiment is conducted by mixing 0.1 mL Ellanse M aliquots with 0.5 mL collagenase mixture (Slide X). Controls are provided by adding 0.5 mL of lignocaine 2% and adrenaline 1:80 000 (Slide L), 0.5 mL hyaluronidase (Slide H), 0.5 mL of 40 mg/mL of triamcinolone (Slide T) separately to 0.1 mL Ellanse M aliquots. RESULTS: Ellanse M is converted from a gel into a solution by collagenase mixture (X) while it is not affected by lignocaine and adrenaline (L), hyaluronidase (H), or triamcinolone (T). The conversion of Ellanse gel into a solution occurs within 5 min of adding the mixture. CONCLUSION: The case series demonstrates the iCare technique's efficacy in addressing delayed onset nodules associated with Ellanse treatment. The experimental study demonstrates in vitro and in vivo dissolution of injected Ellanse aliquots. This article offers a promising solution to significant issues associated with Ellanse treatment-namely, the formation of nodules and the lack of an effective fast-acting reversal agent.