Daily Cosmetic Research Analysis

BACKGROUND: Intraoperative radiation therapy (IORT) delivered during breast-conserving surgery may streamline treatment and enhance cosmetic outcomes. However, optimal patient selection criteria remain uncertain, especially in Asian populations, where international guidelines may not be fully applicable. This study aimed to evaluate local recurrence rates, identify key prognostic factors, and assess the impact of supplemental external beam radiation therapy (EBRT) in Taiwanese patients receiving IORT. MATERIALS AND METHODS: This retrospective analysis included 1,306 Taiwanese patients who underwent IORT between June 2014 and December 2021. Patients were stratified into low-risk and high-risk groups based on institutional criteria. Low-risk patients were those meeting all of the following: age ≥ 45 years, tumor size ≤ 3.5 cm, negative nodal involvement, Ki-67 ≤ 30%, hormone receptor (HR) positivity, and HER2 negativity. Patients who did not meet one or more of these criteria were classified as high-risk and were recommended to receive supplemental external beam radiation therapy (EBRT) following IORT. RESULTS: In our cohort of 1,306 patients, the 3-year disease-free survival rate was 93.11% [95% confidence interval (CI): 91.6-94.4%], with 87 patients (6.89%) experiencing recurrence. The median age was 52 years, and the median follow-up duration was 30.5 months. The overall local recurrence rate was 9.3%, which declined to 1.78% after excluding patients who did not receive indicated adjuvant therapies. Multivariable analysis identified Ki-67 > 30%, omission of hormone therapy, and omission of recommended EBRT as significant predictors of local recurrence, whereas age < 45 was not independently associated with increased risk. Among high-risk patients, the addition of EBRT was associated with a 48.8% reduction in recurrence, achieving outcomes comparable to those of low-risk patients. CONCLUSIONS: Age alone should not determine IORT eligibility. A multifaceted approach, including tumour biology and adherence to recommended therapies, is essential. Supplemental EBRT improves outcomes in high-risk patients, and adapting guidelines may enhance patient selection in Asian populations.

BACKGROUND: Poly-D,L-lactic acid (PDLLA) skin boosters are widely used for biostimulatory skin rejuvenation, but comparative data on pain perception between injection techniques remain limited. OBJECTIVE: To compare patient-reported pain between intradermal and subdermal PDLLA injections using a randomized, double-blinded, split-injection design. METHODS: Twenty-one healthy participants (aged 27-64) each received ten facial injections: five intradermal and five subdermal, administered in randomized order using a 32G needle. Pain was assessed using a Visual Analogue Scale (VAS) immediately after each injection. The primary outcome was the difference in mean VAS scores between techniques. Secondary analyses examined the effects of age and gender on pain perception. RESULTS: The mean VAS score for intradermal injections was significantly higher than for subdermal injections (6.18 vs. 3.85, p<0.001). No significant gender-based differences were observed. Patients under 40 reported higher intradermal pain than older subjects (p=0.04), but age had no impact on subdermal pain. CONCLUSION: Subdermal PDLLA injections are significantly less painful than intradermal injections, likely due to lower nerve density and reduced dermal resistance. With equivalent efficacy and minimal downtime, subdermal injection may be preferable for patient comfort and compliance. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

BACKGROUND: Sensitive skin (SS) is a common dermatological condition characterized by enhanced reactivity to environmental, chemical, and cosmetic stimuli, often accompanied by impaired barrier function and discomfort sensation such as burning or itching. Despite its high prevalence, the molecular mechanism underlying SS remains poorly understood. OBJECTIVES: This study aimed to perform a comprehensive proteomics analysis to characterize molecular alterations in SS compared with nonsensitive skin (NS), thereby uncovering key pathways involved in barrier dysfunction, oxidative stress, and neuroinflammatory responses. METHOD: Thirty subjects with SS and 30 with NS were recruited. Stratum corneum samples were collected via tape stripping and analyzed using four-dimensional data-independent acquisition (DIA) proteomics. RESULTS: Proteomic profiling revealed distinct molecular signatures between SS and NS. SS exhibited enrichment of pathways related to cytoskeletal remodeling, cell-cell adhesion, and tight junction organization, consistent with impaired but dynamically compensatory barrier regulation. Enhanced oxidative phosphorylation and fatty acid β-oxidation indicated increased metabolic activity, while elevated glutathione-related enzyme functions reflected altered redox balance and oxidative stress. Additionally, upregulation of MAPK signaling and neurotrophin-associated pathways suggested active neuro-inflammatory crosstalk, potentially contributing to heightened cutaneous sensitivity and inflammatory susceptibility. Additional alterations were observed in other cellular processes, reflecting the complex molecular landscape of SS. CONCLUSION: These findings provide new insights into the molecular basis of SS, highlighting the interplay between barrier dysfunction, oxidative stress, and neuronal activation. The identified proteins and pathways may serve as potential biomarkers for SS assessment and as targets for the development of cosmetic products or therapeutic strategies aimed at restoring skin homeostasis.