Platelet rich plasma (PRP) was described as a small volume of plasma containing higher concentrations of platelets than those found in peripheral blood and initially used as a transfusion product for treatment of thrombocytopenia. To date, it was discovered that there are several growth factors and cytokines that can accelerate wound healing and tissue regeneration, leading to a wider range of applications in the medical field, such as in sport medicine, regenerative medicine, and aesthetic medicine. Several studies have shown that PRP can be used effectively for treatment of hair loss. Although it has been widely used, the exact mechanism of action of PRP is still not fully elucidated. In this article, we aim to review and update current information on the definition, classification, mechanism of action, clinical efficacy in hair regrowth, and adverse events of PRP.
This study evaluated the efficacy and tolerability of topical aluminum sesquichlorohydrate (AS) when compared to aluminum chloride (AC) as a treatment for primary axillary hyperhidrosis (PAH). Twenty subjects were included in this randomized, controlled, split-side 8-week study. All participants applied 20% AS and 20% AC lotions in their axillae (one treatment per axilla) every night for 2 weeks; next, the application was reduced to three times a week for 4 weeks. The assessment was performed using the sweating intensity visual scale (SIVS), hyperhidrosis disease severity score (HDSS), patient satisfaction score, and the appearance of adverse effects on weeks 0, 1, 2, 4, 6, and 8. Both AS as well as AC application showed positive results, significantly differing from the baseline, as assessed using SIVS, HDSS, and patient satisfaction score at every follow-up visit; however, no significant difference was observed between the AS and AC groups at any follow-up visit. The mean time of response was 1.14 weeks for both treatments. A side effect was observed in one subject (5%), who reported itching on the AC axilla. The therapeutic effects persisted even after reducing the frequency of application and lasted for at least 2 weeks after cessation of use. In conclusion, topical 20% AS demonstrated similar efficacy to topical 20% AC in the treatment of PAH, with a high safety profile.
Demodex mites are common ectoparasites of the human pilosebaceous units. Most adults are infested with Demodex mites without clinical symptoms. Demodex mite will only become a pathogenic organism when there is an abnormal increase in the number of Demodex mite density. This situation happens when the equilibrium between Demodex mites, skin microenvironment and human immunity system changes. Demodex infestation can cause multiple skin disorders, which are grouped under the term demodicosis or demodicidosis. Clinical manifestations of demodicosis can mimic other known skin diseases such as folliculitis, rosacea, perioral dermatitis, which is why it is often misdiagnosed. Diagnosis criteria consists of relevant correlation of suspected clinical skin lesions, confirmed by the presence of abnormal proliferation of Demodex mites and by clinical cure after acaricidal treatment together with normalization of Demodex mite density. Dermatologists should be aware that demodicosis is not an uncommon skin disease, and there are still many unknowns about it that should be researched further.
<i>Demodex</i> mites are common ectoparasites of human pilosebaceous units that do not cause any skin symptoms. However, when there is an abnormal increase in <i>Demodex</i> mite density, it can cause multiple skin disorders which are grouped under the term demodicosis. During the COVID-19 outbreak, public health authorities worldwide recommend people to wear face masks when in public places to reduce respiratory transmission. Wearing face mask can cause changes in microenvironment, skin barrier function, and microbiome on human skin. There are several reports of facial skin diseases such as atopic dermatitis, seborrheic dermatitis, acne vulgaris, and rosacea provoked by wearing masks for long periods of time. This is the first case report of demodicosis associated with wearing a face mask. A 46-year-old female presented with dry, itchy erythematous to purpuric patches with fine follicular scales on both cheeks and chin under the mask. Clinical symptoms started slowly with warm, slightly burning, and periodically itching sensation on both cheeks after 3 weeks of wearing surgical face mask for more than 8 h a day. Even after switching to a cloth mask and using topical steroid, the rash improved slightly and recurred after discontinuation of the treatment. The diagnosis of demodicosis was made by relevant correlation of clinical skin lesions, along with standardized skin surface biopsy results that detected abnormal proliferation of <i>Demodex</i> mites and clinical cure after oral ivermectin therapy.
Background There is no single effective treatment for demodicosis; successful treatment requires a multimodal approach. Relapse or recurrence of demodicosis is relatively high, making the therapy challenging. Several reports have documented the successful treatment of demodicosis with acaricidal agents, which aimed at reducing the excessive number of Demodex mites and improving the patients’ symptoms. Reports of irritation and resistance to topical acaricidal agents have led to the search for effective alternative treatments. Materials and Methods A total of 100 standardized skin surface biopsy (SSSB) biopsy slides from 100 patients with demodicosis were randomly divided into five groups, each with 20 slides exposed to immersion oil, N, N -diethyl-meta-toluamide (DEET) 5%, 10%, 20%, and permethrin 1%, respectively. The microscopic evaluation started immediately after the test agents exposed the mites. The survival time (ST) was defined as the interval between the first exposure of Demodex folliculorum to the test agents to the time the movements ceased. Results The differences between the median ST of DEET 5% (44 min), 10% (22 min), and 20% (14 min) were significant when compared to the negative control group (240 min) with p<0.001, <0.001, <0.001, respectively. While the median ST of permethrin 1% (42 min) was not significantly different from the median ST of DEET 5% (p=0.7395). Conclusion This study demonstrated the dose-related acaricidal effect of DEET on D. folliculorum . The survival times of DEET 5%, 10%, and 20% were significantly shorter than the negative control (immersion oil). DEET 5% had a comparable in vitro killing effect as permethrin 1%. Further in vivo studies are necessary to determine the clinical efficacy in patients with demodicosis.
Demodicosis is caused by Demodex mite infestation and can present with a variety of clinical manifestations, including pityriasis folliculorum type, rosacea-like type, folliculitis-like type and perioral dermatitis-like type. Therefore, this skin condition is often misdiagnosed or underdiagnosed. This report presents a 19-year-old woman with a history of pityriasis folliculorum type demodicosis and successful treatment with oral ivermectin. After one year of remission, the patient began to develop a dry, itchy rash on her face for one month before multiple small edematous papules and pustules gradually appeared on both cheeks. The patient was first diagnosed as acne vulgaris and treated with doxycycline for 2 weeks, but the clinical symptoms did not show any signs of improvement. After reassessment based on clinical presentation and laboratory examination that found multiple Demodex mites from pustules and rash on both cheeks, the patient was diagnosed with folliculitis-like type demodicosis. However, this patient still had a very good response to oral ivermectin and metronidazole gel, and all clinical symptoms disappeared within 4 weeks after treatment. This is a case report of demodicosis imitating acne vulgaris and the first report demonstrating a change in clinical manifestations of demodicosis from pityriasis folliculorum type to folliculitis-like type.
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