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Reticular erythematous mucinosis (REM) is a rare cutaneous condition often referred to as plaque-like mucinosis and midline mucinosis. Although the exact etiology remains undefined, efforts to elucidate pathogenesis, disease associations, and prospective treatment modalities have been encouraging. Induction of the disease has been associated with viral processes, solar irradiation, specific cell lines, and cytokines such as Interleukin (IL)-1β. Clinically, patients typically develop erythematous macules and papules that coalesce into reticulated patterns on the midline of the chest or back. The lesions have a tendency to respond to systemic antimalarial therapy, but novel therapeutic approaches with ultraviolet A1 light (UVA1) and pulse dye laser (PDL) have been promising. Histologically, REM is associated with a mild, predominantly lymphocytic infiltrate with variable deep perivascular extension. Mucin may be seen in the upper and mid dermis and is prominent around the infiltrate and appendages. IgM deposits may be visualized under direct immunoflourescence along the basal layer. Because of the similarities between REM and tumid lupus, the two disease processes have often been grouped together. The remarkable overlap between the two diseases suggests that the two conditions may actually be the same disease.

IMPORTANCE There remains little experimental evidence and no randomized clinical trial to date to confirm the benefit of platelet-rich plasma (PRP) for facial rejuvenation. OBJECTIVE To investigate whether PRP injection improves the visual appearance, including texture and color, of photodamaged facial skin. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, participants and raters were masked to groupings. The setting was an academic-based, urban outpatient dermatology practice in Chicago, Illinois. Participants were adults aged 18 to 70 years with bilateral cheek rhytids of Glogau class II or greater. The duration of the study was August 21, 2012, to February 16, 2016. INTERVENTIONS Each participant received 3 mL intradermal injections of PRP to one cheek and sterile normal saline to the contralateral cheek. MAIN OUTCOMES AND MEASURES Primary outcomes were photoaging scores (with subscores for fine lines, mottled pigmentation, roughness, and sallowness) as rated by 2 masked dermatologists. Secondary outcomes included participant self-assessment scores of improvement on a 5-point scale (worsening, no change, mild improvement, moderate improvement, or significant improvement), participant overall satisfaction scores on a 4-point scale (not satisfied, slightly satisfied, moderately satisfied, or very satisfied), and participant-reported or investigator-observed adverse events. RESULTS Of 27 enrolled participants, 19 (mean [SD] age, 46.37 [10.88] years; 17 female) were analyzed. Reported adverse events, which were not associated with the study agent, included redness (n = 18), swelling (n = 16), bruising (n = 14), pruritus (n = 1), skin scaling (n = 1), and dryness of skin (n = 1). No participants reported any adverse events at 12 months. Mean (SD) photoaging scores rated by 2 dermatologists showed no significant difference between PRP and normal saline for fine lines (baseline, 1.

Our ability to treat vitiligo may be imperfect, but through appropriate patient selection and careful application of one or more of these advanced therapies, successful treatment of vitiligo, even in patients refractory to treatment, can be achieved.

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IMPORTANCE Although hyaluronidase is known to remove hyaluronic acid fillers, use of low doses has not been well studied. OBJECTIVE To assess the effectiveness and dose-related effect of small quantities of hyaluronidase to treat hyaluronic acid filler nodules. DESIGN, SETTING, AND PARTICIPANTS Split-arm, parallel-group, randomized clinical trial at an urban academic center. Participants were 9 healthy women. Recruitment and follow-up occurred from February 2013 to March 2014; data analysis occurred from February to July 2016. INTERVENTIONS Each participant received aliquots (buttons) of either of 2 types of hyaluronic acid fillers into bilateral upper inner arms, respectively. At 1, 2, and 3 weeks each button was treated with a constant volume (0.1 mL) of variable-dose hyaluronidase (1.5, 3.0, or 9.0 U per 0.1 mL) or saline control. MAIN OUTCOMES AND MEASURES Both a blinded dermatologist and the participant independently assessed detectability. RESULTS Seventy-two treatment sites on 9 women (mean [SD] age, 45.8 [15.7] years) received all interventions and were analyzed. There was a significant difference in physician rater assessment between saline and hyaluronidase at 4 weeks

The authors have indicated no significant interest with commercial supporters.

evaluate barriers to care in this and the general population. Another key finding of the present study is that routine visit to a dermatologist is associated with early detection of NMs at a more survivable stage of \2 mm. 2 A previous study also found that individuals who had a skin check in the past 3 years had thinner NMs. 3 Individuals with thinner NMs are also more likely to report ''change in color'' and ''irregular shape'' in their NMs. 3 Taken together, these results suggest that close contact with a dermatologist may result in both institutional-based protective factors (eg, prompt detection by obtaining a biopsy specimen) and individual-based protective factors (eg, routine at-home self-examination and attentiveness to melanoma-specific signs) that can be lifesaving. Routine contact with a dermatologist can be lifesaving for individuals who are at risk for NM. The results of the present study emphasize the importance of preventative care.