Background: Several cases of lichen planus (LP) associated with hepatitis C virus (HCV) infection have been described. The reported prevalence rates of anti-HCV in patients with LP show wide geographical variations. An association of HCV-associated disorders with certain HCV geno/subtypes has not been investigated so far. Objective: The aim of the present study was to define the prevalence rate of anti-HCV in German patients with LP and to determine the distribution of HCV geno/subtypes. Methods: All patients with LP of the present study (n = 84) were tested for anti-HCV antibodies by an enzyme-immunoassay (second generation). HCV RNA was detected by reverse-transcription polymerase chain reaction (RT-PCR) and HCV geno/subtyping was performed by the reverse hybridization assay. Serum samples of 87 patients with various cutaneous diseases excluding LP served as control group. Results: Anti-HCV antibodies were detected in 13/84 patients with LP (16%), and 12/13 anti-HCV-positive patients were viraemic as assessed by the presence of HCV RNA. Most patients were infected with subtype HCV-1b (10/12 patients), while the 2 remaining patients were infected with HCV-2b and HCV-3a, respectively. In the control group, anti-HCV antibodies were only observed in 1/87 patients (1.1%), infected with subtype HCV-1b. Conclusion: The statistically significant (p < 0.002) high prevalence of HCV RNA in patients with LP is suggestive of an aetiological role of HCV in the pathogenesis of LP. Compared to the geno/subtype distribution of patients with chronic hepatitis C without LP of the same geographical area, no convincing correlation between geno/subtype and the presence of LP was obtained.
Following the trend in facial cosmetic procedures, patients are now increasingly requesting hand rejuvenation treatments. Intrinsic ageing of the hands is characterized by loss of dermal elasticity and atrophy of the subcutaneous tissue. Thus, veins, tendons and bony structures become apparent. Among the available procedures, intrinsic ageing of the hands is best improved by restoring the volume of soft tissue. Volume restoration can be achieved with a number of long-lasting dermal fillers with varying degrees of improvement and treatment longevity. The dermal fillers used in hand rejuvenation include autologous fat, collagen, hyaluronic acid, calcium hydroxylapatite and poly-L-lactic acid. Here, we describe our preferred injection method for hand rejuvenation using calcium hydroxylapatite and a single-bolus injection.
BackgroundBotulinum toxin type A treatment has been used for over 20 years to enhance the appearance of the face. There are several commercially available botulinum toxin type A products used in aesthetic clinical practice. The aim of this retrospective analysis was to compare the clinical efficacy of the most commonly used botulinum toxin type A preparations in daily practice.MethodsPhysicians from 21 centers in Germany completed questionnaires based on an inspection of subject files for subjects 18 years of age or over who had received at least two, but not more than three, consecutive treatments with incobotulinumtoxinA, onabotulinumtoxinA, or abobotulinumtoxinA within a 12-month period in the previous 2 years. Data on subject and physician satisfaction, treatment intervals, dosages, and safety were collected from 1256 subjects.ResultsThere were no statistically significant differences between incobotulinumtoxinA and onabotulinumtoxinA with respect to physician and subject satisfaction, dosages, and adverse effects experienced. Both botulinum toxin type A preparations were well tolerated and effective in the treatment of upper facial lines. Due to low treatment numbers, abobotulinumtoxinA was not included in the statistical analysis.ConclusionThe results of this retrospective analysis confirm the results of prospective clinical trials by demonstrating that, in daily practice, incobotulinumtoxinA and onabotulinumtoxinA are used at a 1:1 dose ratio and display comparable efficacy and safety.
Cohesive polydensified matrix (CPM®) hyaluronic acid fillers are now available with or without lidocaine. The aim of this study was to investigate the safety and performance of CPM® fillers with lidocaine in the clinical setting. In an open-label, prospective, postmarketing study, 108 patients from seven sites in Germany and Denmark were treated with one or more lidocaine-containing CPM® fillers. Performance was assessed using the Merz Aesthetics Scales® (MAS). Pain was rated on an 11-point visual analog scale. Patients’ and physicians’ satisfaction as well as adverse events were recorded. Improvements of ≥1-point on MAS immediately after and 17 days posttreatment were observed in ~90% of patients compared with baseline. All investigators assessed ejection force, product positioning, and performance as similar or superior to the respective nonlidocaine products. Overall, 94% of investigators were satisfied with the esthetic outcomes and were willing to continue using the products. All patients except one were satisfied with the results, and all were willing to repeat the treatment. Mean pain scores were low during (<3.0) and after injection (<0.6). Except for one case of bruising, all adverse events were mild to moderate. CPM® fillers with lidocaine are safe and effective for a wide range of esthetic facial indications.
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