Background Even though dermatologists often perform drug delivery procedures, it is necessary to assess their safety. Objective Quantify the amount of medication delivered using the MMP drug delivery technique and outline other safety parameters. Methods Using a simple and novel technique, we attempted to quantify the amount of medication delivered by weighing human skin samples before and after delivery. Results In drug delivery done on human skin using a liquid with a density of 1,271,460 μg/ml (the values expressed in this manuscript are in µg), a needling density of 570 perforations/cm2, and a needling depth of 300 microns, we estimate that 1,175 μg/cm2 were delivered (standard deviation 601 μg/cm2, standard error 190 μg/cm2). Limitations This result is only applicable to the protocol proposed in this study for the MMP drug delivery technique. Conclusion The MMP drug delivery technique injects small amounts of medication (1,175 μg/cm2) homogeneously into the dermis.

The efficacy of combined PUVA and low-dose azathioprine for early and enhanced repigmentation in vitiligo patients.

Treatment of idiopathic guttate hypomelanosis with a tattoo device versus a handheld needle To the Editor: We were pleased to read the case report by Rambhia and Rambhia describing the use of a hypodermic needle dipped in 5-fluorouracil to treat a patient with idiopathic guttate hypomelanosis (IGH). 1 It is a simple and original solution to treat challenging dermatosis. Drug delivery with tattoo devices 2 has similarities and differences with the manual technique proposed by these authors.

Laser tattoo removal is expensive, painful, and time-consuming. Even with the use of the right laser equipment, it is often impossible to eliminate all pigments. Incomplete tattoo removal, one of the undesired effects of laser treatment, is widely disseminated in the media and accepted by most patients. However, few patients know that laser tattoo removal can cause permanent scars. Some patients who develop achromic scars can feel disappointed with the results of laser tattoo removal and take legal action against the physician responsible for the treatment. This paper describes our experience with a drug delivery treatment called MMP® (“Microinfusão de Medicamentos na Pele,” Portuguese acronym for “Microinfusion of Drugs in the Skin”) that repigments and improves the final esthetic results of achromic laser tattoo removal scars.

Objectives We present the results of 11 patients with hypochromic lesions treated with antifibrotic agents delivered through the MMP® technique. Methods Eleven patients with hypochromic lesions because of external injuries were treated at a single clinic with 5‐fluorouracil (5‐FU) and/or bleomycin using the MMP® drug delivery technique. Treatment sessions were repeated at 30‐day intervals until patient satisfaction. The primary outcome was repigmentation of the lesions, assessed independently by two dermatologists and by the patient. Results The MMP® technique injected 0.048 mg/cm2 of 5‐FU or 0.0028 U/cm2 of bleomycin. The accumulated 5‐FU and bleomycin density per patient ranged from 0.02 to 0.77 mg and 0.0022 to 0.2800 U/ml, respectively. Patients were treated with 1 to 6 MMP® sessions with 5‐FU (3 patients), bleomycin (6 patients), or both drugs (2 patients). After the last session, all patients had a significant improvement (>75%) of the lesions compared to baseline. There were no procedure‐related short‐ or long‐term adverse effects in any of the participants up to their last follow‐up visit. Conclusions The injection of antifibrotic agents using the MMP® technique was effective and safe in the treatment of hypochromic lesions. This can be a new therapeutic option for these lesions.