PurposeThe aim of this study was to estimate the efficacy of intense pulsed light (IPL), followed by meibomian gland expression (MGX), for reducing the number and severity of signs and symptoms of dry eye disease (DED) secondary to meibomian gland dysfunction (MGD).Patients and methodsIn a prospective study conducted in two sites, 40 subjects (80 eyes) with moderate to severe MGD were enrolled. Major inclusion criteria consisted of at least two of the following measures being compatible with DED in both eyes: tear breakup time (TBUT), meibomian gland score (MGS), corneal fluorescein staining (CFS), Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and tear film osmolarity (TFO). Enrolled patients underwent four treatment sessions, 3 weeks apart. Each treatment included the administration of 10–15 pulses of IPL on the cheeks and nose, followed by MGX of the upper and lower eyelids. TBUT, MGS, CFS, SPEED, TFO, and lipid layer thickness (LLT) were measured at baseline (BL) and at 9, 12, and 15 weeks after BL.ResultsDue to different staining methods used for TBUT measurements, TBUT and CFS were analyzed separately for each site. From BL to the final follow-up, the number of signs compatible with DED decreased from 3.3±0.1 to 1.4±0.1. TBUT improved by +93% (n=38; P<0.0001) and +425% (n=42; P<0.0001) for sites 1 and 2, respectively. SPEED, MGS, and CFS improved by −55% (n=80; P<0.0001), −36% (n=80; P<0.0001), and −58% (n=38; P<0.0001), respectively. In 20 eyes with abnormally elevated TFO at BL, TFO improved by −7% (n=20; P<0.005). LLT did not change (n=38; P=0.88).ConclusionIn subjects with moderate to severe MGD, IPL combined with MGX reduced the number and severity of symptoms and signs of DED. Except for LLT, all examined outcome measures significantly improved after 15 weeks. These results support the efficacy of IPL + MGX in relieving both signs and symptoms of DED secondary to MGD.

Syringocystadenoma papilliferum can rarely affect eyelid skin. This lesion is frequently clinically misdiagnosed as basal cell carcinoma or cyst. Although syringocystadenoma papilliferum of the eyelid can be associated with other benign lesions, no malignant transformation or association with malignant neoplasms has been reported. The evidence suggests that this tumor should be managed with conservative complete excision.

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 Rosacea is a chronic inflammatory skin condition of varying severity that can significantly impact patient quality of life. Intense pulsed light (IPL) is an established treatment for rosacea‐associated telangiectasia, inflammation, and erythema. This study assessed whether application of a phyto‐corrective mask, gel, and resveratrol antioxidant serum after IPL treatment can improve outcomes and reduce procedure‐related adverse effects. Methods In a prospective, open‐label, split‐face, 3‐month study, 10 subjects with moderate‐to‐severe facial rosacea underwent IPL treatment on both sides of the face. The following were applied to the right side of the face only: phyto‐corrective mask once weekly starting immediately after IPL; phyto‐corrective gel twice daily; and resveratrol antioxidant treatment at night. Both sides of the face were treated with sunscreen. Subjects were assessed on Day 1, 1 and 3 months after IPL by three, independent evaluators using the 5‐point Global Aesthetic Improvement Scale (GAIS). All subjects rated skin redness, hydration, and overall improvement on Day 1 and completed a patient satisfaction questionnaire at the 1‐ and 3‐month visits. Results Ten women were enrolled, aged 44–72 years old, with moderate (n = 6) to severe (n = 4) rosacea. IPL was effective at reducing symptoms with rosacea classified as absent in five women and mild in five at the final 3‐month visit. GAIS scores also revealed improvements on both sides of the face, but the skincare treated side showed continuous improvement over 3 months with all patients remaining at least “Improved”, whereas there appeared to be a waning effect after 1 month with IPL alone. On Day 1 after IPL, all women reported less redness, improved hydration, and improved skin appearance on the right side of the face. Patient satisfaction was consistently rated higher on the right side of the face. Conclusion Application of a phyto‐corrective mask, gel, and resveratrol antioxidant serum may complement IPL treatment for rosacea by enhancing treatment outcomes and reducing procedure‐related symptoms.

Injections of botulinum neurotoxin type A and soft-tissue fillers, particularly hyaluronic acid (HA) fillers, are the mainstay of most medical esthetic practices. This is illustrated by recent data from the American Society of Aesthetic Plastic Surgery (ASAPS), which show that neurotoxin and HA filler treatments continue to represent the top two nonsurgical procedures in US esthetic practices, with an