Background The efficacy of adipose-derived mesenchymal stem cells (ADMSCs) secretome for skin aging has been established, yet no studies hitherto directly investigated the best administration method for such purpose. Purpose We aimed to compare microneedling (MN) versus fractional CO 2 laser (FL) as methods of delivery for ADMSCs secretome in the treatment of aging skin. Patients and Methods A single-blind, randomized split-face clinical trial was conducted on 30 Indonesian women (aged 35–59 years old) with signs of facial cutaneous senescence. Their initial aging status was assessed by dermoscopy photoaging scale (DPAS) and Janus-III measurement system. In the second and fourth weeks, all participants were treated with both MN and FL, followed by the application of a four-fold concentrated ADMSC secretome. The assignment of which side of the face received MN or FL was done by computer-based randomization. Skin parameters were reevaluated on the fourth and sixth weeks, along with patient satisfaction, level of comfort, preference for administration techniques, and also adverse events experienced during the study. Appropriate statistical analyses were subsequently performed at a significance level of 0.05. Results Significant improvements in total DPAS and wrinkles were found in the MN and FL groups at the end of the trial. In contrast, no statistical differences in all parameters were observed between groups in the fourth and sixth weeks. FL scored higher than MN for satisfaction and preference, but lower in terms of comfort. Pain, burning sensation, and itch were the side effects experienced by subjects upon treatment. Two patients had prolonged reddish skin succeeding FL treatment, which relieved with moisturizer application. Conclusion Both MN and FL yielded comparable results for improving several skin aging features. However, subjective preference for ADMSCs secretome administration method may differ when considering satisfaction, comfort, and possible adverse events.

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Information concerning the extent of knowledge, attitude, and practice of elderly caregivers about dermatological care are still limited. This present study aimed to develop a tool with decent validity and reliability to delineate such profiles. A questionnaire was designed by geriatric dermatology experts, followed by content validation and reliability tests using Aiken’s V coefficient, Kuder-Richardson Formula 20 (KR-20) or Cronbach’s α, and Pearson’s correlation. The developed instrument was tested on elderly caregivers, before and after education. Obtained data were analyzed using appropriate inferential statistics. We found that the Aiken’s V coefficient for each item was ≥0.70; KR-20 in knowledge section was 0.81; Cronbach’s α in attitude and practice section were 0.81 and 0.80, respectively; and Pearson’s correlation in all sections was above 0.80. Significant disparities were observed in the initial knowledge (p=0.005) and attitude (p=0.020) based on academic levels. In addition, overall scores generally increased upon education (p<0.001). Therefore, the questionnaire is valid and reliable for assessing elderly caregivers' competencies in geriatric dermatology of which could be improved by education.

Cutaneous manifestations in coronavirus disease 2019 patients may possess prognostic value for identifying potentially severe cases. This systematic review investigated whether dermatological features are associated with COVID-19 outcomes in elderly patients. Literature retrieval was conducted on May 11, 2022, from databases, hand-searching, and tracing citations. Following selection against eligibility criteria, the remaining records were evaluated utilizing the National Heart, Lung, and Blood Institute Study Quality Assessment Tool or Newcastle-Ottawa Scale. The pooled individual data were subsequently analyzed using the Cochran-Mantel-Haenszel test to calculate the odds ratio (ORs) and confidence intervals (CIs) for the severity and mortality of each skin lesion type. We incorporated 70 articles, including 180 and 117 entries, with information regarding disease severity and mortality. Further analysis revealed that vascular type was the skin lesion most frequently noticed in confirmed COVID-19 elderly patients (46.2%) and was associated with an increased risk of developing advanced disease (OR 7.32,) and the ensuing termination (OR 5.73,). The converse phenomenon was observed in maculopapular type (severity OR 0.27, 95% CI 0.14-0.52; mortality OR 0.10, 95% CI 0.03-0.36). In conclusion, skin manifestations may predict COVID-19 severity and mortality in the senior group.

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