What’s the best way to dissolve fillers with hyaluronidase?
Authors of a study published in the Journal of Cosmetic Dermatology evaluated the efficacy of hyaluronidase in degrading different types of hyaluronic acid (HA) fillers and provided clinical guidelines for its use. Hyaluronidase efficacy was found to vary based on the type of HA filler and the enzyme’s concentration. Biphasic fillers dissolved more rapidly at lower concentrations of hyaluronidase compared to monophasic fillers, which required higher concentrations and longer exposure times for effective breakdown.
[Read about filler reversal with hyaluronidase inDermWorld Weekly.]
The study also demonstrated that direct injection of hyaluronidase into the filler mass was more effective than surface application. Pharmacokinetic analysis revealed that hyaluronidase activity diminished within 30 minutes in biological tissues, highlighting the need for timely intervention in clinical scenarios. The authors’ clinical recommendations include using direct injection techniques, tailoring hyaluronidase dosage based on the filler type, and considering hypersensitivity reactions.
DermWorld Insights and Inquiries: Propranolol for infantile hemangiomas — Start to finish
“We have observed that propranolol can inhibit the growth of these [infantile capillary] hemangiomas.” In my career, I cannot think of any statement that led to such a swift, dramatic paradigm shift in management more than this observation by Léauté-Labrèze et al. in 2008. Although propranolol is now considered the primary treatment for infantile hemangiomas (IH) requiring therapeutic intervention, questions remain about its mechanisms of action, dosing initiation, and discontinuation. This commentary addresses new literature about these considerations, exclusive of other therapies that may be indicated in the event of propranolol failure or contraindication. Keep reading!
2025 Allergen of the Year
According to Dermatitis, the American Contact Dermatitis Society named toluene-2,5-diamine sulfate (PTDS), also known as toluene diamine sulfate or 2,5-diaminotoluene sulfate, as the Allergen of the Year for 2025. PTDS is an aromatic amine that can be used as a paraphenylenediamine (PPD) hair dye alternative. Patients may develop a contact allergy to PTDS, and it is often omitted from standard patch test screening series, possibly leading to underdiagnosis. The ACD is raising awareness of its dual role as an allergen and an alternative for some PPD-allergic individuals.
Authors of an article published in the Journal of Cosmetic Dermatology reviewed clinical trials conducted on the effectiveness of herbal remedies in treating melasma. They reviewed a total of 21 clinical trials, which revealed that licorice, rhubarb, a mixture of melon seed and chickpea, sorrel, aloe vera leaf gel, parsley, tomato, fern, olive, pine bark, and Indian gooseberry had positive effects in treating melasma.
Licorice was the most extensively studied herbal remedy, although some patients who used licorice, rhubarb, and parsley experienced redness and skin allergies. The authors concluded that there are few studies that have evaluated the effectiveness of herbal remedies in treating melasma, so further research is required to assess efficacy as well as potential adverse effects.
Dermatologists discuss new understandings of the pathogenesis of melasma and emerging treatments. Read more.
Nearly 20% of adult eczema patients have multiple eczema conditions
The National Eczema Association published research in the Journal of Investigative Dermatology that established the prevalence of multiple eczema diagnoses among adults in the U.S. The researchers aimed to evaluate the prevalence and co-occurrence of different forms of eczema using a large national database.
The study highlighted that nearly one in five adult patients with eczema may have multiple eczema conditions. The most common re-occurring types were atopic dermatitis and seborrheic dermatitis (25.9%); allergic contact dermatitis and seborrheic dermatitis (15.3%); and atopic dermatitis and allergic contact dermatitis (13.8%).
CMS extends 2024 MIPS deadline and reopens EUC applications due to IV fluid shortage
In response to the ongoing IV fluid shortage, CMS will reopen the 2024 MIPS Extreme and Uncontrollable Circumstances (EUC) Exception Application from March 31 to April 14, 2025. Only applications citing the IV fluid shortage will be accepted; all other applications will be denied. Additionally, the MIPS data submission deadline is extended to April 14, 2025. For additional information, visit the Quality Payment Program website and the Academy’s MIPS reporting guidance.
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