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Bioderma EADV 2022 Kongre Raporu

Raporlar Dr. Marcela Cirigliano (Dermatolog, Arjantin), Dr. Marija Buljan (Dermatolog, Hırvatistan), Dr. Nicolas Kluger (Dermatolog, Finlandiya), Prof. Anna Zalewska (Dermatolog, Polonya) ve Dr. Marta Cantarero (Dermatolog, İspanya) tarafından yazılmıştır.

30 okuma

Speakers: Dr. Mina Kang and Dr. Martin Kassir

Report written by Dr. Marcela Cirigliano

 

Classifications and pathogenesis of cutaneous necrosis following sclerotherapy. A comprehensive literature review.

Dr Mina Kang (Rhodes, Australia)

Dr Kang refers to the necrosis following sclerotherapy as a potentially debilitating complication with an incidence rate of 0,2 to 1,2%. The clinical presentation can range from small cutaneous ulcer to muscle necrosis and large ulcers. It may appear following intraarterial injection, which is the most feared and is uncommon with good technique, following extravasation, cited as most common in literature but rather unlikely with detergent sclerosants, and with well executed intra-venous injection. According to ulcer morphology, round or stellate, Dr Kang proposes a classification of the pathogenic mechanism.

Carbon Wave: The newest procedure for treatment of cellulite.

Dr Martin Kassir (Waldorf, United States)

Cellulite is a common dermatological condition with female preponderance, affecting up to 90 % of post-puberal females. It occurs mostly in areas with greater fat storage like thighs, buttocks, and abdomen. Dr Kassir explains that it is now considered a pathological entity with systemic associations (insulin resistance, obesity, increased cardiovascular risk) and a negative psychological impact on patients.

Treatment options mentioned are several different topical treatments, noninvasive device-based and intralesional treatments and surgical modalities, but, as Dr Kassir points out, treatment remains a challenge. Regarding pathophysiology, the hypotheses Dr Kassir mention are sex specific dimorphic skin structure, alteration in the fibrous septae, vascular factors and inflammation. Histopathology shows hypertrophy and dystrophy of the adipocyte, increased fibrosis of the septae, enlargement and thickening of vascular endothelium and septal inflammation. Later stages show atrophy and dystrophy of the skin and extensive vascular damage.

Dr Kassir presents a procedure for the treatment of cellulite that consists in the creation of acoustic waves energy with laser. Q-Switch energy creates acoustic waves when it hits a target (e.g., melanin, tattoo ink) and this energy allows treatment of deeper skin structures. The carbon wave patch is a multilayered hydrogel patch embedded with carbon black, reactive with laser energy (single use).

Hydrogel is a silicone-based gel used to create solid structures (FDA class I device). Carbon black is an inert substance, that has other uses in dermatology. Dr Kassir explains that the laser energy is absorbed by the carbon patch creating the acoustic wave of energy that is contained in the multilayered aspect of the hydrogel. The acoustic waves of appropriate intensity have proved to “subcise” the fibrous septae (cellulite) He also shares a video that shows the different steps of the procedure: first places the patch onto the area to treat and then pulse laser over the patch (1064 laser system, actively Q-switched, nanosecond pulses).

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