BACKGROUND: Systematic studies and a clear consensus on the ideal cranial vault height ratio (CVHR) remain lacking. OBJECTIVE: To identify the optimal CVHR in Chinese women using morphometric and perceptual analyses. MET...BACKGROUND: Systematic studies and a clear consensus on the ideal cranial vault height ratio (CVHR) remain lacking. OBJECTIVE: To identify the optimal CVHR in Chinese women using morphometric and perceptual analyses. METHODS: We conducted an observational study analyzing photographs of 99 women from the TCC Asia 2020 list ("100 Most Beautiful Faces in Asia"). The CVHR was defined as the distance from the hairline midpoint to the cranial apex (bc) divided by the distance from the inner canthi to the cranial apex (ac), that is, bc/ac. In addition, an online survey asked respondents to rank standardized virtual facial models with varying CVHRs (0.55-0.75) from most to least attractive. RESULTS: Morphometric analysis of 99 Asian female celebrities revealed a mean CVHR of 0.640 (SD = 0.078). Online survey data from 552 Chinese respondents indicated that a CVHR of 0.650 was ranked as the most attractive, followed by 0.600, whereas 0.550 was the least preferred. However, aesthetic practitioners exhibited a distinct preference for a CVHR of 0.600 over 0.650. CONCLUSION: A CVHR of 0.60 to 0.65 was perceived as most attractive in this cohort of Chinese women, providing a preliminary quantitative reference for aesthetic cranial contouring procedures. LEVEL OF EVIDENCE: Level IV.
BACKGROUND: Lasers are commonly used to treat fine lines and wrinkles. While traditional 1550-nm resurfacing lasers can be limited by their delivery mechanism, a newer 1550-nm nonablative resurfacing laser was recently d...BACKGROUND: Lasers are commonly used to treat fine lines and wrinkles. While traditional 1550-nm resurfacing lasers can be limited by their delivery mechanism, a newer 1550-nm nonablative resurfacing laser was recently developed, which uses a novel conical beam delivery system for high-energy treatments. OBJECTIVE: To evaluate the utility of this novel 1550-nm nonablative resurfacing laser that uses Focal Point Technology to improve fine lines and wrinkles in Fitzpatrick Skin Types I-VI with high-energy delivery. METHODS: A retrospective, multicenter clinical data review evaluated this device for fine lines and wrinkles by Fitzpatrick Wrinkle and Elastosis Scale with 3 blinded physician reviewers and blinded photographic identification. RESULTS: Thirty-three subjects were treated. Mean age was 56.7 years, and 84.8% were women. Subjects had significant overall improvement in pooled Fitzpatrick Wrinkle and Elastosis Scale score (4.48 vs 3.36; p < .001). For blinded photographic evaluation, 2 of 3 reviewers were in agreement for correct identification of 81.8% of subjects. Treatments were well-tolerated, and there were no serious unanticipated adverse events. CONCLUSION: This new-generation 1550-nm nonablative resurfacing laser that uses Focal Point Technology with high-energy delivery is safe and effective in the treatment of fines lines and wrinkles in diverse Fitzpatrick skin types.
BACKGROUND: Second-intention healing (SIH) has been a cornerstone of Mohs micrographic surgery (MMS) for defect closure. However, advancements in reconstructive techniques have reduced its use, despite evidence supportin...BACKGROUND: Second-intention healing (SIH) has been a cornerstone of Mohs micrographic surgery (MMS) for defect closure. However, advancements in reconstructive techniques have reduced its use, despite evidence supporting its efficacy in appropriately selected cases. Although physician-reported outcomes are well established, patient-reported (PR) perspectives on SIH remain underexplored. OBJECTIVE: To systematically review patient satisfaction and reported outcomes after SIH in MMS. MATERIALS AND METHODS: A systematic literature search was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, using databases including PubMed and EMBASE. Studies assessing PR satisfaction, cosmetic outcomes, healing experiences, and functional results of SIH after MMS were included. Data extraction and quality assessment were performed independently by 2 reviewers (C.H. and C.P.). RESULTS: Eight studies met the inclusion criteria. PR satisfaction/outcomes with SIH were high, with favorable cosmetic and functional outcomes. Minor complications were reported, but did not significantly affect overall satisfaction. However, variability in outcome assessment methods, particularly the use of nonvalidated scoring systems, limits comparability across studies. CONCLUSION: SIH remains a valuable reconstructive option in MMS, offering high patient satisfaction in select cases. Standardization of PR outcome measures is needed to enhance comparability and optimize decision making in dermatologic surgery.
BACKGROUND: Acquired melanocytic nevi (AMN) are common and cosmetically bothersome. Patients may prefer non-invasive laser modalities, but their efficacy remains uncertain. OBJECTIVE: To assess the utility of lasers for...BACKGROUND: Acquired melanocytic nevi (AMN) are common and cosmetically bothersome. Patients may prefer non-invasive laser modalities, but their efficacy remains uncertain. OBJECTIVE: To assess the utility of lasers for AMN removal. MATERIALS AND METHODS: The authors systematically reviewed MEDLINE, EMBASE, and Scopus from inception to May 9, 2024, using the terms "nevi" and "laser." Our primary outcome was clinical efficacy, measured by physician/investigator-graded clinical assessments of (1) >75% lesion clearance or (2) 95% to 100% clearance (complete response). RESULTS: The authors identified 20 studies, including CO2 (n = 5), Q-switched (QS) and long-pulsed (LP) ruby (n = 4), LP or QS Alexandrite (n = 3), QS Nd:YAG 1064 nm (n = 3), Er:YAG (n = 2), LP Nd:YAG 532 nm (n = 1), diode (n = 1) lasers, and 2 combination studies of Er:YAG with LP Alexandrite (n = 1) or QS Nd:YAG 532 nm (n = 1) laser. Combination Er:YAG treatment achieved >75% clearance in 98.5% to 100% of cases, with better outcomes using LP Alexandrite laser. Eight studies assessed complete response. Combination Er:YAG with QS Nd:YAG 532 nm laser (89.4% of cases) or LP Alexandrite (100%) and LP Alexandrite alone (98.1%) demonstrated the highest clearance. CONCLUSION: Combination of Er:YAG with LP Alexandrite, LP Alexandrite alone, and Er:YAG with QS Nd:YAG 532 nm laser are most effective for nevi clearance.
BACKGROUND: Accurate self-reporting of keratinocyte carcinoma (KC) informs clinical decision-making, but real-world performance in dermatology clinics is understudied. OBJECTIVE: To evaluate the sensitivity, specificity,...BACKGROUND: Accurate self-reporting of keratinocyte carcinoma (KC) informs clinical decision-making, but real-world performance in dermatology clinics is understudied. OBJECTIVE: To evaluate the sensitivity, specificity, and accuracy of patient-reported facial or scalp KC, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) during routine dermatology encounters. PATIENTS AND METHODS: In this multicenter cohort study, 338 adults with Fitzpatrick phototypes I-III and visible actinic damage were prospectively enrolled at 6 academic centers. Participants self-reported their history of KC, BCC, and SCC within the prior 2 years. Chart review served as the reference standard. Diagnostic accuracy metrics were calculated, including worst-case sensitivity analyses. RESULTS: Self-reported KC showed high accuracy (92.2%), sensitivity (93.8%), and specificity (91.2%). SCC sensitivity was lower (78.3%) despite high specificity (95.9%). In worst-case analyses, SCC sensitivity declined to 64.3%. Negative predictive values exceeded positive predictive values across all cancer types. CONCLUSION: Patient self-reporting of KC is generally reliable, particularly for excluding disease. However, SCC is more likely to be underreported, underscoring the need to verify cancer history in high-risk patients or those at risk for poor recall.