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Optimal management of facial skin laxity requires a nuanced approach by health care providers working in aesthetics. Radiofrequency microneedling (RFMN) devices have emerged as a popular noninvasive treatment for facial rejuvenation and improving skin laxity. While RFMN has demonstrated efficacy in enhancing skin tightening and complementing aesthetic procedures, its long-term impact on subsequent surgical facelifts remains uncertain. The objective of this scoping review is to explore the interplay between RFMN and surgical facelift outcomes, with a focus on potential complications such as excessive skin tightening, dermal scarring, and altered tissue planes that may pose surgical challenges. A search using PubMed and Google Scholar was conducted, and articles were selected from peer-reviewed journals based on specific inclusion and exclusion criteria. Only articles available in English were selected. In total, 21 articles were included in this scoping review. Papers included in this review discussed the mechanisms of action involved with RFMN, RFMN-related tissue changes, and how these changes could impact future facelift procedures. Most of the papers found that RFMN may drastically alter multiple tissue planes involved in facelift procedures due to collagen deposition through multiple tissue layers and increased tissue fibrosis. Patient factors influencing the effectiveness of RFMN and its role in facial rejuvenation were also examined, emphasizing the importance of navigating patient-specific demographics as a future consideration when creating an individualized treatment plan for each patient. Patients should be informed that RFMN may lead to dermal fibrosis, tissue adhesions, and altered superficial musculoaponeurotic system composition, which could interfere with future facelift procedures and the patient's desired treatment goals. This emphasizes the importance of detailed discussion between the patient and health care provider to improve pretreatment consultation, increase patient education, and set realistic expectations. Further research is needed to determine optimal timing and treatment strategies for patients considering both RFMN and surgical facelifts to achieve the best aesthetic outcomes.

Artificial intelligence (AI) and telemedicine have great potential to transform dermatology care delivery, but patient perspectives on these technologies have not been systematically compared. To examine patient perspectives on AI and telemedicine in dermatology to inform implementation strategies as these technologies increasingly converge in clinical practice. A comprehensive literature search was conducted using PubMed, Scopus, and Embase databases between August 2024 and October 2024. We identified 48 articles addressing patient perspectives on AI and telemedicine in dermatology, with none directly comparing views on both technologies. Several distinct themes emerged regarding patient perspectives on these technologies: willingness to use, perceived benefits and risks, barriers to implementation, and conditions necessary for successful integration. Findings revealed that patients express hesitancy towards AI-based diagnoses that lack dermatologist involvement, while preferences for teledermatology varied by appointment reason, age, and prior technology exposure. Patients' motivations for AI implementation are connected to AI's potential for quicker diagnoses and improved triage efficiency, while telemedicine addresses logistical challenges such as reduced travel time and improved appointment availability. Both technologies were perceived to improve accessibility and diagnostic efficiency, though patients expressed concerns about AI's limited communication abilities and teledermatology's limits in performing physical examinations. Primary adoption barriers for these modalities included technological limitations and trust concerns, with patients emphasizing the need for dermatologist oversight, transparency, and adequate educational resources for successful integration. The complementary strengths of AI and teledermatology suggest they could mitigate each other's limitations when integrated-AI potentially enhancing teledermatology's diagnostic accuracy while teledermatology addresses AI's lack of human connection. By thoroughly examining these perspectives, this review may serve as a guide for patient-centered technological integration in the future landscape of accessible dermatologic care.

The trend of homemade sunscreen recipes has rapidly gained popularity over the last decade, being largely fueled by social media influencers, natural health blogs, and the growing mistrust of large health organizations like the US Food and Drug Administration (FDA). Consumers are increasingly drawn to products labeled \"natural,\" \"organic,\" \"vegan,\" and \"cruelty-free,\" often conflating these terms with safety and effectiveness. However, when applied to sun protection, these assumptions can be dangerously misleading. According to the FDA, there is no verified mathematical formula that can be used to determine an accurate sun protection factor (SPF) rating for the amount of zinc oxide used in many of the recipes found online. The objective of this review is to examine the rising popularity and efficacy of homemade sunscreens compared to commercial sunscreens and highlight the potential public health implications of skin cancer risk related to homemade sunscreen use. Multiple databases were searched to find current and relevant literature analyzing the social media impact relating to homemade sunscreens and the efficacy of homemade sunscreens compared to commercially available products. Digital content that included or discussed homemade sunscreen recipes was included as well to provide examples of information trending online. One study analyzing social media trends found that many strong, unverified claims relating to homemade sunscreen versus commercial sunscreen use are being presented in the media, potentially influencing public knowledge. Additional studies analyzing the components of homemade sunscreen recipes compared to components in commercially available products found that homemade sunscreens offer little to no sun protection, therefore increasing the risk of UV damage for individuals using homemade products. Based on the presented evidence, the adoption of unregulated homemade sunscreens presents a substantial threat to public health. Misinformation spread through social media and influencer culture may unintentionally contribute to an increase in UV-related skin cancers. Greater efforts are needed from health care professionals, regulatory bodies, and online platforms to educate the public and promote the use of scientifically validated sun protection methods.

Chronic dermatologic conditions such as psoriasis, atopic dermatitis, and hidradenitis suppurativa are associated with a high burden of psychiatric comorbidities, including depression, anxiety, and suicidality. Despite growing awareness of the psychosocial impact of skin diseases, mental health needs remain underaddressed in dermatologic care. Digital technologies (including teledermatology, mobile health apps, and internet-delivered psychotherapies) offer promising avenues for integrating psychotherapeutic and psychiatric interventions into dermatology. However, the scope, effectiveness, and implementation of such informatics-based approaches remain poorly mapped in the literature. This scoping review aimed to systematically identify, categorize, and synthesize studies on digital psychotherapeutic and psychiatric interventions targeting patients with dermatological conditions, with a focus on clinical, mental health, and implementation outcomes. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a comprehensive search across 5 databases (MEDLINE, Embase, Web of Science, PsycINFO, and Google Scholar) for articles published up to March 2025. Studies were included if they involved patients with dermatologic conditions and assessed interventions that combined a digital informatics component (eg, telehealth, apps, artificial intelligence, virtual platforms) with a psychotherapeutic or psychiatric element (eg, cognitive behavioral therapy [CBT], mindfulness, consult-liaison psychiatry). Eligible study designs included clinical trials, observational studies, and mixed methods research. Data were extracted systematically, and methodological quality was assessed using JBI tools. Out of 15,176 records identified, 11 studies met the inclusion criteria. Most interventions targeted psoriasis (9/11) and used asynchronous digital platforms such as internet-based CBT and mobile apps. Across studies, dropout rates ranged from 10% to 76%. Improvements in dermatologic quality of life were reported in 6 of 11 studies, with statistically significant reductions in depression and anxiety observed in multiple trials (eg, internet-based CBT and mindfulness-based interventions), alongside reductions in psoriasis severity (Psoriasis Area and Severity Index) and itch intensity in randomized controlled trials. Intervention duration ranged from single-session virtual reality exposure to 8- to 12-week structured programs. However, long-term outcomes beyond 3 to 12 months were rarely assessed, and reporting of sociodemographic variables and equity-related factors was limited. Informatics-based psychotherapeutic and psychiatric interventions represent a promising frontier in psychodermatology, with early evidence suggesting feasibility and potential clinical benefit. Digital platforms may expand access to mental health support and improve holistic care for patients with dermatologic conditions. However, significant gaps remain in terms of equity, long-term effectiveness, integration into clinical workflows, and adaptation for diverse populations. Future research should focus on rigorous, inclusive trials and the development of hybrid models that blend digital and face-to-face care to ensure sustainable and equitable impact.

Skin cancer is a global health concern due to its high and still increasing incidence and associated healthcare cost. Belgium is no exception as one in five people are diagnosed with skin cancer before the age of 75. A promising innovation, the VECTRA WB360, a three-dimensional total body photography system allows clinicians to objectively compare the totality of the skin on a macroscopic level on further appointments. The integrated lesion visualisation software allows automated detection, counts and assessment of skin lesions. And detailed comparison of individual lesions is possible through the attached digital dermatoscope. This study aims to review available literature on the use of the Vectra in research and clinical settings, and to summarise the clinical utility, advantages and limitations reported for this system. An electronic literature search was conducted on PubMed from December 2023 - March 2024 using a combination of following search terms: 3D imaging, VECTRA WB360, melanoma, non-melanoma skin cancer, their synonyms and associated entry terms. Publications that used a device other than the Vectra WB360 were excluded, as were articles reporting on new technology without further research or without added cases. After thorough screening of the articles and removal of duplicates, 11 articles remained. Our literature search yielded 11 relevant papers, which included 2 case studies, 6 prospective and 3 retrospective studies. According to multiple studies, the VECTRA WB360 images were of a high enough quality to allow on-screen diagnosis of some melanoma and nonmelanoma skin cancers by dermatologists. Sensitivity compared to face to face examination for melanoma is unknown. The integrated lesion visualisation software is capable of detecting and counting naevi and distinguishing melanoma from other skin lesions with high accuracy, with convolutional neural network (CNN) integration further enhancing its sensitivity and specificity. However, it is important to note that no comparison to the usual standard of care was made. Also, dermatologists achieved greater specificity and thus remained superior to machine and artificial intelligence. While the VECTRA 3D TBP holds substantial promise for the early detection and monitoring of skin cancer, its application cannot yet replace the expertise of trained clinicians. Although the lesion visualizer and DEXI score offer potential enhancements, they also pose risks, including a significant increase in unnecessary excisions due to lower specificity. Despite these promising results, expert overview is still recommended and superior, since there is not enough evidence yet that 3D TBP and/or AI is reliable on its own or beneficial as a support tool Given the small samples and lack of blinded trials, further studies are needed to explore and improve the diagnostic capacities of 3D TBP and the possible integration of CNN's or other AI extensions. It will also be important to examine the Vectra 360WB compared to the usual standard of care.

Nonresponse to botulinum toxin type A (BoNT-A) has been reported in both medical and aesthetic applications. Secondary nonresponse (SNR) occurs when BoNT-A is initially effective before failure commences at a later point. Most reported cases involve SNR in aesthetics. Several aspects of this complication remain elusive or controversial. We aimed to address unanswered questions regarding the prevalence and etiology of SNR. Additionally, we investigated the immunogenicity of BoNT-A formulations, mainly focusing on the development of neutralizing antibodies that hinder the toxin's pharmacologic effects. Furthermore, we sought to examine the management strategies for SNR. The PubMed and Google Scholar databases were searched from inception for articles on nonresponse to BoNT-A therapy. Articles were evaluated based on their contribution to the field. Expert opinions and panel recommendations regarding management and data gaps were also included in the review. There are limited data on SNR prevalence in aesthetic applications compared to therapeutic uses. Trigger factors of SNR include improper handling of BoNT-A; incorrect injection practices; and impurities present in the formulation, such as clostridial complexing proteins that may increase immunogenicity. Other contributing factors include infection; patient characteristics; and treatment parameters that encompass an increased frequency of BoNT-A injections (ie, <3 months apart), higher cumulative dosages, elevated treatment dosages, and booster injections (retreatment within 3 weeks of the initial injection). Neutralizing antibodies developed with first-generation formulations, such as onabotulinumtoxinA and abobotulinumtoxinA that contain clostridial proteins, but not with second-generation BoNT-As, such as incobotulinumtoxinA and daxibotulinumtoxinA, which lack these proteins. Among patients who developed SNR after using first-generation BoNT-A for aesthetic purposes, switching to incobotulinumtoxinA therapy did not result in the development of immune responses. Switching to a protein-free BoNT-A formulation such as incobotulinumtoxinA upon development of SNR has been advocated. To effectively manage SNR, it is crucial to minimize the identified trigger factors. Nonresponse to BoNT-A is gaining importance in aesthetic treatments. Considering the potential for immunogenicity is essential when selecting a BoNT-A formulation. Preventing SNR is crucial, given the lack of solid data on effective treatments.

Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusions (CSIIs) are the current standard treatment devices for type 1 diabetes (T1D) management. With a high prevalence of T1D beginning in pediatrics and carrying into adulthood, insufficient glycemic control leads to poor patient outcomes. Dermatologic complications such as contact dermatitis, lipodystrophies, and inflammatory lesions are among those associated with CGM and CSII, which reduce glycemic control and patient compliance. This systematic review aims to explore the current literature surrounding dermatologic complications of CGM and CSII as well as the impact on patient outcomes. A systematic review of the literature was carried out using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines using 5 online databases. Included articles were those containing primary data relevant to human participants and adverse reactions to CGM and CSII devices in pediatric populations, of which greater than 50% of the sample size were aged 0-21 years. Qualitative analysis was chosen due to the heterogeneity of outcomes. Following the application of exclusion criteria, 25 studies were analyzed and discussed. An additional 5 studies were identified after the initial search and inclusion. The most common complication covered is contact dermatitis, with 13 identified studies. Further, 7 studies concerned lipodystrophies, 5 covered nonspecific cutaneous changes, 3 covered unique cutaneous findings such as granulomatous reactions and panniculitis, and 2 discussed user acceptability. The dermatologic complications of CGM and CSII pose a potential risk to long-term glycemic control in T1D, especially in young patients where skin lesions can lead to discontinuation. Increased manufacturer transparency is critical and further studies are needed to expand upon the current preventative measures such as device site rotation and steroid creams, which lack consistent effectiveness.

When it comes to health care, everybody - medical professionals, policymakers and patients - wants to know what works and what does not. Every day clinicians debate, implicitly or explicitly, whether new research findings are convincing enough to change the way they practice. The quality of research varies, and so much information is being produced that it is impossible for anyone to know and evaluate it all. Traditionally, randomized controlled trials are considered gold standard study designs. However, if they report discordant results and generate controversies, then what should we look for? The answer to this imbroglio is meta-analysis. Steps in designing and conducting meta-analysis involve describing the purpose of meta-analysis, designing a research question, searching for studies, specifying study selection (inclusion and exclusion) and appraisal criteria, deciding data extraction procedures (including statistical reanalysis), assessing combinability of studies, selecting an analytical strategy (use of models and sensitivity analysis), anticipating systematic errors (biases) and limitations, and presenting and disseminating results of the meta-analysis. The Cochrane Collaboration is significantly contributing to the development of this area of research and making a noticeable dent on the practice of evidence based medicine across the globe. Meta-analytic approaches have been used to resolve long standing controversies in the field of medicine, including dermatology.

Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi’s sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch’s postulates to establish causeeffect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance.

Competitive medical residency specialties, such as Dermatology, have historically placed lofty demands on applicants. We focus on the seemingly increasing demands on applicants to publish, as well as discuss and quantify the delivery of these expectations in the literature. The objective of this article is to systematically review evidence regarding the number of publications possessed by successful applicants to a dermatology residency program. We conducted a systematic review of the literature published before or by April 2023, with no lower limit regarding the publishing date using PubMed, Google Scholar, and OVID. Our summary included 41 publications that specifically cited the number of publications by National Resident Matching Program (NRMP) applicants successfully matching to US dermatology programs. We extracted additional applicant details (demographics, publication type) as available. We found two major categories of cumulative publications reported in the literature: NRMP scholarly works and peer-reviewed indexed publications. Summarizing reports from 21 papers between 2011 and 2022, NRMP showed the overall mean amongst matched applicants to be 14.77 publications, with an upward trend over time. The mean was 3.23 peer-reviewed indexed publications (PIPs) for successful dermatology applicants amongst 11 articles in the literature. Amongst matched dermatology applicants, an average of 3 PIPs is markedly lower than the inflated average count of 15 NRMP scholarly works (which includes non-published research) that is often reported in the literature and national statistics. The distinction between these values must be recognized in the literature, as well as communicated to forthcoming dermatology applicants.