Reticulated livedoid skin patterns after soft-tissue filler-related vascular adverse events.

Autor: Schelke LW; Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: lschelke@outlook.com., Velthuis PJ; Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands., Mojallal A; Department of Plastic, Reconstructive, and Aesthetic Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, Lyon, France., Henry G; Department of Plastic, Reconstructive, and Aesthetic Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, Lyon, France., Hofer SOP; Division of Plastic Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada., Cotofana SC; Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands; Centre for Cutaneous Research, Blizard Institute, Queen Mary University of London, London, UK; Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province, China.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2024 Jul; Vol. 91 (1), pp. 37-42. Date of Electronic Publication: 2024 Feb 15.
DOI: 10.1016/j.jaad.2024.02.008
Abstrakt: Background: For the treatment of vascular adverse events caused by filler injections, duplex ultrasound imaging may be used. The findings of duplex ultrasound examination and the clinical features of reticulated livedoid skin patterns were compared with the hemifaces anatomy.
Objective: The objective of this study was to link the reticulated livedoid skin patterns to the corresponding duplex ultrasound findings and the facial perforasomes.
Methods: Duplex ultrasound imaging was used for the diagnosis and treatment of vascular adverse events. The clinical features and duplex ultrasound findings of 125 patients were investigated. Six cadaver hemifaces were examined to compare the typical livedo skin patterns with the vasculature of the face.
Results: Clinically, the affected skin showed a similar reticulated pattern in each facial area corresponding with arterial anatomy and their perforators in the cadaver hemifaces. With duplex ultrasound, a disturbed microvascularization in the superficial fatty layer was visualized. After hyaluronidase injection, clinical improvement of the skin pattern was seen. Normalization of blood flow was noted accompanied by restoration of flow in the corresponding perforator artery. The skin patterns could be linked to the perforators of the superficial fat compartments.
Conclusion: The livedo skin patterns seen in vascular adverse events may reflect the involvement of the perforators.
Competing Interests: Conflict of interest Drs Schelke and Velthuis are shareholders in Cutaneous BV, a company that provides educational courses and materials in the realm of facial ultrasound imaging. Drs Mojallal, Henry, Hofer, and Cotofana have no conflicts of interest to declare.
(Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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