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Med Sci Law 2020 Jun 5:25802420926867. Epub 2020 Jun 5.

Faculty of Medicine, The University of Adelaide, Australia.

is a traditional Indonesian treatment involving abrading the skin over various parts of the body with a blunt object such as a coin or a piece of ginger which may create suspicious injuries. Here, the case of a 30-year-old woman who had undergone therapy is reported. She was complaining of retro-sternal pain and epigastric discomfort and subsequently became markedly short of breath and died. Read More

Plast Reconstr Surg 2020 May;145(5):1155-1162

Albany, N.Y.; Munich and Darmstadt, Germany; Holon, Israel; San Diego, Calif.; Rochester, Minn.; Medellin, Colombia; and Coral Gables, Fla. From the Division of Anatomy, Department of Medical Education, Albany Medical College; the Division of Plastic Surgery, Department of Surgery, Albany Medical Centre; the Department for Hand, Plastic and Aesthetic Surgery, Ludwig Maximilian University of Munich; Rosenpark Klinik; Wolfson Medical Center, Dermatology; private practice; Cosmetic Laser Dermatology; Mayo Clinic College of Medicine and Science, Mayo Clinic; and Skin Associates of South Florida.

Background: Cosmetic treatment of the forehead using neuromodulators is challenging. To avoid adverse events, the underlying anatomy has to be understood and thoughtfully targeted. Clinical observations indicate that eyebrow ptosis can be avoided if neuromodulators are injected in the upper forehead, despite the frontalis muscle being the primary elevator. Read More

J Craniofac Surg 2020 Apr 16. Epub 2020 Apr 16.

Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery.

Rigid reconstruction for frontal bone defects not only improves function, but also approximates more normal appearance. However, in cases involving dural scar contractures, a concave deformation remains when rigid reconstruction is performed without compensating for dead space created by swelling of the brain. This study involved 4 cases in which a 2-stage reconstruction procedure was used to first eliminate dead space by grafting dermal fat, and subsequently carry out rigid reconstruction to achieve a natural forehead configuration. Read More

Cureus 2020 Feb 29;12(2):e7141. Epub 2020 Feb 29.

Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC.

The supratrochlear artery represents a terminal branch of the ophthalmic artery. Cosmetic interventions may traumatize it, resulting in a circulation in the lesion in glabellar region and in the medial aspect of the forehead. This review article aims to synopsise the existing knowledge of the anatomy of the supratrochlear artery in close correlation with minimally invasive cosmetic procedures in the facial area such as soft-tissue filler injections. Read More

J Cosmet Laser Ther 2020 Feb 29;22(2):100-106. Epub 2020 Mar 29.

Italian Society of Aesthetic Medicine - Agorà, Milan, Italy.

: The forehead is one of the most frequent sites of botulinum toxin (Bont-A) application. To date, few data are available about the anatomy of the frontalis muscle. Its anatomy is highly heterogeneous in Caucasian people. Read More

Clin Cosmet Investig Dermatol 2020 5;13:127-136. Epub 2020 Feb 5.

Dermatologie-Clínica, Cirurgia, Cosmiatria e Laser, São Paulo, Brazil.

It is well known that incobotulinumtoxinA (INCO) is an effective approved treatment for dynamic wrinkles of the upper face caused by the action of mimetic muscles over time. In doing so, it is important to maintain a balance between muscle groups and a natural facial appearance. Patients differ enormously in their facial anatomy regarding structure and function, both within and between genders, ethnicities, and age. Read More

PLoS Genet 2020 02 26;16(2):e1008628. Epub 2020 Feb 26.

Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Skin lesions, cataracts, and congenital anomalies have been frequently associated with inherited deficiencies in enzymes that synthesize cholesterol. Lanosterol synthase (LSS) converts (S)-2,3-epoxysqualene to lanosterol in the cholesterol biosynthesis pathway. Biallelic mutations in LSS have been reported in families with congenital cataracts and, very recently, have been reported in cases of hypotrichosis. Read More

Semin Plast Surg 2020 Feb 15;34(1):30-37. Epub 2020 Feb 15.

Department of Surgery, Division of Plastic Surgery, Michael E. DeBakey, Baylor College of Medicine, Houston, Texas.

For optimal results, facial rejuvenation procedures should address both the tissue laxity and volume deflation associated with facial aging. The lift-and-fill face lift, in which fat grafting provides volumetric rejuvenation to the face while surgical lift effectively repositions and removes ptotic and redundant tissue, has revolutionized the plastic surgeon's approach to the aged face. An understanding of the intricate anatomy of distinct facial fat compartments and a systematic method to assess areas of fat atrophy and volume depletion are keys to provide patients with a natural and youthful result. Read More

Plast Reconstr Surg 2020 Feb 5. Epub 2020 Feb 5.

Skin Associates of South Florida, Coral Gables, FL, USA.

Objective: Cosmetic treatment of the forehead utilizing neuromodulators is challenging. To avoid adverse events the underlying anatomy has to be understood and thoughtfully targeted. Clinical observations indicate that eyebrow ptosis can be avoided if neuromodulators are injected in the upper forehead, despite the frontalis muscle being the primary elevator. Read More

Plast Reconstr Surg 2020 Feb;145(2):523-530

Boston, Mass. From the Division of Plastic and Reconstructive Surgery and the Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital.

Background: The development of migraine headaches may involve the entrapment of peripheral craniofacial nerves at specific sites. Cadaveric studies in the general population have confirmed potential compression points of the supraorbital and supratrochlear nerves at the frontal trigger site. The authors' aim was to describe the intraoperative anatomy of the supraorbital and supratrochlear nerves at the level of the supraorbital bony rim in patients undergoing frontal migraine surgery and to investigate associated pain. Read More

J Cosmet Dermatol 2020 Feb 10;19(2):312-320. Epub 2020 Jan 10.

Division of Anatomy, Department of Medical Education, Albany Medical College, Albany, NY, USA.

Background: Soft tissue filler product distribution and tissue integration have been shown to depend on myriad factors including the injector type, injector size, and injection angle.

Aim: This study aims to investigate the magnitude of product spread across fascial soft tissue layers in relation to product viscoelastic properties.

Patients/methods: A total of 168 injection procedures were conducted in two female Caucasian body donors with a mean age of 80 years (range: 79-81) and a mean body mass index of 23. Read More

Aesthet Surg J 2020 Jan 4. Epub 2020 Jan 4.

Department of Human Anatomy and Embryology, University of Medicine, Valencia, Spain.

Background: Injections are associated with a certain amount of pain, the tolerance of which can vary between individuals. With regard to noninvasive pain control techniques in subcutaneous injections, few studies with adequate levels of evidence and design quality exist to support any specific analgesic method.

Objectives: In this study, we evaluated the efficacy of 3 noninvasive analgesic techniques (cold, anesthetic cream, and vibration) during subcutaneous forehead injections in 100 healthy volunteers. Read More

Int J Mol Sci 2019 Dec 11;20(24). Epub 2019 Dec 11.

Arrhythmology and Clinical Electrophysiology Department, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Milan, Italy.

Alagille syndrome (AGS) is an autosomal-dominant disorder characterized by various degrees of abnormalities in the liver, heart, eyes, vertebrae, kidneys, face, vasculature, skeleton, and pancreas. This case report describes a newborn child exhibiting a congenital neural tube defect and peculiar craniofacial appearance characterized by a prominent forehead, deep-set eyes, bulbous nasal tip, and subtle upper lip. Just a few hours after birth, congenital heart disease was suspected for cyanosis and confirmed by heart evaluation. Read More

BMJ Case Rep 2019 Dec 9;12(12). Epub 2019 Dec 9.

Gynecology and Obstetrics, Hospital de Braga, Braga, Portugal.

Apert syndrome is a rare genetic disorder that manifests as craniosynostosis, craniofacial and limb dysmorphic features. Mutations in fibroblast growth factor receptor 2 (FGFR2) gene account for almost all cases. Given the impact it can have throughout life, prenatal management becomes a challenge. Read More

Eur J Dermatol 2019 Oct;29(5):574-575

Servicio de Dermatologia Hospital, Universitario San Cecilio, Avda Conocimiento 33, 18016 Granada, Spain.

Eur J Dermatol 2019 Oct;29(5):572-573

Dpt of Dermatology, University of Franche Comté EA3181, and University Hospital, Besançon, France.

BMC Med Genet 2019 11 27;20(1):188. Epub 2019 Nov 27.

Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.

Background: Gorlin-Chaudhry-Moss syndrome (GCMS) and Fontaine-Farriaux syndrome (FFS) are extremely rare genetic disorders that share similar clinical manifestations. Because a de novo missense mutation of the solute carrier family 25 member 24 (SLC25A24) gene was suggested to be the common genetic basis of both syndromes, it has been proposed recently that they be integrated into a single disorder under the name of Fontaine progeroid syndrome (FPS).

Case Presentation: A 9-year-old Korean girl presented with typical clinical features of FPS. Read More

J Med Case Rep 2019 Nov 27;13(1):350. Epub 2019 Nov 27.

Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok, 10400, Thailand.

Background: Linear cutaneous lupus erythematosus (LE) is an unusual form of LE-specific cutaneous condition, occurring in children and young adults. Due to its rarity, the diagnosis of linear cutaneous LE can be difficult and facial lesions can resemble linear morphea or en coup de sabre. Differential diagnosis of similar conditions along the lines of Blaschko must be differentiated from linear LE. Read More

Medicine (Baltimore) 2019 Nov;98(47):e17888

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan province.

Rationale: Hemangiopericytoma (HPC) is a rare pediatric neoplasm with a high risk of bleeding, aggressive growth and high early relapse rates. Surgical excision remains the mainstream treatment, while the functions of chemotherapy and radiotherapy remain controversial. In particular, an infantile giant extracranial HPC located in the forehead has never been reported. Read More

BMJ Case Rep 2019 Nov 19;12(11). Epub 2019 Nov 19.

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

BMJ Case Rep 2019 Nov 19;12(11). Epub 2019 Nov 19.

Department of Neurosurgery, Christian Medical College, Vellore, India.

Cholesteatoma of the paranasal sinus is a very rare condition. As in the tympanomastoid region where cholesteatomas are a common entity, the paranasal sinus cholesteatomas also tend to erode the surrounding bony structures. Because of the extensive bony erosion, this condition often masquerades as a chronic granulomatous or a malignant lesion. Read More

Dermatol Online J 2019 Oct 15;25(10). Epub 2019 Oct 15.

Department of Dermatology, University of California, San Francisco, San Francisco, CA.

Follicular spicules are a very rare but highly characteristic cutaneous manifestation of multiple myeloma. The spicules typically appear as hyperkeratotic horns in the follicular openings of the face, most commonly on or around the nose and forehead. The pathophysiology of this condition has not been fully elucidated and remains an active area of research and debate. Read More

Dermatol Surg 2019 Nov 6. Epub 2019 Nov 6.

Dermatology Surgery Unit, Skin Cancer Institute, Auckland, New Zealand.

Background: Medium-sized defects of the scalp, temple, and forehead can be challenging to reconstruct in an aesthetic fashion. The author proposes the use of a hybrid flap that is at times bipedicled, perforator, and/or axially supplied.

Objective: To describe the author's experience with the bridge flap and its various subtypes. Read More

J Cosmet Dermatol 2020 Apr 11;19(4):772-781. Epub 2019 Nov 11.

Department of Plastic and Reconstructive Surgery, Hanyang University Seoul Hospital, Seoul, South Korea.

Background: Soft tissue filler is commonly used for facial contouring. However, incorrect use can lead to severe ocular complications. Even though filler injections are quite different from fat grafts, they are considered similar procedures. Read More

J Forensic Leg Med 2020 Jan 31;69:101883. Epub 2019 Oct 31.

Institute of Forensic and Traffic Medicine, University Hospital of Heidelberg, Heidelberg, Germany.

A fatality of an 83-year-old female experiencing acute circulatory failure as a result of a type II odontoid fracture is compared with the case of an 86-year-old female who died from delayed cardiopulmonary complications due to a lower cervical spine injury. Falls on the forehead from minor height can cause odontoid fractures especially in elderly patients, hyperextension of the neck on the other hand can lead to lower cervical spine injury with prevertebral hematoma. The latter can lead to extensive hematoma of the neck, but might be difficult to diagnose by computed tomography in the living patient. Read More

Clin Anat 2020 Apr 21;33(3):370-382. Epub 2019 Nov 21.

Department of Anatomy, Faculty of Medicine, and The Chula Soft Cadaver Surgical Training Center, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Glabellar augmentation is one of the most popular cosmetic procedures but can entail severe complications caused by inadvertent intravascular injection of filler. Nevertheless, few studies have investigated the arteries on the glabellar and central forehead regions. The aim of this study was to correlate the topography and location of the arteries in this area with anatomical landmarks to propose a safety guideline. Read More

BMJ Case Rep 2019 Oct 30;12(10). Epub 2019 Oct 30.

Pediatric Radiology, Dayton Children's Hospital, Dayton, Ohio, USA.

A previously healthy 8-year-old girl presented to the hospital with right periorbital and forehead swelling in the setting of a 1-week history of upper respiratory symptoms. Contrast-enhanced CT revealed pansinusitis with orbital and frontal abscesses and thrombosis of the anterior portion of the superior sagittal sinus. She was treated with surgical drainage, antibiotics and anticoagulants. Read More

J Craniofac Surg 2020 Jan/Feb;31(1):e57-e60

Department of Surgery "Pietro Valdoni," Plastic Surgery Unit, Sapienza University of Rome, Rome.

In nasal reconstruction, it is necessary to replace all anatomic layers in order to reinstate correct aesthetics. The most apt donor site to use in order to cover the nose has been recognized as forehead skin. Traditionally 2 phases are required to reconstruct the forehead flap; however, an intermediate third phase was described by Millard which is between transfer of the flap and division of the pedicle. Read More

BMC Evol Biol 2019 10 24;19(1):195. Epub 2019 Oct 24.

Department of Life Sciences, Natural History Museum, Cromwell Road, SW7 5BD, London, UK.

Background: Odontocetes (toothed whales) are the most species-rich marine mammal lineage. The catalyst for their evolutionary success is echolocation - a form of biological sonar that uses high-frequency sound, produced in the forehead and ultimately detected by the cochlea. The ubiquity of echolocation in odontocetes across a wide range of physical and acoustic environments suggests that convergent evolution of cochlear shape is likely to have occurred. Read More

Aesthet Surg J 2019 Oct 25. Epub 2019 Oct 25.

Department of Forensic Medicine, Jagiellonian University Medical College, Kraków, Poland.

Background: The forehead has substantial importance as an aesthetic unit. The central and supraorbital parts of this area are supplied by the supratrochlear (ST) and supraorbital (SO) arteries, as well as the recently defined paracentral (PA) and central arteries.

Objectives: This study aimed to assess the morphometry of the vessels of the forehead in the context of plastic surgery and minimally invasive cosmetic procedures. Read More

G Ital Dermatol Venereol 2019 Oct;154(5):581-585

Department of Dermatology, Istanbul Bagcilar Research and Training Hospital, University of Health Sciences, Istanbul, Turkey -

Nevus of Ota (NO) also known as nevus fuscoceruleus ophthalmomaxillaris or oculodermal melanocytosis is a rare hamartoma. It is usually characterized by unilateral, patchy and speckled, blue/gray or brown macules on the forehead and periocular area. Here, we report a rare case of NO with oro-buccal involvement, which is an unusual condition. Read More

Genes (Basel) 2019 10 12;10(10). Epub 2019 Oct 12.

Medical Genetics Unit, Maternal and Child Health Department, Azienda USL-IRCCS of Reggio Emilia, 42122 Reggio Emilia, Italy.

Variations in genes encoding for the enzymes responsible for synthesizing the linker region of proteoglycans may result in recessive conditions known as "linkeropathies". The two phenotypes related to mutations in genes and (encoding for galactosyltransferase I and II respectively) are similar, characterized by short stature, hypotonia, joint hypermobility, skeletal features and a suggestive face with prominent forehead, thin soft tissue and prominent eyes. The most outstanding feature of these disorders is the combination of severe connective tissue involvement, often manifesting in newborns and infants, and skeletal dysplasia that becomes apparent during childhood. Read More

Brain Stimul 2020 Jan - Feb;13(1):117-124. Epub 2019 Oct 2.

Nagoya Institute of Technology, Department of Electrical and Mechanical Engineering, Japan.

Background: In transcranial direct current stimulation (TDCS), electric current is applied via two large electrodes to modulate brain activity. Computational models have shown that large electrodes produce diffuse electric fields (EFs) in the brain, which depends on individual head and brain anatomy. Recently, smaller electrodes as well as novel electrode arrangements, including high-definition TDCS (HD-TDCS) montages, have been introduced to improve the focality of EFs. Read More

Cutis 2019 Aug;104(2):E15-E17

Division of Dermatology, Children's Mercy Hospital, Kansas City, Missouri, USA.

J Craniofac Surg 2020 Jan/Feb;31(1):e92-e95

University of Milan, San Paolo Hospital, Department of Maxillo Facial Surgery, Italy.

Introduction: An increasing number of skin cancer arising over vascular anomaly has been reported in literature. In such cases, the oncologic radicality required to threat skin malignancies may be in contrast with the safety needed when dealing with vascular malformation. As a result, treatment of this association may be insidious and treacherous and imposes a sound knowledge and carefulness. Read More

BMJ Case Rep 2019 Oct 5;12(10). Epub 2019 Oct 5.

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Soft tissue leukaemic masses are a well-described clinical feature of myeloid haematological neoplasms. In paediatric acute lymphoblastic leukaemia (ALL), such soft tissue leukaemic sarcomas have not been reported as a presenting feature. Here we report a 3-year-old boy with ALL who presented to us with isolated soft tissue swellings for a duration of 9 months. Read More

Am J Dermatopathol 2019 Oct;41(10):701-710

Centro Médico Voth, Madrid, Spain.

Introduction: Morbihan disease (MORD) is rare with only 45 clear-cut cases previously reported. Histopathologic findings are supposed to be nonspecific. We report 14 patients and review the previous cases. Read More

Neurochirurgie 2019 Nov 26;65(5):232-238. Epub 2019 Sep 26.

Inserm 1033, French Referral Center for Craniosynostosis, Pediatric Neurosurgery, université de Lyon, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69003 Lyon, France.

Background: Scaphocephaly is usually defined as the deformation of the skull resulting from the premature fusion of the sagittal suture. It is the most common type of craniosynostosis, and can be easily recognized on simple clinical examination. Its pathophysiology is easy to understand and to confirm on neuroradiological examination. Read More

Medicine (Baltimore) 2019 Sep;98(37):e17138

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

Rational: Ehlers-Danlos syndrome (EDS) is a heritable connective tissue disorder. Currently, the genotype-phenotype correlations of classical EDS (cEDS) are still controversial. Hence, this study reported a case of cEDS with both clinical manifestations and COL5A2 gene mutation. Read More

J Craniofac Surg 2019 Oct;30(7):2268-2270

Necmettin Erbakan University, Meram Faculty of Medicine Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Konya, Turkey.

In this study, the authors present the challenges of replantation and management of 2 patients who have total scalp, partial forehead and ear avulsion. A 39-year-old male farmer was admitted to the emergency room with the total scalp, forehead, partial right eyebrow and upper eyelid amputation after his hair was catched by an agricultural machine. Anastomoses of 2 arteries and 2 veins in the occipital region were done first. Read More

Pediatr Dermatol 2019 Nov 29;36(6):961-962. Epub 2019 Aug 29.

Department of Pathology, Faculty of Medicine, Pontificia Universidad Católica, Santiago, Chile.

We describe a case of a 6-month-old female patient with a segmental, superficial, infantile hemangioma (IH) on the forehead being treated with propranolol 2 mg/kg/d for 5 months, who developed a symplastic hemangioma (SH) over the preexisting lesion, highlighting the need to consider SH in the differential diagnosis of vascular lesions arising over preexisting vascular anomalies in children. Read More

Dermatol Ther 2019 09 4;32(5):e13072. Epub 2019 Sep 4.

Department of Pathology, Başkent University Faculty of Medicine, Ankara, Turkey.

J Dermatol 2019 Oct 16;46(10):849-852. Epub 2019 Aug 16.

Department of Dermatology, Wakayama Medical University, Wakayama, Japan.

Infantile hemangioma is one of the most common tumors in infancy. Delivery may be a clue for the trigger of infantile hemangioma formation in the head and face areas. In this study, we tried to plot localization of infantile hemangioma as well as capillary malformation on the head and face, and compared them to identify their characteristics and risk factors. Read More

Australas J Dermatol 2019 Nov 9;60(4):335-336. Epub 2019 Aug 9.

Kossard Dermatopathologists, Macquarie Park, New South Wales, Australia.

Rev Med Liege 2019 Jul;74(7-8):436-440

Service de Dermatologie, CHU Liège, Belgique.

The treatment of locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) essentially relies on surgery and eventually radiotherapy of the treated site and afferent lymph nodes. Unfortunately, some cases are no candidates for surgery or radiotherapy and a systemic treatment may be indicated. Chemotherapies are only partially efficacious and associated with potential toxicities. Read More

Dermatol Ther 2019 09 10;32(5):e13046. Epub 2019 Sep 10.

IDI-IRCCS, Rome, Italy.

Dermatol Ther 2019 09 8;32(5):e13037. Epub 2019 Aug 8.

Department of Dermatology, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang, Korea.

Frontal fibrosing alopecia (FFA) is an inflammatory disorder characterized by scarring alopecia of the frontotemporal scalp, thinning or loss of facial hair, and facial papules. Prompt treatment is essential to prevent permanent hair loss. Although studies have reported the efficacy of oral retinoids (isotretinoin and acitretin) in FFA treatment, a therapeutic role for alitretinoin is known only for lichen planus and not for FFA. Read More

J Cutan Pathol 2020 Jan 11;47(1):36-46. Epub 2019 Aug 11.

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.

We report two cases of combined cutaneous tumors composed of melanoma and carcinoma. The first tumor presented as a 5-mm pink-blue macule over the right zygomatic arch in an 85-year-old man. Shave biopsy and immunohistochemical studies revealed that the tumor was composed of melanoma (highlighted by SOX10 and MART-1, with high Ki-67 proliferative index) intermixed with nodular basal cell carcinoma (highlighted by pan-cytokeratin and Ber-EP4). Read More