Periorbital area is one of the most common target of facial aesthetic procedures. There are a wide range of tools for rejuvenation of the periorbital area, surgical and non-surgical approaches. The patients should receive the most appropriate treatment from these options. For that reason we have to be fully aware of the available options and their limitations. The aim of this article is to introduce the surgical upper and lower blepharoplasty in details, including the indications, contraindications, surgical steps, possible complications and to present the role of non-surgical techniques, too.
Liquid rhinoplasty, also known as nonsurgical rhinoplasty is a procedure, when injectable fillers, like hyaluronic acid is injected into the nose to change its shape. Results are temporary. Liquid rhinoplasty is a quick procedure with limited downtime that could be a good alternative to surgical rhinoplasty. The procedure is minimally invasive, usually safe, with low rates of complications, but the increasing popularity has led to a rise in side effects, too. Serious complications, like vascular occlusion, necrosis, vision loss can occur. Authors present the case of a 27-year-old female patient, who developed vascular occlusion after liquid rhinoplasty with hyaluronic acid. Prompt, and repeated use of intralesional hyaluronidase injections led to restoration of normal tissue vascularity, and complete healing of skin symptoms.
The development of medicine and technology in the 21st century has enabled the use of more new minimally invasive or non-invasive interventions to rejuvenate the skin of the neck and décolleté areas. Techniques have further developed on the base of research, presenting new challenges to professionals adapting them, as patients are keen on options that can preserve or improve their appearance more effectively, quickly, and painlessly. The skin in neck and décolleté area is thinner, more sensitive, contains fewer sebaceous glands and this area presents signs of skin aging early, which requires greater caution, individualized, and mostly combined treatments. The aim of this publication is to present the most frequently used treatment methods together with their advantages and disadvantages.
Superficial and deep chemical peel treatments are safe and effective options for mild acne, pigmentation abnormalities, actinic keratosis, fine wrinkles and for rejuvenation. Possible complications include infection, hyperpigmentation and scarring. The case report of a young female patient is presented who suffered a superficial second-degree chemical burn with bacterial superinfection after a chemical peel done by a cosmetician. It is vital, that cosmetician should only perform superficial chemical peeling of the upper layer of the epidermis. Chemical peels that penetrate deeper should only be performed by dermatologist who is also competent at managing complications.
In recent years, Janus kinase (JAK) inhibitors have proven to be effective in several immune-mediated diseases. A deeper understanding of the pathomechanism of certain conditions continues to open up new indications for clinical practice. In the diseases-vitiligo and hidradenitis suppurativa- discussed in this publication, numerous clinical trials have evaluated their efficacy. Interestingly, in early-stages and limited cases, topical formulation instead of systemic administration appears to be promising. In the case of vitiligo, a topical JAK inhibitor has already been approved. In this publication, we summarize the ongoing studies for vitiligo and hidradenitis suppurativa.
Traumatic tattoo is a persistent presence of foreign bo dieslike sand, asphalt, slag, carbon, graphit, oil, or fireworks’ particles, metal and gunpowder contamination -in dermis after an accident. We present 4 cases with traumatic tattoo on the face and extremities with varying degrees of aesthetically disturbing scarring. We describe the successful removal of foreign bodies with a 1064nm wavelength Q-switched Nd:Yag laser, and the simultaneous treatment of the scar with a pulsed dye laser or a microneedle radiofrequency device. The Q-switched laser seems to be optimal therapeutic solution for the treatment of traumatic tattoos, and the simultaneous scar treatment results in both functional and aesthetic improvement.
The periorbital region has been always in the focus of aesthetic treatments as the ageing of this region of the face causes a sad and weary appearance. Treatments which give natural and fresh appearence are in the focus of today’s trend of aesthetics. Earlier, the possible rejuvenation treatment of the periorbital region was surgical (blepharoplasty) or laser assisted, or by injecting hialuronic acid fillers. Since 2009, a noninvasive plasma technology has provided a new, effective solution for dermatochalasis (skin redundancy of the upper eyelid). The thermal ionisation technology is a modern, medical procedure which can be used for removal of different tissues (skin, mucosa, soft tissue). General dermatologists remove benign lesions (fibroma, seborrhoic keratosis, xanthelasma, viral warts), aesthetic dermatologists make rejuvenation of the eyelids, treat scars, strias, pigmented lesions. The aim of our article was to present the efficacy and technology of the eyelids treatments and the adventages and disadvanteges of the procedures.
Biological therapies have led to dramatic improvements in the treatment of moderate-to-severe psoriasis. The efficacy and safety of the biological therapies are difficult to surpass, the possibility of avoiding self-injection and opting for oral administration is considered as an important advantage. Research aims to develop oral therapies that exceed the effectiveness and safety of available biological treatments. The latest understanding of psoriasis pathogenesis has led to the development of targeted molecules, both for systemic and topical application. The novel small-molecule therapies primarily target intracellular signaling pathways, like the JAK/STAT, PDE-4, and AhR pathways. Deucravacitinib, the first oral allosteric Tyk2 inhibitor, was approved for the treatment of mo derate-tosevere psoriasis. The topical application of the PDE-4 inhibitor roflumilast and the AhR modulator tapinarof was approved for mild, moderate, and severe plaque psoriasis. This article presents the latest approved and under-development small-molecule oral and topical therapies for the treatment of psoriasis.
Although Intense Pulsed Light (IPL) devices emit a broad spectrum of light, which has different properties than laser light, modern, high quality IPL devices, when used with appropriate settings and indications, can achieve treatment outcomes comparable to laser treatments. Since its approval several innovations have been made in IPL technology. SWT® Dual-Filter Technology not only cuts off lower wavelengths, but also uses a water filter to remove wavelengths longer than 950 nm. This reduces light absorption by water in the skin, resulting in less heat generation for a less painful and safer treatment. The aim of this article is to summarize the common indications and advantages of SWT® IPL technology, illustrated with the author’s clinical results.
Picosecond laser technology stands as one of the most advanced and promising tools in dermatology and aesthetic medicine, enabling precise and targeted treatment of various skin layers with minimal thermal impact and short recovery times. The first section of this article provides a detailed overview of the physical characteristics of picosecond lasers, with particular emphasis on phenomena such as Laser-Induced Optical Breakdown (LIOB) and Diffractive Optical Elements (DOE), which play crucial roles in the tissue interaction mechanisms of laser energy. Subsequently, we examine the indications for picosecond lasers within cosmetic practice, including the treatment of epidermal and dermal pigmented lesions, surgical scars, as well as skin rejuvenation and wrinkle reduction. In the concluding part of the article, we present case studies demonstrating the practical applications of picosecond laser treatments, highlighting the advantages of the PicoSculptur® method and the differences in treatment approaches between male and female facial skin. The aim of this summary is to provide a comprehensive overview of the role and power of picosecond lasers in modern cosmetic practice, emphasizing the technology's precision, versatility, and the benefits it offers to patients.
The aging process of the face involves complex, multi-layered changes. Midface volume loss and sagging caused by other factors are among the most prominent signs of aesthetic aging, making their reduction one of the most sought-after treatments in medical aesthetics. Modern minimally invasive treatments, such as hyaluronic acid filling and absorbable thread lifting, can correct these changes. Current trends favor the combined use of the two techniques to achieve the most natural and long-lasting results possible. The article aims to present the scientific background, clinical indications, application aspects, and latest technological innovations of combination treatment strategies, thereby supporting colleagues in the field of holistic facial rejuvenation.
Bruton tyrosine kinase (BTK), a member of the tyro sineprotein kinase Tec family, is a cytoplasmic, non-receptor kinase that plays a key role in numerous immunological pathways. BTK activity is particularly crucial in B-cell development, migration, and activation through B-cell receptor activation. Additionally, BTK is critical for receptor-mediated signal transduction involving Fc receptors, Toll-like receptors, and chemokine receptors. Due to its dual role in innate and adaptive immunity, BTK inhibition represents a promising therapeutic target for immune-mediated dermatological disorders. The potential applications of BTK inhibitors in dermatology have gained increasing attention, with a particular focus on the treatment of chronic spontaneous urticaria and pemphigus vulgaris.
Following the review articles on alopecia published in Bőrgyógyászati és Venerológiai Szemle by Csernus and Gyulai in 2021 and by Friedman-Cserhalmi and Németh in 2024, we present here the latest knowledge on the development and treatment of alopecia areata.
The visual appearance of the lower face and neck region plays a crucial role in maintaining facial aesthetic balance. The definition of the mandibular contour, the transition zone between the face and neck, and the tone of the skin and underlying soft tissues all significantly contribute to facial harmony and a youthful appearance. While aging is a major factor in the descent of lower facial structures and the accumulation of submental fat, other influences such as genetic predisposition, hormonal imbalances, metabolic disorders, and lifestyle choices also significantly affect the aesthetics of the lower face. Beautification of the lower third of the face and the submental region demands a comprehensive, skilled, and often complex approach. Interest in treating this area is steadily increasing, with a growing number of younger patients seeking interventions targeting the lower face. A thorough understanding of the anatomical and structural changes in the lower face and neck is essential for designing effective treatment strategies. This article aims to review the constitutional, pathological, and age-related factors that shape the mandibular and neck areas, and to present available treatment options—both minimally invasive and surgical—within a holistic framework. Finally, two cases from the authors’ own clinical experience are presented to illustrate the therapeutic strategies.
Atopic dermatitis (AD) is a chronic, heterogeneous, inflammatory, pruritic skin disorder. It’s pathomechanism is complex, involves the skin barrier, immunological and genetic factors. Onset can occur at any age but most common in the first year of life. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is of paramount importance in mediating signalling by cytokines of major importance in the immunopathogenesis of AD, such as IL-4, IL-5, IL-13, IL-31, thymic stromal lymphopoietin (TSLP), and in mediating skin barrier function and pruritus. This central role explains why several signalling pathways being important in the development and maintenance of AD can be blocked by inhibition of the JAK-STAT pathway. As a result, inflammation and pruritus are reduced within days, leading to a significant improvement in patients' quality of life. In the present article, the currently used JAK inhibitors in Hungary for the treatment of atopic dermatitis are presented, with focus on the pathomechanism of the disease.
The prevalence of sensitive skin in various populations is about 25-50% and it is especially common among young women. It’s background can be physiological, iatrogenic, provoked by environmental influences or related to cosmetic „abuse”, medical or aesthetic treatments. It might be essential diagnostic symptom of certain skin diseases (eg. atopic dermatitis, rosacea, perioral dermatitis, seborrhoea), but it can also exist without a dermatological cause and can even accompany internal diseases. The management of any underlying disease, modification of the daily skin care routine, use of appropiate products and avoidance of irritating and sensitizing ingredients are the most important factors in treatment of sensitive skin.
Modern eyelid surgery focuses on functional outcome and aesthetic expectations of certain interventions. Clinicians need to be expert in the diagnosis and surgical management of these conditions, and in the preoperative assessment and appropriate management of expectations. The escription of most common abnormal eyelid positions: dermatochalasis, ptosis, entropion as well as ectropion is included in this article. Reconstructive techniques and their potential complications are discussed, presenting the wide range of clinical and surgical challenges. The ideal intervention combines the restoration of optimal eyelid function and aesthetic harmony, providing patients with both good visual function and a natural, healthy appearance.
Janus Kinase (JAK) inhibitors are increasingly used in dermatology and serve as highly effective therapeutic options for the treatment of atopic dermatitis, psoriasis, vitiligo, and alopecia areata. JAK inhibitors received a black box warning after a large, controlled study confirmed that rheumatoid arthritis patients treated with high-dose tofacitinib are exposed to a higher safety risk compared to those receiving TNF inhibitor treatment. However, in clinical trials focusing on dermatologic conditions, the risk of serious adverse events of JAK inhibitors was low. Most adverse effects (such as infections, herpes zoster infection, lymphopenia, neutropenia, and elevated transaminase levels) are likely due to a class effect. JAK inhibitors do not inherently increase the risk of arterial/venous thromboembolic (ATE/VTE) events, gastrointestinal perforation, or malignant disorders. Overall, JAK inhibitors can be used safely; however, post-marketing pharmacovigilance studies remain crucial for further safety assessment.
The JAK/STAT signal transducer pathway is responsible for the regulation of numerous inflammatory, hematopoietic and other cell’ growth and differentiation. Inhibition of the JAK signalling resulted in improvement of immune mediated diseases and haematologic disorders, leading to the approval of more jakinibs in recent years. As selectivity of jakinibs does not reach that of biological therapies, their effect and spectrum of adverse effects are broader. First JAK inhibitors were approved in haematologic disorders and rheumatoid arthritis, then baricitinib, upadacitinib, abrocitinib, ritlecitinib became available in dermatological conditions, also in Hungary. The purpose of this review is to overview the immunological and pharmacological effect of jakinibs in order to better understand their action and adverse effects in dermatological immune-mediated disorders. The summary wants to helpin in preventing, monitoring and managing the adverse reactions of JAK inhibitors.
Acute haemorrhagic edema of infancy is a less-known, probably underdiagnosed condition. Despite of the rapidly evolving, haemorrhagic skin symptoms and the edema affecting multiple bodyparts, the disease is self-heeling and benign. Being aware of it is essential for preventing unnecessary diagnostic measures and inadequate therapies. In the majority of cases, this illness doesn’t require hospitalisation or only a short period of observation is needed to exclude any differential-diagnostic illnesses. It is a self limiting condition, that heels without residual symptoms. In this publication 5 cases of acute haemorrhagic edema of infancy are presented. In addition, differential diagnostics and diagnostic criterias are described.
