highly suggestive contraindication:

1. pregnancy

2. lactatipon

3. age <18

4. severe acute or chronic illness

5. allergy to soy products and/or the benzyl alcohol preservative

relative contraindications:

1. immunocompromised status: but tx for HIV buffalo humps could be considered

2. anticoagulant therapy or chemotherapy,

3. obesity: BMI>30

4. unrealistic expectations. 

 

sites not recommended for tx: 

The area distal to the knee: poor response; laxity; circulation

bresat reduciton in women

 

sites most responsive to tx:

1. abdomen

2. flanks

3. submental

 

sites less responsive to tx:

1. inner thighs

2. outer thighs

3. knees

 

expected sequele: 

1. pain

2. swelling

3. stining & burning

4. bruising

5. nausea: when high dose

6. diarrhea: when high dose

7. hematoma

8. dizziness, light-headedness

9. hives

10. numbness: tx with point by point injections of procain, pentoxyfilline, multi-vitamins with 4mm needle at one week interval (American journal of mesotherapy, Harry Adelson

  

complications: 

1. hyperpigmentation: 0.0021%

2. late onset hives: 0.0003%

3. persistent pain >2wk: 0.015%

4. less than expected aesthetic outcome: 12.34%

 

PCDC vs DC

1. 1) PCDC less pain, bruise & swelling. (Dermatol Surg 2008;34:60–6) (J Clin Exp Dermatol Res. 2012;3(2))

    2) PCDC vs DC no difference in adverse events. (Dermatol Surg 2009;35:792–803)

2. no differecen in efficacy. (Dermatol Surgery 34: 60-66.) (J Clin Exp Dermatol Res. 2012;3(2)

3. incidence of subcutaneous noduels,

    1)DC 70% vs PCDC 10% (J Clin Exp Dermatol Res. 2012;3(2))

    2) no differecne (Dermatol Surg 2009;35:792–803). higher injeciton volume (0.5ml/site), higher conecntration, anatomic location (hips) or higher conectration of DC alone may accounts for persistent nodules. 

4. If subcutanous nodules develops, DC group persists longer (J Clin Exp Dermatol Res. 2012;3(2), 

 

good response at 1st session, stationayr during 2nd~4th sessions, good response at 5th session (Dermatol Surgery 34: 60-66) (J Clin Exp Dermatol Res. 2012;3(2)

 

DC induced necrosis is concentration dependent (0.1~5%) (Dermatol Surg 2009;35:792–803)

 

Techniques of injeciton:

deep into muscle or superficial to dermis may induce necrosis (Dermatol Surg 2009;35:792–803)

no more than 2500mg PC per session

shortest interval between sessions: 1wk 

 

參考文獻:

1. Aesthetic Surg J 2006;26:575–585 (data from 56360 treatments among 17376 patients)

2. J Cos Dermatol. 2006;5:218-226   (10581 treatments)

3. Dermatol Surg 2009;35:792–803

4 .J Clin Exp Dermatol Res. 2012;3(2)

 

創作者介紹
創作者 皮膚科劉權毅醫師 的頭像
皮膚科劉權毅醫師

皮膚科 劉權毅醫師

皮膚科劉權毅醫師 發表在 痞客邦 留言(0) 人氣()