In my experience, surgery at this point may leave a prominent scar which may be hard to camoflouge.Best of luck. saline injection for cortisone induced atrophy. Multiple injections or injecting while withdrawing the needle should be avoided. Has anyone ever experienced this and actually had it fill up eventually? Intradermal injection of normal saline for treatment of fat atrophy following corticosteroid injection. 5. Steroid-induced atrophy caused by injection of intrale-sional corticosteroid 13 months previously to reduce the appear-ance of a subcutaneous cyst. 1 A number of complications can arise when performing procedures involving joints and soft tissues. Chang R, Holcomb JB. Because our patient was within the 1-year timeframe, saline injections were performed. Benefits of fractional radiofrequency treatment in patients with atrophic acne scars - Literature review. A Retrospective Review of the Safety and Efficacy of Low-dose Triamcinolone Mixed with Hyaluronic Acid Fillers to Reduce Post-injection Infraorbital Swelling. As expected, the most frequent are minor complications. 2021 Feb;20(2):381-385. doi: 10.1111/jocd.13900. Please give me any information that might help me, this is very distressing. 14 However, . We performed a literature search based on PubMed, EMBASE, WHO Global Health Library, Virtual Health Library, Web of Science, Scopus, Google Scholar, and Research gate. The clinical picture - soft tissue atrophy after corticosteroid injection. Wish you could get back your pre-pregnancy body? 2009;76(6):373-374. doi:10.3949/ccjm.76a.08096. The degree of steroid atrophy depends on the potency and dose of injected corticosteroid, body site (with the face being more prone to steroid atrophy than other sites), and patient age. I'm so embarrassed by this indentation. I have one too, its been3 weeks so far, and I am going to do saline injections. The injection of saline reportedly acts to dissolve the crystaline precipitate and therefore allow regrowth . Can it be corrected? Final appearance, after 6 saline solution injections, at 4.5 months after initial saline solution injection. So - the dent was not from cortisone, just from how my skin healed. It's pretty expensive and I don't use it anymore now that the dent has filled in, but it definitely helped me get through those few months because it was the only thing I found that could actually fill in a dent and look pretty decent. Even the small joints in your hands or feet might benefit from cortisone shots. Papadopoulos PJ, Edison JD. Be Free from Pain. She stated that the pain was worse with activities that involved gripping with forearm rotation. Learn to identify and prevent bites from summers most common pests. Recombinant adeno-associated viruses (AAVs) have emerged as promising gene delivery vehicles resulting in three US Food and Drug Administration (FDA) and one European Medicines Agency (EMA)-approved AAV-based gene therapies. Bethesda, MD 20894, Web Policies This whole process has been so traumatizing and I'm sorry that it happened to all of us! Good news is that this will reverse, however in the meantime you should undergo temporary Saline/fillers to provide normal contour. Khoo A, Grattan CE. Clipboard, Search History, and several other advanced features are temporarily unavailable. I have one now and am just wondering what I should expect. I had a face lift 4 years ago. Abdel Hay R, Shalaby K, Zaher H, Hafez V, Chi CC, Dimitri S, Nabhan AF, Layton AM. Gonzales EA. She had to call back and ask the doctor and she said "The indentation is normal and that its ok to have it"she also said it would fill in after 6 months and i told her it has been 6 months already. We also hand-searched textbooks. 2016;92(1089):407-411. Am J Dermatopathol. Helpful IF it never fills back in you can get a filler, but technically you're supposed to wait up to a year or so to see if it fills back in naturally! My self confidence just doesn't exist anymore. Injecting the area with filler or fat could have led to eventual overcorrection, as the remaining corticosteroid was gradually removed from the area and the patient's natural fat architecture returned. DOI: https://doi.org/10.1016/j.jseint.2020.08.009. http://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2005.31216/abstract. sharing sensitive information, make sure youre on a federal eCollection 2022 Mar-Apr. I had a dent happen once, and I said I won't do it again. It has been proposed that normal saline injections resuspend the corticosteroid crystals, allowing the body's natural mechanisms to identify and remove the foreign bodies; however, further studies are needed to determine the precise mechanism of action.11 Case reports have demonstrated resolution in 4 to 8 weeks with normal saline injections.7 Resultant skin blanching and edema resolved within 2 hours without sequelae. noticeable effect. and transmitted securely. What's the best wrinkle fillers to get rid of these lines? Background: eCollection 2022 Oct. Indian Dermatol Online J. For more superficial injections such as tendons and skin lesions, more soluble compounds such as betamethasone sodium phosphate and acetate or dexamethasone sodium phosphate could be considered.3,12 Care should be taken to ensure as much of the injection reaches the intended site, while minimizing the chance of spread.2 This can be optimized by choosing a properly sized needle and completing the injection in one push. I went to the dermatologist this past June 20th for my allergies and the doc insisted on me getting a cortisone shot. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. Fat atrophy that results from corticosteroid use typically self-resolves in 6 to 12 months.5 After this time, if the atrophy persists, surgical intervention such as fat grafting or injection is often performed if the areas are bothersome to the patient. Toggle navigation what was joachim kroll childhood like. Shumaker PR, Rao J, Goldman MP. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. official website and that any information you provide is encrypted I talked to my derm to told me the only thing he could suggest was cosmetic fillers, which are expensive and need to be done routinely to keep up the effect. Serial saline solution injections for the treatment of lipoatrophy and depigmentation after corticosteroid injection for medial epicondylitis Amy Birnbaum, Michele Y. Yoon, S. Struhl Medicine JSES international 2020 2 PDF Use of hyaluronic acid gel filler versus sterile water in the treatment of intractable plantar keratomas: a pilot study. Usually, this will be evident within the first year, but sometimes the atrophy is permanent.5 In these situations, if correction is desired, then other procedural techniques are required to restore normal skin topography, such as filler placement or fat grafting. To determine the effectiveness of bacteriostatic normal saline infiltration on the improvement of corticosteroid-induced cutaneous atrophy. Medical practitioners should be aware of the less common adverse effects of steroid injections, such as fat atrophy. Although the exact mechanism of subcutaneous lipoatrophy is unknown, it has been observed that both the size and number of adipocytes decrease with an increase in macrophage cells. Figure 2. The only serious adverse event in the injection therapy group was an Achilles tendon rupture, which happened in a study testing steroid injections. The https:// ensures that you are connecting to the We use cookies to help provide and enhance our service and tailor content. Materi mengenai penyakit dan obat mulut 584 oral medicine determining the true nature of emergency is to check the blood glucose level with glucometer. I was reading a few entries and I am in the same situation. Almost constant burning pain, redness, burning pa Red skin condition on back left side of skull. (canceled) 31. BMJ Case Rep. 2016;2016:bcr2015214225. Although the patient did not recall receiving steroid injections in those areas to treat her pain, her examination was suspicious for localized corticosteroid-induced atrophy. Treatment of steroid induced lipoatrophy with structural fat grafting. Calcified Cephalohematoma Removal - Right Parietal Region, What is the Difference Between a Full Tummy Tuck and a Mini-Tummy Tuck. j. I hope I can say that in a few months too. MeSH (Like a very shallow acne scar pit - fat filled back in, skin had a scar) It never caved back in or regressed as some others have experienced. Not painful but occasionally itchy. Steroid in solution dispersed and causes fat atrophy. How are things nowIs the dent completely gone or have you noticed any caving in again as noted by another post? The exact mechanism of action is poorly understood, but studies suggest that corticosteroid crystals persist in the subcutaneous tissue, resulting in fat involution.2 Histopathology typically demonstrates smaller and fewer fat cells, as well as lipophage-like macrophages without evidence of inflammation or necrosis.3,9 Glucocorticoids also reduce the production of type 1 and type 3 collagen.10. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). I finally gave the clinic a call. Thanks so much for anyone who is reading this/ responds. any info what so ever would be great. Dr. Michael B. Wolfeld explains why new mothers are undergoing a cosmetic precedure called the "mommy makeover.". Sorry to hear about your atrophy after steroid injection. Therefore, scarring is more obvious, making these interventions more apparent. In New Zealand, triamcinolone injection is marketed as Kenacort-A and is available in 2 strengths: 10 mg per ml (Kenacort-A 10) and 40 mg per ml (Kenacort-A 40). lena2 where did you get the saline injections done? It's been a few years, I just was curious if anyone was still posting on this topic. The main purpose of side port incision is to remove the subincisional cortical matter. that is insaneget a new dermatologist. Ahmed I. Post-injection involutional lipoatrophy: Ultrastructural evidence for an activated macrophage phenotype and macrophage related involution of adipocytes. A method for treatment of a neurodegenerative disease, comprising administering to an individual in need of such treatment a therapeutically effective amount of a compound having the structure: wherein R is hydrogen, or a C 1 to C 10 alkyl, C 2 to C 10 alkenyl, C 2 to C 10 alkynyl, or C 2 to C 10 alkoxyalkyl group, optionally including heteroatoms; Y 1 and Y 2 are . An intralesional steroid injection involves a corticosteroid such as triamcinolone acetonide injected directly into a lesion on or immediately below the skin. I had saline injections for a dent on my face from a huge pustule and I have had almost 100% improvement on the indentation. The https:// ensures that you are connecting to the The clinical management of hyponatraemia. Despite being a leading platform for therapeutic gene transfer in several clinical trials, host immune responses against the AAV vector and transgene have hampered their . But then I thought maybe that was just a one-time thing, had a pimple injected 2 weeks ago, and now the skin is starting to sink in I am scared it's just going to get worse and worse. Metopic synostosis in Adults. To update your cookie settings, please visit the, European Society for Surgery of the Shoulder and Elbow, South African Shoulder and Elbow Surgeons, South African Society of Shoulder and Elbow, International Board of Shoulder and Elbow Surgery, American Society of Shoulder and Elbow Therapists, Geometric analysis of the humeral head and glenoid in the Indian population and its clinical significance, Severe joint cartilage degeneration after minimally displaced fracture of proximal radius in children: a report of 2 cases. J Clin Aesthet Dermatol. One case study suggested that saline solution potentially caused a redistribution of the steroid crystals, leading to differing cellular changes. This is a frustrating problem. Brinks A, Koes BW, Volkers AC, Verhaar JA, Bierma-Zeinstra SM. It has been proposed that normal saline injections resuspend the corticosteroid crystals, allowing the bodys natural mechanisms to identify and remove the foreign bodies; however, further studies are needed to determine the precise mechanism of action. We offer this Site AS IS and without any warranties. Or am I screwed :'(. Immune, Lipid Biomarkers May Predict Onset of Atopic Dermatitis in Infants, Treatment for Type 2 Diabetes Reduces Major CV Events in Men, Inflammation Reduction Medications May Lower Dementia Risk in Patients With Rheumatoid Arthritis, Sepsis Increases Risk of Post-Discharge Cardiovascular Events, Death, AHA Releases Statement on Hypertension Induced by Anticancer Therapy, Consultant360's Practical Updates in Primary Care, https://doi.org/10.1111/j.1524-4725.2009.01468.x. So that questions for anyone who knows what they are talking about..? Bookshelf JAAD Case Rep. 2021 Aug 31;16:116-119. doi: 10.1016/j.jdcr.2021.08.022. Localized involutional lipoatrophy: a clinicopathologic study of 16 patients. Making a dent with corticosteroid injections for de Quervain's tenosynovitis. Kim BY, Chun SH, Park JH, Ryu SI, Kim IH. Save Page Now. YES, I am almost 40 and still getting these stupid things! Over time, these effects will gradually dissipate as the body reabsorbs the corticosteroid crystals and the adipocytes return to normal number and size. Although the article recommended 5ccs of saline, I was chicken and told him to start with 2.5ccs (he said 5cc would cause ALOT of swelling, although it would be completely temporary). Federal government websites often end in .gov or .mil. 1. We offer this Site AS IS and without any warranties. So overall I would say it started filling in about a month after I had the cortisone injection and was basically filled in all the way (except for the surface scar which will probably never go away) about two/two and a half months after I had the cortisone shot. Although we could find no published comparative studies, utilizing certain techniques may decrease the chance of fat atrophy based on our current understanding of the pathophysiology of this condition. Does a series of saline injections help the dent go away??? saline injection for cortisone induced atrophy "Bologna da Vivere, non solo la convinzione di coloro i quali visitano questa splendida citt, ma anche e soprattutto uno dei pi importanti e - per qualit di servizi offerti- uno dei pi interessanti portali internet che si possono consultare on line." . Epub 2020 Dec 1. Please enter a term before submitting your search. saline injection for cortisone induced atrophyjobs in jersey city for 17 year olds. Results: Saline was used as a diluent with intralesional injection of steroids to minimize the risk of steroid-induced atrophy, being safe and free from preservatives that may precipitate steroids at site of injection and maximize their side effects. We did it once every 10 days, 4 times in total and the results even impressed him. It is now 9 months later and I just started noticing a slight indent starting again. After injection, corticosteroid is deposited in the area of treatment with differing levels of solubility depending on the formulation. Saline, with its different concentrations, is the most used crystalloid solution in medicine. eCollection 2022. Over time, these effects will gradually dissipate as the body reabsorbs the corticosteroid crystals and the adipocytes return to normal number and size. Structural fat grafting: more than a permanent filler. All rights reserved. Letter: treatment of local, persistent cutaneous atrophy after corticosteroid injection with normal saline infiltration. So I sent my derm the link and begged him to try it. Br J Dermatol. Adverse effects of extra-articular corticosteroid injections: a systematic review. Serial saline solution injections for the treatment of lipoatrophy and depigmentation after corticosteroid injection for medial epicondylitis. For these cases, serial normal saline injections can provide a simple, safe, and effective method to permanently reverse corticosteroid-induced fat atrophy. Epub 2020 Dec 25. I had only 2 injections and I had the first injection only days after I noticed my skin was denting. To begin searching the abstracts, use the search features on the right. Hideous! I saw that you were very distressed about it in many posts, but that you haven't mentioned it recently. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. BMC Musculoskelet Disord. 10 ways to keep your skin healthy all winter long, How to get rid of lumpy fat on your arms, hips, thighs and bottom. Margulies SL, Morris A. DISCLAIMER: https://doi.org/10.1136/bcr-2015-214225, 5. (Which is still painstakingly slow) To cover up it up while it's healing I found a silicone filler "make up." If they use a mixture of saline and cortisone at 3.75ml/cc you should be ok (thats what I get and I have never had an indention). It also contains 8 amino acids, 3 antioxidants, 2 minerals and vitamin B6 to help with undereye dark circles. I am very encouraged to hear that it worked out for you. 2010;36(3):436. https://doi.org/10.1111/j.1524-4725.2009.01468.x, 12. I haven't gone out with my friends in about 4 months since I got the corisone injection in March. 2008;27(2):179-188. The nurse had no idea what the name of the cortisone shot she gave me was called. FOIA Plastic surgeon Michael B. Wolfeld, MD, describes two types of tummy tucks. Topics include, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life. 1. I have small acne scars but I've never had a large scar like this before and I'm freaking out. Now I feel like the center of it is starting to become a defined point which leads me to think that it's permanent! Hope you're all doing well!! government site. Although they were not painful or otherwise symptomatic, she was unhappy with the cosmetic appearance. Accepted October 1, 2021. This is made at 90 to the main incision. The patients were seen on weekly follow-up visits, and improvement was documented. I have never seen anyone with a weird dent like this before. Although these injections are considered low risk, they can cause well-known adverse effects, such as tendon weakening or rupture, infection, bleeding, skin discoloration, skin and fat atrophy, and damage to cartilage and bone.1 The incidence of fat atrophy is not well known but has been estimated to be between 3% and 41%.1 This adverse effect is more frequent with intramuscular injections, such as those used to treat allergies; however, fat atrophy has been reported in intra-articular and peritendinous injections, as well as with oral corticosteroids.3,4 These risks are increased with larger or multiple doses and with corticosteroids of high concentration or low solubility.5 For unclear reasons, corticosteroid-induced skin and fat atrophy appears to occur more frequently in premenopausal women than in men.2,3. I have actually discussed this topical in response to a question several weeks ago. Would you like email updates of new search results? The saline represents a helpful option as a diluent with intralesional injection of steroids in various dermatologic therapeutic indications. Saline injections aid in diluting the corticosteroid that remains in the skin, facilitating a more rapid reversal of fat atrophy than the patient would otherwise experience. According to Medicinenet Corticosteroids can be taken by mouth inhaled applied to the skin given intravenously into a vein or injected into the tissues of the body. If it stays the way it looks now without getting worse, it is not too bad. Oikarinen A, Haapasaari KM, Sutinen M, Tasanen K. The molecular basis of glucocorticoid-induced skin atrophy: topical glucocorticoid apparently decreases both collagen synthesis and the corresponding collagen mRNA level in human skin in vivo. Been there a while didnt grasp its severity until sha yeah, it was a physicians assistant and he is really stupid. This dent is bigup close is looks like a dent the size of a pencil eraser but from a little distance it actually is about an inch long!!!! Careers. 2019 Sep;32(5):e13067. I learned that too much cortisone can break down the collagen and cause either a temporary or possibly PERMANENT atrophe (or indent). Do you find that outpatient rehabilitation is effective for your patients with multiple sclerosis? I'm sorry". JAAD Case Rep. 2021 Aug 31;16:116-119. doi: 10.1016/j.jdcr.2021.08.022. After injection, there is a lymphatic spread of the corticosteroid crystals along the lymphatic channels and resulting linear atrophy of the adjacent tissues (Figure 2). As hard as it is try to hang in there and give it some more time, I think there is a good chance it will get better. Decreased sperm production. Appearance 6 weeks after initial saline solution injection and just prior to fifth saline solution injection. The information on RealSelf is intended for educational purposes only. official website and that any information you provide is encrypted The control group received intralesional. Saline injections can be effective in reversing the atrophy, but often times, multiple injections are required. They are temporary in nature but it is important that one does not continue to inject in the area if atrophy is present. Ophthalmologist Michael Kutryb reports on the success (or failure!) A 20-year-old woman with a Fitzpatrick score of 2 presented via telehealth with divots on her forehead and scalp. J Coll Physicians Surg Pak. Radiologists are commonly asked to perform intra-articular corticosteroid injection in patients with knee and hip OA in clinical practice. Which filler is best for the treatment of under eye tear troughs? Intralesional corticosteroid (IL-CS) injections have been used to treat a variety of dermatological and nondermatological diseases. Treatment for steroid atrophy is mainly to wait for the body to start making more collagen and elastin again in a few months. Postinjection flare reactions is one of the more common side effects of an injection as performed into a joint with a steroid. Local subcutaneous atrophy after corticosteroid injection. CORRESPONDENCE: Making a dent with corticosteroid injections for de Quervain's tenosynovitis. Genital corticosteroid use damage my genital skin. This occurs more frequently with a certain type of steroids. This case study demonstrates that serial injections with normal saline solution may be a viable option for patients who are cosmetically dissatisfied with subcutaneous lipoatrophy as this method is cost-effective and low risk. The site is secure. Shumaker PR, Rao J, Goldman MP. Recommend undergoing subcision and injection with Juvderm Ultra Plus in this area. do you know of anything i can do now to correct this as soon as possible? Typically you will see an inflammatory response with increased pain, redness and heat around the joint. 2016;46(1):17-26. Diagnostic indications include the aspiration of fluid for analysis and the assessment. Normal injectable saline was administered every other week for 3 months, followed by 3 months' rest. eCollection 2021 Oct. Efficacy of Saline Injection Therapy for Atrophic Acne Scars. ANTISENSE MODULATION OF NUCLEAR HORMONE RECEPTORS is an invention by Patrick L. Iversen, Corvallis OR UNITED STATES. Thank you. In my case, I started to notice that it was improving all of a sudden. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. 2020 Dec;13(12):41-43. See an experienced injector. I panicked and searched all over the internet for WTF this was, and how I could fix it. application of binomial distribution in civil engineering eames replica lounge chair review eames replica lounge chair review Let me start by saying my skin is now perfectly clear at this time other then this dent that is dead center in between my forehead a little above my eyebrows. For that first month I saw no improvement whatsoever. Disclaimer. what kind of a doctor gives you a cortisone shot for a single pimple? iv Contents GENERIC AND SELECTED BRAND DRUG DATA 37 COMMONLY USED NATURAL AND HERBAL AGENTS 417 TABLES 433 Table 1 Local Anesthetic Comparison Chart for 434 Commonly Used Injectable Agents Table 2 Comparison of Systemic Steroids 435 Table 3 Topical Steroid Preparations 436 Table 4 Comparison of Insulins 438 Table 5 Oral Contraceptives 441 Table . A week later I realized it was still super sore and that it looked bruise and discolored around the injection site. (The scar seems to be from the pimple itself opposed to the fat loss caused by the cortisone.) Abstract Corticosteroids and local anesthetics have significant variability in their formulations that may increase their adverse event profile for specific procedures. Coumestrol administration at 5 mg/kg for 10 weeks significantly increased uterine weight when mice were treated through the SC route but had no effect on uterine weight when mice were treated . Just try to keep in mind that fat regenerates at a different rate than skin it's odd. Brinks A, Koes BW, Volkers AC, Verhaar JA, Bierma-Zeinstra SM. Korean J Anesthesiol. distance entre support tuyauterie pvc. Whether you have excess skin that needs removal or want a quick fix for those vanity pounds, there are options. Do you know how many times the derm has said 'oh we can do a cortisone injection' and I said 'no because I'm afraid of a dent'. Thank you for the response and good advice sadpotatoes. Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. I'm just mortified. J Clin Aesthet Dermatol. On examination, the left elbow had an asymmetrical appearance, with prominence of the medial epicondyle and significant local lipoatrophy, compared with the opposite elbow. doi: 10.1111/dth.13067. Get more out of your subscription* Access to over 100 million course-specific study resources; 24/7 help from Expert Tutors on 140+ subjects; Full access to over 1 million Textbook Solutions Please enable it to take advantage of the complete set of features! An official website of the United States government. Although an important therapeutic tool in dermatology, a number of local side effects, including skin atrophy, have been reported following IL-CS injections. What Do Herpes Sores Look Like at Different Stages. Massage and covering it up. Steroid injections for medial epicondylitis in particular have been shown to decrease pain in the short term. The procedure was repeated each week for 3 additional weeks. 2016 Apr 3;4(4):CD011946. Any doctors here NY Metro area based that have use the saline technique to flush out cortisone from a cortisone injection? Your Doctor never should have injected you with a steroid. All four patients demonstrated complete resolution of skin atrophy and restoration of surface contour within 4 to 8 weeks of initial presentation. JSES Int. I'm pregnant, so I can't do injections but I would just have to give it time anyway and hope it fills in after a couple months. A repeat biopsy was declined by the patient. To determine the effectiveness of bacteriostatic normal saline infiltration on the improvement of corticosteroid-induced cutaneous atrophy. Usually, this will be evident within the first year, but sometimes the atrophy is permanent. he said it was a very tiny amount and that it was diluted but about 1 week later i started noticing an indent. She then returned 3.5 months after the cortisone injection with cosmetic concerns over the medial aspect of the elbow. Results. There is no evidence that injecting saline will help and in fact if anything, it will just further traumatize the area. 11. 2022 Mar 3;13(2):199-206. doi: 10.4103/idoj.idoj_483_21. I feel like the dent has gotten so much deeper and continues too. I really think mine may be permanentI cant even picture how this thing would fill in and heal? Clin Nutr. Study of this disease has been limited by the lack of available tissue and difficulties in evaluating both treatments and the window of effectiveness after symptom onset. A list of national and international resources and hotlines to help connect you to needed health and medical services. The injection was so painful that I just thought it was normal since it was done in my right cheek on my buttocks. MeSH I've tried doing manual therapy to it but nothing helps. The exact mechanism of how saline solution injections are successful in resolving the cosmetic complications of cortisone injections remains unclear. Complications of endoscopic injection sclerotherapy are related to the toxicity of the sclerosant and include transient fever, stricture, perforation (rarely), chest pain, mediastinitis, ulceration and pleural effusion. Because our patient was within the 1-year timeframe, saline injections were performed. NO improvement. 2022 Jan 15;4:ojac001. She visited the office the following day, and on examination, 2 atrophic plaques were noted on her bilateral forehead around the mid-pupillary lines, with a larger atrophic plaque on the occipital scalp (Figures 1 and 2). J Dermatol Surg Oncol. Our website services, content, and products are for informational purposes only.

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