Lip plumpers are relatively new topical agents on the market that are designed to increase lip volume minutes to days after application. In this report, we describe a case of lip plumper contact urticaria in a young boy. We also discuss the mechanisms of action of lip plumpers and the sociocultural reasons for their use

Firoz, Elnaz F

Hartman, Rachael D

James, William D

Levin, Joshua M, MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works Department of Medicine Lip plumper contact urticaria. Elnaz F Firoz Joshua M. Levin MD Lehigh Valley Health Network, Joshua_M.Levin@lvhn.org Rachael D Hartman William D James Follow this and additional works at: https://scholarlyworks.lvhn.org/medicine  Part of the Medicine and Health Sciences Commons Published In/Presented At Firoz EF, Levin JM, Hartman RD, James WD. Lip plumper contact urticaria. J Am Acad Dermatol. 2009 May;60(5):861-3. doi: 10.1016/j.jaad.2008.09.028. This Article is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. 2. Saldanha G, Fletcher A, Slater DN. Basal cell carcinoma: adermatopathological and molecular biological update. Br JDermatol 2003;148:195-202.3. Gorlin RJ. Nevoid basal cell carcinoma syndrome. DermatolClin 1995;13:113-25.4. Gutierrez MM, Mora RG. Nevoid basal cell carcinoma syndrome:a review and case report of a patient with unilateral basal cellnevus syndrome. J Am Acad Dermatol 1986;15:1023-30.5. Kimonis VE, Goldstein AM, Pastakia B, Yang ML, Kase R,DiGiovanna JJ, et al. Clinical manifestations in 105 personswith nevoid basal cell carcinoma syndrome. Am J Med Genet1997;69:299-308.6. Walsh N, Ackerman AB. Infundibulocystic basal cell carcinoma: anewly described variant. Mod Pathol 1990;3:599-608.7. Gorlin RJ. Nevoid basal cell carcinoma (Gorlin) syndrome. In:Roach ES, Miller VS, editors. Neurocutaneous disorders. Cam-bridge, UK: Cambridge University Press; 2004. pp. 77-87.8. Chiritescu E, Maloney ME. Acrochordons as a presenting signof nevoid basal cell carcinoma syndrome. J Am Acad Dermatol2001;44:789-94.9. Wang SQ, Goldberg LH. Multiple polypoid basal cellcarcinomas on the perineum of a patient with basalcell nevus syndrome. J Am Acad Dermatol 2007;57(Suppl):S36-7.10. Lortscher DN, Sengelmann RD, Allen SB. Acrochordon-likebasal cell carcinomas in patients with basal cell nevussyndrome. Dermatol Online J 2007;13:21.11. Megahed M. Polypoid basal cell carcinoma: a new clinico-pathological variant. Br J Dermatol 1999;140:701-3.12. Menzies SW, Werterhoff K, Rabinovitz H, Kopf AW, McCarthyWH, Katz B. Surface microscopy of pigmented basal cellcarcinoma. Arch Dermatol 2000;136:1012-6.13. Argenziano G, Zalaudek I, Corona R, Sera F, Cicale L, Petrillo G,et al. Vascular structures in skin tumors: a dermoscopy study.Arch Dermatol 2004;140:1485-9.14. Scope A, Benvenuto-Andrade C, Agero AL, Marghoob AA.Nonmelanocytic lesions defying the two-step dermoscopyalgorithm. Dermatol Surg 2006;32:1398-406.15. Kolm I, Puig S, Iranzo P, Malvehy J. Dermoscopy in Gorlin-Goltzsyndrome. Dermatol Surg 2006;32:847-51.Lip plumper contact urticariaElnaz F. Firoz, BA,a Joshua M. Levin, MD,b Rachael D. Hartman, MD,c and William D. James, MDdNew York, New York, and Allentown and Philadelphia, PennsylvaniaLip plumpers are relatively new topical agents on the market that are designed to increase lip volumeminutes to days after application. In this report, we describe a case of lip plumper contact urticaria in ayoung boy. We also discuss the mechanisms of action of lip plumpers and the sociocultural reasons fortheir use. ( J Am Acad Dermatol 2009;60:861-3.)A3-year-old male patient with a medical his-tory of hypoplastic left heart syndrome re-ceived an orthotopic cardiac transplant. Twoweeks after surgery, he developed an urticarialplaque of rapid onset on the right cheek, promptingan urgent consultation. He had not been taking anangiotensin converting enzyme inhibitor and other-wise felt well. Further history revealed that thepatient’s mother had kissed him on the right cheekwhile posing for a photograph moments before thelesion developed. She had applied ‘‘Too Faced LipInjection’’ lip plumper (Too Faced Cosmetics, Inc,Irvine, CA) to her lips two hours earlier.On physical examination, the young boy wasafebrile and his skin lesion had resolved after 15 mgof intravenous Benadryl (Pfizer Inc, Morris Plains, NJ).To reproduce the reaction, a small amount of lip plum-per was applied to the mother’s cheek. Immediatelyafter application of the product, she experienced atingling sensation followed by the formation of anurticarial plaque (Fig 1) similar to the patient’s lesion.The active ingredients of the lip plumper includebenzyl nicotinate and capsicum frutescens resin.DISCUSSIONLip plumpers are cosmetic agents intended tocreate the appearance of increased lip volume. Themechanisms by which lip plumpers act are varied,and include vasodilation secondary to either irritantcontact dermatitis or nonimmunologic contact urti-caria. Common ingredients of lip plumpers are theessential oils of cinnamon and cayenne pepper(capsicum frutescens), spices that are classified asboth irritants and urticariants.1,2 In irritant contactFrom the Columbia College of Physicians and Surgeons,a NewYork; Advanced Dermatology Associates, Ltd,b Allentown; andthe Departments of Dermatology at New York Universityc andthe University of Pennsylvania,d Philadelphia.Funding sources: None.Conflicts of interest: None declared.Reprint requests: William D. James, MD, Department ofDermatology, University of Pennsylvania, 3600 Spruce St,Philadelphia, PA 19104. E-mail: William.James@uphs.upenn.edu.0190-9622/$36.00ª 2008 by the American Academy of Dermatology, Inc.doi:10.1016/j.jaad.2008.09.028J AM ACAD DERMATOLVOLUME 60, NUMBER 5Case reports 861Downloaded for library services (libraryservices@lvhn.org) at Lehigh Valley Health Network from ClinicalKey.com by Elsevier on July 26, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.dermatitis, vasodilation occurs after nociceptorstrigger the release of substance P.3,4 In nonimmuno-logic contact urticaria, vasodilation most likelyoccurs secondary to prostaglandin metabolism.5,6Although irritant contact dermatitis is the most com-mon reaction noted to spices,1 nonimmunologiccontact urticaria is the most frequent immediatecontact reaction6 and clinically may mimic irritantcontact dermatitis.Lip plumpers may also achieve vasodilationthrough compounds that have direct vasodilatoryeffects, such as benzyl nicotinate, also known asniacin or vitamin B3, and L-arginine, an amino acidthat is converted to nitric oxide, a potent vasodilator.7In addition to direct vasodilation, nonimmuno-logic contact urticaria, and irritant contact dermatitis,skin hydration is another mechanism by which lipplumpers cause the appearance of increased lipvolume. Collagen, a high molecular weight humec-tant, binds water in the stratum corneum and in-creases the degree of skin humidity.8 Collagenmicroparticles of the marine sponge are commonlyfound in lip plumpers. Moreover, the glycyl-L-histi-dyl-L-lysine tripeptide has been studied by woundcare researchers and found to enhance the expres-sion of extracellular matrix macromolecules, such ascollagen and glycosaminoglycans, upon subcutane-ous injection in rats.9 This tripeptide has beenintroduced recently into skin careproducts, includinglip plumpers. Small in vivo human studies investigat-ing products with tri- and oligopeptides have failed todetect significant effects on wrinkles, overall skinquality, or lip volume.10,11Lip plumpers have become increasingly popularin recent years. Between 2001 and 2006, the $9.9billion lip products market experienced a 287%increase in sales of ‘‘other’’ lip products, largelybecause of lip plumpers.12 Since 2000, plasticsurgeons have experienced an 81% increase in thenumber of minimally invasive cosmetic proceduresand a 3% decrease in the number of surgical cosmeticprocedures.13 The second-most popular minimallyinvasive cosmetic procedure behind botulinum toxininjection is the injection of hyaluronic acid, whichcan be used to increase lip volume. These datademonstrate the strong desire for alternatives toinvasive procedures and the increase in demandfor cosmetic products and procedures.Studies have shown that lip volume is associatedwith beauty and youth. In photographic studies ofthe female soft tissue profile as presented in fashionmagazines during the 20th century, models havedisplayed greater lip fullness and anterior position inrecent years,14,15 possibly reflecting the recent in-crease in racial diversity in the fashion industry.16Upon analyzing models with respect to ethnicity andrace, white models displayed fuller lips than theirnonmodel counterparts, whereas models of Africandescent displayed lips as full as their nonmodelcounterparts.17 Fashion magazines, therefore, maypromote the idea that full lips are beautiful, even lipsthat are not representative of one’s ethnic group.Finally, the soft tissue profile flattens with age,18which may explain why full lips are thought toconvey youthfulness.REFERENCES1. Brancaccio RR, Alvarez MS. Contact allergy to food. DermatolTher 2004;17:302-13.2. Cleenewerck MB, Martin P. Food. In: Chew AL, Maibach HI,editors. Irritant dermatitis. New York: Springer; 2006. pp. 285-316.3. Kydonieus AF, Willie JJ. Biochemical modulation of skinreactions: transdermals, topicals, cosmetics. New York: CRCPress; 2000.4. Spinella M. The psychopharmacology of herbal medicine:plant drugs that alter mind, brain behavior. Cambridge, MA:MIT Press; 2001.5. Morrow JD, Minton TA, Awad JA, Roberts LJ. Release ofmarkedly increased quantities of prostaglandin D2 from theskin in vivo in humans following the application of sorbic acid.Arch Dermatol 1994;130:1408-12.6. Bashir SJ, Maibach HI. Contact urticaria syndrome. In: Chew AL,Maibach HI, editors. Irritant dermatitis. New York: Springer;2006. pp. 63-70.7. Lundberg JO, Weitzberg E, Gladwin MT. The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics. Nat RevDrug Discov 2008;7:156-67.8. Swatschek D, Schatton W, Kellermann J, Muller WE, Kreuter J.Marine sponge collagen: isolation, characterization and effectson the skin parameters surface-pH, moisture and sebum. Eur JPharm Biopharm 2002;53:107-13.9. Maquart FX, Bellon G, Chaqour B, Wegrowski J, Patt LM, TrachyRE, et al. In vivo stimulation of connective tissue accumulationby the tripeptide-copper complex glycyl-L-histidyl-L-lysine-Cu21 in rat experimental wounds. J Clin Invest 1993;92:2368-76.Fig 1. Formation of an urticarial plaque minutes afterapplication of a lip plumper to the cheek.J AM ACAD DERMATOLMAY 2009862 Case reportsDownloaded for library services (libraryservices@lvhn.org) at Lehigh Valley Health Network from ClinicalKey.com by Elsevier on July 26, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.10. Miller TR, Wagner JD, Baack BR, Eisbach KJ. Effects of topicalcopper tripeptide complex on CO2 laser-resurfaced skin. ArchFacial Plast Surg 2006;8:252-9.11. Lee S, Most SP. Efficacy of an over-the-counter lip enhancer inlip augmentation. Arch Facial Plast Surg 2005;7:203-5.12. Dodson D. Fresh hope on the horizon for lip products.Euromonitor Archive. Available at: http://www.euromonitor.com/Fresh_hope_on_the_horizon_for_lip_products. AccessedJuly 3, 2008.13. 2000/2006/2007 National Plastic Surgery Statistics, Cosmeticand Reconstructive Procedure Trends. In: NCOPS statisticseditor. Procedural statistics trends 2000-2007. ArlingtonHeights, IL: American Society of Plastic Surgeons; 2008.14. Auger TA, Turley PK. The female soft tissue profile aspresented in fashion magazines during the 1900s: aphotographic analysis. Int J Adult Orthodon OrthognathSurg 1999;14:7-18.15. Yehezkel S, Turley PK. Changes in the African Americanfemale profile as depicted in fashion magazines during the20th century. Am J Orthod Dentofacial Orthop 2004;125:407-17.16. Hayt E. Kiss my puffy lips. The New York Times. August 4, 2005.Available at: http://www.nytimes.com/2005/08/04/fashion/thursdaystyles/04skin.html. Accessed October 15, 2008.17. Sutter RE Jr, Turley PK. Soft tissue evaluation of contemporaryCaucasian and African American female facial profiles. AngleOrthod 1998;68:487-96.18. Bishara SE, Jakobsen JR, Hession TJ, Treder JE. Soft tissueprofile changes from 5 to 45 years of age. Am J OrthodDentofacial Orthop 1998;114:698-706.Significant response after treatment with the mTORinhibitor sirolimus in combination with carboplatinand paclitaxel in metastatic melanoma patientsFriedegund Meier, MD,a Emmanuella Guenova, MD,a Stephan Clasen, MD,b Thomas Eigentler, MD,aAndrea Forschner, MD,a Ulrike Leiter, MD,a Christina Zielinski, MD,a Björn Knaudt, MD,aClaus Garbe, MD,a and Mark Berneburg, MDaTuebingen, GermanyMelanoma is highly resistant to chemotherapy. In melanoma, the PI3K-AKT-mTOR signaling pathway isconstitutively activated through multiple mechanisms. Several experimental studies suggest that targetingthe PI3K-AKT-mTOR signaling pathway is a promising strategy to overcome chemoresistance. This is thefirst report describing a chemosensitizing effect of mTOR inhibition in patients with melanoma. We reporttwo cases of patients with metastatic melanoma who showed significant remission after combination ofcarboplatin and paclitaxel with the mTOR inhibitor sirolimus. Our case report, together with the literaturediscussed, suggests that mTOR inhibition possibly enhances the sensitivity of melanoma cells tochemotherapy and should prompt in-depth and clinical investigation. ( J Am Acad Dermatol2009;60:863-8.)We describe two cases of patients withmetastatic melanoma who showed sig-nificant remission after combination ofcarboplatin and paclitaxel with the mTOR inhibitorsirolimus.CASE 1A 26-year-old woman presented with a melanomaon the right calf, which was removed in November2000. The histologic examination showed a superfi-cial spreading melanoma with a tumor thickness of0.75 mm that lacked ulceration, regression, or nu-merous mitoses. A follow-up excision with a safetymargin of at least 1 cm was carried out. In September2005 a palpable lymph node metastasis noted by thepatient was excised from the right inguinal region,followed by radical inguinal lymph node dissection.The pathology results showed 5 tumor-free lymphnodes. Adjuvant immunotherapy was instituted withlow-dose interferon alfa. In March 2007, a whole-body computed tomographic (CT) scan carried outfor melanoma follow-up evaluation detected newlung, mediastinal, and hilar lymph node, liver,From the Division of Dermatologic Oncology, Department ofDermatology,a and the Department of Diagnostic Radiology,bUniversity of Tuebingen.Supported by Deutsche Forschungsgemeinschaft SFB 773.Conflicts of interest: None declared.Reprint requests: Friedegund Meier, MD, Division of DermatologicOncology, Department of Dermatology, University of Tuebingen,Liebermeisterstr. 25, D-72076 Tübingen, Germany. E-mail:friedegund.meier@med.uni-tuebingen.de.0190-9622/$36.00ª 2008 by the American Academy of Dermatology, Inc.doi:10.1016/j.jaad.2008.09.053J AM ACAD DERMATOLVOLUME 60, NUMBER 5Case reports 863Downloaded for library services (libraryservices@lvhn.org) at Lehigh Valley Health Network from ClinicalKey.com by Elsevier on July 26, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.

Lip plumper contact urticaria.

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Lip plumper contact urticaria.

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