{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T20:51:53Z","timestamp":1784062313363,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T00:00:00Z","timestamp":1539302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Rosacea is a common, chronic facial skin disease that affects the quality of life. Treatment of facial erythema with intradermal botulinum toxin injection has previously been reported. The primary objective of the study was the safety and efficacy of thermal decomposition of the stratum corneum using a novel non\u2010laser thermomechanical system (Tixel, Novoxel, Israel) to increase skin permeability for Botulinum toxin in the treatment of facial flushing of rosacea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of16 patients aged 23\u201345 years with Fitzpatrick Skin Types II to IV and facial erythematotelangiectatic rosacea treated by Tixel followed by topical application of 100\u2009U of abobotulinumtoxin. A standardized high\u2010definition digital camera photographed the patients at baseline and 1, 3, and 6 months after the last treatment. Objective and subjective assessments of the patients were done via Mexameter, the Clinicians Erythema Assessment (CEA), and Patients self\u2010assessment (PSA) scores and the dermatology life quality index (DLQI) validated instrument.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average Maxameter, CEA, and PSA scores at 1, 3, and 6 months were significantly improved compared with baseline (all had a <jats:italic>P<\/jats:italic>\u2010value &lt;0.001). DLQI scores significantly improved with an average score of 18.6 at baseline at 6 months after treatment (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Self\u2010rated patient satisfaction was high. There were no motor function side\u2010effects or drooping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Thermal breakage of the stratum corneum using the device to increase skin permeability for botulinum toxin type A in the treatment of facial flushing of rosacea seems both effective and safe. Lasers Surg. Med. \u00a9 2018 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23023","type":"journal-article","created":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T12:15:28Z","timestamp":1539346528000},"page":"325-331","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["The toxic edge\u2014A novel treatment for refractory erythema and flushing of rosacea"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4362-7909","authenticated-orcid":false,"given":"Or","family":"Friedman","sequence":"first","affiliation":[{"name":"The Plastic Reconstructive Surgery Department Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Koren","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Dr. Artzi Treatment and Research Center Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roni","family":"Niv","sequence":"additional","affiliation":[{"name":"Dr. Artzi Treatment and Research Center Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph N.","family":"Mehrabi","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1391-5843","authenticated-orcid":false,"given":"Ofir","family":"Artzi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Dr. Artzi Treatment and Research Center Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,12]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"CD003262","article-title":"Interventions for rosacea","volume":"4","author":"van Zuuren EJ","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13748"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-016-0106-9"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000444082"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03751.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.04.043"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2006.32372.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473-2165.2006.00255.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2230.2003.01379.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-002-0026-x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2004.30017.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.4065\/78.5.603"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01071.2005"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0183"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejps.2013.03.019"},{"issue":"46","key":"e_1_2_5_17_1","first-page":"249","article-title":"Laser assisted drug delivery: A review of an evolving technology","volume":"2014","author":"Sklar LR","journal-title":"Lasers Surg Med"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.4155\/tde.10.16"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2008.03.032"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jconrel.2011.05.003"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/14764172.2012.698284"},{"issue":"1","key":"e_1_2_5_22_1","first-page":"31","article-title":"Fractional treatment of aging skin with tixel, a clinical and histological evaluation","volume":"18","author":"Elman M","year":"2015","journal-title":"J Cosm Therap"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2006.02.034"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1994.tb01167.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"crossref","unstructured":"ErlendssonAM WenandeE HaedersdalM. Transepidermal drug delivery: Overview Concept and Applications. In: Issa M Tamura B editors. Lasers lights and other technologies. Clinical Approaches and Procedures in Cosmetic Dermatology. Springer Cham. 2018. pp 447\u2013461.","DOI":"10.1007\/978-3-319-16799-2_34"},{"key":"e_1_2_5_26_1","doi-asserted-by":"crossref","unstructured":"UchidaY ParkK. Stratum Corneum. In: Kabashima K editor. Immunology of the skin.Tokyo:Springer;2016. pp15\u201330.","DOI":"10.1007\/978-4-431-55855-2_2"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12462252"},{"key":"e_1_2_5_28_1","first-page":"625","article-title":"Water diffusion coefficients versus water activity in Stratum Corneum: A correlation and its implications","volume":"29","author":"Stockdate M","year":"1978","journal-title":"J Soc Cosmetic Chemists"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12292018"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2016.07.070"},{"issue":"1","key":"e_1_2_5_31_1","first-page":"14","article-title":"Fractional ablative laser followed by transdermal acoustic pressure wave device to enhance the drug delivery of aminolevulinic acid: In Vivo fluorescence microscopy study","volume":"15","author":"Waibel JS","year":"2016","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2006.00695.x"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.06.009"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/jidsymp.2011.6"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(92)70086-U"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.22819"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00061.2004"},{"issue":"12","key":"e_1_2_5_38_1","first-page":"e76","article-title":"A new treatment regimen for rosacea: OnabotulinumtoxinA","volume":"11","author":"Dayan SH","year":"2012","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1159\/000368773"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjx005"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000277"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2013.05.011"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.2165\/11534510-000000000-00000"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-016-0545-0"},{"issue":"6","key":"e_1_2_5_45_1","first-page":"785","article-title":"Neurologic uses of botulinum neuro\u2010toxin type A","volume":"3","author":"Ney JP","year":"2007","journal-title":"Neuropsychiatr Dis Treat"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-2952(00)00260-4"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2009.0234"},{"key":"e_1_2_5_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9101(1999)25:2<107::AID-LSM3>3.0.CO;2-2"}],"container-title":["Lasers in Surgery and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flsm.23023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.23023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lsm.23023","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.23023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T14:17:59Z","timestamp":1693405079000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lsm.23023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,12]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1002\/lsm.23023"],"URL":"https:\/\/doi.org\/10.1002\/lsm.23023","archive":["Portico"],"relation":{},"ISSN":["0196-8092","1096-9101"],"issn-type":[{"value":"0196-8092","type":"print"},{"value":"1096-9101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,12]]},"assertion":[{"value":"2018-09-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}