ArticleJournal of cosmetic dermatology2026
Calcium Hydroxylapatite-Carboxymethylcellulose as a Treatment for Forearm Dermatoporosis: A Prospective, Delayed-Start, Contralateral Case Series.
Article in Journal of cosmetic dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDermatoporosis is a chronic cutaneous fragility syndrome marked by dermal thinning, collagen loss, and recurrent purpuric lesions. Effective treatments remain limited. Calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) is a regenerative biostimulator with demonstrated skin extracellular matrix-restorative effects, but its usefulness in forearm dermatoporosis has not been established.
objectivesTo evaluate the efficacy, durability, and safety of hyperdiluted CaHA-CMC for reducing lesion burden, increasing dermal thickness, and enhancing collagen density in dermatoporotic forearms.
methodsIn this prospective, delayed-start, contralateral case series, six patients with bilateral dermatoporosis received a single treatment of 1:2 CaHA-CMC. The more clinically affected arm was treated at Day 0, and the contralateral arm served as a 45-day untreated control before receiving identical treatment. Lesion coverage was quantified from standardized photographs using an ImageJ-based workflow. Dermal thickness was measured by high-frequency ultrasound, and collagen content was assessed from Masson's Trichrome-stained punch biopsies. Early effects (Day 0-45) were evaluated using paired testing and a subject-level difference-in-differences (DiD) estimator. Durability was assessed by aligning post-treatment follow-ups by time-since-treatment (TST), focusing on TST45 and an ~1-year window (320-365 days).
resultsFrom Day 0 to Day 45, lesion coverage decreased in treated forearms from 5.60% ± 4.47% to 1.92% ± 2.07% (p = 0.041), while changes in untreated contralateral forearms were not significant. In pooled participant-level analyses aligned by post-treatment timing, lesion coverage decreased from 4.27% ± 1.88% at baseline to 1.16% ± 1.10% at TST45 (p = 0.0313) and remained reduced at the ~1-year window (1.14% ± 0.68%, p = 0.0313), corresponding to a 73.4% reduction at ~1 year. Collagen area increased by 69.7% at 45 days post-treatment (p = 0.0009), and dermal thickness increased by 36.05% (p = 0.0007). Treatment was well tolerated; one transient nodule resolved with massage.
conclusionsA single session of hyperdiluted CaHA-CMC produced rapid and durable clinical, histologic, and ultrasonographic improvement in forearm dermatoporosis. Findings warrant further evaluation in larger controlled trials.
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