To investigate the histopathological findings of dermatochalasis specimens

Aim: Investigation of histopathological changes on skin and subcutaneous tissue in patients with dermatochalasis and investigation to histopathological effects of botulinum toxin on skin and subcutaneous tissue in patients with blepharospasm Material and Method: Dermatochalasis specimens (dermatochalasis group) of 19 eyes of 19 patients with dermatochalasis, dermatochalasis specimens of 14 eyes of 14 patients with dermatochalasis who treated BTx-A injection due to blepharospasm (botox and dermatochalasis group) and excision materials of normal skin tissues of 8 patients who did not have these pathologies and whose eyelid tissue was resected with intact margins for different indications (control group) were included in this study. Only one eye of each patient was randomly included in the study. Specimens were determined by the number of macrophages, the largest lymphatic vessel diameter, the number of fibroblasts, the percentage of collagen with histopathological examination and collagen 1 levels with Western-Blot method. The study was performed at Düzce University Faculty of Medicine Ophthalmology Clinic between June 2022 and June 2023. Results: The macrophage levels were higher in the dermatochalasis group (10.37±5.94) compared to the other two groups. (p;0.031) (5.86±5.17 in the botox and dermatochalasis group, 5.63±3.66 in the control group). This difference was statistically significant. The macrophage values in the botox and dermatochalasis group were found to be statistically significantly lower than the dermatochalasis group and closer to the control group. The largest lymphatic vessel diameter was found to be statistically significantly higher in the dermatochalasis group (0.348±0.173) compared to the other two groups. (p<0.001) (0.194±0.132 in the botox and dermatochalasis group, 0.085±0.076 in the control group) In addition, the perivascular lymphocyte grade was lower in the botox and dermatochalasis group compared to the dermatochalasis group and tended to approach the control group. The number of G0 and low grade patients in the control group was statistically significantly higher than the other two groups. The number of high-grade patients (G2 and G3) in the dermatochalasis group was significantly higher than in the botox and dermatochalasis group. (p;0.011) Result of western blot, collagen 1 level was found to be statistically significantly decreased in botox and dermatochalasis group compared to dermatochalasis group. (p<0.05) Conclusion: We predict that Btx-A injection has effects that reducing inflammation and fibrosis at the histopathological level on the skin and subcutaneous tissue. Our results need to be confirmed by long-term clinical studies with larger and better standardized patient groups. Key Words: Dermatochalasis, blepharoplasty, blepharospasm, botulinum toxin, histopathology, western-blot