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case_images: Case 1. (A) Pretreatment. Bier spots were marked with black color to orient the injector. The hypopigmented macule highlighted with a red arrow was selected as a control area, and no injection was performed. (B) Post-treatment. Significant improvement was recorded in forehead lines at week 1, while there was no improvement in Bier spots.
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case_images: PMC9946091_01_2488dp1301a32g001.jpg
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case_images: Ipsen, 500 units) were injected to forehead lines considering the localization of Bier spots (Figure 1). In addition to cosmetic improvement of the frontal wrinkles within one week, headache severity regressed from 10 to 5 points according to the visual analog scale (VAS) for pain.
case_images: PMC9946091_02
case_images: Case 2. The patient provoked these lesions by holding his breath for about a half minute and bending down just before the photographs.
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case_images: The symptoms of a 48-year-old male patient (Patient 2) started one year ago on the trunk and face without any triggering (Figure 2).