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European Annals of Otorhinolaryngology,... Feb 2018Rhinophyma is a rare, benign and unsightly disease of the skin of the nose that was first described a very long time ago, as illustrated by portrait of an old man with a...
INTRODUCTION
Rhinophyma is a rare, benign and unsightly disease of the skin of the nose that was first described a very long time ago, as illustrated by portrait of an old man with a bulbous nose holding his grandson, by Ghirlandaio in 1490. It was described for the first time by Ferdinando Hebra Von (1816-1880), as the third stage of rosacea. The objective of this study is to report the author's experience and propose a new treatment option in the management of rhinophyma.
MATERIAL AND METHODS
We describe our experience of rhinophyma based on a retrospective case study.
RESULTS
We identified 12 cases over a 12-year period, with a marked male predominance. The therapeutic approach was the same in all patients, consisting of a combination of dermabrasion, decortication and application of fibrin glue, with a favourable outcome in every case with complete epithelialisation.
CONCLUSION
Rhinophyma is a rare condition of uncertain pathophysiology. Management is surgical and, in view of the many techniques and procedures proposed, we advocate the slogan "to each his own technique", until a consensus has been reached. Our technique combining dermabrasion, decortication and application of fibrin glue has given very good results.
Topics: Aged; Aged, 80 and over; Dermabrasion; Female; Humans; Male; Middle Aged; Retrospective Studies; Rhinophyma; Rhinoplasty; Treatment Outcome
PubMed: 28943211
DOI: 10.1016/j.anorl.2017.08.005 -
Journal of Cutaneous and Aesthetic... 2020Adequate dermabrasion of recipient site is a crucial step in vitiligo surgery. We suggest the use of a commercially available mechanized abrader as an economical and...
Adequate dermabrasion of recipient site is a crucial step in vitiligo surgery. We suggest the use of a commercially available mechanized abrader as an economical and efficient tool for dermabrasion especially in resource poor settings.
PubMed: 33911417
DOI: 10.4103/JCAS.JCAS_28_20 -
Journal of Cutaneous and Aesthetic... 2015Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple... (Review)
Review
Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below.
PubMed: 26157306
DOI: 10.4103/0974-2077.158439 -
Heliyon Jul 2021Acute injuries, such as surgical and traumatic, heal normally in an organized and rapid manner. Studies point to the healing activity of hyaluronic acid in all phases of...
Acute injuries, such as surgical and traumatic, heal normally in an organized and rapid manner. Studies point to the healing activity of hyaluronic acid in all phases of healing. The aim was to evaluate the effectiveness of hyaluronic acid in skin abrasions on the dorsum of rats to compare to usual products on the market. Seventy-two Wistar rats were subjected to excoriation of approximately 2.0 cm on the back by dermabrasion. According to the treatment, 3 groups were established: saline, chlorhexidine digluconate and 0.2% hyaluronic acid for 14 days. Animals were photographed on the 2, 7, 10 and 14 postinjury days, and the index of healing of the abrasions was calculated. Biochemically, myeloperoxidase measurements of skin biopsies in addition to histological studies to assess the crust and epidermal layers were performed. The group treated with hyaluronic acid showed better re-epithelialization from the other groups (p < 0.05) on the 7 and 10 days. For the thickness of the crust, the hyaluronic acid group presented thinner crust than other groups on the 10 and 14 days (p < 0.05), but in the epidermis, no difference was observed between the groups studied. All groups showed an increase in myeloperoxidase enzyme on the 2 day, but a decreasing on the 7 day. On the 10 day, there was a difference in the hyaluronic acid group compared to the other groups (p < 0.05). The application of 0.2% hyaluronic acid significantly accelerated the re-epithelialization of skin abrasions compared to saline and chlorhexidine digluconate.
PubMed: 34345742
DOI: 10.1016/j.heliyon.2021.e07572 -
Frontiers in Surgery 2022The large full-thickness abdominal wall defect has to be treated by considering anatomical and functional requirements. The abdominal wall must regain total...
INTRODUCTION
The large full-thickness abdominal wall defect has to be treated by considering anatomical and functional requirements. The abdominal wall must regain total physiological function, which means that the full thickness abdominal wall defect must be reconstructed anatomically, not only according to the anatomical requirements but also maintaining the functional dynamic voluntary movement. Defects in the abdominal wall alter respiratory mechanics and can impair the diaphragm function. Additionally, muscles of the anterolateral abdominal wall increase the stability of the lumbar region of the vertebral column by tensing the thoracolumbar fascia and by increasing intraabdominal pressure.
MATERIALS AND METHODS
The timing and method of reconstruction must be chosen depending upon the etiology of the defect. Severe traumatic injuries, abdominal wall infections, necrotizing soft tissue loss, or sepsis needs to undergo staged reconstruction following adequate debridement to control the infectious process, establish the zone of injury, and for proper treatment of intraabdominal pathology, thereby achieving temporary primary closure using split-thickness skin grafting to the viscera. At the time of definitive reconstruction, deep skin graft dermabrasion give us a facial-like layer with adequate strength to stabilize the static abdominal wall. This dermal layer is supported by free functional (innervated) latissimus dorsi muscle (fLDM), giving full anatomical coverage and functional stability. After oncologic resections full-thickness abdominal wall reconstruction was performed immediately with a combination of fLDM flaps and meshes.
RESULTS
A total of 14 patients underwent abdominal wall reconstruction using the fLDM flap. Staged reconstruction was applied in 8 cases. In the remaining six cases, two had no mesh support, three had synthetic mesh, and one had a fascial graft, which were covered with fLDM flap. There were no free flaps failure. One flap revision due to venous anastomosis thrombosis was performed. Donor site seromas occurred in 5 cases and were treated with punction and direct doxycycline injection. Electromyographic testing postoperatively confirmed reinnervation of transplanted LDM.
CONCLUSION
Using fLDM as a definitive solution, we are not only able to repair soft tissue defects, but also reconstruct voluntary contractility and dynamic natural functional abdominal wall. Transplanted LDM offers enough contractile capacity and strength to replace the function of the missing abdominal wall muscles.
PubMed: 35372467
DOI: 10.3389/fsurg.2022.853639 -
European Review For Medical and... Apr 2023Hyaluronic acid has been efficient in ameliorating and supporting recovery in both chronic and acute lesions. The aim of this study was to assess the effectiveness of...
OBJECTIVE
Hyaluronic acid has been efficient in ameliorating and supporting recovery in both chronic and acute lesions. The aim of this study was to assess the effectiveness of hyaluronic acid-based cream and gauze pads in cutaneous wounds.
PATIENTS AND METHODS
This retrospective and prospective study examines the use of a 0.2% hyaluronic acid cream or gauze-pads application (Connettivina Bio®). 85 patients participated in the study and were affected by wounds of different etiologies, comprising superficial trauma wounds (20), surgical sutures (15), first- and second-degree burns (15), dermabrasions (30) and ulcers of different etiologies (5). We analyzed the healing process in terms of progression and wound quality. Moreover, we performed biopsies (not on all patients) to evaluate the grade of re-epithelialization.
RESULTS
We observed a reduction in the mean surface area of the wounds, precisely 456 mm2 at baseline to 147 mm2 after six weeks with an average 86% [corrected] decrease in the wound surface area. No fibrin tissue was observed, and a small amount of exudate was noted in 10% [corrected] of wounds. Hyaluronic acid cream and gauze-pads-based treatments were well tolerated by patients. All groups showed a decrease of inflammation with a progressive increase of collagen fibers and granulation tissue.
CONCLUSIONS
The treatment with hyaluronic acid 0.2% yielded remarkable outcomes in the re-epithelialization of superficial wounds and provided favorable recovery and tolerance for patients.
Topics: Humans; Re-Epithelialization; Hyaluronic Acid; Prospective Studies; Retrospective Studies; Wound Healing
PubMed: 37129334
DOI: 10.26355/eurrev_202304_31320 -
Emergency Medicine International 2022The aim of this study is to explore the clinical effect of emergency dermabrasion combined with biological dressing A on wound microcirculation and preventing sepsis in...
OBJECTIVE
The aim of this study is to explore the clinical effect of emergency dermabrasion combined with biological dressing A on wound microcirculation and preventing sepsis in deep degree-II burns.
METHODS
A total of 90 patients with deep degree-II burns admitted to the hospital were retrospectively enrolled between January 2020 and January 2022. According to different treatment methods, they were divided into the control group (42 cases, biological dressing A) and the observation group (48 cases, emergency dermabrasion combined with biological dressing A). The clinical curative effect in both groups was observed. The wound repair rate and wound healing quality, and changes in levels of wound microcirculation-related indexes (serum epidermal growth factor (EGF), wound blood flow, and partial pressure of transcutaneous oxygen) and inflammatory cytokines (C-reactive protein (CPR), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT)) before treatment, at 3d and 7d after treatment were compared between the two groups. The incidence of wound infection and sepsis in both groups was recorded.
RESULTS
The wound healing time in the observation group was significantly shorter than that in the control group, and wound healing quality in the observation group was better than that in the control group ( < 0.05). At 3 d and 7d after treatment, the levels of serum EGF, wound blood flow and partial pressure of transcutaneous oxygen in both groups were all increased ( < 0.05), which were higher in the observation group than those in the control group ( < 0.05). The levels of CRP, IL-6, ESR, and PCT in both groups were all decreased ( < 0.05), which were lower in the observation group than those in the control group ( < 0.05). There was no significant difference in incidence of sepsis between observation group and control group (4.17% (2/48) vs. 7.14% (3/42)) ( = 0.539).
CONCLUSION
Emergency dermabrasion combined with biological dressing A can effectively improve wound microcirculation in patients with deep degree-II burns, promote wound healing, shorten wound healing time, improve wound healing quality, effectively control inflammatory response, and prevent sepsis.
PubMed: 35875249
DOI: 10.1155/2022/4730905 -
Dermatology Reports Sep 2023Hailey-Hailey disease (HHD), or familial benign pemphigus, is a rare genetic condition characterized by recurrent blisters and erosions with a predilection for...
Hailey-Hailey disease (HHD), or familial benign pemphigus, is a rare genetic condition characterized by recurrent blisters and erosions with a predilection for intertriginous areas. There is no specific treatment for HHD. Topical and systemic treatments tend to provide temporary remission. Alternative treatment (surgical interventions such as dermabrasion, excision, and laser) has been shown to prolong remission. Considering the risk of complications associated with surgical modalities, laser is often preferred as an alternative for patients failing to respond to first-line therapies. We report a case of recalcitrant HHD successfully treated with a fractional ablative CO laser procedure (wavelength of 10600 nm, power of 7-10 W, 2-3 passes) on a 35-year-old female. The patient has a 7-year history of therapy-resistant HHD. A 2-month followup showed substantially resolved lesions, with mild erythema and post-inflammatory hyperpigmentation in treated areas.
PubMed: 37860724
DOI: 10.4081/dr.2023.9658 -
International Journal of Surgery Case... 2020Rhinophyma is benign hypertrophic thickening of the skin and edema of the nasal pyramid. The affected tissue enlarges slowly before reaching its permanent size. The...
INTRODUCTION
Rhinophyma is benign hypertrophic thickening of the skin and edema of the nasal pyramid. The affected tissue enlarges slowly before reaching its permanent size. The lobulated skin surface with hundreds of pores can become cosmetically embarrassing and cause significant psychosocial stress, anxiety, and depression for patients. In addition, extensive alar thickening can obstruct the external nasal valves making treatment necessary to alleviate respiratory issues. No consensus has been reached regarding management of rhinophyma and many surgeons follow the "to each his own technique" mindset. Our objective was to present a case report to support the use of electrocautery and dermabrasion as the mainstay of treatment.
PRESENTATION OF CASE
Here we describe the case of a 62-year-old Caucasian male with a long-standing history of acne rosacea who developed severe rhinophyma overtime which lead to nasal obstruction and major cosmetic deformity. Electrocautery and dermabrasion in the operating room were utilized to obtain an outstanding cosmetic result and respiratory function improvement. Loop and Colorado cautery tips were used with cutting current to remove the hypertrophic skin and create a smooth contour. The patient tolerated the procedure well without any complications. The patient's skin was scab-free with normal pigmentation by four weeks post-op. He was satisfied with the cosmetic outcome and reported substantial improvement in his breathing.
DISCUSSION
There have been several case reports published which describe using different surgical methods to treat rhinophyma including lasers, electrocautery dermabrasion, surgical blade, cryosurgery, and radio excision. The main limitations of laser therapy are imprecise tissue removal, risk of scarring, dyspigmentation, and bleeding. Other therapies such as surgical excision and skin grafts may require multiple procedures before obtaining a satisfactory cosmetic outcome.
CONCLUSION
This case report supports electrocautery dermabrasion as the mainstay of treatment as it is a management technique which allows for smooth contouring, efficient hemostasis, more control in the operating room, and does not require multiple procedures.
PubMed: 32698277
DOI: 10.1016/j.ijscr.2020.06.039 -
Iranian Journal of Medical Sciences May 2016Freckles are numerous pigmented spots of the skin, mainly confined to the face, even arms and back. Although freckles are light-brown macules, most frequently observed...
BACKGROUND
Freckles are numerous pigmented spots of the skin, mainly confined to the face, even arms and back. Although freckles are light-brown macules, most frequently observed in individuals with red or blond hair, they are common to Asian people too. Freckles increase in number, size, and depth of pigmentation during the summer months. Histologically, freckles show increased production of melanin pigment by a normal number of melanocytes. Freckles commonly stop spreading before adolescence and last for life, but could sometimes be subtle in adulthood. Treatments are often requested for cosmetic purposes. Before the advent of lasers, treatment modalities for pigmentary disorders included surgical excision, dermabrasion, chemical bleaching, and peeling. These treatments may lead to unwanted side effects of potential scarring or undesired pigmentation changes. In Iranian traditional medicine (ITM), freckles have been known as well. "Namash" was the term used by ITM scholars to indicate freckles. There is a wide range of plants, which were prescribed by Iranian physicians for the treatment of freckles. The purpose of this study is to find the most frequent useful herbs for freckles as mentioned in ITM references.
METHODS
Seven ITM references were studied for anti-freckles medicines. The references were Canon of Medicine (Avicenna), Alhavi (Razes) Tuhfat ul-Momineen (Momen tonekaboni), Makhzan-ul-Adwiah (Aghili), Ikhtiyarat Badi'i (Ansari), Al-abnia An-Haghyegh el-advia (Heravi), and al-jāmi li-mufradāt al-adwiyawa al-aghdhiya (Ibn al-Baitar). Moreover, plants were ordered according to their repetition in the references. Afterwards, traditional names of the selected plants were matched with the scientific names using botanical text references.
RESULTS
This study demonstrated that Myristica fragrans Houtt, Cicer arietema L., Eruca sativa Lam., Lilium candidium L., Amygdalus communis L., Arum italicum L. were the most frequent herbs mentioned in ITM references for the treatment of freckles.
CONCLUSION
Herbs mentioned in this article could be appropriate candidates for future studies in the field of freckles treatment.
PubMed: 27840488
DOI: No ID Found