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Journal of Drugs in Dermatology : JDD May 2021Port-wine stain (PWS) is a congenital vascular malformation affecting 0.3–0.5% of normal population. These characteristic lesions arise due to the interplay of... (Review)
Review
Port-wine stain (PWS) is a congenital vascular malformation affecting 0.3–0.5% of normal population. These characteristic lesions arise due to the interplay of vascular, neural, and genetic factors. Treatment options include lasers, cosmetic tattooing, electrotherapy, cryosurgery, derma-abrasion, and skin grafting; however, none of these treatment alternatives appears to be satisfactory and is unable to provide consistent, satisfactory responses or even complete cures. Currently, laser is the treatment of choice, as it is comparatively safe and more effective than other procedures. The most commonly used modality is pulsed dye laser (PDL). The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) to January 2020 and reference lists of respective articles. Only articles published in English language were included. J Drugs Dermatol. 20(5): doi:10.36849/JDD.5005.
Topics: Administration, Cutaneous; Angiogenesis Inhibitors; Clinical Trials as Topic; Combined Modality Therapy; Cosmetic Techniques; Cosmetics; Cryosurgery; Dermabrasion; Dermatology; Electric Stimulation Therapy; Emollients; Humans; Lasers, Dye; Patient Satisfaction; Port-Wine Stain; Quality of Life; Skin; Tattooing; Treatment Outcome
PubMed: 33938700
DOI: 10.36849/JDD.5005 -
Dermatologie (Heidelberg, Germany) Sep 2023Actinic keratoses (AKs) are common precancerous skin lesions that primarily affect older adults due to cumulative sun exposure. Given the increased vulnerability of... (Review)
Review
Actinic keratoses (AKs) are common precancerous skin lesions that primarily affect older adults due to cumulative sun exposure. Given the increased vulnerability of older adults to developing AKs, appropriate therapeutic strategies are crucial to prevent their progression to invasive squamous cell carcinoma. This comprehensive review aims to explore the various treatment modalities available for AKs in the elderly population, focusing on their efficacy, safety, and suitability for this specific age group. The article discusses topical treatments, cryotherapy, photodynamic therapy, chemical peels, and surgical interventions, providing a detailed analysis of their mechanisms of action, benefits, limitations, and considerations in geriatric patients. Furthermore, the importance of individualized treatment plans, considering factors such as comorbidities, medication interactions, and patient preferences, are highlighted.
Topics: Humans; Aged; Keratosis, Actinic; Cryotherapy; Photochemotherapy; Chemexfoliation; Dermabrasion
PubMed: 37594513
DOI: 10.1007/s00105-023-05208-4 -
Cureus Dec 2022Introduction Dermabrasion and chemical peels are infrequently utilized methods of treatment for medical-grade conditions despite demonstrations of favorable outcomes....
Introduction Dermabrasion and chemical peels are infrequently utilized methods of treatment for medical-grade conditions despite demonstrations of favorable outcomes. Insurance coverage status has previously been shown to impact availability and accessibility to specific treatments. The purpose of this study is to evaluate the rate of insurance coverage provided for dermabrasion and chemical peel procedures in the treatment of acne, acne scarring, and non-melanoma skin cancers (NMSC). Methods A cross-sectional analysis of 58 insurance companies by web-based search or phone interview determined the number of insurers with a publicly available policy on dermabrasion or chemical peels. Coverage status and any corresponding criteria were extracted from existing company policies. Results Thirteen (22%) and 22 (38%) policies discussed dermabrasion in the treatment of basal cell carcinoma and actinic keratosis, with 62% and 73% of these policies providing coverage. Acne scarring was discussed in significantly more dermabrasion policies than basal cell carcinoma (45% vs 22%; p=0.018). However, significantly more insurers denied coverage of dermabrasion for active acne and acne scarring when compared to dermabrasion to treat basal cell carcinoma or actinic keratosis (p<0.001). Eighty-seven percent of companies (n=20) with a chemical peel policy for premalignant lesions would provide coverage, with required criteria present in 95% (n=19) of the policies that would cover chemical peels for actinic keratosis specifically. Of the 25 companies (43%) that discussed the treatment of acne with chemical peel procedures, 14 (56%) provided coverage, and 11 (44%) denied coverage. Coverage was denied by significantly less insurers for the treatment of active acne with chemical peel procedures compared to treatment with dermabrasion (44% vs 83%; p<0.006). Conclusion Significant discrepancies were noted in both the presence of a public policy and the coverage status of dermabrasion or chemical peel procedures among the United States health insurance companies. These inconsistencies, along with multiple criteria required for coverage, may create an artificial barrier to receiving care for specific medical-grade conditions.
PubMed: 36726896
DOI: 10.7759/cureus.33184 -
Dermatologic Surgery : Official... Dec 2021Minimally invasive cosmetic procedures are on the rise. To meet this rising demand, increasing numbers of physicians and nonphysicians are performing these procedures.... (Review)
Review
BACKGROUND
Minimally invasive cosmetic procedures are on the rise. To meet this rising demand, increasing numbers of physicians and nonphysicians are performing these procedures. Understanding malpractice trends and reasons for litigation in cosmetic medicine is important to establish safeguards for patient care and minimize liability.
OBJECTIVE
Perform a comprehensive review of the literature on litigation associated with minimally invasive cosmetic procedures and discuss strategies to avoid facing a lawsuit.
MATERIALS AND METHODS
The authors searched PubMed databases using a variety of keywords to identify studies of lawsuits arising from minimally invasive cosmetic procedures through December 2020.
RESULTS
A total of 12 studies of litigation meeting inclusion criteria were identified: botulinum toxin (1), soft tissue fillers (3), lasers (5), body contouring/liposuction (1), chemical peels/dermabrasion (1), and sclerotherapy (1). Principle factors associated with litigation included negligence, lack of informed consent, vicarious liability for action of delegates, lack of communication, poor cosmetic result, failure to inform of risks, inappropriate treatment or dose, and failure to recognize or treat injury.
CONCLUSION
Understanding malpractice trends and reasons for litigation in minimally invasive cosmetic procedures can strengthen the patient-provider relationship, establish safeguards for patient care, and may minimize future risk of a lawsuit.
Topics: Cosmetics; Humans; Malpractice; Minimally Invasive Surgical Procedures; Plastic Surgery Procedures
PubMed: 34417380
DOI: 10.1097/DSS.0000000000003202 -
Journal of Cosmetic Dermatology Mar 2023Impulsivity is the tendency to make decisions and act quickly without adequate planning and anticipating risks. Impulsivity is among the core symptoms of many...
BACKGROUND
Impulsivity is the tendency to make decisions and act quickly without adequate planning and anticipating risks. Impulsivity is among the core symptoms of many psychiatric disorders. In addition, impulsivity can affect the course of various diseases shaped by behaviors.
AIMS
This study aimed to evaluate the relationship between the presence of acne excoriee and different impulsivity dimensions.
STUDY DESIGN
A case-control study.
METHODS
Thirty patients with acne excoriee (AE+) and 30 acne vulgaris patients without excoriated lesions (AE-) enrolled in this study. Impulsivity was evaluated by The Barratt Impulsivity Scale (BIS). In addition, The Beck Anxiety Inventory, The Beck Depression Inventory, and The Skin Picking Scale were applied to assess the clinical characteristics of the participants.
RESULTS
AE+ patients had higher non-planning subscale scores of BIS than AE- patients in this study. In addition, the acne-picking severity score determined by The Skin Picking Scale was positively correlated with non-planning subscale scores of BIS. There was no significant difference between the groups regarding the Beck Depression Inventory and Beck Anxiety Inventory.
CONCLUSIONS
These results indicate that AE patients have a lack of forethought. In other words, it has been shown that impulsive personality traits, which indicate a lack of planning for the future, may be associated with the acne-picking behavior of the patients.
Topics: Humans; Case-Control Studies; Impulsive Behavior; Acne Vulgaris; Skin Diseases; Dermabrasion
PubMed: 36409553
DOI: 10.1111/jocd.15535 -
Lasers in Medical Science Nov 2023We aim to discuss the use of laser for the treatment of eyebrow microblading and cosmetic tattoo complications through a review of the literature. Our research question... (Review)
Review
We aim to discuss the use of laser for the treatment of eyebrow microblading and cosmetic tattoo complications through a review of the literature. Our research question is whether quality-switched or picosecond laser is superior for the removal of eyebrow tattoos. This structured review was conducted using a PubMed search using the search terms "laser tattoo removal" AND "cosmetic tattoo" AND "eyebrow" with the article type filtered to "case reports," "clinical trial," and "randomized controlled trial" ranging from dates 1994-2023. All case reports or series evaluating the effect of laser on eyebrow cosmetic tattooing pigment were included. We summarize the results of 11 studies evaluating the use of laser for cosmetic tattoo removal, with 129 patients treated specifically for eyebrow pigment. Most studies (8/11) report Fitzpatrick skin type or race. Seven studies utilize quality-switched (QS) neodymium-doped yttrium aluminum garnet (Nd:YAG), alexandrite or ruby, three used picosecond (PS) Nd:YAG or alexandrite, and three used carbon dioxide (CO) laser. We report laser energy, spot size, and pulse duration, as well as treatment outcomes and adverse events. Historically, methods of pigment removal included dermabrasion, cryosurgery, electrosurgery, radiofrequency, infrared light, intense pulsed light, and surgical excision; however, these methods often led to poor cosmetic outcomes including scarring and further dyspigmentation. QS laser treatments provided superior cosmetic outcomes and thus were considered the gold standard treatment option for pigment removal. However, the advent of PS lasers has challenged this given their increased selectivity, lower fluence requirements, and reduction in surrounding thermal damage. Our review demonstrates that PS Nd:YAG is quicker and more effective that QS Nd:YAG in the treatment of eyebrow tattoos. Additionally, the paradoxical darkening seen with QS lasers is less common with PS lasers. We also demonstrate that CO laser may be a helpful adjunct to QS or PS laser. This review focuses on Fitzpatrick skin type and race, providing a unique perspective on the use of laser treatment in skin of color, which often poses an additional treatment challenge.
Topics: Humans; Tattooing; Eyebrows; Carbon Dioxide; Laser Therapy; Lasers, Gas; Lasers, Solid-State; Randomized Controlled Trials as Topic
PubMed: 37932517
DOI: 10.1007/s10103-023-03921-z -
Acta Bio-medica : Atenei Parmensis Mar 2020Striae distensae or stretch marks are mainly a cosmetic concern. They commonly occur in adolescence and in pregnant women. Although, generally more common in females;... (Review)
Review
Striae distensae or stretch marks are mainly a cosmetic concern. They commonly occur in adolescence and in pregnant women. Although, generally more common in females; physiological striae atrophicae of adolescence are more common in males. The pathophysiology is multifactorial with mechanical stretching of the skin being the most important. Despite of an abundance of treatment modalities none is 100% effective.
Topics: Adolescent; Chemexfoliation; Dermabrasion; Humans; Laser Therapy; Prevalence; Risk Factors; Striae Distensae
PubMed: 32191678
DOI: 10.23750/abm.v91i1.9248 -
Indian Journal of Dermatology,... 2021Darier disease (DD) is a rare type of inherited keratinizing disorder with no definitive therapeutic approach. The objective of this study is to provide a detailed... (Review)
Review
Darier disease (DD) is a rare type of inherited keratinizing disorder with no definitive therapeutic approach. The objective of this study is to provide a detailed literature review of all the available treatment modalities of Darier disease, including those that are both surgical and non surgical, to compare their efficacies and to propose a novel therapeutic approach. A complete search of the literature for all articles describing the different treatments of Darier disease, with no restrictions on patients' ages, gender or nationalities, was performed with the use of PubMed. A total of 68 articles were included in the study: 3 prospective studies, 44 case reports/case series and 21 letters/correspondences/clinical images. The treatments described were topical, oral or physical. Retinoids (isotretinoin, tazarotene and adapalene) and fluorouracil were the two most effective topical treatments. Oral retinoids were the most effective oral therapy and were prescribed in the cases of generalized Darier disease. For localized and resistant skin lesions, physical therapies including surgical excision, dermabrasion and CO2 laser ablation were the first line choices. Limitations of this article include the inability to verify the accuracy of the published data, the relatively small sample size, the absence of randomized controlled clinical trials and possible unidentified confounding factors in various studies. In every therapeutic approach to Darier disease, consideration of patient comorbidities, disease distribution, severity and treatment accessibility is essential. Large and randomized clinical trials are necessary for the comparison of the efficacy and the safety of all the treatments of Darier disease and settling a consensus for management.
Topics: Administration, Topical; Algorithms; Botulinum Toxins; Cetirizine; Cyclosporine; Darier Disease; Dermabrasion; Diclofenac; Dihydroxycholecalciferols; Doxycycline; Drug Combinations; Electrosurgery; Ethinyl Estradiol; Fatty Acids; Fluorouracil; Glucocorticoids; Humans; Lasers; Levonorgestrel; Magnesium Chloride; Naltrexone; Photochemotherapy; Retinoids; Tacrolimus
PubMed: 33580925
DOI: 10.25259/IJDVL_963_19 -
Journal of Drugs in Dermatology : JDD May 2021Dinoprostone (DNP), a prostaglandin E2 (PGE2) analogue, has been found to cause repigmenation in vitiliginous lesions. Combined medical and surgical therapy might be... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Dinoprostone (DNP), a prostaglandin E2 (PGE2) analogue, has been found to cause repigmenation in vitiliginous lesions. Combined medical and surgical therapy might be more useful for successful treatment of vitiligo.
OBJECTIVES
In this study, we aimed to evaluate the efficacy and safety of dermabrasion followed by dinoprostone gel and to compare it with tacrolimus ointment following the same procedure in the treatment of localized stable vitiligo.
METHODS
40 patients of stable vitiligo were enrolled which were divided in two groups of 20 patients each. In group 1, dermabrasion followed by tacrolimus 0.1% ointment was done and in group 2, dermabrasion followed by dinoprostone gel was done.
RESULTS
Group 1 patients showed slightly better response (P=0.039), whereas the side effect profile was better for group 2.
CONCLUSION
DNP and tacrolimus have immunomodulatory and melanocyte stimulating effect and are well tolerated when combined with dermabrasion. Their effect on skin pigmentation could be enhanced by dermabrasion. J Drugs Dermatol. 2021;20(5):519-522. doi:10.36849/JDD.5751.
Topics: Adolescent; Adult; Dermabrasion; Dinoprostone; Female; Gels; Humans; Male; Melanins; Melanocytes; Middle Aged; Ointments; Severity of Illness Index; Skin Pigmentation; Tacrolimus; Treatment Outcome; Vitiligo; Young Adult
PubMed: 33938708
DOI: 10.36849/JDD.5751 -
Actas Dermo-sifiliograficas 2020
Topics: Dermabrasion; Self-Injurious Behavior; Skin
PubMed: 32401724
DOI: 10.1016/j.ad.2019.03.017