-
Indian Dermatology Online Journal 2024Bowen's disease (BD) is a precancerous squamous cell carcinoma and has a high recurrence rate with any single treatment modality, necessitating combination therapy for...
BACKGROUND
Bowen's disease (BD) is a precancerous squamous cell carcinoma and has a high recurrence rate with any single treatment modality, necessitating combination therapy for a successful outcome.
AIM
This study aimed to the efficacy and safety of carbon dioxide (CO) laser ablation followed by manual dermabrasion and intralesional 5-fluorouracil (IL 5-FU) injection as combination therapy for BD.
MATERIALS AND METHODS
This was a retrospective, observational study comprising 29 clinically and histopathologically diagnosed BD patients with no history of prior treatment. Demographic characteristics and clinical examination of the lesions and regional lymph nodes were retrieved. All patients were subjected to CO laser ablation followed by manual dermabrasion and IL 5-FU injection.
RESULTS
Mean age was 61.93 ± 9.31 years with male preponderance (62.1%). Trunk (48.3%) was the most frequently involved site. Mean tumor size was 40.8 ± 16.4 mm (range: 15-86 mm). All lesions healed with a cure rate of 96.6%. Complications seen in patients included atrophic scarring with persistent post-inflammatory hyperpigmentation in three patients (10.3%), secondary infection in two cases (6.9%), and hypertrophic scar with early keloid in one patient (3.4%). Recurrence was reported in one patient (3.4%).
LIMITATION
The study was limited by retrospective study design, small sample size, and no comparison with standard therapy.
CONCLUSION
Combination approach using carbon dioxide laser ablation followed by manual dermabrasion and IL 5-FU injection has been proved to be effective, efficient and safe with good functional, oncological and aesthetic outcomes in treating BD.
PubMed: 38550815
DOI: 10.4103/idoj.idoj_339_23 -
Dermatologic Surgery : Official... Jul 2013Squamous cell carcinoma (SCC), which has one of the highest incidences of all cancers in the United States, is an age-dependent disease, with the majority of these... (Review)
Review
BACKGROUND
Squamous cell carcinoma (SCC), which has one of the highest incidences of all cancers in the United States, is an age-dependent disease, with the majority of these cancers diagnosed in people age 70 and older. Recent findings have led to a new hypothesis on the pathogenesis of SCC.
OBJECTIVES
To evaluate the potential of preventive therapies to reduce the incidence of SCC in at-risk geriatric patients.
MATERIALS AND METHODS
Survey of current literature on wounding therapies to prevent SCCs.
RESULTS
This new hypothesis of SCC photocarcinogenesis states that senescent fibroblasts accumulate in the dermis, resulting in a reduction in dermal insulin-like growth factor-1 (IGF-1) expression. This lack of IGF-1 expression sensitizes epidermal keratinocytes to fail to suppress ultraviolet light B (UVB)-induced mutations, leading to increased proclivity to photocarcinogenesis. Recent evidence suggests that dermal wounding therapies, specifically dermabrasion and fractionated laser resurfacing, can decrease the proportion of senescent dermal fibroblasts, increase dermal IGF-1 expression, and correct the inappropriate UVB response found in geriatric skin, protecting geriatric keratinocytes from UVB-induced SCC initiation.
CONCLUSIONS
In this review, we will discuss the translation of pioneering basic science results implicating commonly used dermal fibroblast rejuvenation procedures as preventative treatments for SCC.
Topics: Carcinoma, Squamous Cell; Cellular Senescence; DNA Damage; Dermabrasion; Dermis; Fibroblasts; Humans; Insulin-Like Growth Factor I; Keratinocytes; Rejuvenation; Ultraviolet Rays
PubMed: 23437969
DOI: 10.1111/dsu.12138 -
Scars, Burns & Healing 2017Acne is a common condition that can result in permanent scarring. Acne scars can be broken down into three categories: atrophic; hypertrophic; and keloidal. Atrophic... (Review)
Review
INTRODUCTION
Acne is a common condition that can result in permanent scarring. Acne scars can be broken down into three categories: atrophic; hypertrophic; and keloidal. Atrophic scars can be further sub-classified into: ice pick; rolling; and boxcar.
OBJECTIVES AND METHODS
We have performed a comprehensive literature search of the last ten years in order to determine the efficacy and adverse reactions of commonly used treatments against post-acne scarring.
RESULTS
A total of 36 relevant articles were identified on the following interventions: subcision (n = 10), dermabrasion (n = 1), microneedling (n = 8), dermal fillers (n = 5), and chemical peeling (n = 12).
DISCUSSION
Improvement in the appearance of post-acne scarring following subcision is in the range of 10-100%. Microdermabrasion achieved the least significant results. A total of 27.3% patients did not achieve any benefit despite eight treatment sessions, and only 9.1% achieved good results. All patients treated with microneedling achieved some improvement in scar appearance in the range of 31-62%. Dermal fillers also led to favourable outcomes. In particular, treatment with PPMA led to improvement in 84% of patients. Utilising chemical peels, trichloroacetic acid (TCA) CROSS achieved >70% improvement in 73.3% of patients, whereas 20% glycolic acid did not lead to any improvement in 25%.
CONCLUSION
Post-acne scarring is a common and challenging condition with no easy and definitive solution. The above interventions have been used with varying degrees of efficacy, each having both pros and cons. All have been deemed to be safe with few and transient adverse reactions. However, further trials with a larger number of patients are necessary in order to reach more concrete conclusions regarding their efficacy.
PubMed: 29799567
DOI: 10.1177/2059513117695312 -
Aesthetic Plastic Surgery Dec 2011Atrophic facial acne scarring is a widely prevalent condition that can have a negative impact on a patient's quality of life. The appearance of these scars is often... (Review)
Review
Atrophic facial acne scarring is a widely prevalent condition that can have a negative impact on a patient's quality of life. The appearance of these scars is often worsened by the normal effects of aging. A number of options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, ablative or nonablative laser resurfacing, dermal fillers, and surgical techniques such as subcision or punch excision. Depending on the type and extent of scarring, a multimodal approach is generally necessary to provide satisfactory results. Resurfacing techniques correct surface irregularities, long-lasting dermal fillers address the volume loss resulting from acne, and sub-superficial musculoaponeurotic system (SMAS) face-lift procedures counter the soft tissue laxity and ptosis associated with aging. This article briefly reviews the evolution of individual approaches to treating atrophic acne scarring, followed by case examples illustrating results that can be achieved using a multimodal approach. Representative cases from patients in their 30s, 40s, and 50s are presented. In the author's clinical practice, multimodal approaches incorporating fractionated laser, injectable poly-L: -lactic acid, and sub-SMAS face-lift procedures have achieved optimal aesthetic outcomes, high patient satisfaction, and durability of aesthetic effect over time.
Topics: Acne Vulgaris; Adult; Aging; Cicatrix; Combined Modality Therapy; Face; Humans; Middle Aged
PubMed: 21491169
DOI: 10.1007/s00266-011-9715-y -
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 -
Children (Basel, Switzerland) Jan 2024Congenital melanocytic nevi (CMN) carry an increased risk of melanoma and may be disfiguring, and consensus regarding treatment recommendations is lacking. While... (Review)
Review
Congenital melanocytic nevi (CMN) carry an increased risk of melanoma and may be disfiguring, and consensus regarding treatment recommendations is lacking. While clinical monitoring is the standard of care, many caregivers are interested in its removal to prevent psychosocial burden or to decrease risk. Although melanoma can occur regardless of CMN removal, there are a variety of treatments that may offer improved cosmesis or local symptom control, including surgical excision, laser therapy, and other superficially destructive techniques. Regardless of the selected management, these patients are monitored for ongoing melanoma risk. An extensive discussion with families regarding the risks and benefits of observation versus active intervention is essential. To facilitate these discussions, we herein summarize current CMN management strategies and considerations.
PubMed: 38255375
DOI: 10.3390/children11010062 -
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 -
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 -
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