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Seminars in Plastic Surgery Nov 2020The process of scar formation is a sequela of the healing following soft tissue injury extending to, or through, the reticular dermis. Scars, within the head and neck in... (Review)
Review
The process of scar formation is a sequela of the healing following soft tissue injury extending to, or through, the reticular dermis. Scars, within the head and neck in particular, may be physically disfiguring with resultant psychosocial implications. Mitigation of excessive scar formation during the healing process following surgery, or in the setting of trauma, begins with meticulous soft tissue handling and reconstructive technique. The reconstructive surgeon's armamentarium must therefore include techniques that minimize initial scar formation and revision techniques that address unfavorable outcomes. With this in mind, this article reviews both conservative nonsurgical and surgical treatment modalities that mitigate scar formation or address mature scar formation.
PubMed: 33380918
DOI: 10.1055/s-0040-1721768 -
Clinical Case Reports Apr 2016The most common benign salivary gland tumor is pleomorphic adenoma. They can attain giant proportions and weigh several kilograms. They can cause facial disfigurement...
The most common benign salivary gland tumor is pleomorphic adenoma. They can attain giant proportions and weigh several kilograms. They can cause facial disfigurement and, if untreated, could lead malignant transformation. This image depicts a 7.5 kg pleomorphic adenoma of right submandibular gland with malignant change in a 55-year-old male.
PubMed: 27099752
DOI: 10.1002/ccr3.490 -
AMA Journal of Ethics Apr 2018Facial disfigurement can significantly affect personal identity and access to social roles. Although conventional reconstruction can have positive effects with respect... (Review)
Review
Facial disfigurement can significantly affect personal identity and access to social roles. Although conventional reconstruction can have positive effects with respect to identity, these procedures are often inadequate for more severe facial defects. In these cases, facial transplantation (FT) offers patients a viable reconstructive option. However, FT's effect on personal identity has been less well examined, and ethical questions remain regarding the psychosocial ramifications of the procedure. This article reviews the literature on the different roles of the face as well as psychological and social effects of facial disfigurement. The effects of facial reconstruction on personal identity are also reviewed with an emphasis on orthognathic, cleft, and head and neck surgery. Finally, FT is considered in this context, and future directions for research are explored.
Topics: Body Image; Esthetics; Ethics, Medical; Face; Facial Transplantation; Humans; Self Concept; Transplantation
PubMed: 29671724
DOI: 10.1001/journalofethics.2018.20.4.peer1-1804 -
GMS Interdisciplinary Plastic and... 2013Ophthalmic Plastic and Reconstructive Surgery is a specialized area of ophthalmology that deals with the management of deformities and abnormalities of the eyelids,... (Review)
Review
Ophthalmic Plastic and Reconstructive Surgery is a specialized area of ophthalmology that deals with the management of deformities and abnormalities of the eyelids, lacrimal system and the orbit. An ophthalmoplastic surgeon is able to identify and correct abnormalities of the ocular adnexae such as ectropion, lid retraction, conjunctival scarring with severe entropion, that can cause secondary ocular surface disorders; manage patients with watering eye, and when needed intervene with a dacryocystorhinostomy by external or endonasal approach and moreover minimize disfigurement following enucleation or evisceration and prevent further corneal damage, alleviate complains of tearing and grittiness, but also cosmetic complaints in patients with Graves' orbitopathy. Aim of this manuscript was to review current established and recently evolving surgical procedures.
PubMed: 26504698
DOI: 10.3205/iprs000026 -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2013Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological,... (Review)
Review
OBJECTIVES
Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients.
STUDY DESIGN
MEDLINE search of articles published on "face transplantation" until March 2012.
RESULTS
Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 9 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation.
CONCLUSIONS
Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients.
Topics: Facial Transplantation; Humans; Treatment Outcome
PubMed: 23229268
DOI: 10.4317/medoral.18552 -
Malaysian Family Physician : the... 2014Fungal infection of the nail is a common condition that causes much concern because of its disfiguring appearance. Although specific treatment is available for this... (Review)
Review
Fungal infection of the nail is a common condition that causes much concern because of its disfiguring appearance. Although specific treatment is available for this condition, treatment outcome is variable and persistent nail dystrophy post-treatment may cause distress to both the patient and the physician. This article describes the current available treatment options for onychomycosis, management approach and the expected treatment outcome to enhance primary care physicians' confidence in managing this condition. Oral antifungal agents such as terbinafine and itraconazole are good treatment options for onychomycosis. Combination therapy using oral antifungal agents with topical lacquer preparations may provide added benefits. Evaluation of patient's expectations, providing information on treatment outcome, clinical cure and recurrence rates are essential in the management of onychomycosis. This article is intended to guide primary care physicians to achieve realistic treatment goals and for a satisfactory experience in the overall management of this challenging condition.
PubMed: 25606290
DOI: No ID Found -
Journal of Cutaneous and Aesthetic... Jan 2012Necrobiotic xanthogranuloma is a rare, chronic, progressive granulomatous disorder which manifests as yellowish plaques and nodules, most commonly in the periorbital...
Necrobiotic xanthogranuloma is a rare, chronic, progressive granulomatous disorder which manifests as yellowish plaques and nodules, most commonly in the periorbital region. The exact aetiology is not known. It is commonly associated with monoclonal gammopathy. Various treatment modalities used include chemotherapy, intralesional and systemic steroids, radiotherapy and surgical excision. We report a case of necrobiotic xanthogranuloma involving the periorbital area causing cosmetic disfigurement.
PubMed: 22557857
DOI: 10.4103/0974-2077.94341 -
Journal of Laboratory Physicians Mar 2020Dermatophytes are fungi parasitizing structures rich in keratin such as skin, hair, and nail, which leads to a dermal inflammatory response with intense itching and...
Dermatophytes are fungi parasitizing structures rich in keratin such as skin, hair, and nail, which leads to a dermal inflammatory response with intense itching and cosmetic disfigurement. The climatic condition of eastern India is predominantly hot and humid with severe rainfalls promoting fungal infection. This study was performed to determine the prevalence of dermatophytosis and to isolate and identify the dermatophyte from clinically suspected cases attending tertiary care center. This study was conducted from April 2018 to March 2019 and a total of 1,200 samples were included. Skin scrapings were collected and examined microscopically using 10% potassium hydroxide (KOH) mount. Culture was performed using Sabouraud dextrose agar and dermatophyte test medium. Speciation was done based on macroscopic and microscopic findings using lactophenol cotton blue staining and some special tests like urease test and slide culture. Of 1,200 cases, tinea corporis was the most common clinical presentation. Direct KOH positivity was 89.4% and culture positivity was 61.75%. (77.5%) was the most common dermatophyte isolated followed by (13.3%). Dermatophytic infections are not serious but their propensity to persist leading to chronicity and disfigurement may have personal and social implications.
PubMed: 32792788
DOI: 10.1055/s-0040-1713063 -
The Journal of Dermatological Treatment Dec 2023Lichen planopilaris (LPP) is a lymphocytic primary cicatricial alopecia characterized by perifollicular erythema, follicular hyperkeratosis and scaring, resulting in...
Lichen planopilaris (LPP) is a lymphocytic primary cicatricial alopecia characterized by perifollicular erythema, follicular hyperkeratosis and scaring, resulting in permanent hair loss. Current treatment modalities, both topical and systemic, fail to achieve satisfactory and consistent results. As therapies fail to halt the inflammatory process, patients with LPP may face long-term disfigurement and significant psychological burden. To initiate an efficacious targeted therapy with good tolerability and low side effect profile that will allow hair regrowth and prevent the development to disfiguring alopecia. Here, we report on a case of rare LPP in a linear distribution (LLPP) involving the scalp and forehead failing to achieve satisfactory results with continued hair loss with multiple previous treatments. Complete hair regrowth was achieved 12 weeks after treatment with an anti-psoriatic, anti-interleukin (IL)-17A/F antibody (Taltz, Ixekizumab, Lilly). Patient continued to display sustained efficacy with no reported side effects until 12 months on treatment. The present case underlines the viability of Ixekizumab as a possible first-line, targeted therapy for LPP and its variants with sustained efficacy. Multicenter trials are warranted to confirm the benefit of Ixekizumab as a successful targeted biologic treatment option for LPP and LLPP.
Topics: Humans; Alopecia; Hair; Lichen Planus; Antibodies, Monoclonal, Humanized; Dermatologic Agents; Treatment Outcome
PubMed: 37026832
DOI: 10.1080/09546634.2023.2201364 -
BMJ (Clinical Research Ed.) Apr 1997
Topics: Adaptation, Psychological; Body Image; Face; Humans; Prejudice; Surgery, Plastic
PubMed: 9112836
DOI: 10.1136/bmj.314.7086.991