Dermatologic Surgery最新文献

英文中文

Evaluation of Axillae Skin Thickness by High-Frequency Ultrasound. 用高频超声波评估腋窝皮肤厚度。

IF 2.4 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-12 DOI: 10.1097/dss.0000000000004377

Ada Regina Trindade de Almeida,Virna Luíza de Souza Oliveira,Milena da Rocha E Souza,Maria Victoria Suarez Restrepo,Vanessa Barreto Rocha

BACKGROUNDHigh-frequency ultrasound has been utilized in dermatology to visualize superficial cutaneous structures. Axillae are often target of treatments for hair removal, for spot clearing, and for skin conditions such as hyperhidrosis, bromhidrosis, and hidradenitis. Detailed knowledge of armpit thickness can help improve existing therapies and increase their effectiveness.OBJECTIVETo describe the mean skin thickness of axillae, by further investigating possible correlations with variations in age, sex, and body mass index (BMI).MATERIALS AND METHODSAxillae were divided into 5 quadrants, 1 central and 4 peripherals. Skin has been assessed by ultrasonography, measuring the distance from epidermis surface to dermal depth, in millimeters, for each of the regions.RESULTSThirty healthy patients participated, most of them were female (n = 22; 73%), mean age 50 years (26-70 years). Most patients have maximum thickness in the center of axillae (87%). Average skin thickness in the central region was 3.1 ± 0.4 mm. There was significant difference between axillary thickness in central and peripheral regions (p < .05). On the periphery, the mean thickness was smaller (1.8 mm) without significant variation between the squares. There was no significant variation of skin thickness by sex, age, and BMI.CONCLUSIONThis study shows a difference between thickness of axillae in the central region and in its periphery.

背景在皮肤科中，高频超声已被用于观察表层皮肤结构。腋窝通常是脱毛、祛斑以及治疗多汗症、狐臭和日光性皮炎等皮肤病的治疗目标。对腋窝厚度的详细了解有助于改进现有疗法并提高其有效性。材料和方法腋窝被分为 5 个象限，1 个中央象限和 4 个外围象限。结果30 名健康患者参与了此次研究，其中大部分为女性（22 人；73%），平均年龄为 50 岁（26-70 岁）。大多数患者腋窝中心的皮肤厚度最大（87%）。中央区域的平均皮肤厚度为 3.1 ± 0.4 毫米。腋窝中心区和外围区的皮肤厚度有明显差异（P < .05）。外围区域的平均厚度较小（1.8 毫米），各方阵之间无明显差异。性别、年龄和体重指数对皮肤厚度没有明显影响。

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引用次数: 0

Enhanced Disease-Specific Survival Among Individuals With Malignant Adnexal Tumors of the Skin Treated With Mohs Surgery: A National Database Study. 莫氏手术提高了皮肤恶性附件肿瘤患者的特定疾病生存率：全国数据库研究。

IF 2.4 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-11 DOI: 10.1097/dss.0000000000004397

Mitchell A Taylor,Michelle Swedek,Peter Halloran,Corey Georgesen,Vanessa B Voss,Ashley Wysong

BACKGROUNDMalignant adnexal tumors of the skin are a rare group of tumors that can be locally aggressive and require surgical excision with strict margin control to achieve clearance. Given the rarity of these tumors, there is a limited understanding within the medical community regarding optimal treatment approaches.OBJECTIVETo examine surgical management trends and outcomes for patients diagnosed with cutaneous adnexal tumors from 2000 to 2020.MATERIALS AND METHODSThe Surveillance, Epidemiology, and End Results database was queried to identify biopsy-proven cases of cutaneous adnexal tumors between 2000 and 2020. Clinical and disease characteristics were examined, and disease-specific survivals were compared between surgical approaches using Kaplan-Meier curves and Cox proportional hazards models.RESULTSMohs surgery demonstrated a significant increase in utilization from 2000 to 2020 (+447.1%) and improvements in disease-specific survival (mean 231.7 months; p < .001) compared with no surgery; wide local excision exhibited no improved disease-specific survival (227.7 months; p = .070). Multivariable Cox regression further highlighted that only Mohs surgery exhibited a reduced disease-specific mortality risk compared with no surgery (adjusted HR 0.49; p = .011).CONCLUSIONGiven the enhanced disease-specific survival coupled with tissue preservation strategies, Mohs surgery emerges as a promising surgical approach for the treatment of malignant adnexal tumors of the skin.

背景皮肤恶性附件肿瘤是一类罕见的肿瘤，可能具有局部侵袭性，需要严格控制边缘的手术切除才能达到清除目的。材料和方法通过查询 "监测、流行病学和最终结果 "数据库，确定 2000 年至 2020 年经活检证实的皮肤附件肿瘤病例。结果2000年至2020年间，Mohs手术的使用率显著增加（+447.1%），与不手术相比，疾病特异性生存期有所改善（平均231.7个月；p < .001）；广泛局部切除术没有改善疾病特异性生存期（227.7个月；p = .070）。多变量 Cox 回归进一步表明，与不手术相比，只有莫氏手术能降低疾病特异性死亡风险（调整后 HR 0.49；p = .011）。

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引用次数: 0

Clinical Efficacy and Safety of a Thermomechanical Fractional Injury Device for Neck Rejuvenation. 用于颈部年轻化的热机械点阵损伤设备的临床疗效和安全性。

IF 2.4 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-11 DOI: 10.1097/dss.0000000000004402

Jordan V Wang,Neil Jairath,Joy Tao,David A Hashemi,Shirin Bajaj,Roy G Geronemus

BACKGROUNDNeck rejuvenation has consistently become a popular cosmetic procedure. While various treatment modalities have been used, a novel fractional thermomechanical skin rejuvenation system was recently developed to create dermal coagulation through direct heat transfer with subsequent neocollagenesis.OBJECTIVEA prospective clinical trial evaluated the efficacy and safety of a thermomechanical fractional injury device (Tixel 2, Novoxel, Netanya, Israel) for neck rhytides.MATERIALS AND METHODSSubjects with moderate to severe neck rhytides were enrolled for 4 monthly treatments.RESULTSTwenty-six subjects were enrolled and completed all study visits. The mean age was 58.4 years, and 100.0% were women. Fitzpatrick skin types I to IV were included. For Fitzpatrick Wrinkle Classification System (FWCS), the mean baseline score was 6.3. As per investigator, there was a mean 1.5-grade improvement in FWCS at 1-month follow-up (p < .00001) and 1.4-grade improvement in FWCS at 3-month follow-up (p < .00001). For physician Global Aesthetic Improvement Scale, all subjects (100%) had improvement at both 1- and 3-month follow-up visits. There were no severe adverse events, and subjects experienced minimal pain.CONCLUSIONA novel thermomechanical fractional injury device is effective and safe for the treatment of neck rhytides.

背景颈部年轻化一直是一种流行的美容手术。虽然已经使用了多种治疗方法，但最近开发出了一种新型的点阵热机械嫩肤系统，通过直接热传递产生真皮凝固，随后产生新胶原蛋白。目的一项前瞻性临床试验评估了热机械点阵损伤设备（Tixel 2，Novoxel，Netanya，Israel）治疗颈部皱纹的有效性和安全性。平均年龄为 58.4 岁，100.0% 为女性。菲茨帕特里克皮肤类型 I 至 IV 均包括在内。菲茨帕特里克皱纹分类系统（FWCS）的平均基线分数为 6.3。根据研究者的数据，随访 1 个月时，FWCS 平均提高了 1.5 个等级（p < .00001），随访 3 个月时，FWCS 平均提高了 1.4 个等级（p < .00001）。在医师全球美学改善量表中，所有受试者（100%）在 1 个月和 3 个月的随访中均有改善。没有严重的不良反应，受试者的疼痛感极低。

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引用次数: 0

755-nm Picosecond Laser With Diffractive Lens Array for Acne Scars in Fitzpatrick Skin Types V and VI. 采用衍射透镜阵列的 755 nm 皮秒激光治疗 Fitzpatrick V 型和 VI 型皮肤的痤疮疤痕。

IF 2.4 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-09 DOI: 10.1097/dss.0000000000004398

Joy Tao,David A Hashemi,Shirin Bajaj,Jordan V Wang,Roy G Geronemus

BACKGROUNDPatients commonly complain about the appearance of acne scars. While various lasers and energy-based devices can offer clinical improvement, many of them are limited in treating patients with skin of color. Concerns exist regarding efficacy and safety, including risks of scarring, prolonged dyspigmentation, necrosis, and burns.OBJECTIVETo examine the utility of a 755-nm picosecond laser with fractionated lens array in improving the clinical appearance of acne scars in patients with Fitzpatrick skin types V and VI.MATERIALS AND METHODSA prospective clinical study investigated this laser using up to 5 monthly treatments.RESULTSTwenty-four subjects were enrolled, while 17 subjects completed a 3-month follow-up. The mean age was 33.9 years, and 95.8% of the subjects were women. Fitzpatrick skin types V and VI were represented. Assessments compared baseline to 3-month follow-up. Two of the 3 blinded reviewers agreed on identifying pretreatment and post-treatment photographs for 82.4% of the cases. For physician Global Aesthetic Improvement Scale, 100% of the subjects had clinical improvement. Overall, 94.1% of subjects were satisfied with their treatment. No serious or unanticipated adverse events occurred.CONCLUSIONA 755-nm picosecond laser with fractionated lens array can safely and effectively improve acne scars in patients with Fitzpatrick skin types V and VI.

背景：患者通常会抱怨痤疮疤痕的外观。虽然各种激光和能量设备可以改善临床症状，但其中许多设备在治疗有色皮肤患者时效果有限。目的研究 755 nm 皮秒激光器与分型透镜阵列在改善菲茨帕特里克皮肤 V 型和 VI 型患者痤疮疤痕临床外观方面的效用。材料和方法前瞻性临床研究调查了这种激光器，最多每月治疗 5 次。受试者的平均年龄为 33.9 岁，95.8% 为女性。菲茨帕特里克皮肤类型为 V 型和 VI 型。评估比较了基线和 3 个月的随访。在 3 位盲审者中，有两位对 82.4% 病例的治疗前和治疗后照片的识别达成了一致。在医师全球美学改善量表中，100%的受试者都有临床改善。总体而言，94.1% 的受试者对治疗表示满意。结论755nm皮秒激光配合分型透镜阵列可以安全有效地改善菲茨帕特里克皮肤类型V型和VI型患者的痤疮疤痕。

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引用次数: 0

Reporting Rates of Chemoprevention Agent Use in Individuals With Cutaneous Field Cancerization. 报告皮肤野癌患者使用化学预防药物的比例。

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-05 DOI: 10.1097/DSS.0000000000004394

Katherine Plampton, Bo Kitrell, Ashley Wysong, Adam Sutton

引用次数: 0

Tranexamic Acid in Mohs Micrographic Surgery: A Systematic Review. 氨甲环酸在莫氏显微摄影手术中的应用：系统综述。

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-05 DOI: 10.1097/DSS.0000000000004373

Eenika A Kumar, Lisa M Morris, Basia M Michalski-McNeely

Background: Tranexamic acid (TXA) is an antifibrinolytic that has historically been used to treat menorrhagia and bleeding disorders. Exploration of its use in procedures has grown, and it has shown promise in its ability to achieve hemostasis with low risk to patients. Analysis of its use in Mohs micrographic surgery (MMS) is warranted due to its potential superiority to traditional methods of achieving hemostasis (direct pressure, electrocoagulation, and sutures).

Objective: To perform a systematic review of studies which evaluate the efficacy and safety profile of topical application or subcutaneous injection of TXA and analyze as it applies to MMS.

Materials and methods: A comprehensive literature search was conducted using the PubMed database to identify relevant studies using the search terms: "tranexamic acid" OR "TXA." The search was performed up to December 1, 2023.

Results: Tranexamic acid has a strong safety profile, and its effectiveness in achieving hemostasis is well-demonstrated. Tranexamic acid has reduced risk of bleeding complications compared with traditional methods of achieving hemostasis.

Conclusion: An extensive review of the literature has yielded positive results, suggesting the potential of TXA in improving patient outcomes, reducing surgical time, decreasing intraoperative and postoperative bleeding, and increasing overall patient satisfaction.

背景：氨甲环酸（TXA）是一种抗纤维蛋白溶解剂，历来用于治疗月经过多和出血性疾病。在外科手术中使用氨甲环酸的情况越来越多，而且它在低风险止血方面表现出了良好的前景。由于其止血效果可能优于传统止血方法（直接加压、电凝和缝合），因此有必要对其在莫氏显微摄影手术（MMS）中的应用进行分析：对评估局部应用或皮下注射 TXA 的有效性和安全性的研究进行系统综述，并分析其在 MMS 中的应用：使用 PubMed 数据库进行了全面的文献检索，以确定相关研究，检索词为："氨甲环酸 "或 "TXA"："氨甲环酸 "或 "TXA"。检索时间截至 2023 年 12 月 1 日：氨甲环酸具有很高的安全性，其止血效果也得到了充分证明。与传统止血方法相比，氨甲环酸可降低出血并发症的风险：广泛的文献综述得出了积极的结果，表明氨甲环酸在改善患者预后、缩短手术时间、减少术中和术后出血以及提高患者总体满意度方面具有潜力。

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引用次数: 0

Commentary: Benefits of Punch Excision Followed by Immediate Cryotherapy for Recalcitrant Keloids. 评论：冲切后立即冷冻治疗顽固瘢痕疙瘩的益处

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-05 DOI: 10.1097/DSS.0000000000004395

Tae Hwan Park, Arianne Shadi Kourosh

引用次数: 0

Iatrogenic Transient Nerve Palsy of the Superior Trunk of the Brachial Plexus: A Rare Adverse Event of Local Anesthesia During Mohs Micrographic Surgery Within the Supraclavicular Fossa. 先天性臂丛上干一过性神经麻痹：锁骨上窝内莫氏显微手术局部麻醉的罕见不良反应。

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-05 DOI: 10.1097/DSS.0000000000004392

Justin W Marson, Doaa Shalabi, Daniel M Siegel, Juliya Fisher

引用次数: 0

Efficacy and Safety of Low-Fluence 730-nm Picosecond Laser in the Treatment of Melasma in Chinese Patients. 低能量 730 纳米皮秒激光治疗中国黄褐斑的有效性和安全性

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-04 DOI: 10.1097/DSS.0000000000004393

Rui Han, Yifang Sun, Mingshan Su

Background: The 730-nm picosecond laser has shown promise in treating various benign pigmentary conditions, and it is yet to be determined whether it is effective and safe for melasma.

Objective: The aim of this study was to investigate the potential benefits and risks of using the 730-nm picosecond laser to remove melasma.

Materials and methods: This is a retrospective review of all patients who presented to the clinic between April 2021 and April 2022 for the treatment of melasma with 730-nm picosecond laser alone. The efficacy of the laser was assessed based on the Melasma Area and Severity Index (MASI) score using high-resolution photographs evaluated by blinded dermatologists.

Results: A total of 25 Chinese with Fitzpatrick skin Type II to IV were included. Patients were treated for an average of 3.56 ± 0.77 treatment sessions. The mean MASI scores decreased by 33.7% from 11.38 ± 6.60 to 7.55 ± 6.08 at an average of 8.48 ± 2.16 weeks of follow-up (p < .001). Among the patients, 1 experienced a 79% decrease, 6 had a decrease ranging from 51% to 75%, 10 had a decrease ranging from 26% to 50%, 5 had a decrease of less than 25%, and 3 experienced no changes in MASI scores. No hyper/hypopigmentation was observed.

Conclusion: Low-fluence 730-nm picosecond laser is an effective and safe modality for the treatment of melasma in Chinese patients.

背景：730纳米皮秒激光在治疗各种良性色素性疾病方面已显示出良好的前景，但它对黄褐斑是否有效和安全还有待确定：本研究旨在调查使用 730 纳米皮秒激光去除黄褐斑的潜在益处和风险：这是一项回顾性研究，研究对象是2021年4月至2022年4月期间就诊的所有黄褐斑患者，他们都曾单独使用730纳米皮秒激光治疗黄褐斑。激光疗效根据黄褐斑面积和严重程度指数（MASI）评分进行评估，采用高分辨率照片，由皮肤科盲人医生进行评估：结果：共纳入了 25 名菲茨帕特里克皮肤 II 型至 IV 型的中国人。患者平均接受了 3.56 ± 0.77 个疗程的治疗。在平均 8.48 ± 2.16 周的随访中，MASI 平均得分从 11.38 ± 6.60 降至 7.55 ± 6.08，降幅为 33.7%（p < .001）。其中，1 名患者的评分下降了 79%，6 名患者的评分下降了 51% 至 75%，10 名患者的评分下降了 26% 至 50%，5 名患者的评分下降了不到 25%，3 名患者的 MASI 评分没有变化。没有观察到色素沉着：结论：730nm皮秒低能量激光是治疗中国黄褐斑的一种有效而安全的方法。

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引用次数: 0

Benefits of Punch Excision Followed by Immediate Cryotherapy for Recalcitrant Keloids: A Comparison With Core Excision. 冲孔切除后立即冷冻治疗顽固瘢痕疙瘩的好处：与核心切除术的比较

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery

Pub Date : 2024-09-04 DOI: 10.1097/DSS.0000000000004391

Jin Woong Jung, Yeon Woo Jung, Byung Ho Oh

引用次数: 0

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