Dermatologic Surgery最新文献

Background: Over 1 million skin cancer diagnoses are made each year. Although patients experience stress from the diagnosis, surgical management may cause additional anxiety reducing outcome and satisfaction scores. The authors sought to better understand the impact of local (local anesthesia [LA]) versus intravenous (IV) anesthesia, with the goal of optimizing treatment plans.

Methods: Patients who underwent Mohs micrographic surgery and subsequent reconstruction from 2019 to 2022 completed a survey evaluating satisfaction, pain, and anxiety at 1-week postop. Anesthesia type during reconstruction determined grouping, and analysis between the 2 groups was performed.

Results: Of 78 patients, 30 received IV and 48 received LA. IV group (IVG) was significantly younger (p = .01), had larger defects (p = .04) and final reconstruction sizes (p = .03). The IVG experienced significantly less anxiety during the procedure (p = .02), however, reported more anxiety postoperatively (p = .01). No significant differences regarding satisfaction or pain were identified.

Conclusion: Compared with LA, patients who underwent reconstruction with IV experienced significantly lower intraprocedural anxiety; however, the IVG experienced greater anxiety in the postoperative period. Despite this difference in anxiety, no significant difference was demonstrated in overall satisfaction. In conclusion, with patients undergoing a high anxiety procedure, it is important to tailor the treatment plan to decrease anxiety.

Background: Keloids represent a troublesome condition that lacks a proper standard management protocol. Insulin and botulinum toxin A (BTX-A) both have evidence-based anti-scarring effects. Hence, their role in treating keloids needs to be investigated.

Objective: To compare insulin's efficacy versus BTX-A in treating keloids.

Patients and methods: Sixty-three patients with keloids were randomly allocated into 3 equal groups. Group A was treated with intralesional insulin, Group B with intralesional BTX-A, and Group C with intralesional corticosteroids, each for 4 monthly sessions. The results were assessed objectively and subjectively using the patient and observer scar assessment scale.

Results: All 3 groups showed a statistically significant reduction in volume before and after therapy, with percent changes of 66.6%, 25.3%, and 75% for Groups A, B, and C, respectively. Insulin and corticosteroids were statistically superior to BTX-A in improving pigmentation, reducing thickness, and inducing relief in treated keloids.

Conclusion: Both insulin and BTX-A show a promising role in managing keloids, with insulin demonstrating better efficacy. Botulinum toxin A is better recommended as an adjuvant therapy alongside other mainstay treatment modalities. Larger-scale studies are needed to confirm their roles and establish guidelines for their use.

Background: Skin cancer prevalence has been increasing worldwide, particularly among Caucasian populations. Sun exposure is a significant risk factor, and some tools, such as the sun exposure and behavior inventory (SEBI), have been developed to assess sun-related behaviors.

Objective: To translate, culturally adapt, and validate the Arabic version of SEBI to assess its reliability and validity in measuring sun exposure behaviors.

Methods: A quantitative cross-sectional study was conducted at King Saud University Medical City in Riyadh between May and June 2024, focusing on dermatology patients fluent in Arabic. The instrument was translated forward and backward. Construct validity was assessed through exploratory factor analysis. Reliability was established by internal consistency and the intraclass correlation coefficient.

Results: Arabic SEBI showed good Cronbach alpha values (0.61-0.71) across various domains. The test-retest reliability of intraclass correlation coefficients ranged from 0.67 to 0.72. Furthermore, factor analysis revealed 3 main factors representing 51.2% of the variance. Discriminant validity was also significant; clear differentiation is seen between the highest and lowest quartile scores in the SEBI domains (p < .001).

Conclusion: The Arabic-translated SEBI is a reliable and valid tool for assessing sun exposure and protective behaviors in Arabic-speaking populations.