Dermatologic Surgery最新文献

Background: Digital mucous cysts (DMCs) are benign cysts located in digital interphalangeal joints or the proximal nail fold. Despite various treatments, standardized guidelines are lacking, and recurrence rates remain high.

Objective: This study evaluates the efficacy and safety of a novel treatment combining surgical deroofing with trichloroacetic acid application.

Materials and methods: This study was conducted on 27 patients with DMCs treated from 2019 to 2022. Clinical features and therapeutic responses were documented with photographic records at the initial presentation and follow-ups. Histopathological examinations confirmed diagnoses and classified histopathological types.

Results: Among 27 lesions, 20 were within the proximal nail fold, 7 were beneath the proximal nail fold; 26 were ganglionic, and 1 was myxomatous. Four patients required multiple treatments within 6 months due to recurrences. Long-term follow-up showed clinical improvement in all patients: 17 achieved complete remission, and 8 showed partial improvement. The treatment was effective regardless of cyst type, with minimal complications and mild postoperative pain resolving within days.

Conclusion: The combination of surgical deroofing and trichloroacetic acid application minimizes complications and enhances efficacy. It allows for repetitive treatments in case of recurrence, making it a viable option for managing persistent DMCs, with favorable outcomes and minimal complications.

Background: Several insults can cause acquired localized hypomelanosis which can be a therapeutic challenge. Microneedling is a minimally invasive procedure that stimulates melanogenesis with the benefit of short downtime and a low risk of scarring.

Objective: To determine the efficacy and safety of microneedling in localized acquired hypomelanosis.

Materials and methods: This is a randomized controlled trial. Twenty patients aged 18 years and older had their lesions randomized into either a single session of microneedling with 1.5-mm needles or no treatment. Three months later, peripheral tanning, patient satisfaction, surface tanning grade of improvement, Vitiligo Extent Score for a Target Area (VESTA), patient and physician global assessment of improvement (GAI) were evaluated.

Results: Median peripheral tanning was observed in 80% of lesions in the microneedling arm versus 85% in the no-treatment arm. Median physician GAI was 37.5% versus 33.33%, respectively. Median VESTA was 37.5% versus 29%, respectively. Median Patient GAI was 50% in both arms. Surface tanning showed a median increase of +3 grades in both arms.

Conclusion: Medium-depth microneedling deserves a place in the armamentarium of therapeutic tools for localized acquired hypomelanosis in normal-texture and scarred skin. The authors suggest repetitive sessions at intervals of 1 to 2 months to offer better coverage. Interestingly, a possible systemic effect of microneedling deserves further investigation.

Background: Among the treatment modalities for post-acne scars, microneedling is considered a safe and effective method.

Objective: To compare the efficacy and safety of combined microneedling with topical insulin versus microneedling with placebo (topical saline) in treating atrophic acne scars.

Methods and materials: Twenty-one patients with atrophic post-acne scars were randomized and treated in a split face manner with 4 sessions at 3-week intervals of microneedling using dermapen, followed by application of insulin on one side of the face and saline (placebo) on the other side. Evaluation of response was done before the sessions and after 1 month of the last session using the Global Scarring Grading System of Goodman & Baron and Lipper & Perez scores, Patient reported acne scar improvement using a 4-point scale, patient satisfaction, and the facial acne scar quality of life tools.

Results: Both therapeutic modalities yielded a statistically significant improvement of atrophic acne scars. By comparing both modalities, there was no statistical significance regarding clinical improvement and side effects.

Conclusion: Using topical insulin combined with microneedling may have a value in improving atrophic acne scars, suggesting further evaluation using different delivery systems, insulin formulations, and assessment modalities.