Journal of Cutaneous and Aesthetic Surgery最新文献

A stable and less voluminous nail dressing is required after nail surgery over the nail unit. The bandage should take care of trauma, water and discharge from the wound. We described the use of two layered non-sticky and absorptive bandages. It was cut into dumbbell shape and wrapped over the toe with a nail, and tied at the base of the toe with moderate pressure. To observe the toe, a window is made in the center of the bandage.

Objectives: Stretch marks and post-surgical scar marks may have negative cosmetic and psychological impacts.. Thus, this study aimed to compare the efficacy and safety of microneedling monotherapy versus microneedling in combination with autologous platelet-rich plasma (PRP) for the treatment of stretch marks and post-surgical scars.

Material and methods: This was a prospective randomized non-controlled study. A total of 30 study participants with stretch marks and post-surgery scars were enrolled and randomly divided into two groups, each with 15 study participants. All received three treatment sessions using microneedling monotherapy (Group A) or autologous PRP with microneedling (Group B) at 4-week intervals. Clinical response to treatment was assessed at the end of 20 weeks by comparing clinical photographs, Manchester Scar scale (MSS) score, dermoscopy images, and patient satisfaction scores.

Results: At the end of the study, statistically significant esthetic improvement in terms of MSS scores was seen in Group B when compared to Group A. In Group A, 73.3% of the study participants were satisfied while in Group B, 86.6% were very satisfied with the results. Dermoscopy pictures substantiated the findings of clinical improvement. No major side effects were documented.

Conclusion: PRP in combination with microneedling has a better outcome as compared to microneedling monotherapy. Furthermore, dermoscopy is a non-invasive tool that can be used to evaluate therapeutic response.

Langer's lines, lines of cleavage, and biodynamic excisional skin tension (BEST) lines have been defined for cutaneous surgery to ensure excisional wound closure with the least tension on any part of the body and minimize scarring. This article describes nail unit incision lines (NUIL) with a similar perspective. NUIL are followed by nail surgeons to help regrowth of a normal nail; however, they are not widely understood or respected during nail surgery. Within the anatomically small nail unit, the orientation of these lines varies depending on the area being operated upon. Nail bed incisions should be oriented longitudinally, while nail matrix incisions should be oriented horizontally. Being the germinative portion, the nail matrix should be dealt with more cautiously, avoiding the lunular margin. Lateral nail fold incisions should be longitudinal, while proximal nail fold incisions should be radial. Distal nail fold (hyponychial) incisions should preferably be oriented parallel to the distal nail ridge. Knowledge and compliance with NUIL can help minimize scarring outcomes in nail surgery.

Intralesional injections to wide, thick lesions and lesions on curved surfaces are challenging with the syringe and needle unit being held parallel to the skin surface. Bending the needle eases negotiation by lifting the syringe away from the skin surface with the needle entering parallel to the lesion ensuring uniform and optimal drug delivery.

Injecting botulinum toxin under simple topical anesthesia using a eutectic mixture of lignocaine and prilocaine is a painful procedure. A simple hyper-occlusive modification in the existing technique of topical anesthesia of palms facilitates painless injections leading to greater patient satisfaction and compliance.

Post-acne atrophic scars (PAS) are a common complication of acne, and their treatment can be limited in people of color due to dyspigmentation and scarring risks. This split-face study compared the efficacy of microneedling with topical insulin (TI) on one side of the face with microneedling with platelet-rich plasma (PRP) on the other side for the treatment of PAS. The study included 50 participants with Fitzpatrick skin types III to VI who had never been treated for PAS. Both sides of the face showed significant improvement, with the left side being treated with TI showing a 52% improvement and the right side being treated with PRP showing a 28% improvement. The treatment was well-tolerated, with no significant adverse effects, and no changes in blood glucose levels were observed. The researchers suggest that combining TI or PRP with microneedling can improve PAS treatment, with TI being a superior option due to its ease of use, low cost, and noninvasive nature.

Objectives: To study the efficacy and safety of microneedling radiofrequency (MNRF) in the treatment of acne scars.

Material and methods: This is a hospital-based and prospective interventional study. A total of 44 patients (18- 55 years old), skin types III-V, with acne scars, were enrolled. Four sessions of MNRF (Lumenis legend PRO Machine, with non-insulated needle tips GEN6, GEN6L; Israel) were done with an interval of 3 weeks between each session and followed up 1 month after the last session. The outcome was assessed by Goodman and Baron's qualitative and quantitative acne scar grading, physician global assessment (PGA), and patient satisfaction score (PSS).

Results: Out of 44 patients, four patients could not complete the study. Goodman and Baron's qualitative assessment showed patients with Grades 2, 3, and 4 were 6 (15%), 17 (42.5%), and 17 (42.5%), respectively. At the end of follow-up, patients with Grades 1, 2, 4, and 4 acne scars were 5 (12.5%), 24 (60%), 10 (25%), and 1 (2.5%), respectively, which were statistically significant (P < 0.05). Seven patients showed no improvement. Goodman and Baron's quantitative assessment showed an initial mean of 12.65 and an after-follow-up mean of 8.3, which was statistically significant (P < 0.05). PGA and PSS scores showed excellent to good responses of 70% and 82.5%, respectively. Adverse effects such as post-treatment erythema were seen in all patients, and edema was observed in 12 patients. Post-inflammatory hyperpigmentation was noted in two patients.

Conclusion: MNRF was found to be effective with a better safety profile for acne scars.

Objectives: Eyelid margin lesions cause discomfort by impeding both central and peripheral vision, depending on their position on the eyelids, thus hindering everyday routines. However, surgical excision, radiofrequency, electrocautery, and cryosurgery are employed for treatment, although they are complicated and have functional limitations. Carbon dioxide (CO₂) lasers were used to assess the efficacy, safety, and patient satisfaction with CO₂ laser ablation in managing eyelid margin lesions.

Material and methods: This is a pilot study of patients with eyelid margin lesions presented to a private clinic in urban Gujarat between June 2020 and June 2023. All patients were treated with a 10600 nm CO₂ laser with a power of 1-2 W in continuous mode. The eyelid lesions were classified into three categories based on their size: Small (1-3 mm), medium (4-6 mm), and large (7-10 mm). The clinical response was assessed by the treating physician at week 1 and week 4, and categorized as excellent (complete clearance of lesion), moderate (>50%), or poor (<50%). Patients were asked to rate their level of satisfaction on a three-point scale at the end of the follow-up period: Dissatisfied, somewhat satisfied, or very satisfied.

Results: Ten patients of all females with six of them having compound melanocytic nevi, two of them each had cystic hidradenoma, and one each had cyst of zeis and verruca vulgaris. Six of them had small lesions, two had medium, and two had large lesions. The clinical response grading of physicians at both 1 week and 4 weeks was excellent, and the patient satisfaction questionnaire yielded excellent outcomes.

Conclusion: The ablative CO₂ laser is an excellent device used for the treatment of eyelid margin lesions, particularly when performed by an expert and skilled dermatologist. The application of this treatment approach has proven to be very beneficial and shows excellent results in terms of both the esthetic appearance and structural function of the eyelids.