Journal of Cutaneous and Aesthetic Surgery最新文献

Objectives: Acne scarring occurs from skin damage following acne healing. Treatments such as chemical peels, dermabrasion, and laser therapy can effectively enhance scars' appearance but could be expensive. This study aimed to reflect participants' awareness of treatment options and their willingness to pay (WTP), evaluating their association with sociodemographics, severity, and quality of life (QoL).

Material and methods: A cross-sectional study was conducted in Riyadh, Saudi Arabia, from June to July of 2023. Study participants were chosen using a non-probability sampling technique. Participants were aged 18 or older, had acne scarring, and resided in Riyadh. Data analysis was performed using RStudio, with P < 0.05 indicating statistical significance.

Results: A total of 401 adult participants were included in the study. The prevalence of acne scarring among the participants was 63.4%. About 45.8% of the participants expressed a WTP of <1000 Saudi Riyals (SAR), while 42.2% were willing to pay 1000-6000 SAR. The most well-recognized acne scar management modalities were laser resurfacing (66.3%) and chemical peels (64.1%), while the least recognized were collagen/fat filler injections (23.9%) and radiofrequency microneedling (27.7%).

Conclusion: The most recognized acne scar treatment modalities were laser resurfacing and chemical peels. Participants were willing to pay for reasons such as psychological impact, income levels, and awareness of treatment modalities. The findings could influence dermatologists to start awareness campaigns to debunk misconceptions about acne scar treatment modalities and their efficacy in improving QoL.

Vitiligo is an acquired depigmenting disorder due to the destructive loss of melanocytes, clinically presenting as hypopigmented or depigmented macules and/or patches. Many theories have been proposed to explain its etiopathogenesis among which cell-mediated immunity is one of the crucial links. Estimation of vitiligo activity and extent in a patient is important in tailoring an optimal treatment regimen. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (HsCRP) are sensitive indicators for systemic inflammation and are found to be relevant in determining vitiligo disease activity. This study was conducted to estimate serum levels of IL-6 and HsCRP in vitiligo patients and to correlate them with the disease activity and extent in order to assess if these serum markers serve as objective indicators of vitiligo disease activity. This was a hospital-based cross-sectional study of 58 vitiligo patients diagnosed clinically irrespective of age, gender, and any ongoing or past treatment. Disease activity and extent were calculated using the vitiligo disease activity (VIDA) score and vitiligo area severity index (VASI), respectively. Serum levels of IL-6 and HsCRP were obtained and their correlation with VIDA and VASI values were statistically analyzed. A weak negative statistically insignificant correlation was found between IL-6 and VIDA (P = 0.092). No correlation was found between VIDA and HsCRP (P = 0.998). A weak positive, statistically insignificant correlation was found between VASI and IL-6 as well as between VASI and HsCRP (P = 0.175 and P = 0.238, respectively). Although statistically insignificant, the patients who were not on immunosuppressive therapy showed higher mean values of IL-6 and HsCRP compared to those who were on immunosuppressive therapy. In contrast to the findings of previous studies, our study found a weak negative correlation between VIDA and IL-6 levels possibly attributable to the difference between the mean levels of IL-6 among the subgroups of patients who were, and were not on immunosuppressive therapy. The VIDA score and HsCRP levels did not show any statistical correlation. However, patients who were not on immunosuppressive therapy showed a higher albeit statistically insignificant mean value of HsCRP. Our observations suggest that any ongoing and/or treatment in the recent past, especially immunosuppressive therapy, and any co-morbidities should be essentially considered while investigating for sensitive serum markers of inflammation as determinants of vitiligo disease activity.

Ingrown toenails is a painful foot problem seen in primary care among young men. To provide immediate pain relief, some types of splints are placed in the gutter to separate it from the ingrown lateral nail. There are time-consuming and effort-intensive procedures that use available nail separators and elevators to separate the nail plate. Here, the hub of the syringe is cut obliquely to create a beveled or slant edge to create a custom nail separator which is a useful device for the easy and less painful separation of the ingrown nail plate from its gutter, which is an important stage of nail splinting.

Objectives: Hair is important to trace evidence commonly encountered in almost all criminal cases. Forensic anthropologists routinely compare the morphological characteristics of the hair samples to determine a transfer. Assessment of parameters such as hair density, hair diameter, follicular units, and empty hair follicle/yellow dots are useful for the diagnosis of various hair disorders, monitoring treatment outcomes, and research purposes. The study aimed to analyze the relationship between age and hair density.

Material and methods: The present cross-sectional observational study was carried out at the Department of Dermatology at a tertiary care center. All the subjects attending the Dermatology Outpatient Department fulfilling inclusion criteria were studied. Data were collected after the approval from the Institutional Ethical Committee. The procedure was explained and a written consent was taken. Each patient's hair was parted in the middle and images from a point of roughly 5 inches from the patient's glabella were taken. The parameters such as hair thickness, hair density, hair count, follicular units, and empty hair follicles/yellow dots were noted.

Results: In the present study, the majority of the study subjects belonged to the age group 26-35 years (38%), followed by 18-25 years (34.7%), 36-45 years (20.7%), and least in the age group of 46-55 years (6.7%). In the present study, the mean unit density in males was 104.78 ± 14.33 and that of females was 108.36 ± 17.60.

Conclusion: Mean hair density varies concerning age group in the study population.

Aloe vera is a cactus plant that thrives in warm areas. Since ancient times, it has been used to treat acute wounds. However, the efficacy of aloe vera for burns and split-thickness skin graft (STSG) donor sites is inconclusive. In this study, we have applied pure aloe vera gel extract as an adjunct to dressing second-degree (superficial) burn wounds and assessed the time for complete epithelialization. The time taken for complete epithelialization of the wound was 11 days when compared to the normal (evidence-based) time of 14 days.

Objectives: Acne scars often become challenging to treat with satisfactory results. The chemical reconstruction of skin scars (CROSS) technique has been used with high concentrations of trichloroacetic acid (TCA) which often produces unacceptable side effects. There is a dearth of data, with 50% glycolic acid (GA) for the same indication in the management of acne scars in the Indian population. This study aimed to assess the clinical response of acne scars after the application of 50% GA with that after the use of 65% TCA in a similar manner.

Material and methods: An institution-based prospective comparative study was performed with patients aged 16-45 years of either sex with acne scars and not been treated within the past 1 year. Subjects were assigned to receive one of the formulations (50% GA [Group A] and 65% TCA [Group B]). Grading of scars was done on day 1 and day 35 based on patients' assessment on a four-point visual scale and physicians' assessment by the Goodman-Baron qualitative global acne scar grading scale. The procedure was repeated every fortnightly for three such. Data were analyzed by Statistica version 6 (Tulsa, Oklahoma: StatSoft Inc. 2001).

Results: The visual improvement scale of patients showed 41.38% (n = 12) fair improvement in group A, whereas 58.06% (n = 18) showed good improvement in group B. Grading by the Goodman-Baron scale showed 9.68% (n = 3) showed four grade changes in group B.

Conclusion: Improvement is best observed with 65% TCA. Adverse effects were noted more with 65% TCA, especially acneiform eruption which was lacking in the previous studies. GA can be a safer alternative to TCA with acceptable results. Our study opens the scientific window for future research on different concentrations of GA as a CROSS agent.

Objectives: This study aimed to evaluate the efficacy of autologous non-cultured non-trypsinized melanocytekeratinocyte grafting (JT) with suction blister membrane as biological dressing in stable vitiligo patches.

Material and methods: The study was conducted at Mathura Das Mathur Hospital (MDM), Jodhpur, on 43 patches of Stable vitiligo. It was a prospective single-arm interventional study. All patients were examined clinically and history and informed consent were taken before starting the procedure.

Results: About 95% of patches showed >50% repigmentation with 83.72% having good to excellent repigmentation. About 88% of patches showed good color matches with an excellent decline in Dermatology Life Quality Index (DLQI). No serious complication was observed in the present study. The most common complication observed both in the donor and recipient area was pain.

Conclusion: Our study indicates that combining JT with suction blister epidermal grafting is a comparatively effective technique in terms of good repigmentation (≥75% extent of repigmentation), color match, fewer side effects, good patient satisfaction, and DLQI reduction.

Objectives: Medium-depth peels are dynamic tools when used as part of office procedures for the treatment of acne scars. Most of the available literature on chemical peels focuses on their role in skin rejuvenation and hyperpigmentation. There is a paucity of well-conducted studies that have compared peels in the treatment of acne scars in Asian patients.

Material and methods: The study aimed to compare the efficacy of 70% glycolic acid (GA) and 30% trichloroacetic acid (TCA) chemical peels in the treatment of facial atrophic acne scars. A longitudinal, right-left study was conducted to assess the effectiveness and side effects of 70% GA and 30% TCA in 30 patients with acne scars. A total of four peeling sessions were performed every 4 weeks. Evaluation of the response was done using Goodman and Baron's quantitative global acne scarring grading system (GBASG), physician visual analog scale (VAS), and patient VAS at baseline and 4, 8, 12, and 16 weeks. Relevant statistical tests were employed to study the effectiveness of both TCA and GA peels.

Results: Significant reduction was noted in mean GBASG scores on both sides at 8, 12, and 16 compared to baseline score (P = 0.000). Mean GBASG scores decreased from 12.67 ± 3.19 to 8.97 ± 2.73 on the 70% GA side while that on the 30% TCA side reduced from 13.20 ± 3.56 to 6.83 ± 2.60 (P = 0.003). The results were much better on the TCA peel side as compared to GA peel as per physician VAS (P = 0.000) and patient VAS (P = 0.000). Side effects such as post-inflammatory hyperpigmentation and acne were seen on both sides while dryness and crusting were more common on the TCA peel side.

Conclusion: A 30% TCA peel is efficacious and well-tolerated for mild-to-moderate acne scars. About 70% GA peel is an effective alternative to TCA peel, especially for patients not tolerating TCA or requiring lesser downtime.

Lip augmentation is among the most popular cosmetic procedures done today. Advancements in trustworthy techniques have made it feasible to alter the visual characteristics of the lips through the utilization of various injectable substances and surgical procedures. However, there is a lack of standardization in these techniques. The purpose of this review is to focus on novel dermal filler injection and surgical techniques for lip augmentation. We did a scoping review of the literature using PubMed, Embase, and the Google Scholar database to identify all original articles published up to June 2023, assessing new techniques that focus on lip augmentation. In our review, only two studies out of seven included studies were surgical whereas the other five studies were non-surgical. This suggests that injection of dermal fillers is currently the most opted technique performed. This review suggests that incorporating perioral rejuvenation into the plan for lower facial surgery can help to complete the youthful look sought by patients. Injectable fillers provide excellent but short-term benefits and additional options such as Modified upper lip lift and French kiss techniques exist that offer the patient permanent improvements at a low cost.