Journal of Cutaneous and Aesthetic Surgery最新文献

Objectives: The objective of this study was to determine the effectiveness of intralesional injection of bleomycin in the management of difficult-to-treat and resistant cutaneous warts.

Material and methods: A total of 54 patients were enrolled in the study, of whom 52 completed it. We administered 0.1% bleomycin over the warts and conducted follow-up at 4, 8, and 12 weeks. If the warts were not completely clear, we administered the next dose of intralesional bleomycin at each visit until the third visit. If the lesions resolved at the third visit, we conducted a telephonic interview for the next follow-up at the end of 12 weeks to record any recurrence of warts and residual side effects.

Results: Out of 54 patients enrolled in the study, two were lost to follow-up. About 49 (94.2%) patients had clearance of warts at the end of the study period. About 45 (86.5%) patients had complete resolution of lesions after the first session. Three patients achieved complete clearance after the second treatment session. One patient achieved complete clearance at the end of the 12^th week. One patient showed a partial response at the end of the 12-week treatment. There was no response for two patients at the end of 12 weeks. Two patients were lost to follow-up.

Conclusion: The present study demonstrates that intralesional bleomycin is an efficient and safe treatment option in the management of resistant and difficult-to-treat warts.

Metastatic or cutaneous Crohn's disease (MCD) is a rare manifestation of Crohn's disease and presents with ulcers, nodules, edema, fissures, and fistula. The genital involvement is seen in almost 50% patients and linear ulcers (knife-cut ulcers) are characteristic clinical features. The histopathological findings of skin lesions are similar to gastrointestinal involvement and are diagnostic. The treatment options for the management of MCD include topical and oral steroids, oral metronidazole, as well as immunosuppressants such as methotrexate, azathioprine, cyclosporine, and tumor necrosis factor alpha inhibitors. We present three cases of MCD who were treated with platelet-rich fibrin therapy as adjuvant and resulted in rapid healing of ulcers.

Objectives: Numerous studies have been conducted on the clinical efficacy of immunotherapeutic agents in the treatment of cutaneous warts showing variable results. The present study aimed to compare the clinical efficacy and safety of intralesional tuberculin purified protein derivative (PPD) and Vitamin D₃ therapy in recurrent and recalcitrant extra-genital cutaneous warts.

Material and methods: This study was conducted as a prospective, randomized, comparative, and single-blind study. A total of 104 patients were randomly distributed into two treatment groups: Group A (Tuberculin PPD, n = 53) and Group B (Vitamin D₃, n = 51). Each patient in Group A received an intralesional injection of 0.1 mL tuberculin PPD (5 Tuberculin Units), while each patient in Group B received an intralesional injection of 0.2 mL Vitamin D₃ (Cholecalciferol containing 120,000 IU). The injections were given at the initial visit (week 0) and after every 2 weeks for a maximum of four sessions (weeks 2, 4, and 6). The largest wart was selected for intralesional therapy. The categorization of clinical response was done based on the percent reduction in the size of warts into complete (appearance of normal skin), marked (>50% reduction), moderate (<50% reduction), and inadequate (no change in warts) responses. Adverse effects (if any) were recorded during each patient visit. The final response was evaluated at 6 months follow-up from the last treatment session.

Results: Regarding the response of patients to tuberculin PPD therapy, out of a total of 53 patients, 40 (75.5%) showed a complete response. Regarding the response of patients to Vitamin D₃ therapy, out of a total of 51 patients, 36 (70.6%) showed a complete response. However, the difference in the response to the treatment between the two groups was statistically insignificant (P = 0.402).

Conclusion: Both intralesional tuberculin PPD and Vitamin D₃ are effective and safe in the treatment of all recurrent and recalcitrant extra-genital cutaneous warts.

Forehead defects pose a reconstructive challenge and multiple revisions are often required to achieve satisfactory outcomes. The case history of a 20-year-old woman undergoing radical resection of a forehead arteriovenous malformation and reconstruction with an anterolateral (ALT) free flap is described. Although free tissue transfer with an ALT was successful, its color and texture mismatch were unacceptable to the patient. The esthetic result and patient satisfaction were improved by subsequent tissue expansion of the contralateral forehead, removal of the free flap and advancement of the contralateral forehead skin. Complex reconstructions utilize a breadth of techniques. We illustrate a dynamic use of the reconstructive ladder, implementing a descending approach to achieve a satisfactory reconstruction objectively and subjectively from the patient perspective.

Initially, the application of the follicular unit excision (FUE) technique for hair transplantation faced a challenge due to a significant occurrence of hair follicle damage. However, advancements in techniques, punch designs, and tools have successfully addressed this issue. The integration of motorized equipment featuring rotation, roto-oscillation, oscillation, vibration, suction, and hydration has significantly improved the successful harvesting of grafts. More recently, the adoption of robotic technology for both graft extraction and incision is becoming increasingly common in FUE procedure. Given the wide range of available devices and technologies, hair transplant surgeons may find it challenging to select the most suitable option for their specific practices. The advancements in techniques, punch shapes, and motorized devices have played a key role in reducing the rate of follicle damage and increasing the speed of FUE procedures. It is crucial for hair restoration surgeons to stay informed about the various accessible devices and understand how these tools can be customized to suit the unique hair and skin characteristics of each patient.

Objectives: Cosmetics have become a part of the daily grooming routine. The majority of women utilize cosmetics to some extent without much knowledge about their side effects. Adverse reactions can occur immediately after the application of the product or during their long-term usage. Adverse reactions related to cosmetics go unnoticed and under-reported. Women are most likely affected by adverse reactions compared with men. This study aimed to analyze the awareness level among Indian women regarding adverse reactions caused by cosmetic products.

Material and methods: A cross-sectional study was performed among South Indian women from March 2021 to July 2022. A sample of 400 each, working women (WW) and nonworking women (NW), was selected using the snowball technique, and data were collected using a self-administered questionnaire through Google Forms. Data were analyzed by using Statistical Package for Social Sciences (SPSS) version 21 and descriptive statistics were applied.

Results: In total, 791 (98.8%) participants used various cosmetic products. A total of 163 (41.1%) WW and 139 (35.1%) NW experienced adverse effects due to the use of cosmetic products. Skincare products cause more adverse reactions compared with other cosmetic products. The primarily affected body site was the face. The majority of respondents solved their adverse reactions problem by adopting self- medication.

Conclusion: A significant percentage of the respondents experienced adverse side effects due to the usage of cosmetics. Awareness regarding the possibility of cosmetic-induced adverse effects, as well as the proper use of cosmetics to reduce these adverse effects is imperative. Implementation and appropriate application of cosmetovigilance can aid in limiting or eliminating the presence of dangerous substances in cosmetics and also helps in decreasing adverse events.

Objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicles. Guidelines for the management of HS in North Africa are lacking. We aimed to develop the Tunisian consensus for the management of HS using the conventional Delphi method.

Material and methods: A multidisciplinary panel of 33 experts in the management of HS was selected. A two-round Delphi method was conducted. The first questionnaire consisted of 134 items generated based on a review of the latest international guidelines in the management of HS.

Results: Among the 134 items proposed in the first round, 73 have reached a consensual agreement (median ≥7, and 70% or more responses were ≥7). An agreement was reached for 32 items proposed in the second round. A management algorithm was developed based on consensual items.

Conclusion: The results of this consensus represent a key step in improving the management of patients with HS in North Africa.

Bicalutamide is a non-steroidal androgen receptor antagonist that exerts anti-androgenic effects on peripheral tissues. It has been recently of interest in female pattern hair loss and has led to the off-label use of this drug for the improvement of Sinclair grading in such patients. This review aims to discuss the pharmacological properties along with indications, contraindications, and safety profile of bicalutamide for its use in dermatological research.