Journal of Cutaneous and Aesthetic Surgery最新文献

A 45-year-old man with an asymptomatic lesion on the scrotum since 25 years presented to the skin out patient department (OPD). There were multiple skin-colored to hyperpigmented nodules with areas of calcification on the scrotum. The mass measured 20 cm × 10 cm × 8 cm as a whole. Steatocystoma was clinically diagnosed and excision of the lesion was performed by a plastic surgeon. The mass was removed en masse and the removed specimen was measured to be 20 cm × 10 cm × 5 cm. On histopathological examination, the cysts showed epithelium resembling that of outer hair root sheath. Contents of the cysts were homogenous unlamellated keratin with focal calcification.

Chronic intertrigo of toe-web space is a recalcitrant problem which is often associated with multi-organism infections. For this, a number of topical therapies with preventative measures are used, but many of them are cumbersome and not very effective. Cryotherapy is a good option for treating the toe intertrigo, but its availability is a major concern. Here as an alternative to cryotherapy, trichloroacetic acid (TCA) cautery and Sodium hypochlorite (NaOCl) (a broad spectrum anti-infective agent) solution is advocated as a simple, feasible, and cost-effective treatment of chronic inter digital intertrigo.

Objectives: We aimed to assess the improvement of patterned hair loss with microneedling radiofrequency (MNRF) and its adverse effects in patients.

Material and methods: An open-label study was conducted to evaluate the efficacy and safety of MNRF for the treatment of androgenetic alopecia. Patients diagnosed with patterned hair loss received three MNRF treatment sessions once monthly. Efficacy was assessed by comparing before and after photographs and trichoscopy.

Results: Twenty-four patients were recruited. Excellent improvement in hair growth was observed in 14 patients, fair improvement in seven patients, and no improvement in three patients without significant adverse effects. Slight pain lasting for a day was the most common adverse event following MNRF.

Conclusion: Overall, significant improvement was observed in the majority of the patients without significant side effects.

Objectives: Efficacy of fractional carbon dioxide laser and microfractional radiofrequency in treatment of acne scars is well substantiated. The objective of this study was to compare the efficacy and safety of carbon dioxide laser versus microfractional radiofrequency in treatment of acne scars in skin type 3,4.

Material and methods: Thirty-two patients of skin types 3-4 with grade 3 and 4 atrophic acne scars, of which 16 were treated with fractional carbon dioxide (CO₂) laser and 16 were treated with microfractional radiofrequency were retrospectively analyzed. All patients received either treatment 4 sessions at an interval of 4-6 weeks. Objective assessment was done with qualitative and quantitative Goodman and baron acne scar grading system by assessment of photographs at baseline and 3 months after last session.

Results: All the data collected were entered in a Microsoft Excel worksheet and analyzed using R Software R-4.2.1. The study variables acne scar grades were described using frequency with percentage, acne scar scores were described using Mean with Standard deviation, and Median with interquartile range (IQR) (Q1-Q3). Since the data were ordinal, which is non-normal, hence, non-parametric tests are applied. To compare grades between the groups, Mann-Whitney U-test was applied.

Conclusion: There was no difference in the last session (after the treatment) between the groups, the Mann- Whitney U-test was 109.5 with P-value of 0.484 >0.05. Therefore, there was no statistically significant difference between the microfractional radiofrequency and carbon dioxide laser group. There were 2 (12.5%) cases reported with post-inflammatory hyperpigmentation in the CO₂ laser group and zero cases in the microfractional radiofrequency group.

Autologous platelet-rich fibrin (PRF) therapy is beneficial in the treatment of nonhealing ulcers. We present a case series of nonhealing, trophic ulcers with underlying leprous neuropathy, treated successfully with PRF therapy. It was a prospective study, conducted in a tertiary care hospital in the western Maharashtra, India between April 2021 and March 2022. A total of 11 patients with 18 nonhealing trophic ulcers were included in the study and consisted of 8 men and 3 women. The patient's median age was 41 years (range, 33-68), the median size of the ulcers was 4 cm² (range: 1-12 cm²), the median duration of ulcers was 20 weeks (16-30 weeks), and time to heal after starting treatment was 4 weeks (range: 1-8 weeks). PRF is an easy-to-use, simple, safe, effective, and economical treatment for the management of trophic ulcers.

Objectives: To evaluate the cosmetic result of nasal of an elliptical excision and primary closure on small nasal defect by using Scar assessment using the Stony Brook Scar Evaluation Scale (SBSES) score.

Material and methods: This retrospective interventional study was conducted in a private clinic over a 2-year duration. Patients aged 18-60 years with nasal defects <1.5 cm were enrolled after obtaining informed consent. Exclusion criteria included immunocompromised status, keloidal tendency, local site infection, bleeding disorder, age <18 years, and lack of consent. Scar assessment using the SBSES was performed at the end of 6 months. Statistical analysis included summary statistics, analysis of variance tests, and a significance level of P < 0.05.

Results: The study included 50 patients, with 54% males and 46% females. The most common age group was 21-40 years, and melanocytic nevi was the most common cause for excision. Lesions were excised mainly from the lateral wall and dorsum of the nose. The mean SBSES score was 3.79 ± 0.467. The best cosmetic outcome was observed in lesions involving the dorsum followed by the root of the nose. No significant difference was found among the SBSES scores for various subunits.

Conclusion: Elliptical excision with primary closure is a simple and effective technique for small nasal defects, providing good cosmetic results. The location of the nasal defect influences the cosmetic outcome, with better results observed in areas with thinner skin and increased skin laxity.

Fractional microneedle radiofrequency (RF) is a novel device that is gaining popularity in the treatment of many esthetic and dermatological conditions. The encouraging effectiveness and side-effect profile, along with little or no recovery time makes it an attractive therapeutic option. The device allows non-thermal penetration of microneedles into the dermis followed by RF-induced coagulation. The aim of this article is to provide a thorough understanding of the working principle and physics of this technology so that the clinicians can modulate its various parameters for effective treatment of a variety of dermatological conditions in all skin types. Methods used for locating, selecting, extracting, and synthesizing data include usage of key words such as microneedling, fractional, and RF using multiple search engines such as PubMed and Google search. Multiple articles were surveyed and finally, 30 articles including a few chapters from the textbook were refined into our search. This article is an attempt to simplify the physics of fractional microneedling RF.

Background: Keloids are less responsive to any single treatment modality; hence, there is a need for combination therapy that can yield satisfactory outcomes.

Objective: The present study assessed efficacy and safety of combination therapy-surgical excision or cryotherapy and intralesional corticosteroids along with 5-fluorouracil [IL (S + 5-FU)] injection, followed by silicone gel sheet (SGS) under compression therapy in the treatment of keloids.

Materials and methods: This was a retrospective, observational study comprising 21 clinically diagnosed keloid patients. All patients were treated with the stated combination therapy. Data about demographic, lesions, procedural characteristics, and treatment outcomes were reported.

Results: Of 21, 11 (52.4%) patients were treated with liquid nitrogen (LN₂) cryotherapy, and 10 (47.6%) patients were treated with surgical excision. Mean age was 30.8 ± 7.6 (range: 14-44) years with slight male (52.4%) predominance. A mean surface area of keloid lesion was 96.8 ± 170.5 cm³. The most frequently involved site was auricle (8 [38.1%] patients). Patients received the following types of treatments: intralesional LN₂ cryotherapy (6 [28.6%]), intralesional excisional surgery (6 [28.6%]), surface LN₂ cryotherapy (5 [23.8%]), and extralesional excisional surgery (4 [19.0%]). Complications of recurrence (2 [9.5%]), secondary infections (2 [9.5%]), persistent postinflammatory hypopigmentation (1 [4.8%]), and atrophic scarring with postinflammatory hyperpigmentation (1 [4.8%]) were reported. After a study period of 2.5 years, 100% cure rate was achieved.

Conclusion: Combination therapy of surgical excision or cryotherapy and IL (S + 5-FU), followed by SGS under compression, was safe and effective in treating keloids.

Tessier No. 7 cleft is the most common atypical craniofacial cleft with an incidence of 1:3000-5642 births. This clinical report describes the successful management of a delayed, unusually hypopigmented postoperative facial scar following the surgical closure of a Tessier 7 cleft using the Pfeiffer wave line incision. In the absence of any other associated systemic lesions, the scar was treated as a localized leucoderma. The scar coloration improved dramatically with the chosen line of conservative medical treatment, and a surgical revision was not required. This report highlights the need for continuous follow up despite seemingly good short-term results. The medical management of the hypopigmented scar will aid fellow practitioners who may face similar dilemmas.