Topical therapy is an expanding field not only in dermatology but also in other fields of medicine. An expanding list of systemic medications have been applied topically in several dermatologic conditions. Drugs applied topically have the advantage of fewer side effects, and bypassing the first-pass effect. Also, painless drug delivery which is especially encouraging in children, makes transdermal drug delivery even more appealing.
{"title":"Laser microporation: A promising field in transdermal drug delivery","authors":"Mozhdeh Sepaskhah","doi":"10.18282/JSD.V2.IT1.139","DOIUrl":"https://doi.org/10.18282/JSD.V2.IT1.139","url":null,"abstract":"Topical therapy is an expanding field not only in dermatology but also in other fields of medicine. An expanding list of systemic medications have been applied topically in several dermatologic conditions. Drugs applied topically have the advantage of fewer side effects, and bypassing the first-pass effect. Also, painless drug delivery which is especially encouraging in children, makes transdermal drug delivery even more appealing. ","PeriodicalId":213687,"journal":{"name":"Journal of Surgical Dermatology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125816342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Basal cell carcinoma (BCC) is the most common type of human malignancy. It is a slow-growing skin cancer with little ability to metastasize, but it is aggressive and can cause local tissue destruction. Descriptions of Basal Cell Nevus Syndrome (BCNS), characterized by a predisposition to the formation of BCC and other neoplasms, and identification of the genetic defect in this syndrome, has led to significant advancement in our understanding of the pathogenesis of BCC. Unregulated expression of target genes in the sonic Hedgehog (SHH) signaling pathway plays a prominent role in the pathogenesis of BCC. An understanding of the signaling components has allowed for the development of pharmacologic agents that inhibit the SHH pathway. The first inhibitor of the SHH pathway approved by the Food and Drug Administration (FDA) for the treatment of BCC is vismodegib. In this review, we will discuss the biochemical pathways involved in BCC as targets of novel pharmacologic therapies.
{"title":"Biochemical pathways and targeted therapies in basal cell carcinoma: A systematic review","authors":"B. Tran, Tiffany Alexander, A. Somani","doi":"10.18282/JSD.V2.I1.64","DOIUrl":"https://doi.org/10.18282/JSD.V2.I1.64","url":null,"abstract":"Basal cell carcinoma (BCC) is the most common type of human malignancy. It is a slow-growing skin cancer with little ability to metastasize, but it is aggressive and can cause local tissue destruction. Descriptions of Basal Cell Nevus Syndrome (BCNS), characterized by a predisposition to the formation of BCC and other neoplasms, and identification of the genetic defect in this syndrome, has led to significant advancement in our understanding of the pathogenesis of BCC. Unregulated expression of target genes in the sonic Hedgehog (SHH) signaling pathway plays a prominent role in the pathogenesis of BCC. An understanding of the signaling components has allowed for the development of pharmacologic agents that inhibit the SHH pathway. The first inhibitor of the SHH pathway approved by the Food and Drug Administration (FDA) for the treatment of BCC is vismodegib. In this review, we will discuss the biochemical pathways involved in BCC as targets of novel pharmacologic therapies.","PeriodicalId":213687,"journal":{"name":"Journal of Surgical Dermatology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128255916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Cunha, F. Rezende, Ana Lúcia Gonzaga da Cunha, C. M. Filho
Necrobiosis Lipoidica (NL) is a chronic degenerative disease of the collagen with higher incidence on the anterior part of lower extremities, especially the tibial area. There were a number of proposed treatments, but none is 100% effective. We present a case of a fifty-year-old female patient with a suspected diagnosis of necrobiosis lipoidica, confirmed by histopathological examination. After two years of treatment with topical corticosteroids and weekly applications of Psoralen and ultraviolet A radiation (PUVA), there were no signs of improvement and we decided to perform a treatment with intense pulsed light therapy. Over a period of 14 months, a total of 13 sessions were carried out and a satisfactory treatment result was obtained.
{"title":"Necrobiosis lipoidica treated with intense pulsed light","authors":"M. Cunha, F. Rezende, Ana Lúcia Gonzaga da Cunha, C. M. Filho","doi":"10.18282/JSD.V2.I1.65","DOIUrl":"https://doi.org/10.18282/JSD.V2.I1.65","url":null,"abstract":"Necrobiosis Lipoidica (NL) is a chronic degenerative disease of the collagen with higher incidence on the anterior part of lower extremities, especially the tibial area. There were a number of proposed treatments, but none is 100% effective. We present a case of a fifty-year-old female patient with a suspected diagnosis of necrobiosis lipoidica, confirmed by histopathological examination. After two years of treatment with topical corticosteroids and weekly applications of Psoralen and ultraviolet A radiation (PUVA), there were no signs of improvement and we decided to perform a treatment with intense pulsed light therapy. Over a period of 14 months, a total of 13 sessions were carried out and a satisfactory treatment result was obtained.","PeriodicalId":213687,"journal":{"name":"Journal of Surgical Dermatology","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132004042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felipe Ladeira de Oliveira, L. Silveira, T. Moraes, Fernanda Helena Craide, Maria Cristina Mejia Briceño, B. K. Kac
Cutaneous metastasis may correspond to the initial clinical presentation of hidden internal malignancies. In patients presenting said neoplasia, clinical manifestations of breast cancer reaches 23.9%. Considering that neoplastic alopecia appears as an unusual pattern of the said metastasis, this report describes a case of such uncommon neoplastic alopecia which presents itself as a cutaneous metastasis of rapid progression in a patient with prior breast cancer history. We present a 47-year-old female patient reporting lesions at the scalp, and who was asymptomatic with a 1-year evolution. The patient reported prior breast cancer history and presence of lung metastasis, and was undergoing chemotherapy at the time of consultation. A dermatological evaluation showed only a nodular lesion with erythematous surface and a diameter measuring about 4 cm, firm in consistency, and immovable. She was routed to the Department of Dermatological Surgery, and the results from histopathology were consistent with a diagnosis of metastatic breast adenocarcinoma. Neoplastic alopecia appears as an unusual form of cutaneous metastasis which is predominantly described in association with breast cancer. The lesion’s clinical features play a crucial role at the differential diagnosis, as the presence of erythema could distinguish neoplastic alopecia from alopecia areata. The existence of cutaneous metastasis leads to unfavorable outcomes. As a conclusion, cutaneous evaluation of patients is essential for treating visceral metastases, since the forms of cutaneous metastasis are diverse and can also affect the scalp.
{"title":"Alopecia neoplastica: An uncommon presentation of metastatic breast carcinoma","authors":"Felipe Ladeira de Oliveira, L. Silveira, T. Moraes, Fernanda Helena Craide, Maria Cristina Mejia Briceño, B. K. Kac","doi":"10.18282/JSD.V2.I1.77","DOIUrl":"https://doi.org/10.18282/JSD.V2.I1.77","url":null,"abstract":"Cutaneous metastasis may correspond to the initial clinical presentation of hidden internal malignancies. In patients presenting said neoplasia, clinical manifestations of breast cancer reaches 23.9%. Considering that neoplastic alopecia appears as an unusual pattern of the said metastasis, this report describes a case of such uncommon neoplastic alopecia which presents itself as a cutaneous metastasis of rapid progression in a patient with prior breast cancer history. We present a 47-year-old female patient reporting lesions at the scalp, and who was asymptomatic with a 1-year evolution. The patient reported prior breast cancer history and presence of lung metastasis, and was undergoing chemotherapy at the time of consultation. A dermatological evaluation showed only a nodular lesion with erythematous surface and a diameter measuring about 4 cm, firm in consistency, and immovable. She was routed to the Department of Dermatological Surgery, and the results from histopathology were consistent with a diagnosis of metastatic breast adenocarcinoma. Neoplastic alopecia appears as an unusual form of cutaneous metastasis which is predominantly described in association with breast cancer. The lesion’s clinical features play a crucial role at the differential diagnosis, as the presence of erythema could distinguish neoplastic alopecia from alopecia areata. The existence of cutaneous metastasis leads to unfavorable outcomes. As a conclusion, cutaneous evaluation of patients is essential for treating visceral metastases, since the forms of cutaneous metastasis are diverse and can also affect the scalp.","PeriodicalId":213687,"journal":{"name":"Journal of Surgical Dermatology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123332304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Signs of an aging face beginning at the periorbital region are easily noticeable and may require surgical correction. The hanging of upper eyelids, tired look, and sunken upper eyelids are common symptoms and signs. Most of the described techniques of blepharoplasty for the aging emphasize on the excision of the hanging eyelid skin which will leave patients with long scar. However, eyebrow and eyelid ptosis are common among aging people. Therefore, undertaking only an upper blepharoplasty does not necessarily yield good aesthetic results. This paper describes a modified blepharoplasty technique with limited incision. The operation also includes eyebrow reposition and/or correction of eyelid ptosis that further improve results. An asymmetry of the frontalis muscle could cause asymmetry in the eyelid folds post-operatively. However, botulinum toxin injection may correct this problem.
{"title":"Refinement in Asian blepharoplasty for the aging","authors":"A. Chuangsuwanich","doi":"10.18282/JSD.V1.I3.14","DOIUrl":"https://doi.org/10.18282/JSD.V1.I3.14","url":null,"abstract":"Signs of an aging face beginning at the periorbital region are easily noticeable and may require surgical correction. The hanging of upper eyelids, tired look, and sunken upper eyelids are common symptoms and signs. Most of the described techniques of blepharoplasty for the aging emphasize on the excision of the hanging eyelid skin which will leave patients with long scar. However, eyebrow and eyelid ptosis are common among aging people. Therefore, undertaking only an upper blepharoplasty does not necessarily yield good aesthetic results. This paper describes a modified blepharoplasty technique with limited incision. The operation also includes eyebrow reposition and/or correction of eyelid ptosis that further improve results. An asymmetry of the frontalis muscle could cause asymmetry in the eyelid folds post-operatively. However, botulinum toxin injection may correct this problem.","PeriodicalId":213687,"journal":{"name":"Journal of Surgical Dermatology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124425049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skin hyperpigmentation involves a broad range of skin conditions, including epidermal pigmented lesions, dermal pigmented lesions, and mixed pigmented lesions. Treatment includes various modalities such as brightening cream, chemical peeling, and laser therapy. Responses to various treatment modalities can be quite varied depending on the type of treatment and the degree of pigmentation. Sometimes a lesion can lighten or even partially disappear, while other lesions may recur. This paper provides a brief overview of treatment modalities available for hyperpigmented skin lesions including the importance of photoprotection, various types of brightening creams, suitable types of chemical peels, specific laser therapies targeted for skin hyperpigmentation, and surgery.
{"title":"Treatment modalities for hyperpigmented skin lesions: A brief overview","authors":"Y. Khoo, A. Halim","doi":"10.18282/JSD.V1.I2.35","DOIUrl":"https://doi.org/10.18282/JSD.V1.I2.35","url":null,"abstract":"Skin hyperpigmentation involves a broad range of skin conditions, including epidermal pigmented lesions, dermal pigmented lesions, and mixed pigmented lesions. Treatment includes various modalities such as brightening cream, chemical peeling, and laser therapy. Responses to various treatment modalities can be quite varied depending on the type of treatment and the degree of pigmentation. Sometimes a lesion can lighten or even partially disappear, while other lesions may recur. This paper provides a brief overview of treatment modalities available for hyperpigmented skin lesions including the importance of photoprotection, various types of brightening creams, suitable types of chemical peels, specific laser therapies targeted for skin hyperpigmentation, and surgery.","PeriodicalId":213687,"journal":{"name":"Journal of Surgical Dermatology","volume":"168 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116669039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Tran, T. Huynh, F. M. Bruins, Najeah Ahmad, W. Budris, Alba L. Posligua, J. Hammel, B. Nardone, D. West
Chlorhexidine gluconate (CHG) is a widely used antiseptic agent for skin and wound disinfection. The cationic properties of CHG may allow its inactivation and precipitation by anionic agents in commonly used topical agents. We conducted a systematic review by searching through PubMed, Cochrane Library, and Web of Science databases and selected original research articles reporting on CHG incompatibility, defined as inactivation or precipitation. The search yielded 22 publications that demonstrated CHG incompatibility via: 1) reduced antibacterial activity (carbomer, acrylates/C10-C30 alkyl acrylate crosspolymer, dentin, bovine serum albumin, copolymer M239144, sodium lauryl sulfate, heat-killed microbes, triethanolamine, and bark cork); and 2) visible precipitate formation (sodium hypochlorite, EDTA, saline, ethanol, andnystatin). Only three publications reported on CHG incompatibility in dermatology, specifically for carbomer, triethanolamine, and acrylates/C10-C30 alkyl acrylate crosspolymer. Although limited evidence linking CHG incompatibility and anionic agents exists, clinicians should carefully consider the nature of topical agents used if CHG is concurrently applied. Increased awareness of CHG incompatibility may result in better antibacterial activity thus ensuring optimal patient management.
葡萄糖酸氯己定(CHG)是一种广泛应用于皮肤和伤口消毒的防腐剂。CHG的阳离子性质可能允许其在常用的外用剂中被阴离子剂失活和沉淀。我们通过检索PubMed、Cochrane Library和Web of Science数据库和精选的报告CHG不相容(定义为失活或沉淀)的原创研究文章进行了系统综述。研究结果显示，22篇论文通过以下途径证明了CHG的不相容性:1)抗菌活性降低(卡波姆、丙烯酸酯/C10-C30烷基丙烯酸酯交聚物、牙本质、牛血清白蛋白、共聚物M239144、十二烷基硫酸钠、热杀微生物、三乙醇胺和树皮软木);2)可见沉淀物的形成(次氯酸钠、EDTA、生理盐水、乙醇和制霉菌素)。只有三篇出版物报道了皮肤病学中CHG的不相容性，特别是卡波姆、三乙醇胺和丙烯酸酯/C10-C30烷基丙烯酸酯交聚物。虽然有有限的证据表明CHG不相容与阴离子药物有关，但如果同时使用CHG，临床医生应仔细考虑所使用的局部药物的性质。提高对CHG不相容的认识可能会导致更好的抗菌活性，从而确保最佳的患者管理。
{"title":"Evidence of incompatibility for topical anionic agents used in conjunction with chlorhexidine gluconate: A systematic review","authors":"G. Tran, T. Huynh, F. M. Bruins, Najeah Ahmad, W. Budris, Alba L. Posligua, J. Hammel, B. Nardone, D. West","doi":"10.18282/JSD.V1.I2.21","DOIUrl":"https://doi.org/10.18282/JSD.V1.I2.21","url":null,"abstract":"Chlorhexidine gluconate (CHG) is a widely used antiseptic agent for skin and wound disinfection. The cationic properties of CHG may allow its inactivation and precipitation by anionic agents in commonly used topical agents. We conducted a systematic review by searching through PubMed, Cochrane Library, and Web of Science databases and selected original research articles reporting on CHG incompatibility, defined as inactivation or precipitation. The search yielded 22 publications that demonstrated CHG incompatibility via: 1) reduced antibacterial activity (carbomer, acrylates/C10-C30 alkyl acrylate crosspolymer, dentin, bovine serum albumin, copolymer M239144, sodium lauryl sulfate, heat-killed microbes, triethanolamine, and bark cork); and 2) visible precipitate formation (sodium hypochlorite, EDTA, saline, ethanol, andnystatin). Only three publications reported on CHG incompatibility in dermatology, specifically for carbomer, triethanolamine, and acrylates/C10-C30 alkyl acrylate crosspolymer. Although limited evidence linking CHG incompatibility and anionic agents exists, clinicians should carefully consider the nature of topical agents used if CHG is concurrently applied. Increased awareness of CHG incompatibility may result in better antibacterial activity thus ensuring optimal patient management.","PeriodicalId":213687,"journal":{"name":"Journal of Surgical Dermatology","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134164012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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