The Journal of dermatologic surgery and oncology最新文献

From 1987 to 1990, 21 of 648 patients with basal cell carcinomas (BCCs) had their lesion located on the leg. Basal cell carcinomas in this location are uncommon. Women outnumbered men by 1.6:1. The majority of patients had types I and II skin. Most reported residence in the southwestern United States for many years. Recreational sun exposure was extensive and dominated by activities in which exposure of the legs was common. Most lesions were recognized clinically and located on the anterior lower leg. The most frequent histologic description was superficial BCC. Treatment was with electrodesiccation and curettage or excision.

BACKGROUND. Conventional scalp reduction techniques involve the undermining of bald skin, inducing the problems of stretch-back and slot formation in the majority of patients. Conversely, extensive scalp-lifting, a relatively new technique, never undermines bald skin; therefore, the problem of stretch-back is minimal and slot formation is reduced. This procedure, however, is more intricate, owing to the undermining down to the hairline of the nape. Because not all cosmetic hair replacement surgeons desire to perform this more intricate surgery, the author takes many of the principles of scalp-lifting and applies them to the scalp reduction procedure. With the application of these principles, many of the problems of scalp reduction surgery are significantly reduced and other aesthetic aspects improved.

Dermatopathological examination of excised skin cancers serves the dual purposes of defining the nature of the malignancies and evaluating the resection margins for evidence of tumor involvement. Conventional histological techniques, including horizontal frozen sections as prescribed in Mohs micrographic surgery to evaluate resection margins, can often be tedious and not without many pitfalls. In this study, the use of a stereoscopic dissecting microscope is compared with routine microscopy in the examination of 54 skin specimens resected with the clinical diagnosis of cancer. Our results show that the dissecting microscope is more efficient and as accurate in diagnosing basal and squamous cell carcinomas, and in detecting tumor involvement of resection margins. The ability to visualize marginal surfaces in three dimensions allows for a thorough examination and quick localization and mapping of the involved sites. Tissue artifacts due to fixation, freezing, or sectioning are nonexistent. With the lower cost and ease of operation, we suggest that the dissecting microscope is a more superior instrument. Its usefulness in the surgical management of skin cancers should be emphasized and further validated.

Background: The infrared coagulator (IRC) is an instrument that delivers a narrow beam of noncoherent infrared light to the skin surface.

Objective: The purpose of the study was to determine the utility of the infrared coagulator in treating common warts of the hands and feet.

Methods: Forty-four warts in 21 patients were treated with 1.25-second pulse durations. Thirty-one of the warts were recurrent after previous electrosurgery or cryosurgery. Average follow-up time was 11 months.

Results: Overall, 25 warts (57%) resolved after one treatment, 6 warts (14%) regressed and cleared with additional treatment, and 13 warts (30%) recurred, giving an overall cure rate of 70%. Eleven of the 21 patients (52%) were cleared of all their treated warts.

Conclusion: The IRC is a useful therapeutic modality for common warts.