Journal of Clinical and Aesthetic Dermatology最新文献

V-to-Y advancement flap is a successful repair technique that preserves vascular and tissue integrity adopted after Mohs micrographic surgery to repair cutaneous defects on the head and neck. However, defects at the lateral distal nasal ala requires large extension beyond cosmetic margins that increase risk of skin webbing, an undesired result on a cosmetically sensitive location to the patient. In this article, we present a novel approach to modifying the procedure employing the V-to-Y advancement flap by truncated the trailing end of the island pedicle to allow for successful healing and better patient satisfaction.

In the past three decades, there has been a remarkable surge in the popularity and use of herbal medicines. However, despite their widespread use, herbal remedies remain inadequately regulated, exposing consumers to potential adverse effects. This case series examines eight patients with severe cutaneous manifestations resulting from the topical application of Nigella sativa (black cumin) oil, emphasizing the critical significance of patch testing, thorough history-taking regarding exposures and herbal supplement usage, and the necessity for enhanced regulatory measures. Additionally, it delves into various treatment modalities, offering valuable insights for clinicians managing similar cases.

This article is based on a roundtable discussion in which three panelists review clinically relevant insights about vitiligo and discuss two cases that illustrate the multiple challenges faced by both patients and clinicians in managing this complex disease. The first is a 32-year-old White female patient with Fitzpatrick Skin Type III/IV with extensive depigmentation in the trunk area. The patient achieved 90-percent repigmentation with a combination therapy approach. Treatment included systemic corticosteroids, oral antioxidants, narrowband ultraviolet B phototherapy, and topical therapy initially with tacrolimus ointment followed by topical ruxolitinib cream. Patient counseling around variable rates of progressive repigmentation over time, the significance of combining therapeutic approaches, and the importance of treatment consistency are discussed. The second case is that of a White pediatric female patient with vitiligo, who was treated from the ages of 5 to 11 years, with a break in treatment due to the patient's desire to discontinue treatment. Once treatment recommenced, the patient ultimately achieved 75-percent repigmentation within six months using a combination of narrowband ultraviolet B phototherapy, topical corticosteroids, and topical calcineurin inhibitors. The emotional burden of pediatric vitiligo for patients and their caregivers are discussed, along with joint decision making with this patient and her parents. This was followed by a discussion of the significance of the patient's anti-nuclear antibody positivity and how this affects treatment approach in patients with vitiligo.

This article explains the value and rationale behind the use of checklists. Included is a surgery checklist used successfully over many years by a highly experienced dermatologist and dermatologic surgeon. This approach is used by all clinicians and office staff in a very busy ambulatory practice that incorporates medical, cosmetic, and surgical dermatology, including Mohs micrographic surgery.

Objective: This study aims to assess the correlation between Centers for Disease Control-reported syphilis incidence rates and case burden and public interest in syphilis as indicated by Google search trends.

Methods: This study utilized Google Trends data to analyze popular syphilis-related search terms from 2013 to 2023. The latest Centers for Disease Control-reported syphilis incidence rates for 2022 were compared to Google Trends data to identify patterns or correlations.

Results: Google Trends data showed a 37.65-percent increase in average annual searches for syphilis-related terms in the United States from 2013 to 2023. The largest increase in search volume was observed from 2021 to 2022, with a 14.09 percent rise. Mississippi had the highest ten-year average for syphilis-related search terms (97.9). Arkansas, Oklahoma, Mississippi, Nevada, and Louisiana were among the top ten highest reported primary and secondary syphilis rates and were among the top ten states with the highest Google Trends search volume. Texas was the only state to be in the top ten highest Google Trend searches and among the top states with the highest reported absolute number of cases.

Limitaitons: Limitations include the inability for Google Trends analysis to provide absolute search volumes and limited transparency in its algorithm. Additionally, the study relies on data collected from internet users and may potentially exclude individuals without internet access.

Conclusion: The findings suggest that while public interest in syphilis is increasing overall, there may still exist disparities in awareness and education across different regions of the United States.

Background: Intradermal injections of highly diluted botulinic neuroprotein is a popular aesthetic medicine procedure to improve the texture of the skin, enlarged pores, and fine lines.

Objective: The authors present a case report of nine subjects who received treatment with botulinic neuroprotein combined with an amino acid cluster and low molecular weight hyaluronic acid.

Methods: Nine women between the ages of 30 to 59 years old in a stable medical condition with moderate to severe lateral cantal wrinkles and smile lines at maximum expression and were recruited. The typical exclusion criteria for botulinum neurotoxin and hyaluronic acid injections were fulfilled.

Results: No complications were observed. In all treated patients, there was clinical improvement in skin surface and texture, as well as attenuation of fine lines, with preserved natural facial mimetic activity. In two patients who were prone to rosacea, we noticed an improvement in erythema and flushing. Three patients with oily skin showed decreased oiliness and pore size.

Conclusion: The Jalu-toxin technique is a safe and efficient method for skin quality enhancement.

Giant cell tumors of tendon sheath (GCTTS), also known as synovialomas, are benign tumors that originate from the fibrous sheath, or soft tissue, that surround tendons. These tumors predominantly present on the hand, but can present in the wrist, ankle, knee, elbow, or hip. The classic presentation of GCTTS is a painless, firm, slow growing mass present for weeks to months. The pathogenesis of GCTTS remains unknown. Histopathological examination of the tumor is required to confirm the diagnosis. The preferred treatment is surgical excision with long-term follow up. To our knowledge, this is the third reported case of GCTTS originating in the subunguium and the first reported case of GCTTS in the subunguium of the toe.

Objective: Non-surgical facial aesthetics (NSFA) is a rapidly growing field involving the use of dermal fillers and botulinum toxin for aesthetic enhancement. The aesthetic injectables market is expanding, attracting interest from individuals seeking NSFA procedures. There has also been marked interest among healthcare professionals (HCPs) aspiring to become aesthetic practitioners. Conferences play a crucial role as educational platforms for HCPs venturing into NSFA. We used a national NSFA conference as an education tool for undergraduate and postgraduate healthcare students, assessing the utility of this conference in imparting knowledge on topics such as training pathways, regulations and complications in NSFA.

Methods: The FACExpo conference, held in November 2022, was organized by both qualified and aspiring aesthetic practitioners. Pre- and post-conference questionnaires were administered to attendees to evaluate their interest in facial aesthetics and their knowledge before and after the conference.

Results: A total of 68 delegates responded to the pre-and post-conference questionnaires. There was a statistically significant improvement in awareness of training pathways, regulations, and complications (p<0.0001). Only 39.71 percent of delegates were aware of the NSFA regulations before the conference, which increased to 91.18 percent in the post-conference survey. Similarly, 38.24 percent of delegates were confident in their understanding of training pathways pre-conference which increased to 97.10 percent post-conference.

Conclusion: This study demonstrates that facial aesthetic conferences can be used as an educational tool for aspiring practitioners and highlights the existing knowledge gap among current practitioners. Further research is needed to assess the overall impact of aesthetic conferences on the education of aspiring practitioners.

Objective: The authors sought to compare the results in Fitzpatrick Skin Type (FST) reporting among providers, trainees, and patients. They discussed the implications of discordance in FST reporting among these groups.

Methods: This survey-based study was offered to all adult patients (18 years or older), dermatology residents, and dermatology faculty providers at University of Oklahoma Dermatology Clinic in Oklahoma City, Oklahoma. Deidentified information from the patient survey, provider-assigned FST, and provider credentials were consolidated, and data was analyzed by a biostatistician.

Results: The provider-assigned FST was more accurate than the patient's own estimation of their own ability to tan versus burn. The patient's race played an important factor in a discrepancy between provider and patient described FST. Additionally, provider years in practice increased the odds of any discrepancy existing.

Limitations: This study was conducted at one clinic location encompassing only the immediate geographic population.

Conclusion: Despite being the most used skin tone classification system in dermatology, the FST system has many limitations. The classification system needs to be reevaluated or replaced with methods that more accurately, appropriately, and reliably describe skin tones and skin photo reactivity. Education is necessary for current trainees to avoid erroneous use of classifications such as the FST.