Neema S, Vendhan S, Vasudevan B
… +2 more, K L, Dakshinamurthy S
J Cutan Aesthet Surg
· 2024 · PMID 39483650
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OBJECTIVES: The objective of our study is to assess the efficacy of fractional carbon dioxide (CO2) laser-assisted drug delivery (LADD) in the management of post-burn scars. MATERIAL AND METHODS: It is a prospective stud...OBJECTIVES: The objective of our study is to assess the efficacy of fractional carbon dioxide (CO2) laser-assisted drug delivery (LADD) in the management of post-burn scars. MATERIAL AND METHODS: It is a prospective study conducted from March 2021 to February 2022, with 32 patients ranging in age from 9 to 52 years. The scars lasted anywhere from 6 months to 18 years. The ethical clearance of the Institutional Ethics Committee was obtained. The patient's median age was 22 (range, 09-52). Patients were assessed using a modified Vancouver scar scale (mVSS) score before and after receiving fractional CO2 laser at monthly intervals. RESULTS: After one treatment, statistically significant improvements in pigment, thickness, and pliability were seen according to the mVSS scores, and these improvements persisted through the final laser session. CONCLUSION: Our study has demonstrated that fractional CO2 LADD seems to be an encouraging approach in the management of post-burn scars with good patient satisfaction.
Chandra S, Mysore V, Shah S
… +2 more, Malayanur D, S R S
J Cutan Aesthet Surg
· 2024 · PMID 39483649
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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 l...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.
J Cutan Aesthet Surg
· 2024 · PMID 39483648
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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 th...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 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.
J Cutan Aesthet Surg
· 2024 · PMID 38800820
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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...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 (LN) 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 cm. The most frequently involved site was auricle (8 [38.1%] patients). Patients received the following types of treatments: intralesional LN cryotherapy (6 [28.6%]), intralesional excisional surgery (6 [28.6%]), surface LN 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.
Yadav MK, Soni P, Ghiya BC
… +5 more, Mehta RD, Arora A, Jangir VK, Khokhar R, Pareek S
J Cutan Aesthet Surg
· 2024 · PMID 38800819
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BACKGROUND: Severe post-acne scarring has been implicated as a cause of considerable psychological distress, mainly among adolescents. Subcision and microneedling are cutting-edge treatment options available nowadays. AI...BACKGROUND: Severe post-acne scarring has been implicated as a cause of considerable psychological distress, mainly among adolescents. Subcision and microneedling are cutting-edge treatment options available nowadays. AIM: In this study, we aimed to compare the efficacy of microneedling with platelet-rich plasma (PRP) against subcision with PRP in treating atrophic post-acne scars in a split-face study design. MATERIALS AND METHODS: Fifty patients with atrophic post-acne facial scars were included in this prospective interventional study. Group A included the left side of the face managed by microneedling with PRP and group B included the right side of the face that was subjected to subcision with PRP. Results were assessed based on Goodman and Baron qualitative and quantitative grading. RESULTS: In our study, at the end of the treatment, on the left side, 5 (10%) had 1 grade of improvement showing good response, 35 (70%) had 2 grades of improvement showing very good response, and 10 (20%) had 3 grades of improvement showing excellent response. On the right side, 1 (2%) patient had no improvement in acne grade showing poor response, 9 (18%) had 1 grade of improvement showing good response, 25 (50%) had 2 grades of improvement showing very good response, whereas 15 (30%) had 3 grades of improvement showing excellent response. CONCLUSION: Till date, apart from ours no other study has compared the two modalities head-to-head with adjuvant PRP in both groups. Although both modalities showed statistically significant results individually, there was no significant difference in qualitative improvement of acne scars between the two groups.
J Cutan Aesthet Surg
· 2024 · PMID 38800818
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Squamous eccrine ductal carcinoma is a rare cutaneous malignancy. It has the potential to locally recur and may occasionally metastasize. It presents a diagnostic challenge given its rare nature and overlapping histopath...Squamous eccrine ductal carcinoma is a rare cutaneous malignancy. It has the potential to locally recur and may occasionally metastasize. It presents a diagnostic challenge given its rare nature and overlapping histopathological features with other cutaneous carcinomas.
Gupta S, Jangra RS, Gupta S
… +2 more, Khatri M, Gupta N
J Cutan Aesthet Surg
· 2024 · PMID 38800817
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Venesection is common procedure performed in day to day life of every doctor. Conventional vein finders available are costly and not easily available. The present paper highlights the use of makeshift vein finder.Venesection is common procedure performed in day to day life of every doctor. Conventional vein finders available are costly and not easily available. The present paper highlights the use of makeshift vein finder.
J Cutan Aesthet Surg
· 2024 · PMID 38800816
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Alopecia areata (AA) is an autoimmune disease characterized most commonly by patchy nonscarring hair loss which may progress to alopecia totalis which has poor prognosis. Platelet-rich plasma (PRP) therapy along with int...Alopecia areata (AA) is an autoimmune disease characterized most commonly by patchy nonscarring hair loss which may progress to alopecia totalis which has poor prognosis. Platelet-rich plasma (PRP) therapy along with intralesional triamcinolone acetonide that is modified PRP proved to be beneficial in the case of alopecia totalis and helps in weaning patient off oral immunosuppression.
Gheibi N, Samiee-Rad F, Sofiabadi M
… +2 more, Mosayebi E, Shalbaf Z
J Cutan Aesthet Surg
· 2024 · PMID 38800815
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BACKGROUND: Finding new compounds to accelerate wound healing is critical today. Humic substances or fulvic acid each have anti-inflammatory properties. AIMS AND OBJECTIVES: The purpose of this study is to determine the...BACKGROUND: Finding new compounds to accelerate wound healing is critical today. Humic substances or fulvic acid each have anti-inflammatory properties. AIMS AND OBJECTIVES: The purpose of this study is to determine the effects of poultice 0.5% containing humic and fulvic acids on wound healing in male rats. MATERIALS AND METHODS: An animal model was arranged by making a full-thickness skin wound was created in each rat. Animals were randomly divided into control, sham, and treatment groups. To investigate the effect of humic and fulvic acids combining poultice, the wound area and histological analyses of the number of inflammatory cells, fibroblasts, and angiogenesis were evaluated for 21 days. RESULTS: The animals in the treated group showed higher wound healing percentage, angiogenesis, and fibroblast distribution compared with the control ( < 0.001). Moreover, the topical administration of humic and fulvic acids 0.5% poultice decreased the mean number of inflammatory cells significantly than the other groups ( < 0.001). CONCLUSION: The topical administration of a poultice containing humic and fulvic acid accelerated wound healing by increasing angiogenesis and fibroblast and reducing inflammatory cell distribution in a rat model.
Poleva I, Szomolai E, Hegedus B
… +1 more, Zhukova O
J Cutan Aesthet Surg
· 2024 · PMID 38800814
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BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination programs in Europe began in December 2020, and as the number of vaccinated people increased, more information emerged about the possible side effects of vaccine...BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination programs in Europe began in December 2020, and as the number of vaccinated people increased, more information emerged about the possible side effects of vaccines. Recently, some reports appeared around the association of adverse reactions following soft-tissue filler injections and the COVID-19 vaccines. This fact raised the concerns of esthetic practitioners regarding the possibility of the association of the COVID-19 vaccine and adverse effects in other esthetic treatments. Many of us wonder if botox injection, biostimulation, or other procedure could trigger the same or other adverse reactions after the COVID-19 vaccination. Many colleagues postpone esthetic treatments, canceling the appointments. OBJECTIVE: The objective of our investigation was to understand if any adverse reactions have been observed in the patients who underwent threads implantation before and after the vaccination. MATERIALS AND METHODS: Four medical centers have collected the data of the patients treated with absorbable threads before the vaccination and after vaccination for COVID-19. The dossiers of 190 patients with a mean age of 50.4 years were evaluated. Three questionnaires were administered 1 week, 1 month, and 3 months after thread implantation. RESULTS: There were no adverse reactions in the groups of patients under monitoring. Only one patient presented signs of inflammation and infection, but they are more probably attributable to the contamination during thread insertion. CONCLUSIONS: No patients treated with absorbable threads developed adverse events in relation to the COVID-19 vaccine. The only case of inflammation is attributable probably to the contamination of the thread during the procedure.
Bharati B, Sarkar R, Garg T
… +2 more, Goyal R, Mendiratta V
J Cutan Aesthet Surg
· 2024 · PMID 38800813
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INTRODUCTION: Acanthosis Nigricans (AN) is an acquired disorder of keratinization. It presents as hyperpigmentation, velvety texture of skin that can involve any part of the body including the face. Different topical, sy...INTRODUCTION: Acanthosis Nigricans (AN) is an acquired disorder of keratinization. It presents as hyperpigmentation, velvety texture of skin that can involve any part of the body including the face. Different topical, systemic therapies, or physical therapies including laser have been explored. However, there are not many randomized controlled studies for the majority of therapy alternatives besides lifestyle modifications and weight reduction. OBJECTIVES: The aim of this study was to compare the effectiveness of 15% trichloroacetic acid (TCA) and 35% glycolic acid (GA) peel for AN. MATERIALS AND METHODS: Forty participants were included and randomized into two groups. In groups A and B, peeling with 15% TCA and 35% GA was done, respectively. The effectiveness of each peel was assessed using changes in the Acanthosis Nigricans Area and Severity Index Score (ANASI) and Physician Assessment Score. Statistical analysis included Wilcoxon-Mann-Whitney test, Friedman test, and generalized estimating equations. RESULTS: The overall change in ANASI over time was compared in the two groups using the generalized estimating equations method. A significant difference was observed in the trend of ANASI over time between the two groups ( < 0.001). TCA peel group showed more change in ANASI as compared with GA peel group. CONCLUSION: In our research, 15% TCA has a better efficacy when compared with 35% GA peel after three sessions of chemical peeling. We therefore recommend the use of 15% TCA peel in AN as a safe and effective treatment option. However, more comprehensive randomized control studies are required for supporting data.
Choudhary S, Hayatnagarkar S, Kaur M
… +1 more, Patra S
J Cutan Aesthet Surg
· 2024 · PMID 38800812
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Non-cultured epidermal suspension technique is currently the surgical treatment of choice for vitiligo. Storage of trypsin ethylenediaminetetraacetic acid solution has a stringent requirement. We propose usage of freeze-...Non-cultured epidermal suspension technique is currently the surgical treatment of choice for vitiligo. Storage of trypsin ethylenediaminetetraacetic acid solution has a stringent requirement. We propose usage of freeze-dried trypsin for the procedure which can be kept in usual refrigerator at 2-8°C. This can help us to perform the procedure at resource poor settings.
J Cutan Aesthet Surg
· 2024 · PMID 38800811
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INTRODUCTION: Facial pigmentation is a common presentation of patients attending dermatology out patient department (OPD) and is of great concern to patients. Facial pigmentation may be multifactorial and is only rarely...INTRODUCTION: Facial pigmentation is a common presentation of patients attending dermatology out patient department (OPD) and is of great concern to patients. Facial pigmentation may be multifactorial and is only rarely diagnosed accurately by a detailed history and clinical examination. Pigmentary disorders cause psychological distress and negatively impact the quality of life of an individual. AIMS AND OBJECTIVES: (1) To study different dermoscopic patterns in facial melanosis. (2) To estimate the frequency of different dermoscopic patterns. MATERIALS AND METHODS: Patients with facial hyperpigmentation attending the dermatology OPD were recruited after taking their written consent. A detailed history was taken to collect demographic data. Clinical examination and dermoscopy were done in all patients. Biopsy was done as and when required. Descriptive statistics has been used to describe the quantitative data. Qualitative data were presented as frequency and percentage for clinical and dermoscopic patterns. RESULTS: The study included 100 patients with 15 different facial melanoses. The most common age group affected was 21-40 years in 53 (53%) cases. The female-to-male ratio was 1.63:1. Melasma was reported as the most common cause of facial melanosis constituting 49 (49%) of the total cases. Out of the total melasma cases, epidermal melasma constituted 22 (45%) cases, dermal melasma constituted four (4%) cases and mixed melasma constituted 23 (47%) cases. Other cases included were lichen planus pigmentosus (14; 14%), facial acanthosis nigricans (14; 14%), periorbital hyperpigmentation (7; 7%), post-inflammatory hyperpigmentation (4; 4%), exogenous ochronosis (2; 2%), lentigines (2; 2%), frictional melanosis (2;2%), and one case each of Becker's nevus, nevus of Ota, olanzapine-induced hyperpigmentation, Riehl's melanosis, macular amyloidosis, and tanning. CONCLUSIONS: Melasma was reported as the most common cause of facial melanosis. The most common dermoscopic feature was accentuated pseudopigment network. The study is beneficial in understanding the different clinical and dermoscopic patterns of facial melanosis, thus helping the physician to effectively manage the conditions and reduce the need of biopsy. LIMITATIONS: (1) A small sample size. (2) Histopathological correlation was not done in all cases.
Vashisht A, Krishna A, Chugh R
… +2 more, David A, Srivastava D
J Cutan Aesthet Surg
· 2024 · PMID 38800810
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CONTEXT: Scarring is a biological process of wound repair which leads to a difference in the normal structure and function of the skin and manifests as a depressed or raised area. Treatment of scars is challenging. A num...CONTEXT: Scarring is a biological process of wound repair which leads to a difference in the normal structure and function of the skin and manifests as a depressed or raised area. Treatment of scars is challenging. A number of therapeutic approaches like surgical techniques and non-surgical techniques are performed to improve scarring. AIMS AND OBJECTIVES: The aim of this study was to compare the outcome of subcision followed by microneedling versus subcision followed by microneedling and topical platelet-rich plasma (PRP) in atrophic scars. MATERIALS AND METHODS: A comparative prospective study was conducted at a tertiary care hospital in North India to compare the efficacy of subcision followed by microneedling versus subcision followed by microneedling and topical PRP. A total of 40 cases were taken and were randomly divided into two groups, A and B of 20 patients in each group. Topical PRP was applied as an additional therapy in Group B in the same sitting. Minimum three sittings were done in each patient at an interval of 4 weeks and results were assessed after 1 month of the third session. The statistical software used is Microsoft Excel and SPSS software program, version 24.0 for analysis of data and Microsoft Word to generate graphs and tables. RESULTS: Improvement in scar grading was more in Group B as compared to Group A with statistically significant difference ( 0.032). There was an improvement in scar grading from grade 4 scar to grade 2 in 15% and 30% patients of Groups A and B, respectively, with improvement in skin texture and pigmentation more in Group B. CONCLUSION: PRP proved to add to the improvement of grade of atrophic scars when combined with subcision and microneedling.
J Cutan Aesthet Surg
· 2024 · PMID 38800809
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Plane viral warts on the face can be difficult to treat at times. Various treatment approaches for facial viral warts have had variable degrees of effectiveness. In contrast, the majority of existing treatments are more...Plane viral warts on the face can be difficult to treat at times. Various treatment approaches for facial viral warts have had variable degrees of effectiveness. In contrast, the majority of existing treatments are more costly, painful, and difficult to manage. In approximately 15.6% of instances, retinoic acid (0.05%) is also ineffective. It is very difficult to cure warts on the face at a young age. In pyogenic granuloma, table salt (NaCl) is useful as a sclerosing agent, and its hypertonic solution (15%) is effective in prolabial mucoceles. The aim of treating viral warts is to necrose infected cells and sclerose or thrombose their feeding capillaries at the wart's base.
J Cutan Aesthet Surg
· 2024 · PMID 38800808
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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 fac...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.
Samiee-Rad F, Ghasemi F, Bahadoran E
… +4 more, Sofiabadi M, Shalbaf Z, Taherkhani A, Gheibi N
J Cutan Aesthet Surg
· 2024 · PMID 38800807
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BACKGROUND: Humic derivatives have antibacterial and anti-inflammatory properties. AIM: This study aimed to assess the experimental wound-healing effect of 0.5% humic acid gel. MATERIALS AND METHODS: A full-thickness ski...BACKGROUND: Humic derivatives have antibacterial and anti-inflammatory properties. AIM: This study aimed to assess the experimental wound-healing effect of 0.5% humic acid gel. MATERIALS AND METHODS: A full-thickness skin wound was created on the dorsal side of 24 Sprague Dawley male rats (220-250 g). The animals were then randomly divided into the control, sham, and experimental groups. Skin wounds were bandaged daily using sterile gauze dipped in normal saline, carboxymethylcellulose, and 0.5% humic acid for 21 days. The wound-healing rate was evaluated grossly and histologically at various time intervals post-injury. RESULTS: Wound-healing percentage was significantly higher in the gel treatment group at all time points ( < 0.05). The mean number of inflammatory cells was significantly lower in the humic acid gel group than in the other groups ( < 0.001). Moreover, the number of new vascular cells and fibroblasts were significantly increased in the humic acid gel compared to the control ( < 0.001). CONCLUSION: These data confirmed that 0.5% humic acid gel accelerates wound healing, probably by anti-inflammatory effects, as well as by promoting vascular and fibroblast proliferation. Therefore, the humic acid gel may be used to improve wound care.
J Cutan Aesthet Surg
· 2024 · PMID 38736867
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There are many instruments to prick the comedone before its extraction and scalp during hair transplantation. These instruments are not well guarded, and it can cause deep injury and fear in the patients. Here we describ...There are many instruments to prick the comedone before its extraction and scalp during hair transplantation. These instruments are not well guarded, and it can cause deep injury and fear in the patients. Here we described how to guard these needle for safety during procedure.