Mohapatra DP, Friji MT, Dinesh Kumar S
… +3 more, Chittoria RK, Pathan I, Koliath S
J Cutan Aesthet Surg
· 2023 · PMID 37383975
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INTRODUCTION: Basal cell carcinoma (BCC) is a locally invasive, slowly spreading tumor arising in the basal layer of epidermis and rarely metastasizes. Surgical excision with adequate margins is curative. Reconstruction...INTRODUCTION: Basal cell carcinoma (BCC) is a locally invasive, slowly spreading tumor arising in the basal layer of epidermis and rarely metastasizes. Surgical excision with adequate margins is curative. Reconstruction of post-excisional defects on the face is both essential and challenging. CLINICAL CASES AND METHODS: A retrospective review of hospital records for patients operated for BCC of the face excluding the pinna at our institute in the last 3 years was done and a review of the literature was carried out to identify the most common principles governing the optimal reconstruction of post-excisional defects on the face. Literature search was made in Embase, Medline, and Cochrane databases in the last two decades with the filters placed for human and English language studies with the search terms (Facial Basal cell carcinoma) AND reconstruction AND (Humans[Mesh]). RESULTS: Records of 32 patients with facial BCC who underwent excision and reconstruction at our hospital were identified and details were recorded. Our literature search with the terms and filters mentioned above revealed 244 studies with duplicates removed. After further hand-searching, 218 journal articles were identified, reviewed, and a reconstruction algorithm was designed based on the findings. DISCUSSION: Reconstruction of post-BCC excisional defects of the face relies on an adequate understanding of the general principles of reconstruction, subunit principle of facial esthetics, flap anatomy and vascularity as well as operator experience. Complex defects need innovative solutions, multidisciplinary approaches, and newer methods of reconstruction like perforator flaps and newer techniques like supermicrosurgery. CONCLUSION: Multiple reconstructive options for post-excisional defects of the BCC over the face are available and most defects can be approached in an algorithmic manner. Further well-designed prospective research studies are needed to compare outcomes of different reconstructive options for a given defect and identify the most suitable options.
J Cutan Aesthet Surg
· 2023 · PMID 37383974
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Silicones aka siloxanes are synthetic compounds, which contain siloxane bonds, i.e., the repeat unit -Si-O- with organic side groups such as methyl, ethyl, propyl, phenyl, fluoroalkyl, aminoalkyl, hydroxy, mercapto, hydr...Silicones aka siloxanes are synthetic compounds, which contain siloxane bonds, i.e., the repeat unit -Si-O- with organic side groups such as methyl, ethyl, propyl, phenyl, fluoroalkyl, aminoalkyl, hydroxy, mercapto, hydrogen, and vinyl attached to the silicon atoms. They have ability to create short, long, or complex organosilicone oligomer and polymer particles. The siloxane bond in silicone is very strong and highly stable with nontoxic, noncarcinogenic, and hypoallergic properties. Silicone compounds have become one of the key ingredients in various skin care products namely moisturizers, sunscreen, color cosmetics, hair shampoos, etc. This review focuses on an update on various indications of silicone in dermatology. For this review, the literature search was conducted using keywords such as silicone and role of silicone.
J Cutan Aesthet Surg
· 2023 · PMID 37383973
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The use of face mask is essential in COVID-19 era. During this period for cosmetic procedure on the face, the mask should be of small size and easily procured to maximize the exposure of the face especially in girls goin...The use of face mask is essential in COVID-19 era. During this period for cosmetic procedure on the face, the mask should be of small size and easily procured to maximize the exposure of the face especially in girls going to get married having hirsutism. For this purpose, the surgical mask is customized to get a small face mask.
Vijayvergiya G, Panwar H, Santosh T
… +4 more, Patra S, Joshi D, Asati DP, Kapoor N
J Cutan Aesthet Surg
· 2023 · PMID 37383972
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Fine needle aspiration cytology is a simple, safe, and effective technique that can be used in the diagnosis of cutaneous diseases. Here, we present a case of Hansen's disease with an erythematous dermal nodule mimicking...Fine needle aspiration cytology is a simple, safe, and effective technique that can be used in the diagnosis of cutaneous diseases. Here, we present a case of Hansen's disease with an erythematous dermal nodule mimicking xanthogranuloma clinically. In our scenario, since leprosy is considered eliminated in India, the presentation of patients with classical signs and symptoms is becoming rare. Atypical manifestation of leprosy is increasing day by day, so it is necessary to have a high suspicion of leprosy in every case.
J Cutan Aesthet Surg
· 2023 · PMID 37383971
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Pyogenic granuloma is a benign vascular tumor, with a tendency to bleed on manipulation. A young female presented to us with a disfiguring facial pyogenic granuloma. We adopted a novel approach using pressure therapy to...Pyogenic granuloma is a benign vascular tumor, with a tendency to bleed on manipulation. A young female presented to us with a disfiguring facial pyogenic granuloma. We adopted a novel approach using pressure therapy to treat the same. The use of an elastic adhesive bandage reduced the size and vascularity of the lesion, following which laser ablation was done with minimal bleeding and scarring. This is a simple, inexpensive method to approach large and disfiguring pyogenic granulomas.
Bhat YJ, Rehman F, Hassan I
… +9 more, Krishan K, Daing A, Yaseen A, Jeelani S, Akhtar S, Bashir S, Zareek S, Devi R, Nabi N
J Cutan Aesthet Surg
· 2023 · PMID 37383970
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BACKGROUND: Acne is very common among adolescents, which may sometimes persist into adulthood, and acne scars continue to have a profoundly negative impact on quality of life. Of all the various modalities available, fra...BACKGROUND: Acne is very common among adolescents, which may sometimes persist into adulthood, and acne scars continue to have a profoundly negative impact on quality of life. Of all the various modalities available, fractional lasers have shown effective results. AIMS AND OBJECTIVES: The aim of this study was to assess the efficacy and safety of fractional carbon dioxide (CO) laser resurfacing in atrophic facial acne scars. MATERIALS AND METHODS: The study included 104 subjects aged ≥18 years with atrophic acne scars on face of more than 6 months of duration recruited over a period of 1 year. All the patients were treated with fractional CO laser (600 W power and wavelength 10,600 nm). Four sessions of fractional CO laser resurfacing were done at 6-week intervals in each patient. We compared the improvement rate of scars after every session at 6-week interval, 2 weeks after the last session, and finally 6 months after the last laser session. RESULTS: The difference between the mean baseline score (3.43) and mean final score (1.83) using Goodman and Baron's qualitative scar scale was found to be statistically significant ( = 0.001). Mean improvement increased from first treatment session to the end of the treatment course from 0.56 to 1.62 indicating the role of the number of sessions in the overall improvement of acne scars. With regard to overall satisfaction, maximum number of patients were either very satisfied (55.8%) or satisfied (25%) as compared to those who were only slightly satisfied (11.5%) or completely unsatisfied (7.7%). CONCLUSION: Fractional ablative laser gives excellent results in the management of acne scars and has emerged as an appealing non-invasive option for this indication. Being a safe and effective option for atrophic acne scar treatment, it can be recommended wherever available.
Sulamanidze M, Sulamanidze G, Sulamanidze K
… +1 more, Tsivtsivadze M
J Cutan Aesthet Surg
· 2023 · PMID 37383969
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The periocular area is one of the initial parts of the face that show signs of aging, where patients usually worry about the visual manifestations of aging, such as the sunken lower eyelid. The condition is usually cause...The periocular area is one of the initial parts of the face that show signs of aging, where patients usually worry about the visual manifestations of aging, such as the sunken lower eyelid. The condition is usually caused by iatrogenic factors or involutional changes in the periocular area. This study aimed to develop and improve surgical methods to fill the sunken lower eyelids and examine their efficacy and safety. This study included 26 patients who had been treated with the musculofascial flap transposition method from the upper to the lower eyelid, under the posterior lamella. In the presented method, a deepithelized triangular musculofascial flap with a lateral feeding pedicle was transposed from the upper eyelid to the lower eyelid tear through depression. In all patients, the method achieved either a complete or a partial elimination of the defect. The proposed method to fill a defect of soft tissues in the arcus marginalis can be considered useful if upper blepharoplasty has not been performed previously and the orbicular muscle has been preserved.
Queirós C, Garrido PM, Fraga A
… +2 more, Maia-Silva J, Filipe P
J Cutan Aesthet Surg
· 2022 · PMID 37035605
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Despite being an integral part of dermatologic surgery, nail surgery is infrequently performed in daily practice. Indeed, it is frequently considered difficult, time-consuming, and the results take a long time to be obse...Despite being an integral part of dermatologic surgery, nail surgery is infrequently performed in daily practice. Indeed, it is frequently considered difficult, time-consuming, and the results take a long time to be observed. Nonetheless, nail pathology is a frequent cause of dermatology consultation, so dermatologists should be familiar with its diagnosis and therapeutic approach, which often involves surgical procedures. This article provides a review of nail surgery, focusing on the anatomy of this region, anesthesia of the ungual apparatus, common surgical techniques, reconstruction of defects in these locations, and a general approach to the most frequently encountered conditions in clinical practice.
J Cutan Aesthet Surg
· 2022 · PMID 37035604
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Vitiligo is a common autoimmune depigmentary disorder seen among Indian patients. It has a significant impact on the self-esteem of the patient. Specific sites including acral areas, joints, and lips are usually resistan...Vitiligo is a common autoimmune depigmentary disorder seen among Indian patients. It has a significant impact on the self-esteem of the patient. Specific sites including acral areas, joints, and lips are usually resistant to medical therapy and thus transfer of melanocytes is mandatory for the treatment. Vitiligo at the angle of lips is distinct from the vitiligo on other sites, with respect to response to therapy, lack of hair follicles, and high mobility of the area. Our aim was to review the various therapeutic modalities available for the treatment of vitiligo at this site. In our narrative review, we searched databases including PubMed, Google Scholar, and EBSCO with a full strategic search with keywords "Vitiligo," "leucoderma," "mucosal vitiligo," "lips," "labial," "angle of lips," "Minipunch grafting," "Suction Blister epidermal Grafting," "SBEG," "Micropigmentation," "tattooing," and "Excision" from 2005 to 2021. The relevant articles were extracted and included in the review. Various modalities including suction blister grafting, miniature punch grafting, split-thickness grafting, and micropigmentation have been reviewed with their advantages and disadvantages. Various potential modalities of therapy have also been proposed in the review.
J Cutan Aesthet Surg
· 2022 · PMID 37035599
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Chalazion clamp has a distal tip with a flat oval plate; other side has a ring-like structure and forceps-like handle. Handle has a thumbscrew, which can be tightened and released so as to achieve the required pressure....Chalazion clamp has a distal tip with a flat oval plate; other side has a ring-like structure and forceps-like handle. Handle has a thumbscrew, which can be tightened and released so as to achieve the required pressure. Available in various sizes. Used mainly in ophthalmological procedures primarily. Used in dermatology by modifying its technique and creating an adequate hemostasis in various diagnostic and interventional procedures. In the previous article chalazion clamp was used for preparing SSS for ear lobule, so this article revisited the uses of chalazion clamp in dermatology and extended use in the preparation of adequate blanching while preparing SSS from the peripheral tissue site.
J Cutan Aesthet Surg
· 2022 · PMID 37035598
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Augmentation mammoplasty refers to "top surgery" for transfemale patients. Before this surgery, due to the hormonal treatment being taken, it may be encountered that there would be a glandular tissue of breast that seems...Augmentation mammoplasty refers to "top surgery" for transfemale patients. Before this surgery, due to the hormonal treatment being taken, it may be encountered that there would be a glandular tissue of breast that seems to be similar to the simple tuberous breast disease, which is one of the diseases in female breast development. The presence of areolar protuberance in transfemale would of course undermine the cosmetic gain after augmentation mammoplasty operation. This situation, which can be difficult to diagnose before surgery especially in transfemale patients, will manifest itself clearly after the end of augmentation mammoplasty. As a precaution, resection of a part of glandular tissue equal to the protruding height of the areola from the posterior wall of the gland is an effective method both in terms of its simple applicability and not to use of an extra skin incision while performing augmentation mammoplasty.
J Cutan Aesthet Surg
· 2022 · PMID 37035597
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BACKGROUND: Melasma is a common disorder of hyperpigmentation mainly affecting the face. It is difficult to treat and is a cause for great cosmetic concern for the patient. So, we did this research to compare the therape...BACKGROUND: Melasma is a common disorder of hyperpigmentation mainly affecting the face. It is difficult to treat and is a cause for great cosmetic concern for the patient. So, we did this research to compare the therapeutic efficacy of tranexamic acid (TXA) through oral route versus its transepidermal administration with a dermaroller in melasma. MATERIALS AND METHODS: This was a hospital-based, interventional study carried over a span of 1 year on 40 patients with facial melasma. The enrolled patients were randomly divided into 2 groups of 20 patients each. Group A patients received oral tablet TXA in a dose of 250 mg twice daily for 12 weeks and Group B patients were given TXA solution transepidermally into the melasma lesions using a dermaroller at 2 weekly interval for 12 weeks. Thereafter, all patients were followed up for improvement in Melasma Area and Severity Index (MASI) score, adverse effects and relapse at 4 weekly intervals till 24 weeks. All the patients were evaluated for therapeutic outcome both objectively (by MASI) and photographically at 4, 8, 12, 18, and 24 weeks. Grading of improvement was done by assessing percentage reduction in MASI score. RESULTS: Majority of the patients, 24 (60%) in our study had centrofacial pattern of melasma followed by malar pattern seen in 16 (40%) patients. The baseline MASI score was 11.98 (± 5.47) in Group A and 12.13 (± 3.16) in Group B. The mean MASI score in Group A at the end of 4, 8, 12, 18, and 24 weeks was 9.75 (±4.83), 6.09 (±3.64), 4.21 (±2.48), 2.56 (±1.95), and 3.10 (±3.38) while these values were 9.73 (±3.32), 6.06 (±2.75), 4.55 (±1.89), 2.94 (±1.36), and 3.09 (±1.32) for Group B. At the end of 24 weeks follow-up period, good (51%-75% improvement) and very good (>75% improvement) response occurred in 5 (25%) and 14 (70%) patients in Group A and 11 (55%) and 9 (45%) patients in Group B, respectively. However, the final reduction in MASI score was similar in both the groups. Relapse was uncommon and occurred at 24 weeks in 1 patient from Group A. LIMITATION: The major limitation was small sample size due to time limitation and long follow-up period. CONCLUSIONS: Oral and transepidermal TXA appear equally effective suggesting that the efficacy of TXA is perhaps independent of its route of administration. Oral therapy is convenient for the patient. Transepidermal therapy of TXA has the advantage of local action, hence systemic side effects are avoided, but it is slightly painful and the time period between consecutive microneedling sessions is left to the prerogative of the treating doctor, hence a proper quantification is lacking. Moreover, scheduling of maintenance sessions is necessary as melasma is prone for recurrence.
J Cutan Aesthet Surg
· 2022 · PMID 37035596
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INTRODUCTION: Epinephrine is used in field block anesthesia for cutaneous surgery to enhance the effect of lidocaine and reduce its systemic effects. It has been hypothesized that the use of epinephrine increases the ris...INTRODUCTION: Epinephrine is used in field block anesthesia for cutaneous surgery to enhance the effect of lidocaine and reduce its systemic effects. It has been hypothesized that the use of epinephrine increases the risk for postoperative hemorrhage in cutaneous surgery. CASE: An elderly male was seen in the clinic for excision of a basal cell carcinoma (BCC) in the right upper trapezius area. A field block was performed by injecting lidocaine 1% with epinephrine 1:200,000 (3 mL) circumferentially around the margins of the excision. Adequate hemostasis was achieved during the procedure and the wound was closed without complication. Approximately 45 min post-excision, the patient returned with profuse active bleeding from the wound. The sutures were removed, and an active arterial bleed was identified. The artery was tied off on the lateral side of the wound to achieve hemostasis. CONCLUSION: A wearing-off effect of epinephrine may increase the risk for postoperative hemorrhage in cutaneous surgery, wherein an intraoperative arterial nick, masked by localized vasoconstriction, is revealed by a relative postoperative vasodilation. Practitioners should be aware of this potential complication.
Chandraiah M, Siddappa H, Shenoy C
… +3 more, Ramachandra KM, Jayaram D, Chandrashekar BS
J Cutan Aesthet Surg
· 2022 · PMID 37035595
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BACKGROUND: The major goal of scar revision is to make the scar aesthetically more acceptable. The injection of botulinum toxin type A is known to help in improving the outcomes of scars by reducing the tension across th...BACKGROUND: The major goal of scar revision is to make the scar aesthetically more acceptable. The injection of botulinum toxin type A is known to help in improving the outcomes of scars by reducing the tension across the wound edges and by promoting better wound healing. OBJECTIVE: The aim of this article is to evaluate the efficacy of botulinum toxin injection following scar revision surgeries. MATERIALS AND METHODS: A prospective, comparative study involving 20 patients with post-traumatic scars over the face was conducted between July 2018 and July 2019. The patients were divided into two groups: group A underwent scar revision surgery followed by BTX injection on the day of suture removal and group B underwent scar revision surgery alone. The photographic assessment was done at the end of a 1-year follow-up, by three blind investigators based on a pre-designed scale to grade improvement. RESULTS: The average grade of improvement of group A (3.02±1.1) was significantly higher when compared with that of group B (2.1±0.8) ( = 0.001). CONCLUSION: This study demonstrates that the combination treatment of scar revision with BTX injection is very effective in producing aesthetically better scars.
Navarro R, Pino A, Martínez A
… +7 more, Garrigos E, Grau M, Gallego E, Carme A, García A, González A, Anitua E
J Cutan Aesthet Surg
· 2022 · PMID 37035594
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BACKGROUND: Lasers require several sessions to achieve significant results and may lead to adverse reactions. Platelet-rich plasma (PRP) therapy is a good adjuvant to laser therapies; however, repeated blood extractions...BACKGROUND: Lasers require several sessions to achieve significant results and may lead to adverse reactions. Platelet-rich plasma (PRP) therapy is a good adjuvant to laser therapies; however, repeated blood extractions and invasive injections are needed. A 100% autologous topical formulation based on the patient's proteins has been recently developed, known as Endoret-Serum (ES). Unlike other PRPs, ES provides a home care, storable, and topical needle-free application. OBJECTIVE: Preliminarily assess the clinical performance of a single session of the combined therapy with nonablative laser and ES in the management of cutaneous pigmented and vasculature lesions. MATERIALS AND METHODS: Nine patients with clinical signs of skin aging received a single session of nonablative laser. ES was topically applied twice daily. They were clinically assessed after 1 and 8 weeks. VISIA-CR System was used for high-resolution topographic analysis. Subjects were asked to complete a self-assessment questionnaire and an impression of improvement survey. An investigator's global assessment scale was fulfilled. RESULTS: The combined treatment improved cutaneous spots, wrinkles, and texture after 8 weeks, whereas significant pore reduction was observable at 1 week. Ultraviolet (UV) spots and porphyrins decreased at 1 week, whereas red area improvement was noticeable after 8 weeks. Overall wrinkle amelioration, periorbital hyperpigmentation decrease, softened skin, and tone recovery was observed. Patients referred to be very satisfied and felt that their cutaneous condition was much better. At the end of the study, subjects presented minimal dermatological symptoms like pigmented lesions, redness, or capillaries. No side effects were reported. CONCLUSION: Results presented herein suggest that one session of laser in combination with ES provides a good clinical outcome.