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Hamza Yildiz, Memet Ersan Bilgili, Hasan Aktug Simsek
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i2.178

Abstract:
The positive predictive value (PPV) of smart mobile phone teledermatoscopy is not known. The main purpose of the present study was to investigate the sensitivity and positive predictive values (PPVs) of smart mobile phone teledermatoscopy. Over a period of 6 months, up to three clinical and dermatoscopic images were obtained of 67 skin lesions from 67 patients using a mobile phone camera and standard pocket dermatoscopy device. Out of the 67 patients, 44 were men (65.67%) and 23 were women (34.32%). The mean age of the patients was 39.56 ± 22.19 years (ranging from 18 to 92). The majority of the lesions (71.64%; n=48) were benign, while 11.94% (n=8) of the biopsies were premalignant and 16.41% (n=11) of the lesions were malignant. The sensitivity for the diagnosis of benign, premalignant, and malignant lesions were 93.8%, 100%, and 100%, respectively. PPVs for the diagnosis of benign, premalignant, and malignant lesions were 93.8%, 100%, and 100%, respectively. The sensitivity and PPVs of all lesions were 95.9% and 95.7%. The accuracy of the teledermatoscopic consultation with a mobile phone is very high. We therefore think that it can be a cost effective and useful method in the consultation at distance.
Shilpi Bhadani, , Savita Arora, Vinay Kumar Tiwari, Anmol Chugh
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i2.168

Abstract:
Autologous fat transfer for correcting contour defects of face has gained wide popularity in aesthetic surgery. However, quantification of fat requirement and its survival is still a fertile area for research to improve the predictability of volume retention of injected fat. There have been no detailed studies of the calculation for the amount of fat to be injected and percentage of fat retained. The objective of this study was to quantify the amount of fat required for correcting a facial deformity and amount retained postoperatively over a period of 6 months. Thirty patients were recruited in a prospective study where in, the fat requirement for augmenting the soft tissue defect was assessed using USG preoperatively and followed up at 1, 3 and 6 months by the same technique. It was found that USG is a simple, objective, reliable, cost-effective method of assessing the fat requirement and retention in autologous fat transfer.
Saman Ahmad Nasrollahi, Mansour Nassiri Kashani, , Setareh Ameri,
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i2.170

Abstract:
Hyaluronic acid fillers are considered safe for use in cosmetics as described in the safety assessment. This study was aimed to assess and compare the efficacy and safety of two hyaluronic acid (HA) fillers on mild nasolabial folds. Ten women aged 30-50 years with mild nasolabial folds participated for injection of A and B gels into right or left nasolabial folds. The volume and surface of nasolabial folds were measured by CSI software and the density and thickness of dermis assessed by skin ultrasonography before and 2, 12, and 24 weeks after injection. The data were analyzed using SPSS software version 20, and p-value <0.05 were considered as significant. Global assessment showed over 50% improvement in patients injected with both gel A and B. At 2 weeks after injecting gel A the volume and surface of wrinkles decreased significantly. In the side injected with gel B, this reduction was significant at 2 and 12 weeks after injection. In addition, 24 weeks after injection of both gels the dermis echo-density increased and the dermis thickness decreased. This study indicated the significant positive filling effect of both HA fillers in decreasing the clinical signs of wrinkles at nasolabial folds. Comparing both fillers, there were not any statistically significant differences in any of measurements, but the persistence of gel B to improve the wrinkle appearance was slightly better than gel A.
Ravi Shankar Krishnan, Christy Badgwell, Daniel Yoshor, Ida Orengo
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i2.180

Abstract:
There is a known association between nevus of Ota and melanomas involving the brain parenchyma and/or the meninges. We present the unusual case of a 32-year-old African-American female with a nevus of Ota and a contralateral parenchymal, primary CNS melanoma. We discuss the unique features of this case and provide a brief review of the literature regarding nevi of Ota and associated CNS melanoma. Our patient is a 32 year-old, African-American female with a left-sided nevus of Ota who presented with a three month history of headaches and paresthesias involving her left face and arm. An MRI of the brain revealed a hemorrhagic mass in the right temporal lobe, which, after craniotomy, was determined to be a melanoma. Extensive imaging, ophthamologic examination and full-body skin examination revealed no other foci of melanoma. To our knowlege, this is the only case of a nevus of Ota associated with contralateral parenchymal melanoma in an African-American patient. The association of contralateral parenchymal primary CNS melanoma with nevus of Ota is extremely unusual. Futhermore, despite the association of nevus of Ota with CNS melanoma, the literature does not support routine screening of patients with nevus of Ota for CNS melanoma with imaging modalities.
Nicholas Guido, Erika L. Hagstrom, Erin Ibler, Chantelle Carneiro, Kelsey A. Orrell, Ryan C. Kelm, Alfred W. Rademaker, ,
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i2.177

Abstract:
Although some smartphone applications are designed for total body photography (TBP), few offer the specificity that enables self- as well as dermatologist-, detection of new lesions, or change in lesion color or in size as little as 1mm, on an ongoing basis. The aim of this study is to assess the sensitivity of a novel TBP application in the detection of changes to color and size of simulated skin lesions. Twenty-five subjects underwent one study visit. After baseline photography, new artificial markings were made or naturally occurring pigmented lesions located in any anatomical region were enhanced/enlarged, and a second matching set of photographs was then taken. From all 25 subjects, a total of 262 skin markings were evaluable. Of these, 241 (92%) were detected by the app, which resulted in an overall sensitivity of 92%. The high sensitivity establishes the app as capable of providing reliable self-TBP that allows detection and monitoring of new skin lesions or change in both size and color. This method greatly enhances the ability to accomplish ongoing self-monitoring and yet provides quality informing images to the dermatologist to assist in decision-making with the patient.
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i1.169

Abstract:
We report a rare case of giant plexiform neurofibroma in a patient affected by type-1 neurofibromatosis and we describe the correct surgical management of such lesions in order to avoid intra- and post-op blood loss related complications.
, Sameeksha Chand,
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i1.165

Abstract:
Fiddler’s neck which is also referred to as a “violin hickey” is a benign dermatologic occupational disease associated with the use of certain instruments like the violin, viola, cello etc. It is believed to be a type of allergic contact dermatitis, manifesting as an acute or chronic eczematous lesion typically at the submandibular and/or supraclavicular region on the side of neck. It can present as erythema, oedema and/or vesicles in the acute stage and as scaling, lichenification, hyperpigmentation and scarring in the chronic stage. Acne mechanica has also been considered by some authors as a presentation of fiddler’s neck. Occasionally, there may be associated swelling redness or a cystic lesion that makes it difficult to differentiate from lymphedema or a salivary gland tumor. PubMed search for articles about this entity resulting in instrument-induced dermatitis yielded few results of this forgotten entity which mimics a love bite (love hickey). For diagnosis, history of the usage of a string instrument which is held between the shoulder and neck, local physical examination and a positive patch test are pre-requisites. Management of fiddler’s neck includes application of topical mild steroid, emollient, proper instrument handling, neck padding, changing the material and polish of the instrument, and/or reducing the amount of playing time. Surgical intervention is usually not advisable unless cystic or tumorous lesions are the manifesting feature. The authors intend to revisit this entity and report an improvised modality that is being used by these instrumentalists in India which may help in prevention of this condition.
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i1.143

Abstract:
Eyelid margin is one of the most challenging anatomic regions in the human body and eyelid margin tumors raise special difficulties in the field of periocular surgery based on anatomical, histological and aesthetic points of view.
, Engin Senel, Güven Güney
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i1.173

Abstract:
Trichilemmal cyst also known as pilar cyst first reported by Pinkus in 1969 t is the most common cyst in the parietal and occipital regions of the scalp. Herein we reported a case presented with a giant trichilemmal cyst and review the literature regarding differential diagnosis of this lesion.
Markelova Elena Vladimirovna, Yana Alexandrovna Yutskovskaya, Birko Oksana Nikolaevna, Bajbarina Elena Valerjevna, Natalya Sergeevna Chepurnova
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i1.161

Abstract:
The review is dedicated to the modern concepts in understanding the age-related changes of skin protective functions, with an emphasis on the impairments in interaction between the immune cells of innate and acquired immunity, resulting in a decrease in antigen-specific T cell immune surveillance in the skin. We discuss the various defects of T cells and their environment as well as focus on the issue of possible correction of T-reg and other cells activity in the skin which would increase the level of immune surveillance in elderly persons and reduce the risk of malignant neoplasms or skin infections developing.
, Hasan Mete Aksoy
Journal of Surgical Dermatology, Volume 3; https://doi.org/10.18282/jsd.v3.i1.167

Abstract:
Total nail ablation for the treatment of onychodystrophies can be performed by using chemicals, surgical resection or laser ablation of nail matrix. A female patient with bilateral severe onychodystrophy as a result of inadvertent previous nail surgeries was treated surgically. Proximal complete nail matrix resection and distal 10 mm wide transverse strip partial nail bed resection were performed. A 5 mm wide transverse strip of nail bed was left intact proximally. Proximal nail matrix defect was closed by using the skin of proximal nail fold. The distal nail bed defect was reconstructed by using triple flap technique which was composed of a main central advancement flap containing ventral toe skin and two side flaps containing nail fold skin. The patient healed without any problem and her nail problem was treated successfully. The cosmetic appearance of her first toes was acceptable. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation.
Krishnabharath S
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i4.160

Abstract:
We report a case of 23-year-old male patient with tuberculosis verrucous cutis on the foot for a duration of six months without responding to routine treatment. Tuberculosis is a common disease worldwide. Extrapulmonary tuberculosis contributes to 10% of cases. Cutaneous tuberculosis occupies a small spectrum of extrapulmonary tuberculosis. Tuberculosis verrucosa cutis is an exogenous infection occurring in a previously sensitized patient by direct inoculation of the organism. It occurs in sensitized patients with a moderate to high immune response. The diagnosis in our patient was confirmed by history, clinical examination, histopathological examination and the patient’s response to anti-tuberculous therapy.
Neha Meena,
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i4.138

Abstract:
Giant cell tumour of the tendon sheath (GCTTS) is a slow-growing, usually painless benign lesion of soft tissues. We report the case of a 38-year-old male with a painless, slowly enlarging swelling on right thumb in order to highlight the role of fine-needle aspiration cytology (FNAC) in diagnosing GCTTS.
Heng Jun Khee, Liau MeiQi May, Yang Shiyao Sam, Aw Chen Wee Derrick, Ho Sue-Ann
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i4.94

Abstract:
Acne scarring is a common complication associated with significant psychological distress. Both glycolic acid (GA) and vitamin C are known to improve the appearance of acne scarring. We performed a review of 13 patients treated with three 70% GA peels with vitamin C at four weeks apart. There was a statistically significant` improvement in acne scarring and post-inflammatory hyperpigmentation from the baseline. Maximal effects were noted four weeks after the third chemical peel. It has an excellent safety profile with no permanent adverse effects noted. A combination of 70% glycolic acid with vitamin C chemical peel is an efficacious, well-tolerated treatment of acne scarring in Asian skin.
Piotr Brzezinski, Viktoryia Kazlouskaya,
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i4.156

Abstract:
Multiple clustered dermatofibroma (MCDF) is an unusual variant of dermatofibroma (DF) presentation, localized on one segment of the body. Multiple dermatofibroma is a term for when there are more than 15 dermatofibromas, which in itself is already a rare condition. The dermatofibromas usually appear in younger adults and are predominantly located on lower parts of the body. No associations, except one case with pulmonary hypertension, were described in patients with MCDF. Herein we present another case of this rare complaint in a 58 year old female with clustered lesions on the thigh. Pericardial cyst was identified in our patient during routine chest X-ray and the patient is asymptomatic. MCDFs do not usually require treatment unless requested by the patient for cosmetic reason. This variant of MCDF, which is neither congenital nor eruptive, is extraordinarily rare, with only 13 cases reported. Further reports may identify possible associations of MCDF.
Shahin Aghaei
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i4.172

Abstract:
Melasma, which is derived from the Greek word “Melas” (black) is an acquired, symmetrical and macular pigmentation of exposed areas of skin including cheeks, upper lip, chin, nose and forehead. Although it is much more common in skin of color, any race could be affected. Most of cases are women during their reproductive years.
Komenan Kassi, Vagamon Bamba, Kouame Kanga, Aang Allou, Alexandre Kouassi, Ildevert Patrice Gbery, Sarah Kourouma, Elidje Joseph Ecra, Mamadou Kaloga, Abdoulaye Sangare, et al.
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i4.149

Abstract:
A vascular malformation is a congenital growth of artery, venous, capillary or lymphatic vessels leading to functional and aesthetic problems. Although surgical maneuvers allow correction of abnormalities, it poses risk of intra and post-operative blood loss. Sealants have been used during surgical procedures to reduce blood loss. A descriptive study was conducted on a new generation Floseal® to demonstrate its effectiveness to reduce intra and post-operative bleeding during vascular malformation corrective surgery. A group of 19 patients presented with vascular malformations and underwent surgical correction associated with Floseal® use. The mean age of our patients’ was 12.3 years (1 to 33 years). The majority of them (57.6%) were aged between 5 to 15 years. The most common vascular malformation treated was hemangioma (45.5%). Majority of these lesions were located on the head (72.7%). Blood transfusion was not accounted for in any of the cases as average blood loss was 18.18 mL (5 to 70 mL). The average length of hospital stay was 2.4 days. Ten patients (90.9%) were discharged in 2 days after drain was removed. Floseal®, a new generation local haemostatic, is easy to use and efficient to achieve haemostasis for treatment of vascular malformation. Haemostasis was achieved in a short time and blood loss was minimal. However, caution should be taken to reduce allergic reactions and potential viral transmissions, and further study should be done to recommend its use.
Eduardo Garzón Aldas, Gabriela Torres
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i4.151

Abstract:
Adenoid squamous cell carcinoma is an uncommon histopathological variant of squamous cell carcinoma characterized by acantholysis of tumor cells creating pseudolumina and the appearance of glandular differentiation. It is also known as pseudoglandular, pseudoangiosarcomatous, adenoid, epithelioma dyskeratoticum, or adenoacanthoma. In this article, we describe and analyze three cases of acantholytic cell carcinoma. The purpose is to verify if the data of our cases can be validated with scientific information. All our cases presented lesions in the face, and in one of them the developed tumor on the skin showed actinic keratosis. The other two tumors were located in the right side of the face, and both were big: the bigger tumor was approximately 8 × 4 cm and the other one with a size of 6 × 2.5 cm. Due to the size and location, they were both send to the oncologist for treatment. One of our cases showed metatypical carcinomas accompanied by acantholytic variant of squamous cell carcinoma. None of our cases presented metastasis. The histopathological finding were keratinized squamous tumor cell type, adenoid structures with round spaces with a defined wall of at least one-cell width, and spaces with isolated or group of dyskeratotic cells.
Editorial Office
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.164

Abstract:
JSD Volume 2, Issue 3: Full Issue
Sara Mohamed Ibrahim Awad
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.123

Abstract:
Cryosurgery is used to describe the controlled destruction of tissue by freezing. Today, cryosurgery is widely practiced in medicine, so it would be interesting to know how the story of cryosurgery began. Here are some short stories behind the discovery and evolution of cryosurgery.
Cherrie Chan Yiru, Devananthan Ilenghoven, Shah Jumaat Mohd. Yussof, Salina Ibrahim
Journal of Surgical Dermatology, Volume 2, pp 177-179; https://doi.org/10.18282/jsd.v2.i3.144

Abstract:
Electronic cigarettes (e-cigarettes) have become increasingly popular at an alarming rate. This coincides with the public perception that they are a safer mean of nicotine consumption. Unregulated devices carry unrecognized safety risks that have led to numerous cases of burns, associating with spontaneous combustions of e-cigarettes.
Sandeep Mehrotra, Vikas Singh, Uday Singh Dadwal
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.136

Abstract:
Subungual glomus tumours, though rare, cause distressing symptoms and merit surgical treatment with minimal morbidity. Approaches to the nail bed over the years have varied from earlier nail excisions to trans/sub/periungal techniques. Nail plate preservation has beneficial effects on pain, and cosmesis and surgical modifications to ensure the same are desirable. We employed a simple nail preservation technique on six patients over the last seven years. After an accurate localization of the lesion based on pin test and MRI, a proximally-based nail plate flap was marked and elevated beyond the glomus. The tumour was removed through a linear nail-bed incision, following which the nail plate flap was reposited without suturing. All cases had gratifying relief of symptoms. Within a few weeks of the excision, no nail distortion was noticeable. No recurrences were noted on follow-up for one year. The nail flap transungal approach relies on accurate preoperative tumour localization. It ensures a protective post-operative cover with reduced pain. A minimalistic approach with no skin incisions ensures less morbidity and improved cosmesis with no nail deformity. The nail plate flap technique can be employed in selected cases for improved outcomes.
Samir El Mazouz, Abdelmoughit Echchaoui, Jaouad Hafidi, Nour-Eddine Gharib, Abdellah Abbassi
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.157

Abstract:
Reconstruction of axillary defects following surgery or trauma has always been a significant challenge for plastic surgeons. A variety of reconstruction options are available, including directed cicatrization, skin grafts and local flaps, but all of these procedures may allow skin contracture and leave unsightly scars.
S. Morteza Seyed Jafari
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.163

Abstract:
Surgical excision is the principal treatment for primary cutaneous melanoma.Selection of optimal excision margins is crucial to maximize outcomes and minimize morbidities.Insufficient resection may lead residual tumor cells to disease recurrences.
Rahul Bamal, Rakesh Kain
Journal of Surgical Dermatology, Volume 2, pp 174-176; https://doi.org/10.18282/jsd.v2.i3.141

Abstract:
Split-thickness skin grafting (STSG) is commonly used to cover raw areas of various aetiologies. Donor sites are known to get infected sometimes, but necrotising fasciitis is not often reported. We report here a case of donor-site necrotising fasciitis and its successful management. There is a need for surgeons to stay vigilant for this rare but probable complication of skin grafting.
Elisete Isabel Crocco, Monique Dalapicola, Renata Diniz, Renata Alves, , Rute Lellis
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.110

Abstract:
Foreign body granuloma reaction is a tissue response to some extraneous materials which incite a characteristic pattern of granulomatous reaction. Several cases of foreign body granulomas on the face have been reported, especially after the injection of dermal fillers. Oleoma or paraffinoma is defined as a foreign body granuloma resulting from the injection of oily substances into the skin or subcutaneous tissue. We report a case of an adult woman who had developed foreign body granulomas due to a self-injection of sweet almond oil into the glabella and periorbital area. The diagnosis was based on a thorough interrogation, clinical features and histopathological findings. Treatment of foreign body granuloma is challenging. At first, oral prednisone was initiated with the improvement of the inflammatory signs and reduction of the lesions’ dimension, but recurrence of the lesions occurred when the dose was decreased. After research of literature, a low-dose minocycline regime was prescribed for its beneficial effects in granulomatous diseases, with encouraging results.
Shamma Aboobacker, Kaliaperumal Karthikeyan, Shiraz Naha, Laxmi V Nair, Aneesh Bava, Beegum Sherjeena
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.120

Abstract:
Laugier-Hunziker syndrome (LHS) is an idiopathic hypermelanotic condition that displays a characteristic pattern of mucosal, acral and nail pigmentation. The etiology is unknown, while its benign nature has been repeatedly highlighted. Owing to close resemblance to more serious disorders, it is necessary that the diagnostic features are understood; and thereby we report two sporadic cases of LHS in different age groups displaying varied presentations with identifiable features.
Yang Shiyao Sam, Liau MeiQi May, Heng Jun Khee, Toh Han Sim Matthias, Aw Chen Wee Derrick, Ho Sue-Ann
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i3.80

Abstract:
Glycolic acid peels have been shown in many studies to improve the appearance of photoaged skin. Vitamin C is known to be a potent natural antioxidant and plays an important role in the collagen biosynthetic pathway. In this study, we report our clinical experience with 70% glycolic acid peel added with vitamin C. We found that all parameters of photoaging, in particular the composite wrinkling score, discolouration score and the global photoaged score, showed statistically significant improvement. Patient satisfaction also revealed improvement in keeping with the physician assessment. It is also associated with an excellent safety profile. In conclusion, a combination of 70% glycolic acid with vitamin C chemical peel is a well-tolerated effective treatment of photoaging in Asian skin.
Editorial Office
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.152

Abstract:
Low-risk method presents quick turnaround of the degenerative disease, researchers found
Editorial Office
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.it1.153

Abstract:
It is a great pleasure to present Journal of Surgical Dermatology’s first ever themed issue, “Lasers in dermatology: Current status”. The themed issue contains scientific content that focus on highly relevant and important topics in the area of laser and light-based treatment in dermatology. Our Guest Editor, Dr. Nasrin Saki from the Department of Dermatology, Shiraz University of Medical Sciences, Iran, has been a pillar of support and it has been an honor to be able to work with such a talented laser expert.
Waheed Zaman Khan, Ghazala Butt, Faria Altaf
Journal of Surgical Dermatology, Volume 2, pp 152-157; https://doi.org/10.18282/jsd.v2.it1.115

Abstract:
Acne vulgaris is a very common chronic inflammatory disease of pilosebaceous units. It can be associated with considerable loss of self-esteem and psychological morbidity when left untreated. With the emergence of lasers and intense pulsed light, long-term reduction of acne lesions is now possible. The success of these optical devices depends on the selected parameters and biologic variables of patient. The objective of this study is to determine the efficacy and safety of intense pulsed light (IPL) in the treatment of mild-to-moderate acne vulgaris. This interventional study was conducted for a period of one year after approval of synopsis. A total of 75 patients of mild-to-moderate acne vulgaris were included through non-probability, convenience sampling. Patients were subjected to intense pulsed light (IPL) therapy once a week for four weeks. Digital photography was done at the baseline and at the sixth week. Follow-up was done after two weeks of completion of four sessions. Repeated measurement ANOVA was used for significance of IPL at six weeks of follow-up. The p value < 0.05 was taken as significant. IPL was effective in 52% of the patients. Out of all cases, 6 (8%) showed excellent results. 33 (44%) showed >50% reduction with therapy. Percentage reduction was observed as 49 ± 20% at final follow-up. Papules count was reduced from 11.95 ± 2.89 to 6.69 ± 2.96, pustules count was reduced from 2.55 ± 1.54 to 0.79 ± 1.02 from baseline to final follow-up visit. 16 subjects showed mild erythema that resolved within 24 h. None of the patients showed any severe side effects at final follow-up visit. We conclude from the results of this study that IPL is safe and efficacious in more than half of the patients in the treatment of mild and moderate acne vulgaris. A long-term follow-up is required to determine long-term safety on skin following such procedures.
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.it1.140

Abstract:
A basic understanding of plasma physics and histopathological aspects of plasma is required to understand the impact of plasma technology on aesthetic medicine.
Christofer Tzermias, Areti Eleftheriadi, Ioulia Gkiouzepaki
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.it1.109

Abstract:
One of the most widely used cutaneous applications of Light Amplification by Stimulated Emission of Radiation (laser) concerns the treatment of vascular lesions. During the past two decades, very significant advances in the application of laser technology in dermatology have occurred, with selective photothermolysis being the most important. This review focuses on the application of modern laser devices (Pulsed Dye Laser, or PDL; potassium titanyl phosphate laser, or KTP; diode laser; and neodymium-doped yttrium-aluminium-garnet laser, or Nd:YAG), as well as the combination of laser and photodynamic therapy (PDT) for the treatment of vascular lesions. In particular, both congenital (haemangiomas and port-wine stains) and acquired vascular lesions (facial and leg telangiectasias, rosacea, Poikiloderma of Civatte, spider angioma, pyogenic granuloma, and venous lakes) are discussed. The review of many recent research studies demonstrates that modern applications of lasers in dermatology constitute the finest method for the treatment of vascular lesions, combining the advantages of invasive therapy with the security offered by non-invasive therapy, while in certain cases they are the single and only choice for the treatment of these lesions.
Alberto Goldman,
Journal of Surgical Dermatology, Volume 2, pp 148-151; https://doi.org/10.18282/jsd.v2.it1.145

Abstract:
Syringoma is a benign tumor of eccrine origin which arises from eccrine ducts. Syringomas are most commonly found on the eyelids in middle-aged women. Traditional treatments include surgical excision, curettage, peelings, dermabrasion and laser. We report on the successful use of fractional laser on periocular syringomas. A 53-year-old female patient with multiple periorbital syringomas underwent three sessions of fractional carbon dioxide (CO2) laser. Settings of 20 watts of power, 600 μm of spacing, 800 μs of dwell, time stack 2 (Smartxide DOT, DEKA, Florence, Italy) were used. The sessions were performed monthly. Significant improvement of the esthetic appearance was observed after three sessions. There was a decrease of visible syringomas associated with an evident improvement of the skin texture, skin quality and flaccidity. No side effects were observed. We suggested continuing the treatment but the patient was satisfied with the current aspect and result. In conclusion, fractional CO2 laser represents an effective treatment option for the treatment of periorbital syringomas.
Journal of Surgical Dermatology, Volume 2, pp 111-112; https://doi.org/10.18282/jsd.v2.i2.139

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.
Nasrin Saki
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.it1.142

Abstract:
Clinical trials have reported the efficacy and safety of PS lasers in the treatment of multicolored and recalcitrant tattoos.
, Surendra B. Patil
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.it1.137

Abstract:
Lasers have a number of clinical applications on the face, ranging from aesthetic uses such as the rejuvenation of ageing face to functional ones such as the correction of bleeding vascular malformations. The vast growing uses of lasers on the face emphasises the need to have knowledge of the subject. Though the vast spectrum of lasers is very difficult to compile in an article, the authors give an overview of the application of lasers in the facial region and discuss the most defining treatment of the individual disease processes.
Juliana Merheb Jordão, Priscila Regina Orso Rebellato
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.it1.148

Abstract:
Melasma, as a pigmentation disorder, induces significant stress to the patients and its recurrent nature remains a challenge in clinical practice. Treatment is based on a variety of mechanisms to prevent and/or stop the pigment production process by destroying the deposited pigment for removal or release, by peeling cells to improve their turnover, and by reducing inflammation. The use of appropriate devices and correct settings are crucial in the treatment of melasma. Cases unresponsive to topical bleaches or chemical peels should be referred for laser therapy. It is important that a maintenance therapy to avoid the recurrence of melasma be indicated. In this paper, we review energy-based devices for melasma treatment.
Nouran Abd El-Aziz Abou Khedr, Tarek Mahmoud Hussein, Ayat Mohamed El-Sayed Abd El-Fatah
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.90

Abstract:
Among wound-healing modalities, platelet-rich plasma (PRP) has been used for wound healing, through the release of multiple growth factors. The platelets mediate wound healing by initiating the clotting pathway and the subsequent matrix remodelisation. The aim of the work was to study the role of injection of platelet-rich plasma in the treatment of scars. This study was conducted on thirty patients who were divided into two groups (A and B). Each group included fifteen patients. The two groups were randomly distributed by using individual sealed envelopes. Group A was subjected to subcision of their acne scars using Nokor needle, followed by suction. Group B patients were subjected to the same treatment but followed by an injection of platelet-rich plasma once per month over three months. In Group A, 6 patients (40%) showed moderate improvement, 5 patients (33.3%) showed slight improvement and 4 patients (26.7%) showed significant improvement. In Group B, 7 patients (46.7%) showed moderate improvement, 5 patients (33.3%) showed marked improvement and 3 patients (20%) showed significant improvement. There was a statistically significant difference on the independent observer’s after-treatment assessment between the groups (P=0.014). In conclusion, subcision suction leads to a persistent improvement of acne scars in a short time, and the coupling with injection of PRP is the most effective in the treatment of depressed facial scars.
Rahul Bamal, Amrita Mandal
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.135

Abstract:
The medical education system in India is not perfect and recent developments have again raised questions about the working and conduct of the Medical Council of India. There are loud calls for standardization and, in the midst of this chaos, there are always people who strive for excellence, who try to absorb knowledge at every opportunity and who can burst onto the mega screen anytime. Our aim should be to provide them with the congenial environment in which they can flourish.
Komla Sena Amouzou, Nabil Berny, Tiemoko Moulaye Haidara, Abdessamad Chlihi, Mohamed Ezzoubi
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.111

Abstract:
Anthracycline extravasation remains a feared serious complication of chemotherapy. At late presentation, deep ulceration and extensive soft tissue damage are seen. Hand extravasation of anthracycline may lead to tendon and nerves destruction with functional and economical impairments. We report a case of Epirubicin extravasation seen at day 25 in a 46-year-old woman treated for breast cancer. A groin flap failed due to the persistence of anthracyclin in the wound. A split thickness skin graft was done after all the tendons were removed. The chemotherapy was interrupted for two months. Wide serial debridements are needed to achieve the removal of all molecules of anthracycline that are observed when granulating tissue is observed permanently in the wound.
Eleni Papakonstantinou, Ulrike Raap
Journal of Surgical Dermatology, Volume 2, pp 67-74; https://doi.org/10.18282/jsd.v2.i2.122

Abstract:
Over the last few years, dermoscopy has been shown to be an effective diagnostic tool in assisting the noninvasive diagnosis not only of skin tumors but also of various general dermatological disorders. The use of dermoscopy has offered a new morphological dimension supporting the diagnosis and clinical follow-up of several dermatological conditions. Within the last years, dermoscopy is gaining ground in general dermatology as well. Among the large spectrum of skin infections, specific dermoscopic patterns have been described for common skin infections such as viral warts, molluscum contagiosum, scabies, and pediculosis, as well as for tinea nigra, tungiasis, and cutaneous larva migrans. Also, common skin disorders such as psoriasis, pityriasis rosea or lichen planus show characteristic dermoscopic patterns. The aim of this article is to provide an overview of the use of dermoscopy in general dermatology by analyzing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical characteristics.
, Yuki Yamamoto, Chikako Kaminaka, Seiko Toyozawa, Hiroshi Matsunaka, Fukumi Furukawa
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.127

Abstract:
Angiosarcoma is a rapidly progressing malignant skin tumor associated with a poor prognosis. We report an immunohistochemical investigation of chemokine receptors in angiosarcoma. The aim is to investigate chemokine receptor expression and, if it is expressed, to histologically discuss its association with age, sex, development site, and histological type. Analyzed were 12 angiosarcoma samples (mean patient age: 75.7 years old) collected by biopsy or surgery from patients at our department by comparing with 4 granuloma telangiectaticum samples (mean patient age: 37.5 years old) and 16 healthy skin samples as controls. CXCR4, CCR6, CCR7, and SDF-1 expressions were immunohistochemically investigated. CXCR4 expression was positive in 6 of the 12 samples. CCR6 and CCR7 were negative in all samples. SDF-1 was positive in 4 samples. Out of the 6 CXCR4-positive samples, 4 were SDF-1-positive. No significant difference associated with age, sex, development site, or histological type was noted in the expression of CXCR4, CCR6, CCR7, or SDF-1. Although CXCR4 is regarded as an index of tumor aggressiveness of malignant melanoma, it is suggested that chemokine receptors, such as CXCR4, do not serve as useful markers of angiosarcoma.
Su Li
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.125

Abstract:
Acquired digital fibrokeratoma (ADFK) has typical characteristics and occurs most frequently on the fingers. The size of the tumor is usually less than 1 cm in diameter. We report a case of a typical ADFK, along with a review of the literature. A 76-year-old man presented with a two-year history of a slow-growing keratotic tumor on the edge aspect of his right hand ring finger. A literature search was conducted to identify published case reports of ADFK. Data on patient demographics, size and location of the lump, treatment, and follow-up were collected from each case report. This case is of interest because of the rarity of ADFK. Additionally, we have emphasized the importance of ruling out other causes of abnormal growths and considering fibrokeratoma during differential diagnoses.
Shabeer Ahmad Wani, Loai Abdullah AlSalmi,
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.128

Abstract:
Abdominoplasty is a very common procedure in the plastic surgery practice and may lead to a variety of unfavorable results including incision site complications. The surgical adhesives system, which entered into daily practice to replace the need for subcuticular closure for skin, saves time and may have better wound appearance. Dermabond® Prineo® Skin Closure System (Ethicon Inc., Somerville, NJ, USA) has two major components: 2–Octyl cyanoacrylate glue and a flexible, self-adhesive polyester mesh. It can be used with or without sutures, and has the added benefit of waterproofing, and microbial resistance. It also saves time. This case describes a male patient who experienced a “printing tattoo” effect following an elective procedure of abdominoplasty and the results after this closure system was used.
Shahin Aghaei
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i2.150

Abstract:
Platelet-rich plasma (PRP) is a concentrate of platelet that has broadly been used to speed up the restoration of human skin tissues. Procedures of preparation would differ from method to method, depends on the concentration of various participating ingredients including proteins.
Sandra Jerkovic Gulin, Jaka Rados, Davorin Loncaric, Romana Ceovic,
Journal of Surgical Dermatology, Volume 2, pp 80-82; https://doi.org/10.18282/jsd.v2.i2.119

Abstract:
We present a case of a young patient presenting with a six-month history of multiple squamous pink and light brown papules surrounded by symmetrical eczema on the trunk. Dermoscopy revealed light brown structureless and avascular lesions with an erythematous scaly halo. The patient denied the presence of naevi on the sites of the newly emerging changes. Histopathology revealed acanthotic epidermis and linear clusters of morphologically normal naevi cells in the upper dermis, infiltration of lymphocytes, plasma cells, eosinophils and mild spongiosis in the dermis. Topical betamethasone/gentamicin ointment twice daily for 10 days was prescribed. The erythematous scaly area around lesions completely disappeared on the follow-up visit after six months. This is a unique case of a sudden appearance of newly formed multiple benign dermal naevi with Meyerson phenomenon—the sudden eruption of multiple Meyerson naevi.
, Luisa Kelmer Cortês De Barros Silveira, Thais Schiavo Moraes, Fernanda Helena Craide, Maria Cristina Mejia Briceño, Bernard Kawa Kac
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i1.77

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.
Radmilo Roncevic
Journal of Surgical Dermatology, Volume 2; https://doi.org/10.18282/jsd.v2.i1.117

Abstract:
This question is not uncommonly asked, especially by surgeons who deal with less complex procedures in the field of plastic and reconstructive surgery. The reason for these questions, among others, is probably due to direct competition.
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