bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinoic Acid in the Treatment of Keloids
Authors: PANABIERE‐CASTAINGS MARIE HELENE
Published: June 2013

Abstract. Since retinoids affect collagen metabolism, nine females and two males with keloids were treated with 0.05% tretinoin topically for 12 weeks. The lesions had been present for an average of 7 years prior to therapy. Changes in size were evaluated by serial kodachromes, tape measurements, and appreciation of volume using dental moulages. Two patients abandoned the study due to irritant contact dermatitis. A significant decrease in weight (p < 0.04) and size (p < 0.01) was found when comparing the status of the lesions at the beginning of the study and at week 12.
Advantages of the Paramedian Scalp Reduction
Authors: ALT THOMAS H.
Published: June 2013

Abstract. The paramedian scalp reduction as compared to the midline (sagittal) scalp reduction provides distinct advantages, particularly in the patient who has undergone reconstruction of the frontal hairline. The paramedian approach causes less distortion of the frontal hairline, allows greater direct visualization of the advancement flaps, permits more extensive undermining, creates less stretchback, provides for coronal advancement of the hair‐bearing occipital donor site, and allows for a greater amount of camouflage of the scalp reduction scar during the immediate postoperative period. Surgeons should be knowledgeable and capable of providing varied forms of scalp reduction procedures to meet the specific needs of the various patients that present for hair replacement surgery.
Clinical Photography Utilizing Office Staff: Methods to Achieve Consistency and Reproducibility
Authors: GILMORE JIM , MILLER WANDA
Published: June 2013

Abstract. This report describes solutions to common problems incurred in clinical photography for facial and cosmetic surgery and focuses on the physician who utilizes office staff to obtain photographs. Issues addressed include space and room requirements, camera and lens, lighting and shadows, pose, retrieval, and quality control. The methods and systems described are aimed at assisting the physician in obtaining consistent, reproducible, quality pre‐ and postoperative photographs.
Facial Liposuction and Microlipoinjection
Authors: ASKEN SAUL
Published: June 2013

Abstract. Liposuction and microlipoinjection can be used to improve the contour of the face, correct certain defects, and improve signs of aging. The technique of facial liposuction as well as that of collecting and injecting the fat used for microlipoinjection (autologous fat transplantation), is described.
Patient “Grounding”
Authors: SEBBEN JACK E.
Published: June 2013

Abstract. Dispersive electrodes are often neglected or misused in electrosurgery. A dispersive electrode can increase electrosurgical safety and effectiveness. If misused, however, it can become the source of patient injury. The following article summarizes the proper use of dispersive electrodes and differentiates them from actual grounding. J Dermatol Surg Oncol 1988; 14:926–931.
Wound Healing for the Dermatologic Surgeon
Authors: GOSLEN J. BLAKE
Published: June 2013

Abstract. An understanding of the basic science of cutaneous wound repair is essential to the dermatologic surgeon for the management of the postoperative wound. This review discusses the stages of wound healing and then applies these principles to the preoperative, intraoperative, and postoperative management of the surgical patient. J Dermatol Surg Oncol 1988; 14:959–972.
Adverse Reactions to Bovine Collagen Implant: Clinica1 and Histologic Features
Authors: STEGMAN SAMUEL J. , CHU SHIRLEY , ARMSTRONG ROSA C.
Published: June 2013

Abstract. Over the past several years, the clinical and histologic features of reactions at Zyderm Collagen Implant (ZCI) and Zyplast Implant (ZI) test and treatment sites have been reported by pathologists, dermatologists, and the scientific staff of the manufacturer (Collagen Corporation, Palo Alto, California). This cooperative effort has shown that adverse reactions commonly manifest as erythematous, indurated, occasionally pruritic lesions that usually resolve spontaneously. Approximately 1/3 of the ZCI test sites with clinical signs and symptoms appear normal histologically while the other 2/3 show palisading or diffusely organized granulomas; all of the reactive treatment sites exhibit one of these two patterns of granuloma. Both forms of granuloma occur with equal frequency at test and treatment locations. Microscopic examination of a limited number of adverse reactions from patients treated with cross‐linked collagen (ZI) showed that the reactions closely resemble those from ZCI treatment areas. The reactions are localized and self limiting; they resolve within a few months without therapeutic intervention.
A Modified Technique for Excision of Syringomas
Authors: MORENO‐GONZÁLEZ JORGE , RIOS‐ARIZPE SERGIO
Published: June 2013

Abstract. An easy, rapid, and inexpensive technique for excision of syringomas from eyelids is outlined, using a fine needle as a skin hook and a #11 scalpel blade and leaving superficial wounds for secondary closure. Possible advantages and disadvantages are discussed. We recommend this procedure as an effective alternative that provides good cosmetic results.
Reusable Loop Stitches for Inspection of Grafts
Authors: SNOW STEPHEN N. , LARSON PAUL O. , OLANSKY DAVID
Published: June 2013

Abstract. Reusable loop stitches are a good method of securing the stent in skin grafts. Two suture methods are presented: the free‐loop and the loose‐loop suture technique. Their main advantage is that they provide a loop of suture that can be repeatedly rethreaded with suture, thereby permitting reexaminations and re‐stentings of the graft site without additional anesthesia.
Radiofrequency Hyperthermia Therapy of Murine Melanoma: A Comparison of Fractionated Versus Single‐Dose Treatments
Authors: DON SCOTT A. , KLEWER SCOTT E. , LEVINE NORMAN
Published: June 2013

Abstract. The effects of single and fractionated doses of radiofrequency hyperthermia were investigated in the treatment of cutaneous murine melanoma. S91 murine melanoma cells were implanted into preformed intradermal blister cavities on the backs of DBA/2J mice. Evaluation of treatment response was undertaken after single and fractionated doses of hyperthermia. A single 60‐second treatment at 46°C did not result in any complete regressions, while 3 weekly 46°C treatments produced a 40% incidence of tumor regression. Higher temperature therapy was associated with improved cure rates. A single treatment for 60 seconds at 50°C resulted in a 25% complete response rate while 3 weekly 50°C treatments resulted in the eradication of 92% of the treated tumors. In those tumors that responded only partially to hyperthermia, fractionated low‐ (46°C) and (50°C) high‐dose regimens resulted in significantly smaller melanomas than single‐treatment schedules at the same temperatures. It is concluded that fractionated hyperthermia is an effective modality in the control of intracutaneous murine melanoma. If other cutaneous malignancies are also sensitive to heat, this may provide a useful nonsurgical means of treating skin cancer.
Magnetic Resonance Imaging of Cutaneous Melanocytic Lesions
Authors: ZEMTSOV ALEXANDER , LORIG RONALD , BERGFIELD WILMA F. , BAILIN PHILIP L. , NG THIAN C.
Published: June 2013

Abstract. This is the first literature report on magnetic resonance imaging (MRI) examination of cutaneous melanocytic or any other type of skin lesions. Good resolution, clinically useful MRI scans of a congenital nevus and a metastatic melanoma to the skin are presented. The potential usefulness of MRI technique to physicians dealing with cutaneous disease is discussed.
Lymphatic Bullae Arising as a Complication of Second‐Intention Healing
Authors: MORANZ JANICE F. , SIEGLE RONALD J. , BARRETT JAMES L.
Published: June 2013

Abstract. Cutaneous bullae secondary to lymphatic fluid reflux are rare. We report the case of a patient with lymphatic bullae without lymphedema following second‐intention wound healing.
Anatomy and Pathophysiology of Varicose Veins
Authors: GOLDMAN MITCHEL P. , FRONEK ARNOST
Published: June 2013

Abstract. The venous anatomy of the leg is described with special reference to the superficial venous system. The histologic and histochemical differences between varicose and normal veins are presented. The pathophysiology of varicose veins is related to congential or acquired abnormalities of the deep venous system, venous valves, and/or fascial or vein wall weakness. Increased deep venous pressure may be both proximal and distal in etiology, arising from arteriovenous anastomoses, incompetent communicating veins, or venous obstruction. Primary valvular incompetence arises from venous obstruction (thrombosis), thrombophlebitis, or valvular agenesis. Secondary valvular incompetence occurs from deep venous obstruction or increased venous distensibility (usually secondary to circulating estrogens). Finally, fascial weakness of the vein wall or supporting fascia provided a genetic basis for the pathophysiology of varicose veins. Understanding the anatomy and pathophysiology of varicose veins should lead to a more rational and efficacious treatment.
Noninvasive Examination of the Venous System in the Leg: Presclerotherapy Evaluation
Authors: FRONEK HELANE S.
Published: June 2013

Abstract. Sclerotherapy of varicose veins and telangiectasia should be preceded by a directed medical history and physical examination. Factors including the presence of significant venous disease should prompt a more extensive evaluation. Of the physical examination techniques and noninvasive technologies available, Doppler ultrasound provides the most pertinent information, but the potential uses of each method are described.
Telangiectasia and Sclerotherapy
Authors: OUVRY PAUL A.
Published: June 2013

Abstract. The anatomy, physiology, and etiology of telangiectasia and related varicosities of the lower limbs are presented. Treatment by sclerotherapy is discussed, with various modalities investigated and compared.
Compression in the Treatment of Leg Telangiectasia: Theoretical Considerations
Authors: GOLDMAN MITCHEL P.
Published: June 2013

Abstract. Unwanted leg veins are a common affliction of men and women. They may be either varicose and symptomatic or telangiectatic and of mostly cosmetic concern. Since patients wishing cosmetic improvement commonly present for treatment, one should utilize a technique that produces the least number of adverse sequelae. The use of compression in performing sclerosing treatment for varicose veins produces 5‐year follow‐up results similar to surgical treatments. This article presents theoretic reasons for advocating the use of compression in the treatment of all blood vessels, whether telangiectatic or varicose.
Polidocanol (Aethoxyskerol) for Sclerotherapy of Superficial Venules and Telangiectasias
Authors: GOLDMAN PETER M.
Published: June 2013

Abstract. The history and possible adverse sequelae of polidocanol (Aethoxysklerol) and the sclerotherapy technique used on 1500 patients in 5000 procedures is reviewed.
Sterile Technique and the Prevention of Wound Infection in Office Surgery—Part II
Authors: SEBBEN JACK E.
Published: June 2013

Abstract. Surgical infection and associated complications are minimized by a combination of appropriate sterile technique and careful surgical technique. This review covers the essential elements of infection control for the office‐based surgical practice. Recommendations are made concerning operating room facilities, instrument sterilization, and tray set‐up (Part I, J Dermatol Surg Oncol 14:1364–1371, 1988). Part II addresses surgical prepping, surgical technique, and prophylactic antibiotics.
Button Bolsters in Dermatologic Surgery
Authors: ADNOT JOHN , SALASCHE STUART J. , WEST RONALD W.
Published: June 2013

Abstract. Ordinary plastic buttons may be used as bolster devices to relieve tension across wounds. This article describes the method of placement of those “button bolsters” and suggests two methods of closing the wound once they are in place. This simple technique is easily mastered and gives additional wound closure security in the initial phase of wound healing.
Scarring Following Herpes Simplex Infection of Postsurgical Cutaneous Sites
Authors: DZUBOW LEONARD M.
Published: June 2013

Abstract. Herpes simplex type 1 produces a perilabial vesicular eruption that normally resolves without scarring. Three cases of herpetic infection associated with different dermatologic surgical procedures are presented. Those procedures involving reduction of cutaneous macrovascular blood supply via undermining or flap creation were followed by clinical scarring. None of the recognized etiologies of tissue compromise (bacterial infection, tension, host vascular disease, excessive inflammation, or edema) could be identified. It is speculated that in the immunocompetent host, small vessel injury secondary to herpes simplex may eventuate in scarring if the subdermal vascular network is significantly compromised. Prophylactic oral acyclovir may be useful in select instances where tissue blood supply is judged clinically tenuous and the frequency of herpetic infection at the surgical site judged worrisome.
Treatment of Chromomycosis by Cryosurgery with Liquid Nitrogen: A Report on Eleven Cases
Authors: PIMENTEL EUGÊNIO R. A. , CASTRO LUIZ G. M. , CUCÉ LUIZ CARLOS , SAMPAIO SEBASTIÃO A. P.
Published: June 2013

Abstract. Cryosurgery with liquid nitrogen was used to treat 11 cases of chromomycosis, 5 with localized lesions and 6 with generalized ones. Freezing time varied from 30 seconds to 4 minutes and the number of cycles from 1 to more than 40. All 5 cases with localized lesions responded extremely well to treatment, with no relapse for up to 53 months. Three patients with generalized lesions attained clinical and mycologic remission for up to 26 months, while 3 had significant improvement without cure. Cryosurgery with liquid nitrogen is therefore an effective treatment for chromomycosis, especially for cases presenting with localized lesions.
The Perialar Arc Rotation Skin Flap
Authors: HILL THOMAS G.
Published: June 2013

Abstract. The perialar arc rotation skin flap is an excellent reconstructive option for defects of the lateral nose that do not significantly involve the ala. Design of this new skin flap and potential intraoperative problems are discussed. Use of microlipoextraction for some “trap door” skin flap deformities is presented.
Argon‐Pumped Tunable Dye Laser Therapy for Facial Port‐Wine Stain Hemangiomas in Adults—A New Technique Using Small Spot Size and Minimal Power
Authors: SCHEIBNER ADRIANNA , WHEELAND RONALD G.
Published: June 2013

Abstract. A low power, argon‐pumped tunable dye laser was used to deliver yellow light of 577 nm. Individual blood vessels within port‐wine stain hemangiomas were treated with a 0.1‐mm beam of light using 8x magnification. This technique permits excellent resolution of facial and nuchal port‐wine stain hemangiomas in adults without the adverse complications of textural change, permanent pigmentation abnormality, or hypertrophic scarring.
Superficial Peeling
Authors: STAGNONE JAMES J.
Published: June 2013

Abstract. Superficial peeling involves the topical use of mild exfoliating chemicals to rejuvenate actinically damaged facial skin and to treat acne, pigmentary disturbances, fine wrinkling, and superficial scarring. Some of the chemicals that can be used and the various techniques employed are discussed.
A Surgical Treatment for Vitiligo: Autologous Cultured‐Epithelial Grafts
Authors: PLOTT R. TODD , BRYSK MIRIAM M. , NEWTON RICHARD C. , RAIMER SHARON S. , RAJARAMAN SRINIVASAN
Published: June 2013

Abstract. Medical treatment of vitiligo has been disappointing; therefore surgical treatments using autologous grafts have been tried. We investigated a new technique in which normally pigmented epidermal cells from a vitiligo patient were cultured on a collagen‐coated membrane in MCDB‐153, a media that supports melanocytes and keratinocytes. The cell/collagen‐coated membrane was used to cover a superficially dermabraded vitiliginous area. Clinical repigmentation, though incomplete, was evident in three of four patients in 4 weeks. Immunofluorescence and electron microscopy were performed on the grafted areas (involved and uninvolved controls). These studies demonstrate the reappearance of melanocytes and melanosomes within the grafted area. All three patients who were successfully repigmented retained their pigment at 1 year follow‐up. Further investigation of this promising treatment for vitiligo is warranted.
Cultured Allogenic Keratinocyte Grafts in the Management of Wound Healing: Prognostic Factors
Authors: PHILLIPS TANIA J. , GILCHREST BARBARA A.
Published: June 2013

Abstract. Cultured allografts derived from neonatal fore‐skin provide a potent stimulus to wound healing in a wide variety of wounds. Their application is a simple outpatient procedure involving no discomfort for the patient. In contrast to autografting, no biopsy is necessary, and growth of newborn keratinocytes in cultures is more rapid than that of adult cells. Use of cultured allogeneic cells offers immediate graft availability and the possibility of stockpiling and preserving the graft for future use. Cultured epidermal allografts may be valuable in accelerating healing by second intention in surgical wounds, as well as being a helpful addition to chronic ulcer management. In venous disease, the outcome is at least comparable to other forms of skin grafting. Ulcers due to connective tissue disorders fared less well and deep chronic ulcers (down to fascia or tendon) were not significantly improved by cultured allograft application. Surprisingly, patient age did not influence outcome.
Capillary Hemangiomas: Case Study of a Novel Laser Treatment and a Review of Therapeutic Options
Authors: GLASSBERG EDWARD , LASK GARY , RABINOWITZ LINDA G. , TUNNESSEN WALTER W.
Published: June 2013

Abstract. Capillary (or strawberry) hemangiomas can present a difficult problem in management, and much controversy exists over whether it is better to watch and wait for natural involution, or to be more aggressive and attempt to prevent some of the negative potential sequelae. A case study of a neonate with a large, early macular capillary hemangioma of the head and neck successfully treated with the 585‐nm pulsed dye laser is presented. In addition, a review of a number of treatments for more advanced lesions is presented. Modalities discussed include argon, carbon dioxide, and neodymium: YAG lasers; cryotherapy; local and systemic steroids; and surgical excision.
Surgical Glove Perforation in Dermatologic Surgery
Authors: GROSS DAVID J. , JAMISON YOLANDA , MARTIN KATHY , FIELDS MICHAEL , DINEHART SCOTT M.
Published: June 2013

Abstract. Twenty‐eight of 240 (11.7%) pairs of sterile surgical gloves collected from dermatologic surgery clinics had perforations. Only 17.1% of these perforations were known to the wearer at the time of surgery. Equal numbers of perforations were found in gloves of operators and assistants. Perforations were more numerous in dominant‐handed gloves. Dermatologic surgeons should consider the incidence of unknown glove perforation when planning surgeries in patients with infectious diseases.
Nasal Cartilage Fenestration in the Application of Full‐Thickness Skin Grafts
Authors: ADNOT JOHN , HOFFMAN BONNIE E.
Published: June 2013

Abstract. A technique is described that enables the application of full‐thickness skin grafts to bare cartilage exposed in surgical wounds on the nose. By fenestrating the cartilage so that the lining on the inner side is exposed, the graft is able to receive a blood supply adequate for its survival.
Monopolar and Bipolar Treatment
Authors: SEBBEN JACK E.
Published: June 2013

Abstract. Monopolar and bipolar electrosurgical treatments are markedly different in principle, but the terms are often confused. The following article explains the differences between these two popular modalities.
Evaluating the Efficacy of the Punch Hair Grafting Technique
Authors: NORDSTRÖM ROLF E.A.
Published: June 2013

Abstract. The author evaluates the efficacy of the punch hair grafting technique by measuring hair density and the number of terminal hairs that should grow in a graft.
Harvesting Auricular Cartilage
Authors: LEVIN MITCHELL L. , LOBER CLIFFORD , LEVIN RICHARD R.
Published: June 2013

Abstract. Auricular cartilage has many uses in ophthalmic plastic and reconstructive surgery. We present a simple method to harvest auricular cartilage with minimal complications, allowing the surgeon to avoid bulky pressure dressings and providing adequate examination of the wound in the immediate postoperative phase.
Clinical Characteristics of Cutaneous Melanoma in Southeastern Hungary
Authors: SZEKERES ELENA , BERTENYI CAMILLO , KOROM IRMA
Published: June 2013

Abstract. Clinical and histopathologic characteristics and data on the incidence of primary cutaneous melanoma are presented from an area of Hungary with 1.9 million inhabitants. Experiences with delayed elective node dissection on survival are also documented.
Microcystic Adnexal Carcinoma of the Scalp
Authors: CHOW WILLIAM C. , COCKERELL CLAY J. , GERONEMUS ROY G.
Published: June 2013

Abstract. Microcystic adnexal carcinoma (MAC) is a recently described rare adnexal neoplasm showing benign histologic features but a locally aggressive behavior. It has most commonly been reported to occur on the face but it has also been noted in the axilla and buttock. We describe a 41‐year‐old white male with a 5‐year history of MAC on the scalp and treatment by Mohs micrographic surgery. To our knowledge, this is the first case of MAC reported to occur on the scalp.
A Comparison of Sclerosing Agents: Clinical and Histologic Effects of Intravascular Sodium Tetradecyl Sulfate and Chromated Glycerin in the Dorsal Rabbit Ear Vein
Authors: MARTIN DALE E. , GOLDMAN MITCHEL P.
Published: June 2013

Abstract. The dorsal marginal rabbit ear vein was injected with 0.25 ml of 0.1% or 0.25% sodium tetradecyl sulfate (STS) (Sotradecol Injection) or undiluted or 50% Scleremo (Scl) (chromated glycerin). Only the 50% Scl solution failed to produce clinical or histologic thrombosis at 1 hour. Clinical fading was observed in STS‐treated vessels at 10 days postinjection. Histologically, early thrombus formation with focal endothelial necrosis was replaced by fibrosis and microangiopathic recanalization. Although undiluted Scl caused similar, yet milder histologic findings, luminal recanalization after 10 days resulted in a clinically unfaded vessel. The use of 50% Scl produced no endothelial damage with no subsequent change in vessel appearance. Cutaneous necrosis or extravasation of erythrocytes was not observed.
Argon Laser Treatment of the Red Nose
Authors: DICKEN CHARLES H.
Published: June 2013

Abstract. Ten patients with red nose due to telangiectasias were treated with the argon laser. Seven had telangiectasias due to rosacea, two had had rhinoplasty, and one had experienced trauma. All of the patients had a good clinical result.
Upper Lip Repair—The Subcutaneous Island Pedicle Flap
Authors: SKOUGE JOHN W.
Published: June 2013

Abstract. The repair of medium‐sized defects involving the lateral cutaneous upper lip offers significant reconstruction challenges. The triangular subcutaneous island pedicle flap is described for repair of such defects. Anatomic and technical considerations will be presented as well as the advantages of this flap over other reconstructive alternatives.
Systemic Isotretinoin: Effects on Dermal Wound Healing in a Rabbit Ear Model In Vivo
Authors: MOY RONALD L. , MOY LARRY S. , BENNETT RICHARD G. , ZITELLI JOHN A. , UITTO JOUNI
Published: June 2013

Abstract. Clinical observations have suggested that wound healing may be altered in patients treated with systemic isotretinoin. In this study, we examined the effects of systemic isotretinoin on dermal wound healing and connective tissue metabolism in a rabbit ear model. Forty 6‐mm punch‐biopsy wounds were created in the ears of two control rabbits as well as two experimental animals fed isotretinoin, 4 mg/kg per day. Clinical inspection and histologic examination revealed no difference between the control and isotretinoin‐treated rabbits in terms of the time required for complete wound healing or the appearance of the final scar. The tissue removed from the wound site at days 0, 7, 14, and 21 after wounding was subjected to analysis of a collagen production and collagen gene expression. Collagen production, determined by the synthesis of [3H]hydroxyproline after incubation of tissue slices with [3H]proline in vitro or by the measurement of the steady‐state levels of types I and III procollagen mRNAs, was not significantly different between the two groups. The results indicate that systemic administration of isotretinoin does not affect collagen synthesis in the rabbit ear model of wound healing.
Compression in the Treatment of Leg Telangiectasia: A Preliminary Report
Authors: GOLDMAN MITCHEL P. , BEAUDOING DENIS , MARLEY WAYNE , LOPEZ LUIS , BUTIE ANTON
Published: June 2013

Abstract. The use of postsclerotherapy compression was evaluated in 37 women with bilaterally symmetrical telangiectatic leg veins. Compressed vessels tended to achieve a greater clinical resolution when located on the distal leg and/or when greater than 0.5 mm in diameter. Postsclerotherapy hyperpigmentation fell from 40.5% to 28.5% with the use of compression. In addition, ankle and calf edema were lessened if a graduated compression stocking was worn immediately after sclerotherapy.
Determination of Incidence and Risk Factors for Postsclerotherapy Telangiectatic Matting of the Lower Extremity: A Retrospective Analysis
Authors: DAVIS LINDA T. , DUFFY DAVID M.
Published: June 2013

Abstract. Telangiectatic matting are vessels less than 0.2 mm in diameter that may appear after sclerotherapy treatment of varicose or telangiectatic leg veins. It is a complication about which very little epidemiologic data have been formally accrued. Therefore, a retrospective analysis was conducted by reviewing the records of 2120 patients in a private practice setting. The overall incidence of telangiectatic matting in our patient population was 16%. To identify risk factors, in‐depth comparative analysis of the databases of 160 of the patients who developed telangiectatic matting and a control group of 160 nonmatting patients was performed. Significantly more patients in the matting group were overweight, on hormones during treatment, and had both a family history and a longer duration of spider veins (p<0.05). Additionally, the matting group had a significantly higher proportion of people noting onset of their veins after excess hormonal states, relative to before excess hormonal states, than the nonmatting group. Age and excessive standing did not differ significantly between the two groups. The results of this study provide objective, predictive risk factors for the development of telangiectatic matting.
Resolution of Pain Associated with Varicose and Telangiectatic Leg Veins After Compression Sclerotherapy
Authors: WEISS ROBERT A. , WEISS MARGARET A.
Published: June 2013

Abstract. Many patients presenting for treatment of superficial varicosities and telangiectasias on the legs are seeking relief of pain or discomfort in addition to cosmetic improvement. Of 215 sclerotherapy patients, 114 (53%) complained of various painful symptoms involving areas of telangiectasias (vessels 0.1‐1 mm in diameter) and varicosities (vessels > 1 mm in diameter). In order to determine whether sclerotherapy is effective in reducing leg pain and discomfort, hundreds of patients receiving two or more treatment sessions of compression sclerotherapy with hypertonic saline were surveyed for the pretreatment and post‐treatment presence of numerous symptoms associated with telangiectasias and varicosities of the leg. For all symptoms combined, the overall reported relief of pain was 85% (p < 0.001). Side effects from the treatment were minimal. These results indicate that sclerotherapy for telangiectasias and varicosities is not only a cosmetic procedure but a safe and valuable medical therapeutic modality, highly effective in relieving leg pain and discomfort.
Application of the Tumescent Technique to Hand Augmentation
Authors: LAUBER JEFFREY S. , ABRAMS HARVEY L. , COLEMAN WILLIAM P.
Published: June 2013

Abstract. The harvesting of fat for autologous implantation into the hands via the tumescent technique is presented. The tumescent technique, which involves the administration of large volumes of dilute local anesthetic into the donor site, results in low serum concentrations of anesthetic and produces long‐lasting anesthesia while providing vasoconstriction and a firmness of the subcutaneous compartment ideal for lipoextraction. The tumescent technique has proven to be an important advance in reduction liposuction surgery. We describe our experience with the tumescent technique as applied to microlipoinjection for hand augmentation of aged and sun‐damaged skin.
The Nasolabial Flap—A Defensive Reappraisal
Authors: FIELD LAWRENCE M.
Published: June 2013

Abstract. The nasolabial flap has been a mainstay in reconstructing nasal defects. Errors in design and construction of this flap have caused many to condemn it and move away from its use. This article reaffirms its extensive applicability and seeks to forestall unaesthetic reconstructions by consideration of preventive steps.
The Effect of Topical Interferon Alpha2b on Actinic Keratoses
Authors: EDWARDS LIBBY , LEVINE NORMAN , SMILES KENNETH A.
Published: June 2013

Abstract. As a result of the known effects of intralesional interferon alfa2b (Intron A) on actinic keratoses, we have now examined the effects of topical interferon alfa2b gel on actinic keratoses. Twenty‐four subjects each treated three actinic keratoses with either interferon gel 30 million IU/gm or a placebo preparation applied topically 4 times a day for 4 weeks. Although more lesions treated with the active interferon showed clinical improvement, this difference was not statistically significant.
Subcutaneous Calcification in Venous Ulcers: Report of a Case
Authors: PATHY ARUN L. , RAE VIRGINIA , FALANGA VINCENT
Published: June 2013

Abstract. We report on a 77‐year‐old woman with a recalcitrant leg ulcer that contained and extruded calcified material. Roentgenograms of the involved leg showed extensive subcutaneous calcification. The literature concerning subcutaneous calcification in venous insufficiency is reviewed. The patient responded to surgical debridement of the calcified tissue and subsequent skin grafting.
Apocrine Adenocarcinoma: Case Report and Review of the Literature
Authors: DHAWAN SUNIL S. , NANDA VANDANA S. , GREKIN STEVEN , RABINOVITZ HAROLD S.
Published: June 2013

Abstract. Apocrine adenocarcinoma is a rare, primary malignant neoplasm of the skin. Clinically, it is a painless, skin‐colored, slow‐growing, firm or cystic nodule. The tumor has a high rate of local recurrence and can metastasize. In selected cases, Mohs micrographic surgery appears to be an effective treatment. We report the first case of apocrine adenocarcinoma to occur on the fingertip, and the first to be treated with Mohs micrographic surgery.
Defect Subdivision as a Technique to Repair Defects Following Mohs Surgery
Authors: DZUBOW LEONARD M.
Published: June 2013

Abstract. Defects following Mohs surgery that cannot be closed primarily or with single flaps may often be reconstructed using the concept of defect subdivision. This involves mentally fragmenting the wound into smaller portions. Each subsegment is reconstructed with a small transposition flap. The closures of the donor sites of these flaps are designed so that each taps into a separate and distinct area of skin laxity. In this way efficient and optimal use is made of available matching regional skin for reconstruction.
Postsclerotherapy Hyperpigmentations: A One‐Year Follow‐Up
Authors: GEORGIEV MIHAEL
Published: June 2013

Abstract. In a prospective study of 100 sequential varicose patients treated with sclerotherapy, 15 had some light brown pigmentations at the end of the treatment. One year later, 1 patient still had some linear pigmentations, while 4 other patients had a single, macular, barely visible pigmentation of no cosmetic significance.
Hidradenoma Papilliferum of the Vulva: Report of a Case Characterized by Unusual Clinical Behavior
Authors: VERALDI STEFANO , SCHIANCHI‐VERALDI ROSSANA , MARINI DARIO
Published: June 2013

Abstract. The authors describe a case of hidradenoma papilliferum localized to the right labium majus of a 33‐year‐old woman. The young age of the patient, the rapid growth of the tumor, and its large size are elements that make the case atypical on the basis of the published literature.
An Evaluation of Wound Closure Tapes
Authors: MOY RONALD L. , QUAN MATTHEW B.
Published: June 2013

Abstract. Wound closure tapes are often used to decrease tension on wounds, to close wounds, and to reinforce wounds after suture removal. Seven different brands of wound closure tape, both with and without the additional application of the liquid adhesive Mastisol, were tested for their adhesion to the forearms of 8 volunteers when a 225‐gram weight was applied. Steri‐Strips with Mastisol had the longest time of adhesiveness, and the application of Mastisol markedly increased the adhesiveness of all 7 tapes evaluated. Only 2 of the 7 tapes, Proxi‐Strip and Coverstrip II, showed any significant adhesiveness without Mastisol.
Carbon Dioxide Laser Treatment of Pitted Acne Scarring
Authors: GARRETT ALGIN B. , DUFRESNE RAYMOND G. , RATZ JOHN L. , BERLIN A. JAN
Published: June 2013

Abstract. Laserabrasion has been shown to have limited application in the treatment of acne scarring. Focal laser‐abrasion used to treat individual pitted acne scars may have broader clinical application. We present 8 patients with pitted acne scars who were treated with either conventional continuous wave carbon dioxide (CO2) laser, or with the superpulsed CO2 laser, or both. Cosmetically acceptable results were attained, particularly in the patients treated with the superpulsed laser.
A Psychosocial Assessment of Patients with Basal Cell Carcinoma
Authors: HOLFELD KAREN I. , HOGAN DANIEL J. , ELDEMIRE MICHAEL , LANE PETER R.
Published: June 2013

Abstract. We performed a controlled study to investigate the psychosocial problems of patients diagnosed and treated for basal cell carcinoma (BCC) as compared to the general population. Thirty‐nine BCC patients and 39 matched controls answered a psychosocial questionnaire. Chi square analysis of the questionnaire results revealed no statistically significant difference between the BCC patients and the control group. In conclusion, no more psychosocial problems were found in BCC patients than in members of the general population.
Effect of the Topical Anesthetic EMLA on the Efficacy of Pulsed Dye Laser Treatment of Port‐Wine Stains
Authors: ASHINOFF ROBIN , GERONEMUS ROY G.
Published: June 2013

Abstract EMLA cream (Eutectic Mixture of Local Anesthetics) is a new topical anesthetic composed of 25 mg lidocaine and 25 mg prilocaine in an oil‐in‐water emulsion cream. It has been found to be very effective for local anesthesia prior to venepuncture, minor surgical procedures, and pulsed dye laser (PDL) therapy for port‐wine stains (PWS) in children. However, since EMLA may cause vasoconstriction of cutaneous vessels, we tried to determine whether pretreatment with EMLA decreases the efficacy of subsequent PDL treatment. We report eight patients between the ages of 4 and 32 years with PWS who received two test site treatments prior to PDL treatment. One site was pretreated with EMLA cream under occlusion for 60 minutes and then left unoccluded for 15 minutes prior to PDL test treatment. The other site, in the same area of the PWS and patient's body, was not pretreated with EMLA. The test sites were compared 6–8 weeks later to determine whether EMLA decreased the degree of lightening of the PWS compared to the non‐EMLA‐treated site. We conclude that EMLA is an effective topical anesthetic for PDL treatment of PWS and does not adversely affect the efficacy of the treatment.
Use of Mohs Micrographic Surgery to Establish Quantitative Proof of Heightened Tumor Spread in Basal Cell Carcinoma Recurrent Following Radiotherapy
Authors: SMITH STEVEN P. , FOLEY ELIZABETH H. , GRANDE DONALD J.
Published: June 2013

Abstract We compared 27 basal‐cell carcinomas (BCCs) recurrent following radiotherapy and subsequently excised by Mohs micrographic surgery to a control group of BCCs recurrent following other treatment modalities and similarly excised. Mohs technique permitted precise, quantitative tumor assessment, obtained via a novel method utilizing three parameters: the number of surgical stages required for complete excision, the percentage increase between clinical preoperative tumor area and final postoperative defect area, and the presence of deep subcutaneous tissue invasion. Figures for the postradiation group were larger in all three categories, with the latter two revealing statistically significant differences versus the nonradiation group. This study gives strong, direct quantitative support to the clinical impression that BCC recurrent following radiotherapy is a uniquely aggressive, invasive subset of recurrent BCC.
Complete Spontaneous Regression of Multiple Basal Cell Carcinomas in the Basal Cell Nevus Syndrome: The Possible Role of Transepithelial Elimination
Authors: KELLEY RUSSELL S. , WAGNER RICHARD F. , SANCHEZ RAMON L. , DUFF REBECCA R.
Published: June 2013

Abstract A 36‐year‐old Latin American man with the basal cell nevus syndrome had multiple, soft, hairless, depressed scars of the face, scalp, neck, and back, ranging in size from 0.3 × 0.5 cm to 3.5 × 3.9 cm. These areas had never been treated and previously were sites of basal cell carcinomas that underwent complete spontaneous regression 4–5 years from the date of onset. Pathology of these spontaneously regressed sites was consistent with the criteria established by Curson and Weedon (1979). Type III transepithelial elimination was demonstrated for a basal cell carcinoma. Type III transepithelial elimination may play a role in the spontaneous regression of basal cell carcinomas.
The History and Contributions of the Spanish Dermatosurgical School
Authors: MARTIŃEZ FRANCISCO CAMACHO
Published: June 2013

The origin of dermatologic surgery in Spain may be traced to the efforts of Professor Felipe de Dulanto. Initially the specialty encompassed only simple direct closure, local flaps, and skin grafts. As the field evolved, distant flaps and other techniques, including dermabrasion, cryosurgery, Mohs' surgery, and laser surgery, were added to the armamentarium. The close, interdepartmental relationships between Dermatology and Otolaryngology, Ophthalmology, Pediatrics, and Gynecology allowed Spanish dermatologic surgery to expand and encompass lymph node dissections, complex reconstructions of the neck, eyelid, vulvar area, breasts, and abdomen.
Sunscreens and the Prevention of Skin Aging
Authors: LOWE NICHOLAS J.
Published: June 2013

Abstract. It has been well established in both human and animal skin that ultraviolet radiation from both ultraviolet B (UVB) (290 nm‐320 nm) and ultraviolet A (UVA) (320 nm‐420 nm) can produce profound changes in the skin that with recurrent exposure, cause it to become what we recognize as photoaged skin. Experimental studies in animals have confirmed that some suncreen chemicals are capable of providing protection against ultraviolet‐induced photoaging. It is presumed that regular use of these effective sunscreens will also reduce skin aging changes in humans.
The Future of Topical Therapy for Cutaneous Aging
Authors: SHUPACK JEROME L. , HABER ROBERT S. , STILLER MATTHEW J.
Published: June 2013

Abstract. The elements of cutaneous aging have been well described and include changes of intrinsic or chronologic aging as well as changes of extrinsic or environmental aging. We also include male pattern alopecia in this category. The current dominance of tretinoin in cutaneous aging therapy is likely to be challenged by newer classes of retinoids, by topical antiandrogens, and by alternative treatments for proliferative lesions.
The Face Lift and Ancillary Procedures
Authors: FULEIHAN NABIL S. , WEBSTER RICHARD C. , SMITH RICHARD C.
Published: June 2013

Abstract. In this article, face lift, forehead lift, and blepha‐roplasty procedures are addressed. Special emphasis is made on anatomical and surgical guidelines. Some results and complications of the different procedures are presented.
Infiltrating Lipomas of the Upper Extremities
Authors: HARRINGTON ALLAN C. , ADNOT JOHN , CHESSER RICHARD S.
Published: June 2013

Abstract. The typical lipoma is an encapsulated subdermal tumor, usually easily removed if necessary. We recently encountered two lipomas that infiltrated muscles of the forearm. Excision of infiltrating lipomas may be complicated by their deep location and potential involvement of vascular and neural structures. This paper should increase dermatologists' awareness of this uncommon variant and facilitate appropriate referral for definitive treatment. We believe that this is the first report in the dermatologic literature of infiltrating lipoma of the upper extremity.
The Importance of Accurate Reporting on Liposuction Surgery to the Public
Authors: ASKEN SAUL
Published: June 2013

A relatively negative article on liposuction surgery appeared in the October 1989 issue of a national women's magazine. The following is a copy of a letter to the magazine written in response to that article.
Patterns of Epidermal Growth Factor Receptors in Basal and Squamous Cell Carcinoma
Authors: SPRINGER ELIZABETH A. , ROBINSON JUNE K.
Published: June 2013

The presence of immunoreactive epidermal growth factor receptors in human skin tumors was investigated using the indirect immunoperoxidase technique. Sixteen basal cell carcinomas and 11 squamous cell carcinomas were evaluated. All of the specimens studied were receptor positive. In 70% of the specimens there was prominent staining of the cell membranes. In 54% of the nodular basal cell carcinoma specimens there was increased staining at the periphery of the tumor cell masses.
Basal Cell Carcinoma Recurring after Radiotherapy: A Unique, Difficult Treatment Subclass of Recurrent Basal Cell Carcinoma
Authors: SMITH STEVEN P. , GRANDE DONALD J.
Published: June 2013

Twenty‐seven basal cell carcinomas (BCCs) recurring following radiation therapy alone or in addition to other treatment modalities were treated with Mohs micrographic surgery (MMS) from 1983 to 1989. Mean tumor size was 2.1 cm. Of the tumors, 70.4% arose in the mid‐face region, 55.6% had undergone multiple previous treatment modalities. The present recurrence rate is 7.4% (mean follow‐up: 25 months). Basal cell carcinoma recurring following radiotherapy deserves special subclassification among recurrent BCC. It is very difficult to eradicate, with high recurrence rates following standard surgical excision or further radiotherapy. Tumors are usually large, aggressive, and invasive. Most arise in the cosmetically crucial mid‐face region, where extension into subcutaneous tissue planes is common. Mohs surgery, with its inherent abilities to examine all margins, map tumor extension, and conserve tissue, is uniquely suited to treatment of these difficult tumors.
Incisional Slit Grafting
Authors: STOUGH DOWLING B. , NELSON BRUCE R. , STOUGH D. BLUFORD
Published: June 2013

Incisional slit grafting, a new and greatly improved technique in hair transplantation, is described. Incisional slit grafting utilizes larger numbers of smaller grafts than does traditional punch grafting. No tissue is removed from the recipient bed. The vascular supply is conserved, resulting in an increased graft yield. The clumping and stalking effect associated with traditional round grafting is eliminated largely, and a more natural frontal hairline is achieved.
Daily Observations During Healing of a Full‐Thickness Human Surgical Wound by Second Intention
Authors: HOWE NATHAN R. , Jr LANG PEARON G.
Published: June 2013

After his preauricular basal cell carcinoma had been excised by Mohs micrographic surgery, a patient took daily photographs of his 6 × 3‐cm full‐thickness wound as it healed by second intention over the next 44 days. Wound contraction produced a linear decrease in wound area between postoperative days 3 and 40 that accounted for 57% of the area of the original wound. The remainder of the wound was resurfaced by new epithelium, beginning on day 16. Few comparable reports address the contributions of contraction and re‐epithelialization in large full‐thickness human wounds.
Microsurgical Treatment of Nevus of Ota
Authors: KOBAYASHI TOSHIO
Published: June 2013

A new micropeeling technique for treating nevus of Ota has been performed on 32 patients over a 3‐year period. This technique was conducted by including unique implementations: instrumentally by using special one‐by‐one‐toothed microforceps, and technically by incorporating an accurate system of incising and removing evenly spaced skin sections under a microscope. As a result, precise removal at the desired skin depth is obtained, with healing generally superior to that yielded by conventional techniques.
Treatment of Peutz‐Jeghers Lentigines with the Carbon Dioxide Laser
Authors: BENEDICT LINDA M. , COHEN BERNARD
Published: June 2013

Perioral dark brown macules quickly identify patients with Peutz‐Jeghers syndrome. These lentigines may be cosmetically disfiguring. We report a successful outcome in the treatment of these lentigines with the carbon dioxide laser.
Squamous Cell Carcinoma Arising in a Site of Chronic Osteomyelitis
Authors: GOLDBERG DAVID J. , ARBESFELD DAVID
Published: June 2013

Squamous cell carcinoma (SCO arising in a focus of chronic osteomyelitis is a rare but potentially fatal disease. Because of the possibility of metastases, amputation proximal to the site of the tumor is the current standard of therapy. We report the first case of SCC arising in chronic osteomyelitis treated by Mohs micrographic surgery as an alternative method of treatment.
A Device to Prevent Cross‐Contamination when Directly Applying Liquid Nitrogen
Authors: DOLEZAL JAMES F.
Published: June 2013

A common method of liquid‐nitrogen treatment is with the use of the cotton‐tipped applicator. Cross‐contamination is possible when the applicator is repeatedly dipped into the liquid nitrogen supply. Described is a sterilizable device to hold a small portion of nitrogen sufficient for treatment of a single patient.
The Treatment of Benign Sebaceous Hyperplasia with the Topical Application of Bichloracetic Acid
Authors: ROSIAN ROCHELLE , GOSLEN J. BLAKE , BRODELL ROBERT T.
Published: June 2013

Sebaceous hyperplasia is a benign lesion that occurs commonly on the face of older individuals. A variety of treatment options have been described, including oral isotretinoin, electrodesiccation, CO2 laser surgery, cryosurgery, and shave excision with curettage. Problems have been noted with these approaches. These techniques are more complex, less effective, require more time, or are more likely to scar than the procedure we describe. The treatment of sebaceous hyperplasia with bichloracetic acid is described with results presented after treatment of our first 20 patients.
Hyperbaric Oxygen and Mohs Micrographic Surgery in the Treatment of Osteoradionecrosis and Recurrent Cutaneous Carcinoma
Authors: LAMAN SUSAN D. , WHITAKER DUANE C. , HOFFMAN HENRY H. , JEBSON PETER
Published: June 2013

Recurrent basal cell carcinoma (BCC) overlying bony structures which has been treated with radiation may be complicated by tumor invasion of bone and osteoradionecrosis. The authors present a case of recurrent BCC in which Mohs micrographic surgery and reconstructive surgery were augmented with pre‐ and post‐operative hyperbaric oxygen therapy.