bluuebunny/crossref_metadata_2025 huggingface dataset:
Residents' Corner: Pyoderma Gangrenosum at Surgery Sites
Authors: FULBRIGHT ROBERT K. , WOLF JOHN E. , TSCHEN JAIME A.
Published: June 2013

Abstract. Pyoderma gangrenosum is a necrotizing and ulcerative skin disorder often associated with underlying systemic diseases. The etiology remains obscure, with recent investigations emphasizing an altered immune system. A case report is presented of pyoderma gangrenosum occurring at surgical sites in the absence of predisposing factors. Pyoderma gangrenosum in this setting can mimic infectious causes of wound necrosis. Early recognition of the characteristic lesion morphology may prevent unnecessary treatment directed toward infectious agents and facilitate effective control with systemic corticosteroid therapy.
Prophylactic Antibiotics in Cutaneous Surgery
Authors: SEBBEN JACK E.
Published: June 2013

Abstract. Antibiotics can reduce the incidence of wound infection in some cutaneous surgical cases. In clean, uncomplicated surgical wounds, antibiotics have no effect on the incidence of infection. There is a reduction in infection rate when prophylaxis is used in clean‐contaminated and contaminated surgical wounds. To achieve the maximum effect, the drug should be present in the tissue at the time of wounding. The antibiotic should be given for 24 to 48 hours. Longer treatment provides no greater protection from infection. A cephalosporin or erythromycin by the oral route is usually satisfactory for outpatient cutaneous surgery.
Our Experience in the Surgical Treatment of Cancer and Precancerous Lesions of the Lower Lip
Authors: BRUFAU C. , CANTERAS M. , ARMIJO M.
Published: June 2013

Abstract. We report on 279 patients with cancer and precancerous conditions of the lower lip who have been surgically treated. Cure rates and cosmetic results are evaluated in relation to the different surgical techniques employed. The types of tumors are statistically analyzed and discussed.
Malignant Blue Nevus
Authors: RUBINSTEIN NURIT , KOPOLOVIC JURI , WEXLER MENACHEM R. , PELED ISAAC J.
Published: June 2013

Abstract. A malignant blue nevus of the dorsum of the hand and a review of the literature is reported. Histopathologic examination showed the presence of a blue nevus and a cellular blue nevus, as well as a malignant blue nevus. The cellular blue nevus elements of the lesion showed the characteristic prominent neural‐type fascicles intertwined with melanocytes. There was no evidence for local invasion or regional lymph node metastases. The patient was free of disease 1 year following wide excision.
Large Basal Cell Carcinoma in a Congenital Nevus
Authors: ROSENBLUM GERALD A.
Published: June 2013

Abstract
A large basal cell carcinoma that developed in a previously irradiated congenital nevus is reported. Treatment was by wide surgical excision. A discussion of the possibility that congenital nevi may predispose to tumors other than melanoma is considered. The causes of basal cell carcinoma are reviewed.
Repigmentation of Stable Leukoderma by Autologous Minigrafting
Authors: FALABELLA RAFAEL
Published: June 2013

Abstract
The technique known as autologous minigrafting is reviewed. This procedure has proven useful and reliable for repigmenting diverse types of leukoderma. A few refinements of this technique are described. These refinements were used in six patients who were successfully repigmented. Causes of pigment loss in these cases included thermal burns, contact with monobenzyl ether of hydroquinone, chronic discoid lupus erythematosus, and segmental vitiligo.
Follow‐Up of Vermilionectomies: Evaluation of the Technique
Authors: SANCHEZ‐CONEJO‐MIR J. , BERNAL A. M. PEREZ , MORENO‐GIMENEZ J. C. , CAMACHO‐MARTINEZ F.
Published: June 2013

Abstract
Vermilionectomy is a straightforward technique that provides excellent results, not only in the treatment of solar cheilitis, but also as a prophylactic measure for squamous cell carcinoma (SCC) of the lower lip. Well‐planned and well‐executed, this operation is considered to have no postoperative complications. However, our 12‐month follow‐up of 52 postvermilionectomy patients revealed interesting features with regard to the contraction of the lip scar, sensitive, functional, and cosmetic disorders, and the prophylactic role of vermilionectomy on SCC of the lip.
Basal Cell Carcinoma and Collagenase
Authors: GOSLEN J. BLAKE , BAUER EUGENE A.
Published: June 2013

Abstract. The interaction of connective tissue stroma and epithelial cutaneous cancer is an active area of investigation in dermatology. Studies summarized here explore the role of collagenase in basal cell carcinoma (BCC) invasiveness. Evidence is presented to support the role of a cytokine or cytokines secreted by BCCs that stimulate collagenase production by surrounding stromal fibroblasts. Prospects for further research in this area are proposed.
Trauma as a Possible Etiologic Factor in Basal Cell Carcinoma
Authors: NOODLEMAN F. RICHARD , POLLACK SHELDON V.
Published: June 2013

Abstract. 1774 basal cell carcinoma lesions treated by Mohs surgery between 1979 and 1986 were evaluated for previous trauma histories. These traumas include burns, sharp trauma, chicken pox scars, blunt trauma, and vaccinations. 129 (7.3%) had a previous history of trauma. Analysis revealed that patients with trauma‐related tumors were slightly younger and more likely to be male. Their lesions were larger pre‐ and post‐op, and more often required five or more Mohs surgery stages, indicating these tumors may be especially deceptive clinically. The tumors were not particularly aggressive judging by histologic type. The literature is reviewed and implications for future work suggested.
CO2 Laser Blepharoplasty: A Comparison to Cold Steel and Electrocautery
Authors: DAVID LAURENCE M. , SANDERS GEORGE
Published: June 2013

Abstract. Thirteen patients underwent blepharoplasty in a paired comparison study. A carbon dioxide laser was employed for one side while standard cold steel surgery and electrocautery was used on the contralateral side. In addition to reduced intraoperative time and bleeding, we found less postoperative ecchymosis and edema on the laser‐treated side. Long‐term follow‐up showed no difference between the two sides when cosmetic end result and scars were compared.
Carbon Dioxide Laser Vaporization and Curettage in the Treatment of Large or Multiple Superficial Basal Cell Carcinomas
Authors: WHEELAND RONALD G. , BAILIN PHILIP L. , RATZ JOHN L. , ROENIGK RANDALL K.
Published: June 2013

Abstract. Many of the standard forms of therapy for large or multiple superficial basal cell carcinomas are limited by significant postoperative pain, excessive scarring, and prolonged wound healing time. Combining traditional curettage with carbon dioxide laser vaporization creates a procedure that allows excellent visualization, due to the bloodless surgical field produced by the laser, minimal nonspecific thermal damage, rapid healing, and diminished postoperative pain. In addition, the speed and ease with which this procedure can be performed allow successful treatment of many lesions in a single outpatient session. We wish to report our results using this technique for the treatment of 52 patients with 370 superficial basal cell carcinomas.
Biostimulation of Wound Healing by Lasers: Experimental Approaches in Animal Models and in Fibroblast Cultures
Authors: ABERGEL R. PATRICK , LYONS RICHARD F. , CASTEL JOHN C. , DWYER RICHARD M. , UITTO JOUNI
Published: June 2013

Abstract. Recent evidence suggests that low‐energy lasers, such as an He‐Ne laser, might stimulate wound healing. In this review we are summarizing our recent observations indicating that low‐energy lasers enhance collagen gene expression both in skin fibroblast cultures in vitro, as well as in animal models of wound healing in vivo.
Sutures: The Suspension Suture
Authors: SALASCHE COL STUART J. , JARCHOW LTC ROBERT , FELDMAN CDR BRUCE D. , DEVINE‐RUST CPT MARY JOANNE , ADNOT LTC JOHN
Published: June 2013

Abstract. The suspension suture is a tension‐reducing stitch that anchors the undersurface of a flap or elliptical wound edge to the underlying periosteum. The technique of placing the stitch is described and the indications for and the benefits derived from its use are discussed.
Surgical Gem:New Instruments for Razor Blade Surgery
Authors: JOHANNESSON ANDERS
Published: June 2013

Abstract. Two newly constructed razor blade holders for razor blade surgery are described.
Article: Fibrin Sealant in Punch Hair Grafting
Authors: NORDSTRÖM ROLF E.A. , PIECHOTTA UDO F. , FLEMMING IRENE
Published: June 2013

Abstract. In this study it was shown that fibrin sealant used in eight consecutive patients undergoing their first session of punch hair grafting after sagittal midline ex‐cision(s) reduces the hair survival rate by about 2 hairs per graft from 21.74 on the non‐glued side to 19.79 on the glued side (p < 0.01). The authors did not find this sealant beneficial in routine punch hair transplantation but found it to be of some potential value if the grafts are to be left without any dressing immediately postoperatively.
Nasal Septal Carcinoma Masquerading as Acne Rosacea
Authors: LAW TERESA H. , JACKSON IAN T. , MULLER SIGFRID A.
Published: June 2013

Abstract. A 57‐year‐old woman developed diffuse erythema of the nose that had been diagnosed as acne rosacea for 18 months. Biopsy showed infiltration deep in the nasal skin of a squamous cell carcinoma that extended from the nasal septum. Nasal septal tumors are rare; the most common is squamous cell carcinoma.
Surgical Gem: Hair Transplantation: Using a Power Punch in the Recipient Area
Authors: NUSBAUM BERNARD P. , LEWIS LEONARD A.
Published: June 2013

Abstract A useful technique for using a motorized punch for cutting recipient holes is presented. This technique minimizes the possibility of entangling surrounding hairs. It is easy to perform and requires no special instruments.
Verrucous Hemangioma
Authors: PUIG LLUÍS , LLISTOSELLA ENRIC , MORENO ABELARDO , de MORAGAS JOSÉ MA
Published: June 2013

Abstract Verrucous hemangioma is an infrequent variety of deep‐seated capillary or cavernous hemangioma with reactive epidermal hyperplasia and a superficial component indistinguishable from those of angiokera‐toma. Four cases of verrucous hemangioma are reported herein. Verrucous hemangiomas are usually congenital lesions which do not resolve spontaneously and have a tendency to recur after excision if margins are inadequate. Careful histopathologic and clinical evaluation are required for an optimal therapeutic approach.
“Clear Cell” Atypical Fibroxanthoma
Authors: PATTERSON JAMES W. , KONERDING HAZLE , KRAMER WILLIAM M.
Published: June 2013

Abstract An 87‐year‐old man with extensive solar damage presented with a 2‐month history of a dome‐shaped, crusted lesion on the dorsum of the left hand. Microscopically, the tumor consisted of fascicles of spindle cells with bizarre nuclei and clear, vacuolated cytoplasm. Histochemical, immunohistochemical, and ultrastruc‐tural features supported the diagnosis of atypical fibroxanthoma. There was no evidence of metastatic disease. The lesion was completely excised, and there has been no recurrence in 3 months of observation. This unusual “clear cell” variant of atypical fibroxanthoma must be distinguished from other clear cell tumors, such as metastatic renal cell carcinoma, clear cell eccrine carcinoma, and clear cell sarcoma (malignant melanoma) of soft parts. Although atypical fibroxanthoma is usually cured by complete surgical excision, metastases have been reported.
Transposition “Banner” Flaps of the Torso
Authors: FIELD LAWRENCE M.
Published: June 2013

Abstract Several cases with serial photographs and commentary summarize experiences with well over 200 transposition “banner” flaps on the torso. The technique allows aesthetically acceptable reconstructions on the trunk by attention to detailed planning.
Deformities following Reconstructive Plastic Surgery
Authors: HAUBEN D.J. , BEN‐MEIR P.
Published: June 2013

Abstract Reconstructive plastic surgery provides a surgical solution for congenital and acquired abnormalities. Donor site distortions may occur and recipient sites will be adversely affected as a result of contraction in the wound healing process. Some of the operations illustrated here had inadequate indications. The surgical approach was wrong and its performance poor, in that the possibility of undesired results was not fully anticipated. This article presents eight cases in which healing deformities resulted and illustrates some of the procedures used to correct them.
Fatal Outcome in a Metatypical, Giant, “Horrifying” Basal Cell Carcinoma
Authors: BIANCHINI R. , WOLTER M.
Published: June 2013

Abstract Mutilating, horrifying, aggressive basal cell carcinoma (BCC) is a rare cutaneous neoplasm. We report a case of mutilating BCC of the face and its peculiar his‐tologic features. The primary lesion, before therapy, demonstrated typical BCC in association with lobules of metatypical cells. The recurrent BCC, after radiation therapy, had a metatvpical pattern. We believe that the metatypical BCC is a potentially aggressive lesion. It is essential for this tumor to be recognized early and treated surgically.
The Application of the Tie‐Down Suture to the Excision of Cutaneous Tumors
Authors: OCAMPO JORGE , CAMPS ALEJANDRO
Published: June 2013

Abstract. We describe a surgical procedure that acts as a compressive dressing and contributes to eliminate dead spaces. Because of its similarity to a tie‐down dressing, this technique is called the “tie‐down suture.” It is especially indicated after excision of mass lesions—epidermoid and dermoid cysts, steatocystomas, lipomas, hibernomas, etc.—where there are real or virtual dead spaces; in high‐movement or hairy areas where compressive dressings or adhesive tapes are difficult to hold in place; and in particular, in anatomic sites such as behind the auricle, armpit, or eyebrow.
Cryosurgical Management of Myxoid Cysts
Authors: BÖHLER‐SOMMEREGGER KORNELIA , KUTSCHERA‐HIENERT GABRIELE
Published: June 2013

Abstract. Eighteen patients with digital mucoid cysts and 31 with myxoid cysts of the oral mucosa were treated by cryosurgery using an intermittent spray technique. Double freeze‐thaw cycle (FTC) is recommended for successful treatment of digital mucoid cysts, as the recurrence rate was fairly high when only a single FTC was used. This does not necessarily apply to oral mucous cysts, where the cure rate was nearly 100%, whether a single or double FTC was used. We conclude that liquidnitrogen‐spray cryosurgery is an effective alternative in treating mucous cysts.
Dermatofibrosarcoma Protuberans
Authors: WEBER PAUL J. , GRETZULA JOSEPH C. , HEVIA OSCAR , GARLAND LARRY B. , BARQUIN PEDRO , GOULD EDWIN
Published: June 2013

Abstract. We report the case a 69‐year‐old woman with dermatofibrosarcoma protuberans, present, apparently, since birth. To our knowledge, this case represents the longest reported duration of a dermatofibrosarcoma protuberans.
Cutaneous Metastases from Laryngeal Carcinoma
Authors: VERALDI STEFANO , II ALESSANDRA CANTU , SALA FRANCESCO , SCHIANCHI ROSSANA , GASPARINI GIOVANNI
Published: June 2013

Abstract. The authors describe a case of cutaneous metastases from a squamous cell carcinoma of the laryngeal vestibule. The skin lesions, which consisted of nodules localized to the forehead and left arm, appeared 2 years after diagnosis of the primary tumor. The skin manifestations preceded lung metastases by 5 months.
Electrosurgery Using Insulated Needles: Treatment of Axillary Bromhidrosis and Hyperhidrosis
Authors: KOBAYASHI TOSHIO
Published: June 2013

Abstract. This paper deals with operative techniques and clinical aspects of electrically treating axillary bromhidrosis and hyperhidrosis using insulated needles. Most patients were treated 5 or 6 times using 2 types of needles, one for electroelimination of sweat glands and the other mainly for epilation. The results for most patients were satisfactory, with scarring occurring only in the early developmental stages of the technique.
Pigmented Bowen's Disease and Review of 420 Bowen's Disease Lesions
Authors: RAGI GANGARAM , TURNER MITCHELL S. , KLEIN LAWRENCE E. , STOLL HOWARD L.
Published: June 2013

Abstract. Pigmented Bowen's disease is rare. We report an unusual case of pigmented Bowen's disease of the ring finger, which clinically presented as a superficial, spreading melanoma. Records of 420 lesions of Bowen's disease were reviewed; 7 lesions (1.67%) were pigmented and all occurred outside the anogenital area. We conclude that Bowen's disease should be considered in the differential diagnosis of pigmented lesions.
Zosteriform Metastasis: Case Presentation and Review of the Literature
Authors: MATARASSO SETH L. , ROSEN TED
Published: June 2013

Abstract. In contrast to benign tumors, malignant tumors, by definition, are characterized by the potential of giving rise to metastases. Albeit infrequently, skin metastases do occur, and their clinical appearance varies over a wide morphologic spectrum. We present the case of a 65‐year‐old male with zosteriform metastasis secondary to bronchogenic adenocarcinoma. A review of cutaneous metastasis is presented with emphasis on dermatomal distribution and possible mechanisms of dissemination.
Transplantation of Human Basal Cell Carcinoma to C57/BALB/C bgJ/bgJ‐nu/nu (Beige‐Nude) Mouse
Authors: GRIMWOOD RONALD E. , GLANZ STEVEN M. , SIEGLE RONALD J.
Published: June 2013

Abstract. The purpose of this study was to evaluate the transplantation of BCC to the C57/BALB/C bgJ/bgJ‐nu/nu (beige‐nude) mouse. This animal has two gene defects which are expressed as impairment of natural killer cells (NK cells) as well as the absence of a thymus. The results demonstrate that human BCC can be successfully transplanted to the C57 beige‐nude mouse without the need for supplemental immunosuppression. It may be that the impairment of NK cell activity in the beige‐nude mouse model plays a significant role in tumor transplantation.
Combined Scalp Reduction and Autologous Fat Implant Treatment of Localized Soft Tissue Defects
Authors: ROENIGK HENRY H. , RUBENSTEIN RICHARD
Published: June 2013

Abstract. Autologous fat grafts have recently gained popularity in the treatment of soft tissue defects of the face. We report on two patients with circumscribed scalp alopecia and linear forehead depressions treated with a combination of scalp reduction and autologous fat implants. The patients had significant cosmetic improvement without complications.
Linear Atrophy Following Intralesional Steroid Injections
Authors: JEMEC GREGOR B.E.
Published: June 2013

Abstract. Two cases of perilymphatic atrophy following correctly administered intralesional steroid injections are reported. Perilymphatic atrophy produces a distinct clinical picture and may persist for months. A review of the literature shows that no treatment is indicated. It is stressed that the appearance of this cosmetically disturbing side effect is unpredictable, but spontaneously reversible.
Lateral Nose and Perinasal Defects: Options in Management Following Mohs Micrographic Surgery for Cutaneous Carcinoma
Authors: WHITAKER DUANE C. , GOLDSTEIN GLENN D.
Published: June 2013

Abstract. Primary and recurrent cutaneous carcinomas of the nose and the adjacent perinasal tissues often invade more deeply than cutaneous carcinomas in other areas. The operative defect may be large. The physician who has to close these defects is faced with a challenging problem that requires an appreciation of facial anatomy and function. There is often more than one option in the repair of these defects. Important concepts in the management of lateral nose and perinasal surgical defects are discussed.
Anesthesia for Liposuction in Dermatologic Surgery
Authors: KLEIN JEFFREY A.
Published: June 2013

Abstract. Liposuction is now a well‐established procedure in dermatologic surgery. The relative advantages and risks of the various forms of primary anesthesia and supplemental analgesia used for liposuction surgery in the office by dermatologic surgeons is described. Effective anesthetic techniques include infiltration of local anesthesia (LA) with or without intramuscular (IM), intravenous (IV), or nitrous oxide sedation, cryoanesthesia, and IV or inhalation general anesthesia (GA). Local anesthesia, using large volumes of dilute anesthetic solution containing lidocaine (0.05%), epinephrine (1:1,000,000), and sodium bicarbonate (12.5 meq/L), is a safe and effective modality for liposuction by dermatologists. In a study of 12 liposuction patients treated with this technique, the average lidocaine dose was 1181 mg (9.4 mg/kg/hr). The highest peak lidocaine blood level among all patients was 0.484 μg/ml. Dermatologists should not assume the dual responsibility of surgeon and of monitoring patients given IV sedation. Any form of anesthesia has the potential for serious complications. The surgeon and office staff must be well trained and equipped to perform emergency resuscitation.
Selection and Utilization of Liposuction Cannulas
Authors: COLLINS PAUL S.
Published: June 2013

Abstract. The liposuction surgeon can now choose from a wide variety of cannulas. However, the author has found that most procedures can be successfully performed using five or six basic types. Types of cannulas and techniques of liposuctioning are briefly described.
Microcystic Adnexal Carcinoma: A Case Showing Eccrine Duct Differentiation
Authors: CEBALLOS PATRICIA I. , PENNEYS NEAL S. , COHEN BERNARD H.
Published: June 2013

Abstract. Microcystic adnexal carcinoma (MAC) is a cutaneous neoplasm comprised of pilar and sweat duct structures. Characteristically, the ductal structures manifest immunoreactivity for carcinoembryonic antigen (CEA) on immunostaining. The case of MAC discussed here shows strictly sweat duct differentiation. Using a monoclonal antibody to salivary mucin (CF‐1) that is specific for eccrine duct, we identify the neoplastic structures to be of eccrine sweat duct histogenesis.
Razor Blade Excision of Mohs Specimens for Superficial Basal Cell Carcinomas of the Distal Nose
Authors: GRABSKI WILLIAM J. , SALASCHE STUART J.
Published: June 2013

Abstract. This article describes the excision of tissue for Mohs micrographic surgery utilizing a razor blade. The blade allows the maximum amount of normal tissue to be conserved. This is important when excising a relatively small, superficial basal cell carcinoma arising in an important cosmetic area such as the nose, which is also a region at high risk for recurrence. This technique often produces a wound that will heal secondarily with an excellent cosmetic result.
Micrograft Dilators: In Pursuit of the Undetectable Hairline
Authors: MARRITT EMANUEL
Published: June 2013

Abstract. The process of single‐hair transplanting, though providing obvious cosmetic advantages in hairline refinement, has long been considered too tedious and time consuming to be incorporated into standard transplant sessions. Micrograft dilators provide dilatation, organization, and hemostasis, while permitting large numbers of micrografts to be placed quickly and effortlessly below the standard transplanted hairline.
Ablation of Facial Scars by Programmed Dermabrasion
Authors: YARBOROUGH JOHN M.
Published: June 2013

Abstract. Revisions of scars, characteristically deferred for 6 to 12 months after wounds have healed, are performed to improve function and appearance. However, none of the techniques that has evolved to modify cicatrical deformities has afforded total, permanent effacement of scars already present. Evidence is presented here that dermabrasion of both surgical and accidental scars of the face, done 4 to 8 weeks after the primary wound, usually eliminates visible residual cicatrization.
Postoperative Techniques for Corneal Protection in Mohs Micrographic Surgery
Authors: WHITAKER DUANE C. , GOLDSTEIN GLENN D. , BIRKBY CRAIG S. , NERAD JEFFREY A.
Published: June 2013

Abstract. Corneal abrasion or injury can complicate periorbital surgery. In micrographic surgery of the eyelids and canthal regions, enough palpebral tissue may be sacrificed so that corneal exposure and injury can occur. In the interim between surgery and reconstruction, adequate measures must be taken to ensure protection of the globe. Techniques that protect the corneal epithelium for small or large surgical defects are described. J Dermatol Surg Oncol 1988; 14:951–955.
The Facelift
Authors: CHRISMAN BRUCE B.
Published: June 2013

Abstract. Facelift (rhytidectomy) is an advanced form of cutaneous surgery and therefore a part of dermatologic plastic surgery. The technique has been refined, so that almost uniformly good results can be achieved with few complications, and most of these procedures can be done on an outpatient basis using local anesthesia with sedation. For the advanced dermatologic surgeon, the technique is not difficult to master, and his/her high level of knowledge in the conditions, wound healing, and surgeries of the superficial facial tissues makes this procedure all the more apropos.
Intralesional Steroids in Cutaneous Hemangioma
Authors: REYES BLAS A. , VAZQUEZ‐BOTET MIGUEL , CAPO HILDA
Published: June 2013

Abstract. Cutaneous hemangiomas are present in 2.6% of all newborn children. Conservative management is the preferred method of treatment, and only cases with a high risk of complications should be treated. Periocular cutaneous hemangiomas have been associated with ophthalmic complications in 41%–100% of such cases. Intralesional steroids are frequently used by ophthalmologists for treatment of periocular hemangiomas. We present a case of cutaneous hemangioma treated with this modality. No previous cases have been reported in the dermatologic literature. A review, description, and complications of the use of intralesional steroids in hemangiomas are included.
Treatment of Varicose Veins: Modern Concepts and Methods
Authors: de GROOT WALTER P.
Published: June 2013

Abstract. Varicose veins have been a somewhat neglected entity. Treatment usually consists of routine stripping of the main trunks and excision of all distal tributaries, resulting in many unsightly scars. Modern diagnostic methods trace the origin of the reflux causing the condition. If the saphenofemoral or saphenopopliteal junction is involved, limited surgery is done, followed by sclerotherapy of the varicose tributaries later. Many cases can be treated with sclerotherapy only. A description of the new concepts is given. A diagnostic classification is presented, together with the corresponding methods of treatment.
Buried Vertical Mattress Suture
Authors: ZITELLI JOHN A. , MOY RONALD L.
Published: June 2013

Abstract. The buried vertical mattress suture combines the advantages of the vertical mattress suture and the buried intradermal suture. It provides prolonged wound support and eversion, while leaving no permanent suture marks on the skin.
Topical Minoxidil Used Before and After Hair Transplantation
Authors: BOUHANNA PIERRE
Published: June 2013

Abstract. A 2% solution of topical minoxidil was applied on the recipient bald scalp of 16 patients aged 25 to 52 years with Hamilton classifications of androgenetic alopecia from III to VI. Therapy was begun 4 weeks before surgery, was interrupted for 3 weeks, and was started again and continued for 3 months. Four‐millimeter donor grafts were inserted into 3.5‐mm recipient sites. Follow‐up utilizing macrophotography was done for 3 months on 4 grafts near a tattooed area. In 71% of the 64 grafts, partial or total hair is still growing without the shedding that usually occurs 2–4 weeks after transplantation. Topical minoxidil seems to be an adjunct for a better evolution of grafts after hair transplantation surgery.
Verrucous Hemangioma and Angiokeratoma Circumscriptum: Clinical and Histologic Differential Characteristics
Authors: ROSSI ANTONIO , BOZZI MARIO , BARRA ENRICA
Published: June 2013

Abstract. It is important, from a prognostic and therapeutic point of view, to make a correct diagnosis between verrucous hemangioma (VH) and angiokeratoma circumscriptum. The former needs a large and deep exeresis, while the latter responds to the common means of physical therapy. Two cases of verrucous hemangioma are reported that have allowed us to review the clinical and histologic differential characteristics of the two forms.
The Buried Running Dermal Subcutaneous Suture Technique
Authors: FTAIHA ZACKIE , SNOW STEPHEN N.
Published: June 2013

Abstract. This article illustrates the buried running dermal subcutaneous suture technique, a more rapid method for closing large fusiform open skin wounds than vertically oriented buried dermal subcutaneous sutures that are individually tied and cut. This technique effectively closes dead space, provides excellent strength, and relieves wound tension uniformly.
Marking the Spot
Authors: EPSTEIN ERNST
Published: June 2013

Abstract. Tattooing with India ink is a precise and practical method for identifying biopsy sites when there is a significant delay between biopsy and definitive surgery.
Instrumentation for the Dermatologic Surgeon
Authors: GRANDE DONALD J. , NEUBURG MARCY
Published: June 2013

Abstract. Because dermatologic surgery continues to enjoy widespread popularity as a leading treatment modality for skin disease, the skill and training of the surgeon are critical to patient care. Equally important, however, are the tools the surgeon uses to perform each particular procedure. Surgical instrumentation has often been a confusing subject for the novice surgeon, one in which personal preference often outweighs technical considerations. This article will present the advantages and shortcomings of several instruments that constitute the basic armamentarium of the dermatologic surgeon.
The Accessory Tragus—No Ordinary Skin Tag
Authors: SEBBEN JACK E.
Published: June 2013

Abstract. An accessory tragus can easily be treated by surgical excision. The results are quite satisfactory if care is taken to remove any protuberant portion of underlying cartilage. This lesion is rarely associated with other developmental defects of the first branchial arch.
Depths of Chemexfoliation Induced by Various Concentrations and Application Techniques of Trichloroacetic Acid in a Porcine Model
Authors: BRODLAND DAVID G. , CULLIMORE KIP C. , ROENIGK RANDALL K. , GIBSON LAWRENCE E.
Published: June 2013

Abstract. The depth of wounds created by various concentrations and application techniques of trichloroacetic acid (TCA) in a porcine model is evaluated. The depth of tissue necrosis increased with the concentration of TCA. Tape occlusion did not deepen the wound but rather decreased its depth. An inverse relationship of wound depth to epidermal thickness is described.
Stability‐Time Profile of Trichloroacetic Acid at Various Concentrations and Storage Conditions
Authors: SPINOWITZ ALAN L. , RUMSFIELD JEAN
Published: June 2013

Abstract. Trichloroacetic acid (TCA) is a deliquescent chemical widely used for a variety of procedures. Stability of various concentrations of TCA in both amber glass and plastic bottles stored under refrigeration and at room temperature was measured at several time points. Extended stability data suggest that TCA potency is stable for 23 weeks and would best be maintained in glass amber bottles stored under refrigeration.
Complications of Chemical Peeling
Authors: BRODY HAROLD J.
Published: June 2013

Abstract. In spite of controlled wounding with chemical peeling agents, complications may occur, resulting in patient and physician dissatisfaction. Precautions and factors causing these complications are examined, and relative contraindications to chemical peeling are discussed.
An Ultraviolet B Radiation Protocol for Complete Depletion of Human Epidermal Langerhans Cells
Authors: RAE VIRGINIA , YOSHIKAWA TAKESHI , BRUINS‐SLOT WARNER , STREILEIN J. WAYNE , TAYLOR J. RICHARD
Published: June 2013

Abstract. We report an ultraviolet B (UVB) protocol that achieves essentially complete depletion of Langerhans cells (LC) from human skin, while leaving the skin clinically intact. Sixteen human volunteers of skin types II and III were exposed to 144 mJ/cm2 of UVB each day for 4 successive days, on a 2‐cm‐diameter circle of buttock skin. In each case the irradiated skin showed redness and mild edema but no vesiculation or ulceration. One hour after the last exposure a 4‐mm punch biopsy was taken from the center of the irradiated site. The epidermal sheet from each sample was separated and exposed to CD‐1 antibody (12 samples) or HLA‐DR antibody (4 samples) and the density of LC was assessed by immunofluorescence light microscopy. In each case the epidermal LC population was severely depleted to less than 20 cells/mm2, from a baseline of approximately 565 cells/mm2, and in many cases no morphologically normal LC remained. This simple protocol thus provides intact human skin completely depleted of LC. Such skin will provide an appropriate model for the in vivo study of the immune function in human skin deprived of its epidermal antigen‐presenting capacity.
Benefits of the CO2 Laser for Verruca Resistant to Other Modalities of Treatment
Authors: APFELBERG DAVID B. , DRUKER DAVID , MASER MORTON R. , WHITE DAVID N. , LASH HARVEY , SPECTOR PAT
Published: June 2013

Abstract. The benefits of the carbon dioxide (CO2) laser in the treatment of verruca resistant to other forms of treatment have been studied. Twenty‐five patients with warts unsuccessfully treated from one to five times previously were treated with the laser, followed for a minimum of 6 months, and evaluated. Eight of these patients (32%) gained a total permanent cure. An additional five treatments resulted in a subtotal (over 75%) cure but some warts remained. Thus, 13 of 25 patients (52%) experienced complete or partially successful treatment. The CO2 laser is a valuable modality in the treatment of recalcitrant warts but cannot be expected to cure all such warts.
The Shorthand Vertical Mattress Stitch–A Rapid Skin Everting Suture Technique
Authors: SNOW STEPHEN N. , GOODMAN MATTHEW M. , LEMKE BRADLEY N.
Published: June 2013

Abstract. The shorthand vertical mattress stitch illustrated here provides the same amount of wound eversion in half the time as the classic vertical mattress suture technique.
The Association of Lichen Planus of the Penis with Squamous Cell Carcinoma in Situ and with Verrucous Squamous Carcinoma
Authors: BAIN LAURIE , GERONEMUS ROY
Published: June 2013

Abstract. Two cases of squamous cell carcinoma (SCC) of the penis, one verrucous type and one in situ, arising in association with an inflammatory dermatosis most consistent with lichen planus, are described. Although SCC has previously been reported to have arisen from lichen planus of the oral mucosa, these are the first reported cases of the coexistence of these processes on the penis.
Carbon Dioxide Laser Blepharoplasty: Conjunctival Temperature During Surgery
Authors: DAVID LAURENCE M. , ABERGEL R. PATRICK
Published: June 2013

Abstract. Eight patients underwent carbon dioxide (CO2) laser blepharoplasty. The temperature of the upper eyelid conjunctiva was monitored and recorded during laser surgery. A minimal increase in temperature was noted. This study confirms the absence of thermal injury at a distal site from the laser application and the safety of the laser procedure.
Mohs Surgery Is the Treatment of Choice for Recurrent (Previously Treated) Basal Cell Carcinoma
Authors: ROWE DAN E. , CARROLL RAYMOND J. , DAY CALVIN L.
Published: June 2013

Abstract. We reviewed all studies (since 1945) reporting recurrence rates for treatment of recurrent (previously treated) basal cell carcinomas (BCC) using surgical excision, radiotherapy, cryotherapy, curettage and electrodesiccation, and Mohs micrographic surgery. The 5‐year recurrence rate for Mohs micrographic surgery is 5.6%. The recurrence rate for non‐Mohs modalities of 19.9% is nearly four times higher. Individual recurrence rates for the non‐Mohs modalities are 17.4% for surgical excision, 40.0% for curettage and electrodesiccation, and 9.8% for radiation therapy. There are no studies reporting 5‐year data for cryotherapy. However, the recurrence rate is 13.0% for cryotherapy when the follow‐up period is less than five years. The data support the following conclusions: (1) Mohs surgery is the treatment of choice for recurrent BCC; (2) if the patient is not a surgical candidate and the lesion is small, radiation therapy is an alternative that offers a better chance for cure than the other non‐Mohs modalities; and (3) curettage and electrodesiccation should not be used to treat recurrent basal cell carcinoma.
Laser Vaporization: A Novel Treatment of Botryomycosis
Authors: LEFFELL DAVID J. , BROWN MARC D. , SWANSON NEIL A.
Published: June 2013

Abstract. Botryomycosis is an uncommon, chronic infection of the skin most often caused by Staphylococcus aureus. It has been successfully treated using carbon dioxide laser vaporization in a case in which antibiotic therapy failed, and surgical excision was not feasible.
Superficial Fascia—An Appropriate Anatomic Boundary for Excising Warts on the Foot
Authors: LEMONT HARVEY , PAREKH VIBHA
Published: June 2013

Abstract. When performing wart surgery of the foot, it is necessary to excise the lesion to the level where the superficial fascia is visible. This approach minimizes painful scar formation and ensures complete removal of the wart.
Multiple Glomus Tumors: A Role for Magnetic Resonance Imaging in Patient Evaluation?
Authors: BENEDICT LINDA M. , ZANOLLI MICHAEL D. , KARSTAEDT NOLAN , WHITE WAIN L. , JORIZZO JOSEPH J.
Published: June 2013

Abstract. Glomus tumors may occur as solitary lesions, or rarely as multiple glomus tumors (MGT). Internal organ involvement in patients with MGT has been reported, but is rare. Magnetic resonance imaging (MRI) has been reported to be useful in evaluating patients with blue rubber bleb nevus syndrome for nongastrointestinal internal organ involvement. Three patients with MGT were evaluated by MRI for both cutaneous and internal involvement. MRI, which is useful in evaluating other vascular lesions, is not useful in the evaluation of patients with multiple glomus tumors. With these results, patients with MGT can be spared the expense of MRI procedure.
The Use of Live Pigs in the Surgical Training of Dermatology Residents
Authors: ANDERS KENYA H. , GOLDSTEIN BETH G. , LESHER JACK L. , SHIMP ROBERT G. , CHALKER DAN K.
Published: June 2013

Abstract. Refining of surgical skills requires instruction, manual repetition, and observation of results. This study demonstrates that while many dermatology residents use pig's feet or synthetic models of skin for practice, few use live animals. We describe the benefits and mechanics of utilizing anesthetized pigs for cutaneous surgical training.
Giant Arteriovenous Hemangioma (Cirsoid Aneurysm) of the Nose
Authors: NEUMANN R. A. , KNOBLER R. M. , SCHULLER‐PETROVIC S. , LINDMAIER A. , GEBHART W.
Published: June 2013

Abstract. We describe a 97‐year‐old woman who presented to our clinic with an unusually large pendulous asymptomatic soft tumor on the left side of her nose. History revealed a 40‐year course, with accelerated growth in the last 9 years. Histology of this 7 × 3‐cm large tumor revealed vascular structures composed of densely aggregated thick‐ and thin‐walled vessels, separated by fibrous tissue. These features are characteristic for an arteriovenous hemangioma, also called cirsoid aneurysm. The distal part of the tumor showed nearly total fibrosis and at the proximal end of the tumor signs of incipient basal cell carcinoma were observed. In spite of the accelerated growth, unusual size, and the presence of a basal cell carcinoma at the base of this tumor, giant cirsoid aneurysms appear to be of a benign nature and thus conservative, nonradical surgical treatment can be performed. The tumor was removed by argon laser surgery with excellent results and no sign of recurrence after 1 year.
Carbon Dioxide Laser Treatment of Erythroplasia of Queyrat
Authors: GREENBAUM STEVEN S. , GLOGAU RICHARD , STEGMAN SAMUEL J. , TROMOVITCH THEODORE A.
Published: June 2013

Abstract. We present a case of erythroplasia of Queyrat in a 77‐year‐old man involving the distal two‐thirds of the penis. There was no urethral or periurethral involvement. Due to the location of the lesion, its recognition as carcinoma in situ, and the technical difficulty of cold‐steel excision in this area, we used the carbon dioxide (CO2) laser to selectively destroy the tumor. In this case the laser provided controllable tissue destruction, ease of surgery, and excellent cosmesis.
Treatment of Varicose and Telangiectatic Leg Veins with Hypertonic Saline: A Comparative Study of Heparin and Saline
Authors: SADICK NEIL S.
Published: June 2013

Abstract. The clinical results of treating 800 patients with starburst varicosities using hypertonic saline with and without heparin are described. The extent and type of complications seen in this series of patients are indicated.
EKG Changes in Relationship to the Chemical Peel
Authors: PRICE NORMAN M.
Published: June 2013

Abstract. Holter monitor‐type EKG studies were done in a series of 10 patients during preoperative baseline and intra‐ and postoperative periods of Baker‐type chemical peel procedures. The intention was to assess the quantitative and qualitative EKG changes occurring before, during, and after the procedures. The results show that there were many spontaneously occurring ectopic beats and changes unrelated to the actual application of the chemical peel formula. Only one of the patients demonstrated such changes, which can be potentially life threatening, occurring in relationship to application of the chemical peel formula.
Intraoperative Tissue Expansion Using a Foley Catheter Following Excision of a Basal Cell Carcinoma
Authors: GREENBAUM STEVEN S. , GREENBAUM CHARLES H.
Published: June 2013

Abstract. Chronic tissue expansion has gained an accepted role in reconstructive surgery. Recently, intraoperative tissue expansion (rapid expansion) has been introduced as an alternate technique for recruitment of additional tissue to aid in wound closure. At the present time, the available expanders are designed for single use and then must be discarded; thus they are relatively expensive. We present the use of the readily accessible Foley catheter as a suitable, inexpensive, safe, and practical device for intraoperative tissue expansion.
Razor‐Blade Surgery
Authors: GRABSKI WILLIAM J. , SALASCHE STUART J. , MULVANEY MICHAEL J.
Published: June 2013

Abstract. The razor blade can be a valuable tool in the performance of many minor surgical procedures. It is extremely sharp, flexible, inexpensive, readily available, and easy to use. The technique and specific applications are reviewed and discussed.
The Transverse Anatomy of Androgenic Alopecia
Authors: SPERLING LEONARD C. , WINTON GEORGE B.
Published: June 2013

Abstract. Twenty‐five biopsy specimens from the balding frontal scalp of five patients were studied. Processing included vertical and transverse (horizontal) sectioning, to‐luidine blue and hematoxylin and eosin staining, and fixed and frozen sectioning. Findings included decreased hair density, increased numbers of vellus hairs, and alteration of the normal follicular architecture. Transverse frozen sectioning with toluidine blue staining appeared to be a rapid and reliable tool for studying androgenic alopecia.
Fine‐Needle Aspiration for Diagnosis of Intranodal Squamous‐Cell Carcinoma Metastatic from the Skin
Authors: PARKER RAY , DINEHART SCOTT M. , BENNETT RICHARD G. , HOUN HOUN‐YEE
Published: June 2013

Abstract. Fine‐needle aspiration is a useful way to determine the presence of squamous‐cell carcinoma in enlarged lymph nodes of patients at high risk for metastases. Advantages include a high degree of accuracy, outpatient as well as inpatient availability, and negligible potential for seeding of malignant cells. Cutaneous oncologists should consider using this technique in patients with lymphadenopathy and a previous history of cutaneous squamous cell carcinoma.
Basal Cell Carcinoma Arising in Pemphigus Vulgaris of the Lower Eyelid
Authors: PAGANI WILLY A. , RIMONDI ANNA P. , CHIACCHIARINL ANDREA , LORENZI GIUSEPPE
Published: June 2013

Abstract. A 59‐year‐old woman on continuous treatment with corticosteroids and immunosuppressive drugs for pemphigus vulgaris of 14 year's duration presented with an enlarging nodular lesion on the right lower eyelid. The neoplasm, diagnosed as basal cell carcinoma, was excised conserving the lid margin, and eyelid reconstruction was done with a rotated cheek flap. Wound healing proceeded without complications in spite of immunosuppressive treatment, and the final cosmetic and functional result was satisfactory.
Dermatologic Laser Surgery
Authors: GARDEN JEROME M. , GERONEMUS ROY G.
Published: June 2013

Abstract. The laser is becoming an increasingly important surgical and medical instrument in the field of dermatology. Developments in the areas of laser technology and application have significantly broadened its clinical use over the past several years. These rapid changes and advances in the use of the laser for cutaneous processes may make it difficult for the physician to maintain a current base of knowledge in this area. Relevant laser systems and their clinical applications are presented and discussed, as are investigational laser systems, which may be of importance for the future. This will allow the dermatologic surgeon the opportunity to update concepts and evaluate the various laser systems and their cutaneous applications.
Angiofibromas in Tuberous Sclerosis: Comparison of Treatment by Carbon Dioxide and Argon Laser
Authors: JANNIGER CAMILA K. , GOLDBERG DAVID J.
Published: June 2013

Abstract. Multiple angiofibromas (adenoma sebaceum) of the nose in a dark‐complexioned patient with tuberous sclerosis were treated with laser surgery. One side of the nose was treated with the argon laser. The other side of the nose was treated with the carbon dioxide (CO2) laser. The CO2 laser produced superior cosmetic results with more complete removal of cutaneous lesions.
Pulsed‐Dye Laser Treatment of Leg Telangiectasia: With and Without Simultaneous Sclerotherapy
Authors: GOLDMAN MITCHEL P. , FITZPATRICK RICHARD E.
Published: June 2013

Abstract. Thirty consecutive female patients with red leg telangiectasia less than 0.2 mm in diameter were treated with a Candela SPTL‐1 Pulsed Dye Laser (PDL) tuned to 585 nm with a pulse duration of 450 μs at energies ranging from 6.0 to 8.5 J/cm2 delivered through a 5–mm spot size to the entire length of the telangiectasia. Seven patients with 25 patches of telangiectatic matting after previous sclerotherapy were also treated. Twenty‐seven patients with symmetrical telangiectatic patches or a large “starburst” telangiectatic flair that could be divided into two separate treatment sites were treated at one site with PDL alone, and at the other site with a combination of PDL followed immediately by sclerotherapy (SCL) with Polidocanol 0.1–0.25 ml per injection site at a concentration of either 0.25%, 0.5%, or 0.75%. PDL treatment is efficacious for both essential telangiectasia and vessels that arise through the phenomena of telangiectatic matting. Sixty‐five percent of vessels are completely faded with treatment. PDL alone has a remarkably low incidence of adverse sequelae. Treatment is most efficacious if all vessels larger than 0.2 mm in diameter, especially varicose and reticular feeding veins, are treated first. Treatment results are not affected by vessel location. And post‐treatment compression of this type of vessel appears unnecessary. Combination PDL/SCL treatment appears to offer no advantage to sclerotherapy treatment alone and has a significant degree of complications when treatment is limited to red telangiectasia less than 0.2 mm in diameter with the laser parameters utilized.
The Principle of Cosmetic Junctions as Applied to Reconstruction of Defects Following Mohs Surgery
Authors: DZUBOW LEONARD M. , ZACK LISA
Published: June 2013

Abstract. Reconstruction of defects that cross several cosmetic units can be aesthetically accomplished by preserving the integrity of the cosmetic boundaries using multiple grafts and flaps rather than one all‐encompassing repair.