bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iontophoretic Administration of Lidocaine Anesthesia in Office Practice
Authors: MALONEY J. MICHAEL , BEZZANT JOHN L. , STEPHEN ROBERT L. , PETELENZ TOMASZ J. 
Published: June 2013

background
: Obtaining anesthesia for dermatologic, office‐based surgeries often involves the pain of needle stick and burning upon injection of local anesthetic agents. No truly effective method for obtaining painless anesthesia is well accepted in the United States.
objective
: A study was carried out using iontophoresis of lidocaine with epinephrine to determine the practicality of this method of delivering local anesthesia prior to invasive procedures in dermatology offices.
methods
: A two‐center, open‐label study was undertaken using iontophoretic administration of 4% lidocaine with epinephrine 1:50,000 before painful procedures occurring in the dermatologists’office.
results
: Ninety‐four procedures in 64 patients were evaluated. Both patients and physicians recorded 51% of procedures as painless, 36% as minor (partial), and 14% causing moderate to severe pain. Iontophoretic local anesthesia was 80 to 100% effective for pain relief for injections, abrasions, laser surgery, and cautery; it was significantly less effective in effecting pain relief for dermal excisions.
conclusions
: Iontophoretic administration of anesthesia is a useful adjunct to the armamentarium of dermatologists performing surgical procedures in their office. J Dermatol Surg Oncol 1992;18:937–940.
Lumps and Bumps of the Eyelids and Their Management
Authors: BERGIN DONALD J. 
Published: June 2013

background
. Tumors of the eyelids, because of their location and variety, can present management problems.
objective
. To describe tumors of the eyelid, their identification, and their management.
conclusion
. All tumors and inflammations of the lids, except those that are easily diagnosed, should be biopsied and sent for histologic administration. J Dermatol Surg Oncol 1992;18:1042–1048.
Malignant Lesions of the Eyelids
Authors: PIEST KENNETH L. 
Published: June 2013

background
. The ocular adnexal area contains virtually every tissue type; nearly any type of malignant tumor may develop in this area. However, the vast majority of malignant eyelid tumors are carcinomas. Three types of carcinomas produce most of the malignancies in this group. They are: basal cell carcinomas, squamous cell carcinomas, and sebaceous cell carcinomas.
objective
. The management of these three tumors is discussed.
methods
. A review of current treatment options for eyelid malignancies was performed.
results
. A summary of the current treatment of the three most common eyelid carcinomas is discussed.
conclusion
. With early recognition and appropriate management of eyelid malignancies, an extremely favorable prognosis can be obtained. The management is twofold and consists of curing the patient of the malignancy and then restoring the form and function of the eyelid in order to save the eye if possible. J Dermatol Surg Oncol 1992;18:1056–1059.
Suppression of the Delayed Type Hypersensitivity Response by Tumor Facilitating Factor of B16 Melanoma
Authors: BURNSTEIN PENINA , BRODY NEIL I. 
Published: June 2013

background. Tumor facilitating factor is a cell surface glycoprotein produced by B16 melanoma that has been found to reduce the lethal inoculum for B16. Tumor facilitating factor induces macrophage spreading in vitro, reduces macrophage chemotaxis in vivo, and depresses lymphocyte mitogenesis in vitro.objective. It is assumed that the immune modifying effects are responsible for tumor facilitation. As tumors may be poor immunogens or inducers of inflammation, studies were conducted to determine whether tumor facilitating factor alters the inflammatory cascade of cells found in infiltrates of delayed type hypersensitivity.results. Freeze‐thawed B16 cells, used as the source of TFF, caused a suppression of delayed type hypersensitivity measured as ear swelling in the mouse. When culture supernatant was substituted for freeze‐thawed cells as a source of TFF and injected at different time points of the delayed type hypersensitivity response, the greater suppression was with tumor facilitating factor injections at 24 hours pre‐elicitation only (82%), and 24 hours both presensitization and pre‐elicitation (89%). Immunohistological staining demonstrated that tumor facilitating factor decreases ear thickness and cellular infiltrates, specifically Mac‐1 staining cells, to a site of delayed hypersensitivity. Peritoneal cell analysis confirmed these findings.conclusion. These data are consistent with the hypothesis that tumor facilitating factor alters immune functions including macrophage and lymphocyte mobility and recruitment to a target site, thereby allowing for facilitation of tumor growth.
Medical and Technical Issues in Office Electrolysis and Thermolysis
Authors: WAGNER RICHARD F. 
Published: June 2013

background. Most university medical centers do not directly offer electrolysis or thermolysis services to hirsute patients. Little research activity has been focused on these procedures. The successful introduction of a clinical and research electrolysis service into the University of Texas Medical Branch (UTMB) dermatology clinic is described.objective. The purpose of this communication is to familiarize clinicians with an electrolysis service in a university clinic setting. New advances in permanent hair removal equipment and methods are reviewed.methods. A description of the UTMB electrolysis clinic is given.results. Electrolysis services offered by the UTMB dermatology department have been well received by patients, clinical staff, UTMB faculty, UTMB resident physicians, and private physicians.conclusion. This successful medical model for electrolysis services may provide other university dermatology clinics with background information for the development of their own programs. Future research advances in electrolysis and the management of hirsutism may result from this activity.
The Prevention of Cutaneous Necrosis Following Extravasation of Hypertonic Saline and Sodium Tetradecyl Sulfate
Authors: ZIMMET STEVEN E. 
Published: June 2013

background. Most authors have recommended treating extravasation during sclerotherapy by infiltrating the area with 0.9% sodium chloride and/or procaine.objective. To evaluate interventions in the prevention of necrosis following intradermal injection of 23.4% sodium chloride and 3% sodium tetradecyl sulfate.methods. Following intradermal 23.4% sodium chloride (Study I) or 3% sodium tetradecyl sulfate (Study II), subjects (Sprague‐Dawley rats) received either no treatment or injections of 0.9% sodium chloride, sterile water, 1% procaine, or hyaluronidase. Groups were compared regarding incidence and size of necrosis.results. In study I, hyaluronidase treated groups had significantly fewer and smaller areas of necrosis than other groups. In study II, the hyaluronidase group developed significantly fewer ulcers than the 0.9% sodium chloride group. The 0.9% sodium chloride group had significantly larger ulcers than other groups.conclusion. In the model studied, hyaluronidase was the only effective treatment in the prevention of necrosis. Following 3% sodium tetradecyl sulfate, 0.9% sodium chloride was associated with larger ulcers than other groups.
Histiocytic Reaction Associated with Topical Aluminum Chloride (Drysol Reaction)
Authors: BARR RONALD J. , ALPERN KENNETH S. , JAY SHIRLENE 
Published: June 2013

BACKGROUND. In the past few years, dermatologists have begun to use aluminum chloride (Drysol) as a hemostatic agent for minor surgical procedures. An unusual histiocytic reaction was noted in biopsies of skin previously treated with aluminum chloride. This reaction consisted of a proliferation of histiocytic cells that contained prominent basophilic cytoplasmic granules.OBJECTIVE. To determine the cause of this reaction and the nature of the basophilic granular material within the histiocytic cells.METHODS. Four cases are presented in which re‐excised tissue previously treated with aluminum chloride were examined with special histochemistry staining and roentgen diffraction studies.RESULTS. The granules of these histiocytes stained positively with the aluminon stain, a stain specific for aluminum, although no aluminum was found using the less sensitive roentgen diffraction studies.CONCLUSION. These studies support the concept that aluminum chloride can cause a proliferative histiocytic reaction when used as a topical cauterizing agent.
Intraoperative Tissue Expansion with the Foley Catheter
Authors: GREENBAUM STEVEN S. 
Published: June 2013

BACKGROUND. As surgeons face larger and more complex surgical defects, there is the continual search for more practical, successful, and cosmetically elegant methods for repair. Intraoperative tissue expansion is a relatively new technique built upon the fundamentals of traditional chronic tissue expansion. The Foley catheter is an inexpensive, readily available device that can be used for intraoperative tissue expansion.OBJECTIVE. The purpose of this article is to explain and demonstrate some of the uses for intraoperative tissue expansion with the Foley catheter.METHODS. A series of cycles of inflation and deflation of the Foley catheter balloon allows for gradual stretching of the skin over a period of 15 to 20 minutes.RESULTS AND CONCLUSION. The “tissue gain” achieved via this technique often facilitates wound repair. The Foley catheter is a useful device and a significant addition to the dermatologic surgeon's armamentarium.
Granulomatous Dermatitis to Iron Oxide After Permanent Pigmentation of the Eyebrows
Authors: RUBIANES ELBA I. , SÁNCHEZ JORGE L. 
Published: June 2013

background. Tattooing with iron oxide pigment is used to create a permanent line along the eyelid margins and to cause permanent pigmentation of the eyebrows. However inflammatory sequlae can occur.objective: To present the development and treatment of a granulomatous inflammation as a sequela of iron oxide tattooing in the eyebrows.method: A skin biopsy was performed, Histopathologic examination revealed deposits of reddish‐brown pigment and a superficial dermal infiltrate consisting of lymphocytes and giant multinucleated cells (Langhan's and foreign body).result: A patient developed a granulomatous reaction to iron oxide after undergoing permanent pigmentation of the eyebrows. Treatment with systemic and topical steroids resulted in marked improvement at 6‐month follow‐up.conclusions: This is an unusual complication. A skin test should be performed on any patient who is to undergo tattooing with iron oxide pigment.
Scalp Lifting
Authors: SWINEHART JAMES M. , BRANDY DOMINIC A. 
Published: June 2013

background. Extensive scalp lifting, though offering the potential for tremendous benefit to the patient with extensive male‐pattern alopecia, has not been widely accepted or understood.objective. The anatomic and technical features of extensive scalp lifting are discussed.methods. The performance of extensive scalp lift surgery must be preceded by a thorough understanding of the specific goals, anatomic considerations, surgical techniques, and specific methods for successful completion of this operation. A knowledge of preoperative preparation, anesthesia, intraoperative methods, undermining, hemostasis, means of scalp advancement, and proper closure are essential for minimizing side effects and complications of this beneficial procedure. One must understand the dynamics of scalp stretching and lifting in order to achieve optimum removal of baldness and to successfully predict the outcome of the operation.conclusion. Present and future advantages of scalp lifting over traditional scalp reduction have been enumerated and discussed.
Correlation of Serum Ferritin Levels and Postsclerotherapy Pigmentation
Authors: THIBAULT PAUL KENNETH , WLODARCZYK JOHN 
Published: June 2013

background. Postsclerotherapy pigmentation is a common sequela of sclerotherapy to varicose and telangiectatic leg veins. This pigmentation is thought to be due to hemosiderin deposition in the dermis. A preliminary study indicated that serum ferritin was a good indicator of susceptibility to postsclerotherapy pigmentation.objective. To clarify the relationship between serum ferritin and postsclerotherapy pigmentation using a prospective study.methods. Serum ferritin levels were taken from 233 consecutive patients prior to commencement of sclerotherapy. Patients were assessed clinically for the presence of pigmentation at 3, 6, and 12 months.results. There was a linear relationship between pretreatment serum ferritin level and the occurrence of pigmentation at each posttreatment assessment date.conclusion. The results confirm a relationship between serum ferritin levels and postsclerotherapy pigmentation. This indicates that a significant predisposing factor to the development of persistent postsclerotherapy pigmentation is a high level of total body iron Stores.
Recalling Basal Cell Carcinoma Patients
Authors: EPSTEIN ERNST 
Published: June 2013

background. Patients with a basal cell carcinoma (BCC) are at increased risk for developing further BCCs, and long‐term follow‐up has been recommended to detect new cancers at an earlier, more easily treatable stage. The majority of BCCs are treated by dermatologists in their offices; we do not know to what extent they perform long‐term follow up on their patients.objective. To determine how practicing dermatologists follow up their BCC patients.methods. A mailed questionnaire survey of 166 practicing members of a regional dermatologic society (the San Francisco Dermatological Society), to which 142 (85%) replied.results. Two thirds of the respondents recalled BCC patients for screening examinations; of these, 58% followed up non‐responders. Recall efforts were hampered by inefficient, unwieldy, and time‐consuming techniques.conclusion. Practicing dermatologists are motivated to recall BCC patients for examination, but guidelines and techniques for effective and efficient computerized recalling of skin cancer patients are needed. It is suggested that the American Academy of Dermatology set up a task force to develop guidelines and criteria for effective recall software.
Decrease in Skin‐closing Tension Intraoperatively with Suture Tension Adjustment Reel, Balloon Expansion, and Undermining
Authors: LAM ANSON C. , NGUYEN QUAN H. , TAHERY DAN P. , COHEN BERNIE H. , SASAKI GORDON H. , MOY RONALD L. 
Published: June 2013

background
. The biomechanical and viscoelastic properties of the skin enable it to be significantly stretched within a relatively short period of time. This property, called mechanical creep, is exploited in various surgical maneuvers for intraoperative closure of large surgical defects. The recently introduced Miami Suture Tension Adjustment Reel (S.T.A.R.) device permits both the precise sutured attachment of a linear cycled load to approximate the edges of widened surgical defects, and the easy measurement of wound edge tension across the defects.
objective
. It was our purpose to compare the relative effects of linear load cycling with the S.T.A.R. device, spherical load cycling with balloon expander, and surgical undermining on the closing tension of surgical defects.
methods
. Surgical wounds were created on the flanks of six pigs and these defects were closed by various methods of repair. The combination of undermining and the S.T.A.R. device was also evaluated.
results
. The average total decreases in skin closing tension were: undermining, 17.8 ± 0.5%; balloon, 28.5 ± 1.6%; S.T.A.R. device, 36.6 ± 4.8%.
conclusions
. Our data showed that all three techniques were effective in lowering the tension required to approximate surgically created defects, with the S.T.A.R. device proving to be most effective. Undermining and the S.T.A.R. device also worked synergistically to decrease skin‐closing tension.
Evaluation of Acetowhitening in Bowen's Disease
Authors: SCHELL BARBARA J. , ROSEN TED 
Published: June 2013

background. From a clinical Standpoint, the lesions of Boiven's disease (squamous cell Carcinoma in situ) are generally sharply demarcated. Following excision, however, contiguous extension and/or small foci of Bowen's disease are occasionally found, located outside the clinically apparent margins. Acetowhitening has been suggested as a means of delineating the extent of involvement and identifying subclinical lesions of Condyloma acuminata. More recently, acetowhitening has been similarly reported to be of potential value in the presurgical evaluation of Bowen's disease.objective. The purpose of this investigation was to further evaluate the use and reliability of acetowhitening both to delineate margins of Bowen's disease and to identify subclinical foci of involvement.methods. Eight patients with histologically confirmed Bowen's disease were studied. Six percent acetic acid was applied to the lesions and the surrounding skin. Histologie examination of acetowhite lesions and adjacent acetowhite skin as well as adjacent, nonwhitened normal appearing skin was performed.results. Our results were inconsistent, and included both false positives and false negatives.conclusions. Acetowhitening is unreliable in identification of Bowen's disease. Clinically normal, acetowhite‐negative skin adjacent to a lesion of Bowen's disease may be involved.
Healing Impairment of Open Wounds by Skin Irradiation
Authors: BERNSTEIN ERIC F. , HARISIADIS LEON , SALOMON GARY D. , MITCHELL FRANK HARRINGTON JAMES B. , UITTO JOUNI , GLATSTEIN ELI , RUSSO ANGELO 
Published: June 2013

background. Ionizing radiation isfrequently usedfor the treatment of malignancy. Sequelae of therapeutic radiation frequently present clinical problems in the form of poor wound healing and easy injury of treated tissue in response to mild trauma.objecitve. We describe a radiation‐impaired wound healing model in guinea pigs, developed to determine the effect of cutaneous Irradiation on wound contraction.methods. Guinea pigs were anesthetized and a flap of skin was isolated and treated with x‐rays to 18 Gy. Circular wounds of identical size were made in irradiated and control skin, and average wound size was recorded.results. Our results demonstrate that a statistically significant wound healing deficit is produced in open wounds by surface irradiation of skin.conclusion. Radiation of skin results in slower healing of open wounds, andprovides an in vivo System for evaluation of topical dressings and growth factors in radiation‐impaired wounds.
The Relationship between Basal Cell Epithelioma and Seborrheic Keratosis
Authors: RAO BABAR K. , FREEMAN ROBERT G. , POULOS EVANGELOS G. , ARBESFELD LISA , RENDON MARTA 
Published: June 2013

background. Various skin tumors can be seen rarely in association with seborrheic keratosis. We present 60 cases of seborrheic keratosis related to a basal cell epithelioma in the same specimen.objective. To report association of basal cell epithelioma with seborrheic keratosis and discuss the possibility of malignant change in seborrheic keratosis.methods. Sixty cases of seborrheic keratosis associated with basal cell epithelioma were studied. Tissues were fixed in neutral buffered formalin, processed, and stained with Standard hematoxylin and eosin techniques.results. Histological evaluation showed a seborrheic keratosis associated with basal cell epithelioma in all of the cases. Basal cell epithelioma was attached with seborrheic keratosis in a majority of the cases (40/60) and appeared to represent a part of the same tumor. Both tumors were lying adjacent to each other in the rest of the cases (20/60).conclusion. Malignant change in seborrheic keratosis is controversial. We recommend the histological evaluation of seborrheic keratosis especially when inflamed or atypical in appearance. This should not be taken as a mandate for pathological evaluation or for treatment of every seborrheic keratosis as though it was potentially malignant.
Sclerosing Sweat Duct Carcinoma in an 11‐year‐old Boy
Authors: McALVANY JOANNE P. , STONECIPHER MARCUS R. , LESHIN BARRY , PRICHARD ELIZABETH , WHITE WAIN 
Published: June 2013

background. Sclerosing sweat duct Carcinoma, or microcystic adnexal Carcinoma, is a rare neoplasm of the skin with both pilar and eccrine differentiation. Previously this neoplasm has been reported only in adults. We describe a case of sclerosing sweat duct Carcinoma in an 11‐year‐old white male.objective. Description of Mohs surgical procedure for successful management of sclerosing sweat duct Carcinoma in a child.methods. Mohs micrographic surgery was performed on this rare neoplasm.results. The described procedure resulted in successful excision of this uncommon neoplasm.conclusion. We present a case of sclerosing sweat duct Carcinoma, an unusual cutaneous neoplasm, in an 11‐year‐old male that was successfully managed using Mohs micrographic surgery.
A Technique for the Biopsy of Oral Lesions
Authors: ALINOVI ALBERTO , ALLEGRA FULVIO 
Published: June 2013

background. Biopsy of mucosal lesions can be carried out by means of several methods.objective. To describe a combination technique for the biopsy of mucosal lesions.methods. The combined effect of a chalazion forceps with a 4‐mm punch allows the physicians to work on a stabilized, bloodless, and therefore simplified field.results. A preliminary suture with a 4‐0 catgut chromic is the key step in assuring a safe post‐operative hemostasis.conclusion. This technique allows us to perform accurate and safe oral mucosal biopsies without any major side effects.
The Removal of Cutaneous Pigmented Lesions with the Q‐switched Ruby Laser and the Q‐switched Neodymium: Yttrium‐Aluminum‐Garnet Laser
Authors: TSE YARDY , LEVINE VICKI J. , MCCLAIN STEVE A. , ASHINOFF ROBIN 
Published: June 2013

background. The Q‐switched ruby laser (QSRL) (694 nm) has been used successfully in the removal of tattoos and a variety of cutaneous pigmented lesions. The frequency‐doubled Q‐switched neodymium:yttrium‐aluminum‐garnet laser (QSNd: YAG) (1064 and 532 nm) has also been shown to be effective in the treatment of tattoos, however, little has been published regarding the QSNd:YAG laser in the removal of cutaneous pigmented lesions.objective. The purpose of this study is to compare the efficacy and side effect profile of the QSRL and the frequency‐doubled QSNd:YAG lasers in the removal of cutaneous pigmented lesions, including lentigines, café‐au‐lait macules, nevus of Ota, nevus spilus, Becker's nevus, postinflammatory hyperpigmentation, and melasma.methods. Twenty patients with pigmented lesions were treated with the QSRL and the frequency‐doubled QSNd:YAG lasers. Clinical lightening of the lesion was assessed 1 month after a Single treatment. Side effects and patient satisfaction were also evaluated.results. A minimum of 30% lightening was achieved in all patients after only one treatment with either the QSRL or the frequency‐doubled QSNd.YAG laser. The QSRL seems to provide a slightly better treatment response than the QSNd:YAG laser. Neither laser caused scarring or textural change of the skin. Most patients found the QSRL to be more painful during treatment, but the QSNd:YAG laser caused more postoperative discomfort.conclusion. Both the QSRL and the frequency‐doubled QSND:YAG laser are safe and effective methods of treatment of epidermal and dermal pigmented lesions.