Severe Rhinophyma. Tips and Tricks in Carbon Dioxide Laser Decortication

Publication date: Available online 31 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Álvaro Iglesias-Puzas, Claudia Olmos-Nieva, Manuel Ángel Rodríguez-Prieto

http://bit.ly/2MIuDrM

Patients Believe Cosmetic Procedures Affect Their Quality of Life: An Interview Study of Patient-Reported Motivations

Publication date: Available online 31 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Abigail Waldman, Amanda Maisel, Alexandra Weil, Sanjana Iyengar, Kaitlyn Sacotte, Jake M. Lazaroff, Sasha Kurumety, Sara L. Shaunfield, Kelly A. Reynolds, Emily Poon, June K. Robinson, Murad Alam

Abstract

Background

While treatments to address cosmetic concerns are common, patients' self-reported motives for considering such procedures have not been systematically explored.

Objective

To develop a framework of categories to describe patient's self-reported motivations for undergoing minimally invasive cosmetic procedures.

Methods

Face-to-face, semi-structured patient interviews were conducted with adult participants who had received or were considering minimally invasive cosmetic dermatologic procedures. A qualitative constant comparative approach was employed to analyze interview transcripts, yielding themes and subthemes.

Results

30 interviews were completed. Most patient-reported motivations for cosmetic procedures could be subsumed under eight general categories (themes): 1) mental and emotional health, 2) cosmetic appearance, 3) physical health, 4) work/school success, 5) social well-being, 6) cost/convenience, 7) procedural perceptions, and 8) timing of treatment. Many individual motivations in these categories were unrelated to desire for physical beauty. In particular, participants wanted to avoid being self-conscious, enhance confidence, reduce time and expense required to conceal physical imperfections, and be perceived as capable at work.

Limitations

Only English-speaking patients in the U.S. were interviewed.

Conclusion

Patient-reported motivations for cosmetic procedures mostly pertained to physical and psychosocial well-being. Indeed, a desire for improved cosmetic appearance comprised only one of the 8 themes revealed through patient interviews.

http://bit.ly/2t6ii7X

The Etiology, Diagnosis and Management of Hyperhidrosis: A Comprehensive Review. Part II. Therapeutic Options

Publication date: Available online 31 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Shiri Nawrocki, Jisun Cha

Abstract

Hyperhidrosis (HH) is a chronic disorder of excess sweat production that may have a significant adverse effect on quality of life. A variety of treatment modalities currently exist to manage HH. Initial treatment includes lifestyle and behavioral recommendations. Antiperspirants are regarded as the first-line therapy for primary focal HH and can provide significant benefit. Iontophoresis is considered to be the primary remedy for palmar and plantar HH. Botulinum toxin (BTX) injections are administered at the dermal-subcutaneous junction and serve as a safe and effective treatment option for focal HH. Oral systemic agents are reserved for treatment-resistant cases or for generalized HH. Energy delivering devices such as lasers, ultrasound technology, microwave thermolysis, and fractional microneedle radiofrequency may also be utilized to reduce focal sweating. Surgery may be considered when more conservative treatments have failed. Local surgical techniques, particularly for axillary HH, include excision, curettage, liposuction, or a combination of these techniques. Sympathectomy is the treatment of last resort when conservative treatments are unsuccessful or intolerable, and after accepting secondary compensatory HH as a potential complication. A review of treatment modalities for HH and a sequenced approach are presented.

http://bit.ly/2MIaYs7

Tissue-sparing properties of Mohs micrographic surgery for infiltrative basal cell carcinoma

Publication date: Available online 31 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Marloes S. van Kester, Jelle J. Goeman, Roel E. Genders

Abstract

Background

Mohs micrographic surgery (MMS) should lead to tissue sparing of healthy skin compared to standard surgical excision, because smaller surgical margins are used.

Objective

To quantify the tissue-sparing properties of MMS in primary basal cell carcinoma (BCC) with an infiltrative growth pattern.

Methods

A prospective study including 256 primary BCC with an infiltrative growth pattern was performed. Tumor sizes were measured in two perpendicular directions. Surface defect areas after MMS were measured. The suspected defect surface area with standard excision using a 5 mm margin was calculated. The primary outcome of this study was the size of the defect surface area spared with MMS compared to the calculated defect surface area with a standard excision.

Results

Median tumor size was 71 mm², median defect size after MMS was 154 mm². Median defect size calculated for standard surgical excision was 298 mm².

We show that MMS had a 46.4% tissue sparing effect compared to standard surgical excision of BCC with an infiltrative growth pattern (confidence interval 43.4-49.1.4%, p-value <0.001).

Limitations

Single-center study design. Lack of randomized control group, due to ethical reasons.

Conclusion

46% tissue sparing can be reached for primary BCC with an infiltrative growth pattern using MMS.

http://bit.ly/2sZ5Nux

Topical rapamycin in superficial lymphatic malformation: microcystic lymphatic malformation or verrucous venous malformation?

Publication date: Available online 31 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Dr Ren Cai, Dr Hao Gu, Zhang Yu, Dr Xi Yang, Dr Hui Chen, Dr Xiaoxi Lin

http://bit.ly/2MMeaTy

The Etiology, Diagnosis and Management of Hyperhidrosis: A Comprehensive Review. Part I. Etiology and Clinical Work-Up

Publication date: Available online 31 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Shiri Nawrocki, Jisun Cha

Abstract

Hyperhidrosis (HH) is a dermatologic disorder defined by sweat production beyond the thermoregulatory requirements. Clinically, HH is diagnosed when excess sweating creates significant emotional, physical, or social discomfort, causing negative impact on the patient's quality of life. Existing data imply that this condition may affect at least 4.8% of the US population. The etiology of HH may stem from autonomic nervous system complex dysfunction, resulting in neurogenic overactivity of otherwise normal eccrine sweat glands. Alternatively, HH may be a result of aberrant central control of emotions. This condition is categorized as primary or secondary HH. Approximately 93% of patients with HH have primary HH, of whom >90% have a typical focal and bilateral distribution affecting the axillae, palms, soles, and craniofacial areas. Secondary HH presents in a more generalized and asymmetric distribution and is generated by various underlying diseases or medications. Secondary causes of HH need to be excluded prior to diagnosing primary HH.

http://bit.ly/2sZDV9U

Pityriasis Rubra Pilaris: A Study Evaluating Patient Quality of Life in Two Populations

Publication date: Available online 30 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): A.Brooke Eastham, Elizabeth Y. Tkachenko, Alisa N. Femia, Lisa K. Pappas-Taffer, Misha Rosenbach, Cara J. Joyce, Stephanie Liu, Ruth Ann Vleugels

http://bit.ly/2MIuBAa