RESUMEN
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Asunto(s)
Humanos , Masculino , Femenino , Alopecia/etiología , Alopecia/rehabilitación , Cabello/trasplante , Procedimientos Quirúrgicos Dermatologicos/métodos , Procedimientos Quirúrgicos Dermatologicos/tendencias , Procedimientos Quirúrgicos Dermatologicos/instrumentación , Procedimientos Quirúrgicos Dermatologicos/normas , Procedimientos Quirúrgicos Dermatologicos , Técnicas Cosméticas/tendenciasAsunto(s)
Alopecia/cirugía , Cabello/trasplante , Alopecia/patología , Fibrosis , Humanos , Cuero Cabelludo , PielRESUMEN
BACKGROUND: Plasma cell balanitis or balanitis of Zoon (BZ) is a frequent diagnosis in mature men and lesions are generally localized on the glans but may involve the prepuce; its aetiology remains unknown. OBJECTIVES: To present our experience with tacrolimus 0.1% ointment in the treatment of two patients with BZ refractive to other topical treatments. PATIENTS AND METHODS: Two uncircumcised mature caucasian males were seen, both presenting with BZ; topical tacrolimus 0.1% ointment twice daily was prescribed in each case. RESULTS: Marked improvement of the lesions in both patients has been observed, with follow-up of 1 year and 10 months, respectively. CONCLUSIONS: Topical tacrolimus 0.1% ointment is an effective and safe treatment for BZ.
Asunto(s)
Balanitis/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Tacrolimus/uso terapéutico , Anciano , Balanitis/patología , Estudios de Seguimiento , Humanos , Masculino , Pomadas , Células Plasmáticas/patologíaRESUMEN
BACKGROUND: Widespread unilateral nevus spilus causes important cosmetic and psychological disturbances, and only a few therapeutic options can guarantee good functional and cosmetic results. OBJECTIVE: To evaluate the clinical response of a patient with widespread segmental nevus spilus to Q-switched (QS) alexandrite laser. METHODS: The treatment was QS alexandrite laser (755 nm, 100 nsec) with a mean fluence of 7.28 +/- 0.37 J/cm2 using a single-impact technique at 10 +/- 8.47-week intervals. RESULTS: Fifty percent clearance of the facial portion of the lesion was observed after 16 treatment sessions with QS alexandrite laser. CONCLUSION: QS alexandrite laser is suitable for removal of widespread segmental nevus spilus.
Asunto(s)
Neoplasias Faciales/terapia , Terapia por Láser , Nevo Pigmentado/terapia , Neoplasias Cutáneas/terapia , Adolescente , Biopsia , Neoplasias Faciales/patología , Estudios de Seguimiento , Humanos , Masculino , Nevo Pigmentado/patología , Retratamiento , Piel/patología , Neoplasias Cutáneas/patologíaRESUMEN
BACKGROUND AND OBJECTIVE: Q-switched laser systems have been shown to be useful for removal of nevus of Ota, a pigmented lesion on the face. The purpose of this study was to evaluate the efficacy of Q-switched alexandrite laser in the treatment of nevus of Ota in 13 patients. STUDY DESIGN/MATERIALS AND METHODS: A spot test was made at 6.0, 7.0, and 8.0 J/cm(2) energy fluence, and the best energy fluence was selected after a 2-month postoperative evaluation. Q-switched alexandrite laser with a mean fluence of 7.290.46 J/cm(2) was used at 8-week intervals. Total treatment ranged from 1 to 15 sessions (mean 7.1 +/- 5.1 sessions). The single shot technique was used. RESULTS: More than 75% lightening was achieved in seven patients, between 51% and 75% in three, less than 50% in one, and less than 25% in one. In two patients with excellent clearance, a very light gray macula in the lower eyelid persisted after 8 and 14 treatment sessions, respectively. Mild transient hypopigmentation that subsided spontaneously after 2 months was observed in one patient. No repigmentation was seen. CONCLUSIONS: The Q-switched alexandrite laser seems to be an effective and safe modality for the treatment of nevus of Ota.
Asunto(s)
Neoplasias Faciales/cirugía , Terapia por Láser/métodos , Nevo de Ota/cirugía , Neoplasias Cutáneas/cirugía , Adolescente , Adulto , Niño , Femenino , Humanos , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
BACKGROUND AND OBJECTIVE: Different treatment modalities have been advocated for necrobiosis lipoidica diabeticorum but clinical response is unpredictable. The purpose of this study was to evaluate the usefulness of pulsed dye laser (Candela SPTL, Irvine, MA, USA) in the treatment of an area of necrobiosis lipoidica of 4 cm in diameter on the anterior aspect of the leg in a non-diabetic patient. MATERIALS AND METHODS: A spot test was made at 6.0, 6.5 and 7.0 J/cm(2) energy fluences and the best energy fluence was selected after a 2-month postoperative evaluation. The patient received three treatment sessions with a fluence of 6.5 J/cm(2), 585-nm wavelength, 5-mm spot size, and 450 micro(s) pulse duration at 8-week intervals. The patient was given routine skin care advice with emollient cream and sunscreen (SPF 15) until the following session. RESULTS: Overall cosmetic improvement was achieved, with a decrease of erythema and telangiectasis, and stabilization in terms of progression (size) in the left half of the lesion, with no modification of atrophy or pigmentary changes. The right upper quadrant of the lesion showed an erythematous peripheral halo with minimal reduction in the erythema and telangiectasia, and discrete size increase. CONCLUSION: Pulsed dye laser may be a useful treatment for improving the telangiectasia and erythematous component of necrobiosis lipoidica.
Asunto(s)
Procedimientos Quirúrgicos Dermatologicos , Terapia por Láser/métodos , Necrobiosis Lipoidea/cirugía , Procedimientos de Cirugía Plástica/métodos , Adulto , Femenino , Humanos , Pierna/cirugíaRESUMEN
BACKGROUND: Although second intention healing has been used for many years in Mohs micrographic surgery, it has lost popularity. This is due to the long process and functional alteration of important anatomical units if certain wound healing factors are not carefully taken into consideration. OBJECTIVE: To review indications, contraindications, complications, advantages, disadvantages, as well as basic concepts of the wound healing process, wound care and antibiotic prophylaxis in the management of open wounds after Mohs surgery. METHODS: A short but comprehensive review of studies published in the literature dealing with second intention healing as a reconstruction alternative option in certain situations. CONCLUSIONS: Second intention healing is a simple and cost-effective method for reconstruction after Mohs micrographic surgery in well-defined cases. It allows adequate tumoral control with good to excellent functional and cosmetic results.
Asunto(s)
Cirugía de Mohs , Cicatrización de Heridas/fisiología , Antibacterianos/uso terapéutico , Hemostasis/fisiología , Humanos , Neoplasias Cutáneas/cirugíaRESUMEN
BACKGROUND AND OBJECTIVES: Q-switched laser systems have been used for removal of tattoo-related carbon, graphite, and other particles. We assessed elimination of traumatic tattoos of different origin with Q-switched alexandrite laser in nine patients. STUDY DESIGN/MATERIALS AND METHODS: Fluence threshold was determined and a spot test was made. Q-switched alexandrite laser, with a fluence range 4.5-8.0 J/cm(2) (mean, 7.16 +/- 1.18), was used at 4-5-week intervals. Total treatment ranged from 3-12 sessions (mean, 6.1 +/- 3.6 sessions). Double-pulse technique was used in black/black-bluish areas, but single-shot was applied to slate-gray pigment. RESULTS: More than 95% lightening was achieved in five patients after 5.2 +/- 2.3 sessions, and >75% lightening in six subjects after 6.1 +/- 3.1 sessions of treatment. Blacktop, surgical pen, and gravel tattoos presented a better response than gunpowder/fireworks tattoos (>95% vs. 68.7 +/- 23.9% clearance), or tattoos of unknown origin (>95% vs. 62.5 +/- 53% clearance). Epidermal splattering and pinpoint bleeding were observed in one case. No pigmentary alteration or scarring was seen. CONCLUSION: The Q-switched alexandrite laser is a useful system for removal of traumatic tattoos of diverse origin. The best response (>95% clearance) was achieved in blacktop, surgical pen, and gravel tattoos, although an acceptable degree of lightening may be obtained in tattoos due to gunpowder or fireworks.
Asunto(s)
Procedimientos Quirúrgicos Dermatologicos , Terapia por Láser/métodos , Piel/lesiones , Tatuaje , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
BACKGROUND: Hair micrografting has been widely used in male and female androgenetic alopecia but there is little experience with cicatricial or burn alopecia. OBJECTIVE: To evaluate the clinical outcome of a case of postburn alopecia with marked inelastic affected areas but with good elasticity and hair density over occipital donor site, treated with multiple sessions of hair micrografting. METHODS: Single-hair micrografts were employed to reconstruct the hair line but 2- and 3-hair micrografts were implanted over other alopecic areas. Grafts were placed into oblique slits made with N degrees 15 scalpel blade bevelled due to reduced dermis in the recipient area. Donor site was closed with vertical mattress and running suture with 3-0 silk. RESULTS: In 4 sessions 6500 micrografts were implanted into the affected areas, achieving a natural appearing hair line and a good cosmetic result. CONCLUSION: Hair micrografting is a promising restorative technique for inelastic plaques of postburn alopecia.
Asunto(s)
Alopecia/cirugía , Quemaduras/complicaciones , Cabello/trasplante , Adulto , Alopecia/etiología , Femenino , Humanos , Trasplante Autólogo , Resultado del TratamientoRESUMEN
BACKGROUND AND OBJECTIVE: Permanent tattooing for cosmetic reasons has increased in recent years; as a consequence, there has been an increase of requests for pigment removal due to complications or undesired results. The Q-switched alexandrite laser has been found useful in removing black exogenous pigment, which is the most popular color in eyebrow enhancement. We report the case of a patient with black-pigment eyebrow cosmetic tattoo after treatment with the Q-switched alexandrite laser. STUDY DESIGN/MATERIALS AND METHODS: Treatment conditions included 755-nm wavelength, 100 +/- 10-nsec pulse width, and 3-mm spot size. Fluence threshold was determined, and a spot test was made at the first visit. Single impact technique with 10% overlapping was applied to the whole tattoo. Five treatments were performed with a mean fluence of 7 J/cm(2). RESULTS: Complete pigment removal was achieved after five sessions. Superficial bleeding and vesicle formation was observed. CONCLUSIONS: Eyebrow tattooing can be treated efficiently with the use of the Q-switched alexandrite laser when black pigment has been used for cosmetic reasons.
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Cejas , Terapia por Láser , Tatuaje , Adulto , Femenino , HumanosRESUMEN
BACKGROUND: Eyelid tattooing for cosmetic reasons has increased in the past few years, and unsatisfied customers may request pigment removal. Q-switched laser systems have been useful in these cases. OBJECTIVE: To evaluate the clinical result of a patient with a bluish-black eyelid tattoo treated with Q-switched alexandrite laser. METHODS: Threshold fluence was determined and a spot test made on the first visit. Treatment was with QSAL, with a fluence range of 6.75-7.50 J/cm2 (mean fluence 7.125 +/- 0.26) and overlapping +/- 10% at 4-week intervals. RESULTS: The eyeliner tattoo was not completely removed after five treatments with QSAL, but noticeable pigment lightening was obtained. No side effects were seen. CONCLUSIONS: Q-switched alexandrite laser may be a useful device to remove the bluish-black pigment used in cosmetic eyeliner tattoo.
Asunto(s)
Técnicas Cosméticas , Párpados , Terapia por Láser , Tatuaje , Anciano , Berilio , Femenino , HumanosRESUMEN
BACKGROUND: Lip tattooing is a common cosmetic technique not exempt from certain risks and which may lead an unsatisfied customer to seek tattoo elimination. OBJECTIVE: To assess the clinical outcome of a patient with a brownish-colored cosmetic lip tattoo after treatment with the Q-switched alexandrite laser (QSAL). METHODS: Two sites were tested using the pigment lesion dye laser (PLDL) and QSAL. The patient received 10 monthly sessions with QSAL, with an average fluence of 6.925 J/cm2. The double and triple shot technique was applied. RESULTS: The brownish pigmentation turned black after the PLDL and QSAL tests. Epidermal splattering and bleeding made a fluence increase with QSAL inadvisable. Treatment was unsuccessful. CONCLUSIONS: PLDL and QSAL may induce a photochemical alteration in brownish pigment. Factors that may contribute to the poor response of a cosmetic lip tattoo to QSAL treatment are related to pigment characteristics and laser parameters.