1/32. Histologic features of lichen sclerosus et atrophicus in a surgical scar.A 76-year-old woman presented with a 7-mm, hard, pink nodule at the site of an appendectomy scar of more than 70 years' duration. The clinical impression at the time of biopsy was that of a keloid. Surprisingly, light microscopic examination revealed classic histologic features of late-stage lichen sclerosus et atrophicus (LSA) overlying a scar. elastic tissue stain highlighted the unusual presence of abundant nodules of elastin in the reticular dermis only.- - - - - - - - - - ranking = 1keywords = keloid (Clic here for more details about this article) |
2/32. Frozen human epidermal allogeneic cultures promote rapid healing of facial dermabrasion wounds.BACKGROUND: Clinical studies have shown that cultured human epidermal allogenic sheets promote faster reepithelization of skin donor sites and deep partial-thickness wounds. OBJECTIVE: We describe the results of a controlled, clinical study of facial dermabrasion sites treated with a single application of frozen cultured human allogenic epidermal sheets that were thawed for 5-10 minutes at room temperature before application. methods: Ten patients with scars from acne or of other etiology underwent facial dermabrasion. One side of the face was treated with the frozen and thawed cultures, the other side was treated with standard dry dressing. RESULTS: The epidermal cultures promoted faster reepithelization of the wounds, with complete reepithelization in an average time of 4.6 days, whereas controls healed in an average of 7. 9 days. The reduction in healing time was 42% (P = 4.82 x 10(-7)). pain was reduced in sites treated with the thawed cultures. CONCLUSION: Epidermal allogenic cultures, preserved by freezing, promoted significantly faster reepithelization and reduced pain intensity of dermabraded facial wounds, suggesting that they could be used routinely to improve the recovery from dermabrasion.- - - - - - - - - - ranking = 0.73431864127554keywords = acne (Clic here for more details about this article) |
3/32. glioblastoma multiforme at the site of metal splinter injury: a coincidence? Case report.The authors report the case of a man who had suffered a penetrating metal splinter injury to the left frontal lobe at 18 years of age. Thirty-seven years later the patient developed a left-sided frontal tumor at the precise site of the meningocerebral scar and posttraumatic defect. Histological examination confirmed a glioblastoma multiforme adjacent to the dural scar and metal splinters. In addition, a chronic abscess from which propionibacterium acnes was isolated was found within the glioma tissue. The temporal and local association of metal splinter injury with chronic abscess, scar formation, and malignant glioma is highly suggestive of a causal relationship between trauma and the development of a malignant brain tumor.- - - - - - - - - - ranking = 0.73431864127554keywords = acne (Clic here for more details about this article) |
4/32. Protean manifestations of lipoid proteinosis in a 16-year-old boy.We report a 16-year-old Japanese male with lipoid proteinosis showing various skin manifestations. The patient was born to nonconsanguineous parents and none of his relatives was similarly affected. The patient suffered from a hoarse voice and refractory temporal epilepsy from early childhood. Computed tomography scanning of the brain showed bilateral calcification in the temporal lobes, a characteristic feature of lipoid proteinosis. On physical examination, various skin manifestations, including papules and haemorrhagic blisters, acne-like scars at sites of minor trauma or friction, and beads of small papules along the free margins of the eyelids were noted. A skin biopsy showed deposits of homogeneous hyaline-like material, positive on periodic acid-Schiff staining, throughout the dermis, particularly around small blood vessels. It is noteworthy that a range of characteristic skin lesions can be present in a patient with lipoid proteinosis even with mild systemic involvement.- - - - - - - - - - ranking = 0.73431864127554keywords = acne (Clic here for more details about this article) |
5/32. Successful removal by ruby laser of darkened ink after ruby laser treatment of mismatched tattoos for acne scars.Cosmetic tattoos are becoming increasingly popular. Elimination of cosmetic tattoos is sought because of misplacement or migration of tattoo pigment, allergic reactions to the various pigments or dissatisfaction of the customer for various reasons. Removal of unwanted pigment is a domain of laser surgery using various Q-switched laser systems, such as the ruby, alexandrite, pulsed dye and Nd:YAG lasers. Dark colours are easily removed by these lasers, whereas red, pink and skin-toned pigment may turn black if exposed to Q-switched laser light. This ink-blackening occurs because Q-switched lasers heat up the pigments, which consist of ferric oxide, and reduce them into ferrous oxide, which is black. Laser-induced black ink is not always readily removed. A successful ruby laser-removal of laser-induced blackened cosmetic tattoos for acne scar camouflage is reported. The advantageous outcome in this case contrasts with other published cases where laser-darkened pigment had to be removed by other measures, or was permanent. Test site treatment can limit the problem to some degree but, in addition to test-treating, some kind of 'tattoo identification card' could help to prevent problems in this field and allow 'in vitro' test treatment.- - - - - - - - - - ranking = 3.6715932063777keywords = acne (Clic here for more details about this article) |
6/32. Blood transfer: the use of autologous blood as a chromophore and tissue augmentation agent.BACKGROUND: Atrophic scars, whether traumatic, postsurgical, or postacne, are distressing and difficult to treat. A freely available autologous agent that provides medium- to long-term correction of this problem would be welcome. There are very few endogenous chromophores in the skin for laser or light energy to target. A benign exogenous pigment implanted in superficial scars may be useful in presenting such a target for light energy, allowing selective injury to these scars and the possibility of new collagen formation. OBJECTIVE: To report five representative case reports that describe elements of two new techniques that may be useful in the management of atrophic acne scarring. methods: After drawing blood from the patient, this was immediately reinjected into premarked areas of atrophic scars. If there was substantial tissue deficit, this was either followed by repeated injections of whole blood at monthly intervals on three occasions or until adequate correction was attained and oral antifibrinolysis medication dispensed in addition to the blood transfer (hematogenous augmentation of tissue or the HAT technique). In the other circumstance, where the deficit was superficial, blood was implanted high in the tissue and used as a target for vascular laser or intense pulsed light in a technique termed the blood augmentation (with or without) stimulation of tissues by irradiation with light or laser energy or the Bastille technique. This is again repeated as required. RESULTS: Reasonable short- to medium-term correction has been attained in all five cases and there seemed to be a progressive improvement with each injection session. With the Bastille technique case there seemed to be progressive improvement with time, with the result at 4 weeks being substantially better than that at 2 weeks or at baseline. CONCLUSION: These case reports suggest that blood may be a worthwhile augmentation agent and chromophore. Both these techniques deserve further investigation to determine the optimum parameters. They are so simple in their concept and technique that should they help to provide a medium- to long-term correction for atrophic scars and other depressions, such as expression lines and wrinkles, they would be worthwhile additions to existing dermatologic techniques.- - - - - - - - - - ranking = 1.4686372825511keywords = acne (Clic here for more details about this article) |
7/32. Ultrastructure of keloid: an unusual incident involving lepromatous leprosy.A patient with lepromatous leprosy developed keloids on the dorsum of both arms in response to ulcerations due to acute erythema nodosum leprosum reactions. Electron microscopic examination of the keloidal dermis showed a morphology indicative of increased production of normal collagen fibrils. The greatest cellular changes from normal were in fibroblasts which were enlarged due to increased amounts of rough endoplasmic reticulum and extensive Golgi complexes. Nuclear folds were also evident in these fibroblasts. Some cells, considered to be fibroblasts, were filled with cytoplasmic filaments and contained bizarre shaped nuclei. mast cells, blood vessels and nerve processes were also present.- - - - - - - - - - ranking = 6keywords = keloid (Clic here for more details about this article) |
8/32. Treatment of scars with Er:YAG laser in patients with cleft lip: a preliminary report.OBJECTIVE: Although one goal in cleft lip surgery is to avoid serious scarring, residual scars are often observed after primary surgery. The goal of this preliminary report was to present the standardized application of laser technology to reduce the appearance of residual scars. DESIGN: Ten patients with scarring after unilateral and bilateral cleft lip surgery were treated with a Dual Mode erbium yttrium-aluminum-garnet laser. This laser was recently introduced and had been used only for cosmetic applications, skin resurfacing, and correction of acne scars. RESULTS: An improvement in the clinical appearance of the laser-treated scars was observed after the first treatment, with continued improvement after the second laser session. The clinically observed improvements were corroborated by the patients' reports concerning satisfaction with the result. CONCLUSIONS: The combined mechanisms of ablation/coagulation and shrinking of the skin caused by the laser, in addition to observed patient satisfaction and low risk associated with the procedure, suggest that this treatment approach can be effective in the correction of residual scarring in patients with cleft lip.- - - - - - - - - - ranking = 0.73431864127554keywords = acne (Clic here for more details about this article) |
9/32. Treatment of facial scarring and ulceration resulting from acne excoriee with 585-nm pulsed dye laser irradiation and cognitive psychotherapy.BACKGROUND: Self-inflicted skin ulcers and scars are often observed in patients with compulsive skin picking. The term "neurotic excoriation" has been used to describe this condition and may or may not coexist with other true skin pathologies, such as acne. The condition poses a diagnostic and treatment challenge because patients often also have an undiagnosed underlying psychologic disorder. case reports: Two patients with numerous linear and stellate facial ulcers and hypertrophic and erythematous scars were diagnosed with acne excoriee in the setting of an obsessive-compulsive disorder linked to emotional stress and anxiety. The scars were treated with a 585-nm flashlamp-pumped pulsed dye laser using a 7-mm spot size, 1.5-msec pulse duration, and fluence range of 4.5 to 6.0 J/cm(2). The patients received concomitant cognitive psychodynamic therapy to halt the cycle of impulse-driven skin picking and ulcer/scar formation. Marked clinical improvement of the scars and successful treatment of the acne excoriee were achieved with this combination approach. Relapses occurred when psychodynamic intervention was interrupted. CONCLUSION: The 585-nm flashlamp-pumped pulsed dye laser improves the appearance of hypertrophic erythematous facial scars and ulcers in patients with severe acne excoriee. Proper diagnosis of underlying impulse-control disorders and ongoing psychodynamic therapy is necessary to maintain improvement.- - - - - - - - - - ranking = 5.8745491302043keywords = acne (Clic here for more details about this article) |
10/32. Piloleiomyoma mistaken for postacne scarring.Piloleiomyomas are benign, smooth muscle neoplasms arising from the arrectores pilorum muscles in the skin. They differ in size and number and are often cold and painful or sensitive to touch. Piloleiomyomas, though not exceedingly rare, may not be expected in the differential diagnosis for multiple skin nodules. We present a case of a piloleiomyoma that was initially diagnosed as postacne scarring.- - - - - - - - - - ranking = 3.6715932063777keywords = acne (Clic here for more details about this article) |
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