1/4. Treatment of Hailey-Hailey disease (or benign familial pemphigus) using short pulsed and short dwell time carbon dioxide lasers.BACKGROUND: Surgical intervention of Hailey-Hailey disease (HHD) may be required to achieve prolonged remission or cure. Excisional surgery, dermabrasion, and continuous carbon dioxide (CO2) laser therapies have been utilized with success, though patients may experience considerable morbidity. OBJECTIVE: To evaluate the use of short pulsed and short dwell time CO2 lasers in the treatment of HHD. METHOD: Case report and review of the relevant literature. RESULTS: A 26-year-old woman with refractory axillary HHD was initially treated with a short dwell time CO2 laser. The right axilla was treated with two passes at a fluence of 25 J/cm2, and the left axilla with three passes at 28 J/cm2. Three years later, several foci within each axilla that periodically blistered were further treated with two passes of a short pulsed CO2 laser at a fluence of 15 J/cm2. At a 3.5-year follow-up, the patient reported continued resolution of her left axilla but disease persistence in her right axilla. CONCLUSION: HHD can be effectively treated with a short dwell time CO2 laser if appropriate laser parameters are used.- - - - - - - - - - ranking = 1keywords = dermabrasion (Clic here for more details about this article) |
2/4. Type 2 segmental manifestation of Hailey-Hailey disease: poor therapeutic response to dermabrasion is due to severe involvement of adnexal structures.In autosomal dominant skin conditions, two different types of segmental manifestation can be distinguished. Type 1 represents heterozygosity for a postzygotic mutation, resulting in a degree of severity similar to that of the nonmosaic phenotype. Type 2 reflects loss of heterozygosity and shows an excessively pronounced involvement superimposed on the ordinary nonsegmental phenotype. We describe the clinical, histopathological and therapeutic aspects of the first case of type 2 segmental manifestation of Hailey-Hailey disease (HHD). A 24-year-old woman with a family history of HHD comprising four generations, presented with lesions of erythema and blistering arranged in a unilateral pattern following the lines of Blaschko. The disorder was first noted at the age of 3 months. At the age of 24 years, additional scattered symmetrical lesions involving the axillary and inguinal folds were noted. Histopathological examination of the severely involved linear skin areas revealed pronounced acantholysis within the deep adnexal structures, whereas clinically unaffected skin showed the typical histopathological features of the heterozygous phenotype with suprabasal clefting and acantholysis sparing the adnexae. dermabrasion was performed in the areas of segmental involvement. During a follow-up period of one year, no recurrence was noted, but 18 months after dermabrasion a recurrence was present in the left submammary and left perianal regions. This therapeutic resistance to dermabrasion may be explained by the presence of acantholysis within the adnexal structures of the skin as found in type 2 segmental HHD.- - - - - - - - - - ranking = 6keywords = dermabrasion (Clic here for more details about this article) |
3/4. Lentiginosis profusa. III: Aesthetic and sanguineous aspects.Lentiginosis profusa syndrome and progressive cardiomyopathic lentiginosis are preferable terms to "leopard syndrome". Considerable cosmetic improvement followed facial dermabrasion and light electrodesiccation of lentigines on the exposed surfaces. Hematologic evaluation did not reveal hematopoietic defect in the patient studied.- - - - - - - - - - ranking = 1keywords = dermabrasion (Clic here for more details about this article) |
4/4. Activation of herpes simplex following dermabrasion. Report of a patient successfully treated with intravenous acyclovir and brief review of the literature.herpes simplex labialis developed in a patient immediately following dermabrasion. The patient was hospitalized because the infection had spread rapidly over the dermabraded face and was complicated by secondary impetiginization. Herpesvirus hominis type I and enterobacter aerogenes were isolated from cultures. Intravenous acyclovir and oral antibiotics were administered. On this regimen, new vesicle formation ceased in 36 hours. Complete resolution of the infection occurred within 6 days, with an excellent cosmetic result. observation at 1 month confirmed no sequelae (in particular, scarring). The "at risk" patient with a history of recurrent herpes labialis should be identified prospectively in an attempt to prevent possible reactivation; should this complication ensue, appropriate treatment should be immediately administered because a state of local immunocompromise exists. We believe our patient benefited greatly from vigorous treatment, with significant shortening of time to healing. Prophylaxis with oral acyclovir of "at risk" patients prior to dermabrasion is proposed.- - - - - - - - - - ranking = 6keywords = dermabrasion (Clic here for more details about this article) |