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Dermabrasion in Vitiligo
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Bharat Bhushan Mahajan, Shweta Sethi, Shashank Tyagi
Vitiligo is a cumbersome pigmentary disorder characterized by loss of melanocytes from the skin and subsequent development of depigmented patches of variable sizes that may enlarge and coalesce to form extensive areas of leukoderma [1]. There are many forms of treatment available for vitiligo. Up to 80% of patients suffering from vitiligo respond to medical treatment [2,3]. However, when the disease becomes stable and refractory to medical treatment, surgical treatment may be the only viable option to replenish the lost melanocytes. Dermabrasion is an extensively used surgical modality for treating many cutaneous problems like facial scars, acne, stable vitiligo, hyperkeratotic lesions, pigmentation, tumors, actinic lesions, and removal of tattoos [4].
Retinoids and Concomitant Surgery
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
A 27-year-old woman with acne who underwent dermabrasion for a large traumatic scar on her left cheek while she was on isotretinoin daily for the treatment of acne was also reported. Complete healing took about 3 months. Keloid formation in the treated area was observed 6 months later. A normal healing time after surgical dermabrasion is approximately 10 days, in contrast to the prolonged healing time (3 months) seen in this patient. The same patient had undergone dermabrasion for the correction of the same problem with uneventful healing 1 year prior to the second procedure (23). The second procedure must have involved deeper layers of dermis, which may have contributed to delayed healing and keloid formation in this patient.
Tumescent Anesthesia
Published in Marwali Harahap, Adel R. Abadir, Anesthesia and Analgesia in Dermatologic Surgery, 2019
William B. Henghold, Brent R. Moody
Dermatologic surgeons have been at the forefront of new, innovative applications for TA. Its utility for ambulatory phlebectomy and other venous surgery has been detailed in several reports (63–66). It has been incorporated into dermabrasion (67, 68), chemical peels, and laser resurfacing (69). Our own experience with TA for full-face laser resurfacing has shown it to be somewhat difficult to use as the only means of anesthesia. Most patients require nerve blocks with or without IV sedation as well. An oral and maxillofacial surgery group recently described its experience with TA for facial laser resurfacing (70). Several patients were able to tolerate the procedure entirely under local anesthesia with a modified tumescent technique, although most required IV sedation as well.
Topical rapamycin in the treatment of facial angiofibromas in tuberous sclerosis: a systematic review based on evidence
Published in Journal of Dermatological Treatment, 2022
Clara Cortell Fuster, María Amparo Martínez Gómez, Ana Cristina Cercós Lleti, Mónica Climente Martí
The most prevalent skin condition in TS are facial angiofibromas (FA), which occur in up to 80% of patients (5) and they are one of the main criteria for diagnosis. FA appear between 2 and 5 years of age and grow in number and size stabilizing in adolescence (2). The visual impact of facial injuries, with the esthetic and psychological problem that they entail (6,7), has motivated the use of multiple treatments to improve the quality of life of patients (8). Physical treatment include radiofrequency, electrocoagulation, cryotherapy, dermabrasion and laser therapy (3,9). The main problem with these techniques is that are invasive and painful and require anesthesia. Tranilast or podofilotoxin has been used as a pharmacological treatment, but recent publications place rapamycin (sirolimus) as the most appropriate pharmacological alternative, based on favorable data of effectiveness and safety (5).
The use of isotretinoin for acne – an update on optimal dosing, surveillance, and adverse effects
Published in Expert Review of Clinical Pharmacology, 2020
Edileia Bagatin, Caroline Sousa Costa
Case reports in the 80s and 90s pointed out the risk of hypertrophic scars and keloids after ablative procedures for acne scars during or after the use of isotretinoin, leading to label recommendation to wait 6 months to start treatment of scars and surgeries [104,105]. Recent publications have been emphasizing that there is no evidence on that risk. Therefore, there is no reason to delay cosmetic procedures, including different types of laser, microneedling, biopsies and surgeries, which do not reach the muscular plane. No tendency for hypertrophic scar, keloids, and abnormal healing, in patients that have used in less than 6 months and or are using isotretinoin, has been observed in clinical practice and all published reports [106–120]. On the contrary, authors have been demonstrating that laser is safe and better results may be obtained when associated with low daily dose (10 mg/kg) of isotretinoin in the last month of treatment [111,117–119]. The label recommendation is to wait 6 months after the treatment to perform laser hair removal, dermabrasion, chemical peelings, laser and excisional or incisional surgery. However, recently a group of experts, by using the Delphi method, reviewed the literature and elaborated a consensus. They concluded that there is no sufficient evidence to delay acne scars revision [120].
Broadband light treatment using static operation and constant motion techniques for skin tightening in Asian patients
Published in Journal of Cosmetic and Laser Therapy, 2019
Seunggyun In, Henry Park, Heejin Song, Jiho Park, Heesu Kim, Sung Bin Cho
In total, 27 Korean female patients (median age, 38 years; interquartile range [IQR], 32–45 years; age range, 25–63 years) with Fitzpatrick skin type III–IV were scheduled to undergo static operation or constant motion delivery of BBL energy for skin tightening. Patients were excluded from this study if they had received systemic or topical retinoid therapy, skin resurfacing procedures (chemical peeling or mechanical- or laser-assisted dermabrasion), fractional laser treatment (nonablative or ablative), radiofrequency treatment (monopolar or bipolar; noninvasive or invasive), intensity focused ultrasound treatment, botulinum toxin injection, thread implantation, injection therapy with fillers or tissue activators, or face-lift surgery within the last 6 months. Moreover, patients with a high probability of becoming pregnant or a propensity for photosensitive dermatitis, keloids, or immunosuppression were excluded. This study was approved by the Institutional Review Board of International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.