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2015| April-June | Volume 8 | Issue 2
Online since
June 9, 2015
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SHORT COMMUNICATION
Simple technique for facial dimple
Ahmed Hassan El-Sabbagh
April-June 2015, 8(2):102-105
DOI
:10.4103/0974-2077.158446
PMID
:26157310
Background:
Subjects seeking aesthetic surgery for facial dimples are increasing in number. Literature on dimple creation surgery are sparse. Various techniques have been used with their own merits and disadvantages.
Materials and Methods:
Facial dimples were created in 23 cases. All the subjects were females. Five cases were bilateral and the rest were unilateral.
Results:
Minor complications such as swelling and hematoma were observed in four cases. Infection occurred in two cases. Most of the subjects were satisfied with the results.
Conclusions:
Suturing technique is safe, reliable and an easily reproducible way to create facial dimple. Level of Evidence: IV: Case series.
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ORIGINAL ARTICLES
Comparative study of diode laser versus neodymium-yttrium aluminum: garnet laser versus intense pulsed light for the treatment of hirsutism
Neerja Puri
April-June 2015, 8(2):97-101
DOI
:10.4103/0974-2077.158445
PMID
:26157309
Introduction:
Lasers are widely used for the treatment of hirsutism. But the choice of the right laser for the right skin type is very important. Before starting with laser therapy, it is important to assess the skin type, the fluence, the pulse duration and the type of laser to be used.
Aims:
To compare the efficacy and side effects of Diode laser, Neodymium-yttrium aluminum - garnet (Nd: YAG) laser and intense pulsed light (IPL) on 30 female patients of hirsutism.
Materials and Methods:
Thirty female patients with hirsutism were selected for a randomised controlled study. The patients were divided into three groups of 10 patients each. In group I patients diode laser was used, in group II patients long pulsed Nd: YAG laser was used and in group III, IPL was used. The patients were evaluated and result graded according to a 4-point scale as excellent, >75% reduction; good, 50-75% reduction; fair; 25-50% reduction; and poor, <25% reduction in hair density.
Results:
It was seen that the percentage of hair reduction after two sessions of treatment was maximum (40%) in the diode laser group, followed by 35% hair reduction in the Nd: Yag laser group and 10% hair reduction in the IPL group. The percentage of hair reduction after four sessions of treatment was maximum (64%) in the diode laser group, followed by 62% hair reduction in the Nd: Yag laser group and 48% hair reduction in the IPL group. The percentage of hair reduction after eight sessions of treatment was maximum (92%) in the diode laser group, followed by 90% hair reduction in the Nd: YAG group and 70% hair reduction in the IPL group.
Conclusions:
To conclude for the Indian skin with dark hairs, the diode laser still stands the test of time. But, since the diode laser has a narrow margin of safety, proper pre and post-procedure cooling is recommended. Although, the side effects of Nd: YAG laser are less as compared to the diode laser, it is less efficacious as compared to the diode laser.
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CORRESPONDENCE
Giant acrochordon of labia majora: An uncommon manifestation of a common disease
Shilpa Garg, Sukriti Baveja
April-June 2015, 8(2):119-120
DOI
:10.4103/0974-2077.158454
PMID
:26157316
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REVIEW ARTICLE
Role of recipient-site preparation techniques and post-operative wound dressing in the surgical management of vitiligo
Nour Al-Hadidi, James L Griffith, Mohammed S Al-Jamal, Iltefat Hamzavi
April-June 2015, 8(2):79-87
DOI
:10.4103/0974-2077.158439
PMID
:26157306
Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below.
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ORIGINAL ARTICLES
Comparison of local flaps and skin grafts to repair cheek skin defects
Ali Ebrahimi, Mehdi Ashayeri, Hamid Reza Rasouli
April-June 2015, 8(2):92-96
DOI
:10.4103/0974-2077.158444
PMID
:26157308
Background and Objective:
Selecting the appropriate technique for surgical incisions, and reconstruction of facial defects after skin tumour excision has always been one of the surgeon's biggest concerns. The aim of this study is to compare the results between the local flap and skin graft to reconstruct cheek defects after basal cell carcinoma excision.
Patients and Methods:
In this retrospective study, 40 patients with skin defects resulting from skin tumour (Basal cell carcinoma) excision in cheek zones (16 sub-orbital, 18 bucco-mandibular and six auricular) were treated using local flap (
n
= 20) and skin graft (
n
= 20) from October 2010 to April 2012. All patients were followed up for 12 months, postoperatively. In addition, general assessments including complications, patient satisfaction, tissue co-ordination, skin colour and hospitalisation days were obtained.
Results:
Five patients had postoperative hyper-pigmentation complication in the skin graft group and none occurred in the local flap (
P
= 0.046). In the early postoperative period (2 weeks), mean scores in patient satisfaction, tissue co-ordination and skin colour were statistically significant increase in the local flaps (
P
< 0.001,
P
< 0.001,
P
< 0.001, respectively) and in the later postoperative period (12 months) only mean scores in skin colour significantly increased in the local flaps (
P
< 0.001). The mean postoperative length of hospitalisation days was 1.7 ± 0.4 days in the local flap group, and 3.63 ± 1.16 days in the skin graft group (
P
= 0.001).
Conclusion:
In the local flap group: Patient satisfaction, tissue co-ordination and skin colour were improved after 2 weeks. Also in 12-months follow up visits, skin colour was improved significantly and the hyperpigmentation was reduced. Generally, in this study the local flaps had better results in clinical outcomes and patient satisfaction. However, for each cheek defect the surgeon must choose the appropriate reconstruction strategy to avoid undesirable outcomes.
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Photodynamic therapy followed by Mohs micrographic surgery compared to Mohs micrographic surgery alone for the treatment of basal cell carcinoma: Results of a pilot single-blinded randomised controlled trial
Firas Al-Niaimi, Nisith Sheth, Habib A Kurwa, Raj Mallipeddi
April-June 2015, 8(2):88-91
DOI
:10.4103/0974-2077.158443
PMID
:26157307
Introduction:
Basal cell carcinoma is a common cutaneous malignant tumour. Surgical excision is the "gold standard" treatment for most subtypes, with Mohs micrographic surgery (MMS) offering the highest cure rate. Other treatment modalities used include photodynamic therapy (PDT).
Background:
We aimed to study the efficacy of combining MMS with PDT to see whether this would reduce the number of stages and final defect size when compared with MMS alone.
Materials and Methods:
Our study was a single-centre, single-blinded, randomised and controlled pilot study involving a total of 19 patients. Nine patients were randomised to pre-treatment with PDT followed by MMS of whom two withdrew; the remaining 10 patients were randomised to the MMS alone. Follow-up visits were arranged at 3 and 6 months post-surgery.
Results:
In the PDT arm, five out of the seven treated patients (71%) had their initial tumour size decreased following PDT treatment prior to MMS. The average number of stages in the PDT arm was 1.85, compared to 2.5 in the MMS arm. The average number of sections in the PDT arm was 4.2, in comparison to 5.2 in the MMS arm.
Conclusion:
Our pilot study showed a promising but limited role for PDT as an adjunct in MMS in the treatment of selected cases of basal cell carcinomas. Larger trials, preferably multi-centred are required to further examine the role of this combination therapy.
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5
CASE REPORTS
Solitary cylindroma of tragus of the ear mimicking a keloid
Rupali Bavikar, Sanjay D Deshmukh, Avinash Joshi
April-June 2015, 8(2):114-116
DOI
:10.4103/0974-2077.158452
PMID
:26157314
Cylindromas are very rare primitive sweat gland tumours differentiating towards eccrine or apocrine line. We present a case of cylindroma of tragus of external ear in a 50-year-old female. It was diagnosed clinically as keloid. After excision, histopathological and immunohistochemistry (IHC) studies confirmed diagnosis of solitary cylindroma.
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Angiomatosis: A rare vascular proliferation of head and neck region
Sabina Khan, Mukta Pujani, Sujata Jetley, Sujoy Neogi
April-June 2015, 8(2):108-110
DOI
:10.4103/0974-2077.158448
PMID
:26157312
Angiomatosis is a diffuse vascular lesion which clinically mimics hemangioma or vascular malformation. It usually involves multiple tissues and is histopathologically characterised by proliferation of vessels of varying calibre intimately admixed with large amount of adipose tissue. Its surgical removal is very difficult because of its infiltrative nature. Therefore, a precise histopathological diagnosis is of utmost importance. It is usually seen in females in the first two decades and commonly involves lower extremities. Angiomatosis of head and neck region is very rare. Here we present a rare case of angiomatosis of the lower face involving right cheek and lip in a 4-year-old boy clinically diagnosed as hemangioma. Histopathological differential diagnosis of angiomatosis is also discussed.
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2
EDITORIAL
Changing skin color
Niti Khunger
April-June 2015, 8(2):77-78
DOI
:10.4103/0974-2077.158435
PMID
:26157305
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CORRESPONDENCE
Linear leucoderma following intralesional steroid: A report of three cases
Amit Kumar Dhawan, Kavita Bisherwal, Chander Grover, Nadeem Tanveer
April-June 2015, 8(2):117-119
DOI
:10.4103/0974-2077.158453
PMID
:26157315
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CASE REPORTS
Treatment of laser resistant granuloma faciale with intralesional triamcinolone acetonide and 5-fluorouracil combination therapy
Diana L Norris, Martine Apikian, Greg J Goodman
April-June 2015, 8(2):111-113
DOI
:10.4103/0974-2077.158450
PMID
:26157313
This report describes a sixty year old male with biopsy proven Granuloma Faciale (GF). The patient had been unsuccessfully treated with multiple therapies. A mixture 0.8 ml 5-Fluorouracil (5FU) and 0.2 ml Kenacort-A was trialled initially to treat this patient, followed by a more varied mixture ratio. These were given at intervals ranging from two weeks to two months. The patient received a total of twenty injections over a period of more than three years. An excellent response was noted and the patient is now able to tolerate long treatment free periods of between nine and twelve months. 5FU is a simple injection material and can be considered by clinicians as an option for treatment of GF.
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CORRESPONDENCE
Clinical pearl: Use of Indian dinner plate 'thali' as a surgery tray in dermatosurgery and aesthetics
Madhulika A Mhatre, Venkataram N Mysore, Shamanth S Murthy, Amitoj Garg
April-June 2015, 8(2):120-121
DOI
:10.4103/0974-2077.158455
PMID
:26157317
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3,081
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PRACTICE POINTS
How I manage complications in aesthetic surgery
Maya Vedamurthy
April-June 2015, 8(2):106-107
DOI
:10.4103/0974-2077.158447
PMID
:26157311
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th
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