Journal of Cutaneous and Aesthetic Surgery
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  Citation statistics : Table of Contents
   2014| October-December  | Volume 7 | Issue 4  
    Online since February 4, 2015

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Principles and methods of preparation of platelet-rich plasma: A review and author's perspective
Rachita Dhurat, MS Sukesh
October-December 2014, 7(4):189-197
DOI:10.4103/0974-2077.150734  PMID:25722595
The utility of platelet-rich plasma (PRP) has spanned various fields of dermatology from chronic ulcer management to trichology and aesthetics, due to its role in wound healing. Though PRP is being used over a long time, there is still confusion over proper terminology to define, classify and describe the different variations of platelet concentrates. There is also a wide variation in the reported protocols for standardization and preparation of PRP, in addition to lack of accurate characterization of the tested products in most articles on the topic. Additionally, the high cost of commercially available PRP kits, precludes its use over a larger population. In this article, we review the principles and preparation methods of PRP based on available literature and place our perspective in standardizing a safe, simple protocol that can be followed to obtain an optimal consistent platelet yield.
  194 40,522 5,956
Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period
Maria-Angeliki Gkini, Alexandros-Efstratios Kouskoukis, Gregory Tripsianis, Dimitris Rigopoulos, Konstantinos Kouskoukis
October-December 2014, 7(4):213-219
DOI:10.4103/0974-2077.150743  PMID:25722600
Background: Platelet-rich plasma (PRP) is defined as an autologous concentration of plasma with a greater count of platelets than that of whole blood. Its action depends on the released growth factors from platelets. It has been investigated and used in numerous fields of medicine. Recently, PRP has received growing attention as a potential therapeutic tool for hair loss. Aims: To evaluate the efficacy and safety of PRP injections in the scalp of patients with androgenetic alopecia. Settings and Design: Prospective cohort study. Materials and Methods: 20 patients, 18 males and 2 females, with androgenetic alopecia were enrolled in the study. PRP was prepared using a single spin method (Regenlab SA). Upon activation, it was injected in the androgen-related areas of scalp. Three treatment sessions were performed with an interval of 21 days and a booster session at 6 months following the onset of therapy. Statistical Analysis: Statistical analysis of the data was performed using the Statistical Package for the Social Sciences (SPSS), version 19.0 (IBM, NY, USA). Results: Hair loss reduced and at 3 months it reached normal levels. Hair density reached a peak at 3 months (170.70 ± 37.81, P < 0.001). At 6 months and at 1 year, it was significantly increased, 156.25 ± 37.75 (P < 0.001) and 153.70 ± 39.92 (P < 0.001) respectively, comparing to baseline. Patients were satisfied with a mean result rating of 7.1 on a scale of 1-10. No remarkable adverse effects were noted. Conclusions: Our data suggest that PRP injections may have a positive therapeutic effect on male and female pattern hair loss without remarkable major side effects. Further studies are needed to confirm its efficacy.
  57 11,623 1,049
Split face comparative study of microneedling with PRP versus microneedling with vitamin C in treating atrophic post acne scars
Simran Chawla
October-December 2014, 7(4):209-212
DOI:10.4103/0974-2077.150742  PMID:25722599
Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. Materials and Methods: Thirty patients with post acne atrophic facial scars attending the OPD during the period from April to October 2013 were offered four sittings of microneedling with PRP on one side and microneedling with vitamin C on other side of the face at an interval of 1 month. Results: Twenty-seven out of the total 30 patients completed the treatment schedule. Two patients were lost to follow up and one dropped out of the study due to severe PIH. Mean age of the patients was 27.5 years. Out of 30 patients, 23 achieved reduction in scarring by one or two grades. Excellent response was seen in five (18.5%) patients with platelet-rich plasma (PRP) as compared to two (7%) patients who received treatment with vitamin C according to physician's assessment. As far as up gradation by 1 score is considered, i.e., good response, it was similar in both cases. Vitamin C did not prove to be as efficacious as PRP since 10 (37%) patients had poor response in vitamin C-treated area compared to only 6 (22.2%) patients who underwent PRP therapy, but vitamin C proved to be efficacious in dealing with post inflammatory hyper-pigmentation secondary to acne. Patients were more satisfied with PRP as compared to vitamin C. The results were evaluated and statistical analysis was done using SPSS 16.0.2. Conclusions: Overall results were better with microneedling and PRP. Vitamin C combined with microneedling also showed improvement with respect to firmness and smoothness of skin; as well as post inflammatory hyper-pigmentation. Microneedling combined with PRP proved to be good in treating boxcar and rolling scars but had limited efficacy in dealing with ice pick scars.
  24 19,203 1,231
Glycolic acid peels for nail rejuvenation
Gurvinder Banga, Kalpana Patel
October-December 2014, 7(4):198-201
DOI:10.4103/0974-2077.150737  PMID:25722596
Background: With the increasing use of nail paints, nail art, acetone, repeated manicures, cosmetic nail procedures and detergents, the nail plate undergoes regular damage resulting in rough, lusterless and pigmented nails. Besides that onychomycosis, nail lichen planus, nail pitting and ridging due to various diseases also cause cosmetically disfiguring nails. Objective: The study is directed toward use of 70% glycolic acid for controlled keratolysis of the nail-plate, resulting that could result in shinier, smoother and brighter nails. Materials and Methods: A prospective single-center open-label uncontrolled study of 31 patients, 22 with dry, rough, discolored nails and 9 with hyperkeratotic nails were included in the study group. After examination and ruling out any infection, petroleum jelly was applied on the cuticle margins of the nails for protection and 70% glycolic acid was applied over the nail plate for 45 minutes. In dry rough discolored nails, only a single sitting was done while in hyper-keratotic nail conditions multiple weekly sittings were done. Results: In 22 patients with dry rough nails, 80% showed good improvement, 10% showed average improvement, whereas 10% were non-responsive. Nine patients with thickened nail plate showed good improvement in 60% average improvement in 25% improvement and 15% were non-responsive, after multiple sessions. Conclusion: Controlled keratolysis of the nail plate with application of 70% glycolic acid can be a promising treatment for modality for thick, uneven, rough and pigmented nail-plate conditions with cosmetically pleasing results.
  7 4,106 429
Intralesional immunotherapy for difficult to treat warts with Mycobacterium w vaccine
Shilpa Garg, Sukriti Baveja
October-December 2014, 7(4):203-208
DOI:10.4103/0974-2077.150740  PMID:25722598
Background: Immunotherapy is an evolving therapeutic modality for the treatment of warts. We conducted a study to assess the efficacy and safety of intralesional Mycobacterium w vaccine for the treatment of warts at sites that were difficult to treat. Materials and Methods: Thirty patients with at least one wart present on either the plantar surface of their feet, palms, volar aspect of their fingers, or periungual or subungual region, were treated with 0.1 ml of killed Mycobacterium w vaccine given intralesionally in a single wart, without any prior sensitisation dose. Thereafter, a single injection of 0.1 ml of vaccine was given at intervals of four weeks in a single wart till there was complete resolution of the warts or a maximum of 10 injections. Treatment was stopped if there was no response after three injections. The patients were followed up for at least six months. Results: Out of the 30 patients, 28 (93.33%) patients had complete resolution of their warts, both at the injected and distant sites. The mean (SD) time for complete clearance of warts was 43.71(32.82) days and the mean (SD) dose of vaccine that was required for complete clearance of warts was 0.186 ml (0.101). Four patients (14.28%) had a recurrence of warts. The treatment was well-tolerated and the side effects were reversible in the majority of the patients. Conclusion: In comparison to the earlier studies using Mycobacterium w vaccine for the treatment of warts, our study was different in the following aspects: No sensitisation dose was given, only a single wart was injected at a time and the duration between the period of injections was increased to four weeks. With all these changes we eliminated the complications due to the sensitisation dose and achieved good results. This study provides new insight into the dose and schedule of treatment of this evolving therapeutic modality.
  6 5,881 338
Pseudoepitheliomatous hyperplasia: A clinical entity mistaken for squamous cell carcinoma
Suvadip Chakrabarti, Preeti Rihal Chakrabarti, Deepak Agrawal, Shreyas Somanath
October-December 2014, 7(4):232-234
DOI:10.4103/0974-2077.150787  PMID:25722605
  5 5,324 256
Treatment of a non-healing diabetic foot ulcer with platelet-rich plasma
Deepak H Suresh, Shwetha Suryanarayan, Sacchidanand Sarvajnamurthy, Srikanth Puvvadi
October-December 2014, 7(4):229-231
DOI:10.4103/0974-2077.150786  PMID:25722604
Lower extremity ulcers and amputations are an increasing problem among individuals with diabetes. Among diabetes mellitus-related complications, foot ulceration is the most common, affecting approximately 15% of diabetic patients during their lifetime. The pathogenesis of diabetic ulcer is peripheral sensory neuropathy, calluses, oedema and peripheral vascular disease. Diabetic ulcer is managed by adequate control of infections and blood sugar levels, surgical debridement with various dressings and off loading of the foot from pressure. In spite of these standard measures, some recalcitrant non-healing ulcers need additional growth factors for healing. Autologous platelet-rich plasma is easy and cost-effective method in treating diabetic ulcers as it provides necessary growth factors which enhance healing.
  3 5,062 452
Excellent response to intralesional Bacillus Calmette-Guérin vaccine in a recalcitrant periungual wart
Piyush Kumar, Anupam Das
October-December 2014, 7(4):234-235
DOI:10.4103/0974-2077.150788  PMID:25722606
  2 2,982 194
Angiofibroma on cheek mucosa: A rare entity and its management with laser
Rajesh Kumar Thakur, Ellora Madan, Akhilesh Tomar, Manu Arora
October-December 2014, 7(4):227-228
DOI:10.4103/0974-2077.150785  PMID:25722603
A rare presentation of an angiofibroma in the oral cavity is reported, which was treated with a diode laser. The benefits of laser treatment include bloodless procedure with instant precise coagulation of vessels. Although rare and unusual, it is suggested that angiofibroma should be included as one of the differential diagnoses of soft tissue swellings in the oral cavity.
  1 3,082 136
Infiltrating oral lipoma a rare variant
Sujata Saxena, Pramod Bhimsein Jahagirdar, Dayananda Bagur Chidananda
October-December 2014, 7(4):236-237
DOI:10.4103/0974-2077.150789  PMID:25722607
  1 2,814 96
Extensive abdominal wall and genital pyoderma gangrenosum: Combination therapy in unusual presentations
Zabihollah Shahmoradi, Fatemeh Mokhtari, Mohsen Pourazizi, Bahareh Abtahi-Naeini, Ali Saffaei
October-December 2014, 7(4):238-240
DOI:10.4103/0974-2077.150791  PMID:25722609
  1 5,337 121
Alternative nipple suspension technique in the treatment of inverted nipple: Reverse S-shaped design
Umut Tuncel, Murat Gümüş, Aydın Turan, Deniz Uyanık, Esat Olgun, Naci Kostakoğlu
October-December 2014, 7(4):220-223
DOI:10.4103/0974-2077.150758  PMID:25722601
The primary aim in the treatment of inverted nipple is to achieve a satisfactory and permanent projection of the nipple. The drawbacks of reported techniques include sensory disturbance of the nipple, marked scarring of the nipple and areola, destruction of breast function and incomplete correction. In the present study, the authors introduced a new modification of using two opposite nipple-based areolar dermal flap in the treatment of grades 2 and 3 inverted nipple cases. Nipple-based areolar flaps designed at 3 o'clock and 9 o'clock were raised by two linear incisions and the tip of each flap was sutured on the base of the nipple close to the base itself in a reverse S shape at 6 and 12 o'clock. Successful outcome was obtained due to a strongly suspending effect of the design of the flaps. The mean follow-up period was 6 months. The patients were satisfied with the result and the scars were minimal. The authors recommend the use of the technique that is a simple, reliable and with minimal scars for correcting grades 2 and 3 inverted nipples.
  - 4,842 171
Role of chemical peeling in nail disorders
Chander Grover
October-December 2014, 7(4):201-202
  - 2,788 255
Utility of gel nails in improving the appearance of cosmetically disfigured nails: Experience with 25 cases
Soni Nanda, Chander Grover
October-December 2014, 7(4):240-241
DOI:10.4103/0974-2077.150792  PMID:25722610
  - 2,344 134
An unusual case of lipoma attached to the frontalis muscle
Kavitha Dasari, Harish Kumar Kasetty, Sunita Ghanta
October-December 2014, 7(4):237-238
DOI:10.4103/0974-2077.150790  PMID:25722608
  - 4,578 112
Regenerative medicine in aesthetic surgery: Hope or hype?
Niti Khunger
October-December 2014, 7(4):187-188
DOI:10.4103/0974-2077.150732  PMID:25722594
  - 3,236 284
Railroading technique of dermal grafting for linear atrophic scarring
Balakrishnan Nirmal, Savitha Somiah, Sarvajnamurthy A Sacchidanand
October-December 2014, 7(4):224-226
DOI:10.4103/0974-2077.150781  PMID:25722602
Dermal grafting is a valuable technique in the field of dermatosurgery for the treatment of atrophic scars where the source of filler material is the patient's own dermis. However, it is underused for the reasons being difficulties in placing the graft in the tunnel, keratin cysts and complications due to biofilms. Railroading technique used in urology for rupture urethra has been described for dermal grafts to overcome the technical difficulties of graft placement.
  - 3,329 207
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