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Biomedical subjects

Keyvan Nouri

Publications and source records attributed to Keyvan Nouri.

At least 37 records · Page 2Linked to original sources
PubMed2004

Comparing 18- versus 12-mm spot size in hair removal using a gentlease 755-nm alexandrite laser.

BACKGROUND: Laser epilation is based on the principle of selective photothermolysis, absorption of laser energy by the target chromophore melanin. It is claimed that larger spot sizes may be more effective for hair removal at identical fluences. OBJECTIVE: To compare the efficacy of 18- vs. 12-mm spot size in hair removal using a Gentlelase Alexandrite laser from Candela Corporation (Boston, MA). METHODS: In this double-blind, randomized control trial, patients underwent laser-assisted hair removal on the axillary region. Regions were randomly selected and treated with either an 18- or a 12-mm spot size. Three treatments at 6-week intervals with a 755-nm Gentlelase Alexandrite laser (Candela Corp., Canton, MA) at a fluence of 16 J/cm(2) with cooling and delay times of 60 ms. Hair counts were taken before each treatment session and compared. The mean percentage hair reduction and student's paired t-test were used to compare 18 versus 12 mm versus control sites at each visit and compared it with the baseline hair count. RESULTS: There was a 10.3% difference in mean reduction favoring the 18-mm spot size treated area at the 6-month follow-up. CONCLUSION: Our results indicate that a larger spot size appears to be more effective for laser assisted hair removal.

Adult↗
PubMed2003

Eccrine porocarcinoma arising in a seborrheic keratosis evaluated with dermoscopy and treated with Mohs' technique.

A 78-year-old white woman returned for a routine 6-month skin cancer examination. She had a history of actinic keratosis and multiple basal cell carcinomas. She had no personal or family history of dysplastic nevi or melanoma. The patient was asymptomatic and unaware of any new or changing skin lesions. The patient had multiple lentigines, hemangiomas, and actinic and seborrheic keratoses on all sun-exposed areas. There were no less than 10 seborrheic keratoses on the right mid-back, and one was found to have a 1-cm, reddish nodule asymmetrically located within it (Figs 1 and 2). A clear papule on the left preauricular area was found on biopsy to be a basal cell carcinoma. The nodule on the back was still present 1 month later and it was felt that further evaluation was indicated. As melanoma has been reported to develop in seborrheic keratoses, we decided to examine the lesion using digital dermoscopy. With digital dermoscopy, a well-demarcated reddish nodule was asymmetrically located within a brown lesion. It blanched significantly with pressure. Within the nodule, there were dotted and irregular linear vessels (atypical vascular pattern; also known as polymorphous vascular pattern) and regular-appearing brown dots. Surrounding the reddish nodule, there were pale and pigmented, comedo-like openings, fissures, and ridges (brain-like appearance). Some of the follicular openings appeared to be within the wall of the nodule (Figs 3 and 4). Comedo-like openings, fissures, and ridges are primary dermoscopic criteria for the diagnosis of a seborrheic keratosis; however, the vascular pattern seen has not been reported in seborrheic keratosis. Due to the patient's age and the rarity of significant pathology arising in a seborrheic keratosis, a shave biopsy was performed. To our surprise, the specimen was interpreted by an experienced dermatopathologist as a well-differentiated eccrine porocarcinoma. Due to the high local recurrence rate and metastatic potential of this carcinoma, the patient was referred for Mohs' surgery. Both the basal cell carcinoma and the eccrine porocarcinoma were excised in one stage. A metastatic work-up was negative and the patient appears to be doing well.

Aged↗
PubMed2003

585-nm pulsed dye laser in the treatment of surgical scars starting on the suture removal day.

BACKGROUND: The optimal time frame to improve the quality and cosmetic appearance of scars by laser therapy has not been clearly elucidated by prior controlled clinical trials. OBJECTIVE: To determine the efficacy of the 585-nm pulsed dye laser (PDL) in the treatment of surgical scars starting on the day of suture removal. METHODS: Eleven patients (skin types I-IV) with 12 postoperative linear scars that were greater than 2 cm were treated three times on monthly intervals with the 585-nm PDL (450 micro s, 10-mm spot size, 3.5 J/cm2 with 10% overlap) on one scar half, whereas the other half received no treatment. Scars were later evaluated by a blinded examiner using the Vancouver Scar Scale (VSS) for pigmentation, vascularity, pliability, and height. Scars were then blindly examined for cosmetic appearance using a visual analog scale. RESULTS: One month after the last treatment, final scar analysis by the blinded examiner revealed a significant difference between treated and untreated sites, with the treated halves scoring better in all scar parameters in the VSS and in cosmetic appearance. The treated halves demonstrated an overall average improvement in the VSS between the first treatment score and the final score of 54% versus 10% in the controls (P=0.0002). The cosmetic appearance score (0=worst; 10=best) at final assessment was significantly better for the treated scars, scoring 7.3 versus the averaged control score of 5.2 (P=0.016). CONCLUSION: The 585-nm PDL is effective and safe in improving the quality and cosmetic appearance of surgical scars in skin types I-IV starting on the day of suture removal.

Adult↗
PubMed2003

Histologic cure of basal cell carcinoma treated with cryosurgery.

BACKGROUND: Cryosurgery is a method of treatment for basal cell carcinoma (BCC). Despite numerous studies reporting excellent cure rates with cryosurgery, there are no studies in the literature that have shown a histologic cure of BCC. OBJECTIVE: We sought to show histologically that cryosurgery is an effective cure for well-defined, noduloulcerative BCC of the trunk and upper extremities. METHODS: Twelve noduloulcerative BCCs of the trunk and proximal upper extremities less than 1 cm were treated with single freeze-thaw cryosurgery using a cryoprobe apparatus with liquid nitrogen. A thermocouple needle measured temperature, with the goal to reach between -50 degrees C and -60 degrees C. One to 2 months later, the site was excised and examined with horizontal step sections throughout the entire tissue. RESULTS: No tissue specimens had histologic evidence of tumor. CONCLUSION: Single freeze-thaw cryosurgery provides a histologic cure of well-defined, noduloulcerative BCCs of the trunk and extremities less than or equal to 1 cm.

Biopsy, Needle↗
PubMed2003

Mucoepidermoid carcinoma (adenosquamous carcinoma) treated with Mohs micrographic surgery.

BACKGROUND: Mucoepidermoid carcinoma (MEC), sometimes referred to as adenosquamous carcinoma (ASC), is a common malignant tumor of the salivary glands that can also develop from the esophagus, lacrimal passages, lung, upper respiratory tract, pancreas, prostate and thyroid. Rarely, MEC will present primarily in the skin. CASE: We present a case of primary MEC of the lower eyelid treated successfully with Mohs micrographic surgery. RESULTS: Mohs micrographic surgery was performed because of the highly aggressive and unpredictable nature of this tumor. The tumor was completely excised using Mohs with negative margins achieved in three stages. The patient has been disease free for 3 years since the surgery. CONCLUSION: We offer Mohs as an option for treating MEC.

Aged↗
PubMed2003

Imiquimod for the treatment of Bowen's disease and invasive squamous cell carcinoma.

Topical imiquimod is an immune response modifier FDA approved for the treatment of anogenital warts. Recent studies have reported its effectiveness in the treatment of some types of basal cell carcinomas. There have also been some case reports and case series reporting success treating of squamous cell carcinoma in situ with imiquimod. We report two patients with squamous cell carcinoma in situ and one with invasive squamous cell carcinoma treated with 5% imiquimod cream. Lesions were located on shin, posterior shoulder, and nasal tip. 5% imiquimod cream was applied at night for six weeks. Side effects included erythema and crusting in one patient. Biopsies taken four weeks after treatment revealed no residual squamous cell carcinoma in situ or squamous cell carcinoma. Topical 5% imiquimod cream is becoming established as a promising treatment for squamous cell carcinoma in situ. It also seems to be an alternative treatment for some cases of squamous cell carcinoma.

Administration, Cutaneous↗
PubMed2002

Rare presentations of basal cell carcinoma.

BACKGROUND: Even though basal cell carcinomas (BCC) are the most common skin cancers in the world, they rarely appear in the African-American, Hispanic, and Asian populations. BCCs most commonly present on the head and neck of elderly, light-skinned individuals who have received an excessive amount of sun exposure. However, it has been hypothesized that the development of BCCs in unusual populations is a result of an alteration in tumor surveillance or an impairment in cellular immunity. OBJECTIVE: We present two cases of BCC, one in an Asian woman and one in an African-American woman. Neither of these patients had any history of genodermatoses or were immunocompromised. CONCLUSION: BCCs can occur in Asian and African-American patients. Clinicians should include the diagnosis of BCC in their differential for these patients despite their rare presentations.

Adult↗
PubMed2002

Characterization and changes of a chromosomal-scaffolding protein in human epithelia.

Chromosomal-scaffolding proteins exert DNA structural functions during mitosis, and gene regulatory functions such as RNA splicing/polymerization and DNA replication in interphase, allowing the progression of the cell cycle. Recently, it has been reported that topoisomerases play a key role in DNA repair, suggesting an additional regulatory mechanism of the chromosome structure on DNA metabolism and cell cycle checkpoints. Despite the progress made toward the understanding of the genome organization and expression, few changes have been reported in the chromosome scaffold of malignant cells associated with the cancer phenotype. In a previous work, we reported LFM-1 protein (Licensing Factor Model-1) as a chromosomal-scaffold component transiently associated with mitotic chromosomes in MDCK (Madin Darby canine kidney) epithelial cells (Vega-Salas and Salas 1996). In this work, we explore LFM-1 expression in human epithelia with contrasting tumorigenicity during the progression of the cell cycle. Although cell metabolic labeling shows synthesis of a common 87-kDa LFM-1 precursor during G(2)-phase in both non-tumorigenic and cancer cells, surprisingly, the post-translational LFM-1 chromosome-bound polypeptide displays a different apparent molecular weight and binding to chromosomes in the cancer phenotype. The finding of a highly phosphorylated LFM-1 60-kDa form with abnormal binding to chromosomes in human carcinoma cells suggests a structural/regulatory role(s) of the chromosome-scaffold/matrix in DNA metabolism in cancer-related events of cell proliferation.

Animals↗
PubMed2002

Squamous cell carcinoma in a patient with Netherton's syndrome.

A 29-year-old white woman with a history of Netherton's syndrome presented with two squamous cell carcinomas on the right dorsal hand and the left upper arm. She reported a 2-year history of these lesions, which were originally treated as warts. She denied excessive sun exposure, immunosuppressive therapy, or a previous history of skin cancer. Her past medical history included acute renal failure, multiple urinary tract infections, meningitis, and recurrent otitis media as a child. In addition, she had an ovarian abscess at 4 years of age with resulting salpingo-oophorectomy. She also reported a history of severe myopia, glaucoma, and multiple ocular infections with a resulting corneal scar. In addition to atopic dermatitis, she had a 10-year history of psoriasis. Her medications included topical steroids and emollients for atopic dermatitis and psoriasis, in addition to Timolol ophthalmic drops for glaucoma. Her family history was significant for a 22-year-old sister with Netherton's syndrome (Fig. 1). She denied any history of skin cancer in her sister or other members of her family. On physical examination, she had an exfoliative erythroderma, madarosis, and diffuse patchy alopecia. In the bilateral axilla, she had well-defined pink scaly plaques which were confirmed as psoriasis by biopsy. On the right dorsal hand, she had a 1.5 x 1.0 cm pink verrucous plaque (Fig. 2). On the left upper arm, she had a 1.5 x 0.8 cm pink scaly plaque. Biopsies of both sites confirmed squamous cell carcinomas. Both lesions were completely excised with 4 mm margins.

Adult↗
PubMed2002

Treatment of pigmented hypertrophic scars with the 585 nm pulsed dye laser and the 532 nm frequency-doubled Nd:YAG laser in the Q-switched and variable pulse modes: a comparative study.

BACKGROUND: Pigmented hypertrophic scars are a difficult condition to treat. They may result from traumatic injuries or from surgical and cosmetic procedures. The 585 nm flashlamp-pumped pulsed dye laser (FLPDL) has been used to treat this condition, with significant improvement of varying degrees. It remains to be determined whether other laser modalities may have a similar or even greater success in the treatment of pigmented hypertrophic scars. OBJECTIVE: To determine the efficacy of the 532 nm frequency-doubled Nd:YAG laser in the treatment of pigmented hypertrophic scars as compared to the 585 nm FLPDL. METHODS: Six patients with pigmented hypertrophic scars and skin phototypes II-IV were chosen. A scar was selected for treatment in each patient and divided into four equal 2 cm segments. Three segments were each treated with a different laser modality and one was left untreated to serve as the control. A 585 nm FLPDL was used with an energy of 3.5 J, a pulse duration of 450 microsec, and a 10 mm spot size. A 532 nm Q-switched frequency-doubled Nd:YAG laser was set to an energy of 2.8 J, a 10-nsec pulse, and a 3 mm spot size. The same 532 nm laser was set to the variable pulse mode to treat a 2 cm scar segment, with an energy of 9.5 J, a 10-msec pulse, and a 4 mm spot size. An average of 3.3 treatments were performed on each scar segment, at intervals of 4-6 weeks and long-term follow-up at 22 weeks. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. A SigmaStat t-test was used to determine the statistical significance of the values obtained. RESULTS: Treatment of pigmented hypertrophic scars with the 532 nm Q-switched Nd:YAG laser led to a significant improvement of 38% in the VGH scores when compared to baseline (P =.005). The 585 nm FLPDL also had a favorable effect on the scars, with an average improvement of 36.1% in the VGH scores. There was no significant difference noted between the outcome of treatment with either of these two lasers. Treatment with the 532 nm variable pulse Nd:YAG laser led to a 19% improvement in the VGH scores of scars, which did not differ significantly from the 16.1% improvement observed in control scars on the last follow-up visit. No side effects or complications from treatment were noted or reported during the course of the study. At the conclusion of the study, five of six patients chose the segment treated with the 532 nm Q-switched Nd:YAG laser as the best segment overall. CONCLUSION: The 532 nm Q-switched Nd:YAG laser and the 585 nm FLPDL offer comparable favorable results in the treatment of pigmented hypertrophic scars. The 532 nm Q-switched Nd:YAG laser may be preferred by patients particularly distressed by the dark color of their scars.

Adolescent↗
PubMed2002

Ultrapulse CO2 used for the successful treatment of basal cell carcinomas found in patients with basal cell nevus syndrome.

BACKGROUND: Basal cell nevus syndrome (BCNS) is an inherited condition marked by multiple basal cell carcinomas (BCCs) associated with several other abnormalities. Various treatment modalities have been used to eradicate these tumors. However, recurrences and scarring limit their use. OBJECTIVE: To evaluate the treatment of multiple BCCs associated with BCNS. METHODS: We describe three cases of BCNS in which multiple BCCs were effectively treated with ultrapulse CO2 laser. Postoperative Mohs micrographic surgical sections (thin sections looking for residual tumor) verified complete histologic clearance of the tumors. RESULTS: All three patients were effectively treated with ultrapulse CO2 laser. Minimal scarring was noted at follow-up. CONCLUSION: Ultrapulse CO2 laser can be used to effectively treat small BCCs in low-risk areas associated with BCNS with minimal posttreatment scarring.

Adolescent↗
PubMed2002

Mohs micrographic surgery for dermatofibrosarcoma protuberans: University of Miami and NYU experience.

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a relatively rare cutaneous malignancy with the potential for significant local destruction and morbidity. This neoplasm has a tendency for recurrence following excision due to its infiltrative nature. Surgical excision with wide margins has been considered the standard therapy for DFSP but has had reported recurrence rates of up to 60%. OBJECTIVE: The results of 20 patients with DFSP treated with Mohs micrographic surgery (MMS) are reported. We also reviewed the world literature on the role of MMS for treatment of this tumor. METHODS: Twenty patients between the ages of 20 and 82 years with DFSP were treated with MMS. The patients were followed for recurrences between 4 and 216 months (mean 56.4 months). RESULTS: None of the 20 patients had a recurrence of DFSP following MMS. Of 221 DFSP patients in our review of the world literature treated with MMS, only 5 (2.3%) had a recurrence. CONCLUSION: MMS is an effective treatment of DFSP.

Adult↗
PubMedDate not supplied

Laser therapy for acne.

Considered the most common skin disorder, acne affects millions of people every year. This multifactorial condition of the pilosebaceous follicle is a combination of at least four different primary pathogeneses. In recent years, acne therapies have been improving, becoming more effective, and targeting one or more of these causes. Many current therapies have drawbacks involving patient compliance, systemic toxicities, and bacterial resistance. Lasers are now established options in the armamentarium to treat acne. The 532-nm potassium titanyl phosphate laser, 585- and 595-nm pulsed dye lasers, 1450-nm diode laser, and 1540-nm erbium glass laser have been used with variable efficacy. Lasers may be best used in combination with other therapies to enhance their results. Photodynamic therapy has been successful with substances such as 5-aminolevulinic acid and indocyanine green. Lasers remain viable alternatives for people who may not desire or be able to use topical or systemic formulations. Drawbacks associated with lasers include potential pain, skin discoloration, and cost of treatment. Typically, multiple sessions are required to achieve the desired results, with future maintenance treatments possible to maintain the outcomes. With additional clinical trials underway, laser treatment of acne will surely advance and continue to be optimized in the future.

Acne Vulgaris↗
PubMedDate not supplied

A primer of Mohs micrographic surgery: common indications.

Mohs micrographic surgery is a highly effective technique for the removal of some skin cancers. The technique is founded on the idea of excision with minimal margins (sparing normal tissue) and immediate histologic examination of horizontal frozen sections of the specimen while the patient waits. By doing this, a Mohs surgeon is able to examine the margins. If residual tumor is present, subsequent excisions are performed until it is completely removed. In cases of aggressive tumors, recurrent tumors, or in which the lesions are present in high-risk anatomic locations (H-zone of the face) or functionally important areas (e.g., digits, genitals), the preferred treatment is Mohs micrographic surgery.

Basal Cell Carcinoma↗
PubMedDate not supplied

A primer of Mohs micrographic surgery: uncommon indications.

Mohs micrographic surgery has been used for the treatment of tumors other than basal and squamous cell carcinomas. Parameters to be considered when deciding on a treatment include location, size, growth pattern, and recurrence rates. It is important to consider that sometimes the high-risk nature of the tumor is more significant than the need for tissue sparing. Modifications to the Mohs micrographic surgery technique may be used to ensure diagnostic accuracy and confirm complete removal of the lesion (e.g., immunohistochemical staining and paraffin-embedded sections).

Carcinoma↗
PubMedDate not supplied

The Miami Special: a simple tool for quality section mounting in Mohs surgery.

High quality frozen sections are fundamental in Mohs surgery, and one of the main elements in tissue processing is the mounting of the specimen. The Miami Special has been used for this purpose at the University of Miami for over 30 years. Since 1989 the Miami Special has languished in the literature among a growing list of mounting instruments. Therefore, new generations of Mohs surgeons may not be acquainted with the advantages of this instrument. This article describes the Miami Special and outlines its use for the benefit of current practitioners.

Florida↗
PubMedDate not supplied

Basal cell carcinoma of the areola in a man.

Basal cell carcinomas (BCCs) that arise in sun-protected sites are quite uncommon. We report a case of BCC of the areola, which is extremely rare. Mohs micrographic surgery was used for the treatment. The etiologic factors of BCCs in sun-protected areas are discussed, and previous studies regarding the treatment modalities are reviewed.

Basal Cell Carcinoma↗