Biomedical subjects
Publications and source records attributed to Maria Patricia Rivas.
Many articles have been published on improving the appearance of scars; however, there are no definitive management protocols. Our objective was to review the literature on laser therapy for various types of scars. There are multiple laser modalities that have been studied with certain features that may be indicated for specific scar types. Suggestions are given for further studies.
The trend toward minimally invasive rejuvenation techniques has led to the widespread use of nonablative lasers. Nonablative lasers can be classified in two groups based on their wavelengths: lasers emitting light in the visible range, and those emitting in the infrared range. In this review, different laser and intense pulsed light (IPL) systems are presented and critically discussed along with findings of the studies in the literature.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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.
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.
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).
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.