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Results for “FACIAL DERMATOSES”

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At least 451 records · Page 25Linked to original sources
PubMedDate not supplied

Autologous fibroblasts for treatment of facial rhytids and dermal depressions. A pilot study.

OBJECTIVE: To assess effectiveness of intradermal injections of autologous fibroblasts for the treatment of facial rhytids and dermal depressions. DESIGN: Six-month prospective pilot study. Photographs and silicone molds were taken of a prominent rhytid or dermal depression from each patient prior to treatment and at 6 months after treatment. SETTING: Specialty clinic in academic medical center. PATIENTS: Ten adults (age range, 24-69 years) who each exhibited a prominent rhytid or depressed facial scar. INTERVENTION: A 3-mm postauricular skin biopsy specimen from each participant was sent to Isolagen Technologies, Inc, laboratories, where a fibroblast cell line was developed. Three injection sessions were performed at 2-week intervals; target areas were the study site as well as behind the ear. MAIN OUTCOME MEASURES: Subjective improvement scores were obtained by each patient and 2 clinicians at every follow-up visit. Skin surface topographical features were evaluated with optical profilometry by comparing silicone molds before and after injection. Histological analysis was performed on a biopsy specimen of the postauricular injection site. RESULTS: Nine of 10 patients noted a 60% to 100% improvement with the treatment; clinicians made similar observations. Size reduction of 10% up to 85% of the study site was demonstrated by optical profilometry for every patient. Microscopically, there was evidence of increased thickness and density of dermal-layer collagen. CONCLUSIONS: Intradermal injection of autologous fibroblasts may be an effective treatment option for facial rhytids and depressed scars.

Acne Vulgaris↗
PubMedDate not supplied

Management of infraorbital dark circles. A significant cosmetic concern.

Despite the frequency with which it occurs, little has been written in the scientific literature on the treatment of infraorbital dark circles. I have developed a technique that simultaneously treats the 2 contributing causes of these circles: hyperpigmentation of skin and pseudoherniation of orbital fat. The technique involves simultaneous transconjunctival blepharoplasty and deep-depth phenol chemical peel. Successful outcomes have been obtained in patients with Fitzpatrick classification skin types 1 to 5, with a low incidence of complications. Adequate preoperative counseling regarding prolonged erythema and careful postoperative monitoring with, if necessary, medical intervention are essential if both surgeon and patient are to be satisfied with the outcomes.

Adipose Tissue↗
PubMedDate not supplied

Description and analysis of treatments for port-wine stain birthmarks.

Port-wine stain (PWS) birthmarks are congenital, low-flow vascular malformations of the skin. Lasers are the modality of choice for the treatment of PWS birthmarks, and for most patients the pulsed-dye laser in conjunction with epidermal cooling offers the greatest efficacy and safety. Other light devices, including the 532-nm frequency-doubled Nd:YAG laser, intense pulsed light, 1064-nm Nd:YAG laser, and combined 1064/532-nm system, may be useful during a treatment course for resistant PWS. Laser treatment results in blanching of most lesions, although complete resolution may not occur and some resistant PWS birthmarks respond minimally, if at all. Factors limiting laser treatment include variable vascular geometry, inadequate damage of some vessels, and lesional posttreatment recurrence as a result of neovascularization. Alternative or adjunct treatment options that address these limitations should be explored, including noninvasive real-time imaging to optimize the selection of treatment settings, photodynamic therapy, and perioperative use of antiangiogenic compounds.

Adolescent↗
PubMed1994

Periocular granuloma annulare, nodular type. Occurrence in late middle age.

We describe the two oldest individuals with nodular granuloma annulare (pseudorheumatoid nodules) in the ophthalmologic literature and propose a unified classification scheme that recognizes pseudorheumatoid nodules to be granuloma annulare, nodular type. All lesions in both cases revealed so-called necrobiotic granulomas, characterized by an acellular central area containing mucin (hyaluronic acid) surrounded by palisading histiocytes (macrophages), diagnostic of granuloma annulare. These features are identical to those reported in the ophthalmologic and older general pathology literature as pseudorheumatoid nodules and the contemporary general and dermatologic pathology literature as granuloma annulare. We believe the diagnosis of nodular granuloma annulare should be employed for necrobiotic lesions displaying distinctive clinicopathologic features to unite the ophthalmologic, general, and dermatologic pathology literature. Granuloma annulare, nodular type, must also be considered in the differential diagnosis of ocular and periocular lesions at any age.

Eye↗
PubMed1996

Port-wine stains. An assessment of 5 years of treatment.

OBJECTIVE: To assess objectively the results of flashlamp-pumped dye laser treatment of port-wine stains (PWS). DESIGN: Pretreatment and posttreatment photographs were compared with the appearance of the lesion at follow-up examination. Clinical response was determined by assigning a percentage of lesional lightening score by 2 physicians and the patient, and by reflectance spectrophotometric measurements. SETTING: University and university-affiliated health center. PATIENTS: One hundred two patients (118 PWS) aged 1 month to 66 years (mean, 20 years; median, 16 years) treated from July 1, 1989, to June 30, 1994. RESULTS: Eighteen (15.3%) of the 118 PWS had more than 90% lesional lightening (complete or almost complete response), 77 (65.3%) had lightening from 50% to 90% (good response), 21 (17.8%) had lightening from 11% to 49% (poor response), and 2 (1.7%) had lightening less than 10% (no response). Clinical response did not vary among age groups, but showed statistically significant differences between anatomical locations. A return of PWS after initial response was observed in patients who were seen more than 1 year following completion of treatment. CONCLUSIONS: Treatment of PWS by flashlamp-pumped dye laser results in a good to complete response in most patients. Anatomical location of the lesion is a valuable prognostic indicator of response to treatment. The initially impressive results of flashlamp-pumped dye laser treatment of PWS may be tempered by the gradual return of the vascular lesion as time elapses after completion of therapy. Our experience indicates that PWS show a tendency to recur at a rate approaching 50% between 3 and 4 years after completion of treatment.

Adolescent↗
PubMed1997

Facial keloids. A 15-year experience.

BACKGROUND: Keloids are relatively common sequelae of trauma to the skin of the head and neck. A wide variety of treatment approaches developed over the years document the difficulty in eradicating these lesions. OBJECTIVE: To review the senior author's (W.H.L) 15-year experience in treating keloids both medically and surgically. DESIGN: A retrospective analysis of 202 patients with histologically documented keloids of the head and neck with at least a 2-year follow-up. RESULTS: A combination of precise surgical excision, postoperative steroid infiltration, silicone sheeting, and conservative auricular radiotherapy has resulted in an acceptable 15% recurrence rate overall. CONCLUSIONS: The treatment of facial keloids remains a challenge for the facial plastic and reconstructive surgeon. Precise surgical techniques with adjuvant therapies have resulted in a relatively low recurrence rate.

Anti-Inflammatory Agents↗
PubMed1997

Histological and clinical evaluation of facial resurfacing using a carbon dioxide laser with the computer pattern generator.

OBJECTIVES: To delineate the extreme precision and uniformity of tissue ablation with a carbon dioxide laser using the computer pattern generator (CPG) (Coherent Laser Corp, Palo Alto, Calif) and to determine the ideal treatment parameters for uniform tissue ablation with minimal tissue thermal injury. Also, to evaluate postoperative healing of patients undergoing laser resurfacing compared with the traditional modalities of chemical peels and dermabrasion. DESIGN: A 3-part study was designed to demonstrate the effectiveness of this new modality. Cutaneous tissue from patients undergoing rhytidectomy was treated with a carbon dioxide laser with the CPG varying the treatment parameters. A histological analysis was completed to evaluate the uniformity of tissue ablation and thermal effect. Next, 30 tissue specimens were treated with identical power settings and evaluated histologically to determine the depth of tissue ablation, the variability in depth of ablation, and the degree of thermal effect on the underlying dermis. Finally, a prospective clinical analysis of patients undergoing facial resurfacing with the carbon dioxide laser was undertaken to determine the length of time required for reepithelialization, as well as resolution of postresurfacing erythema. PATIENTS: Seventy-four patients underwent facial resurfacing with a carbon dioxide laser with CPG. Sixty patients were treated for cosmetic procedures and 14 were treated for either chronic acne scarring or posttraumatic scarring. INTERVENTIONS: To evaluate the CPG parameters, skin specimens were treated with the same fluence while the density setting varied from 1 through 9. To evaluate tissue uniformity and thermal effect, the CPG was used with the same treatment parameters of 300 mJ and a density of 5 for all specimens. Patients undergoing clinical evaluation were treated for periorbital, perioral, or full face resurfacing. All patients were treated by the same surgeon. MAIN OUTCOME MEASURES: Histological specimens were evaluated with light microscopy and hematoxylin-eosin staining to determine the depth and uniformity of ablation and the thermal effect. Patients were followed up after the procedure and evaluated for complete reepithelialization and resolution of erythema. RESULTS: A histological evaluation revealed that a treatment parameter of 300 mJ with a density setting of 3, 4, or 5 resulted in uniform ablation of the epidermis with minimal thermal injury to the underlying dermis. At density settings of 1 and 2, irregular ablation of the tissue occurred, while at a density setting of 6 through 9, increasing degrees of thermal injury and tissue necrosis occurred. The depth of epithelial ablation with density set at 5 varied between 65 and 90 microns (average depth, 78 microns). The thermal effect in the papillary dermis varied between 0 and 45 microns (average, 28 microns). No tissue necrosis was seen. Complete reepithelialization occurred an average of 7 days following the procedure, with resolution of cutaneous erythema occurring at an average of 42 days. CONCLUSIONS: The carbon dioxide laser with the CPG is an effective modality for cutaneous exfoliation. With the proper treatment parameters, extreme accuracy and uniformity of tissue ablation can be achieved. The tissue is ablated with micrometer accuracy and minimal thermal effect to the underlying dermis. Postoperative healing is comparable to that of the traditional modalities of dermabrasion and chemical peel. Postresurfacing erythema is transient and resolved in all patients.

Acne Vulgaris↗
PubMed1972

Goltz's syndrome.

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Abnormalities, Multiple↗