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Dermabrasion is a mechanical, "cold steel" method of removing the epidermis and creating an upper to mid-dermal wound. The subsequent restructuring of collagen and a freshly resurfaced epidermis yields excellent results in actinically damaged, aged, and scarred skin. Preoperative and postoperative management to optimize wound healing are well established and predictable, and morbidity and complications are infrequently encountered.
Kaposi varicelliform eruption (KVE) is the name given to a distinct cutaneous eruption caused by Herpesvirus hominis types 1 and 2, vaccinia virus, or coxsackie A16 virus, superimposed on a preexisting dermatosis. A delay in diagnosing this condition may result in intense pain and rapid spread of the cutaneous lesions. We report a patient who underwent perioral dermabrasion for wrinkles who developed KVE secondary to herpes simplex virus infection.
Bacterial colonization and invasive bacterial infection is still one of the major problems in the treatment of burn victims. The standard procedures of bacterial monitoring of the burn would are i) swab-culture which is non-invasive but detects bacteria at the very surface and ii) biopsy-culture which gives a more complete view but has the disadvantage of being invasive. Therefore we developed a new technique for examination of microbial colonization of the wound surface. Dermabrasion of the upper layers of the wound was performed using a small rotating carbon-steel disc of defined roughness. The tissue samples obtained were analysed for bacterial growth in different culture media. Results were qualitatively and quantitatively compared with those of standard techniques performed in parallel. Our results show that this new technique is superior to the swab culture in identifying different bacterial species. The results can be compared with the biopsy technique, but has the advantage of being less invasive.
Tuberous sclerosis is an inheritable disease of varied manifestations. Hallmarks of the disease have historically been identified as infantile seizures, severe mental retardation, and facial growths. The facial lesions were formerly termed adenoma sebaceum, but are now known to be angiofibroma. We present a patient who was referred for management of large facial lesions complicated by intermittent hemorrhage. A combination of shave excision and dermabrasion led to a symptomatic and cosmetic improvement.
The combined use of chemical peel and dermabrasion of the face was widely accepted since the first reports of DuPont and Horton. We present a refinement of this combined method by introducing the use of a simple diathermy head cleaner (Surgikos, Inc) as a safer method of face abrasion. This disposable device, available at every surgical theater allows a better control of the abrasive tool, permits a more accurate depth of the abrasion, and reduces the incidence of unexpected complications in this combined technique.
Nevus of Ota is an anomaly of the dermal melanocytes, which lies primarily in the deep dermis. It causes discoloration of the face and induces a remarkable disfigurement to the patients. This report demonstrates the favorable results of 3 male patients treated with autologous-cultured epithelium grafting combined with dermabrasion. The lesions on the cheek, forehead, and temple were dermabraded to the deep dermal layer. The cultured epithelium obtained from preauricular skin or medial upper arm were grafted on the wounds. The grafts took well, and most of the grafted site healed after 1 week. Facial appearances improved remarkably. There was minimal scar formation and minimal recurrence of nevus cell. After long-term follow-up, the grafted sites resembled the adjacent normal face skin in terms of appearance and texture.
We describe the use of a pinpoint bur to remove traumatic tattooing. The dermabrasion is concentrated on the affected tissues without damage to the surrounding normal skin. With this method, deeper areas of pigmentation are no more difficult to remove than superficial deposits. This technique is easily reproduced and highly effective.
We report a patient with tuberous sclerosis who had chronic bleeding from the fibrous papules on his face. Dermabrasion and local excision of these was a simple and effective treatment. Follow-up at one year is reported.
Scar tissue and leukoderma-type discoloration of the skin due to deep burns are treated by dermabrasion and thin split-thickness skin-graft application. This method was applied to 18 patients on whom the treated lesion sites were located as follows: 8 in the facial area, 9 on the extremities, and 1 on the neck. Adequate repigmentation and flat surfaces were obtained in all patients at the end of 6 months, and results persist at the end of a considerable follow-up period (1 to 4 years). The technique, advantages, disadvantages, and results are discussed.
Colloid milium is an unusual cutaneous disorder characterized by multiple cystic papules. The adult form develops in sun-exposed parts of the body in patients who have actinic-damaged skin. We describe the case of a patient with the classic clinical and histologic features of this disorder. The patient was successfully treated by dermabrasion to the hands and affected facial regions and, 10 months later, has not shown any signs of recurrence.
The management of giant congenital melanocytic nevi remains controversial. There is a balance to be achieved between minimizing the disfiguring appearance of these lesions, both before and after surgical treatment, and limiting the risk of malignant change. A series of seven patients who were treated in the same manner, with carbon dioxide laser dermabrasion, is presented. It has been 6 years since the first patient was treated in this way, and no cases of recurrence have been observed. This technique enables the removal of all or most of the pigmented lesion, with minimal scarring and without the need for disfiguring skin grafts. It has been well proved that there is an increased risk of malignant changes among patients with these lesions, although the amount of increased risk for the patient is not clear. Evidence from a review of the currently available literature is presented to indicate why this management method, at best, should decrease this risk and, at worst, should make no difference to the overall risk for individual patients.
We report the observation of delayed wound healing and keloid formation in three patients, following dermabrasion or Argon laser treatment administered while they were receiving isotretinoin for acne or rosacea.
Seborrheic keratoses, skin tumors of undetermined etiology, are easily traumatized with consequent local irritation and inflammation, and are cosmetically undesirable. They can occasionally undergo malignant degeneration. A rapid increase in size and number of these lesions is thought by many to be a sign of internal malignancy. Dermabrasion using a diamond fraise is a simple and fast method for removing multiple seborrheic keratoses with minimal trauma, rapid healing, and good cosmetic results.
A method by which dermabrasion of the face is performed under a combination of nerve blocks and local infiltration of anesthetics and without refrigeration is described.
Dermabrasion of wound edges before closure minimizes and sometimes prevents scars. The probable mechanisms and some cautions are stated. Representative cases are illustrated.
A case is described in which a large, persistent hemangioma on a cheek of a middle-aged man was removed in stages by means of subcutaneously bipedicled island flaps, a preauricular and postauricular transposition flap, and finished off by dermabrasion. Some such lesions hitherto deemed inoperable may be removed satisfactorily in stages if various techniques of ablation and reconstruction are employed.
A man developed traumatic tattoos of the face from the accidental discharge of a muzzle-loading rifle. One day after the accident, the involved area was dermabraded with good cosmetic results. Dermabrasion is a useful modality in the treatment of traumatic tattoos.
A group of nine patients with severe nodulocystic acne vulgaris were treated with oral 13-cis-retinoic acid and their acne cleared. During or after retinoid therapy, all patients underwent full-face dermabrasion. Postoperative healing was normal, and no significant complications were seen.