Advances in Dermatologic Surgery: Articles 26-30

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• New Approaches to Surgery of Lentigo Maligna
  Skin Therapy Letter: Volume 9 • Number 5 • May 2004
  Abstract: SLentigo maligna (LM) is a pigmented lesion that occurs most commonly on the sun-exposed skin of the head and neck of an older patient. LM can be difficult to completely remove due to its occasional extensive subclinical extension. Surgical treatments, including standard excision and margin-controlled excision (Mohs micrographic surgery or rush permanent sections), are reviewed. Immunostains that can increase sensitivity and specificity of margin-controlled excision are discussed, and other nonscalpel treatments including destruction, topical imiquimod, radiation therapy and cryotherapy are briefly discussed. The gold standard treatment for LM is margin-controlled excision.   |     Full Article ...



• Squamous Cell Carcinoma in Organ Transplant Recipients: Approach to Management
  Skin Therapy Letter: Volume 9 • Number 4 • April 2004
  Abstract: Skin cancer, particularly squamous cell carcinoma (SCC), continues to be a significant cause of morbidity and even mortality in organ transplant recipients (OTRs). As the number of organ transplant patients continues to increase, dermatologists will be faced with the challenge of diagnosing and managing their skin cancers. Evaluation, management and follow up of organ transplant recipients with high risk SCC will be discussed.   |     Full Article ...



• Chemical Peels
  Skin Therapy Letter: Volume 9 • Number 2 • February 2004
  Abstract: With so many new peel preparations on the market today, the dermatologist must ask himself basic questions concerning the products. The most important question is directed to the medical literature rather than the advertising or marketing campaign so common among marketdriven cosmetic products. Since all peeling agents—superficial, medium depth and deep—are derived from basic chemicals known to cause exfoliation, destruction and/or inflammation of skin in a controlled manner, the clinician must ask what is new and better about the product. Peeling agents, regardless of their “proprietary” new name, fall into chemical families. The clinical evaluation of these generic agents is well documented in our literature as to efficacy, technical care and safety. In addition, combinations of peeling agents have been presented in the dermatologic cosmetic literature with scientific clinical trials and histology. These include: 1) The Gordon-Baker phenol peel; 2) Combination medium depth peeling; 3) Glycolic acid formulations. It is the responsibility of the dermatologic surgeon to be in control of his chemicals and his products. It is thus necessary for him to understand all the products and the peel formulation and be sure it has undergone the test of objective scientific study with clear clinical evaluations and histology. Only then will we truly know the effectiveness of the agents we are using for exfoliating and resurfacing.   |     Full Article ...



• Laser Treatment of Scars
  Skin Therapy Letter: Volume 9 • Number 1 • January 2004
  Abstract: Over the past decade, refinements in laser technology as well as advances in laser techniques have enabled dermatologic surgeons to define the most appropriate lasers to use for different scar types without the adverse sequelae and recurrence rates noted with older surgical revision techniques and continuous wave laser systems.   |     Full Article ...



• Blepharoplasty: Laser or Cold Steel?
  Skin Therapy Letter: Volume 8 • Number 7 • November - December 2003
  Abstract: Blepharoplasty of the upper and/or lower eyelids can restore a youthful appearance to the aging face. This is a minimally invasive procedure that can be accomplished with little bleeding and a small incision. Laser-assisted blepharoplasty was pioneered in 1980, with the technique simplified after the subsequent introduction of the pulsed carbon dioxide laser. Laser-assistance helps mitigate bleeding during blepharoplasty. In ideal circumstances, the laser can be used as a multipurpose device that simultaneously offers cutting, cautery and blunt dissection capabilities. However, there is little experimental evidence confirming the superiority of laser-assisted blepharoplasty over more traditional scalpel surgery. For some procedures coldsteel may be preferable, and some surgeons prefer to use a knife for initial incisions and then laser for its coagulative properties. Patient factors and physician skill should guide the selection of the ideal blepharoplasty technique.   |     Full Article ...




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