Effective Picosecond Nd:YAG laser on seborrheic dermatitis and its mechanism.

BACKGROUND: The Picosecond Nd:YAG laser has advantages in skin rejuvenation, which has little damage to surrounding tissues due to the ultra-short pulse width. We perform clinical application of Picosecond Nd:YAG laser's tender skin mode, which could improve the seborrheic dermatitis. MATERIALS AND METHODS: Sixty-three subjects with facial seborrheic dermatitis are randomized to be control and observation groups. Records regarding skin subjective improvement, skin barrier function-related data, skin microbial status, and dermoscopy detection of the two patient groups before and after treatments are investigated. RESULTS: Improvements of erythema and scales in observation group are significant compared with controls (p < 0.05). In terms of skin barrier function, there are significant changes regarding transepidermal water loss and epidermal seborrhea content in observation group after the laser treatments. Skin microbial state, pityrosporum furfur, and Demodex significantly decrement in observation group. Microscopical findings of infiltration mode advise that scales and capillary congestion and dilatation are significantly improved in observation group. Compared with controls, epidermal gloss increases, pore fineness improves, and capillary density decreases in the observation group. CONCLUSIONS: Picosecond Nd:YAG laser could efficiently decrease erythema area and seborrheic dermatitis scales and reduce pruritus incidence. The sebaceous gland secretion of seborrhea and multiplying of epidermal parasitic microbiological are inhibited after laser treatment. Less epidermal seborrhea content and inflammation are induced by parasitic microbiology, which is helpful for skin barrier function and microvascular remodeling.

Comparison of novel dual mode vs conventional single pass of a 1450-nm diode laser in the treatment of acne vulgaris for Korean patients: A 20-week prospective, randomized, split-face study.

BACKGROUND: Although a 1450-nm diode laser has been shown to be effective for acne, the conventional high-energy stamp-only regimen is often associated with pain and hyperpigmentation, especially for dark-skinned individuals. AIMS: To evaluate whether the novel dual regimen has clinical advantages for acne treatments compared with conventional regimen in Asian patients. PATIENTS AND METHODS: Twenty-four Korean patients with facial acne were treated with a 1450-nm diode laser through a 20-week, randomized, split-face study. The patients were treated with three consecutive sessions at 4-week intervals. One half of the face received a dual regimen consisting of low-fluence stamping mode (5-6 J/cm2 ) for inflammatory acne lesions only, followed by 4-5 passes of moving mode for the full face. The other side received a single-pass treatment of conventional high-fluence stamp mode (14-15 J/cm2 ). Evaluations for acne, sebum secretion measurements, and safety profiles were performed. RESULTS: At the final 12-week follow-up evaluations, the dual-mode side demonstrated better improvements in both inflammatory and noninflammatory lesion counts, acne severity assessments, and reduction in sebum secretion compared with stamp-only side. Subjective satisfaction for the improvement for acne, seborrhea, and texture correlated well with objective assessments. In addition, degrees of pain and treatment-related side effects were remarkably decreased in the novel dual mode. CONCLUSION: This novel dual regimen of the 1450-nm laser demonstrated improved efficacies for acne and seborrhea with satisfactory safety profiles. Therefore, this regimen would be a viable option for acne treatments either as monotherapy or as combination therapy.

[A man with an anomaly in his ear]. / Een man met een afwijking in het oor.

A 65-year-old man presented with an anomaly in his left ear. He had no complaints, but was ashamed of the lesion. On physical examination a pigmented, pedunculated, polypoid tumour of approximately 2 x 2.5 cm was seen, which filled the whole cavum conchae. After excision, histopathological examination showed a verruca seborrhoica.

Extracutaneous seborrheic inclusion cyst: an unusual presentation.

Seborrheic inclusion cyst is an unusual variant of epidermal cyst characterized by parietal histology similar to seborrheic keratosis. Cysts with such changes have been called "seborrheic keratosis-like changes in epidermal cyst" or "epidermoid cyst with seborrheic verruca-like cyst wall" or simply "seborrheic cyst". To date, this lesion has been described exclusively in cutaneous sites. We describe the first case of an extracutaneous seborrheic inclusion cyst arising from round ligament. A 30-year-old female was referred to our institution for abdominal pain. Ultrasonography showed a hypoechoic heterogeneous, round mass adjacent to the lower extremity of the left ovary, measuring 4.5 cm in maximum diameter. Contrast-enhanced computed tomography of the pelvis in the venous phase showed a round (4.5 cm in diameter) cystic lesion with inhomogeneous fluid content in the side of the left large ligament and anterior to the homolateral adnexa. Laparoscopic resection of the mass was performed. Intraoperatively, an extraperitoneal glistening pelvic mass was discovered: the lesion was attached to the intrapelvic 1/3 middle portion of the left round ligament. Macroscopically, the mass measured 6 cm x 6 cm x 3.5 cm and exhibited a smooth and glistening external surface. On cut sections, the mass was an unilocular cyst filled with soft, yellow, amorphous material. Histologically, the cystic wall was lined by a stratified squamous epithelium with a granular cell layer. The cavity contained keratin-like material. The cystic wall showed numerous areas with close-set basaloid cells and pseudohorn cysts. The latter aspect consisted of cystic invaginations of the epithelium filled with surface keratin, which in a given microscopic section may be cut in cross-section, thereby appeared as "cysts" within the involved epithelium. Parietal rupture was present, accompanied by granulomatous inflammation. There were no postoperative complications, and the patient was discharged 3 days after the procedure. The present case is unique in that it is the first reported case of an extracutaneous seborrheic inclusion cyst arising from a very unusual site, namely the round ligament. The site of origin of the lesion and its cystic nature were established by computed tomography findings. Conservative treatment with enbloc resection was possible. Histological examination confirmed computed tomography findings. The present report described a lesion typically found in dermatopathology practice, but which had arisen in an extracutaneous site.

[Use of curettage in the treatment of skin tumors]. / Bruk av kyrette ved behandling av hudtumorer.

Many skin tumours can be diagnosed and treated with minimal equipment in general practice. The author describes the indications and technique of curettage for treatment of seborrhoeic warts, simple warts, and molluscum contagiosum, and basal cell carcinomas.

Seborrheic inclusion cyst.

Epidermoid cysts with seborrheic keratosis-like linings are a recently described rare variant of epidermoid cysts. We report a case in which such a cyst developed following the excision of a typical seborrheic keratosis.

Diagnostic accuracy and appropriateness of care for seborrheic keratoses. A pilot study of an approach to quality assurance for cutaneous surgery.

In 1985 there were more than 40 million visits for ambulatory surgical procedures in the United States. Although benign cutaneous lesions are among the most frequent conditions to receive surgical treatment in ambulatory settings, their treatment is seldom subject to peer review. In this pilot study we assessed diagnostic accuracy and appropriateness of care using information available from the surgical pathology laboratory. We assessed these two measures of physician performance for 527 seborrheic keratoses removed by 133 clinicians affiliated with four different institutions. Overall, a correct preoperative diagnosis was provided in only 49% of cases. Dermatologists had the highest diagnostic accuracy (61% vs 35% for all other physicians). An appropriate procedure for the actual pathological diagnosis was performed in only 50% of cases. Lesions with a correct preoperative diagnosis were more than eight times more likely to receive appropriate care. Our data suggest that many clinicians fail to note a correct diagnosis of common cutaneous lesions before surgical removal, and many patients are treated with procedures that are more invasive than necessary for the final pathological diagnosis. Because the approach used in this pilot study relies on data already available, it has promise as a low-cost method of monitoring the quality of care of ambulatory surgery.

Aging hands: a technique of hand rejuvenation by laser resurfacing and autologous fat transfer.

Hands are a primary target for actinic damage and premature aging. Until recently, very little could be done to successfully erase the various signs of photoaging. This article presents a simple technique, combining fat transfer and laser resurfacing, to safely and effectively rejuvenate hands and erase the signs of aging.

[Experience in treating senile and seborrheic keratomata by cryogenic action with liquid nitrogen]. / Opyt lecheniia senil'nykh i seboreinykh keratom metodom kriogennogo vozdeistviia zhidkim azotom.

A total of 189 patients with senile keratosis and 490 with seborrheic keratomata have been treated with cryotherapy. Relapses have been recorded in 6.1% of patients.

Dermabrasion for the treatment of a giant seborrheic keratosis.

A man presented for removal of a giant seborrheic keratosis. Dermabrasion removal of this lesion provided technical ease with good cosmetic results.

A surgical approach for dermatosis papulosa nigra.

Dermatosis papulosa nigra (DPN) is a disorder commonly encountered in the adult black population. We describe 20 cases of clinicopathologically confirmed DPN cases treated with light abrasive curettage without local anesthesia. We found this procedure to be an effective therapy, which did not cause postoperative scarring or significant postoperative pigmentary change.

Extended clinical use of the argon laser for cutaneous lesions.

A safe, easy, and effective outpatient modality for the treatment of various cutaneous lesions such as hemangiomas and decorative tattoos has long been sought. The argon laser has proved satisfactory for such treatment of port-wine hemangiomas, capillary/cavernous hemangiomas, telangiectasia, and decorative tattoos as well as a variety of cutaneous pigmented lesions. The intense laser light is attracted and absorbed by pigmented skin lesions producing heat that selectively destroys the intradermal pathologic condition and spares overlying skin. Hemangiomas and tattoos have undergone satisfactory subtotal blanching in the majority of cases with a low incidence of hypertrophic scarring. Thus, the argon laser has proved useful in the outpatient treatment of a variety of pigmented cutaneous lesions.