RESUMO
BACKGROUND: Adequate preparation of the skin is necessary for a successful chemical peel. Little detailed attention has been given to the effect of degreasing on the efficacy of the peel. OBJECTIVE: To assess the influence of degreasers on the peel, compare their flammabilities, and discuss alternatives. METHODS: Six patients with androgenetic alopecia and widespread actinic keratoses of the scalp were treated with 35% trichloroacetic acid. Scalps were divided into sections and degreased with acetone, rubbing alcohol, Freon Skin Degreaser, or Hibiclens. The influence of these degreasers on trichloroacetic acid peels was assessed by clinical and histologic examination. CONCLUSION: Acetone was not found to be superior to the other agents. Furthermore, the flashpoint of acetone is markedly lower than the others, making it more flammable and hazardous in the workplace. The use of alternative degreasers may lessen or eliminate this hazard.
Assuntos
Abrasão Química/métodos , Ceratose/cirurgia , Cuidados Pré-Operatórios/métodos , Dermatoses do Couro Cabeludo/cirurgia , Ácido Tricloroacético/uso terapêutico , Acetona/administração & dosagem , Idoso , Clorexidina/administração & dosagem , Clorexidina/análogos & derivados , Clorofluorcarbonetos de Metano , Etanol/administração & dosagem , Humanos , Ceratose/patologia , Masculino , Pessoa de Meia-Idade , Necrose , Dermatoses do Couro Cabeludo/patologiaRESUMO
A patient appeared to have von Recklinghausen type I neurofibromatosis, but her numerous cutaneous tumors were intradermal nevi and not neurofibromas. The patient had hundreds of 1- to 3-cm firm, flesh-colored, dome-shaped papules and pedunculated nodules on her buccal mucosa, eyelids, face, extremities, and trunk as well as a large, confluent, cerebriform tumor extending from the 12th thoracic vertebra to the sacrum. No cafe au lait macules, freckles, or Lisch nodules were present. Several hundred lesions were removed using the carbon dioxide laser. Histopathologic examination of all of the lesions revealed all of them to be intradermal nevi. Our patient's skin disease was clinically very similar to neurofibromatosis. We suggest our patient represents a distinct clinical entity that is related to environmental factors or a mutation that affected nevoblasts or melanoblasts and their derivatives during early embryo development.
Assuntos
Neurofibromatose 1/patologia , Nevo Pigmentado/patologia , Dermatopatias/patologia , Adulto , Diferenciação Celular , Movimento Celular , Diagnóstico Diferencial , Feminino , Humanos , Melanócitos/patologia , Nevo Pigmentado/embriologiaRESUMO
A 27-year-old woman with intestinal lymphangiectasia and congenital lymphedema developed cryptococcal cellulitis as a result of her underlying depressed cell-mediated immune responsiveness. Prompt therapy with amphotericin B and 5-fluorocytosine resulted in an excellent outcome. The authors believe that the increasing population of patients with depression of cell-mediated immune response will lead to an increase in the frequency with which cryptococcal cellulitis is seen and emphasize that proper evaluation of a patient with presumptive cellulitis includes consideration of fungal, as well as bacterial, etiology.