Electrosurgical debulking of pretibial myxedema of the foot.

Pretibial myxedema or thyroid dermopathy constitutes dermal deposition of mucin, primarily hyaluronic acid and chondroitin sulfate. It is a manifestation of autoimmune thyroiditis, seen more in Graves disease than in Hashimoto thyroiditis. The time delay from treatment of hyperthyroidism to appearance of localized myxedema varies from one month to 16 years (mean 5.13 years). Despite a variety of therapeutic options, failure and relapse rates are high. Therapeutic options reported in the literature include compression, topical and intralesional corticosteroids, oral pentoxifylline, octreotide, rituximab, plasmapheresis, and high-dose intravenous immunoglobulin. We share our experience in two patients who were treated with electrosurgical debulking of selected longstanding myxedematous lesions, with one positive result and one negative result.

Prevalence and Risk Factors for Lateral Femoral Cutaneous Nerve Palsy in the Beach Chair Position.

PURPOSE: To report on the prevalence of lateral femoral cutaneous nerve (LFCN) palsy in patients who had undergone shoulder surgery in the beach chair position and to identify patient and surgical risk factors for its development. METHODS: We retrospectively reviewed the medical records of 397 consecutive patients who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Patient demographic and surgical data including age, gender, weight, body mass index (BMI), diabetes, procedure duration, and anesthesia type (general, regional, regional/general) were recorded. LFCN palsy symptoms were recorded prospectively at the initial postoperative visit and identified clinically by focal pain, numbness, and/or tingling over the anterolateral thigh. RESULTS: The median patient age was 59.0 years and consisted of 158 males (40%) and 239 (60%) females. Five cases of LFCN palsy were identified for a prevalence of 1.3%. These patients had a higher median weight (108.9 kg vs 80.7 kg, P = .005) and BMI (39.6 vs 29.4, P = .005) than the patients who did not develop LFCN palsy. Median age, gender, diabetes, and surgical time were not significantly different between the groups. All cases resolved completely within 6 months. CONCLUSIONS: LFCN palsy after shoulder surgery in the beach chair position in our study has a prevalence of 1.3%, making it an uncommon complication. Patients with elevated BMI should be counseled about its possible occurrence after shoulder surgery in the beach chair position. LEVEL OF EVIDENCE: Level IV, prognostic.

Male facial rejuvenation using a combination 633, 830, and 1072 nm LED face mask.

Home-based photobiomodulation is a popular treatment modality for patients seeking non-invasive aesthetic treatment. Studies demonstrate that photobiomodulation is effective for skin rejuvenation, which is aimed at improving the overall appearance of the skin by reducing fine lines and wrinkles and improving skin texture, skin tone, and dyspigmentation. Most current skin rejuvenation research focuses on treatments in women. However, men's aesthetics remains an underserved market. A combined red light (RL) and near-infrared (NIR) light-emitting diode (LED) has been designed specifically to target male skin, which may have different physiological and biophysical properties compared to female skin. Herein, the safety and efficacy of a commercially available RL and NIR (633, 830, and 1072 nm) LED array designed to be worn as a face mask was assessed. Primary outcomes included adverse events and facial rejuvenation as determined by participant-reported satisfaction scales and quantitative digital skin photography and computer analysis after 6 weeks of treatment. The participants reported overall favorable results and improvements in all individual categories, were satisfied with the treatment, and would recommend the product to others. The participants perceived the greatest improvement in fine lines and wrinkles, skin texture, and youthful appearance. Photographic digital analysis demonstrated favorable improvements in wrinkles, UV spots, brown spots, pores, and porphyrins. These results support the use of RL and NIR to treat male skin. Advantages of the LED facemask include its safety, efficacy, convenient home-based use, minimal associated downtime, simple operation, non-invasiveness, and appreciable results in as few as 6 weeks.

Generalized fixed drug eruption following Pfizer-BioNtech COVID-19 vaccination.

Fixed drug eruption is a cutaneous drug reaction which recurs at the same site when the individual is exposed to the causative drug, characterized by single or multiple round sharply demarcated erythematous-to-violaceous patches. Here, we report a patient with generalized non-bullous fixed drug eruption following mRNA-based Pfizer-BioNTech COVID-19 vaccine.