Acne scarring: a review and current treatment modalities.

Acne is a prevalent condition in society and often results in secondary damage in the form of scarring. Of course, prevention is the optimal method to avoid having to correct the physically or emotionally troublesome scars. However, even with the best efforts, scars will certainly arise. This article attempts to give a broad overview of multiple management options, whether medically, surgically, or procedurally based. The hope is that a general knowledge of the current available alternatives will be of value to the physician when confronted with the difficult task of developing a treatment plan for acne-scarred individuals, even in challenging cases.

Clinical aspects of full-thickness wound healing.

Optimal management of full-thickness wounds requires a thorough knowledge of wound-healing principles and practices. In the absence of underlying disease, almost every full-thickness wound will heal with minimal intervention; however, the process can be enhanced by judicious wound management. The first clinical decision to be made is whether to repair the wound or to allow it to heal by second intention. This decision is guided by a host of objective and subjective factors. Reconstruction options include primary closure, flaps, and grafts. Materials to aid reconstruction, including the introduction of tissue adhesives, continue to evolve. Both primary and secondary intention wounds are aided by occlusive dressings and adjutants. A plethora of wound-healing adjuncts have been developed to aid wound healing in diseased states, and a working knowledge of their use is beneficial in managing all full-thickness wounds.

The Webb and Rivera (WAR) score: a preoperative Mohs surgery assessment tool.

OBJECTIVE: To make available a simple, quantitative formula for preoperative assessment of both the complexity and the associated time required to complete Mohs surgical cases. It will improve office efficiency, technical performance, and resource management. DESIGN: Surveys were sent to 94 Mohs surgeons requesting information on 10 consecutive cases, including tumor size, recurrence, location, aggressiveness, stages required, and case duration. The data were then aggregated, scored, and statistically evaluated. SETTING: Private practice dermatology offices performing Mohs surgery were included. PARTICIPANTS: Sequential randomized selection of Mohs College and Mohs Society fellows was used for inclusion. Sequential selection of patients for data acquisition was performed by the surgeons. MAIN OUTCOME MEASURE: The statistical significance of a proposed preoperative assessment tool was to be determined. RESULTS: The score ρ values were 0.34 and 0.41 for the time and number of stages, respectively. In addition, the Mohs score obtained a statistically significant P value of <.001 for both the time and number of stages required. CONCLUSIONS: The Webb and Rivera (WAR) score is a low-effort, efficient, reproducible tool to be used in preoperative Mohs surgery planning and office efficiency improvement. The components of the score include maximum tumor dimension, recurrence, location, and aggressiveness. Each is assigned a numerical value that is totaled, resulting in a final quantitative score.