Wound Healing After Fractional Skin Harvesting.

BACKGROUND: Autologous fractional full-thickness skin grafting is a method of harvesting full-thickness skin with reduced donor site morbidity compared with conventional skin grafting. OBJECTIVE: To demonstrate that full-thickness skin microbiopsies can be harvested with minimal scarring or complications. MATERIALS AND METHODS: In a nonrandomized, self-controlled, pilot trial, subjects ( n = 8) underwent tissue harvesting of full-thickness skin columns of 200, 400, 500, 600, 800 µm, 1, and 2 mm diameters. The extent of scarring was measured by using the Patient and Observer Scar Assessment Scale and blinded evaluation of photographs at 6 weeks postprocedure. Pain visual analog scale (VAS) and side effects were recorded. RESULTS: When present, scars were first observed after 2 to 4 weeks, much more often for wounds >400 µm ( p < .001). Blinded dermatologists increasingly identified clinical scarring on photographs with larger harvested microcolumn diameters ( p < .001). Median VAS pain score was 0 (range 0-4). All subjects rated the procedure safe and tolerable. CONCLUSION: Harvesting full-thickness skin microcolumns is well-tolerated over a wide range of column diameters. At diameters of less than 500 µm, side effects including scarring are minimal.

Self-reported Patient Motivations for Seeking Cosmetic Procedures.

Importance: Despite the growing popularity of cosmetic procedures, the sociocultural and quality-of-life factors that motivate patients to undergo such procedures are not well understood. Objective: To estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures. Design, Setting, and Participants: This prospective, multicenter observational study was performed at 2 academic and 11 private dermatology practice sites that represented all US geographic regions. Adult patients presenting for cosmetic consultation or treatment from December 4, 2016, through August 9, 2017, were eligible for participation. Exposures: Participants completed a survey instrument based on a recently developed subjective framework of motivations and a demographic questionnaire. Main Outcomes and Measures: Primary outcomes were the self-reported most common motivations in each quality-of-life category. Secondary outcomes were other frequently reported motivations and those associated with specific procedures. Results: Of 529 eligible patients, 511 agreed to participate, were enrolled, and completed the survey. Typical respondents were female (440 [86.1%]), 45 years or older (286 [56.0%]), white (386 [75.5%]), and college educated (469 [91.8%]) and had previously received at least 2 cosmetic procedures (270 [52.8%]). Apart from motivations pertaining to aesthetic appearance, including the desire for beautiful skin and a youthful, attractive appearance, motives related to physical health, such as preventing worsening of condition or symptoms (253 of 475 [53.3%]), and psychosocial well-being, such as the desire to feel happier and more confident or improve total quality of life (314 of 467 [67.2%]), treat oneself or celebrate (284 of 463 [61.3%]), and look good professionally (261 of 476 [54.8%]) were commonly reported. Motivations related to cost and convenience were rated as less important (68 of 483 [14.1%]). Most motivations were internally generated, designed to please the patients and not others, with patients making the decision to undergo cosmetic procedures themselves and spouses seldom being influential. Patients younger than 45 years were more likely to undertake procedures to prevent aging (54 of 212 [25.5%] vs 42 of 286 [14.7%] among patients ≥45 years; P < .001). Patients seeking certain procedures, such as body contouring (19 of 22 [86.4%]), acne scar treatment (36 of 42 [85.7%]), and tattoo removal (8 of 11 [72.7%]), were more likely to report psychological and emotional motivations. Conclusions and Relevance: This initial prospective, multicenter study comprehensively assessed why patients seek minimally invasive cosmetic procedures. Common reasons included emotional, psychological, and practical motivations in addition to the desire to enhance physical appearance. Differences relative to patient age and procedures sought may need further exploration.

Laws and regulations of laser operation in the United States.

The laws and regulations governing laser operation in the United States are vague, complex, and vary state-to-state. The objective of this study is to present an overview of the laws and regulations of laser operation in each of the 50 states. We performed an extensive online search of the law in each of the 50 states by examining multiple state cosmetology boards, state legislative boards, state nursing boards, and state medical boards. Laser regulations are best divided into three categories: delegation, supervision, and operation. Our findings demonstrate the complicated nature of the regulations covering this issue and identify a lack of regulation in numerous states. Lasers Surg. Med. 50:272-279, 2018. © 2018 Wiley Periodicals, Inc.

Bullous pilomatricoma: a rarely reported variant of pilomatricoma.

Pilomatricomas are cutaneous adnexal tumors with matrical differentiation. We report and describe a rare variant called bullous pilomatricoma.