Carbon Dioxide with a New Pulse Profile and Shape: A Perfect Tool to Perform Labiaplasty for Functional and Cosmetic Purpose.

OBJECTIVE: To describe the benefits and safety of using Carbon Dioxide Laser in multi-pulse modalities when performing labiaplasty and anatomical variants approach for functional and cosmetic indications. DESIGN: This is a prospective, descriptive case series study. SETTING: Private Practice Quirofano Calculaser Megacentro Pinares Pereira Colombia. POPULATION: One Hundred and twelve women seeking labia minora labiaplasty for functional and cosmetic reasons were enrolled in the study protocol from June 2013 to June 2016. Labia minora labioplasty and anatomical variants approach were performed with Carbon Dioxide laser Multi-pulse modalities DEKA M.EL.A Florence Italy. MAIN OUTCOME MEASURES: Good Cosmetic results, functional and sexuality improvement. RESULTS: Dramatic changes in the VAS and VSQ were detected after the surgical procedure. All the participants reported a high degree of satisfaction, felt more confident with their partners during sexual encounters, and the procedure was well tolerated. CONCLUSION: Laser Carbon Dioxide Laser with a new pulse profile and shape seems to be a safe and precise surgical tool to perform this type of procedures, optimal biophysical and bio stimulative laser-tissue interactions allow delicate vulvar tissues to shorten downtime.

Chronic Encapsulated Seroma Persisting for Three Years after Abdominoplasty and a Successful Surgical Solution.

Abdominoplasty is listed among five most common esthetic surgical procedures in the Western World. Despite all efforts, abdominoplasty bears a high risk of complications. We observed a 39-year-old-woman with previous classical abdominoplasty performed elsewhere three years ago. Clinical examination demonstrated a swollen and tense abdominal mass. Laboratory findings were normal. Clinical examination was completed by abdominal ultrasonography which demonstrated both, a significant fluid volume in this area and a dense fibrous "capsule". The diagnosis was a late or chronic encapsulated seroma with a thick pseudocapsule or "bursa". We performed a revision abdominoplasty with a standard supra-fascial dissection. Surgical resection of infra-umbilical flap containing skin, subcutaneous tissue and capsulectomy were performed under general anaesthesia. A new umbilicus was created attaching small skin flaps in the muscular fascia. No drains were used. We observed no seroma formation. Follow up after six and ten months was unremarkable. The fibrous pseudocapsule of chronic seroma results in different degrees of deformities, abdominal scar deviation and asymmetry. Surgical capsulectomy combined with revision abdominoplasty with preservation of Scarpa's fascia and placement of progressive tension sutures resulted in being effective and leads an esthetic outcome without seroma recurrence.

Lip Repair after Mohs Surgery for Squamous Cell Carcinoma by Bilateral Tissue Expanding Vermillion Myocutaneous Flap (Goldstein Technique Modified by Sawada).

Squamous cell carcinoma is the most common malignancy of the lower lip. Environmental factors such as ultraviolet light exposure, arsenic and smoking are contributing factors to the increasing incidence. Mohs surgery is the treatment of choice ensuring the lowest recurrence rates. The closure of the surgical defects, however, can be a challenge. Multiple and versatile methods of reconstructing vermilion defects have been described. Among these options, Goldstein developed the adjacent ipsilateral vermilion flap based on an arterialized myocutaneous flap. The original technique was modified by Sawada based on bilateral adjacent vermilion advancement flap for closure of central vermilion defects. We report the use of bilateral flaps - Sawada's technique (instead of unilateral as suggested by Goldstein) in medium (2 cm of extension) to large defects (> 2 cm) to achieve an effective and functional reconstruction of vermillion defects after Mohs surgery for lip cancer.

Multiple Primary Acral Lentiginous Melanomas (MPALM).

We present a rare case of a patient with multiple primary acral lentiginous melanomas of the foot. We would like to highlight the importance of whole-skin examination in all patients, even by the general practitioners, aiming the maximal early detection of acral lentiginous melanomas, considering their rapid progression, early metastatic spread and extremely poor prognosis. It can be extrapolated from current literature; however, that appropriate management of these patients, including staging work and surgical intervention, is to be determined by the individual characteristics of the melanoma and the patient's concomitant risk factors, if any.

Psychosocial impact of acne and postinflammatory hyperpigmentation.

BACKGROUND:: Acne is one of the most common skin diseases. It has significant effect on self-image and negative impact on quality of life. Postinflammatory hyperpigmentation is an acquired hypermelanosis that occurs after a skin injury or cutaneous inflammation. It is common sequelae in acne patients. OBJECTIVES:: This study aimed to investigate the psychosocial impact of acne and postinflammatory hyperpigmentation among patients treated in a dermatology outpatient clinic at the University of Miami Hospital. METHODS:: The study had the participation of 50 patients with acne and postinflammatory hyperpigmentation. All participants volunteered to complete an anonymous questionnaire containing socio-demographical information, questions about patient's attitudes toward postinflammatory hyperpigmentation caused by acne, the Cardiff Acne Disability Index and the Dermatology Life Quality Index. RESULTS:: Postinflammatory hyperpigmentation was more predominant in the face. Makeup was frequently used to conceal the imperfections and the majority of patients felt embarrassed due to their condition. Interestingly, the majority of our patients did not have their quality of life impacted for acne and postinflammatory hyperpigmentation. STUDY LIMITATIONS:: A limitation of the study was the relatively small sample size. For this reason, the findings of the study should not be generalized to the broader community. CONCLUSION:: The current medical literature has many studies analyzing the psychological impact of acne. This study is the first study in the literature that analyzed the psychosocial impact of acne and postinflammatory hyperpigmentation caused by acne.

A synopsis of the history of Hansen's disease.

Leprosy is a contagious infectious disease caused by the bacillus Mycobacterium leprae. This microorganism was discovered by Dr. Gerhard Hansen, and the illness was then baptized as Hansen's disease. For a long time, Hansen's disease was thought to be hereditary-a curse or a punishment from God. The disease affects skin and nerves and can cause severe damage. Due to its destructive effects, leprosy has caused fear, segregation, and prejudice in all societies since Biblical times. Patients with Hansen's disease have not been treated humanely around the world throughout the ages. This article is a summary of curious and interesting facts about the history and cultural aspects of Hansen's disease, which has chastised humanity for centuries. These facts are about the discovery of the disease, its propagation, the evolution of treatments, and the prejudice of society towards patients.

Psychosocial impact of acne and postinflammatory hyperpigmentation

Abstract: Background: Acne is one of the most common skin diseases. It has significant effect on self-image and negative impact on quality of life. Postinflammatory hyperpigmentation is an acquired hypermelanosis that occurs after a skin injury or cutaneous inflammation. It is common sequelae in acne patients. Objectives: This study aimed to investigate the psychosocial impact of acne and postinflammatory hyperpigmentation among patients treated in a dermatology outpatient clinic at the University of Miami Hospital. Methods: The study had the participation of 50 patients with acne and postinflammatory hyperpigmentation. All participants volunteered to complete an anonymous questionnaire containing socio-demographical information, questions about patient's attitudes toward postinflammatory hyperpigmentation caused by acne, the Cardiff Acne Disability Index and the Dermatology Life Quality Index. Results: Postinflammatory hyperpigmentation was more predominant in the face. Makeup was frequently used to conceal the imperfections and the majority of patients felt embarrassed due to their condition. Interestingly, the majority of our patients did not have their quality of life impacted for acne and postinflammatory hyperpigmentation. Study limitations: A limitation of the study was the relatively small sample size. For this reason, the findings of the study should not be generalized to the broader community. Conclusion: The current medical literature has many studies analyzing the psychological impact of acne. This study is the first study in the literature that analyzed the psychosocial impact of acne and postinflammatory hyperpigmentation caused by acne.

Women in medicine and dermatology: history and advances.

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology.

Pyschodermatology: a trip through history.

The interaction between the mind and diseases of the skin has been the study focus for many researchers worldwide. The field of Psychodermatology, or Psychocutaneous Medicine, is the result of the merging of two major medical specialties, psychiatry and dermatology. Although the history of Psychodermatology is rather old and interesting, the field has only recently gained popularity. Since ancient times, philosophers, surgeons, dermatologists and psychiatrists have reported the presence of psychocutaneous diseases in various scenarios. In this article, the authors describe curious and remarkable facts in the history of Psychodermatology.

Auricular chromoblastomycosis: a case report and review of published literature.

Subcutaneous chromoblastomycosis is an infection commonly seen in tropical and subtropical climates, usually caused by trauma with vegetables and often affects the host's lower limbs. We report a case of auricular chromoblastomycosis in a 67-year-old man and discuss the rarity of this clinical manifestation of chromoblastomycosis in the medical literature. In the present case, the etiologic agent was Fonsecaea pedrosoi, the most common agent found in Brazil.

Hair casts or pseudonits.

Hair casts or pseudonits are thin, elongated, cylindrical concretions that encircle the hair shaft and can be easily dislodged. A case of pseudonits in a 9-year-old girl is reported. Though not unusual, false diagnoses are common.