Subject(s)
Humans , Female , Middle Aged , Darier Disease/diagnosis , Darier Disease/surgery , CryosurgerySubject(s)
Humans , Female , Middle Aged , Darier Disease/diagnosis , Darier Disease/surgery , CryosurgerySubject(s)
Carcinoma, Verrucous , Darier Disease , Darier Disease/diagnosis , Darier Disease/surgery , Humans , SkinABSTRACT
La queratosis folicular invertida es una neoplasia benigna poco frecuente originada en el epitelio folicular a nivel del infundíbulo. Si bien no posee una clínica característica ni patognomónica, suele presentarse como una lesión solitaria, asintomática, de crecimiento lento, en la cara. El diagnóstico de certeza se realiza con el estudio histopatológico, que evidencia una proliferación de células basaloides y de células escamosas queratósicas con remolinos escamosos, que se extienden a la dermis. El tratamiento de elección es la extirpación quirúrgica, con buen pronóstico y escasa tendencia a la recurrencia. La localización en conducto auditivo externo es extremadamente infrecuente (en la literatura revisada hemos encontrado sólo tres casos comunicados) y representa un desafío tanto diagnóstico como terapéutico. Se presenta un paciente con una queratosis folicular invertida localizada en conducto auditivo externo izquierdo de 5 años de evolución que comprometía significativamente su calidad de vida por la sintomatología (dolor, otorrea, hipoacusia) y que evolucionó satisfactoriamente con el tratamiento instaurado (extirpación quirúrgica y posterior topicación de la zona con ácido tricloroacético 50%)
Inverted follicular keratosis is a rare benign neoplasm originating from the infundibulum of the follicular epithelium. Although it does not have a characteristic or pathognomonic clinic, it usually presents as a solitary, asymptomatic, slow-growing lesion on the face. The certain diagnosis is made with the histopathological study, which shows a proliferation of basaloid cells and squamous keratotic cells with squamous eddies, which extend to the dermis. The treatment of choice is surgical removal, with a good prognosis and little tendency to recur. Localization in the external auditory canal is extremely rare (in the reviewed literature we have found only three reported cases) and represents both a diagnostic and therapeutic challenge. We present a patient with an inverted follicular keratosis located in the left external auditory canal of 5 years of evolution that significantly compromised his quality of life due to the symptoms (pain, otorrhea, hearing loss) and that evolved satisfactorily with the established treatment (surgical excision and subsequent topication of the area with 50% trichloroacetic acid).
Subject(s)
Humans , Male , Adult , Trichloroacetic Acid/therapeutic use , Diagnosis, Differential , Ear Canal/pathology , Darier Disease/surgery , Darier Disease/therapyABSTRACT
The aim of this study was to assess and compare the efficacy of fractional CO2 laser, Q-switched Nd:YAG laser (1064 nm), and their combined use in treatment of keratosis pilaris. The study included twenty female patients. For each patient, three areas were randomly assigned to treatment by either fractional CO2 laser (area A) or Q-switched laser (1064 nm) (area C), or both types of laser (area B). All patients were assessed by digital photography at baseline and 1 month after the last session. Assessment was done by two non-blinded and two blinded investigators (blinded investigators do not know which area is treated with which machine and non-blinded knows). Patients reported the degree of satisfaction or any adverse effects also after 1 month from the last session. The three treatment modalities led to overall improvement in the KP lesions. According to patients' score and investigator two, area B showed statistically significant improvement compared to areas A and C (p=0.001 and p=0.039, respectively). The first blinded investigators' assessment revealed that there was statistically significant improvement in area C compared to A and B (p = 0.023). The assessment of both investigator one and the second blinded investigator revealed that there was improvement in the three areas with no statistically significant difference between them. Both fractional CO2 and Q-switched Nd:YAG laser (1064 nm) proved to be safe and effective in the treatment of keratosis pilaris regarding not only pigmentation but also follicular prominence; their combination may have an additive effect.
Subject(s)
Abnormalities, Multiple/surgery , Darier Disease/surgery , Eyebrows/abnormalities , Lasers, Gas/therapeutic use , Lasers, Solid-State/therapeutic use , Adolescent , Adult , Female , Humans , Lasers, Gas/adverse effects , Lasers, Solid-State/adverse effects , Middle Aged , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Numerous treatment modalities for keratosis pilaris have been tried with limited success. AIM: To determine the efficacy, safety, and tolerability of fractional CO2 laser in the treatment of KP. PATIENTS AND METHODS: This prospective, single-blinded split-body placebo-controlled comparative study was conducted on 60 patients with bilateral KP of arms (group A) and thighs (group B). One side randomly received fractional CO2 laser treatment (power 12 W, time on 3 ms, PPI 5) in the form of two sessions four weeks apart. The contralateral control side was treated with a topical keratolytic (10% urea). Standardized digital clinical and dermoscopic photographs were obtained at each visit. RESULTS: Significant improvement has been demonstrated clinically and dermoscopically in both arm and thigh lesions after fractional CO2 laser. In group A, excellent improvement was noted in 10 patients (33.3%), good improvement in 18 patients (60%), and moderate improvement in 2 patients (6.7%) at the second visit. In group B, minimal improvement was noted in 2 (6.7%) patients, moderate improvement in 16 patients (53.3%), and good improvement in 12 patients (40%) at the second. Control sides showed minimal improvement on the arm lesions only. No side effects were reported in both groups. The mean pain score in group A was not significantly different from that group B (P = .057). Patient satisfaction was significantly higher in the laser-treated side arm lesions (P < .001). CONCLUSION: Fractional CO2 laser was associated with significant clinical and dermoscopic improvement of keratosis pilaris lesions in Egyptian patients.
Subject(s)
Abnormalities, Multiple/surgery , Cosmetic Techniques/instrumentation , Darier Disease/surgery , Eyebrows/abnormalities , Lasers, Gas/therapeutic use , Pain, Procedural/diagnosis , Abnormalities, Multiple/diagnosis , Adolescent , Adult , Arm , Cosmetic Techniques/adverse effects , Darier Disease/diagnosis , Dermoscopy , Egypt , Female , Follow-Up Studies , Humans , Pain Measurement , Pain, Procedural/etiology , Patient Satisfaction , Prospective Studies , Severity of Illness Index , Skin/diagnostic imaging , Thigh , Treatment Outcome , Young AdultABSTRACT
Our purpose was accelerating the physiologic wound healing, stimulating tissue regeneration and the reparative tissue processes in resistant skin ulcers as in a case of an erosive lichen planus of the soles and after a surgical treatment as for severe Darier disease. The challenge was to establish an effective therapy to enhance tissue healing by the injection of a mixture of peripheral blood mononuclear cells (PB-MNCs) and platelet-rich plasma (PRP) into a skin autograft area. This new perioperative biotechnological approach enriches PRP with the effects of PB-MNCs. It offers a novel advanced strategy that could become an ideal biologic blood-derived therapy, whose components are entirely autologous and produced by a protocol independent by the operator.
Subject(s)
Leukocytes, Mononuclear/transplantation , Skin Transplantation/methods , Aged, 80 and over , Combined Modality Therapy , Darier Disease/pathology , Darier Disease/surgery , Darier Disease/therapy , Female , Humans , Lichen Planus/pathology , Lichen Planus/surgery , Lichen Planus/therapy , Middle Aged , Platelet-Rich Plasma/cytology , Regeneration , Skin Ulcer/pathology , Skin Ulcer/surgery , Skin Ulcer/therapy , Transplantation, Autologous/methods , Wound HealingSubject(s)
Carcinoma, Squamous Cell/chemically induced , Cryosurgery/methods , Darier Disease/chemically induced , Darier Disease/surgery , Imidazoles/adverse effects , Oximes/adverse effects , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Aged, 80 and over , Biopsy, Needle , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Darier Disease/pathology , Follow-Up Studies , Humans , Imidazoles/therapeutic use , Immunohistochemistry , Male , Melanoma/drug therapy , Melanoma/pathology , Oximes/therapeutic use , Proto-Oncogene Proteins B-raf/administration & dosage , Risk Assessment , Skin Neoplasms/drug therapy , Skin Neoplasms/pathologySubject(s)
Darier Disease/pathology , Darier Disease/surgery , Darier Disease/etiology , Humans , Male , Young AdultABSTRACT
BACKGROUND: Keratosis pilaris rubra is a common but rarely reported condition characterized by follicular-based hyperkeratotic papules on a background of erythema. It can be embarrassing and symptomatic for patients, particularly adolescent boys. We sought to explore the efficacy of pulsed dye laser (PDL) in the treatment of keratosis pilaris rubra. METHODS: Eight patients were treated with PDL for keratosis pilaris rubra. RESULTS: All patients reported noticeable improvement after one to four treatments. CONCLUSIONS: PDL is an effective, easily accessible, and underused therapy in the treatment of keratosis pilaris rubra.
Subject(s)
Abnormalities, Multiple/surgery , Darier Disease/surgery , Eyebrows/abnormalities , Lasers, Dye/therapeutic use , Adolescent , Female , Humans , Male , Treatment OutcomeSubject(s)
Condylomata Acuminata/surgery , Darier Disease/surgery , Dermatologic Surgical Procedures/methods , Laser Therapy/methods , Lasers, Gas/therapeutic use , Adult , Combined Modality Therapy/methods , Condylomata Acuminata/pathology , Darier Disease/pathology , Diagnosis, Differential , Female , Humans , Inguinal Canal/pathology , Inguinal Canal/surgery , Treatment OutcomeABSTRACT
Darier-White disease is one of the most common genodermatoses. The most typical clinical symptoms such as diffuse hyperkeratotic papulae usually appear during puberty or early adulthood in seborrhoeic area. It is connected with substantial deterioration of the quality of life due to aesthetic defect. Although there exist many therapeutic options, the disease still causes considerable therapeutic difficulties. Treatment with fractional CO2 laser seems to be a promising therapeutic method. In this paper, we present two cases of patients with Darier's disease who have been treated with a fractional CO2 laser with very good clinical outcome.
Subject(s)
Darier Disease/surgery , Lasers, Gas/therapeutic use , Adult , Female , Humans , Laser Therapy/methods , MaleABSTRACT
BACKGROUND: Keratosis pilaris (KP) is a very common disorder; yet, very few treatment options are available. OBJECTIVES: To evaluate the efficacy of long-pulsed 1064-nm Nd:YAG laser for the treatment of KP. MATERIALS AND METHODS: Eighteen patients with untreated KP on the upper outer arms were enrolled in a randomized clinical trial. One arm was treated with long-pulsed 1064-nm Nd:YAG laser at 30 msec pulse width and fluence of 34 J/cm(2), while the contralateral arm served as control. Patients received three consecutive treatments at 4-week intervals. Three blinded dermatologists assessed digital photographs using a quartile grading system to separately rate global improvement, erythema and the number of keratotic papules. RESULTS: Seventeen patients completed the study. There were statistically significant improvements in global assessment, erythema and the number of keratotic papules at 4 weeks after the last treatment (p < 0.05). All patients also stated that their lesions improved and were satisfied with the laser treatment. CONCLUSION: Long-pulsed 1064-nm Nd:YAG laser has been shown to improve KP in Thai patients compared with control after three treatment sessions.
Subject(s)
Abnormalities, Multiple/surgery , Darier Disease/surgery , Lasers, Solid-State/therapeutic use , Abnormalities, Multiple/physiopathology , Adolescent , Adult , Darier Disease/physiopathology , Erythema/physiopathology , Eyebrows/abnormalities , Eyebrows/physiopathology , Female , Humans , Male , Treatment Outcome , Young AdultABSTRACT
Darier disease (DD) is a rare autosomal dominant dermatosis that has infrequent ocular manifestations, especially those involving the eyelids. The authors describe a patient with long-standing DD who presented with both classic and unique clinical findings. Eyelid biopsy samples studied with electron microscopy demonstrated histopathological changes consistent with DD. The authors postulate how clinical findings not previously reported as "classic" to DD may be associated. To the authors' knowledge, electron micrographs detailing changes associated with DD have not been published for eyelid tissue.