Porocarcinoma of the Left Foot: A Case Review.

Eccrine porocarcinoma is a rare malignant tumor of the eccrine sweat gland. This malignancy occurs most commonly in the lower extremities. It tends to occur in patients aged 60 to 80 years, affecting men and women equally. We present the case of a 62-year-old man with a lesion on the left foot. The diagnosis of the initial biopsy was squamous cell carcinoma. Six months later, the lesion reoccurred, and a second biopsy confirmed it to be eccrine porocarcinoma.

Sound levels and safety in cosmetic laser surgery.

OBJECTIVES: Measure the sound levels produced by various lasers commonly used during routine outpatient cosmetic surgery to determine whether or not their use exceeds exposure levels set forth by the US National Institute for Occupational Safety and Health (NIOSH) and the US Occupational Safety and Health Administration (OSHA). MATERIALS AND METHODS: Using two different meters, the sound levels of lasers commonly used in cosmetic surgery were recorded during various procedures for several indications: tattoo removal, treatment of lentigines and pigmented lesions, facial erythema and vascular lesions, hair removal and resurfacing of acne scars, and photoaging. RESULTS: All but five lasers had a maximum sound level below 85 dBA, the limit proposed by NIOSH. The loudest laser examined was a fully ablative 2,940 nm Er:YAG during facial resurfacing, with an average maximum sound level of 101.5 decibels (dBA). Two other lasers used for resurfacing exceeded 85 dBA including a fractional ablative 1064 Nd:YAG with an average maximum of 97.8 and a different fully ablative 2,940 nm Er:YAG which had an average maximum of 96.3 nm. The two other lasers that exceeded 85 dBA were picosecond lasers used to treat black tattoos, including a 1,064 nm Nd:YAG with an average maximum of 93.7 dBA and a 755 nm alexandrite with an average maximum of 93.6 dBA. CONCLUSION: Although some lasers in cosmetic surgery may be perceived as being quite loud, they remain safe. Even the loudest laser studied would have to be used for nearly 2 hours before exceeding the OSHA recommended exposure limit. Even physicians who spend a large amount of time using lasers in clinical practice should be reassured that these devices are not likely to produce noise-induced hearing loss (NIHL) hearing loss. Lasers Surg. Med. 51:491-494, 2019. © 2019 Wiley Periodicals, Inc.

Use of Google Trends to Examine Interest in Mohs Micrographic Surgery: 2004 to 2016.

BACKGROUND: Mohs micrographic surgery (MMS) is the gold standard for treatment of high-risk skin cancers. There has been an upward trend in the use of this procedure as demonstrated by data from Medicare and the National Ambulatory Medical Care Survey. OBJECTIVE: To assess interest in MMS among members of the general public as measured by number of online searches, and how that interest has changed over time. MATERIALS AND METHODS: Google Trends was used to plot interest in search terms including "Mohs surgery," "basal cell carcinoma," "squamous cell carcinoma," "melanoma," and "skin cancer" from January 1, 2004, to November 30, 2016. RESULTS: Search interest for the term "Mohs surgery" has steadily increased since 2004 and correlates closely with increased interest for "basal cell carcinoma" (r = 0.82) and "squamous cell carcinoma" (r = 0.85). Search interest in MMS did not correlate well with searches for melanoma (r = -0.15) or skin cancer (r = -0.29). CONCLUSION: Public interest in MMS has continued to steadily increase in the United States, which may be a reflection of the increasing volume of MMS that is performed.

Cellulite: a review of pathogenesis-directed therapy.

Cellulite is a condition that affects the majority of postpubertal women and can negatively impact quality of life. This review discusses several proposed pathophysiologies of cellulite, and examines treatment options that have been utilized, focusing on the etiologic factor targeted by the therapies. This approach aims to help clarify the pathogenesis of cellulite and provide a road map for developing effective treatment paradigms for patients.