Noninvasive Atrophic Acne Scar Treatment in Asians With a 755-nm Picosecond Laser Using A Diffractive Optic Lens-A Retrospective Photographic Review.

BACKGROUND: The diffractive lens of the picosecond laser is relatively new, and there are few reports on its efficacy in treating atrophic acne scars, especially in Asian populations. OBJECTIVE: Evaluating the efficacy of diffractive lens 755-nm picosecond laser for atrophic acne scar treatment in Asians. PATIENTS AND METHODS: Forty-two patients who were treated for facial atrophic acne scars at a private dermatological clinic were enrolled in this retrospective analysis. Mean session count was 4.28. Before and after photographs were assessed by 2 blinded dermatologists, who rated the amount of overall skin quality improvement on a 5-point scale. RESULTS: All patients experienced improvements in scar texture and overall skin quality after 2 to 6 sessions, with scores of +1.4, 1.45, 1.7, 1.33, 2.3, and 1.66 points after 2, 3, 4, 5, 6, and >6 treatments, respectively. There were no obvious adverse effects after treatment. The postinflammatory hyperpigmentation (PIH) risk was 4.7% (2 of 42, both spontaneously resolved). CONCLUSION: The 755-nm diffractive lens picosecond laser showed good efficacy and low PIH rates when treating atrophic acne scars in darker skin-type patients. In addition to treatment results, additional improvements in overall skin quality and pigmentation make the picosecond laser an effective and desirable treatment option for Asians.

Positive effect of modified Goeckerman regimen on quality of life and psychosocial distress in moderate and severe psoriasis.

Psoriasis is a chronic inflammatory skin disease with a profound effect on quality of life and psychosocial stress. The relationship between clinical improvement and psycho-social impact after treatment is complex. The objective of this study was to compare changes in quality of life and psychosocial distress, and overall cost-effectiveness, in patients with psoriasis receiving the modified Goeckerman regimen (UV irradiation and coal tar) with those receiving conventional treatment. Patients with moderate/severe psoriasis receiving the Goeckerman regimen were followed from admission to discharge. Clinical severity, was evaluated weekly using the Psoriasis Area and Severity Index (PASI). Psoriasis Disability Index (PDI) and Hospital Anxiety and Depression Scale (HADS) questionnaires were applied at admission and one month after discharge. Thirty-six patients with psoriasis receiving conventional treatment and 48 patients receiving the Goeckerman regimen were recruited to the study. The mean PASI score in the Goeckerman group decreased from 27.1 to 6.9 and PDI scores decreased from 25.3 to 13.8. HADS scores for anxiety and depression decreased significantly from 9.8 to 6.3 and 9.1 to 6.8, respectively. In comparison with conventional therapy, the modified Goeckerman regime showed similar clinical efficacy, with additional benefits in improving overall quality of life and psychosocial distress in patients with moderate/severe psoriasis, and more cost-effectiveness.

Arthroscopic shaver with refinement for axillary osmidrosis.

BACKGROUND: Minimal invasive treatment with liposuction-curettage for axillary osmidrosis has lead to clinical improvement with lower risk of complications. The incidence of skin necrosis and hematoma in the literature is very limited. Recently, arthroscopic shaver has been used for the treatment of osmidrosis with better efficacy, but associated with variable degrees of complications. OBJECTIVE: To evaluate clinical effect and complication from arthroscopic shaver with preservation of fibrovascular cords. To our knowledge this modification has not been previously described. METHOD: Thirty patients were recruited during a 1-year-period for the treatment of axillary malodor. Incision was made for the arthroscopic shaver and subcutaneous fibrovascular cords were carefully preserved. We evaluated the clinical efficacy (excellent, good, fair, and poor), complications, and subsequent recurrences. RESULTS: Among patients receiving the arthroscopic shaving for axillary osmidrosis, 93% of the patients had achieved excellent to good results, 7% with fair result and none had poor clinical efficacy. None of the patient had any skin necrosis or recurrences during clinical follow up. CONCLUSION: Arthroscopic shaving for axillary osmidrosis has been associated with variable complication rates. Our experience has indicated that preservation of fibrovascular cords protected epidermis from necrosis and such refinement will allow for more optimal clinical result and lower complications.

Treatment of recalcitrant periungual warts with cimetidine in pediatrics.

Viral warts, caused by human papilloma virus (HPV), are commonly seen in dermatology clinics. However, treatment for warts can be challenging, and there is no single method of treatment that is universally effective. Conventional therapies involve the physical destruction of lesions, including cryotherapy, electrodesiccation, CO2 laser, and topical keratolytic agents. Successful treatment of recalcitrant warts, especially periungual lesions and verruca plana of the face, had been limited with the conventional modalities. These painful procedures resulting in poor compliance, cosmetic disfiguration, and residual indolent lesions usually led to incomplete treatment. Use of high-dose cimetidine in the treatment of viral warts has been reported in the literature in recent years; however, with conflicting results. Herein, we present a 12-year-old girl with recalcitrant periungual warts, successfully treated with cimetidine for 4 months without subsequent recurrence and side effects.