Microlipoinjection and autologous collagen.

There has been a resurgence over the past decade of microlipoinjection. Adipose tissue has proved to be a safe and effective filler substance for subcutaneous defects. More recently, lipocytic dermal augmentation, or autologous collagen, has been used to correct dermal defects.

Autologous collagen? Lipocytic dermal augmentation. A histopathologic study.

BACKGROUND: Soft tissue augmentation with processed fat has been used clinically for several years. This material has been termed "autologous collagen" since it was presumed it was composed primarily of collagen and fibrous tissue from lipocyte cell walls. OBJECTIVE: To examine the histologic behavior of dermis implanted with processed fat. METHOD: Volunteers were injected with processed fat intradermally in the post auricular area and these sites were biopsied at one week, one month, and three months. RESULTS: Early biopsies revealed no intact adiopocytes but a significant inflammatory infiltrate. Subsequently biopsies revealed replacement of the inflammatory reaction with cellular fibrosis and expansion of the dermis. CONCLUSION: Intradermal injection of processed fat results in deposition of fibrous material and collagen due to the response of the recipient site. The material itself contains very little collagen.

Autologous fat transplantation. Long-term follow-up.

We present a clinical long-term follow-up of our autologous fat transplantation patients. Our study group consists of 43 patients followed over 3-48 months (mean 26 months). Cosmetic defects treated include linear morphea, expression lines, acne scars, discoid lupus erythematosus scars, and post-traumatic scarring. Postoperative complications were rare and short term. We conclude that autologous fat transplantation is a safe and effective procedure. Fat graft longevity is examined in relation to the cosmetic defect treated, the recipient site, and the donor site.

Liposuction of lipomas.

When lipomas reach 4 cm or more in size or are multiple, liposuction becomes an excellent alternative to excisional surgery. The basic concept is that fat lobules are bluntly broken down or curetted by a cannula and then removed through the cannula's aperture by a vacuum force generated from a suction machine. There are few minor sequelae, and these are rarely of a prolonged nature. The benefits of liposuction are decreased surgical time, a shorter scar, a better final contour, and the ability to remove several lipomas through one opening. In addition, liposuction surgery is a useful modality for the removal of lipomas because of the low recurrence rate and minimal malignant potential of these tumors.

Parapsoriasis and mycosis fungoides: the Northwestern University experience, 1970 to 1985.

One hundred sixty skin biopsy specimens from 89 patients with the clinical diagnosis of large plaque parapsoriasis and 240 specimens from 106 patients with mycosis fungoides were reviewed. Through the use of chart reviews and a retrospective questionnaire, various factors (sex, age, history of eczema/atopy, occupation) were examined in these two patient groups. Mycosis fungoides developed in 30% of the patients in the parapsoriasis group. Nineteen percent of patients in the mycosis fungoides group had worked in industry. Once the clinical diagnosis of mycosis fungoides was considered, an average of four biopsy specimens were needed to establish the diagnosis. The average interval from the initial visit to the diagnosis of mycosis fungoides from examination of biopsy specimens was 22 months. These findings support further the view that large plaque parapsoriasis represents an important precursor of mycosis fungoides. A designation of premycosis fungoides would emphasize this relation more than the term parapsoriasis.

Papillomavirus in the vapor of carbon dioxide laser-treated verrucae.

Vapor produced by the carbon dioxide laser during the vaporization of papillomavirus-infected verrucae was analyzed for viral DNA content. Two models were used for evaluation: an in vitro cutaneous bovine fibropapilloma and an in vivo human verruca model. Four bovine fibropapillomas were exposed to various laser parameters with power densities of 38,200 to 130 W/cm2 and energy fluences of 3820 to 130 J/cm2. The generated vapor was collected in a chamber in line with a vacuum system. Hybridization with bovine papillomavirus DNA probes revealed intact bovine papillomavirus DNA for all power densities and energy fluences used. The laser vapor from seven patients undergoing carbon dioxide laser therapy for plantar or mosaic verrucae was also collected. Laser parameter settings were similar to those usually chosen for clinical tissue vaporization. Intact human papillomavirus DNA was present in the vapor from two of seven patients. These studies indicate that intact viral DNA is liberated into the air with the vapor of laser-treated verrucae. It would be prudent for all practitioners who use the laser in treating patients with viral infections or conditions associated with viruses to practice extreme care and safety throughout the laser procedure.

New aspects of hair transplantation.

Improvements in the technique and instrumentation used in hair transplantation have led to the production of better grafts, a more natural hairline, a greater number of grafts from a donor site, the effective control of postoperative bleeding, and the reduction of large areas of baldness prior to hair transplantation.