Minocycline-induced hyperpigmentation: rapid resolution after 755nm alexandrite picosecond laser treatment.

Minocycline-induced pigmentation (MIP) is an infrequent complication of minocycline therapy, with four subtypes each with distinct clinical features and histologic staining patterns. MIP may resolve following discontinuation of minocycline therapy or it may persist indefinitely. A 64-year-old Caucasian male presented with a 6 month history of progressive blue-gray facial pigmentation distributed symmetrically over his face. One session utilizing a 755 nm picosecond Alexandrite laser resulted in immediate and significant clearance of the pigment in all treated areas. Long-term follow-up at 2 years revealed no recurrence of the MIP.

A customized approach for arm fat reduction using cryolipolysis.

OBJECTIVES: Cryolipolysis of the arms has been demonstrated to be an effective treatment for non-invasive reduction of subcutaneous fat. This study evaluated the safety and efficacy of the concurrent use of a new commercially-available small applicator in conjunction with an existing medium sized applicator for the customized treatment of arm fat. METHODS: Bilateral arms of 15 eligible subjects were simultaneously treated using one or two vacuum applicators with flat contours. Either a medium or small cryolipolysis applicator with an oblong cup-shaped cooling surface was selected to treat upper arm fat. The shape of the fat bulge in each subject's arm was assessed and up to two treatment cycles (-11°C for 35 minutes each) were delivered to each arm in one session, based upon investigator discretion. Throughout the procedure and at the completion of each treatment cycle, investigators assessed the subject's level of comfort, as well as sensory and motor nerve effects. Post-treatment manual massage was performed, and clinical assessments of each treatment site were recorded. Adverse events were recorded to monitor procedural safety. Baseline and 12 weeks post-treatment photographs and ultrasound measurements were taken to assess efficacy. Subject questionnaires were administered to evaluate satisfaction. RESULTS: Fifteen female subjects (mean age of 51.1, mean BMI of 26.8) completed the study. Ultrasound imaging revealed statistically significant fat layer reduction of 2.5 mm (SD ± 2.4 mm, 95%CI 1.6-3.3). Subject surveys administered 12 weeks post-treatment demonstrated 87% satisfaction with the arm cryolipolysis procedure. A panel of blinded, independent physicians correctly identified 83% of the before and after photos. Clinical assessments found adverse events were mild and included erythema and mild swelling that resolved without intervention. Mild treatment area numbness was reported by 73% of subjects at the 4-week interim visit and fully resolved at the 12-week visit. CONCLUSION: This study documents the first reported customized approach for assessment and treatment of arm fat using a small or medium cup applicator with varied applicator placement. By incorporating one or two treatment cycles per arm in a single session, the issue of variable fat distribution in people's arms can be addressed. This approach was shown to be a safe and effective way to reduce unwanted arm fat with high patient satisfaction. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.

Canadian Clinical Practice Guidelines for Rosacea.

Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used as a source of clinical trial evidence on which to base the recommendations.

Trends in invasive cutaneous melanoma in Saskatchewan 1970-1999.

BACKGROUND: Melanoma incidence rates have increased dramatically in white populations worldwide during the past several decades. A more modest increase has been observed for melanoma-related mortality. Cause-specific and disease-free survivals are related to tumor characteristics, gender, age, and possible anatomic site. It is difficult to accurately assess these trends without information on tumor thickness that is often unavailable. OBJECTIVE: This study determines trends in melanoma incidence, mortality, and survival in Saskatchewan for a 30-year period, incorporating analysis of tumor thickness. METHODS: Information about cases of primary cutaneous melanoma for the 30-year period 1970-1999 was obtained from the population-based Saskatchewan Cancer Registry. A 50% random sample of charts was reviewed to collect information about Breslow depth, Clark level, and other demographic data not available from the Registry. Multivariate regression analysis was used to determine the significance of prognostic factors on incidence and five-year relative survival rates. RESULTS: The number of patients registered increased dramatically during the study period. The increase was greatest for thin lesions in all age groups. Anatomic site varied by gender. Head and neck tumors showed continual increase in risk with increasing age. Mortality rates in females have been stable over time but increased for males in the 1990s. The prognostic factors tht predicted excess mortality at five years were tumor thickness, Clark level, and gender. CONCLUSION: The observed increase in melanoma appears to be real and not the result of increased surveillance or screening. Tumor characteristic (Breslow depth, Clark level) and gender were significant prognostic indicators of five-year excess mortality.