Adipose tissue transplant in recurrent folliculitis decalvans.

Folliculitis decalvans is a rare clinical disorder classified as primary neutrophilic scarring alopecia with a slight preference for the male gender. Here, we report the use of autologous fat transplantation as a source of stem cell therapy for hair re-growth assisted by inflammatory action of the fat itself in a female patient. The patient underwent adipose transplantation in April and September 2017. After treatments, the patient had no new pustules and no longer had pain or burning sensation in the affected area. The hair has re-grown at the periphery area of alopecia appearing stronger and shinier.

Ingrowing Hair: A Case Report.

Cutaneous pili migrans and creeping eruption caused by parasitic diseases may present as a moving linear lesion in skin. The former, caused by a hair shaft or fragment embedded in the superficial skin or middle dermis, is a rare condition characterized by creeping eruption with a black line observed at the advancing end. In exceptionally rare instance, the hair grows inside the skin and burrows in the uppermost dermis, such a condition has been called "ingrown hair."We report a 30-year-old Chinese man, who was accustomed to pull or extrude the beard hairs, with 1-year history of slowly extending black linear eruption on his right chin. Cutaneous examination revealed a 4-cm long black linear lesion beneath the skin associated with edematous erythema around and folliculitis on both ends of the lesion. After treatment with topical mupirocin ointment, the erythema and folliculitis improved and 2 hairs of the beard with hair follicles were pulled out from the skin. Two weeks later, another similar black line about 1 cm in length in the skin presented on the prior lesional area, which was pulled out by a shallow incision of the skin and was also demonstrated as a beard hair with hair follicle.The patient was diagnosed as "ingrowing hair" with multiple recurrences. The lesions recovered after the beard hairs were pulled out. No recurrence occurred in a year of follow-up.We suggest that "ingrowing hair" is better than "ingrown hair" to describe such a condition. Pulling out the involved hair and correcting the bad practice are its optimal management strategies.

[Surgical managing of current cutaneous infections in children]. / Prise en charge chirurgicale des infections cutanées communes de l'enfant.

The cutaneous infectious pathology of the child is varied and frequent. Authors deal with surgical infections seen in current pediatrics, which often have to appeal to a plastic pediatric surgeon for their treatment. Superficial infections of skin and pilo-sebaceous follicles are common in big children. The folliculitis and the boil are the most frequent. Their treatment is medical and surgical and does not require an antibiotic treatment in most of the cases. The primitive abscesses or following an anterior lesion recover from a similar treatment. Some localizations or risky context need a particular follow-up. The whitlow is a particular example and needs to have a particular follow-up because of the risk of hand cellulitis. Nails embodied of the child require a specialized notice because of their numerous clinical forms, which must be distinguished according to the age. Finally the necrotizing cellulitis and fasciitis are surgical emergencies and have a well-codified treatment. These infections in children must benefit from an attentive care because when they are badly treated, they can involve the aesthetic, functional and vital forecast.

Difficult wounds: an update.

The purpose of this collective review is to describe revolutionary advances in the treatment of Gardner's syndrome (GS), pseudofolliculitis barbae, nasal septal perforation, factitious wounds, and hidradenitis suppurativa (HS). Gardner's syndrome or familial polyposis has various manifestations that appear to be controlled by a single genetic locus. Apart from the large bowel adenomas, which are always present, a common extracolonic symptom of Gardner's syndrome is the occurrence of epidermal cysts. These cysts can be seen before the intestinal polyps are evident. Because epidermal cysts in patients with Gardner's syndrome are always benign, we excise these cysts using incisions that are commonly used for rhytidectomy. Pseudofolliculitis barbae, a pseudofolliculitis caused by ingrown hairs, effects 85% of blacks who shave their beards. When this disease is allowed to progress to keloid formation, we use a surgical approach that includes excision of the keloidal scar, meticulous debridement of all residual ingrown hairs in the underlying wound, and coverage of the defect with a split-thickness skin graft. More recently, laser therapy has revolutionized the treatment of pseudofolliculitis barbae and has enabled a cure for the first time for those plagued with this disorder and for whom a beardless face is acceptable. Nasal septal perforation is a well recognized complication of septal surgery. Other iatrogenic causes of perforation include cryosurgery, electrocoagulation for epitaxis, nasotracheal intubation, or nose packing. In recent years drugs such as cocaine account for an increasing number of perforations. It has only been with the use of an external approach for the repair of the nasal septal defect that surgical closure has become easier and more reliable. The external approach allows for greater surgical closure and enables the surgeon to use both hands with the aid of binocular vision to mobilize and suture local mucosal advancement flaps and the intraseptal connective tissue grafts. More recently, surgeons have repaired large septal perforations with a radial forearm free flap. Because of its availability and deep emotional significance, the skin is a common site for self-destructive behavior with the development of factitious skin wounds. When suspected, psychiatric care must proceed immediately. Second, the ulcer can then be healed by appropriate techniques and wound repair. It is important to emphasize that the treating physician must first confront the patient, and then a psychiatrist should provide appropriate psychotherapy. Hidradenitis suppurativa is an inflammatory disease of the skin and subcutaneous tissue that occurs in apocrine-gland-bearing areas distributed in the axilla, mammary nipple areola, mons pubis, groin, scrotum, perineum, perianal region, and umbilicus. The condition has an insidious onset. The susceptibility of women's axillary skin to hidradenitis suppurativa may be related, in part, to the practice of axillary removal of hair with a safety razor. Consequently, the use of safety razors must be avoided and replaced with the use of an electric razor. The method of treatment will vary with the stage of the disease. Treatment of the chronic stage of axillary hidradenitis suppurativa is primarily surgical. More recently, carbon dioxide laser treatment, with healing by secondary intention, is proving to be a rapid, efficient, and economic treatment of this difficult wound.

Modified superlong pulse 810 nm diode laser in the treatment of pseudofolliculitis barbae in skin types V and VI.

BACKGROUND: Laser hair removal is a well-established therapy for pseudofolliculitis barbae, but there have been few studies on the use of a very-long-pulse 810 nm diode laser for this condition. OBJECTIVE: To determine the efficacy and tolerability of a modified 810 nm superlong-pulse diode laser (Palomar Medical, Burlington, MA, USA) in the treatment of pseudofolliculitis barbae (PFB) in subjects with type V and VI skin. METHODS: Thirteen patients were treated three times at 2-week intervals on one side of their neck with varying fluences. They were evaluated for (1) reduction of shaving bumps and (2) pain tolerance on the treated versus the untreated side. RESULTS: There was a statistically significant improvement in shaving bumps. The treatment side showed a baseline PFB lesion count of 22.5 (+/- 20 SD), which decreased to a mean of 5 (+/- 5 SD) (p<.05). The control baseline mean count was 27.6 (+/- 22 SD) and at the end of the study was 15 (+/- 12 SD) (p = .13). Pain was rated at 2.5 of 10 for subjects treated both with and without anesthetic. The margin of safety was greater in type V compared with type VI skin. CONCLUSION: A modified 810 nm superlong-pulse diode laser is both effective and well tolerated in the reduction of shaving bumps, especially in patients with type V skin.

Nd:YAG laser treatment of recalcitrant folliculitis decalvans.

BACKGROUND: The scarring follicular disorders pose challenging therapeutic dilemmas. OBJECTIVE: Hair removal lasers have recently been shown to be efficacious in the management of these disorders. METHODS: We present a young, Fitzpatrick skin type VI African-American patient with recalcitrant folliculitis decalvans, whom we treated with the neodymium:yttrium aluminum garnet (Nd:YAG) laser. RESULTS: A remission of folliculitis decalvans was successfully achieved using the Nd:YAG for laser depilation. CONCLUSION: Based on the optical properties of light in skin, the Nd:YAG laser is the best for laser depilation in dark individuals.

Instrument capsules: laser hair removal in pigmented skin.

A 50-year old African-American woman presented to her physician's office seeking treatment of excess hair and secondary hyperpigmentation of her chin. On exam, her skin was noted to be Fitzpatrick Type V and her hair was course and dark.

Chemical peeling in ethnic/dark skin.

Chemical peeling for skin of color arose in ancient Egypt, Mesopotamia, and other ancient cultures in and around Africa. Our current fund of medical knowledge regarding chemical peeling is a result of centuries of experience and research. The list of agents for chemical peeling is extensive. In ethnic skin, our efforts are focused on superficial and medium-depth peeling agents and techniques. Indications for chemical peeling in darker skin include acne vulgaris, postinflammatory hyperpigmentation, melasma, scarring, photodamage, and pseudofolliculitis barbae. Careful selection of patients for chemical peeling should involve not only identification of Fitzpatrick skin type, but also determining ethnicity. Different ethnicities may respond unpredictably to chemical peeling regardless of skin phenotype. Familiarity with the properties each peeling agent used is critical. New techniques discussed for chemical peeling include spot peeling for postinflammatory hyperpigmentation and combination peels for acne and photodamage. Single- or combination-agent chemical peels are shown to be efficacious and safe. In conclusion, chemical peeling is a treatment of choice for numerous pigmentary and scarring disorders arising in dark skin tones. Familiarity with new peeling agents and techniques will lead to successful outcomes.

Massive exophytic abscesses and fibrotic masses of the chin: a variant of the follicular occlusion triad.

We present a patient with an extensive cluster of exophytic nodules that developed on his chin. These nodules consisted of abscesses and fibrotic areas. Lesion morphology, histology, and microbiology support a follicular occlusion triad entity. However, the distribution is striking and does not fit the entities described in the triad. We present the case to show that follicular occlusion was the inciting factor in our patient's eruption and to broaden our concept of clinical manifestations that can arise from this pathologic process.

Treatment of pseudofolliculitis barbae using the long-pulse Nd:YAG laser on skin types V and VI.

BACKGROUND: Pseudofolliculitis barbae (PFB) is a foreign body inflammatory condition that is caused by in-grown hairs of the face and body. An effective treatment to alleviate this condition without the risk of side effects has yet to be found. OBJECTIVE: The objective of this study was to evaluate the Lyra 1064-nm long-pulse ND:YAG laser in the treatment of PFB on skin types V and VI. METHODS: Twenty subjects (12 males and 8 females) were given two treatments approximately 3 to 4 weeks apart and were assessed by objective papule/pustule and hair counts at 1, 2, and 3 months after final treatment. Laser treatments with the Lyra Nd:YAG laser were applied onto 2x2-cm regions on the upper and lower mandible and neck regions. Contralateral controls were used to assess overall effectiveness. Subjective evaluations were also obtained from both subjects and investigators. Assessments of any abnormal side effects caused by laser treatment, including dyspigmentation and/or scarring, were also evaluated. RESULTS: A reduction in the quantity of papules/pustules and hairs when compared with baseline data was statistically significant for treatment of PFB in the mandibular and neck regions at the 1-, 2-, and 3-month follow-up evaluations. Subject evaluations ranged from satisfied to very satisfied. Side effects included transient hyperpigmentation, transient hypopigmentation, mild erythema, and itching. CONCLUSIONS: The use of the 1064-nm long-pulse Nd:YAG laser for the treatment and management of PFB on skin types V and VI is both safe and effective, with positive results lasting for up for to 3 months after two treatments.

Diode laser hair removal of the black patient.

BACKGROUND AND OBJECTIVE: The 810-nm wavelength diode laser can safely and successfully treat all skin types, including dark pigmented skin. STUDY DESIGN/METHODS: Eight Fitzpatrick level V-VI skin type patients, four of which presented with the diagnosis of pseudofolliculitis barbae, were treated with the diode laser for hair removal using low-energy settings and long pulse duration. RESULTS: All eight patients had excellent results with unwanted hair greatly reduced, and pseudofolliculitis barbae resolved. CONCLUSIONS: Diode lasers can be used on dark pigmented skin with positive outcomes. Complications such as hypopigmentation, or hyperpigmentation occurred, but all were transient and resolved within a few months.

Esteatocistoma solitario vulvar: una localización inédita / Solitary vulvar steatocystoma: an unusual localization

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Treatment of pseudofolliculitis barbae using the Q-switched Nd:YAG laser with topical carbon suspension.

BACKGROUND: Pseudofolliculitis barbae (PFB) is a condition caused by ingrown hairs of the face. No treatment to date has shown long-term effectiveness without risk of side effects or ease of treatment. OBJECTIVE: The goal of this pilot study was to evaluate the use of the topical suspension-assisted Q-switched Nd:YAG laser in the treatment of PFB. METHODS: Nine patients were given two treatments 1 month apart and assessed by objective papule/pustule counts at 1 and 2 months after final treatment. Treatment sites were 9 cm2 regions on the mandible and neck, with contralateral controls. Patients also performed subjective evaluations. RESULTS: Reduction in the quantity of papules and pustules when compared with baseline was statistically significant for treatment of the mandibular region and combined sites at 1- and 2-month evaluations, as well as the neck region at the 2-month evaluation. CONCLUSION: Use of the Q-switched Nd:YAG laser with topical carbon suspension is an effective means of treating PFB, with results persisting at least 2 months after treatment.

Foliculitis esclerosante de la nuca (acné queloideo) / Folliculitis nuchea scleroti cans (acne keloidalis nuchae)

Exponemos el caso de un varón negro de 35 años con una foliculitis esclerosante de la nuca(acne keloidalis nuclae). Presentaba unas pápulas de 1 año de evolución de consistencia dura, estables, pero con períodos de exacerbación. Dado que eran asintomáticas se dejó sin tratamiento. Se realiza una revisión de esta entidad (AU)