Vol. 1 No. 1 (2016)

  • Open Access

    Original Research Articles

    Article ID: 6

    Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

    by Laila Mohammad, Lamia H Elgarhy, Dina Saad, Walid Mostafa

    Journal of Surgical Dermatology, Vol.1, No.1, 2016; 4002 Views

    DOI: https://doi.org/10.18282/jsd.v1.i1.6

    There are different modalities for management of atrophic acne scars which include lasers. Ablative fractional CO2 laser was developed to address the shortcomings of traditional ablative lasers, with superior results to non-ablative fractional lasers. Autologous fat transfer has been utilized for nearly a decade in tissue augmentation and reconstruction. Present studies were designed to compare ablative fractional CO2 laser treatment with scar subcision and autologous fat transfer in the treatment of atrophic acne scars. 20 patients with atrophic acne scars were recruited: 10 patients were treated by three sessions of ablative fractional CO2 laser therapy, and 10 patients treated by subcision and autologous fat transfer. All patients were followed up for three months, and were assessed by digital photograph before and after treatment through the application of Goodman and Baron quantitative and qualitative grading systems, in addition to reports by three physicians committees and reports of patients’ satisfaction. Analysis of both groups showed significant improvements in all types of atrophic acne scars. The mean percentage of total quantitative improvement was more significant in the case of autologous fat transfer with regard to ice-pick and total number of scars. Therefore, scar subcision with autologous fat transfer proved to be as effective as, or even more effective than, ablative fractional CO2 laser in the treatment of atrophic acne scars with regard to the total number of scars as well as ice-pick type.

  • Open Access

    Original Research Articles

    Article ID: 15

    Digital dermoscopy to determine skin melanin index as an objective indicator of skin pigmentation

    by Sara Majewski, Chantelle Carneiro, Erin Ibler, Peter Boor, Gary Tran, Mary C Martini, Salvatore Di Loro, Alfred W. Rademaker, Dennis P. West, Beatrice Nardone

    Journal of Surgical Dermatology, Vol.1, No.1, 2016; 3873 Views

    DOI: https://doi.org/10.18282/jsd.v1.i1.15

    Clinical assessment of skin photosensitivity is subjectively determined by erythema and tanning responses to sunlight recalled by the subject, alternatively known as Fitzpatrick Skin Phototype (SPT). Responses may be unreliable due to recall bias, subjective bias by clinicians and subjects, and lack of cultural sensitivity of the questions. Analysis of red-green-blue (RGB) color spacing of digital images may provide an objective determination of SPT. This paper presents the studies to assess the melanin index (MI), as determined by RGB images obtained by both standard digital camera as well as by videodermoscope, and to correlate the MI with SPT based upon subjects’ verbal responses to standardized questions administered by a dermatologist.
       A sample of subjects representing all SPTs I–VI was selected. Both the digital camera and videodermoscope were calibrated at standard illumination, light source and white balance. Images of constitutive skin of the upper ventral arm were taken of each subject using both instruments. The studies showed that 58 subjects (20 M, 38 F) were enrolled in the study (mean age: 47 years; range: 20–89), stratified to skin phototype I–VI. MI obtained by using both digital camera and videodermoscope increased significantly as the SPT increased (p = 0.004 and p < 0.0001, respectively) and positively correlated with dermatologist-assessed SPT (Spearman correlation, r = 0.48 and r = 0.84, respectively). Digital imaging can quantify melanin content in order to quantitatively approximate skin pigmentation in all skin phototypes including Type VI skin. This methodology holds promise as a simple, non-invasive, rapid and objective approach to reliably determine skin phototype and, with further investigation, may prove to be both practical and useful in the prediction of skin cancer risk.

  • Open Access

    Reviews

    Article ID: 20

    Laser therapy for cutaneous sarcoidosis: A review

    by Teo Soleymani, Michael Abrouk

    Journal of Surgical Dermatology, Vol.1, No.1, 2016; 3270 Views

    DOI: https://doi.org/10.18282/jsd.v1.i1.20

    Sarcoidosis is a systemic, multi-organ disease of unknown etiology characteristically defined by the development of non-caseating granulomas. The development of sarcoidosis has been associated with a number of environmental and microbacterial factors coupled with genetic susceptibility. Depending on the type, location and distribution of disease, sarcoidosis can cause functional impairment, symptomatic distress, scarring and disfigurement. The advent of lasers as precise, minimally destructive surgical tools has allowed for their development as promising alternatives that minimize the morbidity associated with current therapies.

    In this paper, we reviewed the role of laser therapy in the treatment of cutaneous sarcoidosis. A comprehensive search of the Cochrane Library, MEDLINE and PUBMED databases was performed to identify relevant literatures investigating the role of laser therapy in the treatment of cutaneous sarcoidosis. In our opinion, laser therapy, particularly PDL, appears to be an effective, safe and generally well-tolerated modality for the treatment of cutaneous sarcoidosis and should be considered in patients with localized cutaneous disease that is refractory to conventional treatments. Less is known about the efficacy and tolerability of ablative laser therapy for the treatment of cutaneous sarcoidosis, though the limited data appears promising as well. With that said, however, the data is limited and warrants a need for additional larger, randomized controlled studies to further investigate the utility and efficacy of laser therapy in the treatment of cutaneous sarcoidosis.

  • Open Access

    Case Reports

    Article ID: 34

    Giant seborrheic keratosis of the face – an unusual presentation

    by Koh Khai Luen, Rashid Shawaltul Akhma, Wan Sulaiman Wan Azman

    Journal of Surgical Dermatology, Vol.1, No.1, 2016; 2442 Views

    DOI: https://doi.org/10.18282/jsd.v1.i1.34

    Seborrheic keratosis is the most common benign epidermal lesion in the world, especially among the elderly. Its inherent benign nature has precluded the need to remove it for medical reasons. Most of the concerns presented to dermatologists or plastic surgeons are of cosmetic reasons, besides some unusual appearances that necessitate cutaneous malignancy evaluation. Unusually large sizes of seborrheic keratosis are rarely reported, and its clinical significance is largely unknown. It has been proven by recent molecular studies that seborrheic keratosis is true neoplasia rather than a mere epidermal hyperplasia, and various authors have reported several cases of concomitant malignancy arising from seborrheic keratosis. Plastic surgeon expertise is often required when faced with an extensive lesion, requiring reconstructive procedures to preserve good aesthetic and functional outcomes. The purpose of this review is to report a case of an unusually large seborrheic keratosis on the face, highlighting its clinical relevance and surgical management.