Vol. 6 No. 2 (2021)

Full Issue

  • Open Access

    Editorials

    Article ID: 143

    Laser Surgery for eyelid margin tumors

    by Adam Kemeny-Beke

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 1909 Views

    Eyelid margin is one of the most challenging anatomic regions in the human body and eyelid margin tumors raise special difficulties in the field of periocular surgery based on anatomical, histological and aesthetic points of view.

  • Open Access

    Original Research Articles

    Article ID: 149

    Floseal® use in dermatologic surgical management of vascular malformations: A novel haemostatic agent in Côte d’Ivoire

    by Komenan Kassi, Vagamon Bamba, Kouame Kanga, Aang Allou, Alexandre Kouassi, Ildevert Patrice Gbery, Sarah Kourouma, Isidore Kouassi, Elidje Joseph Ecra, Mamadou Kaloga, Abdoulaye Sangare, Pauline Yoboue-Yao, Jean-Marie Kanga

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 2545 Views

    A vascular malformation is a congenital growth of artery, venous, capillary or lymphatic vessels leading to functional and aesthetic problems. Although surgical maneuvers allow correction of abnormalities, it poses risk of intra and post-operative blood loss. Sealants have been used during surgical procedures to reduce blood loss. A descriptive study was conducted on a new generation Floseal® to demonstrate its effectiveness to reduce intra and post-operative bleeding during vascular malformation corrective surgery. A group of 19 patients presented with vascular malformations and underwent surgical correction associated with Floseal® use. The mean age of our patients’ was 12.3 years (1 to 33 years). The majority of them (57.6%) were aged between 5 to 15 years. The most common vascular malformation treated was hemangioma (45.5%). Majority of these lesions were located on the head (72.7%). Blood transfusion was not accounted for in any of the cases as average blood loss was 18.18 mL (5 to 70 mL). The average length of hospital stay was 2.4 days. Ten patients (90.9%) were discharged in 2 days after drain was removed. Floseal®, a new generation local haemostatic, is easy to use and efficient to achieve haemostasis for treatment of vascular malformation. Haemostasis was achieved in a short time and blood loss was minimal. However, caution should be taken to reduce allergic reactions and potential viral transmissions, and further study should be done to recommend its use.

  • Open Access

    Original Research Articles

    Article ID: 94

    The efficacy and safety of a 70% glycolic acid peel with vitamin C for the treatment of acne scars

    by Heng Jun Khee, Liau MeiQi May, Yang Shiyao Sam, Aw Chen Wee Derrick, Ho Sue-Ann

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 4125 Views

    Acne scarring is a common complication associated with significant psychological distress. Both glycolic acid (GA) and vitamin C are known to improve the appearance of acne scarring. We performed a review of 13 patients treated with three 70% GA peels with vitamin C at four weeks apart. There was a statistically significant` improvement in acne scarring and post-inflammatory hyperpigmentation from the baseline. Maximal effects were noted four weeks after the third chemical peel. It has an excellent safety profile with no permanent adverse effects noted. A combination of 70% glycolic acid with vitamin C chemical peel is an efficacious, well-tolerated treatment of acne scarring in Asian skin. 

  • Open Access

    Original Research Articles

    Article ID: 177

    A novel total body digital photography smartphone application designed to detect and monitor skin lesions: a pilot study

    by Nicholas Guido, Erika L. Hagstrom, Erin Ibler, Chantelle Carneiro, Kelsey A. Orrell, Ryan C. Kelm, Alfred W. Rademaker, Dennis P. West, Beatrice Nardone

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 3424 Views

    Although some smartphone applications are designed for total body photography (TBP), few offer the specificity that enables self- as well as dermatologist-, detection of new lesions, or change in lesion color or in size as little as 1mm, on an ongoing basis. The aim of this study is to assess the sensitivity of a novel TBP application in the detection of changes to color and size of simulated skin lesions. Twenty-five subjects underwent one study visit. After baseline photography, new artificial markings were made or naturally occurring pigmented lesions located in any anatomical region were enhanced/enlarged, and a second matching set of photographs was then taken. From all 25 subjects, a total of 262 skin markings were evaluable. Of these, 241 (92%) were detected by the app, which resulted in an overall sensitivity of 92%. The high sensitivity establishes the app as capable of providing reliable self-TBP that allows detection and monitoring of new skin lesions or change in both size and color. This method greatly enhances the ability to accomplish ongoing self-monitoring and yet provides quality informing images to the dermatologist to assist in decision-making with the patient. 

  • Open Access

    Reviews

    Article ID: 64

    Biochemical pathways and targeted therapies in basal cell carcinoma: A systematic review

    by Bao Anh Patrick Tran, Tiffany Alexander, Ally-Khan Somani

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 3102 Views

    Basal cell carcinoma (BCC) is the most common type of human malignancy. It is a slow-growing skin cancer with little ability to metastasize, but it is aggressive and can cause local tissue destruction. Descriptions of Basal Cell Nevus Syndrome (BCNS), characterized by a predisposition to the formation of BCC and other neoplasms, and identification of the genetic defect in this syndrome, has led to significant advancement in our understanding of the pathogenesis of BCC. Unregulated expression of target genes in the sonic Hedgehog (SHH) signaling pathway plays a prominent role in the pathogenesis of BCC. An understanding of the signaling components has allowed for the development of pharmacologic agents that inhibit the SHH pathway. The first inhibitor of the SHH pathway approved by the Food and Drug Administration (FDA) for the treatment of BCC is vismodegib. In this review, we will discuss the biochemical pathways involved in BCC as targets of novel pharmacologic therapies.

  • Open Access

    Case Reports

    Article ID: 65

    Necrobiosis lipoidica treated with intense pulsed light

    by Marisa Gonzaga da Cunha, Flavia Cury Rezende, Ana Lúcia Gonzaga da Cunha, Carlos D'Apparecida Machado Filho

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 2491 Views

    Necrobiosis Lipoidica (NL) is a chronic degenerative disease of the collagen with higher incidence on the anterior part of lower extremities, especially the tibial area. There were a number of proposed treatments, but none is 100% effective. We present a case of a fifty-year-old female patient with a suspected diagnosis of necrobiosis    lipoidica, confirmed by histopathological examination. After two years of treatment with topical corticosteroids and weekly applications of Psoralen and ultraviolet A radiation (PUVA), there were no signs of improvement and we  decided to perform a treatment with intense pulsed light therapy. Over a period of 14 months, a total of 13 sessions were carried out and a satisfactory treatment result was obtained.

  • Open Access

    Case Reports

    Article ID: 156

    Multiple clustered dermatofibroma associated with asymptomatic pericardial cyst

    by Piotr Brzezinski, Viktoryia Kazlouskaya, Cesar Bimbi

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 1877 Views

    Multiple clustered dermatofibroma (MCDF) is an unusual variant of dermatofibroma (DF) presentation, localized on one segment of the body. Multiple dermatofibroma is a term for when there are more than 15 dermatofibromas,  which in itself is already a rare condition. The dermatofibromas usually appear in younger adults and are predominantly located on lower parts of the  body. No associations, except one case with pulmonary hypertension, were described in patients with MCDF. Herein we present another case of this rare complaint in a 58 year old female with clustered lesions on the thigh. Pericardial cyst was identified in our patient during routine chest X-ray and the patient is asymptomatic. MCDFs do not usually require treatment unless requested by the patient for cosmetic reason. This variant of MCDF, which is neither congenital nor eruptive, is extraordinarily rare, with only 13 cases reported. Further reports may identify possible associations of MCDF.

  • Open Access

    Case Reports

    Article ID: 145

    Periocular syringomas – Successful treatment with fractional CO2 laser

    by Alberto Goldman, Uwe Wollina

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 4077 Views

    Syringoma is a benign tumor of eccrine origin which arises from eccrine ducts. Syringomas are most commonly found on the eyelids in middle-aged women. Traditional treatments include surgical excision, curettage, peelings, dermabrasion and laser. We report on the successful use of fractional laser on periocular syringomas. A 53-year-old female patient with multiple periorbital syringomas underwent three sessions of fractional carbon dioxide (CO2) laser. Settings of 20 watts of power, 600 μm of spacing, 800 μs of dwell, time stack 2 (Smartxide DOT, DEKA, Florence, Italy) were used. The sessions were performed monthly. Significant improvement of the esthetic appearance was observed after three sessions. There was a decrease of visible syringomas associated with an evident improvement of the skin texture, skin quality and flaccidity. No side effects were observed. We suggested continuing the treatment but the patient was satisfied with the current aspect and result. In conclusion, fractional CO2 laser represents an effective treatment option for the treatment of periorbital syringomas.

  • Open Access

    Case Reports

    Article ID: 167

    A novel surgical method for total nail ablation: Use of triple flap technique

    by Berna Aksoy

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 2567 Views

    Total nail ablation for the treatment of onychodystrophies can be performed by using chemicals, surgical resection or laser ablation of nail matrix. A female patient with bilateral severe onychodystrophy as a result of inadvertent previous nail surgeries was treated surgically. Proximal complete nail matrix resection and distal 10 mm wide transverse strip partial nail bed resection were performed. A 5 mm wide transverse strip of nail bed was left intact proximally. Proximal nail matrix defect was closed by using the skin of proximal nail fold. The distal nail bed defect was reconstructed by using triple flap technique which was composed of a main central advancement flap containing ventral toe skin and two side flaps containing nail fold skin. The patient healed without any problem and her nail problem was treated successfully. The cosmetic appearance of her first toes was acceptable. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation. 

  • Open Access

    Short Communications

    Article ID: 123

    The story behind cryosurgery

    by Sara Mohamed Ibrahim Awad

    Journal of Surgical Dermatology, Vol.6, No.2, 2021; 2465 Views

    Cryosurgery is used to describe the controlled destruction of tissue by freezing. Today, cryosurgery is widely practiced in medicine, so it would be interesting to know how the story of cryosurgery began. Here are some short stories behind the discovery and evolution of cryosurgery.