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  • 机译 化妆品程序皮肤病学教育:居民的经验和看法
    摘要:Background: Currently, dermatology residency training requires minimal experience in cosmetic procedures which can be achieved through observation. Objective: To assess education in and expectations for cosmetic procedures during dermatology residency. Materials and Methods: A 20-question survey was electronically distributed to 138 Accreditation Council for Graduate Medical Education–accredited dermatology residency training programs. Results: One hundred fifty surveys were returned. While 74 percent of the responding residents reported plans to integrate cosmetic procedures into their future practice, only 36 percent felt adequately trained. Forty-eight percent of residents received one or less didactic lectures annually. Over 95 percent of residents felt that a more formal curriculum in cosmetic procedures would benefit residency education. Conclusion: There appears to be insufficient didactic and clinical training in cosmetic procedures during dermatology residency to meet resident expectations and future practice habits.
  • 机译 越南退伍军人中无数鳞状细胞癌暴露于化学脱叶剂
    摘要:Objective. We present a successful multidisciplinary treatment approach used for a patient with rapidly developing, high-volume, and high-risk squamous cell carcinomas (SCCs), addressing short-term treatment, long-term maintenance, and appropriate preventative strategies in a difficult patient population. Case report. An immunocompetent, 84-year-old, Caucasian man with at least 30 SCCs of the scalp, head, neck, and upper extremities, including a 4-cm SCC on the vertex of the scalp infiltrating to the periosteum, presented to a cutaneous oncology clinic. Initial physical examination revealed nearly confluent, erythematous, hyperkeratotic, crusted papules and plaques on the head, neck, back, arms, and dorsal hands, all of which were clinically obvious SCC. Nonlesional skin displayed widespread epidermal dysplasia. The patient was seen by the clinic’s medical oncology and dermatology teams in coordinated dual visits. The invasive scalp lesion was treated by Mohs surgery and radiation, and the large SCC and field cancerization were successfully treated with a combination of topical and intralesional 5-fluorouracil with pulsed oral capecitabine, which resulted in a significant reduction in SCC disease burden. Conclusion. Management of patients with overwhelming numbers of SCCs is extremely challenging. Combination topical and/or intralesional 5-fluorouracil and oral capecitabine may be considered as part of the management approach when mechanical destruction and surgery alone are not feasible. Multidisciplinary care coordinated between the surgeon, dermatologic oncologist, medical oncologist, and radiation oncologist is essential for providing comprehensive treatment and deploying preventative strategies in this population at high risk for metastatic SCC formation.
  • 机译 寻求面部容量增强的患者自我注射局部皮肤制剂的病例报告
    摘要:A 25-year-old man seeking increased prominence of the cheeks self-injected a topical skin preparation containing hyaluronic acid into his malar soft tissues. Labeling and marketing of the product, which highlighted the hyaluronic acid as one of the ingredients, might have contributed to his misunderstanding of the intended use for the product. Additionally, a popular medical-based talk show and numerous videos online contributed to the errant belief that self-administration was a viable option. Complications from the injection of nonpharmaceutical substances of this type and implications for treatment in clinical practice are discussed.
  • 机译 po白菜提取物(PLE):新研究提供了基于证据的洞察力,“没有什么比真实的东西更重要”
    • 作者:James Q. Del Rosso
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2019年第8期
    摘要:Polypodium leucotomos is widely available as an oral supplement and has been shown to exhibit photoprotective properties which might provide adjunctive benefit when used along with topically applied suncreens. However, data are lacking with the majority of Polypodium leucotomos formulations (including extracts) related to their quantitative and qualitative polyphenol content and specific photoprotective properties. This article reviews results from a study of six different Polypodium leucotomos extract formulations, comparing their polyphenol and excipient contents and specific photoprotective properties. Consistency was observed primarily with one specific brand of Polypodium leucotomos extract oral capsules, which is also supported by a large body of published evidence.
  • 机译 关于最近发表的有关胺戊酸的安全性和有效性的文章10%局部凝胶与胺戊酸的20%蓝光光动力疗法之后的解决方案
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  • 机译 致编辑的信
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  • 机译 嗜麦芽窄食单胞菌感染绿色指甲
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  • 机译 细分和微针作为廉价且安全的组合治疗深色皮肤萎缩性痤疮疤痕:三级护理中心的45名患者的前瞻性研究
    摘要:Background: Acne scars are the most common sequele of the inflammatory process of acne and affects almost 95 percent of the patients with acne vulgaris. Hypertrophic scars and keloid scars result from excessive tissue formation; atrophic scars are characterized by loss or damage of tissue, which are further categorized into ice pick, rolling, and boxcar scars. Method: A total of 45 patients underwent four sessions, four weeks apart, of subcision and microneedling and were assessed for scar grading three months after the final treatment session. Results: Overall improvement was seen in 95.6 percent of patients (improvement by at least 1 grade) with slight erythema, edema and pain for 1 to 2 days. The improvement correlated with the patient-reported assessment of improvement in scars; 17.8 percent of patients perceived a 75- to 100-percent improvement in their acne scars, while 24.4 percent of patients perceived an improvement of 50 to 74 percent. The majority of the patients (55.5%) perceived an improvement of 25 to 49 percent in their scars. Conclusion: Rolling and boxcar scars show more improvement compared to ice-pick scars. This combination is well tolerated in Fitzpatrick Skin Types III, IV and V, with no failure rates. We observed a high level of patient satisfaction and minimal downtime.
  • 机译 正常皮肤受试者的卵泡荧光与休闲皮脂水平的相关性
    摘要:Background: Performing objective measurements of skin oiliness requires a device that can directly measure the sebum level on the skin surface, while ultraviolet-induced red fluorescence (UVRF) can be used to indirectly assess the oiliness on the skin. There have been reports showing the association between these two methods in subjects with oily skin, acne-prone skin, but not in subjects with normal skin. Objectives: We sought to study the association between UVRF and casual sebum level in terms of assessing the facial oiliness in individuals with normal skin. Materials and Methods: Thirty subjects with normal skin were recruited for measurements of both casual sebum level and UVRF (porphyrin count) on specified areas of the face (i.e., forehead, nose, and cheek). Results: There were very strong positive correlations with statistical significance in the areas of the forehead, nose, and cheeks (r=0.88, p<0.001; r=0.89, p<0.001; and r=0.95, p<0.001, respectively) when porphyrin counts in each area were compared to those of the whole face. Porphyrin counts were also positively correlated with the casual sebum level with statistical significance on the cheeks (r=0.43, p=0.02), while the forehead and nose showed more modest correlations without statistical significance (r=0.35, p=0.06 and r=0.36, p=0.05, respectively). Conclusions: UVRF is correlated with casual sebum level. It might be useful for evaluating the facial oiliness of people with normal skin.
  • 机译 吸烟和饮酒对妇女面部老化的影响:大型跨国,多种族,横断面调查的结果
    摘要:Objective: Data on associations between facial aging and smoking or alcohol consumption are generally derived from small studies, and therefore, vary. The aim of this large multinational study was to determine more accurately which clinical signs of skin- and volume-related facial aging are associated with tobacco and alcohol use in women. Design: This was a subanalysis of a global, cross-sectional, Internet-based survey of self-reported facial aging. Participants: Women aged 18 to 75 years old (n=3,267) from the United States, Australia, Canada, and the United Kingdom who described themselves as white, Asian, black, or Hispanic were included. Measurements: Using a mirror, participants determined their own aging severity on photonumeric rating scales for 11 facial characteristics. Linear regressions were used to assess associations between each feature’s severity and smoking status (never vs. current and former smoker); smoking pack years (0 versus 1–10, 11–20, and >20 years); alcohol use (none vs. moderate and heavy); and alcoholic beverage type, after controlling for body mass index, country, age, and race. Results: Smoking was associated with an increased severity of forehead, crow’s feet, and glabellar lines; under-eye puffiness; tear-trough hollowing; nasolabial folds; oral commissures; perioral lines; and reduced lip fullness (p≤0.025) but not midface volume loss or visible blood vessels. Heavy alcohol use (≥8 drinks/week) was associated with increased upper facial lines, under-eye puffiness, oral commissures, midface volume loss, and blood vessels (p≤0.042). Conclusion: Smoking and alcohol consumption significantly but differentially impact skin and volume-related facial aging.
  • 机译 定义,与恶性肿瘤的关联,生物学行为和异位乳腺Paget病的治疗:文献综述
    摘要:Background: Extramammary Paget’s disease (EMPD) is a rare neoplasm that affects apocrine gland-bearing skin. Patients usually present with a long-standing, unilateral, ill-defined, erythematous, crusted patch or plaque. In certain cases, this disease can be associated with internal malignancy. EMPD arising in anatomic areas devoid of apocrine glands is exceedingly rare and is termed ectopic extramammary Paget’s disease (E-EMPD). Objective: We discuss the classification, origin, and management of E-EMPD. Methods: We reviewed the literature and herein discuss the reported cases of true E-EMPD. Discussion: Forty-five cases of E-EMPD disease were identified in the literature. The etiology and pathophysiology are largely unknown. Based on there only being one reported case of lymph node metastasis and associated underlying malignancy identified, compared to EMPD, ectopic lesions appear to be less aggressive. Various treatment options have been reported, with surgical removal being the preferred method of treatment. Conclusion: E-EMPD is a rare neoplasm that manifests in areas without apocrine glands. With adequate formal data unavailable, the authors recommend that a diagnosis of E-EMPD warrants a focused malignancy screening. Surgical excision is the most common first-line treatment. Further research is needed regarding the etiology, biologic behavior, and treatment of E-EMPD.
  • 机译 安全有效地使用成纤维细胞和脂肪来源的(但不是骨髓来源的)间充质干细胞分泌蛋白用于皮肤治疗
    • 作者:Greg Maguire
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2019年第8期
    摘要:Stem cell-based products are rapidly emerging in the marketplace as topical skin care and wound care products. Confusion is prevalent among healthcare providers and end-users about these products. Adipose-derived stem cells, fibroblasts, platelets, and bone marrow-derived stem cells are the most common cells used for stem cell therapeutic development, medical procedures, and skin care products. In this review, the significant advantages of adipose-derived stem cells and fibroblasts in terms of safety and efficacy are highlighted and compared to relatively risky platelets and bone marrow stem cells.
  • 机译 氨甲环酸治疗黄褐斑:评估各种配方
    摘要:Melasma is a common dermatological condition that can be notoriously difficult to treat. Topical bleaching agents and strict photoprotection, in addition to adjuvant treatment modalities, such as chemical peels and laser treatments, have been shown to provide only minimal improvements in the condition. Recently, tranexamic acid has shown promise. Topical, intradermal, and oral formulations of tranexamic acid have been studied, with oral formulations demonstrating the greatest, albeit temporary, improvement. In this brief review, we discuss the different formulations of tranexamic acid for melasma and offer suggestions for future directions of research.
  • 机译 黑色素瘤和甲状腺癌:我们目前的理解
    摘要:Melanoma is listed among the most common cancers in the United States, with new cases increasing steadily. Due to the aggressive nature of melanoma and its high risk of metastasis, early detection and treatment is essential. It is noted that the majority of unresectable and metastatic melanomas are BRAF V600-mutated. Recently, rates of papillary thyroid carcinoma have also been increasing. Studies have indicated BRAF V600-mutations are common in papillary thyroid carcinoma, second only to melanoma. The BRAF mutation in thyroid carcinoma similarly portends more aggressive behavior. The association between melanoma and thyroid disease was noted in several patients in our clinic and fueled our literature review in an attempt to better understand this clinical observation. A systematic English-language literature review was performed using PubMed Central and ScienceDirect online databases. Search parameters included articles published from January 2000 to July 2018 and key search terms were melanoma and thyroid carcinoma and BRAF mutation and thyroid cancer. The initial search yielded 2,470 and 234 articles in each respective database. Articles that lacked relevant information were excluded. The literature we reviewed supports our theory that thyroid dysfunction is disproportionately noted among patients with a history of melanoma. In order to detect disease early, it is critical for dermatologists, internists, family practitioners, endocrinologists, and oncologists to be aware of the association between these two primary malignancies when proceeding with appropriate screening examinations.
  • 机译 注射透明质酸以矫正鼻喉沟后长时间的牙周水肿
    摘要:The injection of hyaluronic acid (HA), a naturally occurring biopolymer, is a common cosmetic procedure. Despite their efficacy and growing adaptation by the medical community, HA fillers occasionally give rise to adverse events. Adverse events from HA fillers range from temporary, such as edema and erythema, to more long-term effects, including granulomas or, in rare cases, sequelae from vascular occlusion. Here, we present a case of a 61-year-old Caucasian woman with prolonged infraorbital hollow edema after injection of HA filler for nasojugal groove correction. We review the anatomy of the nasojugal area and differing injection techniques as a possible explanation for the development of prolonged edema. Similarly, the rheological properties of the specific hyaluronic acid used during this procedure might be crucial in the development of this complication.
  • 机译 红斑狼疮扁平苔藓样综合征鳞状细胞癌
    摘要:Lupus erythematosus lichen planus (LE-LP) overlap syndrome remains an uncommon diagnostic entity, combining both the histologic and clinical features of lupus erythematosus and lichen planus. A rare and challenging diagnosis, clinicopathologic correlation is essential for accurate and timely identification. Histologically, superficial evaluation of lupus erythematosus lichen planus overlap syndrome can mimic squamous cell carcinoma due to the presence of squamatized keratinocytes with concomitant irregular acanthosis. Here, we present a case of LE-LP overlap syndrome in a patient with long standing systemic lupus erythematosus initially misdiagnosed as squamous cell carcinoma.
  • 机译 转移性肌上皮癌的异常表现和侵袭性过程
    摘要:Myoepithelial carcinomas are rare tumors that make up 1 to 2 percent of all salivary gland neoplasms. We present a case of a 55-year-old man with myoepithelial carcinoma that developed into widespread cutaneous, lung, and brain metastases refractory to treatment, including newer immunotherapies. Newer strategies or treatments are needed for the future benefit of patients with advanced disease.
  • 机译 MICHAEL JACKSON和WINNIE HARLOW效应:对互联网上的VITILIGO AWARENESS的影响
    • 作者:Nicolas Kluger
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2019年第9期
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  • 机译 一缝制毛边修复:怎么做?
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  • 机译 短期接触他扎罗汀乳液的生物利用度,药代动力学和表皮失水0​​.1%与他扎罗汀(Tazorac®)乳霜0.1%
    摘要:Objective: Two clinical studies were conducted to 1) assess the pharmacokinetic (PK) properties of tazarotene and tazarotenic acid in DFD-03 lotion (a 1-minute, short-contact formulation for the topical treatment of acne vulgaris) and tazarotene cream 0.1% and 2) to evaluate transepidermal water loss (TEWL) with DFD-03 lotion, tazarotene gel (0.1%), or vehicle. Design: The PK study included a single-center, randomized, multiple-dose, laboratory-blinded, open-label, parallel-design, and the TEWL study included a multiple-dose, within-subject comparison design. Participants: The PK study included healthy adult men aged 18 to 40 years (n=43), and the TEWL study included healthy adults, male or female, aged 18 to 40 years (n=24). Measurements: PK was assessed via Cmax, AUC0-12, AUC0-24, Tmax, Cmin, Tmin, and fluctuation. TEWL was assessed via evaporimetry. Results: Tazarotene levels were very low due to rapid esterase hydrolysis to the primary active metabolite, tazarotenic acid. Tazarotenic acid AUC0-24 ratios (%) were at least two times higher when the test product was applied twice daily (Treatment-1) versus once daily (Treatment-2) on Days 7 and 14 (268.73% and 254.42%, respectively). Tazarotenic acid AUC0-24 ratios (%) were nearly 100 percent for Treatment-1 versus once-daily tazarotene cream 0.1% (Treatment-3) (99.36% and 83.21%, on Days 7 and 14, respectively). Starting on Day 7, DFD-03 lotion TEWL readings were significantly greater than vehicle (p≤0.05), except for on one study day. DFD-03 lotion TEWL readings were numerically greater (nonsignificant) than tazarotene gel. Conclusion: DFD-03 lotion was well-tolerated, increased TEWL when applied twice daily for one minute, and had a PK profile with similar overall exposure as compared with commercially available tazarotene formulations applied once daily for 12 hours.

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