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  • 1.

    【2hr】Progressive Facial Papules in an African-American Patient

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    机译 一名非裔美国人患者的进行性面部年轻人
    摘要：This case report highlights a unique variant of seborrheic dermatitis (SD) in a 30-year-old African-American woman with progressive facial papules. Four weeks of uninterrupted mild potency topical corticosteroid therapy produced marked improvement of signs and symptoms of biopsy-confirmed SD. SD mimicking cutaneous sarcoidosis is a unique treatment-responsive variant of SD that may be more likely to be encountered in African-American patients.
  • 2.

    【2hr】This month’s guideline: Management of Necrosis

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    机译 本月指南：坏死的管理
    • 作者：Martyn King
    • 刊名：The Journal of Clinical and Aesthetic Dermatology
    • 2018年第7期
    摘要：
  • 3.

    【2hr】Regarding Statement from FDA Commissioner on New FDA Actions to Keep Consumers Safe from the Harmful Effects of Sun Exposure, and Ensure the Long-Term Safety and Benefits of Sunscreens

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    机译 关于FDA专员关于新FDA行动的声明，以使消费者免受日晒的有害影响并确保防晒霜的长期安全性和益处
    • 作者：Ann M. Smith
    • 刊名：The Journal of Clinical and Aesthetic Dermatology
    • 2018年第7期
    摘要：
  • 4.

    【2hr】What Health-related Quality of Life Factors Influence the Decision of Patients with Acne to Visit a Dermatologist?

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    机译 哪些健康相关的生活质量因素会影响痤疮患者看皮肤科医生的决定？
    摘要：Background: Acne is a common dermatologic disease that can have a profound negative impact on a patient’s health-related quality of life (HRQoL). HRQoL correlates with acne severity in some, but not all, studies. In other words, patients with the same level of acne severity might experience different levels of impact on their HRQoL. Objective: We aimed to determine which HRQoL factors are negatively affected most in patients with acne who seek dermatologic consultation and treatment for their acne. Methods: One hundred patients with acne who sought treatment from a dermatologist (“active” patients) and 159 students with a confirmed diagnosis of acne (“passive” patients) who had not sought treatment from a dermatologist were assessed for HRQoL. To avoid differences in acne severity and possible sex differences, patients were matched according to acne severity grade (mild, moderate, or severe) and sex. All patients completed the Dermatology Quality of Life Index (DLQI) and Cardiff Acne Disability Index (CADI) questionnaires. Results: After matching, 75 active patients and 75 passive patients were selected (mean age: 22.04±4.26 years and 21.00±1.82 years, respectively; 11 male and 64 female patients in each group). Total DLQI and CADI scores were significantly higher in “active” patients. All CADI items and seven (out of 10) DLQI items were more affected by acne in the active group compared to the passive group. A significantly greater number of passive patients reported no effect on their HRQoL, compared to the active group, and a significantly greater number of active patients reported that acne had a moderate effect on their lives, compared to the passive group. Conclusion: Our study demonstrated that the effect acne has on HRQoL is a strong predictive factor for patients seeking dermatological consultation, independent from disease severity. Embarrassment; self-consciousness; aggression and frustration; difficulties in social and leisure activities; difficulties in significant relationships with others, including partners, close friends, and/or relatives; and self-assessment of the current state of the skin were the most important predictive factors that influenced the decision for patients with acne to seek treatment from a dermatologist.
  • 5.

    【2hr】Wash-Line Dermatitis: A Diagnostic Clue

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    机译 冲洗线性皮炎：诊断线索
    摘要：
  • 6.

    【2hr】Patterns of Over-the-counter Lightening Agent Use among Patients with Hyperpigmentation Disorders

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    机译 色素沉着过度患者中非处方美白剂的使用方式
    摘要：Background: Over-the-counter (OTC) lightening agents are commonly used to treat hyperpigmentation disorders. Objective: We sought to determine the characteristics, trends, and preferences of patients with hyperpigmentation disorders seeking OTC agents in the United States. Design: The study was a cross-sectional study of consecutive patients with a disorder of hyperpigmentation seen in a United States-based outpatient dermatology clinic. Multivariable logistic regression models were used to identify factors associated with the use of OTC lightening agents. Setting: The study setting was an outpatient US-based dermatology clinic in Boston, Massachusetts. Results: Of the 406 patients studied, the majority were women (88.9%) with Fitzpatrick Skin Types IV to VI (64.5%). The most frequent diagnoses were melasma (42.9%) and post-inflammatory hyperpigmentation (PIH, 33.9%). Of our responders, 51.0 percent reported use of OTC agents and 44.9 percent reported use of prescription lightening products. Hydroquinone was the most commonly used cream (59.1%), followed by triple combination cream (fluocinolone acetonide, hydroquinone, and tretinoin, 16.3%). Of the cohort, 28.9 percent felt that the greater expense of the product correlated with greater efficacy. After multivariable adjustment, factors associated with a greater odds of using an OTC lightening agent included having a diagnosis of melasma (odds ratio [OR] 5.36; 95% CI: 2.98, 9.63; P<0.01) or PIH (OR 2.38; 95% CI: 1.25, 4.53; P≤0.01). Conclusion: The use of OTC lightening agents is widespread among those patients with hyperpigmentation disorders who reside in the United States. Those with melasma and PIH were more likely to use an OTC lightening cream. The majority of patients believed that OTC creams were safe to use without physician supervision. In those who had also tried prescription products, triple combination was deemed most effective compared to other lightening agents.
  • 7.

    【2hr】MauiDerm for Dermatologists:

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    机译 毛伊皮肤科医生
    • 作者：
    • 刊名：The Journal of Clinical and Aesthetic Dermatology
    • 2018年第5 Suppl期
    摘要：
  • 8.

    【2hr】Erratum

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    机译 勘误表
    • 作者：
    • 刊名：The Journal of Clinical and Aesthetic Dermatology
    • 2018年第10期
    摘要：
  • 9.

    【2hr】Process of Post-operative Telephone Follow-up Implementation for Mohs Micrographic Surgery

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    机译 Mohs显微外科手术后电话随访实施过程
    摘要：Objective: The purpose of this study was to describe and evaluate the process of implementing a routine telephone follow-up (TFU) system for capturing postoperative complications or concerns among Mohs micrographic surgery (MMS) patients. Design: Postoperatively, patients were called twice: 1) within 24 to 48 hours to assess bleeding, swelling, and pain control; and 2) at one week to assess wound care, signs of infection, or other concerns. Setting: The study took place in a single-institution academic dermatology department with five fellowship-trained Mohs surgeons. Participants: Study subjects included patients undergoing MMS during a two-month period. Measurements: Data regarding completed TFU rate, time to complete calls, and patient-reported complication rates were collected and analyzed. Results: Of 349 MMS patients, 263 (75.4%) were successfully contacted during the 24- to 48-hour follow-up window and 232 (66.5%) at the one week interval. Major complication rates were 0.4 percent (n=1) for bleeding and 0.4 percent (n=1) for infection; both were treated by their respective Mohs surgeon. Timed calls averaged approximately three minutes per encounter. Conclusion: TFU is practical and efficient for assessing and mitigating MMS postoperative complications.
  • 10.

    【2hr】Split-face Evaluation of a Multi-ingredient Brightening Foam Versus a Reference Control in Women with Photodamaged Facial Skin

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    机译 面部光损伤女性多成分增白泡沫与参考对照的分面评估
    摘要：Background: The gold standard for the treatment of hyperpigmentation is hydroquinone (HQ), which has been available as a skin lightener for more than 50 years. Numerous clinical studies have proven its efficacy in various topical formulations. In the United States, HQ is available as a nonprescription product in 2% formulations and as a 4% prescription product. Objective: This study compared the safety and efficacy of a 2% hydroquinone multi-ingredient foam with a standard 4% hydroquinone cream on photodamaged facial skin. Methods: A 12-week, investigator-blinded, randomized trial with a split-face design was conducted in women with moderate photodamaged facial skin. Results: Both products improved the appearance of photodamaged facial skin and were well-tolerated. No statistically significant changes were seen between treatments during the efficacy or tolerability evaluations. Conclusion: Both treatments (2% HQ Brighten and 4% HQ) improved the appearance of photodamaged facial skin and were well-tolerated and results well-perceived by subjects over the 12-week treatment period, compared with baseline grading scores.
  • 11.

    【2hr】Patient-perceived Emotional and Functional Benefits of Poly-L-Lactic Acid (PLLA) for the Treatment of Facial Volume Loss

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    机译 患者感觉到的聚L-乳酸（PLLA）在面部体积损失治疗中的情感和功能优势
    摘要：Background: Facial volume loss can substantially impact self-perception of the affected individual and his to her social/professional interactions and opportunities. Persons who are perceived as more youthful and attractive are rated as nicer, more energetic, healthier, and more likely to be productive than those perceived to be older and unattractive. Objective: The goal of this study was to assess the changes in emotional and functional status of subjects treated with 2 to 4 monthly PLLA injections to the upper, mid, and lower face. Methods: Fifty subjects were recruited from two community dermatology centers in the United States (Bucks County, Pennsylvania, and Spokane, Washington). Two patient self-report measures were used—The Facial Volume Restoration Outcome Questionnaire and the Rosenberg Self Esteem Scale. Results: Approximately 30 percent of the subjects who completed pre- and post-injection instruments reported increased confidence, increased sense of control, more comfort with others, increased happiness when looking in the mirror, more happiness when their faces were touched, healthier eating, increased contentment, beliefs that they were seen as less stressed by others, increased happiness with their bodies, exercising more, and that their lives were better. Additionally, 43 percent felt more optimistic and 33 percent felt less anxious. The changes in self-esteem, which was self-reported on the Rosenberg scale, were very modest but also favorable. Investigator’s Global Assessment (IGA) of facial volume loss improved from 2.2 at baseline to 1.2 at six-month follow-up assessment. Conclusion: Treatment of facial volume loss with PLLA was associated with improvements in patient-perceived emotional and functional status at six months after initial injection.
  • 12.

    【2hr】Effectiveness of Topical Onion Extract Gel in the Cosmetic Appearance of Blepharoplasty Scar

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    机译 局部洋葱提取物凝胶在眼睑整容疤痕美容外观中的功效
    摘要：Objectives: Topical onion extract gel is commonly used in commercial anti-scar medications. The purpose of this study was to evaluate the effectiveness of topical onion extract gel on the appearance of blepharoplasty scars and to compare the results of its use to those of petroleum jelly. Design: The participants enrolled in this prospective, double-blind study were randomly treated with either topical onion extract gel or petroleum jelly. The products were applied twice daily for two months following suture removal. Patients were evaluated objectively using the Manchester Scar Scale at the end of treatment. Six months after surgery, a follow-up phone interview was conducted. Setting: The study was carried out in the Khalili and Dastghaib Hospitals in Shiraz, Iran. Participants: Out of 43 participants who had upper blepharoplasty, 26 patients completed the follow up. Measurements: The Manchester Scar Scale evaluates five different characteristics of scar: color (score: 1–4), distortion (score: 1–4), contour (score: 1–4), texture (score: 1–4), and transparency (score: 1–2). A visual analogue scale (VAS) was also used to quantify the overall scar appearance on a range of 0 to 10 (with the highest number indicating the worst appearance). The scores for the five different parameters and the VAS were calculated and compared. Results: There was no statistically significant difference in overall cosmetic appearance objectively and/or subjectively between the two sides (p value: 0.25). Conclusion: Topical onion extract gel was ineffective in improving overall blepharoplasty scar appearance when compared with a petroleum-based ointment.
  • 13.

    【2hr】Androgenetic Alopecia Treatment in Asian Men

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    机译 亚洲男性雄激素性脱发的治疗
    摘要：Background: Androgenetic alopecia (AGA) is a common form of hair loss in Asian men. Although AGA is often regarded as a relatively minor dermatological condition, hair loss can impact self-image and is a main cause for anxiety and depression in some men. We have treated patients with AGA for seven years. Objective: The goal of this study was to evaluate the effectiveness of our combination therapy in Asian men with AGA. Participants: Between the years 2011 and 2017, 18,918 male patients were treated in our center. Our combination therapy consists of oral finasteride once daily, oral and topical minoxidil twice daily, and an injectable treatment of lidocaine and an AGA treatment solution comprising minoxidil, arginine, aspartic acid, caffeine, copper tripeptide, lysine, niacin, panthenol, propanediol, propylen glycol, retinyl palmitate, pyridoxine, sodium hyaluronate, and ubiquinone once monthly for more than six months. Measurements: Digital photographs were taken pre- and post-treatment, and patient assessments were recorded after six and 12 months post-treatment. Results: Significant improvement was observed in all patients in the digital photographs. Ninety-six and 80 percent of the patients reported satisfaction with the results of the treatment after six and 12 months post-treatment. Minor complications were observed in 802 (4.2%) patients, characterized by slight pain and bleeding due to injection, swelling, dizziness, itching, and erythema of the scalp. Slight pain was reported in 651 patients (3.4%), and slight bleeding was reported in 56 patients (0.3%). Sexual dysfunctions were uncommon. These minor complications resolved spontaneously. No treatment-related adverse events were observed. Conclusion: A combination of these therapeutic options offers safe and highly efficacious treatment for AGA with minimal complications.
  • 14.

    【2hr】Detection of Angiotensin II and AT1 Receptor Concentrations in Keloid and Hypertrophic Scar

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    机译 瘢痕loid和肥厚性瘢痕中血管紧张素II和AT1受体浓度的检测
    摘要：Background: Keloid and hypertrophic scars (HTS) are formed by excessive collagen formation. Angiotensin II, through the AT1 receptor, plays an important role in extracellular matrix production. However, less is known about angiotensin II and AT1 receptor concentrations in HTS and keloid tissues. Objective: The purpose of this study was to determine the angiotensin II and AT1 receptor concentrations in keloid, HTS, and normal skin tissues. Methods: Skin biopsy samples from patients with HTS (n=26), keloid (n=20), and normal (n=30) skin tissues were evaluated for angiotensin II and AT1 receptor concentrations by use of the enzyme-linked immunosorbent assay technique. Results: The angiotensin II concentration in patients with HTS was higher than that in the normal (P<0.0067) and keloid (P>0.9553) groups, while the AT1 receptor concentration in patients with keloid was higher than that in the HTS (P<0.0001) and normal (P<0.0048) groups. Conclusion: Angiotensin II and AT1 receptor concentrations could stimulate the formation of HTS and keloid. Angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors may be suitable compounds for the treatment of scar tissue.
  • 15.

    【2hr】The Association of Various Metabolic Parameters with Multiple Skin Tags

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    机译 各种代谢参数与多个皮肤标签的关联
    摘要：Background: Skin tags (STs) are benign skin lesions. Their definite etiology remains unknown. We aim to examine the association of obesity, diabetes mellitus, hyperlipidemia, thyroid abnormalities, acanthosis nigricans, and multiple STs in a Greek primary population. Methods: Phototype and body weight were recorded. Fasting serum blood samples were analyzed for cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, glucose, and thyroid-stimulating hormone. Univariate ordinal logistic regression multivariate analysis was performed. Results: The univariate analysis showed that patients who were overweight with Fitzpatrick Skin Type III, acanthosis nigricans, and hypothyroidism were more likely to present with multiple skin tags as compared with patients at a normal weight with Skin Type I. Statistically significant associations were also found with the presence of cholesterol and triglycerides. In the multivariate analysis, a significant association between hypercholesterolemia and STs was demonstrated. Those with skin tags were more likely to have hypothyroidism. Conclusion: STs are often associated with obesity. An association between lipid profile and STs has been reported. Multiple STs have been independently associated with acanthosis nigricans. Although a possible relationship between STs and thyroid disease has not yet been proved, our review reveals a possible trend. Future investigations with larger sample sizes might clarify the association between skin tags and hypothyroidism.
  • 16.

    【2hr】Hidradenitis Suppurativa: Causes, Features, and Current Treatments

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    机译 化脓性汗腺炎：病因，特征和当前治疗方法
    摘要：Hidradenitis suppurativa (HS), a relatively common and chronic inflammatory skin disorder. HS can have debilitating consequences if not diagnosed and treated appropriately. Clinically defined by recurrent, inflamed nodules in intertriginous regions (i.e., axillary, inguinal, and perianal areas), HS can cause intense pain and, in severe disease stages, lead to the formation of fistulas, sinus tracts, and extensive scarring. Postpubertal onset and female preponderance further characterize HS. Numerous pathogenic mechanisms have been proposed in HS, including immune dysregulation, genetics, smoking, and obesity; however, the exact etiology remains to be elucidated. The association of HS with inflammatory bowel disease, cardiovascular disease risk factors, and psychiatric disorders suggests HS is a systemic disease. HS significantly impairs quality of life in patients in excess versus other skin diseases. Unfortunately, experiences indicate long diagnostic delays, which in many cases might be due to disease unawareness among physicians. Increased knowledge of HS is therefore important in order to optimize disease management and ultimately improve the quality of life of patients.
  • 17.

    【2hr】Examining Dermatologist Use and Opinions of Ultraviolet Radiation for Cosmetic and Medical Purposes

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    机译 检查皮肤科医生在化妆品和医疗用途中的使用和紫外线辐射的观点
    摘要：BACKGROUND: The commercial tanning industry has opposed efforts to educate the public on the risks of tanning as well as attempts to restrict minors’ access to tanning services. Despite a paucity of supporting literature, statements from the tanning industry claiming that dermatologists routinely use in-office phototherapy for cosmetic treatments and refer patients to tanning salons have successfully derailed and defeated legislation in many states. OBJECTIVE: This study aims to evaluate dermatologist referrals for ultraviolet radiation for cosmetic and medical purposes via tanning beds or phototherapy, as well as their opinions on tanning, legislation, and ultraviolet radiation counseling practices. DESIGN: The study was conducted using a 10-question anonymous survey. SETTING: The participants were surveyed during meetings of three regional dermatologic societies. PARTICIPANTS: One hundred and fifty-two dermatologists attending society meetings participated in the study. MEASURES: The authors measured physician referrals, opinions, and recommendations regarding ultraviolet exposure. RESULTS: Zero physicians (0/152) recommended tanning salons for cosmetic reasons. These 152 dermatologists referred 458 (417 adult, 41 pediatric) out of an estimated 809,369 patients (0.057%) to tanning salons for medical treatment. Of these physicians, 76 out of 152 and 15 out of 152 reported referring at least one adult or one pediatric patient, respectively, within the last year. All respondents supported ultraviolet tanning legislation and discouraged cosmetic tanning. CONCLUSION: These findings directly contradict the assertion that dermatologists use ultraviolet radiation for cosmetic purposes or routinely refer patients to tanning salons. This study underscores the complex nature of ultraviolet radiation, as dermatologists infrequently utilize ultraviolet radiation for medical purposes and unanimously support restrictive legislation. In addition, these dermatologists counsel against cosmetic tanning and list tanning bed use among their highest concerns with regard to the health of pediatric patients.
  • 18.

    【2hr】Blaschko-linear “Congenital Mixed Hemato-lymphangio-keratoma Serpiginosum” Naeviforme

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    机译 Blaschko-线性“先天性混合血红蛋白-角膜性角膜病Serpiginosum”
    摘要：We present the case of a 15-year-old girl who presented with an unusual grouping of lesions on her upper left leg. The lesions had been present since birth. The patient had five different types of lesions: 1) transparent grouped or scattered yellowish vesicles; 2) keratotic-surfaced, grouped dark-yellowish papules; 3) bright-red grouped papules; 4) keratotic-surfaced grouped dark-red papules; and 5) patchy, punctate, and erythematous red macules. All of the lesions were intertwined along the lines of Blaschko and were in the form of irregular serpiginous plaques. Histopathological examinations of the lesions showed three main histological features, and diagnoses of the lesions were made as lymphangioma circumscriptum, lymphangiokeratoma, and verrucous hemangioma. To the best of our knowledge, such intertwined lesions have never been reported in the literature. Hence, we suggest that the name of this unique combination of lesions be “congenital nevoid mixed hemato-lymphangio-keratoma serpiginosum.”
  • 19.

    【2hr】Quality of Life in Individuals with Erythematotelangiectatic and Papulopustular Rosacea

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    机译 红细胞毛细血管扩张和丘疹性酒渣鼻患者的生活质量
    摘要：OBJECTIVE: The objective of the study was to evaluate the impact of rosacea on self-perception, emotional, social, and overall well-being and quality of life in individuals with erythematotelangiectatic rosacea (ETR) and papulopustular rosacea (PPR). DESIGN: We distributed a cross-sectional email invitation for participants in the United States to fill out a web-based survey. PARTICIPANTS: We included adults who reported having previously received a diagnosis of erythematotelangiectatic rosacea or papulopustular rosacea. MEASUREMENTS: Questionnaires measured the psychosocial aspects of rosacea, including the Satisfaction With Appearance Scale and modified Satisfaction With Appearance Scale questionnaires, Impact Assessment for Rosacea Facial Redness, Rosacea-Specific Quality-of-Life questionnaire, and RAND 36-Item Short Form Health Survey. The Impact Assessment for Rosacea Facial Bumps or Pimples was administered to the papulopustular rosacea cohort. RESULTS: Six hundred participants enrolled and completed the survey, with most rating their rosacea as mild or moderate (ETR: 95.6%; PPR: 93.7%). In the erythematotelangiectatic rosacea and papulopustular rosacea cohorts, respectively, 45 and 53 percent disagreed/strongly disagreed that they were satisfied with their appearance due to rosacea; 42 and 27 percent agreed/strongly agreed that they “worry how people will react when they see my rosacea”; and 43 and 59 percent agreed/strongly agreed that they feel their rosacea is unattractive to others. Rosacea-Specific Quality-of-Life total and domain scores indicated negative impact of rosacea for both cohorts. Both cohorts reported worse 36-item Short Form Health Survey overall and domain scores than population norms in the United States. CONCLUSION: Rosacea had wide-ranging, negative effects on self-perceptions and emotional, social, and overall well-being as well as rosacea-specific quality of life. Overall, both erythematotelangiectatic rosacea and papulopustular rosacea cohorts reported a substantial negative impact of rosacea on quality of life on a range of instruments.
  • 20.

    【2hr】Intralesional Injection of Triamcinolone Acetonide for Subcutaneous Lipoma causing Musculoskeletal and Neurologic Symptoms

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    机译 曲安奈德乙内酯的皮内脂瘤内注射引起肌肉骨骼和神经系统症状
    摘要：Objective: Benign subcutaneous lipomas can cause musculoskeletal pain and nerve impingement. We hypothesized that the potent lipolytic and atrophic effect of 40mg/mL triamcinolone acetonide would atrophy symptomatic lipomas so surgical excision could be avoided. Design: This was a cohort study. Setting: This study took place in an ultrasound injection clinic. Participants: Eight subjects with painful symptomatic lipoma were included. Measurements: Preprocedurally, the margins of the lipomas were palpated and marked with ink, then measured in centimeters (cm). Small lipomas (1–3cm) were injected with 40mg triamcinolone acetonide, while large lipomas (4–6cm) were injected with 80mg of triamcinolone acetonide. The subjects were reassessed at a four-month follow-up appointment and then again at one year and two years after the procedure. Results: Pre-injection, all eight subjects had symptoms related to impingement or pain with compression of the lipoma. At four months post-injection, none of the patients had symptoms attributable to the lipoma (p<0.001). The mean lipoma palpable dimension was 5.0±1.2cm prior to the injection and was 2.0±1.1cm at four months after the injection, with a significant mean 3.0±0.3cm (60%) reduction in lipoma dimensions (p<0.001). Two subjects demonstrated some mild hypopigmentation of the skin at four months post-injection. Within two years, three lipomas had symptomatically recurred, one of which was removed surgically and the two of which were reinjected. There were no infections or other serious adverse reactions that occurred. Conclusions: For individuals with painful subcutaneous lipoma, intralesional injection of 40mg/mL of triamcinolone acetonide is an effective and safe alternative to surgical excision or injection of sclerosing agents and should be considered as a reasonable therapeutic alternative in select patients.
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