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  • 机译 皮秒激光
    摘要:
  • 机译 脂溢性角化病的近距离观察:患者观点,临床相关性,医疗需求以及对管理的启示
    • 作者:James Q. Del Rosso
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2017年第3期
    摘要:The author sought to discover why seborrheic keratoses that are not symptomatic or clinically suspicious are not considered therapeutically important to most clinicians. The author conducted an office-based, observational study examining how the diagnosis of asymptomatic seborrheic keratoses personally affects patients and what these patients think concerning treatment. Many patients reported being bothered by the diagnosis of seborrheic keratoses, even when told it’s not cancerous, and indicated an interest in its treatment. Lack of insurance coverage for the treatment of non-symptomatic seborrheic keratoses may be the primary reason clinicians do not consider seborrheic keratoses therapeutically important, as clinicians often find the discussion of “self payment” with their patients to be awkward. Furthermore, patients may not understand the implications that “lack of medical necessity” may have on their treatment options. The author describes a clinical approach that may better serve patients and clinicians through the compartmentalization of asymptomatic seborrheic keratoses treatment as a cosmetic procedure within the clinical practice model.
  • 机译 复发性口疮性口炎:综述
    摘要:Aphthous stomatitis is a painful and often recurrent inflammatory process of the oral mucosa that can appear secondary to various well-defined disease processes. Idiopathic recurrent aphthous stomatitis is referred to as recurrent aphthous stomatitis. The differential diagnosis for recurrent aphthous ulcerations is extensive and ranges from idiopathic benign causes to inherited fever syndromes, to connective tissue disease, or even inflammatory bowel diseases. A thorough history and review of systems can assist the clinician in determining whether it is related to a systemic inflammatory process or truly idiopathic. Management of aphthous stomatitis is challenging. For recurrent aphthous stomatitis or recalcitrant aphthous stomatitis from underlying disease, first-line treatment consists of topical medications with use of systemic medications as necessary. Herein, the authors discuss the differential diagnosis and treatment ladder of aphthous stomatitis as described in the literature.
  • 机译 用IncobotulinumtoxinA的不同稀释液治疗侧腹周线
    摘要:BACKGROUND: IncobotulinumtoxinA is a botulinum neurotoxin type A that is free from complexing proteins and is used in various therapeutic indications and aesthetic medicine. It is approved for the treatment of glabellar frown lines in the United States. In Europe, it is also approved for the treatment of lateral periorbital lines (crow’s feet) and for the combined treatment of upper facial lines, including glabellar frown lines, crow’s feet, and horizontal forehead lines. METHODS: In the present study, incobotulinumtoxinA was injected at two different dilutions to treat female subjects aged 40 to 50 years who had moderate-to-severe lateral periorbital lines at maximum contraction according to a score of 2 or 3 points on the 5-point Merz Aesthetics Scales (MAS). For Group 1 (n=20), 50U of incobotulinumtoxinA were reconstituted with 1.60mL of 0.9% NaCI, and for Group 2 (n=20), a reconstitution volume of 0.55mL was used. RESULTS: Merz Aesthetics Scales scores were markedly improved by at least one point in both groups at one month and three months. The mean Merz Aesthetics Scales scores at one month were 0.4 and 0.6 points for Group 1 and Group 2, respectively, corresponding to a mean improvement of 2.0 and 1.8 points compared with baseline, respectively. CONCLUSION: No significant differences in efficacy and tolerability of incobotulinumtoxinA were seen between the two dilutions at any time point.
  • 机译 多囊卵巢综合征相关的融合和网状乳头状瘤病:阿奇霉素成功治疗的患者的报告。
    摘要:Polycystic ovarian syndrome is a common endocrine disorder with a variety of dermatologic manifestations among young women. Confluent and reticulated papillomatosis is a rare dermatosis of unknown etiology that is seldom reported in patients with polycystic ovarian syndrome. We describe the case of a young woman with obesity, confluent and reticulated papillomatosis, and concurrent acanthosis nigricans. Her history, physical examination, and laboratory evaluation led to the diagnosis of polycystic ovarian syndrome. The proposed etiologies and the various of treatment options for confluent and reticulated papillomatosis are discussed. In our case, the patient had a dramatic response to treatment with azithromycin. The etiology of confluent and reticulated papillomatosis remains to be established. Additionally, the mechanism behind the success of treatment with antibiotics is unclear; however, in this patient, azithromycin was a safe and effective option for the treatment of confluent and reticulated papillomatosis.
  • 机译 难治性脓性脓皮病和化脓性汗腺炎两名患者对白介素-1拮抗剂Canakinumab的无应答
    摘要:Pyoderma gangrenosum and hidradenitis suppurativa are skin conditions characterized by an intense neutrophil-mediated inflammatory response that is often difficult to effectively treat. Successful use of interleukin (IL)-1β inhibition using canakinumab and anakinra has been reported in patients with concomitant pyoderma gangrenosum and hidradenitis suppurativa. We report two cases where targeted therapy with canakinumab failed to lead to improvement for patients with pyoderma gangrenosum and hidradenitis suppurativa. The reason behind the non-response to IL-1β blockade seen in these patients is unclear. Our report suggests that further controlled studies are warranted to help clinicians predict treatment responses to anti-IL-1 therapies in these challenging patients.
  • 机译 局部伊维菌素:支持酒渣鼻双重作用模式的数据
    • 作者:James Q. Del Rosso
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2017年第9期
    摘要:Until recently, the potential modes of action of topical ivermectin in rosacea have been speculated but not studied. Short-term studies (12 week), long-term studies (up to 52 weeks), and case report series have now been completed, and topical ivermectin (IVM), formulated as a 1% cream that is applied once daily, has been shown to be effective, well-tolerated, and safe for the treatment of rosacea. This article reviews outcomes from studies that support dual modes of action, including both anti-inflammatory and anti-parasitic effects.
  • 机译 多光谱数字皮肤病变分析设备提供的定量数据对皮肤科医生对活体色素沉着病变的决定的影响
    摘要:BACKGROUND: Early diagnosis of melanoma is critical to survival. New technologies, such as a multi-spectral digital skin lesion analysis (MSDSLA) device [MelaFind, STRATA Skin Sciences, Horsham, Pennsylvania] may be useful to enhance clinician evaluation of concerning pigmented skin lesions. Previous studies evaluated the effect of only the binary output. OBJECTIVE: The objective of this study was to determine how decisions dermatologists make regarding pigmented lesion biopsies are impacted by providing both the underlying classifier score (CS) and associated probability risk provided by multi-spectral digital skin lesion analysis. This outcome was also compared against the improvement reported with the provision of only the binary output. METHODS: Dermatologists attending an educational conference evaluated 50 pigmented lesions (25 melanomas and 25 benign lesions). Participants were asked if they would biopsy the lesion based on clinical images, and were asked this question again after being shown multi-spectral digital skin lesion analysis data that included the probability graphs and classifier score. RESULTS: Data were analyzed from a total of 160 United States board-certified dermatologists. Biopsy sensitivity for melanoma improved from 76 percent following clinical evaluation to 92 percent after quantitative multi-spectral digital skin lesion analysis information was provided (p<0.0001). Specificity improved from 52 percent to 79 percent (p<0.0001). The positive predictive value increased from 61 percent to 81 percent (p<0.01) when the quantitative data were provided. Negative predictive value also increased (68% vs. 91%, p<0.01), and overall biopsy accuracy was greater with multi-spectral digital skin lesion analysis (64% vs. 86%, p<0.001). Interrater reliability improved (intraclass correlation 0.466 before, 0.559 after). CONCLUSION: Incorporating the classifier score and probability data into physician evaluation of pigmented lesions led to both increased sensitivity and specificity, thereby resulting in more accurate biopsy decisions.
  • 机译 痤疮疤痕-发病机理,评估和治疗方案
    摘要:Acne vulgaris is a ubiquitous problem affecting 80 percent of people ages 11 to 30 years, with many patients experiencing some degree of scarring. This review focuses on atrophic scars, the most common type of acne scar. We briefly address the cellular sequelae that lead to scar formation and the initial evaluation of patients with acne scars. We then discuss an algorithmic approach to the treatment of acne scarring based on the classification of scars into erythematous and atrophic types. Lastly, we discuss the future treatment of acne scars and ongoing clinical trials.
  • 机译 甲磺酸丁二醇酯局部用凝胶剂光化性角化病以外的临床应用现状报告
    • 作者:James Q. Del Rosso*
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2016年第11 Suppl 1期
    摘要:Ingenol mebutate is available as a topical gel formulation approved for the treatment of actinic keratosis. Two different concentrations are available for treatment of actinic keratoses at specific anatomic sites with the advantages of short durations of therapy and limited “down time” related to visible inflammation as compared to other topical agents. Due to the various modes of action of ingenol mebutate, it has also been used for treatment of disease states other than actinic keratosis. This manuscript discusses the suggested modes of action of ingenol mebutate and reviews publications on the use of ingenol mebutate gel for cutaneous disorders other than actinic keratosis, including squamous cell carcinoma in-situ, basal cell carcinoma, actinic cheilitis, anogenital warts, and others. Author commentaries are also included with the goal of providing relevant clinical insights.
  • 机译 眼睑的处理
    • 作者:Martyn King
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2016年第12期
    摘要:
  • 机译 面部注射后失明
    • 作者:Askari Townshend
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2016年第12期
    摘要:
  • 机译 维生素D是否对黑素瘤具有“阳光下的时光”?
    摘要:Growing evidence suggests a pivotal role for vitamin D in cancers, particularly melanoma. The broad immunologic effects of vitamin D and its signaling axis make for a complex interplay between tumor cells and the immune system. Preclinical evidence suggests vitamin D to have protective effects in melanoma oncogenesis and progression, creating a potential role for vitamin D supplementation in cancer prevention and/or adjuvant therapy. In this commentary, the authors highlight studies of vitamin D in melanoma with clinical implications and call for large clinical trials to definitively determine the role of supplementation in patients to prevent and help treat melanoma.
  • 机译 新型100%硅酮疤痕凝胶治疗剂在疤痕管理中的早期干预的功效和安全性
    • 作者:David J. Goldberg
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2016年第12期
    摘要:Objective: To evaluate the efficacy and safety of a new topical silicone gel for the early intervention in the management of scars. Design: In this 12-week, observational study, healthy subjects (n=15) with an accessible linear or hypertrophic scar were given the test product and instructed to apply twice daily. Subjects returned 14, 28, 56, and 84 days later for evaluation and recording of adverse events. Setting: Private practice of the author. Participants: Eligible subjects had a scar with a Vancouver Scar Scale total score ≥3 at baseline. Measurements: Improvement was evaluated by the Vancouver Scar Scale and Observer Scar Assessment Scale at baseline and at four follow-up visits. Results: The median total Vancouver Scar Scale score and median total Observer Scar Assessment Scale score decreased significantly from baseline at each visit, showing rapid and continuing improvement in the appearance of the scars. For Vancouver Scar Scale, significant differences of individual parameters from baseline began at 28 days for pliability and height, 56 days for vascularity, and 84 days for pigmentation. For Observer Scar Assessment Scale parameters, significant differences from baseline began at 14 days and continued until 84 days for vascularization, thickness, and pigmentation. Pain and pruritis scores were low at each visit. Overall, 84.6 percent of subjects rated the treatment as excellent, very good, or good after three months of treatment. No adverse events were reported. Conclusion: The test product improved the appearance of scars after three months of twice-daily treatment and without adverse events.
  • 机译 怀孕对白癜风活动的影响
    摘要:Background: Vitiligo vulgaris, an acquired disease related to autoimmune activity directed against melanocytes, is a common disorder of pigmentation affecting up to one percent of the population. Several autoimmune disorders are reported to improve during pregnancy—a state of relative immunosuppression. Objectives: To assess self-reported changes in vitiligo disease activity that occurred during pregnancy. Methods: A survey of 24 subjects with vitiligo was conducted by telephone using questions that pertained to vitiligo history, pregnancy history, and vitiligo disease activity prior to, during, and after pregnancy. Additional questions pertained to demographics, history of other autoimmune disease, and family history of vitiligo. Results: 18 of 24 subjects (75%) reported stable or improvement in vitiligo activity during pregnancy. Of these 18 subjects, five (27%) had discontinued vitiligo therapy during their pregnancies. Conclusion: The majority of patients surveyed reported either stable or improved vitiligo activity during pregnancy. These results support a protective effect exerted by the state of pregnancy against changing or progressing depigmentation characteristic of vitiligo vulgaris in the non-pregnant state.
  • 机译 多囊乳液含神经酰胺的保湿剂:在常见的皮肤疾病管理中的作用的评估。
    摘要:Proper stratum corneum function plays a pivotal role in maintenance of skin health, and improper function leads to skin disease. The stratum corneum is comprised of corneocytes surrounded by intercelluar lipids including ceramides, free fatty acids, and cholesterol. Ceramide predominant moisturizers have become a mainstay of treatment of skin disease. New technologies for delivery of ceramides include multivesicular emulsions, which deposit ceramides in a timerelease manner for a continuous rather than burst effect. Here, the authors review the available data on the use of multivesicular emulsion ceramide moisturizers in various skin diseases.
  • 机译 男性非手术美容程序:趋势和技术注意事项
    摘要:Once sought nearly exclusively by women, nonsurgical cosmetic procedures are increasingly being sought after by men. Reviewed here are survey data that characterize the spectrum of nonsurgical cosmetic procedures men are preferentially utilizing, the percentage of nonsurgical cosmetic procedures consumers who are men, and how some of these figures are changing with time. while men still comprise a small minority (approximately 10–20%) of those pursuing nonsurgical cosmetic procedures, this sector is growing, in particular for injection of neurotoxins. Practitioners performing nonsurgical cosmetic procedures on male patients need to be aware of anatomical, physiological, behavioral, and psychological factors unique to this demographic.
  • 机译 注射脂肪分解:机理,作用因子和未来方向
    摘要:Noninvasive procedures targeting the elimination of unwanted adipose tissues have recently been developed. injection adipolysis is the term for the injection of cytotoxic substances into these tissues, with the intent of cosmetic improvement by volume reduction. initial attempts in the field utilized intravenous preparations of sodium deoxycholate and soy-derived phosphatidylcholine, approved for the intravenous treatment of fat emboli and dyslipidemias in countries outside the United States. it was initially purported that the active ingredient in these injections was phosphatidylcholine. Subsequent research discovered that injections of sodium deoxycholate alone were capable of inducing cellular lysis in vitro. These compounds also demonstrated an affinity for adipose tissue, sparing the overlying dermis and epidermis. The United States Food and Drug Administration (FDA) recently approved a formulation of sodium deoxycholate 10mg/mL for subcutaneous injection with the indication of aesthetic improvement of excess submental fat. it has shown moderate efficacy with appropriate patient selection and good patient satisfaction. However, previous research leading to the development of this drug proposed that including phosphatidylcholine to a more appealing cosmetic result, with decreased severity of injection-site reactions. Future drugs in the field of injection adipolysis may attempt to combine these ingredients for improved cosmesis and tolerability.
  • 机译 迟发性结节的管理
    摘要:
  • 机译 廷德尔效应的管理
    • 作者:Martyn King
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2016年第11期
    摘要:

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