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  • 1.

    【2hr】A Case of Lichen Planus Pigmentosus with Facial Dyspigmentation Responsive to Combination Therapy with Chemical Peels and Topical Retinoids

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    机译 面部色素沉着对化学果皮和局部类维生素A联合治疗的扁平苔藓色素沉着一例
    摘要：Lichen planus pigmentosus is a photodistributed dyschromia of unknown etiology described clinically as hyperpigmented gray-blue or brown-black macules or patches in a photodistributed pattern. Although there has been some debate, lichen planus pigmentosus is considered by many to be a separate diagnostic entity from ashy dermatosis or erythema dyschromicum perstans, which shares similar characteristics. Various treatment strategies have been applied to help resolve or improve the appearance of lichen planus pigmentosus lesions; however, an optimal treatment method is yet to be elucidated. The authors present a case of an 18-year-old Hispanic man with lichen planus pigmentosus whose skin findings responded dramatically to a combined regimen of daily topical azelaic acid foam and tretinoin cream with twice-monthly chemical peels using glycolic acid and Jessner’s solution. The authors have noted a sparcity of therapeutic literature for lichen planus pigmentosus, and hope to aid clinicians in therapeutic management strategy for this patient subset.
  • 2.

    【2hr】Ionic Hydrogel Monotherapy and in Combination with Antiviral-Antibiotic Prophylaxis, in the Post-procedure Management of Fractional Laser-Treated Patients

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    机译 离子水凝胶单一疗法及其与抗病毒-抗生素预防的结合，在部分激光治疗患者的术后管理中
    摘要：Objective: The pre- and postoperative care for fractionated laser resurfacing is still controversial, especially in regard to the use of antibiotics to prevent bacterial infection and potential consequences. Recently, an ionic hydrogel has shown to be useful in the postoperative treatment of minor burns. The aim of this study is to evaluate the use of this hydrogel after fractional laser treatments targeting photoaging and chronoaging damage to skin. Design: A randomized prospective study. Setting: one plastic surgeon private practice. Participant: Fifty patients with chronoaging and photoaging cosmetic issues were enrolled in two different post-treatment regimens: ionic hydrogel alone and ionic hydrogel in combination with antibiotics. Measurements: Patients were evaluated for healing time, complications, and postoperative pain, the latter assessed with a 10-point visual analogue score. A questionnaire to investigate how patients managed through the postoperative phase was also provided to each patient. Results: No significant differences between the two groups were observed in regard to healing time, postoperative pain, complications, and patient satisfaction. Conclusion: Ionic hydrogel alone has shown to provide adequate skin care support in the postoperative phase of fractional-laser-resurfacing-treated patients.
  • 3.

    【2hr】Efficacy of a Low Fluence, High Repetition Rate 810nm Diode Laser for Permanent Hair Reduction in Indian Patients with Skin Types IV–VI

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    机译 低通量，高重复频率的810nm半导体激光对印度IV-VI型皮肤患者永久性脱发的功效
    摘要：Background: The study’s aim is to evaluate the novel “in motion” technique for permanent hair removal using a low level fluence/high repetition rate on patients with a dark skin type over different areas of the body. Objectives: To assess fluence, accumulative energy, and number of treatments needed to achieve a significant hair reduction and patient satisfaction with minimal side effects, low discomfort levels, and high safety profile in a skin type IV–VI Indian patients. Methods: Seventy-one Indian female patients with skin type IV–VI were enrolled in the study. All patients were treated with a low fluence, high repetition rate 810nm diode laser using a predetermined set of parameters for 5 to 6 treatments in 1- to 3-month intervals. Hair reduction was measured by patients’ satisfaction and all adverse effects were documented. Results: Results obtained a high degree of patient satisfaction and a very low record of adverse events. Treatments were complication-free for dark skins and a reasonable schedule or sessions and intervals. The discomfort during the sessions was negligible.
  • 4.

    【2hr】High-dose Rate Electronic Brachytherapy: A Nonsurgical Treatment Alternative for Nonmelanoma Skin Cancer

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    机译 高剂量率电子近距离放射治疗：非黑色素瘤皮肤癌的非手术治疗替代方案
    摘要：The authors summarized data from a group of physicians with experience using high-dose rate electronic brachytherapy for the treatment of nonmelanoma skin cancer. The data have been published or presented in abstract format at national dermatology and radiation oncology meetings. The data included 1,822 treated lesions from 2009 to 2014 in patients ranging in age from 52 to 104 years. Most lesions were basal cell carcinoma (57%) or squamous cell carcinoma (38%) less than 2cm in size (97%). Median follow-up at the various centers ranged from 4 to 16 months, and results yielded an extremely low recurrence rate of less than one percent. Results show that within the confines of this follow up period, electronic brachytherapy is an effective, convenient, nonsurgical treatment option for patients with nonmelanoma skin cancer with few recurrences and excellent cosmetic results.
  • 5.

    【2hr】Topical Treatment for Onychomycosis: Is it More Effective than the Clinical Data Suggests?

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    机译 甲癣的局部治疗：是否比临床数据提示的更有效？
    摘要：Background: The current definition of complete cure is considered too stringent to reflect the true benefit of onychomycosis treatment seen in general practice and may limit the use of newer topical agents in mild-to-moderate disease. In addition, outcomes reported in clinical trials do not consistently report secondary endpoints, making data comparison difficult. Methods: The authors review the clinical data reported on two new topical antifungals, efinaconazole and tavaborole, in light of the latest thinking of more practical approaches to assess improvement and treatment success. Results: Almost 20 percent (19.7%) of patients treated with efinaconazole had absence of clinical signs, and almost a third (31.6%) had ≤10 percent affected toenail and mycologic cure at Week 52. Cure rates for tavaborole (<10% affected toenail and mycologic cure) were 15.3 percent and 17.9 percent at week 52. With both topical treatments, cure rates were higher when only negative culture was considered. Conclusion: These clinical cure rates likely better reflect the efficacy we see in practice. It is probable that efficacy would be further improved with longer treatment courses and/or longer follow-up periods and appropriate prophylactic strategies. This clinical judgment is predicated by any risk of nonadherence or disease recurrence.
  • 6.

    【2hr】The Use of Lipohydroxy Acid in Skin Care and Acne Treatment

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    机译 脂羟基酸在皮肤护理和痤疮治疗中的用途
    • 作者：Joshua A. Zeichner
    • 刊名：The Journal of Clinical and Aesthetic Dermatology
    • 2016年第11期
    摘要：Lipohydroxy acid is a derivative of salicylic acid with unique properties that explain its clinical effects in the skin. Lipohydroxy acid has skin renewing, exfoliating, and acne treating properties and is a commonly used ingredient in personal skin care products. The slow penetration of lipohydroxy acid results in an individual cell-by-cell exfoliation that is associated with excellent tolerability. Lipohydroxy acid has been shown to induce dermal thickening by stimulating glycosaminoglycans, collagen, and elastin production. Finally, lipohydroxy acid has been demonstrated to possess comedolytic properties. This article reviews the available data on the use of lipohydroxy acid in treating aging skin and acne.
  • 7.

    【2hr】Retrospective Study of Punch Scoring Versus Freehand Approach for First Stage Mohs Micrographic Surgery

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    机译 第一阶段Mohs显微外科手术打孔计分与徒手方法的回顾性研究
    摘要：Objective: The objective was to observe whether there is a difference in the number of subjects requiring more than one stage of Mohs micrographic surgery for small lesion nonmelanoma skin cancers using the punch scoring method versus freehand approach. Design: Retrospective review. Setting: Outpatient Mohs Clinic. Participants: Thirty patients with small lesion (<5mm) basal cell and squamous cell carcinoma who had Mohs micrographic surgery using either the punch scoring method (15) for scoring the first layer or the freehand method (15). Measurements: Differences between the two groups were evaluated by the number of subjects requiring more than one stage and the reason for any additional stages. Results: There was no observed difference in the number of subjects requiring more than one Mohs stage between the punch scoring group and the freehand group. Conclusion: Dermatologic surgeons can use the punch scoring method or the freehand approach for scoring small lesion Mohs based on provider preference.
  • 8.

    【2hr】Oral Apremilast for the Treatment of Plaque Psoriasis

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    机译 口服菊粉治疗斑块状牛皮癣
    摘要：This article provides an update on the use of oral apremilast, a phosphodiesterase-4 (PDE4) inhibitor, for the treatment of plaque psoriasis. Emphasis is placed on safety evaluations, although efficacy considerations are also addressed. Both two-year and three -year data analyses support the favorable safety profile reported in pivotal trials with this agent. Although effective in many study subjects despite baseline characteristics, higher response rates were noted in those with a baseline psoriasis area and severity index (PASI) score <20 and in subjects not previously treated with systemic therapy for psoriasis. Gastrointestinal (GI) side effects are the most common adverse events (AEs) reported, especially during the first few weeks of use; recommendations on management of GI AEs are discussed. Psychological AEs appear to be rare, including with prolonged durations of use, and are not clearly associated with the drug itself as depression and suicidal behaviors are common in individuals with psoriasis. Data reported through up to 182 weeks of exposure to apremilast do not support an association with cardiac AEs, emergence of malignancies, enhanced predilection to develop significant opportunistic infections, or reactivation of occult infection, such as tuberculosis.
  • 9.

    【2hr】Patient Factors and Their Association with Nonmelanoma Skin Cancer Morbidity and the Performance of Self-skin Exams

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    机译 患者因素及其与非黑素瘤皮肤癌发病率和自我皮肤检查表现的关系
    摘要：Objective: Mohs micrographic surgery is widely utilized for the treatment of nonmelanoma skin cancers with the advantage of tissue sparing and higher cure rate. The preoperative tumor size and post-Mohs micrographic surgery defect size are useful surrogate measures of nonmelanoma skin cancer morbidity. The authors sought to evaluate whether gender, Hispanic ethnicity, socioeconomic status, sun-safe practices and self-skin exams affected tumor size and Mohs micrographic surgery defect size. They also investigated factors associated with self-skin exams. Design: A cross-sectional survey-based study. Setting: Two dermatologic surgery clinics—one academic-associated and the other private. Participants: Patients receiving Mohs surgery for nonmelanoma skin cancers. Measurements: Tumor size and Mohs defect size and their relationship to patient factors ascertained from a survey, as well as the number of patients performing self-skin exams. The authors used t-tests and analysis of variance to compare tumor and defect sizes for each patient factor. Chi-squared tests were used to determine the factors associated with self-skin exams performance. Results: Lower education was associated with greater head and face tumor area (95mm2 vs. 41mm2, P=0.019), but not Mohs micrographic surgery defect size. Other studied patient factors were not associated with an increased morbidity. Hispanics performed self-skin exams at a lower rate than non-Hispanics (27% vs. 46%, p=0.03). Conclusion: This study innovatively uses tumor and Mohs micrographic surgery defect area as a measure of morbidity, allowing for identification of populations at need for improved education and prevention. (J Clin Aesthet Dermatol. 2016;9(9):16–22.)
  • 10.

    【2hr】Assessment of Online Patient Education Materials from Major Dermatologic Associations

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    机译 主要皮肤科协会对在线患者教育材料的评估
    摘要：Objective: Patients increasingly use the internet to find medical information regarding their conditions and treatments. Physicians often supplement visits with written education materials. Online patient education materials from major dermatologic associations should be written at appropriate reading levels to optimize utility for patients. The purpose of this study is to assess online patient education materials from major dermatologic associations and determine if they are written at the fourth to sixth grade level recommended by the American Medical Association and National Institutes of Health. Design: This is a descriptive and correlational design. Setting: Academic institution. Participants/measurements: Patient education materials from eight major dermatology websites were downloaded and assessed using 10 readability scales. A one-way analysis of variance and Tukey’s Honestly Statistically Different post hoc analysis were performed to determine the difference in readability levels between websites. Results: Two hundred and sixty patient education materials were assessed. Collectively, patient education materials were written at a mean grade level of 11.13, with 65.8 percent of articles written above a tenth grade level and no articles written at the American Medical Association/National Institutes of Health recommended grade levels. Analysis of variance demonstrated a significant difference between websites for each reading scale (p<0.001), which was confirmed with Tukey’s Honestly Statistically Different post hoc analysis. Conclusion: Online patient education materials from major dermatologic association websites are written well above recommended reading levels. Associations should consider revising patient education materials to allow more effective patient comprehension. (J ClinAesthet Dermatol. 2016;9(9):23–28.)
  • 11.

    【2hr】Study on the Efficacy of Platelet-rich Fibrin Matrix in Hair Follicular Unit Transplantation in Androgenetic Alopecia Patients

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    机译 富血小板纤维蛋白基质在雄激素性脱发患者毛囊单位移植中的功效研究
    摘要：Objective: Hair loss is a significant problem worldwide. The most common cause of hair loss in men is male androgenetic alopecia, male pattern baldness, which is primarily due to the presence of nonfunctional or dead hair follicles in the scalp. Hair follicular unit transplantation has been a widely used technique to transplant hair follicles into bald areas. Although follicular unit transplantation generally gives satisfactory hair transplantation, efforts have been made to further increase the efficacy of follicular unit transplantation in hair regeneration. The crucial discovery of platelet-derived growth factors has resulted in the development of novel autologous therapeutic methods. Platelet-rich fibrin matrix represents a revolutionary step in the platelet gel therapeutic concept. This technique is fast and involves minimal in vitro manipulations. In this paper, the authors studied the efficacy of platelet-rich fibrin matrix in conjunction with follicular unit transplantation for regeneration of new hair in bald areas in male androgenetic alopecia patients. Design: Ten male subjects between 18 and 50 years of age with Norwood Alopecia from Grade 4 to 6 were chosen for the study. Setting: The study was performed at Derma Solutions clinic, Bengaluru, Karnataka, India. Participants: Patients with thyroid disorders, bleeding disorders, or other co-existing morbidities were excluded. Results: The number of hair follicles began to increase progressively after platelet-rich fibrin matrix treatment was performed on the right side of the scalp and the effect was very distinct after six months of platelet-rich fibrin matrix treatment. Conclusion: This study clearly indicates that platelet-rich fibrin matrix plays a key role in hair regeneration using follicular unit transplantation techniques. Further studies are needed to determine how platelet-rich fibrin matrix helps improve hair retention and regeneration. Additionally, it would be interesting to know how long the effect of platelet-rich fibrin matrix lasts after the termination of therapy. Thus, a future longitudinal study would be very useful. (J ClinAesthetDermatol. 2016;9(9):29-35.)
  • 12.

    【2hr】Pediatric Lichen Sclerosus: A Review of the Literature and Management Recommendations

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    机译 儿科地衣硬化：文献和管理建议的审查。
    摘要：Lichen sclerosus is an uncommon, inflammatory disease of the skin and mucosa that can cause significant pruritus, pain, and scarring. There are two peaks of incidence: one in adult females, and the other in young girls. Early recognition and prompt management of the disorder is crucial in preventing long-lasting complications. This article reviews lichen sclerosus in children and provides evidence-based guidance for treatment in the pediatric population.
  • 13.

    【2hr】A Retrospective Analysis Comparing the New Standardized Letter of Recommendation in Dermatology with the Classic Narrative Letter of Recommendation

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    机译 皮肤科新标准推荐信与经典叙述推荐信的回顾性分析
    摘要：Background: In an effort to avoid numerous problems associated with narrative letters of recommendation, a dermatology standardized letter of recommendation was utilized in the 2014–2015 resident application cycle. Objective: A comparison of the standardized letter of recommendation and narrative letters of recommendation from a single institution and application cycle to determine if the standardized letter of recommendation met its original goals of efficiency, applicant stratification, and validity. Methods: Eight dermatologists assessed all standardized letters of recommendation/narrative letters of recommendation pairs received during the 2014–2015 application cycle. Five readers repeated the analysis two months later. Each letter of recommendation was evaluated based on a seven question survey. Letter analysis and survey completion for each letter was timed. Results: Compared to the narrative letters of recommendation, the standardized letter of recommendation is easier to interpret (p<0.0001), has less exaggeration of applicants’ positive traits (p<0.001), and has higher inter-rater and intrarater reliability for determining applicant traits including personality, reliability, work-ethic, and global score. Standardized letters of recommendation are also faster to interpret (p<0.0001) and provide more information about the writer’s background or writer-applicant relationship than narrative letters of recommendation (p<0.001). Limitations: This study was completed at a single institution. Conclusions: The standardized letter of recommendation appears to be meeting its initial goals of 1) efficiency, 2) applicant stratification, and 3) validity. (J Clin Aesthet Dermatol. 2016;9(9):36–2.)
  • 14.

    【2hr】Updates on Psoriasis and Cutaneous Oncology

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    机译 银屑病和皮肤肿瘤学的最新进展
    摘要：
  • 15.

    【2hr】The Use of Noninvasive Optical Coherence Tomography to Monitor the Treatment Progress of Vismodegib and Imiquimod 5% Cream in a Transplant Patient with Advanced Basal Cell Carcinoma of the Nose

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    机译 使用无创光学相干断层扫描监测Vismodegib和咪喹莫特5％乳膏治疗晚期鼻基底细胞癌移植患者的治疗进展
    摘要：Immunosuppressed transplant recipients have increased risk for the development of basal cell carcinoma skin cancers. While oral vismodegib therapy has been successful in treating locally advanced basal cell tumors, few studies document its use and efficacy in organ transplant patients. In this immunocompromised population, topical imiquimod 5% cream has been shown to be an effective and well-tolerated option for superficial and nodular basal cell carcinomas. To the authors’ knowledge, no data documents the use of optical coherence tomography, a noninvasive imaging technique, to monitor progress of such combined therapies on in vivo skin. The authors report the successful treatment of an extensive basal cell carcinoma on the nose of an immunosuppressed 54-year-old Caucasian man with a history of kidney and pancreas transplantations. By combining continuous noninvasive lesion monitoring with vismodegib 150mg/d therapy and adjuvant imiquimod 5% topical cream, the patient showed complete disease clearance on clinical, optical coherence tomography, and histological evaluation. This report supports the feasibility and efficacy of nonsurgical treatment of basal cell lesions in complicated transplant patients and the need for individualized treatment plans. A noninvasive follow-up tool, especially during nonsurgical therapy, is of critical value to ensure the best possible treatment outcome for the patient.
  • 16.

    【2hr】Fully Regressive Melanoma

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    机译 完全退化的黑色素瘤
    摘要：Fully regressive melanoma is a phenomenon in which the primary cutaneous melanoma becomes completely replaced by fibrotic components as a result of host immune response. Although 10 to 35 percent of cases of cutaneous melanomas may partially regress, fully regressive melanoma is very rare; only 47 cases have been reported in the literature to date. AH of the cases of fully regressive melanoma reported in the literature were diagnosed in conjunction with metastasis on a patient. The authors describe a case of fully regressive melanoma without any metastases at the time of its diagnosis. Characteristic findings on dermoscopy, as well as the absence of melanoma on final biopsy, confirmed the diagnosis.
  • 17.

    【2hr】Central Forehead Reconstruction with a Simple Primary Vertical Linear Closure

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    机译 简单的初级垂直线性闭合的中央额头重建
    摘要：Objective: Following Mohs surgery, medium-to-large defects on the central forehead can often be complicated to surgically reconstruct. In this paper, the authors discuss possible central forehead reconstructions and report their successful experience employing a simple primary vertical linear closure with a special technique to demarcate forehead rhytides rather than performing an overly complicated flap or graft. Case report: The patient was a 57-year-old man who presented with a broad superficial basal cell carcinoma that required treatment with Mohs surgery. For the resulting defect, the authors elected to perform a complex linear repair taking advantage of substantial side-to-side laxity in the supraperiosteal plane and carefully labeling and matching each forehead rhytide across the defect as the wound was sutured. Conclusion: The findings of this case demonstrate that medium-to-large wounds of the central forehead can be aesthetically repaired with a simple primary vertical linear closure. Carefully mapping and labeling horizontal forehead rhytides with a sterile surgical marking pen prior to anesthesia ensures accurate approximation during wound closure.
  • 18.

    【2hr】Results of a Phase 2 Efficacy and Safety Study with SB204, an Investigational Topical Nitric Oxide-releasing Drug for the Treatment of Acne Vulgaris

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    机译 SB204（用于研究寻常型痤疮的局部用一氧化氮释放研究药物）的2期功效和安全性研究的结果
    摘要：Objective: To compare efficacy, tolerability, and safety of two concentrations of topical SB204 and vehicle twice daily for 12 weeks in the treatment of acne vulgaris. Design: Randomized, double-blind, placebo-controlled, three-arm, Phase 2 study. Setting: Dominican Republic, Panama, and Honduras. Participants: Subjects with acne, age 12 to 40, with 25 to 70 noninflammatory lesions, 20 to 40 inflammatory lesions, and a baseline Investigator’s Global Assessment score of mild, moderate, or severe. Measurements: The primary efficacy assessment was the absolute change in noninflammatory lesion counts. Other assessments included inflammatory lesion counts, success on dichotomized Investigator’s Global Assessment, reported adverse events, physical examinations, laboratory testing, and tolerability. Results: One hundred fifty-three subjects were randomized to vehicle (n=52), SB204 1% (n=51), or SB204 4% (n=50). When compared to vehicle, subjects treated with SB204 1% and SB204 4% had significantly greater mean percent reduction in noninflammatory lesions from baseline and subjects treated with SB204 4% had a significantly greater mean percent reduction in inflammatory lesion count from baseline at Week 12. There were no significant differences in the IGA success rates between groups. Both concentrations of SB204 were safe and well-tolerated. Conclusions: When compared to vehicle, both SB204 1% and SB204 4% significantly decreased the percentage of noninflammatory lesions and SB204 4% also significantly decreased the percentage of inflammatory lesions in subjects with acne vulgaris treated for 12 weeks. Treatment with SB204 1% and SB204 4% was safe and well-tolerated. Registry: clinicaltrials.gov ().
  • 19.

    【2hr】Gender Differences in Self-assessed Health-related Quality of Life in Children with Atopic Dermatitis

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    机译 特应性皮炎儿童自我评估的健康相关生活质量的性别差异
    摘要：Background: Atopic dermatitis has a significant impact on quality of life of children and families. Objective: It is important to assess gender differences in health-related quality of life in children with atopic dermatitis in order to effectively use health-related quality of life results. Methods: Children 5- to 16-years of age with atopic dermatitis from Italy, Singapore, Czech Republic, and Ukraine were divided into two groups (boys and girls). Each child in the group of boys was matched to a corresponding child in the group of girls from the same country whose age and scoring atopic dermatitis value were almost identical. Self-assessed health-related quality of life was measured by the Children’s Dermatology Life Quality Index. Results: The difference in overall Children’s Dermatology Life Quality Index between boys and girls was not significant (P=0.33). Girls with atopic dermatitis assessed Children’s Dermatology Life Quality Index item on embarrassment significantly higher (0.78±0.93 for boys and 1.14±0.93 for girls, P<0.05). Lowest scored items were the same and overall Children’s Dermatology Life Quality Index results significantly correlated with scoring atopic dermatitis values in both groups. Two separate Children’s Dermatology Life Quality Index items in boys and five items in girls significantly correlated with atopic dermatitis severity. The Children’s Dermatology Life Quality Index item on affected sleep significantly correlated with the age of boys (r=0.38, P=0.02) and another Children’s Dermatology Life Quality Index item on school work/holiday with the age of girls (r=0.59, P<0.01). Conclusion: Despite that the authors did not find differences in overall health-related quality of life results, girls were more embarrassed, self-conscious, upset, and sad because of atopic dermatitis. The authors’ results may influence the educational part of consultations of children with atopic dermatitis.
  • 20.

    【2hr】New Oral Therapies for Psoriasis

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    机译 牛皮癣的新口服疗法
    摘要：Conventional oral therapies for psoriasis, including methotrexate, cyclosporine, and acitretin, have generally unfavorable safety profiles and are not ideal for long-standing use. Thus, new oral therapies are necessary for patients with more moderate disease, patients who prefer oral treatments to injectable biologies, and patients who failed conventional therapies. The authors review here the clinical and safety evidence of phosphodiesterase 4 inhibitor, apremilast, janus kinase inhibitors, including tofacitinib, and fumarie acid esters as additional options in oral psoriasis therapy.
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