scholarly journals Pulse dye laser therapy and superficial cryotherapy as a novel combination treatment for hypertrophic scars and keloids

2022 ◽  
Vol 13 (1) ◽  
pp. 28-31
Author(s):  
Iqbal A. Bukhari
Keyword(s):  
Laser Therapy ◽  
Combination Treatment ◽  
Treatment Options ◽  
Fibrous Tissue ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Dye Laser ◽  
Hypertrophic Scars ◽  
Pressure Therapy ◽  
One Year

Background: Hypertrophic scars are benign and fibrotic skin lesions caused by defects in the regulation of cellularity during the wound-healingprocess, in which there is higher collagen production and less degradation. Genetic predisposing factors and different skin injuries may play a role in developing these types of lesions. On the other hand, keloids are overgrowths of fibrous tissue outside the original boundaries of trauma, yet these may also occur spontaneously. There are numerous treatment options for both conditions, including silicone gel sheeting, pressure therapy, intralesional triamcinolone acetonide, radiation, laser therapy, cryosurgery, interferon, 5-fluorouracil, and surgical excision as well as a multitude of extracts and topical agents. Objective: The objective was to evaluate the effectiveness of pulse dye laser (PDL) therapy and superficial cryotherapy as a combination treatment for hypertrophic scars and keloids. Method: Four Arabic female patients were seen at the outpatient clinic of the Department of Dermatology at the King Fahd Hospital of the University in Khobar, Saudi Arabia. The patients had keloids and hypertrophic scars. Treatment with cryotherapy every week for three weeks followed by one session of pulsed dye laser was administered rotationally for three to six months until the lesions displayed remarkable physical improvement or complete resolution. Results: All patients experienced significant improvement, showing a reduction in the size, erythema, pliability, and pruritus. None of the hypertrophic scars or keloids deteriorated during the one year of treatment. No complications were noted during the treatment period. Conclusion: Sequential PDL therapy combined with superficial cryotherapy may be an option for treating hypertrophic scars and keloids.

scholarly journals Cutaneous Rosai-Dorfman disease: a case report of disease limited only to skin

2021 ◽  
Author(s):  
Aureja Kontrimiene ◽  
Emilija Serpytiene ◽  
Monika Macejevska ◽  
Jonas Lauraitis ◽  
Jurate Grigaitiene
Keyword(s):  
Co2 Laser ◽  
Treatment Options ◽  
Infectious Agent ◽  
Treatment Decision ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Barr Virus ◽  
Aesthetic Appearance ◽  
Rosai Dorfman Disease ◽  
Epstein Barr

Rosai – Dorfman disease is a disorder of histiocytic proliferation that can affect almost every organ. Skin may be involved in about 10% cases, but only 3% of patients have skin lesions exclusively. Patients with CRDD usually are healthy, without leading constitutional or other symptoms. Etiology of this disease is unclear, but it might be triggered by an infectious agent such as Herpesvirus 6 and Epstein-Barr virus, there is also predisposition to autoimmune diseases, hematological malignancies. In our case patient was diagnosed with Borrelia burgdorferi infection. Any known association between this infection and Rosai – Dorfman disease was not described before. The disease may manifest in any age group. The differential diagnosis includes Langerhans cell histiocytosis, metastasis, Hodgkin’s lymphoma and other diseases. Disease usually resolves spontaneously over a period of months to years. Treatment should be administered in non-responsive or multiple relapsing cases. Also, it is very important to take into consideration the patient’s expectations and aesthetic appearance before making a treatment decision. Various treatment options are described, including surgical excision, cryotherapy, corticosteroids, antibiotics, Methotrexate, Dapsone. In our case, we used CO2 laser treatment successfully. To our knowledge, this is only the second case where CRDD lesions were treated successfully with CO2 laser.

scholarly journals Multiple Reticulohistiocytomas in an 88-year-old Man: a Case Report

2013 ◽  
Vol 5 (2) ◽  
pp. 87-93
Author(s):  
Branislava Gajić ◽  
Tatjana Roš ◽  
Andrijana Arapović ◽  
Nada Vučković ◽  
Aleksandra Fejsa Levakov
Keyword(s):  
Treatment Options ◽  
Skin Lesions ◽  
Systemic Involvement ◽  
Multicentric Reticulohistiocytosis ◽  
Mucosal Involvement ◽  
Multinuclear Cells ◽  
Systemic Symptoms ◽  
One Year ◽  
Foamy Cytoplasm

Abstract Solitary and multiple reticulohistiocytomas, often referred to as diffuse cutaneous reticulohistiocytosis, that are generally restricted to skin, must be differentiated from multicentric reticulohistiocytosis. Multicentric reticulohistiocytosis is a rare histiocytic proliferative disease affecting joints, skin and mucous membranes, while arthropathy usually precedes skin and mucosal involvement. Other organs may also be involved, and 20% of patients have an associated internal malignancy. Multicentric reticulohistiocytosis has been reported to be associated with autoimmune diseases and malignancies. We present an 88-year-old man, with a sudden eruption of asymptomatic, firm, skin to brown colored papules and nodules, 6 to 17 mm in diameter, localized on forehead, arms, legs, and buttocks. There were no symptoms of joint or other organ involvement. Clinical and dermoscopic characteristics pointed to reticulohystiocytomas. Multiple excision biopsies of different tumors were performed and histopathology reports confirmed the diagnosis. In the case presented, reticulohistiocytosis was limited to the skin, exhibiting multiple reticlohistiocytomas with typical clinical, dermoscopic and rather peculiar histopathology presentation. Apart from this, some histologic features were seen in early lesions of multicentric reticulohistiocytosis, such as multinuclear cells dissociating collagen fibers with pale eosinophilic and foamy cytoplasm. Besides surgical excisions, no other treatment options were done. Laboratory and other tests showed no presence of extracutaneous illness, and no autoimmune or paraneoplastic processes. At one year follow up, the remaining tumors were of the same size, but there were no recurrences at excision sites, no signs of disease progression or systemic involvement. Since diffuse cutaneous reticulohistiocytosis without arthropathy as well as isolated reticulohistiocytomas have been described, in some cases of multiple reticulohistiocytomas even without systemic symptoms and signs, multicentric reticulohistiocytosis should be considered with an appropriate follow up. In such cases, skin lesions have the same histological features as lesions in multicentric reticulohistiocytosis, but they are not associated with joint problems or neoplasms.

scholarly journals Burn Hypertrophic Scar in Pediatric Patients: Clinical Case

2020 ◽  
pp. 517-521
Author(s):  
Roohi Vinaik ◽  
Joel Fish ◽  
Marc G. Jeschke
Keyword(s):  
Laser Therapy ◽  
Hypertrophic Scar ◽  
Clinical Case ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Healing Process ◽  
Hypertrophic Scars ◽  
Limited Mobility

AbstractRecent improvements in burn care have resulted in greater patient survival of severe burns. With improved survival, treatment of the resulting permanent burn hypertrophic scars requires extensive care. Hypertrophic scarring occurs due to aberrations in the normal healing process, resulting in excessive inflammation and collagen deposition at the site of injury. These scars are accompanied by symptoms such as pain, pruritus, erythema, and limited mobility. The high scar prevalence in pediatric patients and accompanying physical, psychological, and social burden warrant a better understanding of the possible treatment options. Currently, several therapeutic strategies exist for hypertrophic scar management in the pediatric patient, although none are completely effective. Recently, laser therapy has emerged as a potential therapy for symptomatic relief and scar modulation. Here, we provide an up-to-date review of treatment options for hypertrophic scars in the pediatric population. In addition, we discuss a clinical case, outlining the potential merits of addition of laser therapy and surgical revision for the treatment of hypertrophic scars.

Preventing Premature Weaning: Management Options for Common Lactation Conditions, Including OMT

2020 ◽  
pp. 20-25
Author(s):  
Denise Sackett ◽  
Tala Dajani ◽  
David Shoup ◽  
Uzoma Ikonne
Keyword(s):  
Postpartum Depression ◽  
Family Physician ◽  
Treatment Options ◽  
World Health ◽  
Management Options ◽  
Pharmacological Management ◽  
Control And Prevention ◽  
Lactational Mastitis ◽  
One Year ◽  
Health Organization

The benefits of breastfeeding are well established. The World Health Organization and the Centers for Disease Control and Prevention recommend that mothers breastfeed infants for at least one year, but most children are not breastfed that long because of many factors. Breastfeeding mothers face many challenges to continued breastfeeding, including medical conditions that arise during this period, such as postpartum depression and lactational mastitis. Because of a perceived lack of consistent guidance on medication safety, it can be difficult for the family physician to treat these conditions while encouraging mothers to continue breastfeeding. The purpose of the current review is to summarize and clarify treatment options for the osteopathic family physician treating lactating mothers. We specifically focus on the pharmacological management of contraception, postpartum depression, and lactational mastitis.

CYTOLOGICAL DIAGNOSIS AS A METHOD OF SCREENING OF PRE-MALIGNANT MELANOCYTIC TUMORS AND EARLY FORMS OF SKIN MELANOMA

2018 ◽  
Vol 64 (3) ◽  
pp. 384-387
Author(s):  
Viktor Novik ◽  
D. Dreval
Keyword(s):  
Laser Therapy ◽  
Histological Examination ◽  
Clinical Data ◽  
Surgical Excision ◽  
Cytological Diagnosis ◽  
Skin Melanoma ◽  
Cytological Examination ◽  
Melanocytic Tumors ◽  
Quality Character ◽  
Atypical Nevi

Cytohistological comparisons to the account of the clinical data and revision of cytological and histological preparations on a material received from 21 patients are made. Cytomorphological features of juvenile nevi (Spitz-nevus, Reed-nevus), dysplastic and atypical nevi and early forms of melanoma are described. The establishment at cytological examination of good-quality character of melanocytic defeats at the account of the clinical data could be the basis for appointment laser therapy. At revealing of atypical melanocytes in cytological preparations patients should be referred to specialized oncological institutions for surgical excision of tumor with the subsequent histological examination. Thus cytological examination could be used in dermatological practice as a method of screening pre-malignant melanocytic tumors and skin melanoma.

scholarly journals Treatment of angiolupoid sarcoidosis with tofacitinib ointment 2% and pulsed dye laser therapy

2021 ◽  
Vol 7 ◽  
pp. 122-124
Author(s):  
Katelyn Singh ◽  
Alice Wang ◽  
Peter Heald ◽  
Jennifer M. McNiff ◽  
Kathleen Suozzi ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Dye Laser ◽  
Pulsed Dye Laser

scholarly journals 766. Everything Old is New Again-A Case Series of New World Leishmaniasis in African Children in Portland, Maine

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S428-S428
Author(s):  
Jennifer Jubulis ◽  
Amanda Goddard ◽  
Elizabeth Seiverling ◽  
Marc Kimball ◽  
Carol A McCarthy
Keyword(s):  
Latin America ◽  
Cutaneous Leishmaniasis ◽  
New World ◽  
Pediatric Patients ◽  
Data Extraction ◽  
Clinical Manifestations ◽  
Case Series ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Travel History

Abstract Background Leishmaniasis has many clinical manifestations and treatment regimens, dependent on species and host. Old world leishmaniasis is found primarily in Africa and Asia, and is associated with visceral disease, while new world disease, seen primarily in Latin America, is more commonly mucocutaneous. We present a case series of pediatric African patients with New World cutaneous leishmaniasis (NWCL). Methods Data extraction was performed via chart review, analyzing travel history, clinical presentation, diagnosis, and management in children with cutaneous leishmaniasis presenting to the pediatric infectious diseases clinic in Portland, ME. Biopsy specimens were sent to the federal CDC for identification by PCR and culture. Results Five cases of NWCL were diagnosed in pediatric patients in Maine from November 2018 through February 2020. Median age of patients was 10 years (range 1.5-15 years). Four cases (80%) occurred in children from Angola or Democratic Republic of Congo, arriving in Maine via Central/South America, with one case in a child from Rwanda who arrived in Maine via Texas. Three patients had multiple skin lesions and two had isolated facial lesions. Leishmaniasis was not initially suspected resulting in median time to diagnosis of 5 months (range 1-7 months). Four patients were initially treated with antibacterials for cellulitis and one was treated with griseofulvin. After no improvement, patients underwent biopsy with 2 patients diagnosed with L panamensis, 1 with L braziliensis, 1 with mixed infection (L panamensis and L mexicana), and 1 with Leishmania species only. One patient was managed with surgical excision, 3 with ketoconazole, and 1 was observed off therapy. Four patients were referred to otolaryngology. All continue to be followed in infectious disease clinic. Conclusion We present five cases of new world cutaneous leishmaniasis in African pediatric patients arriving to Maine through Latin America or Texas. Patients were diagnosed with cellulitis, tinea corporis or atopic dermatitis initially, underscoring importance of high index of suspicion in migrant patients. Detailed travel history and epidemiologic knowledge is essential to diagnosis, as patients may present with illness not congruent with country of origin. Optimal therapy remains unclear. Disclosures All Authors: No reported disclosures

scholarly journals Multiple Koenen Tumors, a Rare Entity: Combination Treatment with 1% Topical Sirolimus Electrofulguration and Excision

2020 ◽  
Vol 7 (1) ◽  
pp. 66-70
Author(s):  
Vishalakshi Viswanath ◽  
Jay D. Gupte ◽  
Niharika Prabhu ◽  
Nilima L. Gour
Keyword(s):  
Tuberous Sclerosis ◽  
Combination Treatment ◽  
Tumor Regression ◽  
Surgical Excision ◽  
Tumor Formation ◽  
Rare Entity ◽  
Rare Presentation ◽  
Cutaneous Manifestations ◽  
Elderly Female

<b><i>Introduction:</i></b> Koenen tumors are benign, cutaneous manifestations of tuberous sclerosis. These are disfiguring, painful, and challenging to treat as they frequently recur. We report a case of long-standing, multiple Koenen tumors affecting all twenty nails in an elderly female who was successfully treated with a combination of topical sirolimus 1%, surgical excision, and electrofulguration. <b><i>Case Report:</i></b> A 57-year-old lady presented with multiple, asymptomatic periungual, and subungual tumors affecting all twenty nails since 27 years. Cutaneous examination revealed confetti macules, ash-leaf macule, and shagreen patch over trunk. Nail biopsy was compatible with Koenen’s tumor. Computerized tomography of brain showed diffuse patchy sclerosis. The tumors were treated with topical sirolimus 1% ointment for 10 months with excellent regression. Electro­fulguration for both great toenails and surgical excision of right thumbnail periungual fibroma was done. 1% sirolimus was advised after the surgical treatment. There were no adverse effects or recurrence of tumors over a 2-year follow-up. <b><i>Discussion:</i></b> Topical sirolimus 1% was effective in tumor regression and preventing new tumor formation. Larger tumors that interfered in daily chores were treated with excision and electrofulguration. Thus, a combination treatment for this rare presentation of tuberous sclerosis provided optimum results.

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