Recurrent disseminated herpes zoster and cytomegalic perianal ulcer: a case report and review of the literature.

We describe a patient with lymphocytic leukemia who developed multiple, disseminated, vesiculopustular eruptions in combination with perianal ulcer. Four years earlier, she had a herpes zoster (HZ) infection involving the ophthalmic division of her left trigeminal nerve with subsequent postherpetic neuralgia that was treated with steroids. After the studies, we concluded that the patient had a recurrent disseminated HZ infection and perianal ulcer caused by cytomegalovirus (CMV).

Skin resurfacing of facial rhytides and scars with the 90-microsecond short pulse CO2 laser. Comparison to the 900-microsecond dwell time CO2 lasers and clinical experience.

Background: Carbon dioxide lasers that produce either short pulses or scanned continuous beams have been used for skin resurfacing to improve wrinkles or scars. Using a high peak power, short pulse CO2 laser can produce clinically effective results with minimal thermal damage.

Objective: To evaluate the effectiveness of skin resurfacing using the 90-microsecond pulse duration CO2 laser compared to other laser systems.

Quantitative comparison of inflammatory infiltrate and linear contraction in human skin treated with 90-microsecond pulsed and 900-microsecond dwell time carbon dioxide lasers.

Background: Skin resurfacing with 90-microsecond pulse duration carbon dioxide (CO2) resurfacing lasers has been reported to have shorter duration of erythema compared with skin resurfacing with 900-microsecond dwell time lasers. The presence of inflammatory infiltrate following resurfacing may correlate with the persistence of this erythema. Furthermore, skin treated with the 90-microsecond pulse duration laser and the 900-microsecond dwell time lasers both result in equivalent improvement of rhytids in the treated skin.

Comparison of skin anesthetic effect of liposomal lidocaine, nonliposomal lidocaine, and EMLA using 30-minute application time.

Background: Liposomes are microscopic phospholipid vessels that have been utilized to extend the action of topical medications. Previous studies have demonstrated that liposomal vehicles can prolong the action of a variety of medications, including antifungals, anesthetics, interferon, and antineoplastic agents.

Objective: The purpose of this study was to examine the degree and duration of anesthesia produced by lidocaine in a liposomal vehicle compared with lidocaine in a nonliposomal vehicle and compared with EMLA.

Topical anesthetic agents in dermatologic surgery. A review.

Background: The ideal topical anesthetic agent is one that provides 100% anesthesia in a short period of time, work on intact skin without systemic side effects, and invokes neither pain nor discomfort. The quest to find such an agent continues today. Because a topical anesthetic agent will induce anesthesia painlessly, the need for an effective agent is clear.

Photoelastic models of wound closure stress.

Background: Areas of high stress in surgical closures are known to have adverse effects on wound healing.

Objective: To create a surgical model that will predict areas of high stress and allow for quantitative comparison of stress distributions in different closure geometries.

Methods: Surgical models were constructed consisting of soft polyurethane plastic.

Inhibition of cell proliferation by chronic wound fluid.

It has been proposed that occlusive wound dressings may enhance chronic wound repair by the stimulatory action of the fluid accumulating beneath the dressings. In this report, we investigated the in vitro proliferative effects of chronic wound fluid obtained from under a polyurethane membrane applied for 24 hours to venous ulcers in the ambulatory setting. By measuring cell counts and DNA synthesis, we found that chronic wound fluid inhibited the proliferation of human dermal fibroblasts (p = 0.

Use of a durometer to assess skin hardness.

Background: Skin induration is difficult to quantify. In patients with systemic sclerosis (scleroderma), a clinical skin severity score (0 = normal skin; 3 = maximal induration) has been in use for several years for assessment of skin involvement and therapeutic outcome.

Objective: The purpose of this study was to find a more objective method to assess skin hardness in patients with scleroderma.

Topical use of human recombinant epidermal growth factor (h-EGF) in venous ulcers.

A great deal of interest has been focused recently on the potential use of synthetic polypeptide growth factors to stimulate healing of chronic wounds. In this pilot double-blind randomized study conducted at a single center, we used human recombinant epidermal growth factor (h-EGF) to treat 44 patients with venous ulceration of the lower extremities. An aqueous solution (10 micrograms/mL) of h-EGF was applied topically to the ulcers twice a day until healing occurred or for a maximum of 10 weeks.