Development of a core outcome set for basal cell carcinoma.

Background: There is variation in the outcomes reported in clinical studies of basal cell carcinoma. This can prevent effective meta-analyses from answering important clinical questions.

Objective: To identify a recommended minimum set of core outcomes for basal cell carcinoma clinical trials.

Use of a Buried Intradermal (Subcutaneous) Running Suture for Superficial Repair to Optimize Cosmetic Outcome.

Superficial repair after excisions helps to optimize cosmetic outcomes. Possibly due to how wound closures are traditionally taught in dermatology, simple interrupted or continuous sutures are overwhelmingly favored by dermatologic surgeons in superficial repair, especially on cosmetically sensitive areas such as face and ears. However, this repair method risks wound overgrowth around the points where the suture traverses through the epidermis, and long-term postsurgical healing frequently leaves behind scars with ‘railroad track’ suture marks rather than a fine line.

Solitary necrobiotic xanthogranuloma of an upper extremity in association with multiple myeloma.

Necrobiotic xanthogranuloma (NXG) is an uncommon granulomatous disorder of unknown pathogenesis that often presents with yellowish plaques in a periorbital distribution. While a majority of cases are associated with an underlying paraproteinemia of the IgG kappa type, a much smaller number are found to be associated with an underlying multiple myeloma. We present a case of a 78-year-old male with an isolated lesion of NXG on his right upper extremity.

Adverse events associated with mohs micrographic surgery: multicenter prospective cohort study of 20,821 cases at 23 centers.

Importance: Detailed information regarding perioperative risk and adverse events associated with Mohs micrographic surgery (MMS) can guide clinical management. Much of the data regarding complications of MMS are anecdotal or report findings from single centers or single events.

Objectives: To quantify adverse events associated with MMS and detect differences relevant to safety.

Laser skin resurfacing, chemical peels, and other cutaneous treatments of the brow and upper lid.

The focus of this article is treatments of the brow and upper lid, in the context of appreciating their relationship to the forehead and periorbital complex to best evaluate and treat. This material is focused on treatments designed to stimulate collagen synthesis, as well as improve fine lines, wrinkles, and overall appearance of the skin, by mechanical dermabrasion, application of chemical peels, laser surgery, and treatment with energy devices including radiofrequency and focused ultrasound.

1927-nm fractional resurfacing of facial actinic keratoses: a promising new therapeutic option.

Background: Actinic keratoses (AK) are precancerous epidermal proliferations commonly present on chronically sun-damaged skin. These lesions are among the most often treated dermatologic conditions.

Objective: We sought to investigate the 6-month safety, tolerance, and efficacy of nonablative 1927-nm fractional resurfacing of facial AK.

Ablative fractional resurfacing for involuted hemangioma residuum.

BACKGROUND Given the natural tendency for 15% to 40% of infantile hemangiomas to spontaneously involute over time, much debate surrounds the issue of treatment. Until recently, effective therapies to improve the appearance of residual textural skin changes in these patients were lacking. We suggest the use of ablative fractional resurfacing for the treatment of textural skin changes resulting from involuted hemangiomas.

Successful and rapid treatment of blue and green tattoo pigment with a novel picosecond laser.

Background: While the understanding and technology of laser tattoo removal has advanced much over the last 5 decades, treatments and results remain far from perfect. With currently available devices, treatment courses are often painful and prolonged with mixed results. We describe the successful and rapid treatment of 12 tattoos containing blue and/or green pigment with a novel, picosecond, 755-nm alexandrite laser.

Infliximab (Remicade) and increased incidence of development of basal cell carcinoma.

Immunosuppression is a known risk factor for the development of non-melanoma skin cancers (NMSC). Certain medications that induce immunosuppression, such as tumor necrosis factor-α (TNF-α) inhibitors, are being used more frequently. We report a case of a young, pregnant woman who was treated with infliximab for Crohn's disease, and subsequently experienced a rapid growth of two pre-existing basal cell carcinomas.

Investigation into optimal treatment intervals of facial port-wine stains using the pulsed dye laser.

Background: Port-wine stains (PWS) affect 0.3% to 0.5% of newborns and pulsed dye laser (PDL) remains the treatment of choice.

Musculoskeletal disorders and ergonomics in dermatologic surgery: a survey of Mohs surgeons in 2010.

Background: Dermatologic surgeons perform numerous procedures that put them at risk of developing work-related musculoskeletal disorders.

Objective: To study the prevalence of work-related musculoskeletal disorders and role of ergonomics in dermatologic surgery.

Methods And Materials: A survey study was sent to members of the American College of Mohs Surgery in 2010.

Association between number of stages in Mohs micrographic surgery and surgeon-, patient-, and tumor-specific features: a cross-sectional study of practice patterns of 20 early- and mid-career Mohs surgeons.

Objective: To determine the number of Mohs micrographic surgery (MMS) stages per tumor taken by early- to mid-career Mohs surgeons and to assess other factors affecting number of stages.

Methods: Statistical analysis of MMS logs of 20 representative early- to mid-career surgeons.

Results: There was no difference in stages when surgeons were divided into two categories based on whether they had more than 500 cases per year or more than 5 years of experience.

Procedural dermatology training during dermatology residency: a survey of third-year dermatology residents.

Background: Given the expanding role of multiple surgical procedures in dermatology, resident training in procedural dermatology must be continually assessed to keep pace with changes in the specialty.

Objective: We sought to assess the third-year resident experience in procedural dermatology during residency training.

Methods: This survey study was mailed to third-year dermatology residents at 107 Accreditation Council for Graduate Medical Education (ACGME)-approved dermatology residency programs in 2009.

Successful treatment of atrophic postoperative and traumatic scarring with carbon dioxide ablative fractional resurfacing: quantitative volumetric scar improvement.

Objective: To assess the safety and efficacy of ablative fractional resurfacing (AFR) for nonacne atrophic scarring.

Design: In this before-and-after trial, each scar received 3 AFR treatments and 6 months of follow-up.

Setting: Private academic practice.

Outcomes of childhood hemangiomas treated with the pulsed-dye laser with dynamic cooling: a retrospective chart analysis.

Background: Laser treatment of childhood hemangiomas remains controversial. Previous studies have used outdated technology, resulting in a potential overrepresentation of adverse outcomes.

Objective: To evaluate outcomes of hemangiomas treated with the most current laser technology.

Port wine stain progression: a potential consequence of delayed and inadequate treatment?

Background And Objectives: Port wine stains are congenital low-flow vascular malformations of the skin. Unlike hemangiomas, PWS do not involute with time, but rather if left untreated can hypertrophy and develop nodularity. Laser therapy of PWS particularly with pulsed-dye lasers, is a safe, well-established treatment that is successful in the majority of patients, especially for younger patients.

Eyelid tightening and improved eyelid aperture through nonablative fractional resurfacing.

Background And Objective: The effects of fractional resurfacing on eyelid tightening and aperture are unknown. Our purpose was to retrospectively examine the potential for eyelid tightening and eye-aperture opening in patients treated with nonablative fractional resurfacing for facial photorejuvenation.

Study Design/materials And Methods: Fractional laser treatments using a 1,550-nm erbium-doped fiber laser system on the upper and lower eyelids were given at a pulse energy of 17 to 20 mJ at 125 micro-thermal zones (MTZ)/cm(2) to a final density of 500 to 750 MTZ/cm(2).

Mohs micrographic surgery for an unusual case of keratoacanthoma arising from a longstanding tattoo.

This case report seeks to alert the reader to the possibility that the keratoacanthoma (KA) may develop in tattoo sites, specifically in red tattoo sites. We further wish to describe the senior author's treatment of such a lesion using Mohs micrographic surgery and a rotation flap to preserve the integrity of the original tattoo design in an area of minimal skin laxity. We briefly discuss the etiology of the KA and review potential tattoo reactions as presented in the literature.

Primary mucinous carcinoma with direct histopathologic evidence of lymphatic invasion.

Background: Primary mucinous carcinoma of the skin is a rare sweat gland neoplasm which occurs most commonly in the periorbital region. Although the tumor has a propensity for local recurrence and regional spread, distant metastases are rare. The standard treatment of primary mucinous carcinoma is wide local excision.