Increased burden of melanoma and nonmelanoma skin cancer in young women.

Background: A higher and increasing incidence of skin cancer has been noted in younger women as compared with men.

Objective: To assess the relative gender burden of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma in various age groups, particularly in young adult women.

Materials And Methods: A total of 16,994 biopsy-proven skin cancers in 9,376 patients in a single private dermatologic surgery practice was included in this study.

Evaluation of the chemopreventative effects of ALA PDT in patients with multiple actinic keratoses and a history of skin cancer.

Background: Actinic keratoses (AKs) are in situ epidermal tumors that may progress to invasive squamous cell carcinomas (SCCs). Aminolevulinic acid with photodynamic therapy (ALA PDT) is a field treatment for AK.

Objective: To evaluate the time to development of new non-melanoma skin cancers (NMSC) within one year of ALA-PDT treatment in immunocompetent patients with AK and a history of skin cancer.

Repair of scalp defects using an H-plasty type of bilateral advancement flap.

Background: Defects of the scalp often pose a reconstructive challenge in dermatologic surgery. OBJECTIVE We report our experience with the H-plasty type of bilateral advancement flap for the closure of small to medium-sized scalp defects that cannot be closed primarily.

Methods: In this case series study, 69 scalp defects 1.

Frontalis muscle plication and imbrication in reconstruction of forehead defects.

The forehead is a common site for nonmelanoma skin cancer. For medium to large sized defects, the primary reconstructive challenge is the paucity of loose adjacent donor skin. The authors describe frontalis muscle plication, imbrication, and related surgical techniques utilized in reconstructing forehead defects.

Fractional photothermolysis: a review and update.

Fractional resurfacing is a new laser treatment modality that creates numerous microscopic thermal injury zones of controlled width, depth, and density that are surrounded by a reservoir of spared epidermal and dermal tissue, allowing for rapid repair of laser-induced thermal injury. This unique modality, if implemented with proper laser-delivery systems, enables high-energy treatments while minimizing risks. In this article, we review the various fractional laser devices, including the new fractional ablative devices, as well as the results of studies on the clinical efficacy of fractional photothermolysis.

The 20-minute rapid MART-1 immunostain for malignant melanoma frozen sections.

Background: Immunohistochemical staining has been used to help detect malignant melanoma on Mohs surgery frozen sections. Previous investigators have developed protocols for reliable MART-1 immunostaining of frozen sections, but these protocols are time-consuming.

Objective: The objective was to report a rapid 20-minute MART-1 immunostaining protocol for frozen sections.

Margin involvement after the excision of melanoma in situ: the need for complete en face examination of the surgical margins.

Background: The standard treatment for cutaneous melanoma in situ is surgical excision followed by standard pathologic evaluation. Serial cross-sectioning (bread-loafing) may result in false negative margin examination and higher local recurrence rates than Mohs micrographic surgery, which histologically evaluates the entire surgical margin.

Objective: To estimate the sensitivity of bread-loafing in detecting residual melanoma in situ at surgical margins.

Fractional photothermolysis for photoaging of hands.

Background: Laser treatment for photoaging of the hands should ideally address pigmentary alteration as well as associated skin roughness and wrinkling. Fractional resurfacing has been previously shown to effectively treat facial rhytids and dyschromia.

Objective: We examined the effect of fractional resurfacing for photoaging of the hands.

Laser treatment of acne vulgaris.

Traditional medical treatments for acne vulgaris include a variety of topical and oral medications. The combination of poor compliance, lack of durable remission, and potential side effects are common drawbacks to these treatments. The use of lasers and light devices has increased dramatically in recent years due to the overall ease of treatment, predictable clinical efficacy, and minimal adverse effects.

The 1450-nm diode laser for facial inflammatory acne vulgaris: dose-response and 12-month follow-up study.

Background: The 1450-nm diode laser has been known to thermally alter sebaceous glands and has been found to be effective for the treatment of inflammatory facial acne.

Objective: Our aim was to evaluate the dose response of a 1450-nm diode laser for treatment of facial acne, sebum production, and acne scarring utilizing two laser fluences and to determine long-term remission after laser treatment.

Methods: Twenty patients (Fitzpatrick skin phototypes II-VI) received 3 treatments using the 1450 nm diode laser (3-4 week intervals).

The incidence of major complications from Mohs micrographic surgery performed in office-based and hospital-based settings.

Background: There has been significant interest in the safety of office-based surgery.

Objective: Our purpose was to compare the safety of Mohs micrographic surgery and related surgical repairs performed in office- and hospital-based settings.

Methods: The study included 3937 consecutive patients undergoing Mohs surgery.

Treatment of inflammatory facial acne vulgaris with combination 595-nm pulsed-dye laser with dynamic-cooling-device and 1,450-nm diode laser.

Background And Objectives: The 585-nm pulsed-dye laser and the 1,450-nm diode laser have been found effective for the treatment of mild-to-moderate inflammatory facial acne. This study was designed to evaluate the efficacy and safety of the combined treatment with the 595-nm pulsed-dye laser and the 1,450-nm diode laser for inflammatory facial acne.

Study Design/materials And Methods: Fifteen patients with inflammatory facial acne were treated with a combination of the 595-nm pulsed-dye laser and the 1,450-nm diode laser.

Accuracy of serial transverse cross-sections in detecting residual basal cell carcinoma at the surgical margins of an elliptical excision specimen.

Background: There has been no published study estimating the proportion of positive surgical margins that is missed when serial transverse cross-sectioning (bread-loafing) is used to histologically evaluate the surgical margins.

Objective: Our purpose was to estimate the accuracy of serial transverse cross-sectioning (bread-loafing) at 4-mm intervals in detecting the presence of residual tumor at the margins of well-defined facial basal cell carcinomas excised as an ellipse with 2-mm surgical margins.

Methods: Forty-two small (<1 cm), well-defined, primary, nonmorpheaform facial basal cell carcinomas that had been excised as an ellipse with 2-mm margins and that had positive surgical margins utilizing en-face Mohs sections were included.

Efficacy of narrow-margin excision of well-demarcated primary facial basal cell carcinomas.

Background: A 4-mm surgical margin of clinically normal skin is the current standard for elliptical excision of basal cell carcinomas (BCCs). However, a 4-mm surgical margin is often not feasible on the face because of cosmetic and functional concerns. As such, facial excisions of BCCs are typically performed with the appropriate margin determined by the surgeon based on clinical features of the tumor.

A rare case of fatal primary cutaneous mucinous carcinoma of the scalp with multiple in-transit and pulmonary metastases.

Background: Primary cutaneous mucinous carcinoma is a rare neoplasm derived from the sweat glands. It is usually located in the head and neck region, with the eyelids being the most common site of presentation. Recurrence following primary excision is common but metastasis is rare.

Surgical repair of temple defects after Mohs micrographic surgery.

Background: It is typically recommended that linear surgical closures follow a relaxed skin tension line (RSTL). In the temple, these lines generally run parallel to the orbital rim. However, closures parallel to RSTLs are not feasible for many medium and large surgical defects because of anatomic constraints.

Curettage prior to Mohs' micrographic surgery for previously biopsied nonmelanoma skin cancers: what are we curetting? Retrospective, prospective, and comparative study.

Background: Curettage prior to excision and Mohs' micrographic surgery for nonmelanoma skin cancer is performed based on the assumption that the curette will remove softer, more friable tumor-infiltrated dermis and leave structurally intact normal skin. This assumption, however, has not been objectively examined in the dermatologic surgery literature.

Objective: We performed a study to examine the ability of curettage to selectively remove and delineate nonmelanoma skin cancer prior to Mohs' micrographic surgery.

Analysis of 197 female scalp tumors treated with Mohs micrographic surgery.

Background: There has been no previously published study on skin cancers on the scalp of women.

Objectives: To better elucidate the characteristics of skin cancers that develop on the female scalp.

Methods: A retrospective review of 13,885 biopsy-proven skin cancers treated by Mohs micrographic surgery was performed.