Revisiting the purse-string closure: some new methods and modifications.

Background: Surgical wounds resulting from the extirpation of cutaneous malignancies can be repaired in a number of ways. One alternative, which has been used extensively in our practice, is the purse-string closure. This method of closure offers distinct advantages in the proper setting over traditional methods of closure.

Pigmentary changes after alexandrite laser hair removal.

Background: Postinflammatory pigmentary changes are a frequently encountered problem with numerous dermatologic procedures. Limited literature is available that documents this complication with laser hair removal.

Objective: It is important for all physicians performing laser hair removal to be aware of this potential complication.

Therapeutic response of a brother and sister with xeroderma pigmentosum to imiquimod 5% cream.

Background: Xeroderma pigmentosum (XP) is an autosomal recessive disease marked by solar sensitivity, photophobia, early onset of freckling, and solar-induced cutaneous neoplastic changes. These patients can often develop hundreds of cutaneous tumors, making surgical therapy difficult. Imiquimod 5% cream has been shown to have activity in treating various cutaneous malignancies.

A comparison of scar revision with the free electron and carbon dioxide resurfacing lasers.

Laser scar revision was studied to measure the effects of targeting extracellular matrix protein versus tissue water on scar revision. We compared the free electron laser used at 7.7 microm (the amide III protein absorption band) to the carbon dioxide (CO2) laser and dermabrasion.

Potential utility of adjunctive histopathologic evaluation of some tumors treated by Mohs micrographic surgery.

Background: Mohs micrographic surgery is a highly effective, tissue-conserving method for removing certain cutaneous neoplasms. Horizontal Mohs tissue sectioning permits complete histologic evaluation of the true surgical margin, but does not aim to evaluate the overall morphology of the tumor. Mohs surgery is designed primarily to answer the question "Is it all out?" as opposed to "What is it?" A preoperative biopsy is relied on, in most cases, to provide an accurate diagnosis.

Combined sentinel lymphadenectomy and mohs micrographic surgery for high-risk cutaneous squamous cell carcinoma.

Background: There are subgroups of cutaneous squamous cell carcinoma (SCC) that have a higher risk for both regional and distant metastasis. When cutaneous SCC does metastasize, it typically spreads first to local nodal groups. Sentinel lymph node (SLN) localization has been successfully used to evaluate nodal metastasis in breast carcinoma, melanoma, and other select tumors.

Dog-ears: a review.

Background: The closure of any circular or asymmetric wound results in puckering or excess of tissue known as dog-ears.

Objective: Facility in managing dog-ears is an invaluable tool in cutaneous surgery due to its common presentation.

Methods: Methods for correcting dog-ears are extensively detailed in both the plastic and dermatologic surgery literature.

Collagenous fibroma (desmoplastic fibroblastoma).

Collagenous fibroma (desmoplastic fibroblastoma) is a recently described tumor that may arise in the subcutaneous tissue or skeletal muscle. We report a case of collagenous fibroma, occurring on the forehead of a 67-year-old man. An awareness of this entity is necessary to avoid confusion with other soft tissue neoplasms, especially extraabdominal fibromatosis.

Free electron laser infrared wavelength specificity for cutaneous contraction.

Background And Objective: Short pulsed and scanned CO(2) lasers that target water molecules are currently used for cutaneous resurfacing. These CO(2) resurfacing lasers produce acute cutaneous contraction, which can be quantitated as a measure of the laser's effect. We postulated that targeting the vibrational and rotational modes of proteins with specific infrared laser wavelengths might be more effective at inducing cutaneous contraction than the CO(2) resurfacing lasers.

Optimizing fluence and debridement effects on cutaneous resurfacing carbon dioxide laser surgery.

Objective: To develop methods to compare carbon dioxide (CO2) resurfacing lasers, fluence, and debridement effects on tissue shrinkage and histological thermal denaturation.

Design: In vitro human or in vivo porcine skin samples received up to 5 passes with scanner or short-pulsed CO2 resurfacing lasers. Fluences ranging from 2.

Stretch-induced nerve injury as a cause of paralysis secondary to the anterior cervical approach.

The anterior approach to the cervical spine, first described 40 years ago, has become a popular and widely used procedure by spine surgeons to expose the anterior vertebral bodies from C3 to T1. A significant complication of this procedure is transient or permanent ipsilateral recurrent laryngeal nerve paralysis. In a previous review at our institution of patients with hoarseness after an anterior cervical approach, 15 of 16 patients demonstrated right-sided paralysis.