Journal of Cutaneous and Aesthetic Surgery
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  Access statistics : Table of Contents
   2012| October-December  | Volume 5 | Issue 4  
    Online since December 20, 2012

 
 
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REVIEW ARTICLES
Dermal fillers for the treatment of tear trough deformity: A review of anatomy, treatment techniques, and their outcomes
Jaishree Sharad
October-December 2012, 5(4):229-238
DOI:10.4103/0974-2077.104910  PMID:23378704
Tear trough deformity is a major concern in a lot of individuals seeking periorbital rejuvenation. A prominent tear trough deformity is characterised by a sunken appearance of the eye that results in the casting of a dark shadow over the lower eyelid, giving the patient a fatigued appearance despite adequate rest, and is refractory to attempts at cosmetic concealment. The tear trough deformity is a natural consequence of the anatomic attachments of the periorbital tissues. A variety of techniques have evolved to address this cosmetic issue. Traditional techniques relied on surgical excision of skin, muscle, and fat as well as chemical peels. Treatment is now tailored towards specific anatomic abnormalities and often employs multiple modalities including surgery, botulinum toxin, and replacement of volume. Various original research articles, text book publications and review articles were studied. Data specific to the historical aspect and anatomy of tear trough have been enumerated. Techniques of different authors were analysed and their results and complications have been summarised. The technique of the author has also been described here.
  18,577 1,115 -
CME
Complications of medium depth and deep chemical peels
Nanma Nikalji, Kiran Godse, Jagdish Sakhiya, Sharmila Patil, Nitin Nadkarni
October-December 2012, 5(4):254-260
DOI:10.4103/0974-2077.104913  PMID:23378707
Superficial and medium depth peels are dynamic tools when used as part of office procedures for treatment of acne, pigmentation disorders, and photo-aging. Results and complications are generally related to the depth of wounding, with deeper peels providing more marked results and higher incidence of complications. Complications are also more likely with darker skin types, certain peeling agents, and sun exposure. They can range from minor irritations, uneven pigmentation to permanent scarring. In very rare cases, complications can be life-threatening.
  19,098 506 1
REVIEW ARTICLES
Chemical peels for acne and acne scars in asians: Evidence based review
Evangeline B Handog, Maria Suzanne L Datuin, Ivan A Singzon
October-December 2012, 5(4):239-246
DOI:10.4103/0974-2077.104911  PMID:23378705
Chemical peeling is a widely used procedure in the management of acne and acne scars, but there are very few studies on Asian populations who are more prone to develop hyper pigmentation. This article aims to summarize and evaluate the existing studies on the role of chemical peels in the treatment of acne and acne scars among Asians. An online search was conducted to identify prospective studies published in English that evaluated the use of chemical peels in active acne and acne scars in Asian populations. There were six studies for acne and eight studies for acne scars that were identified using our search parameters. Most were single-centre, open label and with small sample sizes. Acne severity was not uniformly reported and the objective outcome measures of some studies were not explicitly reported as well. The general trend of the results of the studies support the safety and efficacy of chemical peels for acne and acne scars including those of darker skin types. The existing studies support the use of chemical peels in the treatment of acne and acne scars in Asians. Further clinical trials with better study design and more subjects are needed to further establish the role of chemical peels in Asian acne patients.
  7,449 866 -
Chemical peels for melasma in dark-skinned patients
Rashmi Sarkar, Shuchi Bansal, Vijay K Garg
October-December 2012, 5(4):247-253
DOI:10.4103/0974-2077.104912  PMID:23378706
Melasma is a common disorder of hyperpigmentation, which has a severe impact on the quality of life. Inspite of tremendous research, the treatment remains frustrating both to the patient and the treating physician. Dark skin types (Fitzpatrick types IV to VI) are especially difficult to treat owing to the increased risk of post-inflammatory hyperpigmentation (PIH). The treatment ranges from a variety of easily applied topical therapies to agents like lasers and chemical peels. Peels are a well-known modality of treatment for melasma, having shown promising results in many clinical trials. However, in darker races, the choice of the peeling agent becomes relatively limited; so, there is the need for priming agents and additional maintenance peels. Although a number of new agents have come up, there is little published evidence supporting their use in day-to -day practice. The traditional glycolic peels prove to be the best both in terms of safety as well as efficacy. Lactic acid peels being relatively inexpensive and having shown equally good results in a few studies, definitely need further experimentation. We also recommend the use of a new peeling agent, the easy phytic solution, which does not require neutralisation unlike the traditional alpha-hydroxy peels. The choice of peeling agent, the peel concentration as well as the frequency and duration of peels are all important to achieve optimum results.
  5,892 772 3
ORIGINAL ARTICLES
A comparison of low-fluence 1064-nm Q-switched Nd: YAG laser with topical 20% azelaic acid cream and their combination in melasma in Indian patients
Charu Bansal, Hira Naik, Hemanta K Kar, Amrita Chauhan
October-December 2012, 5(4):266-272
DOI:10.4103/0974-2077.104915  PMID:23378709
Background: Melasma is an acquired symmetric hypermelanosis characterised by irregular light to gray-brown macules on sun-exposed skin with a predilection for the cheeks, forehead, upper lip, nose and chin. The management of melasma is challenging and requires meticulous use of available therapeutic options. Aims: To compare the therapeutic efficacy of low-fluence Q-switched Nd: YAG laser (QSNYL) with topical 20% azelaic acid cream and their combination in melasma in three study groups of 20 patients each. Materials and Methods: Sixty Indian patients diagnosed as melasma were included. These patients were randomly divided in three groups (group A = 20 patients of melasma treated with low-fluence QSNYL at weekly intervals, group B = 20 patients of melasma treated with twice daily application of 20% azelaic acid cream and group C = 20 patients of melasma treated with combination of both). Study period was of 12 weeks each. Response to treatment was assessed using melasma area and severity index score. Statistical Analysis: The statistical analysis was done using Chi-square test, paired and unpaired student t-test. Results: Significant improvement was recorded in all the three groups. The improvement was statistically highly significant in Group C as compared to group A ( P < 0.001) and group B ( P < 0.001). Conclusions: This study shows the efficacy of low-fluence QSNYL, topical 20% azelaic acid cream and their combination in melasma. The combination of low-fluence QSNYL and topical 20% azelaic acid cream yields better results as compared to low-fluence QSNYL and azelaic acid alone.
  5,286 342 5
Evaluation of the utility of the Fournier's gangrene severity index in the management of Fournier's gangrene in North India: A multicentre retrospective study
Satyajeet Verma, Ashutosh Sayana, Sanjay Kala, Sujeet Rai
October-December 2012, 5(4):273-276
DOI:10.4103/0974-2077.104916  PMID:23378710
Objective: To study the utility of Fournier's Gangrene Severity Index (FGSI) with mortality predictive value in our tertiary institutes in North India. Materials and Methods: A retrospective study of 95 cases of Fournier's Gangrene (FG), admitted from 2009 to 2011, was carried out. We analysed clinical and laboratory findings, various prognostic factors, surgical treatments and their outcomes in FG patients. FGSI was used as individual variable to estimate the severity of FG; the effects of these factors on mortality were also evaluated. Results: The overall mean age was 46.5 ± 15.6 (range 24-82) years. Anorectal and urological regions were the main sites of the infection. The most common site of infection origin was scrotum in 81.3% in group A and 41.2% in group B. One or more predisposing factors such as diabetes mellitus (DM; 55%) malignancies (4.6%), chronic renal failure (4.5%) and previous surgery (9.2%) were detected. We observed mortality in 26.5% cases (17/65). The FGSI calculated averaged 5.95 ± 365 in group A and 9.44 ± 2.56 in group B, at the time of admission ( P > 0.05). Conclusion: In FG, an early diagnosis and early surgical debridement are essential. The FGSI seems to be an excellent tool for the outcome prediction.
  3,515 181 1
A split-face comparative study of 70% trichloroacetic acid and 80% phenol spot peel in the treatment of freckles
PR Mradula, S Sacchidanand
October-December 2012, 5(4):261-265
DOI:10.4103/0974-2077.104914  PMID:23378708
Aim: To study and compare the efficacy of TCA (70%) and phenol (80%) in the treatment of freckles. Settings and Design: A prospective study was done, over one year, on patients having freckles on the face. The freckles on the right side of the face were treated with TCA (70%) and those on the left side of the face were treated with phenol (80%). Materials and Methods: Twenty patients of Fitzpatrick type II-IV were treated. The freckles on the left side of the face were treated with phenol, while those on the right were treated with TCA in all patients. The patients were reviewed at weekly intervals for three weeks. Evaluation of the results was done photographically, subjectively, and objectively. Results: Fifteen out of 20 patients (75%) noted a complete clearance (90 - 100% lightening) of the lesions treated. Four patients (darker skin types) noted hyperpigmentation. One noticed recurrence where TCA was applied. Conclusions: Both TCA and phenol are found to be equally effective in the treatment of freckles in fair skin. Both are cheap and effective alternatives for the treatment of freckles.
  3,289 279 1
LETTERS
Subungual vascular malformation with unusual presentation
Uwe Wollina
October-December 2012, 5(4):289-290
DOI:10.4103/0974-2077.104921  PMID:23378715
  3,131 88 -
CASE REPORTS
Surgical therapy by sandwich transplantation using a dermal collagen-elastin matrix and full thickness split grafts and gait rehabilitation with individualized orthesis
Uwe Wollina, Birgit Heinig
October-December 2012, 5(4):277-280
DOI:10.4103/0974-2077.104917  PMID:23378711
Painful callosities of the feet (PCOF) are a rare complaint in children with severe impairment of mobility and quality of life. There is no medical treatment available.We investigated the usefulness of a recently developed combined transplant technique-the sandwich transplantation with dermal collagen-elastin template in this rare condition. A 14-year-old boy suffered from PCOF for several years without any improvement by topical therapy, dermabrasion, and oral retinoids. He was unable to walk normally and suffered from severe pain. We performed a complete deep excision of the hyperkeratotic plantar tissue in general anaesthesia in combination with sandwich transplantation in the same setting. Dry sheets of collagen-elastin matrix (1 mm thickness) were placed on the soft tissue defects and covered by full-thickness mesh graft transplants from the upper leg. An individualized orthosis was produced for gait rehabilitation. Two weeks after surgery the gait-related pain was reduced remarkably. Using the orthosis, the boy was able to walk pain-free even on staircase. Surgery of PCOF with sandwich transplantation and gait rehabilitation appears to be a promising strategy for this rare condition.
  3,120 89 1
Dracunculiasis: Two cases with rare presentations
Anirudha Gulanikar
October-December 2012, 5(4):281-283
DOI:10.4103/0974-2077.104918  PMID:23378712
Dracunculiasis (Guinea worm Disease) is a debilitating disease caused by parasite Dracunculus medinensis. The condition is not life threatening, but causes significant morbidity. Patients may be sick for several months. Dracunculiasis has been claimed to be eradicated in India since 1999. We report two patients with calcified guinea worm. Both patient required surgical removal of calcified worm. The cases document that the parasite can cause chronic recurrent nodules and ulcers.
  2,776 108 2
EDITORIAL
Chemical peels and fillers-incorporating scientific evidence in clinical practice
Rashmi Sarkar, Jaishree Sharad, Maya Vedamurthy
October-December 2012, 5(4):227-228
DOI:10.4103/0974-2077.104909  PMID:23378703
  2,186 288 -
CASE REPORTS
Transcutaneous blepharoplasty in blepharochalasis
Sarvajnamurthy A Sacchidanand, Hurkudli Suresh Deepak, Chugh Vishal, Tumkur Narasimhan Revathy
October-December 2012, 5(4):284-286
DOI:10.4103/0974-2077.104919  PMID:23378713
Blepharochalasis is a rare degenerative disease of skin of lids. We report 3 cases of blepharochalasis, out of which two involved upper eyelids and one involved lower eyelids. All the three cases were treated with transcutaneous blepharoplasty with acceptable cosmetic results.
  2,255 164 -
COMMENTARY
Comment on subungual vascular malformation with unusual presentation
Eckart Haneke
October-December 2012, 5(4):291-294
  2,196 78 -
LETTERS
Non ablative fractional photothermolysis for atrophic acne scars
Rajat Kandhari, Sanjiv Kandhari
October-December 2012, 5(4):287-289
DOI:10.4103/0974-2077.104920  PMID:23378714
  1,993 195 -
BOOK REVIEW
Facial Topography: Clinical Anatomy of the Face
Subrata Basu Ray
October-December 2012, 5(4):295-295
  1,596 174 -
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