Journal of Cutaneous and Aesthetic Surgery
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   2013| April-June  | Volume 6 | Issue 2  
    Online since May 29, 2013

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Hypomelanoses in children
Nanja van Geel, Marijn Speeckaert, Ines Chevolet, Sofie De Schepper, Hilde Lapeere, Barbara Boone, Reinhart Speeckaert
April-June 2013, 6(2):65-72
DOI:10.4103/0974-2077.112665  PMID:24023426
Hypomelanosis of the skin is a frequently encountered problem in childhood, being totally innocent or representing the first sign of a multisystem disorder. Medical history, clinical examination, Wood's light investigation, histological analysis of the skin and a multidisciplinary consultation can contribute to a correct and early diagnosis of the different types of hypopigmentations. In the present paper, we present a systematic clinical approach to the differential diagnosis of those skin disorders.
  11,246 533 1
Depigmentation therapy with Q-switched Nd: YAG laser in universal vitiligo
Imran Majid, Saher Imran
April-June 2013, 6(2):93-96
DOI:10.4103/0974-2077.112670  PMID:24023431
Background: Any residual pigment left in patients of universal vitiligo is managed with topical treatments, cryotherapy, and lasers. Aim: The study aims to assess the efficacy and safety of Q-switched Nd: YAG laser in treating the residual pigmentation in patients with universal vitiligo. Materials and Methods: Fifteen patients of universal vitiligo with residual pigmentation on the face, hands, or feet, resistant to topical treatments, were treated with single or multiple sessions of Q-switched Nd: YAG laser treatment. Topical treatments were continued in between the laser sessions and the depigmentation achieved was monitored by clinical examination and repeat digital photographs. Response to the treatment was labelled as excellent if the residual pigment could be reduced by at least 90% while 50-90% resolution of pigmentation was labelled as a partial response. Adverse effects to the treatment offered were also monitored. Results: Thirteen of the 15 patients enrolled for the study showed an excellent response to the treatment offered. Two other patients showed a poor response with less than 50% resolution of pigmentation. The number of laser sessions needed at a particular site ranged from 1 to 3 and no patient was offered more than three sessions of laser treatment at any site. No significant adverse events were reported by any patient. Conclusions: Residual pigmentation in patients with universal vitiligo that does not respond to topical treatment options alone can be managed quite effectively with Q-switched Nd: YAG laser without any significant adverse effects.
  5,617 239 -
Grafting in vitiligo: How to get better results and how to avoid complications
Imran Majid
April-June 2013, 6(2):83-89
DOI:10.4103/0974-2077.112668  PMID:24023429
Grafting procedures in vitiligo have become quite popular over the last one or two decades especially in India. Starting with the simplest punch grafting we have now a multitude of different grafting techniques available in vitiligo. All of these grafting procedures are associated with certain complications. In addition there are certain factors and surgical pearls that can go a long way in improving the cosmetic results achieved with any of these grafting techniques. This paper will try to address these specific factors and complications associated with these grafting techniques and the ways and means to avoid them.
  4,766 414 -
A new era of vitiligo research and treatment
Davinder Parsad
April-June 2013, 6(2):63-64
DOI:10.4103/0974-2077.112664  PMID:24023425
  4,503 453 -
Direct hair transplantation: A modified follicular unit extraction technique
Pradeep Sethi, Arika Bansal
April-June 2013, 6(2):100-105
DOI:10.4103/0974-2077.112672  PMID:24023433
Background: In hair transplantation, the survival rate of harvested grafts depends upon many factors like maintenance of hydration, cold temperature, reduced mechanical handling and asepsis. All these factors are favourably improved if time out of body is reduced significantly. We have tried a modification called direct hair transplantation in the existing follicular unit extraction technique, in which the follicular unit grafts are implanted as soon as they are harvested. In this article, we have described the detailed methodology and a series of 29 patients who underwent direct hair transplantation. Aim: To evaluate the efficacy and feasibility of direct hair transplantation. Subjects and Methods: The patients willing to undergo hair transplantation by the technique of follicular unit extraction were enrolled for the surgery. After administration of local anaesthesia, the recipient sites were created. Thereafter, the processes of scoring the skin with a motorized punch, graft extraction and implantation were performed simultaneously. These patients were followed up to look for the time period of initiation of hair growth, the growth achieved at the end of 6-8 months and any adverse events. The results of patients with noticeable improvement in the photographs and reduction in baldness grade were taken as 'good', whereas, in other patients, it was classified as 'poor'. Results: All patients were males with age ranging from 21 to 66 years (median 30 years). Twenty-six patients had androgenetic alopecia, 1 patient had traction alopecia and 2 patients had scarring alopecia. Twenty-seven patients showed 'good' results, whereas 2 patients showed 'poor' results. Conclusion: Direct hair transplantation is a simple and feasible modification in the follicular unit extraction technique. It is an efficacious surgical treatment modality for baldness.
  4,183 659 -
Stability in vitiligo: Is there a perfect way to predict it?
Kanika Sahni, Davinder Parsad
April-June 2013, 6(2):75-82
DOI:10.4103/0974-2077.112667  PMID:24023428
Stability is a hard-to-define concept in the setting of vitiligo, but is nonetheless extremely crucial to the planning of treatment regimens and also in prognosticating for the patient. There are several ways to judge stability in vitiligo, which include clinical features and, recently, many biochemical, cytological and ultrastructural correlates of the same. These recent advances help in not only in prognosticating individual patients but also in elucidating some of the mechanisms for the pathogenesis of vitiligo, including melanocytorrhagy and oxidative damage to melanocytes.
  4,275 448 -
Extracted hair follicle outer root sheath cell suspension for pigment cell restoration in vitiligo
Anil Kumar, Sujata Mohanty, Kanika Sahni, Rajesh Kumar, Somesh Gupta
April-June 2013, 6(2):121-125
DOI:10.4103/0974-2077.112679  PMID:24023440
Vitiligo surgery has come up a long way from punch skin grafts to epidermal cell suspension and latest to the extracted hair follicle outer root sheath cell suspension (EHF-ORS-CS) transplantation. The progressive development from one technique to the other is always in a quest for the best. In the latest development- EHF-ORS-CS, which is an enriched source of follicular inactive melanocyte (melanocyte stem cells), seems to be a good addition to the prevailing cell-based therapies for vitiligo; however, need to be explored further in larger, and preferably randomized blinded studies. This review discusses the principle, technical details, and stem cell composition of hair follicular outer root sheath cell suspension.
  3,750 397 -
Successful treatment of laser induced hypopigmentation with narrowband ultraviolet B targeted phototherapy
Venkataram Mysore, B Anitha, Abhineetha Hosthota
April-June 2013, 6(2):117-119
DOI:10.4103/0974-2077.112677  PMID:24023438
Q-switched 1064 nm neodymium-doped yttrium aluminium garnet (Qs 1064 nm Nd: YAG) laser plays an important role in the treatment of pigmentary skin disorders, including tattoos. Although it has high efficacy and safety, adverse effect like hypopigmentation may occur causing anxiety to patients. We present a case report of Qs 1064 nm Nd: YAG laser induced hypopigmentation which was successfully treated with ultraviolet B targeted phototherapy, with rapid and satisfactory re-pigmentation.
  3,966 167 -
Autologous platelet rich plasma in chronic venous ulcers: Study of 17 cases
Sacchidanand Sarvajnamurthy, Shwetha Suryanarayan, Leelavathy Budamakuntala, Deepak Hurkudli Suresh
April-June 2013, 6(2):97-99
DOI:10.4103/0974-2077.112671  PMID:24023432
Background: Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs. They are the major cause of chronic wounds, occurring in 70% to 90% of chronic wound cases. The treatment of venous ulcers also entails substantial costs. Autologous platelet rich plasma (PRP) is a simple office based procedure which helps in enhancing the wound healing by releasing many growth factors like platelet derived growth factors, fibroblast derived growth factors and epidermal growth factors. Aim: To study the efficacy of autologous platelet rich plasma in the management of chronic venous ulcer. Methodology: 12 patients with 17 venous ulcers were treated with PRP and treatment outcome was measured by percentage of improvement in area and volume of the ulcer. Results: 12 patients with 17 ulcers were treated with PRP. The mean age of the patients was 33.5 years (SD 9.82). 10 were males and 2 were females. The mean duration of the healing of the ulcers was in 5.1 weeks (SD 3.1). The mean percentage improvement in the area and volume of the ulcer was 94.7% (SD 11.12) and 95.6% (SD 10.19) respectively. Conclusions: PRP is safe, simple and effective procedure in treating chronic venous ulcers
  3,359 453 1
Patient profile and outcome of pilomatrixoma in district general hospital in United Kingdom
Mahmoud AbdelDayem, Peter Mekhail, Maged Farag, Guirguis Shehata, Mustafa Al Sheikh, Asal Izzidien, Nader Naguib
April-June 2013, 6(2):107-110
DOI:10.4103/0974-2077.112674  PMID:24023435
Introduction: A pilomatrixoma is a benign appendage tumour related to hair cells matrix. Most of the literature review about pilomatrixoma is in the form of case reports with fewer cohort studies. The objective of this cohort is to study the variable demographic characteristics, presentation and histopathology of this condition among a larger group of patients. Materials and Methods: We conducted a retrospective study of patients who had excision of pilomatrixoma between February 1998 and August 2011 in a District General Hospital in UK. Results: The study included 67 patients with histopathologically diagnosed pilomatrixoma. The mean age was 32 years. Male to Female ratio was 35:32. The average diameter of the lesion at presentation was 13 mm (range: 2-30 mm). 66 of 67 (98.5%) patients presented with solitary lesion, while 1 patient (1.5%) had two lesions. Conclusion: Pilomatrixoma is not an uncommon benign lesion. It is more common in the maxillofacial area.
  3,230 105 -
Body hair transplantation: Case report of successful outcome
Venkataram Mysore
April-June 2013, 6(2):113-116
DOI:10.4103/0974-2077.112676  PMID:24023437
Transplantation of body hair in to scalp has been suggested as an option to treat extensive cases of baldness with poor donor scalp. However, evidence about its long-term efficacy is yet lacking, with very few published reports and the routine use of the technique is still controversial. We report the satisfactory outcome in a case of extensive baldness in whom hairs from different donor areas such as chest, abdomen, arms, thighs were transplanted on to scalp.
  3,004 189 -
Body hair transplantation in vitiligo
Kavish Chouhan, Amrendra Kumar, Amrinder J Kanwar
April-June 2013, 6(2):111-112
Hair transplantation has been used to repigment a stable vitiligo patch. Body hair transplant was done for a 28-year-old male with stable vitiligo with scarring. Peri-folllicular repigmentation was noted at 4 weeks and complete repigmentation of vitiligo patch was achieved at 12 weeks. No recurrence was noted at the end of 3-month follow-up with a good colour match with surrounding skin. To the best of our knowledge, this is the first case report highlighting the effectiveness of body hair transplantation by FUE in focal vitiligo patch with leukotrichia.
  2,800 244 -
Depletion of CD200+ hair follicle stem cells in human prematurely gray hair follicles
Sujata Mohanty, Anil Kumar, Jyoti Dhawan, Vinod K Sharma, Somesh Gupta
April-June 2013, 6(2):90-92
DOI:10.4103/0974-2077.112669  PMID:24023430
Introduction: Melanocyte stem cells (MelSCs) are known to be depleted in gray hair follicles. Hair follicle stem cells (HFSCs) are important for maintenance of stemness of MelSCs. Methods: We compared the proportion of CD200+ (Cluster of Differentiation 200 positive) stem cells in the outer root sheath cell suspension of gray and pigmented hair follicles of three patients with the premature graying of hair. In addition, explants culture for HFSCs was also carried out from gray and pigmented hair follicles. Cultured HFSCs were also differentiated into melanocytes. Results: The mean ± SD CD200+ HFSCs population were 9.4 ± 1.4% and 3.5 ± 0.5% for pigmented and gray hair follicles, respectively ( P = 0.002). In explants culture, the growth of HFSCs from the gray hair follicle stopped at around day 20-22, whereas the growth of the cells from the pigmented follicle continued. Conclusion: CD200+ HFSCs are depleted in prematurely gray hair in the humans. CD200+ hair follicle stem cell yield is poorer in gray hair explant culture than pigmented hair explant culture.
  2,805 181 -
Direct hair transplantation (DHT): An innovative follicular unit extraction (FUE) technique of hair transplantation
Venkataram Mysore
April-June 2013, 6(2):106-106
  2,100 235 -
A concise approach to childhood hypopigmentation
Vasanop Vachiramon
April-June 2013, 6(2):73-74
  1,989 233 -
Can injectable lignocaine be replaced by topical anesthesia in melanocyte transplant or ultrathin skin grafting?
Imran Majid
April-June 2013, 6(2):127-128
DOI:10.4103/0974-2077.112681  PMID:24023442
  1,996 121 1
Successful treatment of laser induced hypopigmentation with targeted narrow band UVB therapy
Anil Ganjoo
April-June 2013, 6(2):120-120
  1,883 91 -
Epidermal cell suspension: Achieved by incubation at room temperature
Mohammed I AlJasser, Smita S Mulekar, Sanjeev V Mulekar
April-June 2013, 6(2):126-126
DOI:10.4103/0974-2077.112680  PMID:24023441
  1,683 126 -
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