Therapeutic regional dermabrasion in papular lichen amyloidosis of shins

Therapeutic regional dermabrasion of shins is a useful surgical method for planing away the persistent pruritic lichenified hyperkeratotic eruptions of papular lichen amyloidosis. Seventeen patients [12 females and 5 males] of 35 to 52 years age having papular lichen amyloido sis on shins, refractory to various medical lines of treatment for 5-12 years duration were subjected to regional dermabrasion. Extensor surfaces [shins] of both lower extremities [34 sites] in all 17 cases were treated by multiple sittings of spot dermabrasion. All 34 sites healed with superficial scarring and complete response [100%] with total clearance of lesions was observed in all 34 sites. Pruritus stopped in all the dermabraded sites immediately. No local recurrence has been observed in any sites over a minimum follow up period of 2 years. Apart from superficial scarring occurring at all 34 sites, the other side effect observed was varying degree of hypopigmentation in 20 out of the 34 sites dermabraded. Complication in the form of parchment like deep atrophic scarring with persistent hypopigmentation, erythema and at places depigmentation were observed, at 4 sites which were dermabraded deeply. Similar complications with delayed wound healing were observed at the 5th site as sequel to secondary bacterial infection following spot dermabrasion

Local anesthesia in dermatosurgery

Local anesthetics abolish the pain sensation in localized areas without affecting the degree of consciousness. This is a review article

Gem in dermatosurgery

Many times we perform surgical procedures in routine standard manners, wondering if the same or better results could have been achieved with an easier and more cost effective way. There are many such procedures which can easily be adapted for diagnostic or therapeutic purposes with the help of certain practical tips. Most of them are actually standard procedures, but with a little variation here, and a little adaptation there, they become simple and quick to perform, cost effective and result oriented. These practical office procedures will be useful in day to day practice to the dermatologist. In other words, rather than 'Gems in dermatosurgery', they are actually 'Surgical gems in dermatology'. One such gem is discussed herewith

Modifiled miniature punch skin grafting in stable vitiligo

Autologous split thickness miniature punch skin grafting is one of the surgical modes of treatment of stable vitiligo. Out of 512 different sites, of stable vitiligo, occurring in 382 cases, [169 focal, 127 segmental and 86 generalized] 459 sites i.e. 89.65% showed total repigmentation with excellent cosmetic colour match. Out of the 382 cases, 281 cases who were treated postsurgically with PUVA or PUVASOL therapy repigmented within 21/2 to 3 months, 101 cases, who received no treatment postsurgically repigmented by 31/2 to 6 months. In addition 39 cases in whom no treatment was given postsurgically had to be given PUVA therapy 3 months after surgery as there was poor repigmentation. The complications seen were graft rejection due to improper immobilization in 18 cases, graft rejection due to local mobility of skin in 7, graft rejection due to secondary infection, in 4, contact allergic dermatitis to framycetin in 12, and reactivation of vitiligo in 5. Side effects seen were cobblestoning in 70, sinking pits in 54, polka dot appearance in 52, depigmentary junctional line in 37, variegated appearance in 10 and superficial scarring at donor site in all 382 cases