Subject(s)
Aftercare , Mohs Surgery , Pain, Postoperative , Patient Satisfaction , Postoperative Care , Postoperative Hemorrhage , Humans , Mohs Surgery/adverse effects , Pain Measurement , Pain, Postoperative/diagnosis , Pain, Postoperative/etiology , Postoperative Hemorrhage/diagnosis , Postoperative Hemorrhage/etiology , Prospective Studies , Telephone , Time FactorsABSTRACT
Hypertrichosis is a condition in which hair is longer and denser than what is considered normal for an individual based on age, sex, ethnicity, and location on the body and can be classified based on its distribution (generalized vs localized), age of onset (congenital vs acquired), and type of hair (lanugo or vellus vs terminal). We describe a rare case of monozygotic female twins who presented for localized hypertrichosis of the intermammary cleft that developed during puberty. Endocrine examination was unremarkable. Discussion of various treatment modalities should be considered, because localized hypertrichosis may have a considerable psychosocial effect.
Subject(s)
Hair Removal/methods , Hypertrichosis/etiology , Adolescent , Diagnosis, Differential , Female , Humans , Hypertrichosis/therapy , Thoracic Wall , Twins, MonozygoticSubject(s)
Antineoplastic Agents, Immunological/adverse effects , Drug Eruptions/etiology , Keratoacanthoma/chemically induced , Nivolumab/adverse effects , Aged , Antineoplastic Agents, Immunological/administration & dosage , Biopsy, Needle , Carcinoma, Renal Cell/drug therapy , Carcinoma, Renal Cell/pathology , Drug Eruptions/pathology , Female , Hand Dermatoses/chemically induced , Hand Dermatoses/pathology , Humans , Immunohistochemistry , Immunotherapy/adverse effects , Immunotherapy/methods , Keratoacanthoma/pathology , Kidney Neoplasms/drug therapy , Kidney Neoplasms/pathology , Nivolumab/therapeutic use , Prognosis , Risk AssessmentABSTRACT
BACKGROUND: Scarring following skin surgery is an unavoidable certainty. Scars resulting from Mohs Micrographic Surgery (MMS) can cause both cosmetic and functional problems. Various lasers have been used to treat scars, but the role of the microsecond pulsed 1064 nanometer neodymium-doped yttrium aluminum garnet (1064 nm Nd:YAG) in treating surgical scars is not well-defined. OBJECTIVE: We aim to examine the clinical application of the 1064 nm Nd:YAG laser in improving surgical scars. METHODS: Ten patients who were unhappy with cosmetic or functional outcomes of their surgical scars following MMS were treated with 1-3 sessions of the 1064 nm Nd:YAG laser to improve their scars. Therapy completion was determined by patient satisfaction with the appearance of their scars and/or resolution of any contractures that formed following surgery. RESULTS: All ten patients were pleased with the improved appearance of their scars. Four patients saw complete resolution of an ectropion or eclabium that formed secondary to scar contractures from MMS. The side effects of laser treatments were limited to 1-2 hours of erythema, and there were no incidences of adverse effects or recurrence of contractures. CONCLUSION: Our clinical experience with the 1064 nm Nd:YAG laser provides promising data on improving appearance of and functionality from post-surgical scars.
Subject(s)
Cicatrix/radiotherapy , Lasers, Dye/therapeutic use , Lasers, Gas/therapeutic use , Low-Level Light Therapy/methods , Mohs Surgery/adverse effects , Adult , Cicatrix/etiology , Cosmetic Techniques , Female , Humans , Male , Treatment OutcomeABSTRACT
CONTEXT: Rosacea fulminans is a rare skin disorder with a multifactorial etiology. Stress is one of the common precipitating factors of this condition but is not often targeted in treatment. Isotretinoin is considered part of the first-line therapy for this condition but, in cases where its use is restricted, other therapeutic interventions as part of an integrative approach may be effective. PATIENT CONCERNS: A 38-y-old female presented with rosacea fulminans brought on by an acutely stressful event. After multiple failed therapies, she experienced resolution of her symptoms with a combination of systemic corticosteroids, antibiotics, diet modification, and stress reduction, with the treatment of stress playing a significant role. CONCLUSIONS: Stress management and diet modification are key adjunctive therapies in the treatment of rosacea fulminans and need to be addressed more often in treatment. In cases where patients are reluctant or unable to take isotretinoin, an integrative approach may be effective in achieving symptomatic improvement.
