Reduction in osmidrosis using a suction-assisted cartilage shaver improves the quality of life.

BACKGROUND: Axillary osmidrosis is a benign disorder that causes functional and emotional problems in Asian patients. Surgical treatments have proven effective in treating this disease, but changes in quality of life after surgical procedures have not been investigated so far. OBJECTIVE: To evaluate quality of life in patients with osmidrosis before and after surgery with suction-assisted cartilage shaver using the Dermatology Life Quality Index (DLQI). METHODS: Seventy patients with axillary osmidrosis (aged 14-49, 8 men and 62 women) who were treated using a suction-assisted cartilage shaver at the Department of Dermatology, Chang Gung Memorial Hospital, from May 2006 to November 2008 were included. Patients completed the DLQI before and 6 to 35 (mean 18.3) months after treatment. Scores for patient satisfaction and improvement were also investigated. RESULTS: Mean DLQI score before treatment was 11.3 (range 5-27). After 6 to 35 (mean 18.3) months of postoperative follow-up, DLQI scores (mean 0.8, range 0-4) declined significantly (93% reduction). Fifty-nine patients (84.2%) reported odor reduction of 90% or more; 24 patients (34.3%) were greatly satisfied, and 41 were (58.6%) absolutely satisfied with this procedure. CONCLUSION: Our data demonstrate that the suction-assisted cartilage shaver can greatly improve functional and social disabilities in patients with axillary osmidrosis. The authors have indicated no significant interest with commercial supporters.

Skin rejuvenation with 1,064-nm Q-switched Nd:YAG laser in Asian patients.

BACKGROUND: In recent years, using the 1,064-nm Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser (QSNYL) with or without exogenous topical carbon solution application for facial skin rejuvenation has become popular in Southeast Asia, but there has not been any published clinical report discussing the rejuvenation effect of QSNYL for Asian patients. OBJECTIVE: To evaluate the efficacy of QSNYL in improvement of pore size, sebaceous secretion, skin texture, and skin tone of Asian patients. We also observed whether there is any enhancement of application of topical carbon solution before the therapy. METHODS: Twenty-four female patients completed four sessions of treatments at 4-week intervals. The assessment was evaluated by the patients, two independent physicians, and Canfield VISIA Complexion Analysis. In addition, we conducted a split-face study such that, in each case, topical carbon solution was applied to the right side of the face before the laser treatment. RESULTS: All evaluations showed significant improvement in rejuvenation effect. There was no difference in improvement in skin texture even after the application of topical carbon solution in our split-face study. CONCLUSION: The QSNYL is a safe and effective rejuvenation modality in Asian patients. Topical carbon solution application did not enhance laser efficacy.

Intense pulsed light for the treatment of facial freckles in Asian skin.

BACKGROUND: Freckles are melanotic lesions frequently seen on the face and other sun-exposed areas. Previously evaluation of the severity of freckles has relied on the ultimately subjective assessment of the doctor or patient. Intense pulsed light (IPL) is newly introduced to treat facial freckles in Asian skin. OBJECTIVE: To determine the effectiveness of IPL treatment for Asian patients with freckled skin and to assess a new and objective method for evaluation of the severity of freckling and posttherapy improvement using an ultraviolet (UV)-sensitive camera and film. METHODS: Thirty-six patients with freckles were enlisted. IPL treatment was administered to patients with freckles in 4-week sessions. Irradiation wavelength was controlled using cutoff filters ranging from 550 to 590 nm, with a fluence of 25-35 J/cm2, with single- or double-pulse illumination and a pulse width of 4.0 msec. The assessments of the physician and patient were compared with the objective dermatologic evaluation with black-and-white and UV photography used to derive two treatment parameters, cosmetic density of freckles (CDF) and freckles area and severity index (FASI), which are applicable in a clinical setting. RESULTS: By the end of the study, two attending physicians assessed the results for 86.1% of the subjects as excellent or good, with 91.7% of the patients reporting that they were extremely or very satisfied. A statistically significant improvement in mean FASI score was demonstrated at 6 months after treatment compared with baseline (n = 36, p <.005; paired t-test). Mean overall improvement rate (n = 36), as determined from the difference in mean FASI score, was 63% at 12 weeks and 58% at 6 months. CONCLUSION: IPL is an effective and safe treatment for facial freckles in Asian skin, with relatively few adverse effects and high satisfaction levels.

The distribution of follicular units in the Chinese scalp: implications for reconstruction of natural-appearing hairlines in Orientals.

BACKGROUND: Follicular transplantation using hair in its naturally occurring groups, called follicular units (FUs), has become the most popular technique in hair restoration surgery. Recently follicular transplantation was performed with a qualitative and quantitative concept to achieve the best clinical result. The characteristics and distribution of FUs are well studied in Caucasians and widely applied in hair transplantation surgery. OBJECTIVE: In order to understand the normal distribution of FUs in the Chinese scalp, we counted the number of hairs and FUs in normal Chinese scalp to provide general information for surgical planning and design in bald Chinese patients. METHODS: A total of 50 normal and 50 bald Chinese adults were enrolled to count the hairs on their scalp. One hundred bald patients receiving hairline reconstruction were also prospectively quantitatively evaluated. RESULTS: In normal Chinese scalp, an average 71.78 FUs/cm(2) and 137.08 hairs/cm(2) were calculated with a follicular density of 1.91 hairs/FU. Two-hair FUs are the predominate group (50.29%). In bald patients, an average of 68.07 FUs/cm(2) was found, which was less than that of the occipital scalp in normal nonbald patients. In reconstruction of the frontal hairline, a total of 700-1000 FUs were implanted with an average density of 30 FUs/cm(2). CONCLUSION: We found the average number of FUs (0.72 FU/mm(2)) was less than that in Caucasian patients (1 FU/mm(2)). The average density of 30 FUs/cm(2) implanted was suitable to reconstruct a natural frontal hairline in bald Chinese patients, which can achieve about 40% of normal hair density. Our results could provide the hair surgeon with general information about hair distribution on the Chinese scalp for surgical planning and design in their patients.