RESUMO
BACKGROUND: In the United States, liposuction is the most commonly performed cosmetic surgical procedure. Laser lipolysis is the latest adjunct to liposuction. This technique employs laser energy to induce lipolysis and hemostasis and stimulate neocollagenesis. Multiple laser systems have been studied. METHODS: PubMed literature search with the key words laser lipolysis and laser assisted liposuction. Original articles that studied the internal application of laser energy to adipose tissue were reviewed and included. RESULTS: Nineteen manuscripts were reviewed. One double-blind randomized controlled trial compared laser liposuction with tumescent liposuction. Several authors claimed that laser lipolysis offers fewer side effects than "traditional" liposuction performed under general anesthesia. A true objective comparison with tumescent liposuction is missing in the literature. LIMITATIONS: Comparison studies between laser-assisted lipolysis and conventional liposuction are limited, as are comparisons between the different laser systems and wavelengths. Standardization of laser energy settings is lacking. CONCLUSION: Laser-assisted lipolysis is a safe and efficacious procedure that may possess advantages over conventional liposuction. Lipolysis occurs in a dose-response relationship. No advantage over tumescent liposuction has been demonstrated. A specific laser wavelength may prove superior for each clinical application, but more studies are needed.
Assuntos
Terapia a Laser , Lipectomia , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Lasers Semicondutores/efeitos adversos , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/efeitos adversos , Lasers de Estado Sólido/uso terapêutico , Lipectomia/efeitos adversos , Lipectomia/métodosRESUMO
BACKGROUND: With the advent of incorporating the immunoperoxidase staining technique into the processing of frozen tissue, the use of Mohs micrographic surgery (MMS) has been expanded to include several high-risk tumors such as lentigo maligna, malignant melanoma, and dermatofibrosarcoma protuberans. OBJECTIVES: To thoroughly review the English medical literature pertaining to the use of immunohistochemical staining techniques on frozen sections during MMS and to summarize the basic relevant outcomes from the different relevant studies. MATERIALS AND METHODS: Medline search was conducted, with the following words used in the search criteria: "Mohs surgery,""staining,""immunostaining," and "immunoperoxidase." RESULTS Generally, all immunostains showed advantage over the traditional hematoxylin and eosin approach. Studies of MART-1 in melanoma chemosurgery indicated that it is typically crisp and has less background staining than MEL-5 and better staining consistency than HMB-45. In cases of desmoplastic melanomas, S100 is the stain of choice. CONCLUSION: Immunostaining offers an advantage in MMS. Large, randomized, prospective studies comparing the different immunostains are still lacking in the literature. The authors have indicated no significant interest with commercial supporters.
Assuntos
Técnicas Imunoenzimáticas/métodos , Imuno-Histoquímica/métodos , Cirurgia de Mohs , Antígenos de Neoplasias , Dermatofibrossarcoma/diagnóstico , Secções Congeladas , Humanos , Sarda Melanótica de Hutchinson/cirurgia , Antígeno MART-1 , Melanoma/imunologia , Melanoma/cirurgia , Antígenos Específicos de Melanoma , Proteínas de Neoplasias , Proteínas S100 , Sensibilidade e Especificidade , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/cirurgiaRESUMO
Acrodermatitis paraneoplastica is a rare paraneoplastic entity that has been associated with multiple neoplasms, most commonly squamous cell carcinoma of the aerodigestive tract. Therapies have focused on treatment of the underlying carcinoma. We report a case of acrodermatitis paraneoplastica successfully treated with PUVA therapy.
