Practical aspects of laser safety.

Lasers have several unique properties that allow for the production of intensely powerful beams of light. These same properties also carry significant hazards for those not familiar with their safe use. If misdirected, laser beams can produce blindness or full-thickness cutaneous burns. Dry surgical gauze and drapes can ignite with sufficient exposure to laser energy, and treatment of infected tissue can generate a plume that poses a biohazard risk to the physician and staff as well. In order to use these powerful devices most effectively and safely, the physician should understand the basics of laser safety and be able to implement practical methods of operation.

Immediate postoperative laser resurfacing improves second intention healing on the nose: 5-year experience.

BACKGROUND: Mohs surgery defects on convex nasal surfaces do not reliably heal well by second intention. Prior to the availability of laser resurfacing we found that immediate postoperative dermabrasion improved the predicted outcome from second intention healing for these defects. OBJECTIVE: To determine the ability of immediate postoperative CO2 and Er:YAG laser resurfacing to improve predicted healing by second intention. METHODS: Seventy-four patients with Mohs surgical defects on the nose underwent immediate postoperative resurfacing with either a scanned CO2 or long-pulsed Er:YAG laser. Thirty patients had photographs of appropriate quality and follow-up for evaluation by a panel of nine objective physicians. RESULTS: All 74 patients were satisfied with their result and none have requested scar revision. Of the 30 patients evaluated by the panel, all were scored acceptable to excellent. CONCLUSION: Immediate laser resurfacing can improve the predicted outcome from second intention healing on the nose and should be considered for select patients.

The major inherited disorders of cornification. New advances in pathogenesis.

This article provides a synopsis of the major (most common) inherited disorders of cornification. It also reviews the recent advances that have been made for each disorder and their practical applications.

Multiple eruptive dermatofibromas in three men with HIV infection.

BACKGROUND: Multiple eruptive dermatofibromas (MEDF) are rare and their etiology is unknown. An association with immunosuppression has led to the speculation that they are the result of an abortive immunoreactive process. In the literature, there have been 5 isolated case reports of multiple dermatofibromas and human immunodeficiency virus (HIV) infection. Three of these cases had other immune modulators present (i.e. prednisone, systemic lupus erythematosus, alpha-interferon, UVB phototherapy). The other 2 cases had disseminated mycobacteriosis. OBSERVATIONS: A series of 3 men with HIV infection and MEDF is described. In contrast to previous case reports, our patients did not have other immune modulators besides HIV infection nor did they have disseminated mycobacteriosis. CONCLUSIONS: This series lends support to the speculation that MEDF may be associated with immunosuppression. Further study is needed to delineate the exact mechanism for this relationship. These patients presented within a 4-month period and illustrate the frequency at which MEDF may be seen in the HIV-positive population. As clinicians who care for patients with HIV infection, it is important to be aware that MEDF may be seen in this immunosuppressed population.