Cosmetics in the postsurgical patient.

The application of colored facial cosmetics is an important part of patient postsurgical rehabilitation. Careful cosmetic selection can avoid surgical complications while providing necessary camouflaging until healing is complete. Dermatologic surgeons should provide guidelines to their patients on postsurgical cosmetic use.

Cosmetic camouflaging techniques.

Cosmetic camouflaging techniques can be used to minimize the appearance of facial scarring due to trauma and/or surgery. Facial pigmentation defects are minimized through the application of facial foundations of complimentary colors. Principles of high-lighting and shadowing are used to conceal surface contour defects by combining opaque facial foundations with colored cosmetics.

Eyebrow loss, eyelash loss, and dermatochalasis.

The eyebrows, eyelashes, and eyelids are important protective structures for the eye and are also of considerable cosmetic value. The dermatologist should understand the available cosmetic and surgical techniques for helping patients with eyebrow loss, eyelash loss, and dermatochalasis.

Eye cosmetics.

Eye cosmetics are useful to highlight and emphasize the eyes. Currently available eye cosmetics include eye shadows, eye shadow setting creams, under-eye concealers, eye-liners, mascaras, artificial eyelashes, and eyebrow pencils. Special care must be taken when patients with sensitive skin or contact lens wearers select eye cosmetics. Eye cosmetics may also be the cause of either irritant or allergic contact dermatitis, which are two causes of the upper-eyelid dermatitis syndrome.

Hair cosmetics.

Alterations in the cuticle, cortex, and medulla are necessary to modify the hair cosmetically. The hair can be modified externally by the use of shampoos to remove excess sebum, conditioners to restore shine, and styling aids to increase manageability. Several different formulations of all these products exist, depending on the needs of the patient. Furthermore, the hair can be modified both externally and internally through the use of hair dyes, permanent waving lotions, and hair straighteners. Use of these products causes external damage to the hair shaft by disrupting the overlapping cuticular scales, rendering the hair susceptible to static electricity and the effects of humidity while decreasing manageability and shine. Internal damage created by these products decreases the hair shaft's elastic properties, allowing increased hair breakage. The dermatologist can better aid the patient with hair difficulties if he or she has an understanding of the formulation and effects of products designed to cleanse, beautify, and modify the hair.

Radiofrequency hyperthermia and topical retinoic acid therapy in murine melanoma.

Malignant cells are known to be sensitive to increased temperature. The effects of hyperthermia (HT) on intradermally implanted S91 melanoma cells in syngeneic mice were investigated with a hand-held radiofrequency generator. The possible additive effects of topical retinoic acid (RA) in this system also were studied. Five millimeter diameter melanomas were treated with either HT alone, RA alone, or a combination of HT and RA and were then evaluated after 43 days and 59 days. Eighteen of 20 tumors treated with HT alone and all 20 melanomas treated with HT/RA were eradicated. RA alone caused complete regression in 11 of 19 treated tumors. It is concluded that radiofrequency HT is an effective treatment in intradermal murine melanoma and that the addition of RA does not significantly alter the outcome because of the extreme effectiveness of HT alone.

Schamberg's purpura in children: case study and literature review.

Schamberg's purpura or progressive pigmentary dermatosis is uncommon in pediatric patients. A case study and literature review are presented to encourage the inclusion of Schamberg's purpura in the differential diagnosis of purpuric eruptions in childhood.

Capacitive radiofrequency hyperthermia in the treatment of cutaneous murine melanoma.

We have evaluated localized capacitive radiofrequency hyperthermia in the treatment of murine S91 melanoma. Two hundred and ten DBA/2J male mice were implanted with 1 X 10(6) S91 murine melanoma cells innoculated into a noninflammatory upper dermal suction blister cavity. Two tumors were implanted per animal, so that each animal served as its own control in evaluating the effects of temperature, treatment duration, and tumor size on tumor growth following radiofrequency hyperthermia treatment. The data supported the following conclusions: (1) capacitive radiofrequency hyperthermia is effective in the treatment of murine S91 melanoma; (2) duration of treatment between 10 and 60 seconds at 52 degrees C does not influence effectiveness; and (3) treatment temperatures greater than 49 degrees C are needed for maximal effectiveness in the treatment of these tumors. Based on these preliminary findings, high temperature, short duration capacitive radiofrequency hyperthermia may prove to be a useful modality in the treatment of certain cutaneous malignancies.

Polymorphic light eruption in pediatric patients with American Indian ancestry.

Polymorphic (polymorphous) light eruption (PMLE) is a cutaneous reaction to a broad spectrum of light energies that is found in persons of American Indian ancestry. We treated PMLE in 11 pediatric patients of American Indian ancestry.

Gianotti-Crosti syndrome associated with infections other than hepatitis B.

Although the Gianotti-Crosti syndrome (GCS) is regularly associated with hepatitis B infection elsewhere, in North America that association is rarely made. Accordingly, we studied nine children with acral, symmetrical eruptions typical of GCS for evidence of other infections. All were negative for hepatitis B surface antigen. Viral cultures were done in nine patients, and viruses isolated in two. One patient with a respiratory prodrome had respiratory syncytial virus (RSV) isolated, and a second patient studied simultaneously showed serological evidence of RSV infection. A third patient with both respiratory tract and gastrointestinal tract symptoms yielded a polio-vaccine enterovirus. Two patients with fever and pharyngitis had group A beta-hemolytic streptococci isolated from the throat. Skin biopsies were done in three cases, and findings were consistent with GCS. Electron microscopy of two lesional biopsy specimens failed to demonstrate viral particles. Epstein-Barr virus serological findings were negative in six cases and showed evidence of past infection in three cases. This study strengthens the observation that hepatitis B is not the causative agent of GCS in this country and suggests that multiple infectious agents may be associated with this distinctive exanthem.

Symmetric, progressive telangiectatic nevi with hemorrhagic angiokeratomas.

We examined an 11-year-old female with symmetric, progressive telangiectatic nevi associated with venous varicosities and angiokeratomas. Clinical bleeding occurred from cutaneous angiokeratomas and mucosal telangiectasias.

Polymorphic light eruption in childhood.

The purpose of this article is to acquaint the pediatrician with polymorphic light eruption (PMLE) a light-induced, eczematous, cutaneous reaction that frequently begins in childhood. This sun-induced eruption is frequently misdiagnosed because of its similarity to atopic dermatitis.

Hyperthermic treatment of cutaneous malignancies.

Malignant cells are susceptible to high temperatures, and recent technical advances have allowed heat to be concentrated at the site of the neoplasm in vivo. The mechanism(s) of hyperthermic cytotoxicity is(are) unclear but may involve cellular accumulation of nuclear proteins, plasma membrane damage, and/or lysosomal effects. Three methods of localized hyperthermia delivery have been described: ultrasound, radiofrequency, and microwave. All involve production of high-energy save forms which are produced by passing electrical energy through an oscillator that produces heat of sufficient magnitude to cause tumor necrosis. Temperatures of at least 42 degrees C are necessary, but other factors, such as tissue pH, metabolic depletion, tissue hypoxia, and tumor vascularity, also influence cell killing. Hyperthermic treatment of cutaneous neoplasms may have great potential usefulness. Animal studies show high cure rates for squamous cell carcinoma with the use of radiofrequency hyperthermia. Human trials are needed before this technic can be considered suitable for clinical use.