Digital Anaesthesia and Relevant Digital Anatomy for the Dermatologist.

Cutaneous surgery requires a precise understanding of anatomy. This review describes the clinically relevant anatomy of the hand and relates it to the most common methods of digital anaesthesia.

Type 1 Boston keratoprosthesis: outcomes at two Canadian centres.

OBJECTIVES: To report the outcomes of patients who underwent Boston type 1 keratoprosthesis (Kpro) surgery at the University Health Network (Toronto, Ont.) and the University of Ottawa Eye Institute (Ottawa, Ont.) between June 2008 and July 2013. DESIGN: Retrospective case series. PARTICIPANTS: Forty-four eyes of 43 patients who underwent Kpro surgery. METHODS: A retrospective review was conducted of all Kpro procedures performed by 4 attending cornea surgeons. The preoperative characteristics and postoperative course of each patient were analyzed. RESULTS: In 31 eyes (70%), the primary indication for a Kpro was failed corneal transplantation. The remaining 13 eyes (30%) had Kpro as a primary procedure. In all eyes, preoperative visual acuity (VA) was 20/150 or worse, with 39 eyes (89%) having a VA of counting fingers, hand movement, or light perception. Mean follow-up time was 21 ± 12 months (range 12-57 months). The retention rate at the last follow-up was 95%. Best-achieved median VA was 20/100 (range 20/20 to no light perception [NLP]), with 37% of patients achieving a VA of >20/40 at some point during their postoperative course. At the last follow-up, median VA was 20/400 (range 20/30 to NLP). The 2 most common complications included retroprosthetic membrane formation (23 eyes, 52%) and elevated intraocular pressure (10 eyes, 23%). There were 5 cases (11%) of stromal melt and 1 case (2%) of infective keratitis. CONCLUSIONS: This study demonstrates that Kpro improves VA in a majority of cases, and is a viable option in situations in which there is a poor prognosis for traditional penetrating keratoplasty.

Surface Anatomy of the Nail for the Dermatologist.

Expert diagnosis of cutaneous pathology requires precise anatomic description. In this brief report the authors review the clinically relevant surface anatomy of the nail and relate it to a case of squamous cell carcinoma.

Botulinum neurotoxin treatment of palmar and plantar hyperhidrosis.

Palmar and plantar hyperhidrosis is relatively common and can have severe psychological and medical consequences for those afflicted. A multitude of treatments exist but are often inadequate especially for those with significant disease. In these cases botulinum neurotoxin provides a reliable method for reducing the symptoms and improving quality of life. Although actual administration is relatively straightforward, pain management is a crucial component that requires a mastery of several techniques. Patients have a high degree of satisfaction with botulinum neurotoxin treatment and are motivated to come back for repeat treatments, usually every 6 months.

Surface anatomy of the lip for the dermatologist.

BACKGROUND: Expert treatment of cutaneous facial pathology requires the correct diagnosis and precise anatomic knowledge. Lip surface anatomy is complex. CASE REPORT: This brief report reviews the clinically relevant surface anatomy of the lip.

Periorbital surface anatomy for the dermatologist.

BACKGROUND: Optimal management of skin pathology demands accurate anatomic description, especially in the orbit and periorbital region. CASE REPORT: This brief article reviews the clinically important surface anatomy of the orbit and periorbital region for the dermatologist.