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Seminars in Cutaneous Medicine and Surgery

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https://www.readbyqxmd.com/read/29224039/state-of-the-art-lasers-and-light-treatments-for-vascular-lesions-from-red-faces-to-vascular-malformations
#1
Manuel Valdebran, Brent Martin, Kristen M Kelly
Notable milestones in the treatment of vascular lesions have been achieved over the past century. Many cutaneous vascular lesions can be successfully treated with lightbased devices. In this review, we will discuss the treatment of port-wine birthmarks, lymphatic malformations, infantile hemangiomas, rosacea, venous lakes, pyogenic granulomas, cherry angiomas, and angiofibromas using lasers, total reflection amplification of spontaneous emission of radiation, intense pulsed light, and photodynamic therapy. In addition, for several of these diagnoses, we will review medical therapies that can be combined with light-based devices to provide enhanced results...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224038/skin-tightening-does-it-really-exist
#2
Monica Boen, Monique J Vanaman Wilson, Sabrina Fabi
Skin tightening is one of the cornerstones of skin rejuvenation and is defined as the improvement of skin laxity and crepiness of the skin. There are several energy-based devices that can produce significant skin tightening without surgery, both on and off the face. The mechanisms of skin tightening involve collagen denaturation resulting in collagen shrinkage and tissue tightening, and the wound healing response that generates new collagen and elastin. These hypothesized mechanisms of skin contraction leading to clinical skin tightening have been derived from histological, immunohistochemical, and electron microscope analysis, as well as in vitro and in vivo experiments...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224037/opportunities-for-laser-assisted-drug-delivery-in-the-treatment-of-cutaneous-disorders
#3
Emily Wenande, Andrés Már Erlendsson, Merete Haedersdal
Fractional laser-assisted drug delivery (LADD) is increasingly finding its way into clinical practice as a new means to enhance topical drug uptake and improve treatment of cutaneous disorders. To date, LADD has been used for a wide range of conditions, including photodamaged skin, neoplastic lesions, scars, cutaneous infections, and vitiligo as well as for topical anesthetic and aesthetic procedures. Substantiated by randomized controlled clinical trials, strong evidence is available for LADD's usefulness for photodynamic therapy (PDT), for which improved efficacy using laser-assisted photosensitizer treatment is established for actinic keratosis compared with conventional PDT...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224036/laser-advances-in-the-treatment-of-burn-and-traumatic-scars
#4
Shilpi Khetarpal, Urvashi Kaw, Jeffrey S Dover, Kenneth A Arndt
The realm of scar management is constantly changing. Many factors need to be considered when developing a comprehensive treatment plan, including the nature of the scar and the patient. Scar characteristics can be divided by color, scar type and thickness, and body location. Topical and intralesional agents and light- and laserbased treatments can be used to revitalize and restore damaged skin in atrophic and hypertrophic scars. The most commonly used lasers are the pulsed-dye laser (PDL) and fractional lasers...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224035/cellulite-a-review-of-pathogenesis-directed-therapy
#5
Daniel J Callaghan, Deanne Mraz Robinson, Michael S Kaminer
Cellulite is a condition that affects the majority of postpubertal women and can negatively impact quality of life. This review discusses several proposed pathophysiologies of cellulite, and examines treatment options that have been utilized, focusing on the etiologic factor targeted by the therapies. This approach aims to help clarify the pathogenesis of cellulite and provide a road map for developing effective treatment paradigms for patients.
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224034/noninvasive-body-contouring
#6
Nicole Y Lee, Deanne Mraz Robinson
In a society where stigma surrounds cosmetic procedures and yet a thin and sculpted physique is idealized, noninvasive body contouring satisfies the demand to reduce excess and undesired body fat in areas that persist despite exercise and diet. Numerous devices are available to meet this need; however, choosing the "perfect" device is challenging because the science and data are often limited with variable results. In this paper, we review 7 US Food and Drug Administration-approved noninvasive body contouring therapies in hopes of providing some clarity to this area...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224033/noninvasive-approach-to-treatment-of-submental-fullness
#7
Geeta M Shah, Judah N Greenberg, Elizabeth L Tanzi, Gary D Monheit
A recent survey done by the American Society for Dermatologic Surgery indicated that 67% of respondents were bothered by "excess fat under the chin/neck." Accumulation of fat in the preplatysmal compartment of the neck is a common cause for fullness in the submental area. In the past, surgical liposuction was the only option to remove fat in the submental area. Although effective, liposuction does have risks and downtime. Recently, noninvasive options for treatment of submental fat have been introduced. These include treatment with deoxycholic acid, known as Kybella®, and cryolipolysis using the CoolMini™ handpiece...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224032/microneedling-a-new-approach-for-treating-textural-abnormalities-and-scars
#8
Sara Hogan, Mara Weinstein Velez, Omer Ibrahim
Microneedling is a minimally invasive procedure wherein small holes are created across the stratum corneum while keeping the epidermis partially intact. This produces microchannels that increase skin permeability and simultaneously stimulate growth factor release. Since the epidermis is retained, microneedling has less risk of infection, postinflammatory hyperpigmentation, and scarring compared to other resurfacing modalities. This is a review of the literature on microneedling in the treatment of textural abnormalities, specifically rhytides, scars, and striae...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224031/short-pulsed-laser-for-the-treatment-of-tattoos-pigmented-lesions-scars-and-rejuvenation
#9
Emil A Tanghetti, Kristina Andrea Hoffmann, Klaus Hoffmann
This review describes the use of picosecond lasers for the treatment of tattoos, pigmented lesions, scars, and their use in rejuvenation. These devices have delivered enhanced efficacy for the treatment of tattoos and pigmented lesions when compared to the older 40-50 nanosecond devices. The fractional delivery with the picosecond devices have opened up a new method of rejuvenation for photodamaged skin and the treatment of scars. The delivery of these high-energy short pulses have created zones of injury in the skin referred to as areas of laser-induced optical breakdown...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224030/advances-in-fractional-technology-for-skin-rejuvenation-skin-tightening-drug-delivery-and-treating-scars-and-skin-defects
#10
Deirdre Connolly, Laura Schilling, Nazanin Saedi
The development of fractional photothermolysis has revolutionized the treatment of skin scarring, rejuvenation, and tightening. By creating targeted microthermal zones and leaving surrounding tissue intact, this concept has provided the field with efficacious results, with less downtime and a better safety profile. This has started to change the paradigm of what is considered first-line treatment for scarring and rejuvenation. While originally applied to nonablative lasers, fractionation has now been employed in ablative, quality-switched, picosecond, and novel hybrid fractional lasers...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29224029/lasers-lights-and-energy-devices-state-of-the-art-introduction
#11
Omer Ibrahim, Jeffrey S Dover, Kenneth A Arndt
No abstract text is available yet for this article.
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895960/atopic-dermatitis-therapeutic-care-delivery-therapeutic-education-shared-decision-making-and-access-to-care
#12
Jennifer LeBovidge, Jenna Borok, Jeremy Udkoff, Gil Yosipovitch, Lawrence F Eichenfield
Atopic dermatitis (AD) is a chronic skin condition affecting children and adults, with a significant negative impact on patient and caregiver quality of life (QOL). Although effective treatments for AD are available, outcomes are often limited by poor adherence to treatment plans. Effective patient and caregiver education about the disease and its management is a necessary and important component of AD care. Therapeutic patient education (TPE) is a patient-centered process that aims to transfer information and skills necessary to manage and cope with a disease from health care professionals to patients and caregivers...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895959/atopic-dermatitis-emerging-therapies
#13
Eric Simpson, Jeremy Udkoff, Jenna Borok, Wynnis Tom, Lisa Beck, Lawrence F Eichenfield
Crisaborole and dupilumab represent the first 2 Food and Drug Administration (FDA)-approved therapies for atopic dermatitis (AD) in more than 15 years, and there are many promising drugs currently in development. This new wave of therapeutics capitalizes on the large body of work clarifying the pathogenesis of AD over the last several decades. In particular, type 2 cytokine-driven inflammation and skin barrier dysfunction are key processes underlying AD pathogenesis.
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895958/atopic-dermatitis-phototherapy-and-systemic-therapy
#14
Dawn Marie Davis, Jenna Borok, Jeremy Udkoff, Peter Lio, Jonathan Spergel
The majority of atopic dermatitis (AD) patients respond satisfactorily to gentle bathing, frequent moisturizing, and topical medications. Second-line therapies for AD should be used in recalcitrant cases or in patients with uncontrolled disease despite compliance with first-line measures and avoidance of allergens. Recommended advanced therapies include phototherapy, especially narrowband ultraviolet B, systemic immunosuppressants, and a new biologic agent. Few studies have compared head-to-head efficacy of the different immunosuppressant therapies such as cyclosporine, methotrexate, azathioprine and mycophenolate mofetil...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895957/atopic-dermatitis-addressing-allergy-infection-itch-and-complementary-therapies
#15
Jusleen Ahluwalia, Dawn Marie Davis, Sharon Jacob, Andrea Waldman, Peter Y Ong, Stuart Cohen, Adam Friedman, Peter Lio, Nathan Jetter, Jeffrey Bienstock, Jennifer LeBovidge, Jonathan Spergel, Luz Fonacier
Atopic dermatitis (AD) is a complex condition that results from the dynamic interplay between genetic predisposition, skin barrier defects, environmental factors, and a dysfunctional immune system. As a result, AD can be complicated by irritant and allergic contact dermatitis and imbalances in the skin microbiome, which can subsequently exacerbate the severity and complicate the course of preexisting atopic disease. Itch is an important symptom of AD, as it plays a large role in the quality of life of patients and their families...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895956/atopic-dermatitis-skin-care-and-topical-therapies
#16
David M Fleischer, Jeremy Udkoff, Jenna Borok, Adam Friedman, Noreen Nicol, Jeffrey Bienstock, Peter Lio, Megha M Tollefson, Lawrence F Eichenfield
Atopic dermatitis (AD) pathogenesis is strongly influenced by Type 2 innate lymphoid cell and T-helper cell type 2 lymphocyte-driven inflammation and skin barrier dysfunction. AD therapies attempt to correct this pathology, and guidelines suggest suggest basics of AD therapy, which include repair of the skin barrier through bathing practices and moisturizers, infection control, and further lifestyle modifications to avoid and reduce AD triggers.While some patients' AD may be controlled using these measures, inflammatory eczema including acute flares and maintenance therapy in more severe patients are treated with topical pharmacologic agents such as topical corticosteroids, topical calcineurin inhibitors, and, more recently, topical PDE-4 inhibitors...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895955/atopic-dermatitis-pathogenesis
#17
Emma Guttman-Yassky, Andrea Waldman, Jusleen Ahluwalia, Peck Y Ong, Lawrence F Eichenfield
Atopic Dermatitis (AD) is a complex inflammatory cutaneous disorder characterized by immune mediated inflammation and epidermal barrier dysfunction. Arising from a complex interplay between environmental and genetic factors, the definitive etiology of AD is perplexing and controversial. Advances in molecular medicine are radically transforming our understanding of AD pathogenesis. Increasing knowledge on the pathogenesis of AD results in novel therapeutic targets and pathways. This article details the pathogenesis section of the Curriculum United for Better Eczema Care (CUBE-C), facilitating primary care and sub-specialist education on the scientific advances driving recent AD therapeutic innovations...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895954/diagnosis-comorbidity-and-psychosocial-impact-of-atopic-dermatitis
#18
Dawn Marie Davis, Andrea Waldman, Sharon Jacob, Jennifer LeBovidge, Jusleen Ahluwalia, Megha Tollefson, Nathan Jetter, Jonathan Spergel
Atopic dermatitis (AD) is a chronic inflammatory skin disease, with a remitting relapsing course. The central diagnostic features of AD include pruritus, xerosis, eczematous lesions with a characteristic morphology and distribution, and a personal or family history of atopic disease. Several clinical studies have emphasized the link between AD and other atopic disorders including asthma, allergic rhinitis, and food allergies. More recent studies indicate possible links between AD and other nonatopic disorders, including ADHD, sleep disturbance, and mental health disorders, suggesting an even more profound impact of this disease...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895953/curriculum-united-for-better-eczema-care-why-how-and-what
#19
Lawrence F Eichenfield, Jusleen Ahluwalia, Dawn Marie Davis, David M Fleischer, Andrea Waldman, Jonathan Spergel
While various medical specialties treat eczema patients, care for these patients is largely fragmented and disorganized. Moreover, standardized treatment protocols that incorporate upcoming eczema therapies and emerging guidelines have yet to be established. Thus, there is both a need and an opportunity to equip clinicians to succeed in this novel and changing era of eczema care. The National Eczema Association's (NEA) strategic plan-developed through extensive discussions with patients who have atopic dermatitis and their caregivers, industry, and providers representing different specialties-called for the creation of an interdisciplinary coalition to steer this initiative...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28745729/highlights-of-skin-disease-education-foundation-s-41st-annual-hawaii-dermatology-seminar%C3%A2
#20
Kenneth B Gordon, Craig L Leonardi, Daniel E Furst, Neal Bhatia, Lawrence F Eichenfield, Katie Beleznay
New therapies, recent pathophysiological findings, and updated guidelines combined to create compelling presentations at the Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar™. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. A growing understanding of the biology of psoriasis has facilitated the development of increasingly efficacious medications. Skin clearance used to be regarded as an impractical goal for psoriasis therapy...
June 2017: Seminars in Cutaneous Medicine and Surgery
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