Facial Fat Grafting: Why, Where, How, and How Much

Abstract

Although the importance of volume loss in the aging face is now well recognized and fat grafting has increasingly become an integral part of contemporary facelift procedures, general acceptance of the fat grafting technique is a relatively recent occurrence and many surgeons reluctance to adopt the technique can be traced back in part to questions they have as to how loss of volume contributes to how the face ages, how to specifically recognize those changes, and questions they have about how to perform the fat grafting procedure to correct them. In this article we attempt to answer the questions "why perform facial fat grafting during facelift procedures?", "where should fat be placed in the face?", "how should fat be injected?", and "how much should be injected in each area?".

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Incisional Ptosis Correction with Hidden Double Fold in Asian Patients

Abstract

Background

Korean males and a few females desire to have larger eyes; however, they often wish to enlarge their eyes and conceal their double eyelids. This paper attempts to describe how to make the eyes bigger and brighter without showing double-fold eyelids.

Methods

The authors performed cosmetic ptosis correction in 121 cases from April 2013 to December 2017. All patients enrolled in this retrospective study underwent surgical procedures at the author's institutions. Patients were included that had mild-to-moderate degrees of ptosis and levator function greater than 5 mm, ages greater than 16 years, and no prior ptosis surgery.

Results

A successful outcome was achieved with this surgical approach in 113 (93.4%) patients. Complications potentially associated with ptosis surgery were not observed.

Discussion

A refined method of preoperative evaluation for incisional ptosis correction to conceal a double fold with no visible signs of surgery is described. Ptosis correction without the formation of double eyelids will result in skin hooding and visible scarring, and thus, it is recommended to lower the height of the double eyelids. The lower height of double eyelids can cover the incisional scar and make it appear there are no double eyelids.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

A Modified Double Eyelid Plastic Surgery Method: Continuous Buried Suture Method Accompanied by Simultaneous Correction of Mild Blepharoptosis

Abstract

Background

Double eyelid surgery with a buried suture is a popular plastic surgery procedure in Asia owing to the relatively minor scarring and quick recovery associated with it. In this article, we present a new approach involving a continuous single-loop buried suture method, which expands the operating site to the conjunctiva and the aponeurosis–Müller's muscle complex.

Methods

The medical records of 42 patients (80 eyes) who underwent double-eyelid blepharoplasty were retrospectively reviewed. We performed double-eyelid blepharoplasty with a single-knot continuous buried suture method, along with the resection of a small piece of the orbicularis oculi muscle. The formation of a double eyelid was achieved through traction of the aponeurosis–Müller's muscle complex from the medial conjunctiva and penetration of the upper eyelid.

Results

The majority of patients achieved the expected cosmetic effect of double eyelid formation after the procedure. In the subsequent follow-up period of 2–30 months, no complications, such as loosing or sagging of the double eyelid or granuloma formation, occurred. The mean recovery time ranged between one and 6 weeks. The pre-operative margin reflex distance (MRD1) was 2.36 ± 0.61 mm, and the post-operative MRD1 was 3.72 ± 0.63 mm, (p < 0.001). The Wilcoxon signed rank test was used for nonparametric, paired comparisons.

Conclusions

We proposed a modified technique involving a continuous buried suture method to create a better cosmetic effect through the formation of a double eyelid and simultaneous correction of mild blepharoptosis. This modified procedure is simple, fast, and effective, with limited adverse effects.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Comparison of the Scar Prevention Effect Between a Carbon Dioxide Fractional Laser and a Continuous Ablative Carbon Dioxide Laser with a 595-nm Nd:YAG Laser

Abstract

Purpose

A linear surgical scar, when located in the head and neck region, can be a significant cosmetic concern. Laser skin resurfacing with a fractional laser and a pulsed dye laser has been proven to be useful for treating such scars. As alternatives, we used a classic ablative CO₂ laser in continuous mode with a 1-mm spot size and a 595-nm Nd:YAG laser. We investigated the effect of the combination of the continuous CO₂ laser and 595-nm Nd:YAG laser and compared it to the effect of fractional CO₂ laser monotherapy on linear scars.

Methods

This was a retrospective, case-controlled study designed to compare the efficacy between fractional CO₂ laser therapy and combination therapy with a conventional CO₂ laser in continuous mode and a 595-nm Nd:YAG laser. Treatment efficacy was evaluated by two different scar scales: the Stony Brook Scar Evaluation Scale (SBSES) and the modified Vancouver Scar Scale (mVSS). Laser treatments were performed every month until the 6th month after surgery.

Results

The SBSES and mVSS scores improved over time in both the monotherapy and the combination therapy (P < 0.001). No significant differences were found between the therapies for all the subcategories of the SBSES. However, among all the subcategories of the mVSS, pigmentation showed a better prognosis with combination therapy (P = 0.04).

Conclusion

Monotherapy and combination therapy can provide similar positive effects on linear scar improvement after repeated treatment, whereas combination therapy exerts more favorable anti-pigmentation effects than monotherapy. The combination of a continuous ablative CO₂ laser with a 595-nm Nd:YAG laser can be used as a favorable alternative to a fractional CO₂ laser. The 1-mm spot size of the CO₂ laser beam may mimic the fractional laser form and offer more effective results for linear incision scars.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Fat Necrosis After Autologous Fat Transfer (AFT) to Breast: Comparison of Low-Speed Centrifugation with Sedimentation

Abstract

Background

Despite the advantages of autologous fat transfer to the breast, there are many complications after the surgery, such as oil cysts, calcification and palpable breast nodules. The fat purification process is a key step to reduce those complications, but there is currently no standard processing method. This study was designed to compare the incidence of fat necrosis after autologous fat grafting to the breast with low-speed centrifugation and sedimentation.

Methods

This study analyzed 100 patients (167 breasts) who underwent autologous fat grafts to the breasts from January, 2015 to March, 2017. Patients were divided into two groups randomly, low-speed centrifugation (800 r/min) and sedimentation (15 min). Postoperative fat necrosis such as oil cysts and palpable breast nodules was measured using physical examination and breast ultrasound 3 months after the surgery. The number and the diameter of the fat necroses were detected.

Results

A total of 100 patients (167 breasts) were included this research. There were 21 breasts with clinically palpable nodules (12.57%); fifteen (19.48%) were in the low-speed centrifugation group and six (6.67%) were in the sedimentation group (p < 0.05). According to postoperative breast ultrasounds, there were 83 breasts with hypoechoic cyst formations (49.7%); forty-five (58.44%) in the low-speed centrifugation group and 38 (42.22%) in the sedimentation group (p < 0.05). A positive correlation between the number of operative sessions and fat necrosis was found out.

Conclusion

Although low-speed centrifugation could achieve higher fat purification efficacy when compared with sedimentation, it causes more fat necrosis than sedimentation, such as clinically palpable nodules and subclinical nodules, especially in patients who had a history of breast surgery and those who needed more than one fat grafting session.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

The Use of a Retromammary Adipofascial Flap in Breast Augmentation for Patients with Thin Soft Tissue

Abstract

Background

In patients with a thin soft tissue breast envelope, lower pole implant palpability is a postoperative sequela that concerns patients. Anatomically, the lower aspect of the breast near the inframammary fold lacks sufficient soft tissue to cover the breast implant after augmentation.

Methods

A transareolar incision was made, and subcutaneous dissection was performed. The dissection first proceeded caudally to the lower aspect to the breast parenchyma. The dissection then changed direction and moved cephalad to the mid breast or nipple region. The fatty tissue and pectoralis muscle fascia were cut transversely at this level, and the dissection was reversed caudally in a subfascial plane to the new inframammary fold region. This maneuver created a retromammary adipofascial flap.

Results

A total of 368 breast augmentations were performed in 184 patients. Breast implants were inserted in the subfascial plane in 40 patients (21.7%) and in the subpectoral–subfascial plane in 144 patients (78.3%). A total of 368 breast implants were inserted, including 140 smooth cohesive silicone implants (38.0%), 2 textured round implants (0.5%), and 226 anatomic-type implants (61.5%). A cadaveric dissection revealed that a retromammary adipofascial flap measuring 3–4 mm in thickness can be acquired. Capsular contracture occurred in six breasts (1.7%).

Conclusions

During breast augmentation, an inferiorly based retromammary adipofascial flap can be created to help cover the lower pole of the breast from implant palpability. This is helpful especially in patients with thin skin, hypoplastic breasts, or constricted breasts.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Measurement of Warping Angle in Human Rib Graft; Experimental Study

No abstract available

Reply to: “The addition of Platelet-rich Plasma to facial lipofilling A Double-Blind, Placebo-Controlled, Randomized Trial.”

No abstract available

“Impact of Chronic Steroid Use on Plastic Surgery Outcomes: Analysis of 94,140 Cases”

Background: Steroids, commonly used to treat many chronic conditions, have been proven to suppress inflammation, edema, autoimmunity, and delay wound healing. Using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), this study aims to characterize the risk of perioperative chronic steroid use for complications in plastic surgery cases. Methods: A retrospective study was performed on 94,140 plastic surgery cases from the ACS NSQIP database for the years 2006-2015. Current procedural terminology codes were used to categorize the operations. Patients were separated into two cohorts based on chronic steroid use status. Univariate analysis was performed using χ2, Fisher's exact tests, or Wilcoxon rank sum tests. Logistic regression models were fitted to evaluate the association between chronic steroid use and postoperative complications. Total hospital length of stay was compared for cohorts. Odds ratios were computed at the 95% confidence interval. Results: Chronic steroid users were more likely to develop surgical complications (OR 1.3; p=0.0452) and medical complications (OR 1.8; p=0.0002) compared to non-steroid users. Among the ten most frequent procedures performed on chronic steroid users, steroid use was a significant risk factor for postoperative complications after reduction mammoplasty (OR 2.2; p=0.001); delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction (OR 2.2; p=0.049); and in trunk muscle, myocutaneous or fasciocutaneus flap (7.2; p=0.0029). Conclusion: With this information in hand, plastic surgeons will be better equipped to counsel patients and adequately design perioperative protocols for chronic steroid users. Financial Disclosure: Nothing to disclose. Presented at: None applicable Acknowledgement: We would like to thank Dr. Ari Rubenfeld and Julie Moore for their assistance and guidance with access to the ACS NSQIP database and their guidance with this project. DISCLAIMER: American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding Author: Matthew J Ranzer, MD, Assistant Professor of Surgery, University of Illinois at Chicago, Division of Plastic, Reconstructive, and Cosmetic Surgery, 820 S Wood St, Suite 515 CSN, Chicago, IL 60612 USA. Office: 312-996-9313 Fax: 312-413-0495, E-mail: ranzerm@uic.edu ©2018American Society of Plastic Surgeons

Preclinical experience using a new robotic system created for microsurgery

Background: Completing microsurgical anastomosis requires great technical skills. Robotic assistance in microsurgery can exceed the maximum human level of precision and manual dexterity to improve clinical outcomes. Since no robotic device has been designed primarily for microsurgery the authors developed a dedicated microsurgical robotic system (MSR). This preclinical study investigates whether microsurgical anastomosis can be successfully completed on silicone vessels using a prototype of this newly developed robotic system, and compares outcomes of robotic-assisted versus conventional anastomotic microsurgery. Methods: Three participants at different levels of microsurgical training completed ten anastomoses by hand and ten anastomoses with robotic assistance. Four blinded experienced microsurgeons evaluated the quality of the microsurgical skills using a modified version of the Structured Assessment of Microsurgical Skills (SAMS). Time to perform the anastomosis and adverse events were recorded. Results: The total time to perform the anastomoses with and without robotic assistance decreased to 35.1 minutes and 12.5 minutes respectively during the study. The overall performance and indicative skill of the SAMS improved during the conventional method (from respectively 2.8 to 3.6 and 2.6 to 3.7) and the robotic-assisted method (from respectively 2.3 to 3.0 and 2.3 to 3.1). Conclusions: It is feasible to complete anastomotic microsurgery on silicone vessels using the MSR. In comparison to the conventional method, time to perform the anastomosis was longer and quality of the microsurgical skills were lower in the robotic-assisted group. However, the robotic-assisted performance showed steeper learning curves (faster improvement) compared to the conventional performance for both surgical time and domains of microsurgical skills. The encouraging results indicate further development of the MSR and additional preclinical trials as step up towards clinical validation. FINANCIAL DISCLOSURE STATEMENT: Tom van Mulken has a financial disclosure, as he is Chief Medical Officer of the spin off company MicroSure: costs of travel and share in company. Rene van der Hulst has a financial disclosure as shareholder of MicroSure. Raimondo Cau has a financial disclosure, as he is Chief Technical Officer and shareholder of MicroSure. Ferry Schoenmakers is a software developer for MicroSure. The other authors have no financial disclosures. ACKNOWLEDGEMENTS: The four microsurgeons, forming the assessment panel, are gratefully acknowledged for their efforts. CORRESPONDING AUTHOR: Tom J.M. van Mulken, MD, Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands, Tel: (+31) 043-3875474; Fax: (+31) 043-3875473, Email: tom.van.mulken@mumc.nl ©2018American Society of Plastic Surgeons

Donor Site Morbidity and Functional Status Following Medial Femoral Condyle Flap Harvest

Background: The medial femoral condyle (MFC) free vascularized bone flap is a valuable alternative to other types of vascularized bone grafts. The donor site morbidity and functional outcomes after flap harvest have not been fully appreciated. Herein, we report the postoperative outcomes and analyze the impact of increasing the size of the flap on the knee donor site morbidity. Methods: A retrospective chart review of patients who underwent MFC flap between 2001 and 2012 at our institution was done. The size of the flap was stratified, based on the largest dimension, into 3 groups. Demographics, outcomes, and complications related to the flap donor site were recorded and analyzed. Subsequently, functional status was assessed by administering a validated condition-specific measure: the Lower Extremity Functional Scale (LEFS) questionnaire. A univariate logistic regression analysis was done, and results were analyzed. Results: A total of 75 patients were identified. Average age was 29.5 ± 15.2 years (range: 14-72). Average follow-up time was 13 months postoperatively. Overall Complication rate was 18.6%. Donor site paresthesia in the saphenous nerve distribution was the most common complication. Increasing size of the flap did result in a significant elevation in complication risk (p<.05 a total of patients completed the lefs questionnaire. average score was scored points indicating normal level function on average. conclusions: mfc flap has overall acceptable donor site morbidity with good post-operatively. larger flaps are associated greater number complications. meetings at which paper partially presented: none financial disclosures: authors interest in any products devices or drugs mentioned this manuscript. corresponding author: brian t. carlsen md division plastic surgery department mayo clinic first street sw rochester minnesota usa. phone: fax: email: carlsen.brian society surgeons>

Introducing Knowledge Translation to Plastic Surgery: Turning Evidence into Practice

Best evidence has no bearing on quality of life if it is not implemented in clinical practice. We introduce knowledge translation as a theoretical framework for closing the gap between evidence and practice in plastic surgery. The current state of published evidence in plastic surgery is reviewed and evaluated, with the recommendation to utilize the EQUATOR network's guidelines for reporting clinical research findings. Tools and strategies are offered for the reader to understand and integrate evidence at the bedside. Systemic solutions are also proposed for the dissemination of best evidence to facilitate its translation into practice. Financial Disclosure: The authors have no financial conflicts of interest or sources of funding to declare. Correspondence: Dr. Achilleas Thoma, 101-206 James Street South Hamilton, ON, L8P 3A9,, Phone (905) 523-0019, Fax (905) 523-0229, Email: drathoma@cogeco.net ©2018American Society of Plastic Surgeons

“Increasing Diversity in Plastic Surgery”

No abstract available

Reply to “Lymphedema Quality of Life Score (LeQOLiS): A Simple Method for Evaluation of Subjective Symptoms in Extremity Lymphedema Patients”

No abstract available

An Intraoperative 3D Imaging System for Better Image Sharing and Protection of Reconstructive Surgeons’ Neck

No abstract available

Reply: Reconstruction of the Heel, Middle Foot Sole, and Plantar Forefoot with the Medial Plantar Artery Perforator Flap Clinical Experience with 28 Cases.

No abstract available

Commentary to “Targeting Reflux-free Vein Using Indocyanine Green Dye Angiography”

No abstract available

Reply: An Intraoperative 3D Imaging System for Better Image Sharing and Protection of Reconstructive Surgeons' Neck

No abstract available

Reply to the letter of Klinger et al. on our manuscript “Autologous Fat Injection vs. Lundborg´s Resection Arthroplasty for the Treatment of Trapeziometacarpal Joint Osteoarthritis”

No abstract available

Aesthetic Functional Surgery with ulnar artery perforator, an easier alternative to super-thin SCIP.

No abstract available

Response to: Autologus Fat Injection versus Lundborg Resection Arthroplasty for the treatment of Trapeziometacarpal Joint Osteoarthritis

No abstract available

Reply: Aesthetic Functional Surgery with proximal ulnar artery perforator, an easier alternative to super-thin SCIP.

No abstract available

“Vascular Anomalies: From a Clinicohistologic to a Genetic Framework”

No abstract available

Reply: Increasing Diversity in Plastic Surgery

No abstract available

Lymphedema Quality of Life Score (LeQOLiS): A Simple Method for Evaluation of Subjective Symptoms in Extremity Lymphedema Patients

No abstract available

Three-dimensional reconstruction: the waveform design of free perforator flap for the heel defect repair

No abstract available

Melatonin ameliorates TNBS-induced colitis in rats through the melatonin receptors: involvement of TLR4/MyD88/NF-κB signalling pathway

Abstract

Aim

The aim of the present study is to investigate the anti-inflammatory effect of melatonin in trinitrobenzene sulfonic acid (TNBS)-induced rat colitis through the inhibition of Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signalling pathway and activation of melatonin receptor.

Methods

Colitis was induced in Wistar rats by administration of 100 mg/kg TNBS dissolved in 0.25 ml of 50% ethanol solution using a flexible plastic rubber catheter into the colon via the anus. This resulted in incidence of colitis on the first day, and all treatments were conducted for 10 days after induction of colitis. Melatonin was administered intraperitoneally (i.p.) at doses of 1, 5, and 10 mg/kg/day. Luzindole (non-selective MT1/MT2 receptor antagonist) was administered i.p. at dose of 5 mg/kg/day 15 min prior to melatonin injection. During the experiment, animals were monitored for the appearance of diarrhoea, body weight loss, and rectal bleeding. Myeloid peroxidase enzyme and tumour necrosis factor-α (TNF-α) activities were detected by immunohistochemistry. The protein expression level of TLR4, myeloid differentiation factor 88 (MyD88), NF-κB p65, and inhibitor of kappa B (I-κB) were detected by western blotting analysis.

Results

Treatment with melatonin improved weight loss, mucosal, and histological damage compared with TNBS group. In addition, melatonin decreased TNBS-induced up-regulation of TLR4, MyD88, and NF-κB p65, and increased down-regulation of I-κB proteins. On the other hand, the administration of luzindole resulted in the inhibition of melatonin effects.

Conclusions

It seems that the inhibition of TLR4/NF-κB signalling pathway may mediate the anti-inflammatory effects of melatonin in TNBS-induced rat colitis.

Rutin protects against lipopolysaccharide-induced mastitis by inhibiting the activation of the NF-κB signaling pathway and attenuating endoplasmic reticulum stress

Abstract

Rutin, found widely in traditional Chinese medicine materials, is used to treat eye swelling and pain, hypertension, and hyperlipidemia. In the present study, a mouse mastitis model induced by lipopolysaccharide (LPS) was established to explore rutin's inhibitory mechanism on mastitis via nuclear factor kappa B (NF-κB) inflammatory signaling and the relationship between NF-κB signaling and endoplasmic reticulum (ER) stress. Mice were divided into six groups: Control group, LPS model group, LPS + rutin (25, 50, and 100 mg/kg) and LPS + dexamethasone (DEX) group. DEX, rutin, and PBS (control and LPS groups) were administered 1 h before and 12 h after perfusion of LPS. After LPS stimulation for 24 h, to evaluate rutin's therapeutic effect on mastitis, the mammary tissues of each group were collected to detect histopathological injury, tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, and IL-6 mRNA and protein levels; and glucose-regulated protein, 78 kDa (GRP78) protein levels. The protein and mRNA levels of TNF-α, IL-1β, and IL-6 in the LPS + rutin group were significantly lower than those in the LPS model group. Similarly, p50/p105, phosphorylated (p)-p65/p65 and p-inhibitor of nuclear factor kappa b kinase subunit beta (p-IKKβ)/IKKβ ratios in the LPS + rutin group (50 mg/kg) and LPS + rutin group (100 mg/kg) decreased significantly. GRP78 protein expression was significantly higher in LPS + rutin group (100 mg/kg). The structure of mammary tissue became gradually more intact and vacuolization of acini decreased as the rutin concentration increased. The nuclear quantity of p65 in the LPS + rutin group decreased significantly in a rutin dose-dependent manner. Rutin had an anti-inflammatory effect in the LPS-induced mouse mastitis model, manifested by inhibition of NF-κB pathway activation and attenuation of ER stress.

SB203580 attenuates acute lung injury and inflammation in rats with acute pancreatitis in pregnancy

Abstract

Acute pancreatitis in pregnancy (APIP) can lead to multiple maternal and fetal organ injury and mitogen-activated protein kinase (MAPK) signaling pathway may be involved in it; however, whether APIP can result in acute lung injury and P38MAPK signaling pathway is involved in the pathogenesis has not been elucidated. The present study was undertaken to investigate the participation of P38MAPK signaling pathway and the protective effect of SB203580, an inhibitor of P38MAPK on acute lung injury induced by APIP. Twenty-four late-gestation SD rats were randomly assigned to four groups: Sham operation (SO) group, SB302580 (SB) group, APIP group, and SB + APIP group. All the rats were killed 6 h after modeling. The severity of pancreatitis was evaluated by serum amylase (AMY) and lipase (LIPA) and histopathological changes. Histological assessment of the lung and inflammatory cell infiltration was performed by H&E and immunofluorescence assay. The lung wet/dry (W/D) weight ratio was determined, and the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 were detected by enzyme-linked immunosorbent assay (ELISA). Western blot analysis was used to detect the protein expression of phosphorylated and total P38, tumor necrosis factor (TNF)-α, and intercellular adhesion molecules 1 (ICAM-1) in lung tissues. Obvious pathological changes existed in pancreas and lung after the induction of APIP, and their pathological scores were significantly higher than that of control group. The results showed that the phosphorylation of P38MAPK was elevated in the lung of APIP rats. Compared with APIP group, the intervention of SB203580 alleviated the pathological injury of the pancreas and lungs, decreased serum AMY and LIPA, attenuated the secretion of TNF-α, IL-1β, and IL-6 in lung, reduced the inflammatory cells' infiltration and lung W/D ratio and inhibited the activation of P38MAPK signaling pathway. These results suggest that APIP can lead to acute lung injury and inflammation and SB203580 can inhibit the lung injury by inhibiting the P38MAPK signaling pathway and blocking the inflammatory responses.

Troubling Hope: Performing Inventive Connections in Discomforting Times

Abstract

In what follows, we revisit the most promising conceptions of "hope" while following Haraway's admonition to "stay with the trouble." Thirty-five years after Haraway's (1991) opening to the Manifesto for Cyborgs where she states that "irony is about contradictions that do not resolve into larger wholes" (p. 149), we move with her ceaseless task to eschew resolution and certainty, urging instead a radical contingency that is fundamental to thought itself. The radical contingency recognizes the limits of what any one individual or one species is capable of unto itself. Any such exceptionalism is spurned. The possibilities of thinking-with, and making-with, are the necessary path of the troubled present. And there is no escaping the present, a present that is thick with affliction but is still unfinished and ongoing. We enter into the thick presence of our ongoing conversation around hope by revisiting the concepts that help us to think our thoughts, exploring how these conceptions worked and did not work for our collective thinking. We then build on the concepts' appendages, their attachments and detachments to our conversation around hope, by sketching Haraway's materialist challenge to hope (and despair), and her refusal of futurism and contingency that raise some questions about the potentialities of "critical hope." Finally, we situate our work within an understanding of the "pedagogical work of the concept," drawing a line from Haraway to Stengers to Deleuze, which allows us to explore resonance between concepts and posit a "pedadogy of the concept" to situate the limits of hope and potentialities of "staying with the trouble." To work towards a pedagogy that "stays with the trouble," we extend Haraway's critique that it matters "what thoughts think thoughts" by suggesting that it also matters which feelings we feel with, highlighting the vital necessity of feeling to the project of staying with the trouble.

Reinforcement of barrier function – skin repair formulations to deliver physiological lipids into skin

International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.

Consensus research priorities for facial palsy: a Delphi survey of patients, carers, clinicians and researchers

Despite the potential negative impact of facial palsy, major gaps in understanding persist surrounding the treatment and care of those affected. This collaborative three-round Delphi process aimed to identify priorities for future facial palsy research, from the perspective of clinicians, researchers, patients and carers. It also determined whether the research priorities of patients and carers aligned with those of health professionals and researchers.In Round one participants (n=85) were asked to generate research questions via focus groups or an online or postal survey.

Granuloma Annulare’s Triangular Association with Malignancy

Effect of iron plaque and selenium on mercury uptake and translocation in rice seedlings grown in solution culture

Abstract

A hydroponics experiment was conducted to investigate the effect of iron plaque on root surfaces and selenium (Se) on the uptake and transfer of mercury (Hg) in rice seedlings by adding in the EDTA-Fe (0, 10, 30, 50, 70 mg Fe l⁻¹) into the solution to produce a different amount of iron plaque outside rice root. After 24 h, the red-brown iron plaque was formed on the root surface, and the amount of iron plaques was positively correlated with the amount of Fe in the solution. The iron plaque deposited on the root surface has a strong adsorption effect on the inorganic Hg. The addition of Se could promote the adsorption of Hg²⁺ on the iron plaque of rice, and the introduction of Se could increase the adsorption capacity of Hg on iron plaque on average by 1.42 times. The Hg was extracted by DCB (Dithionite-citrate-bicarbonate) up to between 66.2 and 67.8% of the total Hg when the roots with iron plaque (Fe70) were incubated with the combination of 5 μmol L⁻¹ of HgCl₂ and 5 μmol L⁻¹ of Na₂SeO₃ for an hour. After 3 days, the content of Hg in the iron plaque decreased to 6.3–33.9%, indicating that part of the inorganic Hg adsorbed by the iron plaque could be reabsorbed and used. Besides that, the iron plaque allowed the Hg to stay longer in the iron plaque, which hindered the transfer of Hg to the shoot significantly. Hg adsorbed in the iron plaque can be desorbed by low-molecular-weight organic acids, which was equivalent to desorption of Hg from ferric hydroxide oxides. Hg adsorbed on the iron plaque can be moved back to the rest of the plant. These results suggest that the iron plaque and Se in the root surface might play a role as "physical buffer" in the absorption and transfer of Hg.

Defending stance voluntarism

Abstract

In this paper, I argue that stance voluntarism is a coherent and useful view for understanding debates about the ontological commitments warranted by science. To do so, I first engage in a defensive move: I rescue stance voluntarism from what I take to be the most pressing objection to have emerged in recent literature, which I call the 'irrationality objection'. According to this objection, an agent courts irrationality by simultaneously holding an epistemic stance and believing that stance voluntarism is true. I argue that this objection is based on a misunderstanding of stance voluntarism and the kinds of reasons that agents take themselves to have for their adopted stances. I then make the positive contention that we can expect the idea of stance voluntarism, thus saved, to not only be a defensible, but also a useful framework for understanding ontological disputes within science. I do this by presenting a case study from contemporary cosmology in which it is so. Combining these two claims, I argue that stance voluntarism is a coherent and useful view for understanding some ongoing disputes about ontology within scientific contexts.

Construction of a risk model for the development of metachronous squamous cell carcinoma after endoscopic resection of esopahageal squamous cell carcinoma

Abstract

Background

Previously, we identified that rs1229984 in ADH1B, rs671 in ALDH2, and smoking status were independently associated with the risk of developing metachronous squamous cell carcinoma (SCC) after endoscopic resection (ER) for esophageal SCC (ESCC). However, this analysis included cases with short-term follow-up. In the present study, we investigated the environmental and genetic factors associated with developing metachronous SCC using long-term follow-up observation after ER for ESCC.

Methods

One hundred and thirty ESCC patients who underwent treatment with ER were followed up using endoscopy for ≥ 30 months. We investigated the incidence of, and genetic/environmental factors associated with, metachronous SCC development after ER for ESCC. We also analyzed the potential risk factors for multiple metachronous SCC development using Cox's proportional hazards model. Moreover, we constructed a risk model for the development of metachronous SCC after ER for ESCC.

Results

Male, rs1229984, rs671, alcohol consumption (> 20 g/day), smoking, and multiple Lugol-voiding lesions (LVLs) significantly affected the incidence of multiple metachronous SCCs. Multiple Cox proportional analysis revealed that rs1229984, rs671, alcohol consumption, smoking, and multiple LVLs were independently associated with the risk of developing metachronous SCC. Patients who had ≤ 2 risk factors did not develop metachronous SCC, and the risk of developing metachronous SCC in patients with ≥ 3 risk factors was significantly higher than in patients with ≤ 2 risk factors.

Conclusion

The risk model using these 5 genetic and environmental factors is useful as an indication for multiple metachronous development in ESCC patients.

Preparation and application of magnetic nitrogen-doped rGO for persulfate activation

Abstract

A heterogeneous catalyst (M-N-rGO) composed of stability enhanced magnetic iron oxide nanoparticles and nitrogen-doped reduced graphene oxide was synthesized and characterized by SEM, XRD, BET, and XPS. It showed excellent catalytic degradation properties in advanced oxidation technology. In the presence of 200 mg/L catalyst and 135 mg/L persulfate at pH 5, 95% of 10–20 mg/L methylene blue could be degraded in 90 min with the TOC removal efficiency of 50%. The rate constant based on pseudo-first-order kinetics ranged from 0.0227 to 0.0488/min in the temperature range of 15 to 32 °C, and the activation energy was 32.5 kJ/mol. Under the optimal operation conditions, 20 mg/L of 2,4-dichlorophneol (2,4-DCP) could be removed almost completely. EPR analysis showed that sulfate and hydroxyl radicals were responsible for degradation of pollutants, and radical quenching experiments indicated that nonradical pathway also played a role in pollutant removal. And a mechanism for M-N-rGO and persulfate system was elucidated. This catalyst was easy for preparation, low-cost, highly effective, convenient for separation, and could be used effectively for four times through 0.1 mol/L H₂SO₄ regeneration. It provided a choice for wastewater treatment in practice.

Orthogonal design-guided preparation of multi-level porous-activated carbon by pyrolysis of waste polyester textiles

Abstract

Multi-level porous amorphous-activated carbon with excellent adsorption performance was prepared by a ZnCl₂-assisted pyrolysis of waste polyester textiles. Experimental parameters were optimized by using orthogonal design. Result of orthogonal design revealed that pyrolysis temperature and pyrolysis time were the dominant individual factors. Samples prepared at the optimal condition were systematically characterized by Brunauer-Emmett-Teller (BET) porosity analyzer, FT-IR spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscope (SEM), and transmission electron microscope (TEM). Iodine (I₂), methylene blue (MB) and phenol (PhOH) were selected as target dyes to measure the adsorption performance. Experimental results showed that porous-activated carbon with multi-level pores could be obtained by optimizing experimental parameters. The specific surface area and total pore volume were calculated to be 846.37 m² g⁻¹ and 0.726 cm³ g⁻¹, respectively. Benefit from its multi-level rich porosity, the optimized sample possessed attractive adsorption performance toward different types of dyes. The corresponding adsorption capacity toward I₂, MB, and PhOH were calculated to be 980.48, 384.00, and 300.62 mg g⁻¹, respectively.

Palpebral cutaneous melanomas: a review of 17 cases from a tertiary center

International Journal of Dermatology, EarlyView.

Development of the International Severe Asthma Registry (ISAR): a modified Delphi study

Publication date: Available online 1 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Lakmini Bulathsinhala, Nevaashni Eleangovan, Liam G. Heaney, Andrew Menzies-Gow, Peter G. Gibson, Matthew Peters, Mark Hew, Job FM. van Boven, Lauri Lehtimäki, Eric van Ganse, Manon Belhassen, Erin Harvey, Luis Perez de Llano, Anke H. Maitland-van der Zee, Nikolaos Papadopoulos, J. Mark FitzGerald, Celeste Porsbjerg, G. Walter Canonica, Vibeke Backer, Chin Kook Rhee

Abstract

Background

The lack of centralised data on severe asthma has resulted in a scarcity of information about the disease and its management. The development of a common data collection tool for the International Severe Asthma Registry (ISAR) will enable standardised data collection, subsequently enabling data interoperability.

Objectives

To create a standardised list of variables for the first international registry for severe asthma via expert consensus.

Methods

A modified Delphi process was used to reach consensus on a minimum set of variables to capture in ISAR: the core variables. The Delphi panel brought together 27 international experts in the field of severe asthma research. The process consisted of three iterative rounds. In each round, all Delphi panel members were issued an electronic ISAR Delphi workbook to complete and return to the ISAR Delphi administrator. Workbooks and result summaries were anonymously distributed by the Delphi administrator to all panel members at subsequent rounds. Finalisation of the core variable list was facilitated by two face-to-face meetings.

Results

Of the initial 747 selected variables, the Delphi panel reached a consensus on 95. The chosen variables will allow severe asthma to be assessed against patient demographics and medical history, patient-reported outcomes, diagnostic information and clinical characteristics. Physician-reported outcomes such as non-adherence and information about treatment and management strategies will also be recorded.

Conclusion

This is the first global attempt to generate an international severe asthma registry using a common set of core variables to ensure that data collected across all participating countries are standardised.

Hymenoptera Venom Extracts in Clinical Practice

Publication date: Available online 1 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): James M. Tracy, David BK. Golden

Abstract

Venom immunotherapy is the only treatment for the prevention of anaphylaxis and remains the prototypical model for its diagnosis and management. Unlike other causes of anaphylaxis, such as foods and drugs, preventative treatment is highly effective and widely available. Hymenoptera venoms are also unique in that the primary allergens are directly measurable in terms of micrograms, rather than labeled based on potency. As such, venoms were the first truly standardized extracts. However, Hymenoptera venom presents unique challenges in collection, processing and stabilization of the venom extract product. Historically, there have been minor variations in insect composition in venom extract content. These differences were in part, based on variation of insect availability and venom collection and have created minor challenges. However, it is a recognized need that venom extracts contain an optimal and complete repertoire of relevant venoms so as to be assured of appropriate diagnosis and treatment. As such, insect availability and collection, as well as storage, stability and sterility of venom extracts have remained critical components to appropriate diagnosis and prevention of venom induced anaphylaxis. In recent years there has been concerns of adequate supplies of venom for appropriate diagnosis and treatment of venom allergy, but these concerns seem to have stabilized, with the movement to a single venom supplier. This movement to a single supplier may provide its own challenges.

Drug Rash Eosinophilia and Systemic Symptoms (DRESS) Syndrome Identified in the Electronic Health Record Allergy Module

Publication date: Available online 31 August 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Anna R. Wolfson, Li Zhou, Yu Li, Neelam A. Phadke, Ohn A. Chow, Kimberly G. Blumenthal

Abstract

Background

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare but severe hypersensitivity reaction that remains poorly characterized in the US.

Objective

We aimed to identify and describe DRESS syndrome cases in an integrated healthcare system using electronic health record (EHR) allergy module free text searches.

Methods

We identified DRESS syndrome cases with rash, absolute eosinophil count ≥500/L, organ involvement, and RegiSCAR (European Registry of Severe Cutaneous Adverse Reactions [SCAR]) to Drugs and Collection of Biological Samples) score ≥2 by reviewing patients from 1980-2016 whose EHR allergic reaction matched DRESS-related keywords. Liver injury required alanine aminotransferase ≥100U/L and renal injury required creatinine increase by ≥0.5mg/dL or 50%. Patient and DRESS characteristics were described, resource use was determined, and cost was estimated.

Results

Among 3,162,562 patients with 3,319,387 million allergy entries, 538 reactions matched keywords, and 69 were DRESS cases (prevalence 2.18 in 100,000). DRESS patients had liver (42%) or renal (42%) injury; 11 (16%) had both liver and renal injury. Primary drug culprits were antibiotics (74%) (vancomycin [39%], beta-lactams [23%], fluoroquinolones [4%], tetracyclines [4%], and sulfonamides [3%]) and anticonvulsants (20%). Of 65 (94%) hospitalized DRESS patients, 43 (66%) were hospitalized for DRESS syndrome management with median length of stay 9 days [IQR, 6-17 days] and cost approximately $17,101 per patient.

Conclusions

Using free text search of the EHR allergy module identified a large US DRESS syndrome cohort. DRESS prevalence was 2.18 per 100,000 patients. Both liver and kidney injury were frequent, and vancomycin was the most common drug culprit. DRESS cases were morbid and resource-intensive.

Routine clinical utility of honeybee venom allergen components

Publication date: Available online 31 August 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Martina Vachová, Petr Panzner, Peter Kopac, Urska Bidovec Stojkovič, Peter Korošec

Adjuvant treatment for high-risk renal-cell carcinoma: the jury is still out

Larva migrans cutánea facial de origen autóctono en España

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): C. Durán-Vian, I. Vilanova-Udaniz, B. Castro-Gutierrez, M.A. González-López

Enfermedad de Kikuchi-Fujimoto con compromiso de cuero cabelludo

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): A. Combalia, X. Fustà-Novell, A. García-Herrera, J. Ferrando

Enfermedad de Rosai-Dorfman cutánea: una nueva presentación clínica

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): J.M. Conde, A.Y. Kim, R. de Miguel, C.H. Nousari

Melanocitosis dérmica agminada en el territorio del nevus de Ota

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): L. Diluvio, M. Mazzeo, L. Bianchi, E. Campione

Celulitis cervical odontógena

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): P. García-Montero, G. González-Pérez, N. Blázquez-Sánchez

Raro compromiso lingual de leishmaniasis mucocutánea por Leishmania perteneciente al subgénero Viannia

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): R. Bueno-Filho, S. Vernal, C.M. Gomes, A.M. Roselino

FR-Calidad de vida en cáncer cutáneo no melanoma

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): P. García-Montero, M.V. de Gálvez-Aranda, M. de Troya Martín

Máculas evanescentes en tronco y extremidades

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): M.Á. Flores-Terry, M. Franco-Muñóz, J.A. Garrido-Martín, N. Villasanti-Rivas

Lesión ulcerada en pene

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): E.R. Martínez Lorenzo, B. Moreno Torres, A.I. Sánchez Moya

Pitiriasis liquenoide y varioliforme aguda asociada al virus herpes humano tipo 7

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): M. Costa-Silva, A. Calistru, J. Sobrinho-Simões, C. Lisboa, F. Azevedo

Resumen

Tanto la pitiriasis liquenoide y varioliforme aguda como la pitiriasis liquenoide crónica representan 2 extremos de un espectro de enfermedad de etiología desconocida. En este trabajo se describen 2 casos de pitiriasis liquenoide y varioliforme aguda, en los que se detectó ADN de virus herpes humano tipo 7 en muestras de piel mediante la metodología de reacción en cadena de la polimerasa, una asociación no descrita previamente. Este manuscrito puede apoyar la participación de la infección viral en la etiopatogenia de esta enfermedad.

Abstract

Pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica represent 2 ends of a disease spectrum of unknown etiology. Herein we describe 2 cases of pityriasis lichenoides et varioliformis acuta, in which human herpesvirus 7 DNA was detected in skin samples by polymerase chain reaction methodology, an association not previously described. This report may support the involvement of viral infection in the etiopathogeny of this disease.

Granuloma aséptico facial idiopático: hallazgos clínicos y ecográficos de 3 casos

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): A.I. Rodríguez-Bandera, M. Feito-Rodríguez, R. Maseda-Pedrero, R. de Lucas-Laguna

Resumen

El granuloma aséptico facial idiopático es una entidad propia de la infancia que se caracteriza por la presencia de uno o varios nódulos asintomáticos en la mejilla. Aunque su patogenia no está clara, se ha sugerido que pueda pertenecer al espectro de la rosácea infantil. Resuelve espontáneamente pero puede plantear dudas diagnósticas con otras lesiones que sí requieren tratamiento.

Presentamos los hallazgos clínicos y ecográficos y la evolución, tanto clínica y ecográfica, de 3 nuevos casos. En 2 pacientes, la lesión se presentó en el contexto de una rosácea infantil. En ecografía, el granuloma aséptico facial idiopático mostró un patrón característico, con variaciones en función del momento evolutivo.

La ecografía de alta frecuencia puede facilitar el diagnóstico diferencial, evitando biopsias o extirpaciones innecesarias.

Abstract

Idiopathic facial aseptic granuloma is a typical childhood disease characterized by the presence of one or more asymptomatic nodules on the cheek. Although pathogenesis remains unclear, the disease is thought to be a type of childhood rosacea. It resolves spontaneously, yet it could be confused with other lesions that require treatment.

We present clinical and ultrasound findings and outcome from 3 new cases. In 2 cases, the lesion presented as childhood rosacea. Ultrasound revealed a characteristic pattern, with variations depending on the stage of development.

High-frequency ultrasound can facilitate the differential diagnosis and thus obviate unnecessary biopsy or excision.

Registro de linfomas cutáneos primarios de la AEDV: primer año de funcionamiento

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): Y. Peñate, O. Servitje, S. Machan, R. Fernández-de-Misa, M.T. Estrach, E. Acebo, J. Mitxelena, M.D. Ramón, A. Flórez, M. Blanes, M. Morillo, S. Medina, J. Bassas, A. Zayas, P. Espinosa, A. Pérez, N. Gónzalez-Romero, J.D. Domínguez, C. Muniesa, J. López Robles

Resumen

Antecedentes y objetivo

Los linfomas primarios cutáneos son enfermedades poco frecuentes. Este artículo describe el Registro de linfomas cutáneos primarios de la AEDV y sus primeros resultados.

Pacientes y métodos

Registro de enfermedad de pacientes con linfomas cutáneos primarios. Los centros participantes recogieron datos prospectivamente de todos los pacientes, incluyendo datos del diagnóstico, de los tratamientos, de las pruebas realizadas y del estado actual del paciente. Se realizó un análisis descriptivo.

Resultados

En diciembre del 2017 el registro tenía datos de 639 pacientes pertenecientes a 16 hospitales universitarios. Un 60% eran hombres y los diagnósticos, por orden de frecuencia, fueron: micosis fungoide/síndrome de Sézary (MF/SS) (348 casos; 55%), linfoma cutáneo primario de células B (LCCB) (184; 29%), trastorno linfoproliferativo de células T CD30+ (LTCD30+) (70; 11%) y otro tipo de linfoma T (OLT) (37; 5%). El número de casos incidentes recogidos durante el primer año fue de 105 (16,5%). En los pacientes con MF/SS, el diagnóstico más frecuente fue MF clásica (77,3%). La mitad de estos casos se diagnosticaron en estadio IA. La mayoría de los pacientes estaban en remisión parcial (32,5%) o enfermedad estable (33,1%). Los tratamientos más usados fueron los corticoides tópicos (90,8%) seguidos de fototerapia. En los pacientes con LCCB el diagnóstico más frecuente fue el linfoma de la zona marginal (50%). Casi todos los pacientes tuvieron afectación exclusivamente cutánea y casi la mitad fue T1a. La mayoría (76,1%) estaba en remisión completa. Los tratamientos más utilizados fueron la cirugía (55,4%) y la radioterapia (41,9%). En los pacientes con LTCD30+, el diagnóstico más frecuente fue la papulosis linfomatoide (68,6%). La mayoría fueron clasificados T3b (31,4%). La mitad de los casos estaban en remisión completa. Los tratamientos más frecuentes fueron los esteroides tópicos (68,6%), seguidos de la quimioterapia sistémica (32,9%).

Conclusión

Las características del paciente con linfoma cutáneo primario en España no difieren de otras series descritas en la literatura. El registro facilitará al grupo de linfomas de la AEDV realizar investigación clínica.

Abstract

Background and objective

Primary cutaneous lymphomas are uncommon. This article describes the Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV) and reports on the results from the first year.

Patients and methods

Disease registry for patients with primary cutaneous lymphoma. The participating hospitals prospectively recorded data on diagnosis, treatment, tests, and disease stage for all patients with primary cutaneous lymphoma. A descriptive analysis was performed.

Results

In December 2017, the registry contained data on 639 patients (60% male) from 16 university hospitals. The most common diagnoses, in order of frequency, were mycosis fungoides/Sézary syndrome (MF/SS) (348 cases, 55%), primary cutaneous B-cell lymphoma (CBCL) (184 cases, 29%), primary cutaneous CD30⁺ T-cell lymphoproliferative disorder (CD30⁺ CLPD) (70 cases, 11%), and other types of T-cell lymphoma (37 cases, 5%). In total, 105 (16.5%) of the cases recorded were incident cases. The most common diagnosis in the MF/SS group was classic MF (77.3%). Half of the patients with MF had stage IA disease when diagnosed, and the majority were either in partial remission (32.5%) or had stable disease (33.1%). The most widely used treatments were topical corticosteroids (90.8%) and phototherapy. The most common form of primary CBCL was marginal zone lymphoma (50%). Almost all of the patients had cutaneous involvement only and nearly half had stage T1a disease. Most (76.1%) were in complete remission. The main treatments were surgery (55.4%) and radiotherapy (41.9%). The most common diagnosis in patients with CD30⁺ CLPD was lymphomatoid papulosis (68.8%). Most of the patients (31.4%) had stage T3b disease and half were in complete remission. The most common treatments were topical corticosteroids (68.8%) and systemic chemotherapy (32.9%).

Conclusion

The characteristics of patients with primary cutaneous lymphoma in Spain do not differ from those described in other series in the literature. The registry will facilitate clinical research by the AEDV's lymphoma group.

Graphical abstract

Actualización en la dermatitis de contacto alérgica por parafenilendiamina

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): B. Encabo Durán, D. Romero-Pérez, J.F. Silvestre Salvador

Resumen

La parafenilendiamina (PPD) es una amina empleada en la actualidad principalmente como componente de tintes capilares y en tatuajes de henna. Se ha observado un incremento en la incidencia de la dermatitis alérgica de contacto por PPD, y en edades cada vez más tempranas. En el presente trabajo se realiza una revisión de las principales fuentes que contienen PPD, así como de las sustancias con las que puede interaccionar, y se propone un algoritmo de manejo diagnóstico y terapéutico desde un enfoque práctico, para los pacientes que presenten una clínica compatible con sospecha de alergia a PPD.

Abstract

Paraphenylenediamine (PPD) is an amine that is mainly used as an ingredient in hair dyes and henna tattoos. The incidence of allergic contact dermatitis to PPD is increasing, particularly in younger patients. In this article, we review the main sources of PPD and the substances with which it can interact and present a practical algorithm for diagnosing and treating suspected cases of PPD allergy.

Graphical abstract

Papel de la ecografía doppler color en el diagnóstico de granuloma aséptico facial idiopático

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): X. Wortsman

Posturas ergonómicas para la exploración en dermatología

Publication date: September 2018

Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 7

Author(s): I. Hernández Aragüés, A. Neyra Castañeda, E. Fernández Vilariño, G. Simal

Comprehensive Long‐Term Safety of Adalimumab from Eighteen Clinical Trials in Adult Patients With Moderate to Severe Plaque Psoriasis

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.

Reconstruction mammaire par lambeau musculo-cutané de grand dorsal avec prothèse : la technique du soutien-gorge dorsal

Publication date: Available online 1 September 2018

Source: Annales de Chirurgie Plastique Esthétique

Author(s): C. Bruant-Rodier, L. Ruffenach, S. Hendriks, F. Bodin, C. Dissaux

Résumé

Malgré l'essor de la microchirurgie, la reconstruction mammaire par lambeau musculo-cutané de grand dorsal pédiculé reste une intervention très pratiquée. Elle est fiable, réalisable chez la quasi-totalité des patientes, sans contre-indication chez les fumeuses et est indiquée après radiothérapie. La variante technique qui combine le lambeau de grand dorsal et un implant, permet de reconstruire le volume mammaire désiré et favorise l'augmentation prothétique controlatérale si la patiente le souhaite. La palette dorsale augmente la poche cutanée, le muscle étoffe en profondeur la peau irradiée et protège la prothèse. Un positionnement précis de la palette cutanée en zone mammaire, soit dans la cicatrice de mastectomie, soit dans une contre-incision à part, permet un apport cutané dans le pôle inféro-externe du sein le plus galbé et permet au muscle d'englober la prothèse à la manière d'un soutien-gorge. Ces repères précis de positionnement du lambeau sont reproductibles et assurent un résultat d'emblée harmonieux et stable dans le temps.

Summary

Despite the development of microsurgical techniques, latissimus dorsi myocutaneous pedicle flap remains mainly used in breast reconstruction surgery. It is reliable and could be performed on almost all the patients, even if they smoke. It is also a good indication in case of irradiation. The technical alternative, which combines latissimus dorsi myocutaneous flap and an implant, allows the reconstruction of the expected volume and enables controlateral implant augmentation if the patient desires. The dorsal skin paddle increases the cutaneous pocket. The muscle in-depth enhances the irradiated skin and protects the implant. Positioning the skin paddle on the breast area is essential: it should be based on the mastectomy scar or on an added contraincision barring it. Thus it allows the muscle to embrace the implant as a bra. The precise reference points helping the placement of the flap could be reproduced and ensure pleasant and stable results over time.

Real‐world use of apremilast for patients with psoriasis in Japan

The Journal of Dermatology, EarlyView.

Atypical pemphigus developed in a patient with urothelial carcinoma treated with nivolumab

The Journal of Dermatology, EarlyView.