Category: Health - Part 4

Acute generalized

INTRODUCTION

In 1980, Beylot et al first described acute gen­eralized exanthematous pustulosis (AGEP) as an acute pustular eruption on an erythematous bed, accompanied by fever and neutrophilia. A wide range of systemic drugs have been suspected of causing these reactions in more than 90% of cases. Rarely, intake of lacquer chicken can be a cause of AGEP, and Park et al reported four such cases. …Read the rest of this article

The double-bladed scalpel consists of a handle, blade holder and metal-spacers, as is shown on Fig. 2; this instrument can hold two blades and the distance between the two blades can be adjusted. This device was described in 1977 by Coiffman, and it was originally developed for harvesting strip grafts from the scalp for hair transplantation. Up to 16 parallel blades have been placed on a single knife for this purpose. The double-bladed scalpel has been employed for scar removal, staged excision of lentigo maligna melanoma with permanent vertical section margin control and excision of small basal cell carcinoma.

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A 58-year-old man presented with a 1-year history of a black mass measuring 2.0×0.5 cm on the right nasolabial fold. No pain, tenderness or itching was associated with the lesion which was pathologically diagnosed by biopsy as basal cell carcinoma.

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Double-Bladed Scalpel

INTRODUCTION

The introduction of Mohs micrographic surgery minimized the loss of normal tissue while also enabling complete tumor resection. Thenceforth, Mohs micrographic surgery was used for various cutaneous neoplasms, and it was reported as the most efficient treatment method with regard to the recurrence rates and aesthetic aspects, relative to those of the various other methods that were being applied before. So far, a single-bladed scalpel that can be used for removing common malignant skin lesions has been used. The double-bladed scalpel, with its improved ability to excise uniform strips of tissue, was originally created to harvest donor strips for hair transplantation. …Read the rest of this article

Most cases of port-wine stain (PWS) are congenital, but the acquired form of PWS has only recently been described. In 1939, Traub reported the first case of acquired port-wine stain (APWS). The average age of onset of APWS is usually after 1 year. M-any cases of acquired PWS have since been reported – , , but there has been little discussion about treatment. There have been only two reports investigating the efficacy of laser therapy in APWS. Dinehart et al found that APWS had generally a faster response to the PDL treatment than CPWS, however, they could not explain the exact mechanism because some patients responded rather poorly to laser treatment. Lanigan2 supposed that APWS’s telangiectatic nature, relatively sparse number and superficial site of ectatic vessels probably explained why the response was better than CPWS to laser therapy. Therefore, he concluded that patients with APWS could be expected to respond well to PDL therapy and fewer treatments were required than those patients with CPWS. But in these articles, only small numbers of patients were studied and the therapeutic results were not same in all patients with APWS. As for our experience of long pulsed dye laser in APWS therapy, the result was rather similar to that of Dinehart et al. The response to PDL in patients with APWS was controversial, so we undertook this study to find out whether there are some differences of histo- pathologic features of the two entities or not.

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Port-Wine-Stain

In capillary malformations, there are two types: port-wine stain (PWS) and telangiectasia. PWS is one of the most common types of capillary malformation and occurs as pink to red macules or patches, usually on a unilateral side. The color of the lesion tends to gradually deepen with time. The lesion grows proportionately and becomes raised and nodular as a result. Although the initial nature is similar to PWS, fading macular stains, referred to as stork bite or salmon patch, are located most commonly on the nape of the neck, the eyelids, and the glabella and may disappear spontaneously between 1 and 3 years of age. In these cases, there is no need for treatment.

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The Table 1 shows the summary of the mean data of vessel area, percentage of vascular area and vessel depth of each patient.

Vessel area

The mean vessel area in APWS was 1014.7 ± 782.5 //m2 and CPWS, 1341.5 ± 689.9 ^m2. The mean data was higher in CPWS, but there was no significant statistical difference between APWS and CPWS.

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