Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
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Randomized Controlled Trial Clinical Trial
Self-warming lidocaine/tetracaine patch effectively and safely induces local anesthesia during minor dermatologic procedures.
Dermatologic procedures often cause some degree of pain. A self-warming patch containing lidocaine and tetracaine (L/T) was developed to provide topical local anesthesia prior to painful procedures. ⋯ The self-warming L/T patch was effective in providing clinically useful local anesthesia for minor dermatologic procedures in adult patients.
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There is currently a lack of objective methods to assess scars. ⋯ Objective rating systems using reliable instruments can be used to replace subjective scar assessment. Larger multicenter prospective studies should test this new scale in scars due to other mechanisms of injury.
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Randomized Controlled Trial Multicenter Study Clinical Trial
5% imiquimod cream and reflectance-mode confocal microscopy as adjunct modalities to Mohs micrographic surgery for treatment of basal cell carcinoma.
Imiquimod is an immune response modifier that up-regulates cytokines and has been shown in clinical studies to reduce or clear basal cell carcinoma tumors when applied topically. ⋯ Imiquimod improved excision results relative to vehicle when used for treating basal cell carcinoma before Mohs micrographic surgery. Confocal microscopy assessments correlated well with tumor response to therapy, suggesting that confocal microscopy may help determine the need for surgery.
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Patient injuries from surgical procedures performed in medical offices: three years of Florida data.
Many state medical boards and legislatures are in the process of developing regulations that restrict procedures in the office setting with the intention of enhancing patient safety. The highest quality data in existence on office procedure adverse incidents have been collected by the state of Florida. ⋯ Restrictions on office procedures for medically necessary procedures, such as requiring office accreditation, board certification, and hospital privileges, would have little effect on overall safety of surgical procedures. These data also show that the greatest danger to patients lies not with surgical procedures in office-based settings per se, but with cosmetic procedures that are performed in office-based settings, particularly when under general anesthesia. Our conclusions are dramatically different from those of a recent study, which claimed a 12-fold increased risk of death for procedures in the office setting.
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Case Reports
Intense pulsed light treatment of persistent facial hypermelanosis following drug-induced toxic epidermal necrolysis.
Cutaneous hyperpigmentation is one of the most cosmetically disturbing sequel of drug-induced toxic epidermal necrolysis. Intense pulsed light is a promising tool for treating some melanocytic lesions. ⋯ Intense pulsed light appears to be effective and safe for treating post-toxic epidermal necrolysis hypermelanosis in Caucasian patients.