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Prevention and treatment of nonfacial scars.
Authors: Keaney TC Abstract Hypertrophy in nonfacial scars can be caused by mechanical stress created by large core muscles and joint movement and by increased pressure and shear over sites with boney prominences. Careful surgical planning and technique to minimize wound tension, followed by tension offloading, can help minimize scar hypertrophy. Both surgical and nonsurgical techniques can be utilized for nonfacial scar revision. The adoption of a combination therapy with multiple treatment modalities may be required to improve the appearance of nonfacial scars. PMID: 26566572 [PubMed - as supplie...
Source: Seminars in Cutaneous Medicine and Surgery - November 14, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Biology of the hair follicle and mechanisms of nonscarring and scarring alopecia.
The objectives are to normalize the hair growth cycle, modulate the size of hair follicles, and potentially regenerate hair follicles to stabilize hair density. The purpose of this manuscript is to review the basic biology of the hair follicle, as well as causal mechanisms for the disordered hair follicle using some selected examples of hair disorders. PMID: 26176280 [PubMed - as supplied by publisher] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

The scalp biopsy for hair loss and its interpretation.
Authors: Knopp E Abstract The diagnosis of alopecia is an area of dermatology that frequently relies on the close correlation of clinical and pathological features. Therefore,careful selection of the scalp biopsy site, optimal biopsy technique, and proper specimen processing followed by informed histological interpretation are essential steps in the successful evaluation of both cicatricial and noncicatricial alopecias. This review will serve as a primer for clinicians and pathologists alike wishing to optimize their approach to the scalp biopsy and interpretation of key noncicatricial and cicatricial alop...
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Female pattern alopecia and telogen effluvium: figuring out diffuse alopecia.
This article will highlight how to distinguish between and properly manage these 2 conditions. PMID: 26176282 [PubMed - as supplied by publisher] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Alopecia areata update.
Authors: Hordinsky M, Junqueira AL Abstract There is neither a cure for alopecia areata (AA) nor any universally proven therapy that induces and sustains remission in patients afflicted with this autoimmune disease. AA is characterized as a nonscarring alopecia which affects children and adults. It can be relatively easy to treat when the disease is patchy and limited; but when children and adults present with long standing extensive scalp and body hair loss, successful management can be challenging. Of the treatment choices available, physicians and midlevel providers usually select a cost-effective treat...
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Scarring alopecias: a trichologic emergency.
This article will review different types of primary scarring alopecia in hopes of helping clinicians accurately diagnose these conditions as well as provide appropriate treatment. PMID: 26176284 [PubMed - as supplied by publisher] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Hair loss in patients with skin of color.
Authors: Semble AL, McMichael AJ Abstract Hair loss in skin of color patients can vary from the very simplest of diagnoses to a unique diagnostic challenge requiring extensive knowledge of historical symptoms, haircare practices, and previous treatments. There are several disorders in the literature that are noted to be more common in patients of African descent as compared to Caucasian populations. These disorders include central centrifugal cicatricial alopecia, dissecting cellulitis, discoid lesions of lupus erythematosus, traction alopecia, seborrheic dermatitis, and hair breakage. While there is no de...
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Hair transplantation update.
Authors: Rogers NE Abstract Contemporary hair transplant surgery offers results that are natural and undetectable. It is an excellent treatment option for male and female pattern hair loss. Patients are encouraged to also use medical therapy to help protect their surgical results and prevent ongoing thinning of the surrounding hairs. The two major techniques of donor elliptical harvesting and follicular unit extraction are discussed here. PMID: 26176286 [PubMed - as supplied by publisher] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Anatomy of the nail unit and the nail biopsy.
Authors: Haneke E Abstract The nail unit is the largest and a rather complex skin appendage. It is located on the dorsal aspect of the tips of fingers and toes and has important protective and sensory functions. Development begins in utero between weeks 7 and 8 and is fully formed at birth. For its correct development, a great number of signals are necessary. Anatomically, it consists of 4 epithelial components: the matrix that forms the nail plate; the nail bed that firmly attaches the plate to the distal phalanx; the hyponychium that forms a natural barrier at the physiological point of separation of the...
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Pigmented lesions of the nail unit.
Authors: Ruben BS Abstract Longitudinal melanonychia originates from pigmented and/or melanocytic lesions of the nail unit. It may be a less-common entity encountered in dermatologic practice, but it is often a vexing one. Lesions occurring at this location present particular problems due to the unfamiliarity with clinical assessment, their relative inaccessibility, requiring more surgical finesse, and the lack of experience with histopathologic examination. Obtaining a specimen sufficient for interpretation is one of the main impediments to successful diagnosis in this setting. Most pigmented bands are be...
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Inflammatory diseases of the nail unit.
Authors: Hinshaw MA, Rubin A Abstract inflammatory disorders of the nail unit are frequently encountered in clinical medicine and are a cause of significant morbidity. Psoriasis, lichen planus, chronic paronychia, and trachyonychia will be discussed. An approach to diagnosis and management of these disorders requires knowledge of nail unit anatomy, consideration of associated systemic manifestations, and patient education with respect to prognosis and management of factors that will maximize disease improvement. The nail unit responds with a limited number of signs to disparate clinical entities such that ...
Source: Seminars in Cutaneous Medicine and Surgery - July 18, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

An idiosyncratic history of burn scars.
This article selects from among a myriad of examples of modern military treatments as they relate to those survivors. Larrey, with Napolean's Grand Army, Sir Harold Gilles during and following World War I, and the Boston area preparation and response to the Cocoanut Grove Fire in 1942 are the principle topics examined. Recent modern interventions, related to the survival of horrific blast and burn injuries, with modern wound care and scar manipulation techniques provide context to the current ability to modify healing and scars. PMID: 25922950 [PubMed - as supplied by publisher] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - May 2, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Microstructural and molecular considerations in the treatment of scars with ablative fractional lasers.
Authors: Giordano CN, Ozog D Abstract Fractional ablative lasers have recently proven to be an effective modality for improving the clinical appearance and minimizing the morbidity associated with restrictivetype scars. Their tolerable safety profile on nonfacial sites and darker Fitzpatrick skin types provides an advantage over its fully ablative counterpart in treating facial rhytides, photodamaged skin, and acne scars. However, despite its increasing usage in clinical practice, the mechanism behind the observed clinical benefit remains complex and has yet to be fully elucidated. This paper reviews the w...
Source: Seminars in Cutaneous Medicine and Surgery - May 2, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Current trends and future considerations in scar treatment.
Authors: Waibel JS, Rudnick A Abstract The goal of scar therapy is the restoration of the patient to their preinjury state. A combination of injected antimetabolites, surgery, laser, and laser-assisted delivery of drugs is needed for minimally invasive surgical correction of scars. As a result, laser therapy is emerging as an essential treatment element. It has been noted that fractional lasers normalize both the clinical and histological appearance of scars. Laser- and light-based therapies complement existing approaches of surgery and physical therapy, resulting in significant gains with minimal associat...
Source: Seminars in Cutaneous Medicine and Surgery - May 2, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Laser tratment of traumatic scars: a military perspective.
Authors: Shumaker PR Abstract Advancements in medical treatment and transport over more than a decade of conflict have resulted in unprecedented survival rates for service members despite catastrophic injuries. Enhanced survival has created an unprecedented need for comprehensive rehabilitation and transition services. Though far from the exclusive domain of military dermatologists, military medicine has had a prominent role in integrating cutaneous procedural techniques into the rehabilitation of traumatically injured patients for a variety of reasons. The introduction of fractional laser technology in th...
Source: Seminars in Cutaneous Medicine and Surgery - May 2, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research