Butchermiller4982

The comedone counts were significantly decreased after PDL therapy (SMD, -0.596; 95% CI, -1.137 to -0.054).

When treatment consisted of 4 or more sessions or longer pulse duration, PDL could significantly decrease the acne severity score.

When treatment consisted of 4 or more sessions or longer pulse duration, PDL could significantly decrease the acne severity score.

The Covid-19 Pandemic prompted the widespread implementation of telemedicine across healthcare.

To analyze telemedicine adoption by Mohs Micrographic surgeons (MMS) during the COVID-19 pandemic; to analyze the attitudes and perceived barriers to its long-term continuation by MMS practices.

An online multiple-choice survey was distributed to members of the American College of Mohs Surgeons.

86.1% of surveyed Mohs surgeons initiated telemedicine during the pandemic surge. The most common uses for telemedicine amongst respondents were post-surgery management (77.4%), "spot checks" (60.9%), and surgical consultations (59.1%). 73.1% report patients were receptive to telemedicine. 68.6% believe that telemedicine has a place in dermatologic surgery; 49.5% plan to incorporate telemedicine into their surgical practices long-term. Physical exam limitations, fitting telemedicine into practice workflow, and patient reception/patient training were viewed as the most significant barriers to long-term implementation.

While valuable use cases for telemedicine were identified with most Mohs surgeon respondents feeling that telemedicine has a place in their practices, there is uncertainty in how to implement telemedicine into the dermatologic surgery practice workflow.

While valuable use cases for telemedicine were identified with most Mohs surgeon respondents feeling that telemedicine has a place in their practices, there is uncertainty in how to implement telemedicine into the dermatologic surgery practice workflow.

Bilobed transposition flaps are prone to pincushioning (trapdooring), whereby contraction of the flap over the wound bed may produce an unsatisfactory functional and aesthetic outcome. There are several proposed methods to prevent this, but there is currently no clear consensus on the ideal technique.

To compare primary lobe pexing sutures versus intraoperative triamcinolone (TAC) injection as methods to prevent pincushioning in bilobed transposition flaps.

A retrospective chart review of bilobed flap reconstructions identified from the Mohs micrographic surgery database at a single tertiary center in New Zealand.

Three hundred forty-two patients met the inclusion criteria 37 received pexing sutures, 42 intraoperative TAC, and 263 no additional intervention. The most defect common location was the nasal tip (43.6%), followed by the ala (20.8%). Ninety-three participants (27.2%) developed pincushioning at a median 35 days postoperatively. Participants receiving no intervention had a 30.8% pincushioning rate. The TAC group had a 23.8% pincushioning rate (p = .358), and the pexing group had a 5.5% pincushioning rate (p = .001).

Participants receiving primary lobe pexing sutures had a statistically significantly lower rate of pincushioning than those receiving no intervention. Intraoperative TAC injections appeared to have little impact on pincushioning.

Participants receiving primary lobe pexing sutures had a statistically significantly lower rate of pincushioning than those receiving no intervention. Intraoperative TAC injections appeared to have little impact on pincushioning.

The forehead has high risks associated with filler injection considering its highly complex vascular system. This study aims to thoroughly describe the anatomical variations and relationships between the supratrochlear artery (STA) and supraorbital artery (SOA).

We studied 56 cadaveric heads by computed tomography after contrast-agent injection.

The deep branch of the STA originated in the deep superior orbital arcade and the ophthalmic artery (OA), whereas that of the SOA originated at 3 locations the deep superior orbital arcade, deep superior orbital artery, and OA. The superficial branch of the STA also had 3 origins the superficial superior orbital arcade, OA, and angular artery, whereas the superficial branch of the SOA had 2 origins the superficial superior orbital arcade and OA. Based on the relationship between the STA and SOA, 2 main arterial distribution patterns were observed in both superficial and deep layer arteries STA/SOA connected pattern and STA/SOA disconnected pattern, of which the latter pattern has 3 subtypes.

The forehead arteries have complex origins. The relationship of the supratrochlear and supraorbital arteries could be categorized into 2 main patterns. The study elucidated the complexity of the forehead vasculature.

The forehead arteries have complex origins. The relationship of the supratrochlear and supraorbital arteries could be categorized into 2 main patterns. The study elucidated the complexity of the forehead vasculature.

Scarring is a common complication of acne vulgaris with a significant impact on the psychological well-being of patients. Focal application of high concentration trichloroacetic acid (TCA) has been proven efficacious in treating ice-pick scars, but the utility in other scar types is understudied.

The aim of this study is to evaluate the efficacy and safety of 90% TCA in boxcar and polymorphic acne scars using a novel brush applicator.

Forty-one patients with acne scars were recruited for treatment of boxcar and polymorphic scar with 90% TCA applied with a cosmetic brush. Each patient received 3 treatment sessions spaced between 7 and 9 weeks apart.

All participants had good to excellent outcomes as per Jacob and colleagues grading. Patients with skin Type 3 to 6 had more excellent outcomes (13 patient, 59%) than patients of skin type 1 to 2 (9 patients, 41%). Two participants (5%) had postprocedural complications. Five participants (14%) were on concomitant isotretinoin with no appreciable increase in reepithelialization time or rate of complications.

Focal 90% TCA with a cosmetic brush applicator is safe and effective in treating boxcar and polymorphic scars. The clinical outcome is good to excellent with low rates of complication.

Focal 90% TCA with a cosmetic brush applicator is safe and effective in treating boxcar and polymorphic scars. The clinical outcome is good to excellent with low rates of complication.

Optical coherence tomography (OCT) is an invaluable imaging tool in detecting and assessing diabetic macular edema (DME). Over the past decade, there have been different proposed OCT-based classification systems for DME. In this review, we present an update of spectral-domain OCT (SDOCT)-based DME classifications over the past 5 years. In addition, we attempt to summarize the proposed OCT qualitative and quantitative parameters from different classification systems in relation to disease severity, risk of progression, and treatment outcome. Although some OCT-based measurements were found to have prognostic value on visual outcome, there has been a lack of consensus or guidelines on which parameters can be reliably used to predict treatment outcomes. We also summarize recent literatures on the prognostic value of these parameters including quantitative measures such as macular thickness or volume, central subfield thickness or foveal thickness, and qualitative features such as the morphology of the vitreoretave prognostic value on visual outcome, there has been a lack of consensus or guidelines on which parameters can be reliably used to predict treatment outcomes. We also summarize recent literatures on the prognostic value of these parameters including quantitative measures such as macular thickness or volume, central subfield thickness or foveal thickness, and qualitative features such as the morphology of the vitreoretinal interface, disorganization of retinal inner layers, ellipsoid zone disruption integrity, and hyperreflective foci. In addition, we discuss that a framework to assess the validity of biomarkers for treatment outcome is essentially important in assessing the prognosis before deciding on treatment in DME. Epigenetic inhibitor Finally, we echo with other experts on the demand for updating the current diabetic retinal disease classification.

Picture archiving and communication system (PACS) is a medical imaging system for sharing, storage, retrieval, and access of medical images stored. Our study aimed to identify ophthalmologists' views on PACS, with the comparison between 3 platforms, namely electronic patient record (ePR), HEYEX (Heidelberg Engineering, Switzerland), and FORUM (Zeiss, US), following their implementation in an eye hospital for common ophthalmic investigations [visual field, optical coherence tomography (OCT) of retinal nerve fiber layer and macula, and fluorescein/indocyanine green angiography (FA/ICG)].

An online survey was distributed among ophthalmologists in a single center. Primary outcome included comparison of PACS with paper-based system. Secondary outcomes included pattern of use and comparison of different PACS platforms.

Survey response rate was 28/37 (75.7%). Images were most commonly accessed through ePR (median 80% of time, interquartile range 50 to 90%).All systems scored highly in information display itemsrevious results. Subspecialty played an important role in evaluating PACS.

To assess differences in anal cancer incidence between racial/ethnic groups among a clinical cohort of men with HIV who have sex with men.

Clinical cohort study.

We studied men who have sex with men (MSM) in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) who initiated antiretroviral therapy (ART) under HIV care in CNICS. We compared anal cancer incidence between Black and non-Black men and calculated hazard ratios controlling for demographic characteristics (age, CNICS site, year of ART initiation), HIV disease indicators (nadir CD4, peak HIV RNA), and co-infection/behavioral factors including hepatitis B virus (HBV), hepatitis C virus (HCV), tobacco smoking and alcohol abuse.

We studied 7,473 MSM with HIV who contributed 41,810 person-years of follow-up after initiating ART between 1996 and 2014 in CNICS. Forty-one individuals had an incident diagnosis of anal cancer under observation. Crude rates of anal cancer were 204 versus 61 per 100,000 person-years among Black versus non-Black MSM. The weighted hazard ratio for anal cancer in Black MSM (adjusting for demographics, HIV disease factors, and co-infection/behavioral factors) was 2.37 (95% CI 1.17, 4.82) compared to non-Black MSM.

In this large multicenter cohort, Black MSM were at significantly increased risk for anal cancer compared to non-Black MSM. Further detailed studies evaluating factors impacting anal cancer incidence and outcomes in Black men with HIV are necessary. Inclusion of more diverse study cohorts may elucidate modifiable factors associated with increased anal cancer risk experienced by Black MSM.

In this large multicenter cohort, Black MSM were at significantly increased risk for anal cancer compared to non-Black MSM. Further detailed studies evaluating factors impacting anal cancer incidence and outcomes in Black men with HIV are necessary. Inclusion of more diverse study cohorts may elucidate modifiable factors associated with increased anal cancer risk experienced by Black MSM.