Acne Scars

Clin Exp Allergy. 2009 Apr 21; Salib RJ, Howarth PHTGF-beta is a multi-functional cytokine with a huge array of effects on a variety of cell types. It is rapidly emerging as a key major player in the way the airway epithelium behaves and its ability to repair itself. This is not only of relevance to allergic airway diseases such as asthma and allergic rhinitis, which are increasing in prevalence worldwide, but in many other diseases. The full impact any disruption of TGF-beta signalling may have in the development and persistence of allergic inflammatory airway diseases is yet to be fully realized and remains the subject of ongoing research. There has been a recent revival of interest in the role of regulatory T cells in controlling allergic inflammation. Evidence is emerging of a significant contribution by TGF-beta to this regulatory process. This review aims to summarize current knowledge relating to TGF-beta in relation to allergic inflammatory upper airways disease, and attempts to clarify some of the discrepancies and inconsistencies in this area. It also considers the therapeutic implications of novel TGF-beta therapy, including potential future applications in the treatment of nasal polyposis and reduction of post-operative scar tissue formation following endoscopic sinus surgery.

J Dermatolog Treat. 2009 Jan 1; 1-5Castineiras I, Del Pozo J, Mazaira M, Rodriguez-Lojo R, Fonseca EBackground: Actinic cheilitis (AC) is a precancerous lesion of the lip. Treatment of AC is indicated for prevention of squamous cell carcinoma (SCC), although the exact transition rate of AC to SCC is unknown. Carbon dioxide laser (CO(2)) vaporization seems to be an adequate therapy for AC, but there are no references about the evolution rate of AC to SCC after this treatment. Objective: To evaluate the results obtained after treatment of AC by CO(2) laser vaporization in comparison with other treatment modalities and the evolution rate of AC to SCC after CO(2) laser treatment. Methods: A retrospective review identified 43 patients with AC treated with CO(2) laser vaporization at our hospital from 2002 to 2006. Clinical and therapeutic information was evaluated. All patients were followed for more than 15 months after treatment. Results: After a mean follow-up period of 29.4 months, 3/43 treated AC showed local recurrence. Another two patients developed SCC in the treated field. A residual scar was clinically evident in two patients. Conclusions: CO(2) laser vaporization with an adequate postoperative follow-up is an effective treatment for chronic AC. Nevertheless, some patients (6%) went on to develop lip SCC. The follow-up of these patients is mandatory.

Dermatol Surg. 2009 Apr 8; Erba P, Wettstein R, D'Arpa S, Kalbermatten DFBACKGROUND The perichondral cutaneous graft (PCCG) from the posterior conchal region is an elegant solution for the coverage of facial defects with particular stability requirements. The donor defect can easily be covered with a transposition flap from the postauricular region. Although this region is a common donor site for skin grafts and has an important supporting function for glasses or hearing aids, little is known about long-term morbidity after graft harvest. OBJECTIVE To assess the morbidity of the posterior concha and the postauricular region in terms of pain, scar formation, and patient satisfaction. MATERIALS AND METHODS A retrospective study of 16 patients who had a PCCG harvested from the posterior concha. RESULTS Two patients presented with a postoperative wound dehiscence on the postauricular region and one with a keloid scar on the posterior concha. One case of transitory hyperesthesia and pain when sleeping on the operated site was observed. None had complaints related to wearing glasses or hearing aids. CONCLUSION Donor site morbidity of the postauricular and posterior conchal region is minimal and associated with high patient satisfaction, excellent aesthetic results, and emotional detachment from the hidden donor site. The authors have indicated no significant interest with commercial supporters.

J Minim Invasive Gynecol. 2009 May-Jun; 16(3): 326-32Trehan AK, Sanaullah FSTUDY OBJECTIVE: To evaluate the outcome of posthysterectomy laparoscopic vaginal vault excision and its long-term effects on chronic pelvic pain, dyspareunia, quality of life, and patient satisfaction. MATERIALS AND METHODS: This is a retrospective cohort study (Canadian task force classification II-3) incorporating case note review and a postal questionnaire. It describes 22 consecutive patients who underwent laparoscopic vaginal vault excision for posthysterectomy dyspareunia and chronic pelvic pain. At laparoscopy, full thickness vaginal vault was excised along with scar tissue or any cyst. The vaginal cuff was closed laparoscopically. The patients were sent a validated questionnaire to assess their pain scores, general health, quality of life, and satisfaction with the surgery. The mean interval from vaginal vault excision and to questionnaire distribution was 1.8 years. The statistical analysis was performed with SPSS 15. RESULTS: The mean age of the women was 40 years. All women had vaginal vault tenderness on examination and underwent laparoscopic vaginal vault excision. The only intraoperative complication was 1 puncture injury of the bladder, which was produced by 10-Veres needle during manipulation. A single or a combination of additional procedures was performed at the same time. The patient satisfaction questionnaires were received from 16 (72.7%) women. Of the 16 (72.7%) respondents, 13 (81.25%) confirmed improvement in dyspareunia. The mean pain scores decreased, and quality of life and general health improved significantly after vaginal vault excision (p

Ophthalmic Physiol Opt. 2009 May; 29(34th European Meeting in Visual and Physiological Optics (EMPO)): 357-362Ginis H, Pentari I, de Brouwere D, Bouzoukis D, Naoumidi I, Pallikaris ICorneal haze following excimer laser ablation is an adverse after-effect of photorefractive keratectomy (PRK) and is associated with the development of subepithelial opacities. The present work pertains to the measurement of light scattering in rabbit corneas following excimer laser treatment; to the microscopic analysis of the light-scattering corneal structures; and to the development of a mathematical model of light propagation through the post-laser treatment cornea. Photorefractive keratectomy (PRK-6D, 6 mm optical zone) followed by standard postoperative pharmaceutical treatment was performed on rabbit eyes. Animals were examined clinically on a weekly basis and sacrificed after the tenth postoperative week. Confocal microscope image sequences were acquired immediately before animal sacrifice. After the scatter measurement, the corneas were prepared for histopathological evaluation. The subepithelial structures observed using the confocal microscope correspond to refractive index (and therefore optical path difference (OPD) variation. This OPD distribution can be approximated with a fractal surface, band-pass filtered in the Fourier domain. The angular distribution of scattered light is characterised by a narrow forward peak of the order of 0.5 degrees full-width at half maximum (FWHM) in accordance with the sizes of the subepithelial structures (5-150 mum).The intensity of scattered light is correlated with the thickness of the subepithelial scar-tissue layer.