Acne Scars

Laryngoscope. 2009 Jun 24; Mortensen M, Woo POBJECTIVES/HYPOTHESIS:: The microdebrider has become a valuable instrument for otolaryngologists. It is now used in the larynx for treatment of recurrent respiratory papillomatosis, laryngeal stenosis, and debridement of large cancers for airway control. There are few reported complications reported with the use of the microdebrider in the larynx. STUDY DESIGN:: A case report. METHODS:: A patient with a vocal fold polyp underwent removal of the polyp with a microdebrider at an outside institution. He presented to our clinic 2 months after the excision with a severely strained near aphonic voice. On rigid stroboscopic examination we saw a large anterior commisure laryngeal web with a granuloma. This was repaired by granuloma excision, web lysis, buccal graft, and laryngeal stent placement. CONCLUSIONS:: The microdebrider is an extremely valuable tool for the otolaryngologist. Violation of the epithelium and the lamina propria with muscle exposure can result in serious damage to the vocal folds. When using powered instrumentation the surgeon should use the upmost caution in the larynx to avoid causing debilitating injury and scar with subsequent dysphonia. Laryngoscope, 2009.

J Plast Reconstr Aesthet Surg. 2009 Jun 17; Schleich AR, Black DM, McCraw JB'No vertical scar' techniques of breast shaping have received increasing attention during the last decade and are sometimes viewed as 'new' methods. In this article, we provide a comprehensive introduction to the roots of this procedure. Raymond Passot has to be credited with the original design of 'no vertical scar' methods. We provide a contemporary translation of his original article written in French in 1925. The historical context of this new procedure was researched using original sources that were in French and German languages. The evolution of the procedure and its reception by Passot's contemporaries up to 1932 are examined, which give insight into the concepts of blood supply to the breast, shaping techniques and the aetiopathology of breast deformities in the pre-World War II era, which were successfully developed by the Austrian-German school of thought, resulting in the birth of modern breast shaping surgery based on Passot's 'no vertical scar' procedure. The lasting truths discovered in that era were frequently reinvented in the subsequent decades in English without crediting the original authors.

J Plast Reconstr Aesthet Surg. 2009 Jun 4; Brown BC, Moss TP, McGrouther DA, Bayat AGreater objective scar severity and visibility should intuitively cause greater psychosocial distress for patients. Previous research is contradictory and has employed non-validated scar severity measures whilst neglecting patient-rated severity. The aim of this study was to assess the effects of objective and patient-rated scar severity, scar type and location on psychosocial distress. Skin scars were quantitatively assessed on two independent occasions using the 'Manchester Scar Scale' (MSS) - a validated measure. Scars were scored twice independently. Patients also rated their scars (from 'very good' [zero] to 'poor' [four]) and good completed the Derriford Appearance Scale (DAS24) and Dermatology Life Quality Index (DLQI). Eighty-two patients, with an average+/-SD (range) age of 34+/-15 (16-65) years were recruited. Mean psychosocial questionnaire scores were: DAS24 45.5+/-17.8 (15-91); DLQI 7.5+/-6.7 (0-26). Participants had 1.9+/-1.5 (1-8) scars with an MSS score of 31.3+/-24.0 (6.6-162.0) and subjective score of 2.6+/-1.2 (0-4). Correlation between psychosocial distress and objective severity was not significant (DAS24 0.14 p=0.11; DLQI 0.16 p=0.06). Correlation between psychosocial distress and subjective severity was significant (DAS24 0.48 p

Rev Pneumol Clin. 2009 Jun; 65(3): 159-63Maalej S, Zidi A, Ayadi A, Chorfa A, Bourguiba M, Kilani T, Ben Kheder A, Drira IMediastinal fibrosis or fibrosing mediastinitis is a rare condition characterized by chronic fibrosis occurring in mediastinal structures, in proliferating fibrous scar tissue. The disease may be secondary or idiopathic. The authors report the case of a 46-year-old woman, without a particular past history, who, in December 2006, presented dyspnoea on exertion and a superior vena cava syndrome. Her chest X-ray showed a right laterotracheal opacity. Fiberoptic bronchoscopy revealed concentric tracheobronchial narrowing, severe hyperemia and mucosal edema. The chest computed tomography documented the obstruction of the superior vena cava, the right main bronchus and the right upper lobe bronchus secondary to a mediastinal mass. Mediastinoscopy revealed a hard and dense mass, surrounding the different structures of the mediastinum. Pathologic examination corroborated mediastinal fibrosis. No cause was determined. Prednisone and anticoagulant were prescribed during 2 years with a regression of dyspnoea and the superior vena cava syndrome and an important regression of radiological lesions. In conclusion, prolonged corticosteroids may be efficient in the treatment of idiopathic mediastinal fibrosis.

J Bone Joint Surg Br. 2009 Jun; 91(6): 725-9Livesey C, Wylde V, Descamps S, Estela CM, Bannister GC, Learmonth ID, Blom AWWe undertook a randomised controlled trial to compare the outcomes of skin adhesive and staples for skin closure in total hip replacement. The primary outcome was the cosmetic appearance of the scar at three months using a surgeon-rated visual analogue scale. In all, 90 patients were randomised to skin closure using either skin adhesive (n = 45) or staples (n = 45). Data on demographics, surgical details, infection and oozing were collected during the in-patient stay. Further data on complications, patient satisfaction and evaluation of cosmesis were collected at three-month follow-up, and a photograph of the scar was taken. An orthopaedic and a plastic surgeon independently evaluated the cosmetic appearance of the scars from the photographs. No significant difference was found between groups in the cosmetic appearance of scars at three months (p = 0.172), the occurrence of complications (p = 0.3), or patient satisfaction (p = 0.42). Staples were quicker and easier to use than skin adhesive and also less expensive. Skin adhesive and surgical staples are both effective skin closure methods in total hip replacement.