Acne Scars

BMC Infect Dis. 2009 Jun 26; 9(1): 100Ellertsen LK, Storla DG, Diep LM, Brokstad KA, Wiker HG, Hetland GABSTRACT: BACKGROUND: It is still a matter of debate whether there is an association between infection with Mycobacterium tuberculosis (M. tuberculosis) and allergy. Previously, we have shown higher levels of specific IgE to different inhalant allergens and total IgE in tuberculosis (TB) patients compared to controls. The objectives of this study were to evaluate a possible change in allergic sensitisation after successful TB treatment and to confirm the finding of our previous study of enhanced allergic sensitisation in TB patients compared to controls in a more controlled setting. Additionally, we wanted to determine the cytokine profile in the same groups and finally to evaluate the association between Bacillus Calmette-Guerin vaccination (BCG) scar and allergic sensitisation among the controls. METHODS: Sera were analysed for specific IgE to inhalant allergens (Phadiatop) and total IgE by the use of ImmunoCAP 1000 (Pharmacia Diagnostics). Thirteen different cytokines were also analysed in the sera by multiplex bead immunoassay (Luminex 100, Luminex Corporation), and clinical symptoms of allergy and BCG scar were reported in a questionnaire. RESULTS: A reduction in levels of specific and total IgE were observed after successful TB treatment. TB patients also had higher levels of specific and total IgE compared to healthy controls. Both interleukin (IL)-6 and interferon (IFN)gamma were higher in tuberculosis patients compared to healthy controls. The levels of IL-6 were reduced after successful tuberculosis treatment. The presence of a BCG scar was associated with a reduced risk of developing allergic sensitisation. CONCLUSIONS: We observed a reduced level of allergic sensitisation after successful TB treatment. TB patients seem to be more allergically sensitised than healthy controls confirming our previous finding. Furthermore, we observed an inverse association between allergic sensitisation and visible BCG scar, which adds additional support to the hygiene hypothesis.

J Burn Care Res. 2009 Jun 5; Grishkevich VMThe treatment of postburn contractures of perineum remains a complex and an unsolved problem. Fourteen patients were operated. According to our observations, the perineum contracture can have two formations: (a) transverse scar folds formed between both the thighs and (b) obliteration of perineum by scar tissues. The first type, most common, is successfully eliminated by using local trapezoid flaps. The flaps are prepared from the divided sheets and adjacent tissues on both inner thighs' surfaces. The flaps are performed by cross-incisions of the fold; several pairs of adipose-scar flaps are formed. Because of the crescent shape of the fold, the flaps acquire a trapezoid shape. Then, they are transposed toward each other without rotation, doubling the surface of maximum tension thus eliminating the contracture completely. This technique allows releasing the contracture without skin grafting. The flaps are 4 to 5 cm wide, and they contain subcutaneous fat layer and have no sharp angles. All this assures stable circulation and prevents necrosis, flap loss, and contracture recurrence.

Acta Psychiatr Scand. 2009 May 29; Lloyd AJ, Moore PB, Cousins DA, Thompson JM, McAllister VL, Hughes JH, Ferrier IN, Young AHObjective: We aimed to quantify both load and regional distributions of hyperintensities on magnetic resonance imaging (MRI) in prospectively verified euthymic bipolar patients and matched controls. Method: Cerebral hyperintensities on T2, proton density and fluid-attenuated inversion recovery (FLAIR) MRI were compared between 48 bipolar and 47 control subjects using semi-quantitative rating scales. Results: Bipolar subjects had more severe frontal deep white matter lesions (DWML). Hyperintensity load was independent of age in bipolar patients but increased with age in controls. Global prevalence and severity of hyperintensities did not differ between groups. Exploratory analysis showed DWML in excess in the left hemisphere in bipolar subjects but not in controls. Conclusion: Findings are consistent with clinical, particularly some neurocognitive, features of bipolar disorder and implicate fronto-subcortical circuits in its neurobiology. They more probably reflect a trait abnormality or illness scar rather than a mood state-dependent finding. Processes other than ageing and vascular factors may underlie their development.

Colorectal Dis. 2009 Apr 13; Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Weiss HAim: On the way to "no-scar" techniques we developed a novel method for colorectal resection utilizing three intraumbilical trocars which results in a non-visible postoperative scar. Methods: Two female patients (Age: 56a, 42a) underwent laparoscopic colorectal resection for diverticulitis and infiltrating endometriosis of the rectosigmoid colon, respectively. The entire operation was carried out transumbilically following the standardized principles of colorectal resection. Results: The operative time was 110min and 180min, respectively. No intraoperative adverse events or significant perioperative complication was noticed. The specimen measured 22cm and 18cm in length respectively. Estimated blood loss was minimal in both cases. Oral diet was resumed on postoperative day 1. Patients were discharged on postoperative day 7 and day 6, respectively. At follow-up patients presented with an optimal cosmetic result without apparent scarring. Conclusions: For the first time a novel laparoscopic technique for sigmoid colon resection utilizing a single intraumbilical approach is presented. This new method allows further reduction of the surgical trauma and obviates any visible scar.

Ophthalmic Surg Lasers Imaging. 2009 May-Jun; 40(3): 245-50Kremer I, Ehrenberg M, Weinberger DBACKGROUND AND OBJECTIVE: When corneal perforation develops in patients with severe ocular surface disease and limbal stem cell deficiency following childhood trachoma infection, penetrating keratoplasty is doomed to fail. To overcome this problem, the use of a fresh-tissue corneolimbal covering graft is described. PATIENTS AND METHODS: Retrospective interventional case series of four patients who presented to a tertiary center from 2003 to 2005 with a large corneal perforation due to ocular surface disease. Emergency surgery consisted of suturing a fresh-tissue corneolimbal covering graft to the patients' peripheral sclera. RESULTS: The corneolimbal graft became partially incorporated into the perforated cornea, which healed by scar tissue, after a few months. The ocular epithelial surface improved considerably. There was no recurrence of corneal perforation during the follow-up period of 1 to 3 years. CONCLUSION: Fresh-tissue corneolimbal covering graft was found to be a useful technique for saving the integrity of the eye in cases of a large corneal perforation in patients with severe ocular surface disease, such as in childhood trachoma.