Treatment of psoriasis by dermabrasion

Aim The aim of the study was to utilize the so-called reversed Köbner phenomenon to treat psoriasis by dermabrasion. Background The background has been reports on long term remissions following other surgical procedures such as dermatomy or laser surgery. Methods 11 psoriatics with localized, chronic heavily infiltrated plaques, which had not responded sufficiently to topical treatment with steroids and/or ditranol or tar, were treated with dermabrasion, using a diamond fraise. Results All treated lesions healed within 3-4 weeks without recurrence with the exception of a 0.5 X 0.5 cm minor recurrence in one patient. The observation period has been from 6 months to 5 years. Conclusions For this particular group of patients we can recommend dermabrasion as a suitable surgical therapy for psoriasis.     

A new technique for quantitative bacterial assessment on burn wounds by modified dermabrasion

Bacterial colonization and invasive bacterial infection is still one of the major problems in the treatment of burn victims. The standard procedures of bacterial monitoring of the burn would are i) swab-culture which is non-invasive but detects bacteria at the very surface and ii) biopsy-culture which gives a more complete view but has the disadvantage of being invasive. Therefore we developed a new technique for examination of microbial colonization of the wound surface. Dermabrasion of the upper layers of the wound was performed using a small rotating carbon-steel disc of defined roughness. The tissue samples obtained were analysed for bacterial growth in different culture media. Results were qualitatively and quantitatively compared with those of standard techniques performed in parallel. Our results show that this new technique is superior to the swab culture in identifying different bacterial species. The results can be compared with the biopsy technique, but has the advantage of being less invasive.     

皮肤磨削术及其应用

皮肤磨削术是在皮肤病的治疗及美容治疗中适应证较为广泛的一种治疗手段,是医学美容换肤技术在临床上最为常用的一种方法,磨削术常规是使用一些器械或设备,对表皮和真皮浅层进行可控制的机械性磨削、以完成治疗及美容的一种手术。不同类型的患者的治疗方法选择是有所区别的,医生应对不同患者选取不同的治疗方法及设备。本文通过综述结合临床病例治疗经验对皮肤磨削术的方法加以系统介绍,让大家重新认识皮肤磨削术这一古老而传统的治疗方法,对临床应用具有重要意义。     

机械磨削术在皮肤外科的临床应用

目的:探讨机械磨削术在皮肤外科手术中的应用及临床效果。方法:选笔者科室2017年8月-2018年11月收治的机械磨削术治疗的患者107例,包括白癜风68例,酒渣鼻19例,疣状痣、炎性线状表皮痣16例,痤疮凹陷性瘢痕4例。术后随访1年,观察外观改善效果、皮损复发及瘢痕形成情况。结果:本组107例患者,非常满意率为77%(82/107),满意率为23%(25/107)。白癜风患者达80%复色52例,50%~80%复色16例;52例(76%)非常满意,16例(24%)满意。酒渣鼻患者均为鼻赘期,15例(79%)对外观改善非常满意,4例(21%)满意。疣状痣、炎性线状表皮痣患者12例(75%)非常满意,4例(25%)满意;1例炎性线状表皮痣位于手足的皮损约30%复发。痤疮凹陷性瘢痕患者3例(75%)非常满意,1例(25%)满意。结论:机械磨削术在皮肤外科应用于治疗白癜风、酒渣鼻、疣状痣、凹陷性瘢痕的临床及美学效果显著,满意度高。     

机械磨削术联合氨基酮戊酸光动力疗法治疗手部Bowen病

目的:探讨机械磨削术联合氨基酮戊酸光动力疗法(ALA-PDT)治疗手部Bowen病疗效。方法:10例经病理确诊的手部Bowen病患者,均行机械磨削术联合ALA-PDT治疗。磨削时从外向里进行磨削,磨至弥漫性出血为止。后将氨基酮戊酸配成20%溶液涂于皮损及外周0.5cm,3~4h后行635nm红光照射,能量密度为80~100J/cm2,时间20min,每周照射1次,共3次。6个月后观察肿瘤有无复发,患者满意度及瘢痕形成等情况。结果:10例患者行机械磨削联合ALA-PDT治疗后,至少随访6个月,均未见肿瘤复发;10例患者均非常满意,治疗后无明显瘢痕增生。结论:机械磨削术联合ALA-PDT治疗手部Bowen病安全高效,痛苦小,创伤轻,患者满意度高,无明显瘢痕形成,值得临床推广。     

皮肤磨削及术后外用硅凝胶或积雪苷治疗面部增生性瘢痕的疗效比较

目的：比较单纯皮肤磨削以及磨削术后联合外用硅凝胶或积雪苷治疗面部增生性瘢痕的临床疗效。方法：皮肤磨削术后外用莫匹罗星软膏,将101例随机分为三组：A组为对照组;B组和C组为治疗组,分别于术后5天起外用硅凝胶和0.25%积雪苷霜至术后8周结束。均观察治疗结束时红斑及色素沉着发生率,治疗前后瘢痕严重程度的积分评价。结果：与对照组A比较,治疗C组红斑发生率及色素沉着发生率均降低,C组的色素沉着发生率低于B组;B组和C组的瘢痕疗效明显优于A组,而B组和C组之间差异无显著性。结论：皮肤磨削术后联合外用硅凝胶或者积雪苷治疗面部增生性瘢痕效果可靠,后者还可以较好地改善患者肤色。     

Post acne scarring: a review

Historically, post acne scarring has not been well treated. New techniques have been added and older ones modified to manage this hitherto refractory problem. The patient, his or her expectations and overall appearance as well as the morphology of each scar must be assessed and treatment designed accordingly. Upon reaching an understanding of what the pathology of the scar is and where it resides in the skin, the most pertinent treatment for that scar may be devised. Post acne scars are polymorphous and include superficial macules, dermal troughs, ice picks, multi‐channelled fistulous tracts and subcutaneous atrophy. The wide variety of new methods includes the latest resurfacing tools such as CO₂ and erbium infrared lasers, dermasanding and possibly some future techniques such as non‐ablative and radiofrequency resurfacing. Dermal and subcutaneous augmentation with autologous (including fat and blood transfer) and non‐autologous tissue augmentation and the advent of tissue undermining has greatly improved the treatment of atrophic scars. Use of punch techniques for sharply marginated scars (such as ice picks) is necessary if this scar morphology is to be treated well. One should attempt to match each scar against an available treatment as far as possible. Many of these techniques may be performed in a single treatment session but repeat treatments are often necessary. The treatment of hypertrophic acne scarring remains difficult, but silastic sheeting, vascular laser and intralesional cytotoxics are interesting developments. Most often occurring extra‐facially and in males, these distressing scars often require multiple treatments and modalities before adequate improvement is achieved.     

加压负压吸疱与磨削自体表皮移植治疗白癜风

目的：缩短白癜风自体表皮移植起疱时间和减少手术次数。方法：用加压负压吸疱结合磨削术对30例白癜风患者行自体表皮移植,并加压负压吸疱与单纯负压中疱的发疱时间进行比较。结果：加压负压吸疱移植皮片的痊愈率为72．2％,显效率14．9％,总有效率96．1％,与单纯负压吸疱相比,起疱时间有显著性差异,前者快于后者,结论：加压负压吸疱结合磨削术是一快速,安全,有效的方法,优于单纯的负压吸疱。     

Treating traumatic tattoo by micro-incision

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