Surgical Treatment of Burn Scars

The relationship between a burns patient and a reconstructive surgeon is normally long lasting and continues lifelong. Patients not only require a surgeon’s professional expertise, but also time, optimism and compassion. Scar management relates to the physical and aesthetic components as well as the psychosocial implications of scarring. Hypertrophic scar formation which can cause debilitating deficiencies and poor aesthetic outcomes might be a result of burn injuries. Although nonsurgical treatment modalities in the early phase of scar maturation are critical to decrease hypertrophic scar formation, surgical management is often indicated to restore function. Operative scar management releases the tension and can often be achieved through local tissue arrangement

Herbal Therapy for Burns and Burn Scars

Burn wound healing is a complex process including inflammation, epithelialization, granulation, neovascularization, and wound contraction. Modern therapies present a large number of options, while traditional therapies are promising effective choices. Plant-based products have been used in the treatment of wounds for centuries worldwide. Recently, the mechanisms behind many of these traditional therapies could be explained in detail. The most commonly found mechanisms behind the herbal source products supporting wound healing are mostly their antioxidant, anti-inflammatory, antimicrobial, cell proliferative, and angiogenic effects. However there is not much more studies demonstrated in patients except Aloe vera and Avena sp., herbal treatment still show a lot of promise in the future. It is important not to ignore possible toxic and allergic effects of plants and phytochemical agents, but the studies mostly resulted with antitoxic effects. Several herbs show efficient results with therapies of wounds also in burn wounds, which may be considered as an option for treatment. On the other hand, herbal treatment in burn wounds still needs to have more clinical and pharmaceutical studies to place in modern therapies safely

Urticaria and Angioedema Treatment

Chronic urticaria (CU), one of the most frequent skin disorders, is defined as the repeated occurrence of red, swollen, itchy and sometimes painful hives (wheals), and/or angioedema (swellings in the deeper layers of the skin), for more than 6 weeks [1, 2]. CU has an estimated worldwide prevalence of approximately 1% [3], which includes spontaneous and inducible types. In chronic spontaneous urticaria (CSU), the most common type of CU, symptoms occur without a specific trigger [1, 3]. In contrast, in chronic inducible urticaria (CIndU), symptoms occur in response to specific stimuli, such as exposure to cold, heat or pressure [4]. Patients may suffer from CSU and CIndU in parallel [2]. Chronic urticaria (CU) is defined as the repeated occurrence of red, swollen, itchy and sometimes painful wheals, and/or angioedema, for more than 6 weeks. CU includes spontaneous and inducible types. In chronic spontaneous urticaria (CSU), the most common type of CU, symptoms occur without a specific trigger. Treatment of urticaria and/or angioedema mainly consist of antihistamines, short courses of corticosteroids, other immunosuppressive, and anti‐inflammatory agents. Angioedema is a deeper expression of urticaria which is classified by allergic, hereditary, acquired, and angiotensin‐converting enzyme inhibitor (ACEI)‐induced forms

Evaluation of the relationship between rosacea cutaneous subtype and meibography findings

Acne rosacea (AR) is a chronic inflammatory skin disease that can cause serious ocular complications. This study was designed to evaluate dry eye disease (DED) and meibomian gland dysfunction (MGD) in AR patients and to investigate the relationship between the cutaneous subtype of AR and ocular involvement. Materials and Methods: This study included 67 participants with AR and 50 healthy individuals. Patients diagnosed with 3 cutaneous subtypes were examined: erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), and phymatous rosacea (PR). An ophthalmatological examination was performed that included an evaluation of lid margin alterations due to meibomian gland (MG) obstruction, Ocular Surface Disease Index assessment, tear film break-up time testing, Schirmer testing, and a corneal conjunctival fluorescein staining assessment. Meibography was used to evaluate the upper and lower lids for MG loss. Results: Findings in the AR group revealed MGD in 45.5% and DED in 28.1%. The meibomian gland loss rate (MGLR) was 38.7±16.9% and the meibomian gland loss grade (MGLG) was 1.57±0.82%. The rate of MGLR and MGLG was significantly greater in the AR group than in the control group (p<0.001). PPR was seen in 59.7% of the 67 patients, ETR in 29.9%, and PR in 13.4%. A comparison of the MGD, MGLR, MGLG, and presence of DED in the 3 cutaneous subtype groups yielded statistically insignificant results. Conclusion: AR can affect MG morphology, which may result in MGD or DED. Though we did not find a significant difference in the ocular findings by subgroup, ocular involvement is a recognized risk in AR. Ophthalmologists and dermatologists should cooperate in the evaluation of AR patients. Additional studies to further examine the effects in subtype groups are recommended

A case of lipomembranous panniculitis with a dramatic response to the treatment of venous insufficiency

Lipomembranous panniculitis (LP) is a peculiar type of fat necrosis and is reported with various clinical conditions, mostly with peripheral vascular diseases. Here, a case of a 57-year-old woman with a painful erythematous swelling of the right leg in association with venous insufficiency has been reported. Although LP is frequently associated with venous insufficiency, to the best of our knowledge, this is the first report on the beneficial effect of venous insufficiency treatment in LP