4 research outputs found
Effect of microneedling by dermaroller on acne scars: an observational study at tertiary care hospital
Background: Post acne facial scar is very distressing phenomenon. There are many treatment options like laser resurfacing, dermabrasion, microdermabrasion and non-ablative laser resurfacing but it may cause adverse effects and interference with the daily activities of the patient. Microneedling or dermaroller therapy is newer modality in management of acne scars with satisfactory improvement and no significant side effect. Objective of our study was to evaluate efficacy and safety of microneedling in the treatment of atrophic facial acne scars.
Methods: Twenty-eight patients of Fitzpatrick skin type IV to V having atrophic facial acne scars and fulfilling inclusion criteria were treated with multiple sittings of microneedling (dermaroller) treatment at monthly interval. Goodman and Baron’s qualitative and quantitative acne scar grading system was used for assessment. Patients were evaluated clinically and by serial photography. Presence of any active infection, active acne, wounds, blisters, keloids, taking some medications like Accutane, antihypertensives, anticoagulants, systemic retinoids, topical retinoids, those undergoing cosmetic procedures, treatment with injecting fillers or ablative or non-ablative laser resurfacing, diabetes, collagen diseases and those who do not agree to participate in study were excluded.
Results: Any change in the grading of scars after the end of treatment and follow-up period was noted. Efficacy and improvement of dermaroller treatment was assessed by Goodman and Baron’s global acne scarring system. Out of 18 patients (of total 28) with Goodman and Baron’s qualitative grade-4, 16 (88.90%) patients reduced to grade-1. 21 out of 28 patients achieved ‘excellent’ response. Adverse effects were limited to transient erythema and post inflammatory hyperpigmentation.
Conclusions: Microneedling therapy seems to be simple, safe and efficacious for the management of atrophic facial acne scars
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Kaposi's sarcoma: A presenting sign of HIV
Kaposi′s sarcoma (KS) is a multifocal cutaneous and extra
cutaneous vascular proliferative disorder. In India, there are only a
few cases of HIV-associated KS in published literature. A 26-year-old
married man presented with asymptomatic elevated skin lesions over the
face, trunk, both upper limbs and lower limbs with a duration of
one-and-a-half months. Cutaneous examination revealed multiple
violaceous papules and nodules, on the face (right upper and lower
eyelids, upper lip), trunk and proximal part of both limbs. Oral cavity
showed erythematous plaques, two in number, on the hard palate. Skin
biopsy showed proliferation of thin walled capillaries with formation
of slit like spaces, spindle cell proliferation, abundant extravasation
of RBCs and moderately dense inflammatory infiltrate in the dermis.
Thus a clinical diagnosis of cutaneous KS was confirmed. On testing
with ELISA for HIV, the patient was for the first time diagnosed as HIV
reactive. Thus KS was the presenting manifestation of HIV disease
Effect of Topical 5% 5-Fluorouracil with Microneedling in Vitiligo Patients as an Additional Modality to Standard Treatment at Tertiary Care Hospital
Background:
Vitiligo is an inveterate disease of great aesthetic concern presenting with depigmented macules and patches. It is often incorrigible to medical treatment.
Aim:
To study the clinical profile of vitiligo patients and evaluate the effect of 5% 5-fluorouracil (5-FU) cream with microneedling.
Materials and Methods:
This observational analytical study was conducted from November 2019 to July 2021. A total of 33 adult vitiligo patients were treated with oral mini-pulse (dexamethasone) therapy and topical corticosteroid (clobetasol propionate 0.05%). Patient’s total number of vitiligo lesions with <10-cm size were counted and half of the lesions were treated with 5-FU + microneedling (Group A), while a remaining number of lesions were not treated with 5-FU + microneedling (Group B). In the case of the odd number of lesions, the total number of lesions minus one was considered and then divided into equal numbers for treatment. The procedure was performed every 2 weeks for 3 months. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading scores.
Results:
Initiation of repigmentation started in the first month in Group A, whereas in Group B, it was seen in the second, which was statistically significant (P 75% repigmentation) was noted in Group A as compared to Group B at the end of 6 months (P < 0.0001).
Conclusions:
Needling with 5% 5-FU appears to be a simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy