Lance H. Brown, MD; and Paul J. Frank, MD
This article is an in-depth review of various materials and products that have been used for the augmentation of
soft tissue in the past, and covers several new products, methods, and techniques that may provide new options
for dermatologists who use fillers in their practice. Pros and cons of each are discussed, along with mechanisms
of action, dosages, approved and off-label uses, as well as a look ahead at some prospective technology.
Rosacea is a chronic disease that affects millions of men and women. Topical and oral antibiotics are effective,
yet often leave individuals with treatment plateau associated erythema and persistent flushing. We investigated
the use of intense pulsed light for treatment of the redness, flushing, and breakouts associated with rosacea.
Thirty-two consecutive patients of Fitzpatrick skin types I- III underwent 1 to 7 treatments with intense pulsed light.
Patients were assessed clinically and photographically. In addition, patients completed a detailed questionnaire
regarding their response to treatment.
Following treatment, eighty-three percent of patients had reduced redness, 75% noted reduced flushing and
improved skin texture, and 64% noted fewer acneiform breakouts. Complications were minimal and transitory.
It appears that intense pulsed light is an effective treatment for the signs and symptoms of rosacea and represents
a new category of therapeutic options for the rosacea patient.
Alice B. Gottlieb, MD, PhD; Umesh Chaudhari; Daniel G. Baker, MD; Michelle Perate, MS and Lisa T. Dooley, DrPH
The Psoriasis Area and Severity Index (PASI) and Physician Global Assessment (PGA) are commonly used,
but fail to measure quality of life and the patient’s perception of well-being. In response to these limitations,
the National Psoriasis Foundation (NPF) Medical Advisory Board has developed the NPF Psoriasis Score
(NPF-PS). This article evaluates the degree of concordance between NPF-PS, PASI, and PGA scores via an
investigator-initiated, single-center, double-blind, placebo-controlled study of thirty-three patients with
moderate to severe plaque psoriasis.
Our results indicated that NPF-PS was strongly correlated with PASI and PGA in this study, while better
reflecting patient perception. This is the first report of a double-blind placebo-controlled study demonstrating
Vicky Kwan Wong, BA; Christine Della Croce, MA; Sara Schonfeld; Anthony M. Mastrangelo, PhD and Mark Lebwohl, MD
Topical corticosteroids have improved the management of many inflammatory skin diseases, such as psoriasis
and atopic dermatitis. However, these medications are associated with certain adverse effects that are potentially
serious. The potent anti-inflammatory actions of these drugs increase susceptibility to bacterial and fungal
infections, and therefore may preclude them from use when infection is the known cause of the disease. In
addition, children may be more vulnerable than adults to systemic effects of topical corticosteroids because percutaneous
absorption is proportionately greater. These are important considerations, and physicians need to
weigh and compare the risks and benefits associated with these medications before initiating treatment. This
involves an appreciation of which patient populations are at high risk, which skin conditions are incompatible
with topical corticosteroid therapy, and which alternative nonsteroidal medications are effective in treating
inflammatory skin diseases.
Simon Nigen, MD, FRCPC; Sandra R. Knowles, BScPhm; and Neil H. Shear, MD, FRCPC
Adverse drug reactions are a major problem in drug therapy, and cutaneous drug reactions account for a large
proportion of all adverse drug reactions. Cutaneous drug reactions are also a challenging diagnostic problem since
they can mimic a large variety of skin diseases, including viral exanthema, collagen vascular disease, neoplasia,
bacterial infection, psoriasis, and autoimmune blistering disease, among others. Furthermore, determining that a
particular medication caused an eruption is often difficult when the patient is taking multiple drugs.
In this review, we will describe and illustrate a thoughtful, comprehensive, and clinical approach to the diagnosis
and management of adverse cutaneous drug reactions. A morphologic approach to drug eruption includes
those that are classified as maculopapular, urticarial, blistering or pustular with or without systemic manifestations.
Exanthematous drug eruptions, drug hypersensitivity syndrome, urticaria and angioedema, serum sickness-
like reactions, fixed drug eruptions, drug-induced autoimmune blistering diseases, Stevens-Johnson syndrome,
toxic epidermal necrolysis, drug-induced acne, acute generalized exanthematous pustulosis, lichenoid
drug eruptions and photosensitivity eruptions will be discussed.
Oscar M. Ramirez, MD FACS; Anjum S. Khan, BA and Keith M. Robertson, MB, Bch, BAO, LRCPI, LRCSI
Our lift lip technique consists of an excision of the white part of the upper lip directly beneath the nose in the
shape of a ‘bull’s-horn’, with advancement of the inferior border of the incision to the area directly beneath the
nose. Pre-operative markings on the skin ensure the lip lift is approximately symmetric. Advancement of the
inferior edge of skin directly beneath the nasal base lifts the lip, producing more visible vermilion and about 3
mm of tooth show at rest. The position of the final incision is such that it is located within the shadow of the
nose. Meticulous technique produces an almost invisible scar. The amount and width of skin excised is individualized
depending on the desired aesthetic goals.
The procedure is straightforward and is usually performed under local anesthetic. Abdominal fat is frequently
injected into both the upper and lower lips to increase the volume and improve the rejuvenation. Lip lifts using
this technique provide an immediate, dramatic, and permanent result.
The Skin Cancer Foundation is the only national and international organization devoted exclusively to malignancies of the skin. It conducts public and medical education programs and provides support for research and professional training to reduce the incidence, morbidity, and mortality of skin cancers.
The following article is abstracted from the Skin Cancer Foundation Journal. Outstanding articles from the foundation's award-winning publications, The Skin Cancer Foundation Journal, the Melanoma Letter, and Sun & Skin News will regularly appear here in upcoming issues.