Photodynamic therapy is a relatively new and rapidly evolving therapeutic option in dermatology.
Initially used for the treatment of actinic damage and nonmelanotic skin cancer,
more recent work indicates efficacy in the treatment of a wide range of conditions, such as
acne, infectious processes, cutaneous T-cell lymphoma, and photorejuvenation, among
others. This article provides a comprehensive review of applications and outcomes that use
topical photodynamic therapy in the treatment of dermatologic disease.
Semin Cutan Med Surg 27:52-62 © 2008 Elsevier Inc. All rights reserved.
Fractional resurfacing is a new laser treatment modality that creates numerous microscopic
thermal injury zones of controlled width, depth, and density that are surrounded
by a reservoir of spared epidermal and dermal tissue, allowing for rapid repair of
laser-induced thermal injury. This unique modality, if implemented with proper laserdelivery
systems, enables high-energy treatments while minimizing risks. In this article,
we review the various fractional laser devices, including the new fractional ablative
devices, as well as the results of studies on the clinical efficacy of fractional photothermolysis.
This technology offers patients significant clinical improvement in photodamage,
melasma, and scarring with modest treatment-related downtime and minimal
risk of complications.
Semin Cutan Med Surg 27:63-71 © 2008 Elsevier Inc. All rights reserved.
Although suction-assisted liposuction under tumescent anesthesia remains the traditional
method for body sculpting, newer technologies promise to increase efficiency, decrease
surgeon fatigue, and minimize complication. Power-, ultrasound-, and laser-assisted devices
are ideal in large volume cases and in areas of fibrous tissues as an adjunct to
traditional liposuction. Although skepticism remains chemical lipolysis, more commonly
termed mesotherapy or lipodissolve may be an alternative to surgical treatment of localized
fat. This article reviews the recent advancements in the field of liposuction and the current
literature which support their use.
Semin Cutan Med Surg 27:72-82 © 2008 Elsevier Inc. All rights reserved.
Imaging has always had an important role in the practice
and evolution of medicine. Even in the earliest medical
documents, illustrations were used to depict tumors, lesions,
and procedures. The development of small film cameras revolutionized
medical imaging in the twentieth century. The
office-based practitioner could readily process film into
prints or slides for personal records and for teaching purposes.
1 Today’s digital cameras have further improved medical
imaging by decreasing the time and expense needed to
view and share photos.
Photography is particularly important in the visuallybased
specialty of dermatology. Medical dermatologists use
photographs to display the pattern of a cutaneous eruption,
the characteristics of skin surface changes, and location, size,
shape, and color of a visible lesion.2,3 Surgical dermatologists
record preoperative, intraoperative, and postoperative images
to evaluate tumor growth, location, defect size, and
wound healing.4 Cosmetic dermatologists use photography
to evaluate a patient’s appearance pre- and postcosmetic intervention.
Digital photography has revolutionized the dermatology
office by providing cost-effective imaging, storage, and retrieval.
Initial equipment costs and recurring costs are nominal,
storage space needed for medical images is minimal, and
properly labeled digital photographs can be rapidly retrieved
and viewed with no degradation of picture quality over time.
Who benefits and who pays for the electronic health records? Patients may obtain better
health care, while payers benefit from lower costs. Providers pay greater costs to implement
health information technology, however, and may experience lower revenues after
implementation. Although large multispecialty practices or medical centers may benefit
from electronic health record systems, dermatologists—particularly those in dermatology
specialty groups or in solo practice—may be adequately served by document-management
systems that are less complex and less expensive. This article offers a perspective on
medical record documentation alternatives.
Semin Cutan Med Surg 27:86-88 © 2008 Elsevier Inc. All rights reserved.