Publications by authors named "Hooman Khorasani"

33 Publications

Reply.

J Am Acad Dermatol 2021 Feb 4. Epub 2021 Feb 4.

private practice, New York, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jaad.2021.02.002DOI Listing
February 2021

Brief Educational Video Improves Patient Understanding of Mohs Surgery: A Randomized Controlled Trial.

Dermatol Surg 2020 Dec 15;Publish Ahead of Print. Epub 2020 Dec 15.

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Albany Medical College, Albany, New York.

Background: Patient's retention and recall of material discussed in a medical consultation is often inadequate.

Objective: To assess patient's knowledge, anxiety, and understanding of Mohs surgery after viewing a brief educational video.

Method: A prospective, investigator-blinded, randomized controlled trial of 120 consecutive patients before the first Mohs surgery procedure. Sixty subjects viewed an instructional video and 60 subjects did not. A survey was administered to both groups, measuring knowledge, anxiety, and understanding of Mohs surgery.

Results: The video group scored higher than the control group on the knowledge portion of the survey (median score 78% vs 56%, p < .01), but there were no differences in anxiety or understanding scores between groups. The percentage of subjects who answered each knowledge question correctly was greater in the video group than in the control group. In the subgroup of patients who had not previously had a consultation with a Mohs surgeon, the video group had higher median knowledge scores (67% vs 44%, p < .01), higher median understanding scores (8 vs 6, p = .05), and lower median visual analogue anxiety scores (4 vs 6, p = .01) compared with the control group.

Conclusion: A brief educational video increases patient's knowledge of Mohs surgery. For patients who have not yet had a consultation with a Mohs surgeon, the video may also reduce anxiety.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000002843DOI Listing
December 2020

Intraoperative Electrosurgical Depilation of a Skin Graft.

J Cutan Aesthet Surg 2020 Jul-Sep;13(3):257-258

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA.

Full-thickness skin grafts harvested from hair-bearing areas may negatively impact cosmetic outcomes if the recipient site is hairless. Intraoperative depilation of unwanted hair follicles using an electrosurgical device can permanently remove hair with a single treatment and improve overall cosmesis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/JCAS.JCAS_31_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646417PMC
November 2020

Basal cell nevus syndrome: From DNA to therapeutics.

Clin Dermatol 2020 Jul - Aug;38(4):467-476. Epub 2020 Mar 25.

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Basal cell nevus syndrome, also known as Gorlin syndrome, is a hereditary cancer syndrome associated with multiple basal cell carcinomas, congenital defects, and nondermatologic tumors. This disease is autosomal dominant with variable expressivity and is caused by abnormalities in the sonic hedgehog signaling pathway. Management requires a multidisciplinary approach and should include the biopsychosocial needs of patients and their families. Genetic testing is necessary to confirm an unclear diagnosis, evaluate at-risk relatives, and assist with family planning.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clindermatol.2020.03.003DOI Listing
October 2020

Safe and Successful Administration of Deoxycholic Acid in a Patient With Chronic Active Liver Disease.

Dermatol Surg 2020 09;46(9):1240-1242

Division of Dermatologic and Cosmetic Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000002041DOI Listing
September 2020

Botulinum Toxin for Paramedian Interpolated Forehead Flaps.

J Cutan Aesthet Surg 2020 Apr-Jun;13(2):170-172

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

The forehead skin closely resembles the texture and color of the midface region. As such, the use of a paramedian forehead flap to repair a midface defect provides optimal cosmesis; however, the donor forehead site may be left with an undesirable scar in a highly visible region of the face. Cutaneous surgeons possess a variety of traditional techniques intended to minimize scarring. We have found that the addition of 50 units of botulinum toxin at the time of wound closure has improved scar outcomes for patients undergoing reconstruction with paramedian interpolated flaps. Possible mechanisms for the efficacy of botulinum toxin lie in its ability to chemically paralyze the frontalis muscle and glabella complex. This immobilization leads to a reduction in unwanted wound tension during the most vulnerable first few days of healing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/JCAS.JCAS_56_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394119PMC
August 2020

Polydioxanone Threads for Atrophic Neck Scars.

Dermatol Surg 2020 Aug 5. Epub 2020 Aug 5.

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000002535DOI Listing
August 2020

The effect of platelet-rich plasma on female androgenetic alopecia: A randomized controlled trial.

J Am Acad Dermatol 2020 Nov 7;83(5):1294-1297. Epub 2020 Jul 7.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: Platelet-rich plasma (PRP) may be a useful treatment for androgenetic alopecia (AGA), although objective studies are needed.

Objective: To determine whether PRP injections improve female AGA.

Method: Prospective randomized controlled trial of 30 women diagnosed with AGA. Patients received subdermal scalp injections of Eclipse system PRP or placebo saline at weeks 0, 4, and 8. Outcome measures were changes in hair density (hair/cm), hair caliber (mm), and blinded global photographic assessment (improved or not improved) at week 24.

Results: Blinded global photographic assessment indicated that 57% of patients receiving PRP versus 7% of patients receiving saline improved at week 24 from baseline (P < .01). Compared to baseline, there was improvement in mean density in the PRP group versus the placebo group at week 8 (+71.1 vs -26.7 hairs/cm; P < .01) and week 24 (+105.9 vs -52.4 hairs/cm; P < .01). Compared to baseline, there was improvement in mean caliber in the PRP group versus the placebo group at week 8 (+0.0043 vs -0.0034 mm; P < .01) and week 24 (+0.0053 vs -0.0060 mm; P < .01). Adverse effects included headache, scalp tightness, swelling, redness, and postinjection bleeding.

Limitations: Two patients lost to follow-up.

Conclusions: PRP with the Eclipse system is a safe and effective intervention for female AGA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jaad.2020.06.1021DOI Listing
November 2020

Antibiotic Practices in Mohs Micrographic Surgery.

J Drugs Dermatol 2020 May;19(5):493-497

Background: Mohs micrographic surgery is a safe procedure with low rates of infection.

Objective: To establish current antibiotic prescribing practices amongst Mohs surgeons.

Methods And Materials: 16-question survey sent to American College of Mohs Surgery members.

Results: 305 respondents with collectively 7,634+ years of experience. The majority performed outpatient surgery (95.0%) and avoided oral or topical antibiotics for routine cases (67.7% and 62.8%, respectively). Prophylactic antibiotics were routinely prescribed for artificial cardiac valves (69.4%), anogenital surgery (53.0%), wedge excision (42.2%), artificial joints (41.0%), extensive inflammatory skin disease (40.1%), immunosuppression (38.9%), skin grafts (36.4%), leg surgery (34.2%), and nasal flaps (30.1%). A minority consistently swabbed the nares to check for staphylococcus aureus carriage (26.7%) and decolonized carriers prior to surgery (28.0%).

Conclusion: Disparity exists in antibiotic prescribing practices amongst Mohs surgeons. There may be under-prescription of antibiotics for high risk factors like nasal flaps, wedge excisions, skin grafts, anogenital/lower extremity site, and extensive inflammatory disease. Conversely, there may be over-prescription for prosthetic joints or cardiac valves. Increased guideline awareness may reduce post-operative infections and costs/side effects from antibiotic over-prescription. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.4695.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2020

Utility of Preinjection Aspiration for Hyaluronic Fillers: A Novel In Vivo Human Evaluation.

J Cutan Med Surg 2020 Jul/Aug;24(4):367-371. Epub 2020 Apr 22.

6559 Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA.

Background: Hyaluronic acid (HA) fillers have increased in popularity. While complications are rare, practitioners should focus on their prevention. Preinjection aspiration remains controversial as an effective safety checkpoint.

Objectives: Our study investigated the utility of preinjection aspiration as a safety checkpoint for HA fillers through comparison of physiochemical and rheological properties in a novel in vivo human model.

Methods: An in vivo human model consisted of a cannula inserted into a peripheral vein. Preinjection aspiration was evaluated using syringes of 10 commonly used HA fillers. The time required to visualize a flash was recorded.

Results: Using a multivariable regression model, needle gauge, HA concentration, elastic modulus ('), viscous modulus (), and complex modulus (*) had significant relationships with time to flash, whereas pullback volume did not. However, when comparing pullback volume using a more appropriate paired analysis, 0.5 cc pullback volume had a significantly decreased time to flash than 0.2 cc.

Conclusions: Preinjection aspiration for HA fillers has utility as a safety checkpoint. The times to visualize flashback decreased when using a human peripheral vein model compared to a previous in vitro model, suggesting that there may be real-time clinical utility of preinjection aspiration. Waiting times to visualize flashback may be affected by physiochemical and rheological properties. Additional studies would help to validate our results.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1203475420921387DOI Listing
April 2020

The Impact of Submental Deoxycholic Acid Injections on Neck Surgery

J Drugs Dermatol 2019 Dec;18(12):1281

Non-invasive procedures targeting the submental fat or “double chin” have undergone a surge in popularity. Injections of deoxycholic acid, a secondary bile acid, have recently received FDA-approval for fat reduction in this area. With appropriate patient selection, this preparation of 10 mg/mL of sodium deoxycholate (Kybella®, Kythera Biopharmaceuticals, Westlake Village, CA) leads to aesthetic improvement of moderate-to-severe convexity or fullness associated with submental fat in adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2019

Methacrylate Polymer Powder Dressing for a Nasal Surgical Defect

J Drugs Dermatol 2019 Dec;18(12):1274-1275

The fusion of technology and medicine has led to the advent of advanced wound healing techniques that may be adapted to the management of surgical defects. Shortened duration of healing and ease-of-use are two potential benefits under investigation. Here we describe a 65-year-old male with a nasal alar wound that was allowed to heal with secondary intention, assisted by a novel methacrylate polymer powder dressing. J Drugs Dermatol. 2019;18(12):1274-1275.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2019

The potential role of cannabinoids in dermatology.

J Dermatolog Treat 2020 Dec 10;31(8):839-845. Epub 2019 Oct 10.

Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Cannabis is increasingly being used world-wide to treat a variety of dermatological conditions. Medicinal cannabis is currently legalized in Canada, 31 states in America and 19 countries in Europe. The authors reviewed the literature on the pharmacology and use of cannabinoids in treating a variety of skin conditions including acne, atopic dermatitis, psoriasis, skin cancer, pruritus, and pain. Cannabinoids have demonstrated anti-inflammatory, antipruritic, anti-ageing, and antimalignancy properties by various mechanisms including interacting with the newly found endocannabinoid system of the skin thereby providing a promising alternative to traditional treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09546634.2019.1675854DOI Listing
December 2020

Practices in the Usage and Reconstitution of Poly-L-Lactic Acid

J Drugs Dermatol 2019 Sep;18(9):880-886

BACKGROUND: Poly-L-lactic acid (PLLA) is increasingly used for a range of indications, from HIV lipodystrophy to gluteal augmentation; however, there is no clear consensus on appropriate product preparation and use. OBJECTIVE: To establish current practices for PLLA reconstitution and usage in the USA. METHODS AND MATERIALS: A 19-question survey pertaining to the reconstitution and use of PLLA was distributed to members of the American Board of Cosmetic Surgery and American Board of Facial Cosmetic Surgery and at several cosmetic conferences. 410 questionnaires were returned anonymously over a 3-month period. The results were collated and analyzed. RESULTS: The commonest indication for PLLA was HIV lipodystrophy (46.8%), followed by gluteal augmentation (42.4%). For the face, the majority used a dilution of 9-10 mL (60.4%). For the gluteal region, the majority used a dilution greater than 21 mL (51.3%). Most respondents reconstituted PLLA in sterile water (59.8%) more than 21 hours before use (51.0%) and added lidocaine to the solution (94.7%). Most physicians used topical anesthetic cream (83.2%), manual agitation (85.8%) and recommended self-massage post-treatment (99.6%). CONCLUSION: There is considerable variation in PLLA reconstitution and use. Further well-designed studies are needed to establish the safest, most effective ways to use this product. J Drugs Dermatol. 2019;18(9):880-886.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2019

Response to Commentary on Intralesional Deoxycholic Acid as a Neoadjuvant Treatment of a Large Lipoma.

Dermatol Surg 2020 05;46(5):718-719

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000002136DOI Listing
May 2020

Presurgical Curettage Improves Accuracy for Nonmelanoma Skin Cancer Excision.

J Cutan Med Surg 2019 Nov/Dec;23(6):617-623. Epub 2019 Aug 17.

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Presurgical curettage before nonmelanoma skin cancer surgery may help delineate tumor subclinical extensions.

Objective: To determine histologically whether presurgical curettage appropriately or inappropriately changes excision specimen size.

Materials And Methods: One hundred fifty consecutive nonmelanoma skin cancers treated with Mohs micrographic surgery. The clinical margin (CM) was marked. Presurgical curettage was then performed and the resultant presurgical curettage margin (PCM) marked. Frozen section analysis of the CM and PCM revealed whether the curettage-induced margin change was appropriate or unnecessary.

Results: Presurgical curettage appropriately increased the surgical margin in 9.3% of cases, reducing the number of Mohs stages from 2 to 1. It appropriately decreased the surgical margin in 17.3% thereby conserving normal skin. In 19.4% of cases the curettage increased the margin in situations where the CM had underestimated the size of the tumor; however, in these cases, the curettage did not increase the margin sufficiently to clear the tumor. In 44.0% of cases the PCM did not change the size of the stage I specimen compared to the CM and confirmed the CM. In 10.0% of cases, preoperative curettage reduced margin accuracy by removing healthy tissue (8.0%) or underestimating tumor (2.0%). These errors were associated with eyelid location, severe background photodamage, and morpheiform/infiltrating/sclerosing basal cell carcinomas.

Conclusion: Presurgical curettage can improve tumor excision accuracy and efficiency. Careful tumor selection is important to optimize curette utility.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1203475419871048DOI Listing
August 2020

Acellular Porcine Transitional Cell Matrix Xenograft for Genital Wounds.

Dermatol Surg 2020 09;46(9):1245-1246

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000002096DOI Listing
September 2020

Nitrous Oxide Reduces Pain Associated With Local Anesthetic Injections.

J Cutan Med Surg 2019 Nov/Dec;23(6):602-607. Epub 2019 Aug 12.

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Local anesthetic injections can be painful and distressing.

Objective: The aim of this study was to determine whether nitrous oxide, ice, vibration, or topical anesthetic improves analgesia for local anesthetic injections.

Method: A cohort study of 400 patients undergoing Mohs micrographic surgery with local anesthetic was conducted. Patients received no intervention ( = 200), ice ( = 50), topical anesthetic cream ( 50), vibration device ( = 50), or nitrous oxide ( = 50). Pain was rated using the Visual Analogue Scale (VAS) and Wong-Baker FACES Pain Rating Scale.

Results: Without intervention, mean VAS was 4.2 and FACES was 4.6. Nitrous oxide was the most successful in reducing pain (mean VAS 1.6 vs. 4.2, < .01, FACES 1.2 vs. 4.6, < .01). Topical ice reduced pain (mean VAS 3.0 vs. 4.2, < .01, FACES 3.0 vs. 4.6, < .01). Vibration reduced pain (mean VAS 3.5 vs. 4.2, < .01, FACES 3.6 vs. 4.6, < .01). Higher pain scores were associated with age <50 ( = .02), male sex ( = .05), and surgery on the nose, lip, ear, or eyelid ( = .02).

Conclusion: Nitrous oxide, ice, and vibration reduce injection pain. These interventions are especially useful for younger males undergoing surgery on the nose, lip, ear, or eyelid.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1203475419867606DOI Listing
August 2020

Intralesional Deoxycholic Acid as Neoadjuvant Treatment of a Large Lipoma.

Dermatol Surg 2020 05;46(5):715-717

Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000002034DOI Listing
May 2020

Poly-L-Lactic Acid for Minimally Invasive Gluteal Augmentation.

Dermatol Surg 2020 03;46(3):386-394

Division of Dermatologic and Cosmetic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: There is increased emphasis on the importance of the gluteal region in the perception of beauty. Biodegradable fillers provide a nonsurgical method of augmenting and rejuvenating this area.

Objective: To review pertinent aspects of anatomy, patient evaluation, injection technique, and complications for gluteal augmentation using injectable biodegradable fillers.

Methods: The authors review the literature for poly-L-lactic acid-based gluteal augmentation.

Results: Like many aesthetic procedures, there is a paucity of literature on this emerging treatment modality (Level 4, Centre for Evidence-Based Medicine, Oxford). However, the collective clinical experience is that poly-L-lactic acid fillers are an effective treatment for patients seeking noninvasive gluteal enhancement with minimal downtime. Physicians must understand gluteal anatomy and avoid injecting deeply in the danger triangle to prevent intravascular injection into the gluteal vessels or injury to the sciatic nerve. Other safety elements include the use of blunt cannulas, reduced pressures, smaller volumes, and retrograde delivery.

Conclusion: Gluteal augmentation with fillers can safely and effectively improve gluteal firmness, shape, proportion, and projection. Practitioners injecting fillers in the gluteal region must be aware of appropriate patient selection, regional anatomy, and safe injection techniques. Given the increasing demand for this procedure, further high-quality studies are needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000001967DOI Listing
March 2020

Review of non-invasive body contouring devices for fat reduction, skin tightening and muscle definition.

Australas J Dermatol 2019 Nov 6;60(4):278-283. Epub 2019 Jun 6.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.

Non-invasive body contouring is a rapidly growing field in cosmetic dermatology. Non-invasive contouring devices improve the body's appearance through the removal of excess adipose tissue, particularly in areas in which fat persists despite optimal diet and exercise routine. The technology can also be used for skin tightening. This article reviews the five FDA-approved non-invasive body contouring modalities: cryolipolysis, laser, high-intensity focused electromagnetic field, radiofrequency and high-intensity focused ultrasound. These devices have emerged as a popular alternative to surgical body contouring due to their efficacy, favourable safety profile, minimal recovery time and reduced cost. Although they do not achieve the same results as liposuction, they are an attractive alternative for patients who do not want the risks or costs associated with surgery. When used appropriately and correctly, these devices have demonstrated excellent clinical efficacy and safety.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajd.13090DOI Listing
November 2019

Acellular porcine transitional cell matrix xenograft for surgical defects.

Australas J Dermatol 2019 Nov 22;60(4):e345-e346. Epub 2019 May 22.

Division of Dermatologic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajd.13080DOI Listing
November 2019

Antibiotics for Prevention of Postoperative Infection From Mohs on the Leg: A Survey of the American College of Mohs Surgery.

J Cutan Med Surg 2019 Jan/Feb;23(1):121-122

1 Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1203475418800944DOI Listing
November 2019

Evolution of the Picosecond Laser: A Review of Literature.

Dermatol Surg 2019 02;45(2):183-194

Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.

Background: Picosecond pulse duration lasers (PS) have altered the field of dermatology. PS were initially used in tattoo removal, to optimize efficacy and reduce side effects with nanosecond domain lasers. More recently, they have been demonstrated to be effective in the treatment of pigmentary disorders, acne scarring, and photoaging.

Objective: In this article, we critically analyze the published data on the many uses of picosecond lasers in dermatology.

Materials And Methods: A systematic review of PubMed was conducted using the following search terms: "picosecond," "picosecond laser," "picosecond laser dermatology," "picosecond laser pigment/pigmentation," and "picosecond laser tattoo removal." Articles ranged from 1988 until 2017.

Results: Forty-one articles were identified, and 27 met inclusion criteria for review. Indications for the PS included a variety of dermatologic applications include tattoo removal, benign pigmented lesions/pigmentary disorders, acne scarring, and photoaging. Most studies demonstrated safe and effective treatment.

Conclusion: The development of the picosecond pulse duration is a breakthrough innovation in laser technology, changing the scope of laser treatment. Encouraging findings in tattoo pigment clearance spurred the use of PS in a wider array of dermatologic issues. The increasingly positive results and low incidence of adverse effects further substantiates PS efficacy for a variety of dermatologic uses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000001697DOI Listing
February 2019

In Vitro Evaluation of Preinjection Aspiration for Hyaluronic Fillers as a Safety Checkpoint.

Dermatol Surg 2019 07;45(7):954-958

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: Hyaluronic acid (HA) fillers have increased in popularity. Although complications are rare, knowledge regarding their prevention and management are crucial. The utility of preinjection aspiration has become controversial.

Objective: Our study investigated the utility of preinjection aspiration as a safety checkpoint for HA fillers through comparison of physiochemical and rheological properties in an in vitro model.

Materials And Methods: Whole blood was drawn from vacutainers using syringes containing 10 commonly used HA fillers. Each HA filler was examined with the plunger pulled back at volumes of 0.2 and 0.5 cc. The time required to visualize a flash was recorded. Data were compared using physiochemical and rheological properties, pullback volumes, and needle gauges.

Results: Using a multivariable regression model, HA concentration, elastic modulus (G'), viscous modulus (G″), and complex modulus (G*) had significant relationships with time to flash, whereas needle gauge and pullback volume did not. However, when comparing pullback volume using an appropriate paired analysis, 0.5 cc pullback volume had a significantly decreased mean time to flash than 0.2 cc.

Conclusion: Preinjection aspiration may have utility as a safety checkpoint for HA fillers. Practitioners may have to adjust pullback volume and waiting time to visualize the flash based on physiochemical and rheological properties.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000001767DOI Listing
July 2019

Association Between Surgeon-Specific Features and Number of Stages, Flaps, and Grafts in Mohs Micrographic Surgery: A Retrospective Observational Study of 59 Early-, Mid-, and Advanced-Career Mohs Surgeons.

Dermatol Surg 2017 Nov;43(11):1358-1362

*All authors are affiliated with the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: There is limited data available to correlate Mohs surgeons' behavior and years of experience. Moreover, the recent standardization of Mohs surgery training programs may allow for the prediction of future trends in Mohs micrographic surgery surgery based on the current behavior of recently trained Mohs surgeons.

Objective: To better understand the relationship between surgeon-specific characteristics and the number of Mohs micrographic surgery total cases, stages per case, number of grafts, and number of flaps performed by each surgeon.

Materials And Methods: Procedure data of 59 early-career, mid-career, and advanced-career Mohs surgeons were obtained from the website of the Centers for Medicare & Medicaid services.

Results: No statistically significant differences were identified in the number of stages per case between the 3 groups. Two-proportion testing between advanced-career surgeons and early-career surgeons indicated a statistically significant difference in the number of surgeons performing flaps or grafts (p < .05). Similarly, a statistically significant difference was noticed between mid-career surgeons and early-career surgeons (p < .05).

Conclusion: The result of this study showed that more years of experience was significantly associated with reported utilization of flaps or grafts in practice. Furthermore, no significant difference was observed between years in practice and number of stages per case.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000001187DOI Listing
November 2017

Porokeratotic eccrine ostial and dermal duct nevus: a unique case treated with CO laser.

Clin Case Rep 2017 05 31;5(5):675-678. Epub 2017 Mar 31.

Department of Dermatology Mount Sinai School of Medicine New York City New York USA.

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare eccrine hamartoma, with treatment generally being unsatisfactory. The unique features of PEODDN presented include bilateral and facial lesions, and extensive body involvement. Management with CO laser was successful, and follow-up will be necessary to monitor for recurrent lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccr3.846DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412763PMC
May 2017

Retrospective Study of Punch Scoring Versus Freehand Approach for First Stage Mohs Micrographic Surgery.

J Clin Aesthet Dermatol 2016 Sep 1;9(9):55-56. Epub 2016 Sep 1.

Division of Dermatologic Surgery, Department of Dermatology, Mount Sinai School of Medicine, New York, New York.

The objective was to observe whether there is a difference in the number of subjects requiring more than one stage of Mohs micrographic surgery for small lesion nonmelanoma skin cancers using the punch scoring method versus freehand approach. Retrospective review. Outpatient Mohs Clinic. Thirty patients with small lesion (<5mm) basal cell and squamous cell carcinoma who had Mohs micrographic surgery using either the punch scoring method (15) for scoring the first layer or the freehand method (15). Differences between the two groups were evaluated by the number of subjects requiring more than one stage and the reason for any additional stages. There was no observed difference in the number of subjects requiring more than one Mohs stage between the punch scoring group and the freehand group. Dermatologic surgeons can use the punch scoring method or the freehand approach for scoring small lesion Mohs based on provider preference.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110330PMC
September 2016

Does an increased number of moles correlate to a higher risk of melanoma?

Melanoma Manag 2016 Jun 19;3(2):85-87. Epub 2016 May 19.

Department of Dermatology, Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, 5 East 98th Street, NY 10029, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/mmt-2016-0001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096442PMC
June 2016

Report of an unusually large, surgically excised squamous cell carcinoma successfully treated with porcine transitional epithelium.

JAAD Case Rep 2015 Jul 13;1(4):200-2. Epub 2015 Jun 13.

Department of Dermatology, Mount Sinai School of Medicine, New York, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jdcr.2015.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808737PMC
July 2015