30 results on '"Sasima Eimpunth"'
Search Results
2. Siliconoma successfully controlled with low-dose oral isotretinoin: A case report with histopathologic and ultrasonographic findings
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Siriwan Palawisuth, Janice Natasha C. Ng, Rungsima Wanitphakdeedecha, Nuttagarn Jantanapornchai, Penvadee Pattanaprichakul, Sasima Eimpunth, and Yanisorn Nanchaipruek
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medicine.medical_specialty ,foreign body granuloma ,business.industry ,Low dose ,isotretinoin ,Case Report ,Dermatology ,siliconoma ,Oral isotretinoin ,medicine.disease ,LIS, liquid injectable silicone ,RL1-803 ,medicine ,business ,Isotretinoin ,injectable silicone granuloma ,Foreign body granuloma ,medicine.drug - Published
- 2021
3. Effectiveness of a 595-nm Pulsed Dye Laser for the Treatment of Basal Cell Carcinoma Using One Double-Stacked Pulse Session: A Randomized, Double-Blinded Controlled Trial
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Sasima Eimpunth, Maggie Chow, Michael Shane Hamman, and Shang I Brian Jiang
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Adult ,Male ,Skin Neoplasms ,Double blinded ,Lasers, Dye ,Dermatology ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,medicine ,Humans ,Basal cell carcinoma ,Aged ,Dye laser ,business.industry ,Pulse (signal processing) ,Pulse duration ,General Medicine ,Middle Aged ,Laser ,medicine.disease ,Trunk ,Carcinoma, Basal Cell ,030220 oncology & carcinogenesis ,Female ,Surgery ,Nuclear medicine ,business - Abstract
Background Surgical and nonsurgical methods are used for treating basal cell carcinoma (BCC). Few randomized controlled trials exist on the effectiveness of the pulsed dye laser (PDL) on BCC treatment. Objective We investigated the effectiveness of PDL treatment in a single session for the management of nodular and superficial BCCs on the trunk and extremities of adults using a randomized, double-blind, controlled technique. Methods We used settings of fluence 7.5 J/cm2, 3-ms pulse duration, no dynamic cooling, 10-mm spot size, 10% overlap between pulses, and 2 stacked pulses on a 595-nm wavelength laser. Histopathologic clearance on excision of tumor with 4-mm margins was the primary outcome measure. Results Twenty-four patients were included in the study, with 14 in the laser treatment group and 10 patients in the sham/control group. In total, 10/14 (71.4%) of the tumors in the treatment group were successfully treated with no residual tumor on excisional specimen histology, compared with 3/10 (30.0%) of the control group (p = .045). Conclusion Our study shows that PDL may be an effective treatment for low-risk BCCs of the trunk and extremities, but the cure rate is lower than those of other treatments for BCC. Thus, PDL under the current settings cannot be recommended.
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- 2020
4. Successful treatment of acupuncture-induced argyria using Q-switched 1064-nm Nd:YAG laser
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Sukhum Jiamton, Sasima Eimpunth, Sittiroj Arunkajohnsak, Kanchalit Thanomkitti, Penvadee Pattanaprichakul, and Pranee Kasemsarn
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medicine.medical_specialty ,business.industry ,Case Report ,Dermatology ,Silver jewelry ,lcsh:RL1-803 ,medicine.disease ,Laser ,law.invention ,Eccrine gland ,Tissue sections ,law ,Q-switched 1064-nm Nd:YAG laser ,Nd:YAG laser ,lcsh:Dermatology ,Acupuncture ,Medicine ,Argyria ,Nd:YAG, neodymium-doped yttrium aluminum garnet ,localized argyria ,business ,Silver particles ,acupuncture - Abstract
Localized argyria is a benign rare condition resulting from impregnation of silver particles in the skin by various exposure sources such as silver jewelry,1 occupational exposures,2 topical medications,3 and medical procedures (ie, acupuncture).4 We report a case of acupuncture-induced argyria on the face, both dorsa of the hands, wrists, legs, and dorsa of the feet, successfully treated with 1 to 2 sessions of Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. Tissue section demonstrated refractile granules around the eccrine glands under dark-field microscopy.
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- 2020
5. The efficacy of macro‐focused ultrasound in the treatment of upper facial laxity: A pilot study
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Rungsima Wanitphakdeedecha, Chadakan Yan, Ploypailin Tantrapornpong, Ya-Nin Nokdhes, Sasima Eimpunth, Janice Natasha C. Ng, Thanya Techapichetvanich, and Woraphong Manuskiatti
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Orthodontics ,business.industry ,Ultrasonic Therapy ,Eyebrow ,Ultrasound ,Pilot Projects ,Dermatology ,Focused ultrasound ,Skin Aging ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Treatment Outcome ,0302 clinical medicine ,medicine.anatomical_structure ,Patient Satisfaction ,030220 oncology & carcinogenesis ,medicine ,Forehead ,Humans ,In patient ,Prospective Studies ,business ,Adverse effect ,Skin roughness ,Single session - Abstract
Background Recently, macro-focused ultrasound (MFU) has become a popular noninvasive esthetic treatment for facial laxity. However, there are no studies done that evaluated the use of MFU with a 2.0 mm transducer for upper facial lifting. Aims To evaluate the efficacy and safety of MFU with a 2.0 mm transducer in the treatment of upper facial laxity in Thai patients. Methods This was a prospective, evaluator-blinded pilot study with 34 Thai patients diagnosed with mild to moderate facial laxity. Patients were treated with a single session of MFU with 2.0 mm transducer at the forehead, lateral and just below the eye area. Primary outcome was the clinical improvement of upper facial laxity graded by 2 blinded dermatologists at baseline, 1-week, 1-, 3-, and 6-month follow-up. Objective measurements including eyebrow height, upper facial volume, and textural irregularities were evaluated. Patients' self-assessment scores and adverse effects were also recorded. Results Out of 34 patients, 27 (79.4%) attended all follow-ups. Clinical improvement of upper facial laxity was observed as early as 1-week follow-up. Eyebrow height elevation was significantly increased at every follow-up (P = .000) with an average of 1.22 mm at 6-month follow-up. Wrinkles improved significantly at 1-week and 6-month follow-up (P = .002 and P = .010, respectively). Skin roughness showed significant improvement at 6-month follow-up (P = .004). Majority of the patients (53.6%) reported marked improvement at 3-month follow-up. No serious adverse event was noted. Conclusion Macro-focused ultrasound is a safe and effective treatment for upper facial laxity and skin textural irregularities in patients with mild to moderate degree of laxity.
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- 2020
6. The efficacy and safety of fractional radiofrequency nanoneedle system in the treatment of atrophic acne scars in Asians
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Rungsima Wanitphakdeedecha, Janice Natasha C. Ng, Sasima Eimpunth, Woraphong Manuskiatti, and Sunatra Nitayavardhana
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Scab formation ,medicine.medical_specialty ,Erythema ,Volume analysis ,Dermatology ,acne scar ,nanoneedle ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Cicatrix ,0302 clinical medicine ,Energy Based Devices Articles ,Asian People ,Edema ,Acne Vulgaris ,medicine ,Humans ,Prospective Studies ,Acne scars ,Adverse effect ,Acne ,business.industry ,fractional radiofrequency ,Original Contribution ,medicine.disease ,Radiofrequency Therapy ,Hyperpigmentation ,Treatment Outcome ,030220 oncology & carcinogenesis ,medicine.symptom ,business - Abstract
Background Multiple treatment modalities have been developed to treat atrophic acne scars with varying degrees of success. Post‐inflammatory hyperpigmentation (PIH) after acne scar treatments remain a major concern in Asian patients. Fractional radiofrequency (FRF) has been used in many dermatological skin conditions including acne scars. Aims To determine the efficacy and safety of FRF nanoneedle system in the treatment of acne scars in Asians. Methods This is a prospective, evaluator‐blinded study with 25 subjects diagnosed with moderate to severe acne scarring. All subjects received 3 monthly treatments of the FRF nanoneedle system on both cheeks. Primary outcome was the clinical improvement of acne scars graded by 2 blinded dermatologists at baseline, 1‐, 3‐, and 6‐month follow‐ups. Objective scar volume analysis was done using ultraviolet A (UVA) light video camera. Subjects’ self‐assessment, pain score, and adverse events were also recorded. Results Twenty‐three out of 25 subjects completed the study and attended all follow‐up. Clinical improvement of acne scars was observed as early as 1‐month follow‐up. Objective evaluation of acne scar volume decreased significantly on all follow‐up compared to baseline (P
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- 2020
7. Intradermal Micro-Dosing of AbobotulinumtoxinA for Face-Lifting: How Long Does It Last?
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Kathryn Anne G Cembrano, Chalermkwan Apinuntham, Rungsima Wanitphakdeedecha, Chadakan Yan, Sasima Eimpunth, Woraphong Manuskiatti, and Viboon Rojanavanich
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Side effect ,medicine.medical_treatment ,Dermatology ,Vial ,Fitzpatrick Skin Type II ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Long-term ,ABO blood group system ,medicine ,Intradermal injection ,Face-lifting ,Saline ,Original Research ,business.industry ,AbobotulinumtoxinA ,Micro-dosing ,Nasolabial fold ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Anesthesia ,RL1-803 ,business ,Facial symmetry - Abstract
Introduction Intradermal injection of botulinum toxin type A (BoNT/A) has been used off-label by many clinicians for face-lifting. Previous studies on abobotulinumtoxinA (ABO) (Dysport®; Ipsen Biopharm Ltd.) have demonstrated clinical efficacy in face-lifting when compared to normal saline solution (NSS). However, few clinical studies have evaluated ABO in terms of duration of sustained effects for face-lifting. Methods Thirty subjects were enrolled, and their face was injected with ABO at a dilution of 1 vial:7 mL (500 U in 7 mL of NSS) using an intradermal injection technique. Standardized photographic documentation was obtained using a two-, and three-dimensional imaging system (Vectra H1, Canfield Scientific, Inc, Fairfield, NJ) at baseline, immediately after injection, 2 weeks after injection and at 1 , 2 , 3 , 4 , 5 and 6 months of follow-up after treatment. The face-lifting effects were graded by both the subjects and two blinded dermatologists who compared photographs taken at the different time points. Side effects were also recorded at the end of the study. Results Of the 30 subjects, 28 completed treatment and attended every follow-up visit. All subjects were female with Fitzpatrick skin type II to IV. The average age of the subjects was 27.6 ± 3.4 (range 22–34) years. The total number of ABO units used varied for each subject (range 200–250 U), with the average (± standard deviation) dose being 237 ± 19 units. Most of the subjects reported significant face-lifting up to 3 months post-procedure. However, face-lifting assessed by blinded dermatologists was notably lower than that of each patient’s evaluation. The difference in the facial contouring volume of the nasolabial fold and jawline, as measured by the Vectra H1 imaging system, was statistically significant from baseline up until 3 months after injection (p = 0.001 and p = 0.001, respectively). The only side effect found in this study was minimal bruising, which was seen in 13.8% of subjects. None of the subjects reported facial asymmetry, either at rest or during facial expression. Conclusion The results of this study demonstrate the face-lifting effect of ABO intradermal injection. The results show sustained effects up to 3 months after injection.
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- 2020
8. Key characteristics of basal cell carcinoma with large subclinical extension
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Shang I Brian Jiang, Alina Goldenberg, Sasima Eimpunth, and Tanya Greywal
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Male ,medicine.medical_specialty ,Surgical margin ,Skin Neoplasms ,medicine.medical_treatment ,Dermatology ,Lesion ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Mohs surgery ,Humans ,Basal cell carcinoma ,skin and connective tissue diseases ,Aged ,Retrospective Studies ,Subclinical infection ,Aged, 80 and over ,integumentary system ,business.industry ,fungi ,Fitzpatrick Skin Type I ,Margins of Excision ,Retrospective cohort study ,Middle Aged ,Mohs Surgery ,medicine.disease ,Infectious Diseases ,Carcinoma, Basal Cell ,030220 oncology & carcinogenesis ,Female ,Histopathology ,Radiology ,medicine.symptom ,business - Abstract
Background Basal cell carcinoma with large subclinical extension (BCC-LSE) is a tumour whose extensive spread becomes apparent during Mohs surgery histopathology review. Not recognizing BCC-LSE preoperatively may result in a greater number of Mohs layers and in larger than anticipated postoperative defects. Objective To evaluate the characteristics of BCC-LSE. Methods This retrospective study reviewed BCC treated with Mohs surgery at a single academic surgical centre between March 2007 and February 2012. A total of 2044 cases met the criteria of BCC-LSE, which was defined as a lesion requiring at least three Mohs stages and a final surgical margin (difference between preoperative and postoperative measurements in either vertical or horizontal dimensions) of ≥1 cm. Results In adjusted multivariable analysis, male sex (P = 0.05), Fitzpatrick skin type I (P = 0.002), history of prior BCC (P = 0.003) and subtypes of basosquamous, metatypical, micronodular, infiltrative, morpheaform and sclerosing (P = 0.005) remained significant BCC-LSE predictors. Conclusions Demographic factors, including personal history of BCC, skin type, anatomic location, gender and age, in addition to tumour histologic subtype assessed through incisional biopsy, can help predict occurrence of BCC-LSE and assist physicians in optimizing preoperative assessment of surgical time and complexity.
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- 2019
9. Intradermal injection of <scp>incobotulinumtoxinA</scp> for face lifting
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Rungsima Wanitphakdeedecha, Chadakan Yan, Poramin Patthamalai, Thanya Techapichetvanich, Weeranut Phothong, Woraphong Manuskiatti, Sasima Eimpunth, and Ya-Nin Nokdhes
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Adult ,Injections, Intradermal ,medicine.medical_treatment ,Face lifting ,Dermatology ,Vial ,Injections ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Photography ,Humans ,Medicine ,Clinical efficacy ,Intradermal injection ,Botulinum Toxins, Type A ,Saline ,Aged ,business.industry ,Significant difference ,General Medicine ,Skin Aging ,Treatment Outcome ,030220 oncology & carcinogenesis ,Comparison study ,business ,Nuclear medicine ,Facial symmetry - Abstract
Intradermal injection of botulinumtoxinA (BoNT/A) has been used off-label by many clinicians for the purpose of face-lifting effect. Some studies on AbobotulinumtoxinA (AboA) demonstrated clinical efficacy on face-lifting effect when comparing to normal saline solution (NSS). So far, there is no split-face comparison study on face-lifting effect of IncobotulinumtoxinA (IncoA). The objective of this study was to compare the face-lifting effect of IncoA intradermal injection and NSS. Twenty-two subjects were enrolled and randomly injected with IncoA at 1:6 cc dilution (100 unit or 1 vial in 6 cc of NSS) on one side, and NSS on the other side by using intradermal injection technique. Standardized photographic documentation with 2-, and 3-dimentional imaging system (Vectra H1, Canfield Scientific, Inc., Fairfield, NJ) were obtained at baseline, and at 2 weeks after treatment. The face-lifting effect was graded by the subjects and two blinded dermatologists, using photographic comparison. Side effects were also recorded at the end of the study. Immediate face-lifting was identified on the side that was treated with IncoA by blinded injectors in 63.6% of patients. Of all subjects, 17 (77.3%) have noticed the improvement of skin laxity on the side that was treated with IncoA at 2 weeks after treatment. The difference in facial contouring volume measured by Vectra H1 imaging system on IncoA side was significantly higher (P = .033) when comparing to NSS side in patients aged
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- 2020
10. The efficacy and safety of a 577-nm high-power optically pumped semiconductor laser in the treatment of postacne erythema
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Weeranut Phothong, Klaus Fritz, Rungsima Wanitphakdeedecha, Kathryn Anne G Cembrano, Chanida Ungaksornpairote, Woraphong Manuskiatti, Carmen Salavastru, Waritch Kobwanthanakun, and Sasima Eimpunth
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medicine.medical_specialty ,Erythema ,Pilot Projects ,Dermatology ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Acne Vulgaris ,medicine ,Humans ,Facial erythema ,Low-Level Light Therapy ,business.industry ,Atrophic scars ,Outcome measures ,Sequela ,Inflammatory acne ,medicine.disease ,Treatment period ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,medicine.symptom ,Lasers, Semiconductor ,business - Abstract
BACKGROUND Postacne erythema (PAE) is a common sequela of inflammatory acne vulgaris, treatment of which has been challenging due to limited options available and the variability of results for each modality. Recently, a 577-nm high-power optically pumped semiconductor laser (HOPSL) initially developed for vascular lesions has shown promising results for the treatment of PAE. AIMS To evaluate the efficacy and safety of 577-nm HOPSL in the treatment of postacne erythema. METHODS This was a split-face, randomized controlled trial pilot study. Twenty-one patients with PAE on both sides of their face were enrolled. Each subject's face sides were randomly assigned to either receive 577-nm HOPSL treatment (QuadroStar PRO™, Asclepion Laser Technologies) using the scanner handpiece, 1mm spot size, 80% coverage, 12-15 J/cm2 , 30 ms, 2 passes for 3 sessions at 1-month intervals, or no treatment at all. Outcome measures such as overall improvement, the Erythema Index (EI), and Melanin Index (MI) from 3 different areas on both treatment and control sides were assessed at baseline, and 1-month follow-up after each treatment session. Side effects including pain, erythema, swelling, and crusting were also recorded. RESULTS Upon completion of the treatment period, the mean EI was significantly decreased in both treated and nontreated sides of the face (P
- Published
- 2020
11. Efficacy of olive leaf extract-containing cream for facial rejuvenation: A pilot study
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Weeranut Phothong, Woraphong Manuskiatti, Rungsima Wanitphakdeedecha, Natchaya Junsuwan, Sasima Eimpunth, Janice Natasha C. Ng, and Sutasinee Phaitoonwattanakij
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Erythema ,Facial rejuvenation ,Photoaging ,Human skin ,Pilot Projects ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Olive leaf ,Oleuropein ,Olea ,medicine ,Humans ,Rejuvenation ,Food science ,Prospective Studies ,Transepidermal water loss ,integumentary system ,business.industry ,medicine.disease ,Skin Aging ,chemistry ,030220 oncology & carcinogenesis ,medicine.symptom ,Wound healing ,business - Abstract
BACKGROUND Olive leaf extract (OLE), a naturally extracted product from olive leaves, contains oleuropein and other bioactive phenolic compounds. Oleuropein was identified to have various medical properties. It was also found to inhibit the effects of both acute and chronic UVB-induced skin damage as well as accelerate wound healing activity. AIMS To evaluate the efficacy of olive leaf extract-containing cream on facial rejuvenation. METHODS This is a prospective pilot study with a total of 36 participants, who presented with photoaging skin. All participants applied the olive leaf extract-containing cream (SUPERHEAL™ O-Live Cream, PhytoCeuticals, Inc, USA) to their whole face twice daily for 2 months. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: melanin and erythema index, transepidermal water loss (TEWL), skin hydration, skin pH, sebum level, texture, and wrinkles. RESULTS After 2 months, TEWL decreased significantly (P = .007) and maintained the results 1 month after discontinuation of the treatment (P = .007). Skin hydration also increased significantly after 2 months (P = .004). Wrinkles improved significantly on all follow-ups (P
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- 2020
12. Squamous Cell Carcinoma In Situ Upstaged to Invasive Squamous Cell Carcinoma: A 5-Year, Single Institution Retrospective Review
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Sasima Eimpunth, Robert Lee, Alina Goldenberg, Silvia Soohyun Song, Shang I Brian Jiang, Saowalak Hunnangkul, Gagik Oganesyan, Michael Shane Hamman, and Tanya Greywal
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Adult ,Oncology ,medicine.medical_specialty ,Skin Neoplasms ,Biopsy ,medicine.medical_treatment ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Mohs surgery ,medicine ,Carcinoma ,Humans ,Neoplasm Invasiveness ,Basal cell ,Single institution ,Shave biopsy ,Nose ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,Mohs Surgery ,medicine.disease ,stomatognathic diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Surgery ,Radiology ,business ,Carcinoma in Situ - Abstract
Background Shave biopsy may not be able to accurately distinguish squamous cell carcinoma in situ (SCCIS) from invasive squamous cell carcinoma (SCC). Information on the incidence of biopsy-proven SCCIS upstaged to SCC after a more complete histologic examination is limited. Objective To determine the incidence and clinical risk factors associated with upstaging the biopsy diagnosis of SCCIS into invasive SCC based on findings during Mohs micrographic surgery (MMS). Methods All MMS cases of SCCIS performed between March 2007 and February 2012 were identified, MMS operative notes were examined, and invasive dermal components were confirmed by the MMS slide review. Upstaged SCCIS was defined as biopsy-diagnosed SCCIS subsequently found to be an invasive SCC during MMS. Results From 566 cases with the preoperative diagnosis of SCCIS, 92 (16.3%) cases were SCCIS upstaged to SCC. Location of ears, nose, lips, and eyelids, preoperative diameter >10 mm, and biopsy report mentioning a transected base were significant predictors of upstaged SCCIS. Conclusion Considering the possibility that over 16% of SCCIS may be truly invasive SCC, biopsy-proven SCCIS should be treated adequately with margin-assessed treatment modalities such as surgical excision or Mohs surgery when indicated.
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- 2017
13. Acne treatment efficacy of intense pulsed light photodynamic therapy with topical licochalcone A, l-carnitine, and decanediol: A spilt-face, double-blind, randomized controlled trial
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Sasima Eimpunth, Rungsima Wanitphakdeedecha, Ploypailin Tantrapornpong, Thanya Techapichetvanich, Panittra Suphatsathienkul, Woraphong Manuskiatti, and Nudpanuda Tavechodperathum
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Adult ,Male ,medicine.medical_specialty ,Erythema ,Licochalcone A ,medicine.medical_treatment ,Skin Cream ,Photodynamic therapy ,Dermatology ,Intense pulsed light ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Chalcones ,Randomized controlled trial ,Double-Blind Method ,law ,Carnitine ,Acne Vulgaris ,medicine ,Humans ,Adverse effect ,Acne ,business.industry ,medicine.disease ,Hyperpigmentation ,Treatment Outcome ,chemistry ,Photochemotherapy ,030220 oncology & carcinogenesis ,Face ,Female ,medicine.symptom ,Fatty Alcohols ,business - Abstract
Background Depending on disease severity, standard acne treatments can vary from topical to systemic therapy. However, poor compliance caused by adverse events and antibiotic resistance is a major cause of treatment failure. Aims To determine the effectiveness of photodynamic therapy (PDT) with intense pulsed light (IPL) in the treatment of acne when combined with a cream containing licochalcone A, L-carnitine and decanediol (so-called, 'active formulation') versus PDT alone. Patients/methods Twenty-nine volunteers, aged 21-39 years (26 women and 3 men, mean age 29.41 ± 5.24 years), with mild to severe facial acne, were enrolled. Each subject's face sides were randomized in a split-face manner to either receive PDT (IPL with a 400-720 nm cut-off filter, at 4 sessions with two-week intervals) combined with the active formulation cream twice daily for 10 weeks on one face side; or PDT and the vehicle cream on the other side, with the same treatment protocol. Reduction in acne quantity, melanin index and erythema index were assessed 2 weeks after the second treatment (day 28), 1 week after the fourth treatment (day 49), and 1 month after the fourth treatment (day 70). Results Compared to baseline, patients in the active formulation group demonstrated a faster onset of reduction in the number of lesions at 2 weeks after the second treatment (p=0.010 for inflammatory acne and p=0.001 for non-inflammatory acne). A significantly greater reduction in lesion count was observed in the active formulation group compared with the vehicle group at all timepoints of evaluation for noninflammatory acne (day 28, day 49, and day 70; p=0.003, 0.005 and 0.002 respectively), and at 1 month after the fourth treatment for inflammatory acne (p=0.036). Compared to the vehicle group, the melanin index of the active formulation group decreased significantly at 1 month after the fourth treatment (p=0.015). Conclusion PDT is more effective in treating acne when combined with a topical cream containing licochalcone A, L-carnitine and decanediol, than PDT alone. Significant acne reduction and improvements in post-inflammatory hyperpigmentation were observed, which offers acne patients a better therapeutic option. It is a safe and effective combination treatment for patients with moderate and severe acne.
- Published
- 2019
14. Local and systemic effects of low-level light therapy with light-emitting diodes to improve erythema after fractional ablative skin resurfacing: a controlled study
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Weeranut Phothong, Thanawan Iamphonrat, Rungsima Wanitphakdeedecha, Sasima Eimpunth, and Woraphong Manuskiatti
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Light therapy ,Adult ,Male ,medicine.medical_specialty ,Erythema ,medicine.medical_treatment ,Fractional laser ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Wound care ,Cicatrix ,0302 clinical medicine ,Low-Level Light Therapy ,Ablative case ,Medicine ,Humans ,Prospective Studies ,Skin ,Transepidermal water loss ,business.industry ,030206 dentistry ,Water Loss, Insensible ,Skin resurfacing ,Lasers, Gas ,Surgery ,Female ,medicine.symptom ,business - Abstract
Therapy with light-emitting diodes (LED) has been associated with the reduction of erythema and accelerated wound healing. LED phototherapy has been used in various clinical practices including post-laser wound healing enhancement. Fractional laser resurfacing is one of the popular dermatological procedures; however, the duration and degree of downtime may limit daily life activity and studies on the effect of LED low-level light therapy (LED-LLLT) on post-ablative laser wound care are still limited. To evaluate local and systemic effects of LED-LLLT on post-ablative laser erythema and wound healing acceleration after fractional ablative laser resurfacing. The study was divided into two arms. First, a prospective split-face randomized controlled and single-blinded study involved 17 patients (split-face group) to determine the local and systemic effect of LED-LLLT. Patients with acne scars or rhytides were treated with a single session of fractional CO2 laser followed by 830/590 nm LED-LLLT on one side of their faces. The duration of post-laser erythema, the erythema index, and transepidermal water loss were collected at baseline, and compared with 7-daily follow-up visits posttreatment for the non LED- and LED-treated sides. The second controlled arm of the study was performed on an additional 19 subjects (CO2 group). The patients received a single fractional CO2 laser treatment without any LED-LLLT with the same follow-up protocol. All measurements were compared with the results from the patients from the split-face group. In the split-face group, the duration of erythema post laser was equal (7.4 ± 2.8 days). No significant reduction in the erythema index and transepidermal water loss was seen in the LED-treated vs the non-treated side (p values = 0.99 and 0.78 respectively). For the second part of the study that compared the results between the split-face group and the control CO2 only group, the duration of the post-laser erythema was comparable (p value = 0.32). However, the percentage difference of the erythema index from baseline in the split-face group was significantly lower than the CO2 group on days 1, 4, 5, and 7 post-laser treatment (p value = 0.03 on days 1, 4, 5, and 0.04 on day 7) and the LED-treated side provided the lowest percentage difference of the erythema index followed by the non LED-treated side compared with the control CO2 only group. 830/590 nm LED-LLLT may provide both local and systemic effects on the degree of post-ablative laser erythema in human skin, however, appropriate protocol settings should be considered to achieve a significant clinical outcome.
- Published
- 2018
15. A Randomized, Double-Blind, Placebo-Controlled Study of the Effect of a High-Potency Topical Corticosteroid After Sclerotherapy for Reticular and Telangiectatic Veins of the Lower Extremities
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Mitchel P. Goldman, Sasima Eimpunth, Ana Marie Liolios, Douglas C. Wu, and Daniel P. Friedmann
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Adult ,medicine.medical_specialty ,Erythema ,Administration, Topical ,medicine.medical_treatment ,Anti-Inflammatory Agents ,Polidocanol ,Placebo-controlled study ,Betamethasone dipropionate ,Dermatology ,Placebo ,Betamethasone ,Polyethylene Glycols ,law.invention ,Double-Blind Method ,Randomized controlled trial ,law ,Sclerotherapy ,medicine ,Humans ,Prospective Studies ,Telangiectasis ,Postoperative Care ,business.industry ,General Medicine ,Middle Aged ,Sclerosing Solutions ,Surgery ,Lower Extremity ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
Background Although typically mild, transient, and expected, most adverse events (AEs) postsclerotherapy are inflammatory in nature. Objective To evaluate the effects of a high-potency topical corticosteroid (TC) applied immediately postsclerotherapy. Materials and methods Subjects undergoing bilateral lower extremity sclerotherapy with polidocanol had extremities randomized to a single application of betamethasone dipropionate and placebo saline solutions immediately post-treatment in a double-blind manner. Adverse events were assessed for each extremity by subjects at t = 0 (preapplication) and t = 15 (15 minutes postapplication) and by an investigator at t = 0 and t = 15, and at Days 14 and 60. Subjects and investigator evaluated efficacy with a quartile improvement scale. Results Sixteen female subjects completed the study. Subjects reported no statistically significant differences in AEs between TC and placebo at either t = 0 or t = 15. Investigator scores for erythema and swelling/urtication were not significantly different between groups at the same time points. Although most subjects demonstrated 26% to 75% improvement at Day 60, results were not significantly different between extremities on subject and investigator evaluation. Conclusion High-potency TC application immediately postsclerotherapy produced no statistically significant differences in subject- and investigator-assessed AEs and clearance rates compared with placebo. Foam sclerotherapy with polidocanol is safe and effective for the treatment of lower extremity reticular veins.
- Published
- 2015
16. Comparative outcomes of different endovenous thermal ablation systems on great and small saphenous vein insufficiency: Long-term results
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Sasima Eimpunth, Robert Weiss, Karen L. Beasley, Sandra Wheeler, Suthipol Udompunturak, and Margaret A. Weiss
- Subjects
medicine.medical_specialty ,Duplex ultrasonography ,business.industry ,medicine.medical_treatment ,Ultrasound ,Reflux ,Retrospective cohort study ,Dermatology ,Ablation ,Surgery ,Small saphenous vein ,medicine.anatomical_structure ,Medicine ,Outpatient clinic ,business ,Vein - Abstract
Background and Objective This study examined the outcomes of over a decade of endovenous thermal ablation (EVTA) treatments for great and small saphenous vein (GSV and SSV) insufficiency, utilizing three different endovenous thermal ablation systems. Materials and Methods This retrospective study reviewed EVTA treatments performed at an outpatient clinic (MDLSVI) from April 1999 to February 2013. Systems included 810 nm diode (hemoglobin targeting), 1,320 nm laser (water targeting) and a radiofrequency (direct thermal transfer) (RF) device. Clinical and ultrasonographic evaluation were performed before treatment and at each follow-up visit. Patients were examined yearly by Duplex ultrasonography. Success was defined as complete absence of reflux. Results Analysis of 934 treatments demonstrated that although recanalization could occur over time, endovenous ablation has a very high success rate. Ablation rates were 92.5%, 85.9%, and 71.9% at 6-months, 1-year, and 5-years after procedures. Recanalization occurred in 156 out of 934 treatments (16.7%) during the follow-up period. Among three difference systems, the total ablation success rate was significantly different (P
- Published
- 2015
17. Therapeutic outcome of melasma treatment by dual-wavelength (511 and 578 nm) laser in patients with skin phototypes III-V
- Author
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Daranporn Triwongwaranat, Rungsima Wanitphakdeedecha, Woraphong Manuskiatti, Sasima Eimpunth, and Supenya Varothai
- Subjects
Adult ,medicine.medical_specialty ,Erythema ,Visual analogue scale ,Melasma ,Dermatology ,Patient assessment ,Melanosis ,Young Adult ,Asian People ,Humans ,Medicine ,Dual wavelength ,In patient ,Low-Level Light Therapy ,Adverse effect ,Aged ,business.industry ,Middle Aged ,Thailand ,medicine.disease ,Hyperpigmentation ,Lasers, Gas ,Female ,medicine.symptom ,business ,Facial Dermatoses - Abstract
SummaryBackground Recent evidence suggests that vascular abnormalities are involved in the pathogenesis of melasma. Copper bromide (CuBr) laser, which emits dual wavelengths (511 and 578 nm), enabling simultaneous and selective destruction of melanin-containing cells and blood vessels, may be of benefit in the treatment of melasma. Aim To investigate the efficacy and adverse effects (AEs) of CuBr laser for melasma treatment in patients with skin phototypes III–V. Methods We enrolled 24 Thai women with melasma to receive six CuBr laser treatments, 2 weeks apart. Objective (colour measurement) and subjective (clinical evaluation of photographs by three dermatologists blinded to the order of the photographs) assessments were obtained at baseline, after three and six treatments, and at the 3-month follow-up visit. A visual analogue scale (VAS) was used for patient assessment of change at baseline, after six treatments and at the 3-month follow-up. AEs were recorded at every follow-up visit. Results Of the 24 patients, 20 completed the study. Mean melanin index (MI) showed no statistically significant improvement compared with baseline measurements at any of the follow-up visits. There were significant improvements in clinical evaluation after three treatments (P = 0.00); however, this difference was no longer visible after six treatments. At follow-up 1 week after the end of the full course of six treatments, there was an improvement in VAS (P = 0.02). However, there was no improvement as measured by clinical evaluation or MI. Mild, transient AEs including erythema, burning sensation, scaling, hyperpigmentation and crusting were noted. Conclusions CuBr laser did not show effectiveness in improving melasma in patients with skin phototypes III–V.
- Published
- 2014
18. Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the décolletage
- Author
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Ane Massaki, Mitchel P. Goldman, Sasima Eimpunth, Sabrina G. Fabi, and Janice M. Pogoda
- Subjects
Adult ,Moderate to severe ,Orthodontics ,medicine.medical_specialty ,business.industry ,Ultrasonic Therapy ,Ultrasound ,Small sample ,Dermatology ,Wrinkle reduction ,Middle Aged ,Thorax ,Skin Aging ,Visualization ,Surgery ,Patient satisfaction ,Rhytidoplasty ,Humans ,Medicine ,Female ,medicine.symptom ,business ,Wrinkle ,Postinflammatory hyperpigmentation ,Aged - Abstract
Laxity and rhytides are manifestations of photodamage on the chest.We sought to evaluate efficacy and safety of microfocused ultrasound with visualization treatment of décolletage laxity and rhytides.In all, 24 subjects with moderate to severe rhytides, as measured by a validated 5-point photonumeric scale (Fabi/Bolton Chest Wrinkle Scale), received microfocused ultrasound with visualization treatment. Efficacy was measured at 90 and 180 days by the Fabi/Bolton Chest Wrinkle Scale, mid-clavicular to nipple distance, masked assessment, Physician and Subject Global Aesthetic Improvement Scales, and patient satisfaction. Adverse events were recorded.Rhytides improved over time (P.0001), with 46% and 62% of subjects showing a 1- to 2-point improvement at days 90 and 180, respectively. Mean (SD) mid-clavicular to nipple distance decreased (P.0001), from 20.9 (1.57) cm to 19.8 (1.50) cm and 19.5 (1.59) cm, at days 90 and 180, respectively. At day 90, 100% were improved by Subject Global Aesthetic Improvement Scale score (P.0001) and 96% were improved by Physician Global Aesthetic Improvement Scale score (P.0001), with similar findings at day 180. All subjects were satisfied or very satisfied at day 90, with similar results at day 180. Improvement by masked assessment at day 90 was 71%.Single-center study, small sample size, and only Fitzpatrick skin types I and II enrolled were limitations.There was appreciable efficacy and patient satisfaction after a single microfocused ultrasound with visualization treatment in wrinkle reduction and lifting of the décolletage.
- Published
- 2013
19. Comparison of Fractional Erbium-Doped Yttrium Aluminum Garnet and Carbon Dioxide Lasers in Resurfacing of Atrophic Acne Scars in Asians
- Author
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Thanawan Iamphonrat, Woraphong Manuskiatti, Sasima Eimpunth, and Rungsima Wanitphakdeedecha
- Subjects
Adult ,Male ,medicine.medical_specialty ,chemistry.chemical_element ,Scars ,Lasers, Solid-State ,Dermatology ,Statistics, Nonparametric ,law.invention ,Erbium ,Cicatrix ,Young Adult ,Asian People ,Hyperpigmentation ,law ,Abdomen ,Acne Vulgaris ,medicine ,Humans ,Single-Blind Method ,Acne scars ,Co2 laser ,business.industry ,Cerebral Palsy ,Significant difference ,Atrophic scars ,General Medicine ,Yttrium ,Middle Aged ,Laser ,Surgery ,Treatment Outcome ,chemistry ,Erythema ,Face ,Multivariate Analysis ,Lasers, Gas ,Microcephaly ,Female ,Atrophy ,medicine.symptom ,Nuclear medicine ,business ,Follow-Up Studies - Abstract
Background The efficacy of fractional erbium-doped yttrium aluminum garnet (Er:YAG) and carbon dioxide (CO2) lasers are well substantiated. Objective To compare the efficacy and safety of these two laser systems for treatment of atrophic scars in dark-skinned patients. Materials and Methods Twenty-four subjects with acne scars were randomly treated with a fractional Er:YAG laser on one side and a fractional CO2 laser on the other side. All subjects received two treatments with a 2-month interval. Objective and subjective assessments were obtained at baseline and 1, 3, and 6 months after the final treatment. Results At the 6 month follow up, 55% and 65% of Er: YAG and CO2 laser sites, respectively, were graded as having more than 50% improvement of scars. Improvement progressed significantly from 1- to 6-month follow-up (p
- Published
- 2013
20. A focused review on acne-induced and aesthetic procedure-related postinflammatory hyperpigmentation in Asians
- Author
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R. Wanitphadeedecha, Woraphong Manuskiatti, and Sasima Eimpunth
- Subjects
medicine.medical_specialty ,business.industry ,Treatment options ,Dermatology ,medicine.disease ,Infectious Diseases ,Quality of life ,medicine ,Primary treatment ,Cutaneous inflammation ,medicine.symptom ,business ,Postinflammatory hyperpigmentation ,Acne - Abstract
Postinflammatory hyperpigmentation (PIH) is a common consequence following cutaneous inflammation in dark-skinned individuals with Fitzpatrick skin phototypes (SPTs) III–VI. The exact pathogenesis of this condition is unknown, but is believed to be an integral part of the normal response of the skin to inflammatory stimuli. PIH can last from months to years and may significantly impair quality of life of affected individuals. The primary treatment of PIH is prevention and treatment of the underlying inflammatory condition. In addition to prevention, there are a variety of medication and procedures used to treat PIH. Although topical skin-depigmenting agents remain the treatment of choice for PIH, lasers and light sources may be an effective adjunctive therapy or alternative for treatment failures. When treating PIH, any treatment options selected should be optimized and utilized carefully because the treatments itself may worsen the PIH.
- Published
- 2012
21. The effect of pre-operative topical anaesthetic cream on the ablative width and coagulative depth of ablative fractional resurfacing laser
- Author
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Rungsima Wanitphakdeedecha, Panitta Sitthinamsuwan, Woraphong Manuskiatti, Weeranut Phothong, Penvadee Pattanaprichakul, Preawphan Punyaratabandhu, Sasima Eimpunth, and Visnu Lohsiriwat
- Subjects
medicine.medical_specialty ,Administration, Topical ,Dermatology ,Lasers, Solid-State ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,law ,Ablative case ,Preoperative Care ,medicine ,Humans ,030212 general & internal medicine ,Anesthetics ,Skin ,Laser Coagulation ,business.industry ,Topical anaesthetic ,Laser ,Pre operative ,Surgery ,Coagulative necrosis ,Female ,Nuclear medicine ,business - Abstract
Topical anaesthetic cream (TAC) is commonly used as a pre-treatment of ablative fractional resurfacing (AFR) laser. Most of anaesthetic cream contains distilled water as major component. Therefore, pre-operative TAC may interfere the photothermal reaction in the skin treated with fractional carbon-dioxide (FCO2) laser and fractional erbium-doped yttrium aluminium garnet (FEr:YAG) laser. The objective of the study was to compare the ablative width (AW) and coagulative depth (CD) of AFR laser with and without pre-treatment with TAC. Four Thai females who underwent abdominoplasty were included in the study. The excised skin of each subject was divided into four areas. TAC (eutectic mixture of local anaesthesia; EMLA) with 1-h occlusion was applied only on the first and second areas. The first and third areas were treated with FCO2 at 15 mj and 5% density. The second and fourth areas were treated with FEr:YAG at 28 J/cm2 and 5% density. Six biopsied specimens were obtained from each area. A total of 96 specimens (24 specimens from each area) were collected from four patients and examined randomly by two dermatopathologists. The ablative width and coagulative depth from each specimen were determined. In FCO2-treated specimens, the mean AW of the specimens that were pre-treated with TAC and control was 174.86 ± 24.57 and 188.52 ± 41.32 μm. The mean CD of the specimens that were pre-treated with TAC and control was 594.96 ± 111.72 and 520.03 ± 147.40 μm. There were no significant differences in AW and CD between both groups (p = 0.53 and p = 0.15). In FEr:YAG-treated specimens, the mean AW of the specimens that were pre-treated with TAC and control was 381.11 ± 48.02 and 423.65 ± 60.16 μm. The mean CD of the specimens that were pre-treated with TAC and control was 86.03 ± 29.44 and 71.59 ± 18.99 μm. There were no significant differences in AW and CD between both groups (p = 0.16 and p = 0.24). The pre-treatment with TAC provided no statistically difference from the control group on AW and CD of both FCO2 and FEr:YAG laser irradiation. However, there was a tendency to have narrower AW and deeper CD of the areas that were pre-treated with TAC when comparing to that of the control.
- Published
- 2016
22. Nonmelanoma Skin Cancer With Aggressive Subclinical Extension in Immunosuppressed Patients
- Author
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Gagik Oganesyan, Shang I Brian Jiang, Arisa E. Ortiz, Alina Goldenberg, Sasima Eimpunth, and Silvia Soohyun Song
- Subjects
Male ,medicine.medical_specialty ,Skin Neoplasms ,medicine.medical_treatment ,HIV Infections ,Dermatology ,Preoperative care ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Immunocompromised Host ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Mohs surgery ,Humans ,Subclinical infection ,Aged ,Retrospective Studies ,Aged, 80 and over ,Immunosuppression Therapy ,business.industry ,Cancer ,Immunosuppression ,Retrospective cohort study ,Odds ratio ,Middle Aged ,medicine.disease ,Mohs Surgery ,Transplant Recipients ,Surgery ,030220 oncology & carcinogenesis ,Hematologic Neoplasms ,Female ,Skin cancer ,business ,Immunocompetence - Abstract
Immunosuppression (IS), such as in solid-organ transplant recipients (SOTRs) and patients with human immunodeficiency virus (HIV) or hematologic malignant neoplasms, increases the risk of developing nonmelanoma skin cancers (NMSCs). However, it is unknown whether IS patients are at increased risk of developing NMSCs with aggressive subclinical extensions (NMSC-ASE), which may extend aggressively far beyond conventional surgical margins.To study clinical characteristics of NMSC-ASE among immunocompetent (IC) and various subgroups of IS patients and to suggest a predictive model for NMSC-ASE lesions.A 6-year retrospective review of 2998 NMSC cases between February 26, 2007, and February 17, 2012, at the Dermatologic and Mohs Micrographic Surgery Unit of the University of California, San Diego, Medical Center. Nonmelanoma skin cancers that required at least 3 Mohs micrographic surgery stages with final surgical margins of at least 10 mm were defined as ASE lesions. All cases were categorized into 1 of 2 groups, IS or IC. Immunosuppressed cases were further subcategorized into 3 subgroups: SOTRs and patients with HIV or hematologic malignant neoplasm. The data were analyzed in December 2012.We evaluated the odds ratio of having NMSC-ASE lesions in IS patients (SOTRs, HIV, hematologic malignant neoplasm) compared with IC patients. Other clinical characteristics and preoperative risks were analyzed and compared.Of all 2998 cases, we identified 805 NMSC-ASE cases: 137 IS and 668 IC. Immunosuppressed patients had an odds ratio of 1.94 of having ASE lesions compared with IC patients (95% CI, 1.54-2.44; P .001). Additionally, the SOTR subgroup was associated with a 2.74 odds of having NSMC-ASE compared with non-SOTRs (95% CI, 2.00-3.76; P .001), and the presence of hematologic malignant neoplasm was associated with 1.74 times the odds compared with IC patients (95% CI, 1.04-2.90; P = .04). Multivariate analysis found older age (P .001), lesion locations such as zone 1 (OR, 1.39 [95% CI, 1.04-1.85]; P = .02) or zone 2 (OR, 1.45 [95% CI, 1.08-1.94]; P = .01), and IS status (OR, 1.94 [95% CI, 1.54-2.44]; P .001) to be significant predictors of ASE.The findings of this study suggest an increased risk for NMSC-ASE lesions in IS patients, especially in SOTRs and those with hematologic malignant neoplasm, but not patients with HIV. Statistically significant predictors of NMSC-ASE lesions such as age, location, and IS status can help physicians choose the most appropriate treatment modalities and optimize surgical planning.
- Published
- 2016
23. Tender cutaneous nodules of the legs: diagnosis and clinical clues to diagnosis
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Punkae Mahaisavariya, Panitta Sitthinamsuwa, Sasima Eimpunth, Piyaroj Sethabutra, Penvadee Pattanaprichakul, and Leena Chularojanamontri
- Subjects
Erythema nodosum ,medicine.medical_specialty ,Pathology ,biology ,business.industry ,Leukemia cutis ,Retrospective cohort study ,Dermatology ,Mycobacterium abscessus ,biology.organism_classification ,medicine.disease ,Leiomyoma ,medicine ,Mycobacterium fortuitum ,medicine.symptom ,Vasculitis ,business ,Mycobacterium leprae - Abstract
Background “Tender cutaneous nodules of the legs” is a common manifestation in dermatology. Histopathological investigation is usually required for this condition, because clinical data are frequently insufficient to make a definite diagnosis. Objective To identify and analyze the causes of patients presenting with tender leg nodules and to reveal clinical clues that could help to differentiate causes. Materials and methods The medical records and histopathological slides of patients presenting with tender cutaneous nodules of the legs between January 2005 and December 2007 were retrospectively reviewed. Results Of the total of 154 patients, 122 (79.2%) were female. Definite diagnoses were categorized into four groups: inflammation (84.4%); infection (5.8%); tumor (6.5%); and nonspecific (3.2%). The most common cause in the inflammation group was erythema nodosum. The infections found were Acremonium spp., Penicillium sp., Mycobacterium abscessus, Mycobacterium fortuitum and Mycobacterium leprae. The tumors included leiomyoma, leukemia cutis, and lymphomas. Clinical data that correlated with and could be used as clues for the inflammation group were female sex (P = 0.03, OR 6.43) and lower leg involvement (P = 0.03, OR 7.14). Limitations The retrospective manner of this study is a limitation. Conclusion Various inflammatory conditions, infections, and tumors can present as tender cutaneous nodules of the legs. Female sex and lower leg involvement were clinical data that could be used as clues for the diagnoses in the inflammation group. However, histopathological investigation is still crucial to determine a definite diagnosis in patients presenting with tender cutaneous nodules of the legs.
- Published
- 2012
24. A split axilla comparison study of axillary hair removal with low fluence high repetition rate 810 nm diode laser vs. high fluence low repetition rate 1064 nm Nd:YAG laser
- Author
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Sasima Eimpunth, Rungsima Wanitphakdeedecha, Piyaroj Sethabutra, Woraphong Manuskiatti, and Kanchalit Thanomkitti
- Subjects
medicine.medical_specialty ,Low fluence ,Repetition (rhetorical device) ,business.industry ,medicine.medical_treatment ,Dermatology ,Laser ,Fluence ,law.invention ,Axilla ,Infectious Diseases ,medicine.anatomical_structure ,law ,Nd:YAG laser ,medicine ,sense organs ,Nuclear medicine ,business ,Laser hair removal ,Diode - Abstract
Background A low fluence, high repetition rate 810 nm diode laser using constant motion technique has been recently introduced with advantages of less treatment discomfort and fewer side effects compared with traditional laser hair removal. Objective To compare hair reduction and side effects of low fluence high repetition rate 810 nm diode with high fluence low repetition rate 1064 nm Nd:YAG lasers. Methods Forty-nine subjects were randomly received five monthly treatments with diode laser on one side of their axilla and long-pulsed Nd:YAG laser on the other side. Hair count was recorded at baseline, 1- and 6-month follow-up visits. Results Percentage of axillary hair reduction at 1-month follow-up visit after receiving diode and Nd:YAG laser treatment were 71.0% and 82.3%, respectively, and at 6-month follow-up were 35.7% and 54.2%, respectively. There were significant differences in hair reduction between both laser systems at 1- and 6-month follow-ups (P
- Published
- 2011
25. Surgical smoke in dermatologic surgery
- Author
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Sasima Eimpunth, Gagik Oganesyan, Shang I Brian Jiang, and Silvia Soohyun Kim
- Subjects
Smoke ,medicine.medical_specialty ,Electrosurgery ,Practice patterns ,business.industry ,medicine.medical_treatment ,Dermatologic Surgical Procedures ,Objective data ,Dermatology ,General Medicine ,Gas Chromatography-Mass Spectrometry ,United States ,Surgical smoke ,Occupational Exposure ,Surveys and Questionnaires ,Medicine ,Dermatologic surgery ,Humans ,Surgery ,Particulate Matter ,Practice Patterns, Physicians' ,business - Abstract
Background Potential dangers associated with smoke generated during electrosurgery have been described. However, the use of smoke management in dermatology is unknown. There is no objective data showing the amount or the composition of the smoke generated in dermatologic surgeries. Objective To assess the use of smoke management in dermatologic surgery and provide data on the amount and chemical composition of surgical smoke. Methods A total of 997 surveys were sent to dermatologic surgeons across the United States to assess the use of smoke management. Amounts and concentrations of particulates and chemical composition were measured during electrosurgery using a particulate meter and the Environmental Protection Agency-standardized gas chromatography-mass spectrometry analysis. Results Thirty-two percent of the surgeons responded to the survey, and 77% of the respondents indicated no use of smoke management at all. Only approximately 10% of surgeons reported consistent use of smoke management. Active electrosurgery produced significant amounts of particulates. In addition, surgical smoke contained high concentrations of known carcinogens, such as benzene, butadiene, and acetonitrile. Conclusion Surgical smoke contains toxic compounds and particulates. Most dermatologic surgeons do not use smoke management within their practices. Raising the awareness of the potential risks can help increase the use of smoke management.
- Published
- 2014
26. Treatment of melasma with the 1,927-nm fractional thulium fiber laser: a retrospective analysis of 20 cases with long-term follow-up
- Author
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Richard E. Fitzpatrick, Sabrina G. Fabi, Isabella Guiha, Ane Massaki, William Frederick Groff, and Sasima Eimpunth
- Subjects
Adult ,medicine.medical_specialty ,Melasma ,Dermatology ,Lasers, Solid-State ,Severity of Illness Index ,Melanosis ,Patient satisfaction ,Refractory ,Fiber laser ,Severity of illness ,medicine ,Humans ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Hyperpigmentation ,Surgery ,Treatment Outcome ,Patient Satisfaction ,Female ,medicine.symptom ,business ,Postinflammatory hyperpigmentation ,Follow-Up Studies - Abstract
Background Melasma is a common acquired symmetrical hyperpigmentation that is often recurrent and refractory. Objectives To investigate the efficacy and safety of a single administration of high-density fractional thulium fiber laser (1,927 nm) for the treatment of refractory melasma in 20 patients. Materials and Methods A retrospective chart and photographs review of 20 women (Fitzpatrick skin type II–IV) with clinical diagnosis of melasma treated with the 1,927-nm fractionated thulium laser at 10 or 20 mJ/cm2, with 60–70% surface area coverage. Four investigators independently evaluated Melasma Area Severity Index (MASI) scores before, 4 weeks, 3–6 months, and 6–12 months after treatment. Results Mean MASI scores decreased dramatically from 13.2 ± 5.4 before treatment to 8.5 ± 3.5 at 4 weeks after laser treatment (P = 0.004). Patient assessment revealed that 12 of the 20 subjects had more than 50% clearance of their melasma. Recurrence was reported by 7 out of 15 patients who were successfully followed-up (mean 10.2 months). Two patients developed postinflammatory hyperpigmentation that subsided with topical bleaching after 3 months. Conclusion High-density coverage fractional 1,927-nm thulium laser proved to be safe and effective for melasma with long-term remission. Lasers Surg. Med. 45: 95–101, 2013. © 2012 Wiley Periodicals, Inc.
- Published
- 2012
27. The efficacy in melasma treatment using a 1410 nm fractional photothermolysis laser
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Sasima Eimpunth, Rungsima Wanitphakdeedecha, Woraphong Manuskiatti, and N. Keoprasom
- Subjects
Adult ,medicine.medical_specialty ,Erythema ,Melasma ,Visual analogue scale ,business.industry ,Laser treatment ,Dermatology ,Middle Aged ,medicine.disease ,Hyperpigmentation ,Melanosis ,Index score ,Infectious Diseases ,medicine ,Humans ,Female ,Laser Therapy ,medicine.symptom ,business ,Adverse effect ,After treatment - Abstract
Background Melasma treatment modalities including topical and procedural therapy have been employed with variable results and high recurrence rate. Objective To quantitatively assess improvement in melasma and side effects after 1410 nm fractional photothermolysis laser treatments and to determine efficacy at 1-, 2- and 3-month follow-up after treatment. Methods Thirty volunteers with melasma were treated with 1410 nm fractional photothermolysis for four passes on full face and additional four passes on melasma area. They were randomly treated on one side of their face with 20 mJ at 5% coverage and the other side of their face with 20 mJ at 20% coverage. All subjects were treated monthly for five times. Melanin index, Visual analogue scale and Melasma Area and Severity Index score were measured at baseline and 1-, 2- and 3-month follow-up after complete treatment protocol. Results There was statistically significant improvement of Melanin index at 2- and 3-month follow-up visits, but not at 1-month follow-up visit. Visual analogue scale and Melasma Area and Severity Index score improved significantly on both sides at 1-, 2- and 3-month follow-ups. The overall patients' satisfaction was significantly higher on the side treated with 20 mJ, 5% coverage. Adverse reactions included erythema, dryness and post-inflammatory hyperpigmentation on melasma area. Those side effects were significantly more intense on the side treated with 20 mJ, 20% coverage. Conclusions 1410 nm fractional photothermolysis laser treatment is a safe and temporary effective procedure for melasma; however, long-term follow-up is still needed. Only 5% coverage should be used to minimize risks of adverse effects.
- Published
- 2012
28. The effects of mucopolysaccharide polysulphate on hydration and elasticity of human skin
- Author
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Woraphong Manuskiatti, Rungsima Wanitphakdeedecha, and Sasima Eimpunth
- Subjects
medicine.medical_specialty ,Both forearms ,Article Subject ,integumentary system ,business.industry ,Human skin ,Dermatology ,lcsh:RL1-803 ,Placebo group ,Surgery ,Double blind ,medicine.anatomical_structure ,Forearm ,Anesthesia ,Dry skin ,lcsh:Dermatology ,medicine ,medicine.symptom ,Elasticity (economics) ,business ,Mucopolysaccharide polysulphate ,Research Article - Abstract
Background. Mucopolysaccharide polysulphate (MPS) has been used in medicine as an anti-inflammatory and antithrombotic agent for over 50 years. Its chemical structure permits considerable hydrogen bonding with adjacent water molecules, which effectively leads to hydration of the surrounding tissue. In addition, it stimulates endogenous hyaluronate synthesis, resulting in an increase in water-binding capacity and viscoelasticity of the skin.Objective. To study the efficacy of 0.1% MPS on hydration and elasticity of human skin.Methods. The first part of this study was a randomized double blind placebo-controlled study which included 60 female volunteers aged 30–45 years with dry skin, defined by Corneometer CM 825. The volunteers were treated with either 0.1% MPS or vehicle control. All subjects were asked to apply 1 g of cream to their face twice daily for a total period of 4 weeks. Skin hydration and elasticity were measured at baseline and week 4 with Corneometer CM 825 and cutometer MPA 580, respectively, at forehead and both cheeks. The second part of this study focused on the efficacy of 0.1% MPS on skin hydration after single application. 20 female volunteers aged 30–45 years with dry skin, defined by Corneometer CM 825, were recruited to the study. All subjects were asked to apply 2 g of 0.1% MPS cream on entirely randomly selected forearm. Skin hydration at the middle of both forearms was measured at baseline, immediately after application, and every 1 hour after application for a period of 10 hours.Results. 57 subjects (28 in vehicle control group, 29 in MPS) completed treatment protocol. The baseline skin hydration of both groups was not significantly different (P=0.47). Hower, there was a statistically significant difference in skin hydration at 4 weeks between MPS and placebo group (P=0.01). Skin elasticity was significantly improved at week 4 in both groups (vehicle-control,P<0.01, and MPS,P<0.01). However, no significant difference in skin elasticity between MPS and vehicle-control group was noted (P=0.15). Lastly, there was a statistically significant improvement in skin hydration after a single application (P<0.01). This improvement was maintained for 10 hours.Conclusions. MPS provided improvement of skin hydration but not skin elasticity in woman with dry skin, compared with vehicle control. And MPS improved the skin hydration for at least 10 hours after single application.
- Published
- 2011
29. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians
- Author
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Ratchathorn Mornchan, Penpun Wattanakrai, and Sasima Eimpunth
- Subjects
Adult ,Male ,medicine.medical_specialty ,Melasma ,Administration, Topical ,chemistry.chemical_element ,Skin Pigmentation ,Dermatology ,Lasers, Solid-State ,Neodymium ,Melanosis ,law.invention ,Asian People ,law ,medicine ,Humans ,Low-Level Light Therapy ,Hypopigmentation ,Skin ,Low fluence ,business.industry ,General Medicine ,Yttrium ,Middle Aged ,medicine.disease ,Laser ,Hyperpigmentation ,Combined Modality Therapy ,Hydroquinones ,Treatment Outcome ,chemistry ,Surgery ,Female ,Dermatologic Agents ,medicine.symptom ,business - Abstract
BACKGROUND Pigment lasers have been used in melasma with unsatisfactory results. OBJECTIVE To determine the effectiveness and safety of 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QS-Nd:YAG) laser treatment of melasma in Asians. MATERIALS AND METHODS Split-face randomized study comparing combination QS-Nd:YAG laser and 2% hydroquinone with topical treatment in dermal or mixed-type melasma. Twenty-two patients were treated with 1,064-nm QS-Nd:YAG laser, 6-mm spot size, 3.0- to 3.8-J/cm2 fluence for five sessions at 1-week intervals. Pigmentation was objectively recorded using a colorimeter (lightness index score), and subjective assessments were evaluated using the modified Melasma Area and Severity Index (mMASI) score. RESULTS After five laser treatments, statistically significant improvement of melasma from baseline was observed in colorimeter (p
- Published
- 2010
30. Effect of Cold Air Cooling on the Incidence of Postinflammatory Hyperpigmentation After Q-Switched Nd:YAG Laser Treatment of Acquired Bilateral Nevus of Ota–like Macules
- Author
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Rungsima Wanitphakdeedecha, Sasima Eimpunth, and Woraphong Manuskiatti
- Subjects
Adult ,medicine.medical_specialty ,Skin Neoplasms ,Dermatology ,Nevus of Ota ,law.invention ,Hyperpigmentation ,law ,Humans ,Medicine ,Nevus ,Low-Level Light Therapy ,Aged ,business.industry ,Incidence (epidemiology) ,General Medicine ,Middle Aged ,medicine.disease ,Laser ,Q-switching ,Cold Temperature ,Nd:YAG laser ,Female ,Facial Neoplasms ,medicine.symptom ,business ,Nuclear medicine ,Postinflammatory hyperpigmentation - Abstract
Objective To investigate the effect of cold air cooling on the incidence of postinflammatory hyperpigmentation (PIH) after laser treatment in Asian patients. Design Randomized, controlled, split-face study. Setting Skin laser center of a university hospital. Patients Twenty-three Thai women with acquired bilateral nevus of Ota–like macules. Interventions Patients were treated using a 1064-nm Q-switched Nd:YAG laser at an average fluence of 7.0 J/cm 2 using a 3-mm spot size. The same laser fluence was used on both sides of the face in individual patients. One randomly selected face side of each patient was cooled using a cold air cooling device during and 30 seconds before and after laser irradiation, and the other side was irradiated without cooling. Main Outcome Measures Occurrence of PIH was objectively evaluated by measuring the melanin index using a spectrometer, and it was subjectively assessed by 2 nontreating physicians before treatment and once weekly for 4 weeks. Results Of the 21 patients who completed the study, 13 (62%) and 5 (24%) developed PIH on the cooled and uncooled sides, respectively. One patient (5%) had PIH on both the cooled and uncooled sides, and 2 (10%) did not experience PIH. The cooled sides were significantly more likely to become hyperpigmented after laser irradiation than the uncooled sides (relative risk, 2.6; 95% confidence interval, 1.13-6.00; P = .03). The clinical evaluation corresponded to the spectrometer reading. Conclusion Epidermal cooling with cold air is associated with an increased risk of PIH after Q-switched Nd:YAG laser treatment. Trial Registration clinicaltrials.gov Identifier:NCT00287001
- Published
- 2007
Catalog
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