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Alternative methods for the reconstruction of small-to-intermediate scalp defects include rotation, advancement, transposition, bipedicled, and V-Y advancement flaps. Scalp defects not amenable to primary closure can be difficult to restore, due to the poor mobility of the scalp tissue and the frequent occurrence of actinic damage. [Extracted from the article]

Summary Background Fractional resurfacing is a laser treatment modality to create numerous microscopic thermal injury zones of controlled width, depth, and density that are surrounded by a reservoir of spared epidermal and dermal tissue, allowing rapid repair of laser-induced thermal injury. Objective To evaluate the safety and efficacy of a fractional CO2 laser system in the treatment of photo-damaged skin with clinical, histological, and ultrastructural evaluation, with special attention to one of the parameters of this laser system: the fluences. Materials and methods Twelve patients with Fitzpatrick skin types II to III with photo-damage skin underwent fractional laser treatment with one single-pass superficial on the face and forearm. Clinical outcome and histological and ultrastructural changes were assessed. Results Light microscopy of biopsies gave important information about skin changes at three different times after fractional treatment, especially revealing some differences between the fluences used in the three groups of patients. Conclusion Fractional resurfacing offers significant surgical advantages allowing to achieve excellent esthetic results in balance with the biological structure. Besides, our study shows already that with 2.07 and 2.77 J/cm2, instead of 4.15 J/cm2, it is possible to reach a biological response without scar formation. [ABSTRACT FROM AUTHOR]

Background: The CO 2 laser has become the gold standard treatment in dermatologic surgery for the treatment of a large number of skin and mucosal lesions. The introduction of the fractional micro-ablative technology represented an integration to the ablative resurfacing technique, reducing the healing time and the side effects., Objective: Vaginal rejuvenation performed with this technique is a minimally invasive procedure that stimulates internal tissues of the female lower genital tract to regenerate the mucosa, improving tissue trophism and restoring the correct functionality., Methods: In our experience, 386 menopausal women affected with vulvo-vaginal atrophy (VVA) were treated with three section of fractional micro-ablative CO 2 laser., Results: After three treatments, patients reported a complete improvement of the symptoms (59.94% dryness, 56.26% burn, sensation, 48.75% dyspareunia, 56.37% itch, 73.15% soreness, and 48.79% vaginal introitus pain)., Conclusions: Fractional micro-ablative CO 2 laser seems to reduce symptoms related to vaginal atrophy. The beneficial effects were reported just after the first session and confirmed 12 months after the last session.

Objectives: To determine homocysteine (Hcy) serum levels in patients with cutaneous lupus erythematosus (CLE) and a possible correlation with the disease activity., Methods: Ninety-three patients with LE and 30 healthy controls were included in the study. For each patient, disease activity was calculated and plasma levels of Hcy was measured by enzymatic colorimetric assay., Results: Forty-six patients had chronic cutaneous LE (CCLE), 14 had LE tumidus (LET), 17 had subacute CLE (SCLE) and 16 had SLE. Median values [25°-75° percentile] were 7[4-9] for CCLE, 3.5[2.3-4.8] for LET, and 8[7-10] for SCLE; for SLE the RCLASI score was 7.5[4.8-13] and the SELENA/SLEDAI score was 10.5[9-13.3]. HHcy was present in 73.9% of patients with CCLE, 35.7% with LET, 82.4% with SCLE, 81.2% with SLE, 20% of healthy controls. Overall, patients with LE showed a higher median serum Hcy level than the control group (15[13-18.2] vs. 11[8.8-12.2], p<0.001). There was a significant correlation between Hcy serum levels and disease activity, both in patients with CLE and SLE., Conclusions: We demonstrated that Hcy levels were higher in patients with different forms of CLE and correlated with disease activity calculated by CLASI. Therefore, HHcy could be related to LE pathogenesis and might be a triggering factor in predisposed individuals.

Objectives: Entheseal involvement is a frequent and distinctive feature of psoriatic arthritis (PsA), and is often under-diagnosed. The aim of the present study is to investigate using ultrasound (US), lower limb entheseal abnormalities in patients with early psoriatic arthritis (ePsA) and to evaluate their correlation with ePsA clinical characteristics., Methods: Ninety-two ePsA patients (with duration of symptoms less than 1 year), diagnosed according to CASPAR criteria, were consecutively scored with Glasgow Ultrasound Enthesitis Scoring System (GUESS) and Power Doppler (PD) US (My Lab 70 Esaote) of lower limbs entheses (quadriceps, patellar, achilles tendons and plantar fascia). Patients were clinically examined by palpation of lower limbs entheses, Maastricht Ankylosing Spondylitis Enthesitis Index (MASES) and total Psoriasis Area and Severity Index (PASI). Correlations were investigated between GUESS and PD with other ePsA clinical characteristics (duration of symptoms and morning stiffness, pain and fatigue visual analogue scale [VAS], Health Assessment Questionnaire SpA-modified [S-HAQ])., Results: All patients had GUESS>1 and 40.2% showed positive PD signal on entheses, at a higher percentage than tenderness revealed by clinical examination (29.3%). GUESS and PD did not correlate with MASES, PASI and other clinical characteristics. No significant differences in GUESS and PD were detected between positive or negative findings of MASES and PASI., Conclusions: US detects subclinical entheseal involvement in ePsA, independently of ePsA clinical examination and symptoms.