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Biomedical subjects

J K Geisse

Publications and source records attributed to J K Geisse.

10 recordsLinked to original sources
PubMed1999

Therapeutic response of basal cell carcinoma to the immune response modifier imiquimod 5% cream.

BACKGROUND: Basal cell carcinoma (BCC) responds to interferon therapy. Imiquimod is a cytokine and interferon inducer. OBJECTIVE: This randomized, double-blind pilot trial evaluated the safety and efficacy of imiquimod 5% cream versus vehicle in the treatment of BCC. METHODS: In this population of 35 patients with BCC, 24 received imiquimod 5% cream and 11 received vehicle cream in 1 of 5 dosing regimens for up to 16 weeks. Six weeks after treatment, an excisional biopsy of the target site was performed. RESULTS: BCC cleared (on the basis of histologic examination) in all 15 patients (100%) dosed twice daily, once daily, and 3 times weekly; in 3 of 5 (60%) patients dosed twice weekly; 2 of 4 (50%) dosed once weekly; and in 1 of 11 (9%) treated with vehicle. Adverse events were predominantly local reactions at the target tumor site, with the incidence and severity of local skin reactions declining in groups dosed less frequently. CONCLUSION: Imiquimod 5% cream shows clinical efficacy in the treatment of BCC.

Adult↗
PubMed1995

Treatment of adenoma sebaceum with the copper vapor laser.

BACKGROUND: Angiofibromas of the central part of the face (adenoma sebaceum) occur pathognomonically in tuberous sclerosis, causing significant cosmetic and hygienic morbidity. Treatment has included excision, dermabrasion, cryosurgery, carbon dioxide laser, and argon laser. Copper vapor lasers emit light at 511 nm (green) ad 578 nm (yellow), useful for treating pigmented and vascular lesions, respectively. OBJECTIVE: Because of the vascular nature and progressive pigmentation of adenoma sebaceum, we examined the utility of the copper vapor laser in treating this disorder. METHODS: Nine patients with adenoma sebaceum were treated with the copper vapor laser. Individual lesions were treated with the yellow light (578 nm) at 0.4 to 0.6 mW. Pigmented lesions or lesions resistant to treatment were treated with the green light (511 nm) at 0.4 to 0.9 mW. Intervals between treatments were at least 6 weeks. RESULTS: Good to excellent cosmetic results were seen in all treated patients. Scarring or hyperpigmentation occurred in none of the patients. Most patients required additional treatments with the copper vapor laser as new lesions developed. CONCLUSION: The copper vapor laser is safe and effective for the treatment of adenoma sebaceum in tuberous slerosis.

Adenoma↗
PubMed1994

The dermatologic surgical suite.

In summary the size, layout, surgical lighting, and operative table are the most important variables in providing a comfortable, efficient surgical suite. Each physician will develop their own likes and dislikes when using and experimenting with various instruments and surgical devices. Wherever possible, trial periods should be obtained before committing excessive funds to major purchases. Nothing replaces personal experience in making such selections. A well-equipped, well-designed surgical suite improves the experience for both patients and the dermatologic surgeon.

Dermatology↗
PubMed1994

Biopsy techniques for pigmented lesions of the skin.

Proper biopsy techniques for pigmented skin lesions are critical to early detection and treatment of malignant melanoma. Complete surgical excision allows evaluation of size, symmetry, circumscription, and maturation, whereas partial biopsies may result in misinterpretation because of sampling error or inadequate architectural detail. The author briefly reviews standard techniques for excisional biopsy and addresses special clinical scenarios in which incisional or partial biopsies may be necessary.

Biopsy↗
PubMed1993

510-nm pigmented lesion dye laser. Its characteristics and clinical uses.

BACKGROUND: Benign pigmented lesions are of a cosmetic concern to many individuals. Numerous treatments exist, including several types of lasers. The Candela 510 nm pigmented lesion dye laser has recently been added to this armamentarium. It is designed specifically for the treatment of superficial pigmented lesions while significantly decreasing the risk of scarring and prolonged hypopigmentation. OBJECTIVES: To describe the characteristics of the Candela pigmented lesion dye laser and report on the therapeutic outcome of patients treated for actinic lentigines, café-au-lait macules, melasma and red tattoos by one of the authors (RCG). METHODS: The Candela 510 nm pigmented lesion dye laser was used to treat solar lentigines, café-au-lait macules, melasma and red tattoo. RESULTS: Excellent outcomes resulted on facial and hand lentigines (89% and 88% of patients had greater than 75% clearing, respectively), but often required more than one treatment. Lentigines located on the upper extremities and trunk improved less dramatically. Immediate greying occurred universally. Bruising was often noted. Treatment failures have been observed especially in treating lentigines located on the lower extremities. Café-au-lait macules responded inconsistently, with facial lesions giving the best results. Melasma responded poorly, often with hyperpigmentation. Three red tattoos cleared. Treatment failure may be related to inaccurate clinical assessment of pigment depth or regrowth of the lesion. Several cases are presented to demonstrate clinical and histologic effects of the laser. CONCLUSION: The Candela 510-nm pigmented lesion dye laser is an effective treatment for superficial pigmented lesions. Its associated morbidity is minimal.

Adult↗
PubMedDate not supplied

Comparison of treatment modalities for squamous cell carcinoma.

Numerous treatment modalities exist for cutaneous SCC. Having a variety of modalities in our armamentarium is useful, but they should be selected carefully based on certain key clinical and histologic prognostic factors. The histologic parameters should be provided to you by your dermatopathologist and can direct the clinician to better tailor treatment to specific neoplasms and thus produce more predictable outcomes. By incorporating the available prognostic factors in the literature, we can develop a reproducible schema or algorithmic approach to the treatment of cutaneous SCC to provide the highest cure rates possible while minimizing the morbidity for our patients (see Table 1).

Carcinoma, Squamous Cell↗