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Biomedical subjects

Murad Alam

Publications and source records attributed to Murad Alam.

52 records · Page 3Linked to original sources
PubMed2003

Horizontal advancement flap for symmetric reconstruction of small to medium-sized cutaneous defects of the lateral nasal supratip.

BACKGROUND: Aesthetic repair of small cutaneous defects of the nose is a common challenge for the dermatologic surgeon because nonmelanoma cancers occur frequently in this location. OBJECTIVE: Our aim was to devise a simple flap for repair of small to medium-sized defects of the lateral nasal supratip. METHODS: The mechanics of the proposed horizontal advancement ("east-west") flap are described. Patient selection, flap design, and flap mechanics are discussed. The benefits and limitations of this repair are compared with those of alternative closures. RESULTS: The horizontal-advancement flap is an easily visualized, constructed, and executed flap that permits repair of small to moderately sized lateral nasal supratip defects without inducing asymmetry of the nasal architecture. The flap is well camouflaged in skin lines, the ala and nares are not distorted, and the large, untwisted pedicle contributes to flap viability. Large defects and defects far lateral to the midline may not be amenable to this repair. CONCLUSIONS: In selected patients with small to medium-sized lateral nasal supratip defects, the horizontal advancement flap is a simple, reliable, and aesthetically pleasing reconstruction option.

Humans↗
PubMed2003

The dermatologist's academic portfolio: a template for documenting scholarship and service.

The clinician-teacher of dermatology often seeks recognition for academic efforts, the most visible of which is a university appointment with the potential for promotion. Success in achieving this goal requires careful planning to ensure effective involvement in academic pursuits that serve the mission of the university, and there must be concomitant documentation of this involvement. The template in this article provides one format for organizing an academic portfolio that stimulates prospective documentation and enhances the possibility of academic advancement.

Career Mobility↗
PubMed2002

Pain associated with injection of botulinum A exotoxin reconstituted using isotonic sodium chloride with and without preservative: a double-blind, randomized controlled trial.

CONTEXT: Botulinum A exotoxin is used for various indications, including the treatment of dynamic forehead lines. OBJECTIVE: To determine whether injection with botulinum A exotoxin reconstituted with preservative-containing normal saline (isotonic sodium chloride) is less painful than injection with exotoxin that has been reconstituted with preservative-free saline. DESIGN: Two arms: (1) retrospective study; (2) double-blind, randomized controlled trial. SETTING: A multiple-physician dermatology practice. PATIENTS: (1) Retrospective study-20 consecutive adult patients presenting for treatment of upper-face dynamic lines; (2) prospective study-15 consecutive adult patients presenting for treatment of upper-face dynamic lines. INTERVENTION: In prospective study only, one side (left or right) of the face was treated with exotoxin reconstituted with preservative-containing saline, and the other side, with exotoxin reconstituted with preservative-free saline. MAIN OUTCOME MEASURES: (1) Retrospective study-discomfort at current treatment (with preservative-containing saline) compared with discomfort with most recent prior treatment (with preservative-free saline); (2) prospective study-discomfort on the side treated with preservative-containing saline compared with discomfort on the side treated with preservative-free saline. RESULTS: (1) Retrospective study-18 (90%) of 20 patients reported that treatment with exotoxin reconstituted with preserved saline was less painful than prior treatment with exotoxin reconstituted with preservative-free saline; (2) prospective study-15 (100%) of 15 patients reported less pain in the side of their face treated with exotoxin reconstituted with preservative-containing saline (P<.001). Pain on the preservative-containing side was 54% less. No difference in treatment efficacy between the sides was observed by investigators or patients. CONCLUSION: Use of preservative-containing saline to reconstitute botulinum A exotoxin can significantly decrease patient discomfort on injection.

Adult↗
PubMed2002

Glycolic acid peels compared to microdermabrasion: a right-left controlled trial of efficacy and patient satisfaction.

BACKGROUND: Glycolic acid peels and microdermabrasion are widely recommended by dermatologists and others for facial skin rejuvenation, but few studies have assessed their clinical efficacy. OBJECTIVE: To compare the relative efficacy of glycolic acid peels and microdermabrasion for facial skin rejuvenation. METHODS: An unblinded, randomized controlled trial was used. Each of 10 patients received paired treatments with glycolic acid peels (20%) and microdermabrasion (mild setting) for 6 consecutive weeks. The right and left sides of the face were treated with different modalities. Once a patient was assigned to receive a particular modality to a particular side of the face, all subsequent treatments were delivered in the same manner. Patient ratings, investigator ratings, and photographs were obtained before the first treatment and 1 week after the last treatment. RESULTS: In terms of overall preference for a given type of treatment, seven patients chose glycolic acid peels, one selected microdermabrasion, and two had no favorite treatment. The relative preference for glycolic acid peels approached significance (P =.0578). Investigator ratings and photographic comparisons did not reveal treatment-specific differences or significant improvement from baseline. No serious side effects were seen with either treatment, and even mild effects were seldom reported. CONCLUSION: In this study, patients appeared to prefer low-strength glycolic acid peels to low-intensity microdermabrasion for facial rejuvenation. Differences in patient satisfaction were subtle and may be technique dependent.

Adult↗
PubMed2002

Clinical application of lasers in Asians.

BACKGROUND: Laser surgery for Asians differs from that for Caucasians in several important respects. In Asians, some conditions such as nevus of Ota are frequently seen and certain adverse reactions, especially postinflammatory hyperpigmentation, tend to be more common. OBJECTIVE: This article reviews the use of different types of lasers and intense pulsed light (IPL) sources for the treatment of Asian patients. METHODS: Various cutaneous conditions amenable to laser treatment, including lentigines, nevus of Ota, acquired bilateral nevus of Ota-like macules, port-wine stains, and acne scarring, are discussed. Strategies for the management of postinflammatory hyperpigmentation are offered. RESULTS: Appropriate selection and careful planning of the treatment can lead to excellent clinical outcome. CONCLUSION: Lasers and intense pulsed light sources are important tools for the treatment of a wide range of cutaneous conditions in Asians.

Asian People↗
PubMed2002

Serious adverse vascular events associated with perioperative interruption of antiplatelet and anticoagulant therapy.

BACKGROUND: Antithrombotic medications may increase perioperative bleeding during cutaneous surgery. Whether to discontinue these medications before surgery is controversial. OBJECTIVE: To evaluate the available evidence in order to generate preliminary guidelines regarding the perioperative use of antithrombotics. METHODS: Presentation of two cases of adverse events after preoperative discontinuation of antithrombotics, review of current anticoagulant and antiplatelet drugs, and review of the literature concerning perioperative antithrombotics in cutaneous surgery. RESULTS: Perioperative withholding of antithrombotics in cutaneous surgery may be associated with serious adverse vascular events. Continuing antithrombotics in these circumstances does not appear to significantly increase bleeding complications. The complexity of available antithrombotics makes case-by-case determinations regarding their use difficult. CONCLUSION: Cutaneous surgeons should strongly consider perioperative continuation of patients' antithrombotic drugs. The final determination should be made by the surgeon after evaluation of the circumstances and, if necessary, consultation with other experts.

Aged↗
PubMed2002

Vitreous floaters following use of dermatologic lasers.

BACKGROUND: Laser eye protection has been designed to protect operators and patients from severe eye injuries. OBJECTIVE: To describe two cases in which lasers used for cutaneous therapy may have been associated with the induction of vitreous floaters, a subacute eye injury, in physicians operating these devices, and to review the theoretical feasibility of such injuries, prior reports of the same, and strategies for minimizing risk. METHODS: Report of two cases and review of the literature. RESULTS: Given the circumstantial evidence, it is possible that subacute vitreous injuries may be sustained by the operators of dermatologic lasers. Ex vivo experiments and previous case reports have demonstrated the possibility of laser-induced vitreous injury, including changes in vitreous conformation and vitreous hemorrhage, in the absence of permanent retinal deficits. It may be speculated that vitreous floaters are a milder manifestation of such subacute injuries. CONCLUSION: To the extent that vitreous floaters can multiply and presage the onset of severe retinal injury, the risk of their induction by dermatologic lasers should be minimized. Simple strategies and further research can help achieve this goal.

Adult↗
PubMed2002

Dermatologic surgery in geriatric patients: psychosocial considerations and perioperative decision-making.

BACKGROUND: Dermatologic surgery, both for cutaneous malignancies and for management of the visible signs of photodamage, is frequently performed on older persons. OBJECTIVE: To review common psychologic and physiologic limitations among the elderly that may affect their ability to tolerate cutaneous surgery and to outline a stepwise approach for management of these conditions during the perioperative period. METHODS: Literature review, MEDLINE (1966-2001) search, and personal experience. RESULTS: Communication with patients, their families, and their physicians, management of patients' underlying medical problems, and special sensitivity to patients' cognitive and physiologic limitations can minimize perioperative risk during cutaneous surgery in the elderly. CONCLUSION: Given appropriate physician management, elderly patients can usually safely undergo cutaneous surgery.

Aged↗
PubMed2002

Severe, intractable headache after injection with botulinum a exotoxin: report of 5 cases.

BACKGROUND: Botulinum A exotoxin is a safe agent in common use in dermatology. Occasionally, patients receiving botulinum toxin injections report postprocedure discomfort, including headaches. OBJECTIVE: Our purpose was to estimate the rate of severe headaches occurring after injection with botulinum toxin for dermatologic indications. METHODS: We used prospective monitoring of botulinum toxin injection outcomes in a single-site, 3-dermatologist practice. There was in-office and telephone follow-up of patients experiencing severe headaches. RESULTS: Approximately 1% of patients (4/320) receiving botulinum A exotoxin injections may experience severe, debilitating headaches. These may persist at high intensity for 2 weeks to 1 month before gradually fading. CONCLUSION: Botulinum A exotoxin injection may be associated with the development of life-altering headaches. Patients should be informed of this possibility.

Adult↗
PubMed2002

Airbag trauma induced cutaneous fistulae in a heart transplant patient.

In recent years, trauma resulting from airbag inflation has been reported to cause skin injuries. These include minor abrasions and lacerations, chemical and thermal burns, and irritant dermatitis. We report what we believe to be the first case of airbag related cutaneous fistulae in a heart transplant patient. We believe that the increasing frequency of placement of subcutaneous and relatively superficial appliances in transplant and other surgical patients will result in an increasing frequency of similar injuries. Dermatologists may be uniquely suited to identify and treat such cutaneous trauma.

Aged↗
PubMed2002

Gabapentin treatment of multiple piloleiomyoma-related pain.

Familial leiomyomatosis cutis et uteri may present with numerous cutaneous leiomyomas, or piloleiomyomas, which can be painful. Pharmacologic agents have had limited efficacy in mitigating leiomyoma-associated discomfort. We describe a case of familial piloleiomyomas in which intermittent pain at the site of the lesions was substantially reduced by the administration of oral gabapentin. The unusual unilateral distribution of leiomyomas in this case is discussed.

Acetates↗
PubMedDate not supplied

The development of actinic keratosis into invasive squamous cell carcinoma: evidence and evolving classification schemes.

Actinic keratosis is an incipient form of cutaneous squamous cell carcinoma. Consequently, actinic keratoses must be treated expeditiously to forestall their downward growth. Several classification schemes have been proposed to better categorize actinic keratoses, and to guide their diagnosis and treatment. Among these approaches is the "keratinocyte intraepithelial neoplasia" (KIN) system developed by Cockerell; Goldberg's concept of the "proliferative actinic keratosis" (PAK), and Berhane's emphasis on the "inflamed actinic keratosis" (IAK). In the future, disparate classification schemes may be unified into a single pragmatic approach which accurately reflects the biological process whereby actinic keratoses devolve into invasive squamous cell carcinoma.

Carcinoma, Squamous Cell↗