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Biomedical subjects

R K Roenigk

Publications and source records attributed to R K Roenigk.

At least 19 recordsLinked to original sources
PubMed1992

Carbon dioxide laser surgery for skin disease.

Since it was developed in the 1960s, the carbon dioxide (CO2) laser has had an important role in the practice of dermatology. The CO2 laser has some advantages over conventional techniques used in dermatologic surgical treatment. It routinely provides a bloodless surgical field as well as unusual surgical precision. Although the CO2 laser is specifically indicated for certain conditions, in other situations, only marginal benefit may be noted in comparison with standard techniques such as scalpel surgical procedures, dermabrasion, cryosurgery, and electrosurgery. In this article, we briefly review the history and physics of the CO2 laser, its operation, and safety principles and discuss dermatologic conditions that are treated with the CO2 laser. We also describe 8 representative cases from our experience with more than 800 cases of CO2 laser treatment in the practice of dermatology at the Mayo Clinic since 1986.

Adult↗
PubMed1992

Cutaneous micrographic surgery: Mohs procedure.

Skin cancer is an increasingly serious public health issue that affects a high percentage of the population. Surgical resection is still standard treatment for skin cancer, but for difficult cases, cutaneous micrographic surgery, originally described by Mohs, is our preferred technique because of the routine methodic accuracy for evaluation of the surgical margin, the high rate of oncologic cure, and the tissue-sparing quality of the procedure. We report the Mayo Clinic experience with cutaneous micrographic surgery from July 29, 1986, through June 30, 1991, which consisted of 3,355 cases (principally basal cell and squamous cell carcinoma). Herein we discuss practical concerns about this procedure: duration of the technique, reconstruction, cure rates, tumors best treated by cutaneous micrographic surgery, and cost. In addition, we review the Mayo Clinic multidisciplinary management of difficult skin cancers.

Adult↗
PubMed1992

Focal mucinosis (myxoid cyst). Surgical therapy.

Myxoid cysts typically arise in association with distal interphalangeal joint arthritis. When myxoid cysts become problematic, surgical excision is a standard treatment with a high cure rate and few complications. The origin, anatomy, and alternative medical and surgical treatment options are discussed.

Humans↗
PubMed1991

Spectrum of results after treatment of rhinophyma with the carbon dioxide laser.

Between 1986 and 1989, 30 patients with rhinophyma were treated with the carbon dioxide (CO2) laser at our institution. The duration of disease ranged from 1 to 20 years, and the duration of follow-up ranged from 1 to 4 years. All the patients were men, and all had fair skin (predominantly type I skin); their mean age was 63 years. Patients with minor and moderate rhinophyma were treated with CO2 laser vaporization only, whereas patients with major rhinophyma were treated sequentially with CO2 laser excision and then vaporization. A spectrum of long-term results is presented. Although dilated pores developed in many patients, no re-treatment with the CO2 laser was necessary. In one patient each, leukoderma, unilateral alar lift, and mild hypertrophic scarring developed. In general, use of the CO2 laser is effective for precise decortication of rhinophyma in an office-outpatient setting.

Adult↗
PubMed1991

Office dermatologic surgery and laser therapy.

As the result of a dramatic increase in the incidence of skin cancer and the need for effective outpatient surgical treatment, dermatology is now a surgical as well as a medical specialty, and many procedures are commonly performed on an outpatient basis. Mohs micrographic surgery is used to remove basal cell and squamous cell carcinomas, and the resulting cure rates are high. Excisional biopsy can facilitate the early diagnosis of melanoma, while it is still in clinical stage I. Carbon dioxide lasers are commonly used to destroy epidermal lesions and yellow light lasers to destroy hemangiomas or other vascular malformations. Facial chemical peel (chemexfoliation) with trichloroacetic acid can improve the appearance of photoaged skin.

Biopsy↗
PubMed1991

Diagnostic and therapeutic nail surgery.

The function of the nail unit is as a protective covering over the dorsal distal end of the digit. Some basic disease processes affecting the nail unit and the surgical techniques used for diagnosis and treatment are reviewed.

Anesthesia, Local↗
PubMed1991

Regional anesthesia of the hand for dermatologic surgery.

The basic principles of regional and local anesthesia of the hand are reviewed, and safe and effective methods for outpatient dermatologic procedures and three representative cases are discussed with respect to anatomy, local anesthetic agents, and techniques. Block techniques are preferred to local infiltration because they provide complete and long-lasting anesthesia more comfortably.

Adult↗
PubMed1991

Nerve blocks for cutaneous surgery on the foot.

Anesthesia for cutaneous surgery on the foot is often achieved by local infiltration. However, procedures that involve large surface areas are anesthetized more effectively with peripheral nerve blocks. This discussion of peripheral nerve blocks for the feet includes an overview of the relevant sensory innervation, a brief discussion of local anesthetics, a description of the techniques, and representative cases.

Adult↗
PubMed1990

Management of superficial squamous cell carcinoma of the lip with Mohs micrographic surgery.

Forty-one patients were treated with Mohs micrographic surgery for well-differentiated superficial squamous cell carcinoma of the lip; 34 had closure of their surgical site by a mucosal advancement flap, and five were allowed to heal by second intention. Cases were limited to T1N0M0 or T2N0M0, these being early superficial lesions. Primary closure by mucosal advancement provides cosmetic and functional healing for these lesions. The combination of Mohs micrographic excision and mucosal advancement closure may be considered standard office or outpatient surgical management of these common tumors.

Adult↗
PubMed1990

Actinic cheilitis. Treatment with the carbon dioxide laser.

Actinic cheilitis is a premalignant condition that can be treated in several ways. A total of 43 patients with biopsy-proven actinic cheilitis were treated with the carbon dioxide (CO2) laser. After follow-up of at least 10 months, 26 patients thought that the lip was cosmetically improved, and 40 thought that the function of the lip was improved or had not changed. Complications were few and included only mild hypertrophic scarring, which resulted most often from the diagnostic biopsy and was corrected with topical or intralesional steroids or no therapy except simple massage. The CO2 laser is a simple, inexpensive, effective therapy for actinic cheilitis.

Adolescent↗
PubMed1990

Recalcitrant periungual verrucae: the role of carbon dioxide laser vaporization.

Recalcitrant periungual verrucae (24 lesions) in 17 patients were vaporized with the carbon dioxide laser. The lesions had been present for 1 to 15 years and treated an average of nine times previously. Vaporization of these warts, in combination with partial or complete nail avulsion, resulted in complete cures in 71% of patients who had one or two treatments. The cure rate was 94% when the patients who had clearing after one or two laser treatments in combination with other therapies are included. Further follow-up indicates that infection and significant onychodystrophy are uncommon. Pain occurs, but in most cases it is short lived and manageable.

Adolescent↗
PubMed1990

Carbon dioxide laser vaporization of recalcitrant symptomatic plaques of Hailey-Hailey disease and Darier's disease.

Carbon dioxide laser vaporization of localized, recalcitrant intertriginous plaques was done in two patients with Hailey-Hailey disease and two patients with Darier's disease. After treatment, only one patient had recurrence in one treatment site. All patients had significant clinical and symptomatic improvement. Destructive treatment must include the follicular infundibulum in Darier's disease, because histologically this was the focus of recurrent disease at one treated site. We suggest carbon dioxide laser vaporization for the treatment of chronic, localized, symptomatic plaques of Hailey-Hailey or Darier's disease, if medical therapy has been ineffective.

Adult↗
PubMed1990

Current surgical management of skin cancer in dermatology.

Skin cancer has become a major public health problem in the United States and worldwide. Epidemiologic studies confirm a continued increase in the number of basal cell carcinomas, squamous cell carcinomas, and malignant melanomas. Dermatologists, the primary caretakers of the skin, manage skin cancer with various modalities that have been time tested and found reliable, including excision, electrosurgery, cryosurgery, and Mohs micrographic surgery. Extirpative procedures for basal cell carcinoma and squamous cell carcinoma are considered with attention to cure, restoration of function, and cosmesis--in that order. The dermatologic management of melanoma is critical because early diagnosis and treatment of thin lesions has been the only effective improvement in melanoma management in the last several decades. Wide excision, with a 1-3-cm margin, of thin stage I melanoma has moved surgical management from the operating room to the outpatient surgical setting. Management of these increasingly common problems, as reviewed here, is principally responsible for the growth of surgical practice as a subspecialty of dermatology.

Carcinoma↗
PubMed1990

Know your anatomy: perineural involvement of basal and squamous cell carcinoma on the face.

Knowledge of facial anatomy, particularly innervation, is basic to performing dermatologic surgery. There are clinical implications for cutaneous oncology (tumor spread), anesthesia, and postoperative complications, such as motor or sensory deficits. Perineural invasion of the facial nerves by squamous and basal cell carcinomas (SCCs and BCCs) occurs occasionally. We present three representative cases of both sensory and motor nerve involvement by SCC and BCC. The anatomy of the nerve supply of the face is summarized and the literature on perineural invasion by SCC and BCC is reviewed.

Aged↗
PubMed1989

Recurrent pyogenic granuloma with satellitosis.

The development of recurrent pyogenic granulomas as multiple satellite lesions is rare and often associated with trauma or treatment of the primary lesion. At least 34 cases of such lesions after various treatment modalities have been reported, but none occurred in conjunction with laser therapy. We report a case of recurrent pyogenic granuloma with satellite lesions that developed after carbon-dioxide laser excision of a previously recurrent lesion.

Cephalexin↗