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Thomas E Rohrer

Publications and source records attributed to Thomas E Rohrer.

14 recordsLinked to original sources
PubMed2006

Striae and pelvic relaxation: two disorders of connective tissue with a strong association.

Pelvic relaxation, a weakening of pelvic support structures, is an under-reported condition that affects a multitude of women. In the United States alone, more than 338,000 procedures for prolapse are performed annually. Decreased collagen content has been noted in the tissues of women affected by this condition. Interestingly, biopsy specimens of women with striae also show a diminution of collagen. Using self-reported anonymous data, we compared the prevalence of striae in women with and without pelvic relaxation to see if an association between these two disorders of connective tissue existed. More than half the women with prolapse (54.7%) (n = 41) reported striae, whereas only 25.0% of women in the non-prolapse group (n = 8) reported striae (P < 0.01). Multivariate logistic regression analysis confirmed striae as a significant risk factor for the development of clinical prolapse (odds ratio 3.12, P < 0.05). There appears to be a strong association between the presence of striae and the development of pelvic relaxation, which is unrelated to conventionally cited risk factors, such as age, weight, number of pregnancies, or postmenopausal status.

Adult↗
PubMed2006

Novel cutaneous uses for botulinum toxin type A.

Botulinum toxin type A is a neurotoxin produced by the bacterium Clostridium botulinum which causes a flaccid muscle paralysis. It has been used extensively in the field of dermatology for the treatment of dynamic rhytides and in the treatment of hyperhidrosis. Botulinum toxin has an excellent safety profile and few side effects when used for these purposes. Recently, botulinum toxin has also been used experimentally in a number of other dermatologic conditions with good results. These conditions include: persistent facial flushing, gustatory sweating and epiphora, anal fissures, familial benign pemphigus (Hailey-Hailey disease), dyshidrotic eczema, and following surgical wound closures. While randomized, controlled prospective trials are still needed to further understand the efficacy and safety of botulinum toxin in these conditions, anecdotal and case report data suggest that botulinum toxin is both safe and efficacious in these and many other procedures.

Administration, Cutaneous↗
PubMed2005

Use of lasers and light-based therapies for treatment of acne vulgaris.

Over the last two decades, lasers and light-based therapies have been developed to treat a wide variety of cutaneous maladies. Given the prevalence and number of patients who suffer from refractory acne, alternatives to existing care are constantly sought after. In this review, we discuss the evidence currently available to justify the use of laser and light-based modalities and conclude that in combination therapy, such approaches provide a safe and effective treatment for acne vulgaris.

Acne Vulgaris↗
PubMed2005

Lasers and light therapy for acne vulgaris.

Acne vulgaris remains an emotionally and debilitating dermatologic disease, and is conventionally treated with a variety of oral and topical therapies with a number of significant side effects. An evolving understanding of laser-tissue interactions involving Propionibacterium acnes-produced porphyrins, and the development of infrared nonablative lasers to target sebaceous glands, has lead to the development of an escalating number of laser, light and radiofrequency devices for acne. Used as monotherapy or in combination, these devices are showing promise as a method to clear acne in a convenient, non-invasive manner, though there remains a clear need for long-term data and randomized, blinded studies.

Acne Vulgaris↗
PubMed2005

Transposition flaps in cutaneous surgery.

BACKGROUND: Transposition flaps are powerful reconstructive tools that are frequently called on in cutaneous reconstruction. Transposition flaps tap into adjacent areas that may have relative laxity while redirecting the vectors of tension during closure. OBJECTIVE: As with the closure of any surgical defect, the goal is to achieve the best possible functional and esthetic result. MATERIALS AND METHODS: Manual manipulation is used to "feel" for areas of relative laxity and test the effects of various tension vectors on adjacent structures. Every effort should be made to avoid distortion of the free margins of structures such as the nose and eyelids. Consideration must be taken to best camouflage incision lines within existing lines or creases, at the junction of cosmetic units, or at least parallel to lines of relaxed skin tension. CONCLUSIONS: A complete knowledge of the possible variations and modifications of transposition flaps can help fine-tune the execution of the flap to provide the patient with the best possible result. Good surgical technique and proper wound eversion through meticulous suture placement also help tremendously in consistently attaining esthetically pleasing results. At the surgical bedside, an artistic eye should meet the science of cutaneous biomechanics.

Humans↗
PubMed2004

The new age of acne therapy: light, lasers, and radiofrequency.

BACKGROUND: Current treatments for acne vulgaris include topical and oral medications that counteract microcomedone formation, sebum production, Propionibacterium acnes, and inflammation. Concerns about the short- and long-term consequences of these medications, along with technological advancements, have to significant progress in the management of acne. These developments include light, laser, and radio frequency, which may offer faster onset of action, equal or greater efficacy, and greater convenience than traditional approaches. CONCLUSION: Research emphasizing long-term follow-up and comparative, randomized trials is necessary to determine whether these emerging technologies will become a viable alternative to standard therapies such as antibiotics.

Acne Vulgaris↗
PubMed2004

Does pulse stacking improve the results of treatment with variable-pulse pulsed-dye lasers?

BACKGROUND: It has been suggested that multiple stacked pulses of lower fluence may have a similar effect on targets as a single pulse of higher fluence. When treating vascular lesions, increasing the fluence beyond a certain point will increase the risk of purpura given a constant pulse duration. Stacking pulses of lower fluence may have the advantage of heating vessels to a critical temperature without creating purpura. OBJECTIVE: To determine whether stacking low-fluence pulses of a variable-pulse pulsed-dye laser would improve clinical results without significantly increasing side and adverse effects. METHODS: Twenty-five patients between the ages of 18 and 65 years with facial telangiectasia and skin types I-IV were enrolled in the study. For each subject, the cheek or nasal ala areas on either side of the facial midline with similar telangiectasia density ratings were randomized to single pulse and multiple stacked pulse groups. One side of the cheek or nasal ala was treated with single nonoverlapping pulses with the Candela Vbeam 595-nm pulsed-dye laser. The opposite side of the cheek or nose was treated with the same parameters but with three or four pulses stacked on top of each other at a 1.5-Hz repetition rate. Patients were asked to rate the pain of the procedure on each side on a 0 to 3 scale. Investigators rated the erythema and edema after the procedure as well as vessel clearing and overall telangiectasia density scale at 1 and 6 weeks after the procedure. RESULTS: Twenty-three patients completed the study. The mean pain rating was 1.58 for the pulse stacked side and 1.38 for the single-pass side. The mean erythema score after the procedure was 1.17 for the pulsed stacked side and 1.09 for the single pulsed side. The mean vessel clearing 1 week after the treatment was 74.3% for the pulse stacked side and 58.5% for the single pulsed side. The mean vessel clearing 6 weeks after the treatment was 87.6% for the pulse stacked side and 67.4% for the single pulsed side. The mean telangiectasia density scale score before treatment was 2.67 for the pulse stacked side and 2.59 for the single pulsed side. At 1 week after treatment, the mean telangiectasia density scale score was 1.06 for the pulsed stacked side and 1.5 for the single pulsed side. At 6 weeks after treatment, the mean telangiectasia density scale score was 0.72 for the pulsed stacked side and 1.30 for the single pulsed side. No patients experienced purpura in either group, and there were no cases of hyperpigmentation, hypopigmentation, or scar formation. One patient experienced significant edema on the side of the cheeks treated with pulse stacking. CONCLUSIONS: Treating superficial facial telangiectasia with a pulse stacking technique may improve clinical results without significantly increasing adverse effects.

Adolescent↗
PubMed2003

Can patients treat themselves with a small novel light based hair removal system?

BACKGROUND AND OBJECTIVES: This study was designed to evaluate the safety and effectiveness of a small, low energy light based system for hair removal, when used by non-healthcare professionals ("patients") for self treatment in home-like environment following instructions and guidance provided by a physician. STUDY DESIGN/MATERIALS AND METHODS: A total of 73 patients between the ages of 19 and 54 years with skin types I through IV were enrolled in the study out of which 67 completed the study. Two treatment sites were chosen from among the arms, axilla, legs, bikini, back, belly, chest or face. The hair on the sites was trimmed and photographed. Each patient performed two self-treatments, using the hair removal device on their designated body sites, under the Investigator's direction. The first self-treatment was performed at the Investigator's office by the patient while the second self-treatment was performed 4 weeks later at a hotel room, simulating the home environment. Follow-up visits to evaluate the safety and efficacy of the treatments were performed 2 and 12 weeks following the last self-treatment. RESULTS: The mean hair reduction was 33.6%, 4 weeks after the first self-treatment, 44.3%, 2 weeks following the last self-treatment, and 32.3%, 12 weeks following the last treatment. All the noted side effects were mild and transient. Transient erythema was noted in 47.5% of the patients. Other transient side effects reported include edema (5%), hyperpigmentation (4.75%), crusting (2.35%), hypopigmentation (1.55%), and blistering (1.4%). All noted side effects were resolved by the 12-week follow-up visit. CONCLUSIONS: With adequate training and instruction, patients may administer self-treatments for hair removal with this small light based unit in a safe and effective manner.

Adult↗
PubMed2003

Planning the closure.

Consistently achieving aesthetically pleasing closures of the skin requires a significant amount of forethought and planning. In addition to understanding the regional anatomy, recognizing and respecting free margins, cosmetic unit junctions, and skin tension lines are all of critical importance.

Face↗
PubMed2002

Evaluating the efficacy of using a short-pulsed erbium:YAG laser for intraoperative resurfacing of surgical wounds.

BACKGROUND AND OBJECTIVE: There are many studies demonstrating the aesthetic benefits of resurfacing a wound 4-8 weeks following surgical closure. Several anecdotal reports have been published stating that resurfacing a wound at the time of closure is also of cosmetic benefit. Our study was designed to evaluate the effects of resurfacing wound edges at the time of surgical closure. STUDY DESIGN/MATERIALS AND METHODS: Ten patients with skin types I-III undergoing reconstruction on the head or neck using a complex linear closure of at least 4 cm in length were enrolled in the study. Following the placement of subcutaneous sutures and an intradermal running suture, a split scar study was designed. Half of the wound was left as a control and half of the wound was resurfaced with a short pulsed Erbium:YAG laser. Both sides were treated with a hydrogel dressing. Follow-up evaluations were performed 1 week, 1 month, and 3 months post-operatively. The wound was evaluated for any adverse reactions. The degree of erythema, textural misalignment or tissue mismatch, and overall aesthetic appearance of both sides of the scar were evaluated and scored. RESULTS: There were no incidents of infection, dehiscence, hematoma, necrosis, or reaction to the dressing during the study. There was a trend towards greater erythema in the resurfaced half of the scar at the 1 week and 1 month evaluation. There was a trend towards less tissue mismatch and better overall aesthetic appearance of the side of the scar that had been resurfaced. The differences however were not statistically significant. CONCLUSION: Given the time and resources necessary to perform an intraoperative resurfacing procedure on the wound edges, it may be more reasonable to withhold resurfacing procedures for those few cases that may require it postoperatively (patients with a history of poor healing, highly sebaceous areas, etc.). When good operative technique is used, most surgical wounds on the head and neck heal very well with excellent aesthetic outcomes without any additional intervention.

Adult↗
PubMed2002

Granuloma faciale successfully treated with long-pulsed tunable dye laser.

BACKGROUND: Granuloma faciale has been treated in the past with different modalities but the majority have had the risk of scarring. OBJECTIVE: Based on the principle of selective photothermolysis, we considered using the newer long-pulsed tunable dye laser for the treatment of granuloma faciale to target the vessels and minimize scarring. METHODS: Confirmation of the diagnosis by a punch biopsy of the lesion was followed by three treatments on separate occasions 6 weeks apart with the long-pulsed tunable dye laser. RESULTS: There was significant flattening of the lesions after two treatments, with complete clearing after the third. No scarring was detectable and there was no recurrence in the 9-month follow-up. CONCLUSION: We conclude that granuloma faciale may be successfully treated with the long-pulsed tunable dye laser with minimal risk of scarring, especially in cosmetically sensitive areas.

Facial Dermatoses↗
PubMedDate not supplied

Laser treatment of vascular lesions.

Laser treatment of vascular lesions remains one of the more common applications of lasers in dermatology. In fact, lasers have largely become the treatment of choice for vascular birthmarks such as hemangiomas and port-wine stains and the definitive treatment of the telangiectatic form of rosacea. The range of congenital and acquired vascular lesions effectively treated with lasers continues to expand.

Humans↗