PubMed · 8705191
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R H Corbett, G Hart. 1996. A burning question.. https://doi.org/10.1259/0007-1285-69-821-482-a
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Sarcoidosis, a multisystem disease of unknown aetiology, is characterized by the formation of non-caseating granulomas which may involve any organ of the body. The commonest sites of predilection are the lungs, skin and lymph nodes. We now report a patient who presented with palmar erythema which on biopsy confirmed the presence of non-caseating granulomas and who responded to systemic corticosteroids. We are unaware of any previous report in the literature of sarcoidosis presenting in this way.
This paper presents a method for the evaluation of the distribution of the facial erythemal UV exposure and the erythemal UV exposure per unit area of the face using only eight dosimeters located on the vertex of the head, forehead, nose, chin, left and right ears and left and right cheeks. An overall picture of the parts of the face receiving high UV exposures is provided. The distribution of the erythemal UV exposure to the human face at a subtropical latitude was shown to change with time of year and with cloud cover. On two days with similar solar zenith angles, the ratio of the erythemal UV exposure to the nose compared with that on a horizontal plane changed from 0.47 to 0.84 with increased cloud cover. At the same time, the total erythemal exposure per unit area of the face dropped from 122 to 56 ml cm-2. Although the absolute exposures decreased, the nose received a relatively high exposure.
Each of the increasing number of resurfacing lasers uses a unique strategy to produce tissue ablation. Erbium:YAG (Er:YAG) lasers have been used in other applications for precise tissue removal with little thermal effect. Recovery time, duration of erythema, and clinical improvement were evaluated using an Er:YAG resurfacing laser (2.94-microm wavelength, 350-microsec pulse, 2 J, 3-5-mm spot). Twenty-five patients were treated with two passes to the full face and 3 to 5 passes to the most affected aesthetic unit. At each follow-up visit, percent epithelialization, erythema, and swelling were graded, and the presence or absence of complications was noted. Clinical improvement was evaluated at 6 months by optical profilometry on a subset of patients. Er:YAG resurfacing produced a transient whitening of dermis followed by a resumption of pink appearance. The surgical end point was judged by elimination of visible rhytids or presence of punctate bleeding. Bleeding from the dermal surface was encountered less than customarily in dermabrasion, but more than seen with carbon dioxide laser resurfacing. A moderate amount of tissue shrinkage was observable during the treatment. Mean period to full epithelialization was 6.9+/-0.97 days (range, 5-9 days). The mean duration of erythema (4.24+/-1.5 weeks) was relatively short compared with carbon dioxide resurfacing. Clinical improvement was 44+/-30% in the lateral canthal area and 55+/-22% in the upper lip area. There were no infections or hypertrophic scars. Hyperpigmentation and hypopigmentation was seen in 24% and 12% of patients respectively. Er:YAG resurfacing is a reliable means of obtaining rhytid improvement with less recovery time and duration of erythema compared with carbon dioxide resurfacing. The technique is significantly different from carbon dioxide resurfacing in selection of end point, number of passes, and energy settings.