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C020 Cosmetic dermatologic surgery course
Courses
- European
Society
of Dermatological
European Society of Dermatological Surgery: Cosmetic Dermatological Surgery ElCO20 Cosmetic dermatologic surgery course D. Roseeuw. Akademisch
Ziekenhuis,
VUB, Brussels,
Surgery:
Cosmetic
Dermatological
Surgery
References
[l] Ditre CM, Griffin TD, Murphy GF et al J Am Acad Dermatol 1996; 34: 187-195. [2] Ghersetich I, Lotti T. Abstract Book 4th EADV Congress, Brussels, October 10-15, 1995, p.118.
Belgium
This session has as object to review the mechanism of aging and to discuss the new informations about this subject. The second part of the session will be devoted to the newest techniques of treating aged skin and rejuvination.
I CO23 Dermabrasion Ant6nio Silva Picoto. Portugal
ElCO21 Mechanisms of ageing G.E. Pierard, C. Pierard-Franchimont.
ElCO24 Skin resurfacing S. Letessier. Plastic Surgery Department,
Dermatopathology,
University
of Lidge,
Department Belgium
of
Florence,
University
Abstract not available.
Paris,
The unprecedented size of the elderly population compels research to understand the physiological changes related to skin ageing. A classical, yet oversimplified classification of cutaneous alterations contrasts intrinsic ageing and photoageing. That dual classification does not precisely distinguish the various mechanisms involved in skin ageing. Seven distinct influences have been described, namely the chronologic, genetic, actinic, behavioral, catabolic, endocrine and gravitational types. The chronologic ageing is explained in part by the progressive deletion of telomeres during cell division, and by the expression of gerontogenes. The ~53 and Cipl proteins are also key molecules in the ageing cell biology. The other aspects of ageing are most probably mediated by hormones, cytokines and various enzymes. Among them TNF-(r might be a good candidate explaining some aspects of the heliodermatosis. ElCO22 Light peelings I. Ghersetich. Department of Dermatology,
S63
of
Italy
Light peeling provokes epidermal injury with stratum comeum separation, upper epidermal intraepithelial and intercellular edema and minimal dermal changes. The primary indications are the treatment of wrinkles and photoaging, but this technique is also used in the treatment of acne and post-acneic scars, melasma, actinic keratosis and flat warts. Alpha hydroxy acids, especially glycolic acid, in concentrations of 70% or higher, induce epidermolysis. It has been suggested that glycolic acid also induces activation of fibroblasts to produce collagen and glycosaminoglycans (1). It has been also proved that it determines an increase in levels of Langerhans cells in the epidermis, thus justifying its use in preventing photocarcinogenesis in photoaged skin (2). Many studies are in progress in this field to prove the real efficacity of this substance, in particular compared to that of other substances, such as Jessner’s solutions, TCA and salicylic acid. Glycolic acid peeling seems to be less aggressive than both Jessner solution and 20% TCA peelings. In conclusion many substances are available and used for superficial peelings, but comparative studies establishing which substances are the most adequate and effective in treating the different skin disorders are still lacking.
Hospital
Saint-Louis,
France
Our experience of Laser resurfacing is now five years and represents more than one thousand cases for cosmetic surgery. All our patients have been treated by the Sharplan CO2 Laser. We think that it is actually the best procedure to realize a face abrasion for actinic damages, wrinkles or scars. It is a very predictable technic but is still an operator-dependant procedure. Complications can occur if the physician is not well trained. Pre and post operative care are most important to get a safe healing and better results. L-iCO25 Facial mole surgery for cosmetic purposes G. Landi. Dermatological Division, M. Bufalini Hospital, Cesena,
Italy
Melanocytic nevi and other benign lesions of the face are normally removed with an excisional biopsy to establish histologically their diagnosis and to prevent their possible transformation into malignancy. Elevated lesions subject to trauma are often excised for mechanical reasons. However, in most cases nevi are removed at any age only for cosmetic purposes. Alongside other cosmetic procedures, surgical removal of facial moles is frequently requested even by the elderly. The modality of surgical excision depends on the form and on the location of the mole. Elevated lesions are preferably removed by cold knife shave excision. Flat lesions, on the other hand, require a standard fusiform excision placed into the natural folds or wrinkles, respecting the cosmetic units of the face. The surgical defect should be repaired with a simple interrupted suture or for bigger lesions with a continuous subcuticular suture. References
[l] Lask GP, Moy RL: Principles and techniques of cutaneous surgery. McGraw-Hill, New York, 1996. [2] Robinson JK, Arndt KA, Leboit PE, Wintroub BU: Atlas of cutaneous surgery: Saunders, Philadelphia, 1996. [3] Wheelaud RG: Cutaneous surgery. Saunders, Philadelphia, 1994.
- European
Society
of Dermatological
European Society of Dermatological Surgery: Cosmetic Dermatological Surgery ElCO20 Cosmetic dermatologic surgery course D. Roseeuw. Akademisch
Ziekenhuis,
VUB, Brussels,
Surgery:
Cosmetic
Dermatological
Surgery
References
[l] Ditre CM, Griffin TD, Murphy GF et al J Am Acad Dermatol 1996; 34: 187-195. [2] Ghersetich I, Lotti T. Abstract Book 4th EADV Congress, Brussels, October 10-15, 1995, p.118.
Belgium
This session has as object to review the mechanism of aging and to discuss the new informations about this subject. The second part of the session will be devoted to the newest techniques of treating aged skin and rejuvination.
I CO23 Dermabrasion Ant6nio Silva Picoto. Portugal
ElCO21 Mechanisms of ageing G.E. Pierard, C. Pierard-Franchimont.
ElCO24 Skin resurfacing S. Letessier. Plastic Surgery Department,
Dermatopathology,
University
of Lidge,
Department Belgium
of
Florence,
University
Abstract not available.
Paris,
The unprecedented size of the elderly population compels research to understand the physiological changes related to skin ageing. A classical, yet oversimplified classification of cutaneous alterations contrasts intrinsic ageing and photoageing. That dual classification does not precisely distinguish the various mechanisms involved in skin ageing. Seven distinct influences have been described, namely the chronologic, genetic, actinic, behavioral, catabolic, endocrine and gravitational types. The chronologic ageing is explained in part by the progressive deletion of telomeres during cell division, and by the expression of gerontogenes. The ~53 and Cipl proteins are also key molecules in the ageing cell biology. The other aspects of ageing are most probably mediated by hormones, cytokines and various enzymes. Among them TNF-(r might be a good candidate explaining some aspects of the heliodermatosis. ElCO22 Light peelings I. Ghersetich. Department of Dermatology,
S63
of
Italy
Light peeling provokes epidermal injury with stratum comeum separation, upper epidermal intraepithelial and intercellular edema and minimal dermal changes. The primary indications are the treatment of wrinkles and photoaging, but this technique is also used in the treatment of acne and post-acneic scars, melasma, actinic keratosis and flat warts. Alpha hydroxy acids, especially glycolic acid, in concentrations of 70% or higher, induce epidermolysis. It has been suggested that glycolic acid also induces activation of fibroblasts to produce collagen and glycosaminoglycans (1). It has been also proved that it determines an increase in levels of Langerhans cells in the epidermis, thus justifying its use in preventing photocarcinogenesis in photoaged skin (2). Many studies are in progress in this field to prove the real efficacity of this substance, in particular compared to that of other substances, such as Jessner’s solutions, TCA and salicylic acid. Glycolic acid peeling seems to be less aggressive than both Jessner solution and 20% TCA peelings. In conclusion many substances are available and used for superficial peelings, but comparative studies establishing which substances are the most adequate and effective in treating the different skin disorders are still lacking.
Hospital
Saint-Louis,
France
Our experience of Laser resurfacing is now five years and represents more than one thousand cases for cosmetic surgery. All our patients have been treated by the Sharplan CO2 Laser. We think that it is actually the best procedure to realize a face abrasion for actinic damages, wrinkles or scars. It is a very predictable technic but is still an operator-dependant procedure. Complications can occur if the physician is not well trained. Pre and post operative care are most important to get a safe healing and better results. L-iCO25 Facial mole surgery for cosmetic purposes G. Landi. Dermatological Division, M. Bufalini Hospital, Cesena,
Italy
Melanocytic nevi and other benign lesions of the face are normally removed with an excisional biopsy to establish histologically their diagnosis and to prevent their possible transformation into malignancy. Elevated lesions subject to trauma are often excised for mechanical reasons. However, in most cases nevi are removed at any age only for cosmetic purposes. Alongside other cosmetic procedures, surgical removal of facial moles is frequently requested even by the elderly. The modality of surgical excision depends on the form and on the location of the mole. Elevated lesions are preferably removed by cold knife shave excision. Flat lesions, on the other hand, require a standard fusiform excision placed into the natural folds or wrinkles, respecting the cosmetic units of the face. The surgical defect should be repaired with a simple interrupted suture or for bigger lesions with a continuous subcuticular suture. References
[l] Lask GP, Moy RL: Principles and techniques of cutaneous surgery. McGraw-Hill, New York, 1996. [2] Robinson JK, Arndt KA, Leboit PE, Wintroub BU: Atlas of cutaneous surgery: Saunders, Philadelphia, 1996. [3] Wheelaud RG: Cutaneous surgery. Saunders, Philadelphia, 1994.