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Objectives: To determine the pattern of histological findings in prostatic chips obtained from cases of enlarged prostate gland and to correlate the findings with PSA levels. Materials and Methods: It was a cross sectional descriptive study conducted in Northwest General Hospital , Peshawar from 1st January 2018 to 23rd December 2021. A total of 500 male cases with features of enlarged prostate, frequency, urgency and dribbling with mean age of 52 ± 12.3 years (range 45 -80 years) were included in the study. The prostatic biopsy specimens were obtained and PSA levels were done in all cases. The histological specimens were subjected to microscopic examinations and findings were recorded in proforma. The findings were correlated with the PSA levels. Mean and standard deviation were used for quantitative data. Frequency and percentages were used for qualitative data Results: Out of 500 cases of enlarged prostate, benign prostate hypertrophy was seen in 375 (75%) cases. 125 cases (25%) had micro invasive carcinoma prostate . All 375 cases of benign prostate hypertrophy had prostate specific antigen levels less than 4ng. Out of 125 cases of micro invasive carcinoma, 120 (96%) had PSA levels >10ng . Sensitivity of PSA at levels of 10ng/ml for prostatic carcinoma was 96%. Conclusion: Benign prostate hypertrophy is the commonest lesion in cases of prostate pathology. PSA is useful marker to determine the presence or absence of micro invasive carcinoma in patients with prostate hypertrophy. Keywords: Benign prostate hypertrophy, micro invasive carcinoma prostate, prostate specific antigen.

The Fraxel Dual laser system (Solta Medical, Inc., Bothell, WA) contains a 1,550 and 1,927 nm wavelength single handpiece with different indications for each wavelength.To discuss treatment setting recommendations and best practices for select on-label and investigational applications of the 1,550 and 1,927 nm dual laser system.Eight board-certified dermatologists with 10 or more years of experience with the 1,550 and 1,927 nm laser system completed an online survey about their clinical experience with the system and then participated in a roundtable to share clinical perspectives and best practices for using the laser system.For all Fitzpatrick skin types, treatment recommendations were described for selected approved indications for the 1,550 and 1,927 nm laser system, including both lasers in combination. Treatment recommendations were also reached for investigational applications with the 1,550 nm laser and 1,927 nm laser. Best practices for using the lasers during the treatment session to achieve optimal outcomes and decrease the post-treatment recovery time were compiled.The 1,550 and 1,927 nm dual laser system is effective for a wide range of aesthetic and therapeutic applications, on and off the face and across all Fitzpatrick skin types.

CONTEXT: The accuracy of colposcopy has recently been called into question particularly with regard to determining the site requiring biopsy. The technique of colposcopy is largely operator dependent, and the agreement between colposcopists is less reliable than once presumed. In an attempt to standardize colposcopy a new scoring system, the Swede score has been devised, which includes lesion size as a variable to be scored in addition to the 4 variables found in the modified Reids Colposcopic Index (RCI). AIM: To assess the diagnostic accuracy of Swede score for pre-invasive cervical lesion. SETTING AND DESIGN: A cross-sectional study in a tertiary care centre. METHOD: Swede score was calculated for assessment of pre-invasive cervical lesions on patients undergoing colposcopy who were suspected with pre-invasive cervical lesion. Cervical biopsy was taken if modified RCI ≥ 3 or Swede score ≥ 5. Histopathology report of the cervical biopsy was taken as gold standard. RESULTS: Swede scores of 5 or more had sensitivity, specificity, positive and negative predictive values of 94.9%, 88.4%, 75.5% and 92.9% respectively. CONCLUSION: The Swede score by just incorporating one additional variable that is size of the lesion, showed better correlation with histopathology.

Background Fractional laser treatment was introduced in 2004 as a non-invasive technique to treat sun-damaged and aging skin. Since then, numerous ablative and non-ablative photothermolysis technologies and devices have been introduced, increasing the options for clinicians and patients but also increasing the complexity regarding which system to use and the techniques to optimize outcomes. No two devices are the same and the user-manuals preset dosimetry does not address many clinical situations, which can create confusion for new and inexperienced users. Methods An online survey addressing use of a 1550 nm /1927 nm dual wavelength, non-ablative, fractional laser was sent to eight (8) US board certified dermatologists with extensive experience in the use of the device. The survey included 39 questions, addressing experience, best practices and recommendations for use. Results The survey data suggests that the device can be used to treat patients of all ages and skin types for indications including photoaging and photodamage, periorbital wrinkles, freckles, (ephelides), solar lentigines, poikiloderma, scarring due to acne or surgery. It can be used on both facial and non-facial areas, including neck, chest, hands, arms, abdomen, legs, and buttocks. Unexpected and adverse effects were rarely reported and those that did were mild and transient. Conclusions This position paper provides practical real-world guidelines resulting from a small survey of experienced users, for new and early uses of the novel 1550 nm /1927 nm dual wavelength, non-ablative, fractional laser. J Drugs Dermatol. 2021;20(11):1150-1157. doi:10.36849/JDD.6181.

Numerous lasers and other energy-based devices have been explored in the treatment of scarring. The following review of the literature examines types of post-operative scarring, features that distinguish scars from normal skin, the pathogenesis of these skin changes, the evidence for laser and other energy-based modalities in the treatment of postsurgical scars, scar prevention using lasers, and future directions for therapy. Utilization of laser and light-based therapies can induce scar remodeling and significantly improve scar appearance. Pulse dye lasers have been the mainstay in laser-based scar therapy. Fractional lasers have provided a major breakthrough in the treatment of scars in all skin types. Based on current research, the most efficacious laser therapies include pulsed dye laser for erythematous, hypertrophic, or keloidal scars; fractional non-ablative lasers for atrophic, hypopigmented scars in almost all skin types; and fractional ablative lasers for patients and clinicians who wish to maximize scar improvements while reducing downtime relative to fully ablative laser technologies.

Background:Diet diversity of pregnant women is associated with nutrition sufficiency, micronutrient adequacy, and pregnancy outcomes. However, the sociodemographic determinants of diet diversity among pregnant women in low-income countries are not well studied.Objective:The analysis was undertaken to study the determinants of high dietary diversity and consumption of micronutrient-rich foods by pregnant women from rural Bangladesh.Methods:Pregnant women (508) were randomly selected from southwestern Bangladesh and interviewed to collect data about diet and sociodemographic characteristics. A 24-hour recall was used to collect information about diet. Diet diversity score was calculated for 9 major food groups. All analyses were conducted using STATA SE 12.Result:The overall mean diet diversity score was low at 4.28 and was significantly high among pregnant women who have higher educational achievement, whose husbands’ occupation was business, who live in households of 4 or more family members, and who were dwelling in a house with more than 1 room. Highest gap on knowledge and consumption was reported for 3 food groups including dairy foods, eggs, and dark green leafy vegetables. Consumption of dairy and eggs was lower among women from low socioeconomic status, but no significant association was found between sociodemographic characteristics and consumption of leafy vegetables.Conclusion:Our analysis has shown that diet quality of pregnant women was poor and intake of micronutrient-rich foods was low despite having knowledge about the importance of these foods, underscoring the need for promoting the diet quality in developing countries through behavior change communication programs.

Background: Pregnancy induced hypertension (PIH) is associated with many other pathological complications. Pathological changes of this disease appear to be related to vascular endothelial dysfunction and its consequences. One such complication or effect of PIH is retinal changes.Methods: This observational study was conducted of 110 cases over a period of 12 months from March 2018 to February 2019 in department of obstetrics of gynecology in Kamla Raja Hospital, G. R. Medical College, Gwalior, Madhya Pradesh. All the patients who fulfilled the diagnostic criteria of PIH admitted in the obstetric ward.Results: Retinopathic changes were noted in 36.36% out of which grade I, grade II, grade III and grade IV have 11.82%, 8.18%, 10.19% and 5.45% cases respectively. In + proteinuria 10.9% of cases have positive findings, in ++ proteinuria 18.18% cases have positive findings, in +++ 7.27% cases have retinopathy but severity increases with a grade of proteinuria. 40% cases retinopathic changes of mild preeclampsia have positive finding, 36.36% in severe preeclampsia and 23.64% in cases of eclampsia. As overall severity of PIH increases retinopathies in patients increases.Conclusions: Visual symptoms are few in patients with PIH and often absent unless the macula is involved. Sudden onset of headache, which is resistant to routine therapy in these patients, may be the warning symptom before the onset of first convulsion. By repeated fundus examinations at regular intervals one can assess the severity of the disease and also response to treatment instituted.

Background: Chemoexfoliation, also known as chemical peeling, is a method of targeted cutaneous ablation using specific caustic agents that allow for rapid, predictable, and uniform thickness of chemoablation to a desired cutaneous depth, ultimately resulting in an improved appearance of skin. Objective: In this review, we provide an up-to-date analysis of all currently available chemical peels for dermatologic use, as well as a step-by-step instructional protocol for an algorithmic approach to treatment. Methods: A comprehensive search of the Cochrane Library, MEDLINE, and PUBMED databases was performed to identify relevant literature investigating chemical peeling agents. In addition, a search of all commercially available, prescription-based peeling agents was performed to identify all products currently available in the United States market. Results and Conclusion: Chemical peels are the third most commonly performed noninvasive cosmetic procedure in the United States, with over 1,300,000 procedures performed in 2016 alone. There has been a paradigm shift in recent years, with lasers largely supplanting deep peels. Despite this shift, superficial peels have proliferated in both popularity and product diversity.

We present a case of a 28-year-old woman second gravida with a full-term pregnancy who presented to us in active phase of labour with third degree uterovaginal prolapse complicated by entrapment of fetal head by dystocia of cervix and fetal distress. Patient was immediately shifted to the operation theatre and prompt delivery was conducted by giving Duhrssen’s incision on the highly vascular, oedematous prolapsed cervix. The outcome was an alive and healthy male baby. Duhrssen’s incision was stitched with minimal blood loss. Postnatal management included antibiotics and daily intravaginal packing. Patient was discharged along with the baby in satisfactory condition.

Poor IYCF (Infant and Young Children Feeding) practices are factors of poor nutrition among infants and young children in developing countries including Bangladesh. To address this problem, a national mass media campaign was launched using television channels along with home counseling. The study was designed to explore the effect of IYCF intervention on changing knowledge and practices of mothers in rural Bangladesh. The study used a cluster randomized trial design where six unions were randomized to allocate them to 'only mass media intervention (intervention-I)' or 'mass media + direct counseling (Intervention-II)'. Three unions were subjected to 'intervention-I' and the other three were subjected to 'intervention-II'. In intervention-I areas, the knowledge of initiation of breast feeding was improved by 8.5% and practice was improved by 23.7%. It was 17.9% and 16.6% respectively in intervention-II areas. In intervention-I areas knowledge about initiation of complementary feeding improved by 2.7% and in practice it was 19.3%. In intervention-II areas it was 8.6% and 21.3% respectively. Regarding giving the right quantity of complementary food, in intervention-I areas the improvement rate was 6.2% for children between 7-8 months old and 34% for children between 9-12 months old. In intervention-II areas it was 13.7% for children between 7-8 months old and 56.8% for children between 9-12 months old. Significant improvements were found in both the intervention areas, but changes were almost similar in both groups. Coverage of interpersonal communication was found to be very low. Improvement of IYCF knowledge and practice might be the contribution of mass media.South East Asia Journal of Public Health Vol.5(1) 2015: 18-24

Dermatologic surgery, including cancer surgery, cosmetic surgery, and laser and energy device procedures, is a well-established branch of dermatology known for minimally invasive, effective, and safe solutions to patient problems. Over time, clinical research pertaining to dermatologic surgery has improved in terms of methodologic rigor, with dermatologic surgery accounting for a large proportion of the comparative effectiveness studies and randomized controlled trials in dermatology. Further improvements in the quality of studies examining dermatologic surgery therapies will require understanding and overcoming several remaining challenges.

Nasopharyngeal carcinoma is a rare disease in children. It present with mass in the nasopharynx or neck swelling. Recently a six year old boy was diagnosed as a case of NPC and treated with standard chemotherapy. The boy was presented with neck swelling, palatal palsy and ear discharge. The patient was diagnosed by lymph node biopsy and immunohistochemistry. The diagnosis was delayed for 4 months which usually occur in our country. He was diagnosed by lymph node biopsy and immunohistochemistry. He was treated with standard protocol based chemotherapy.J. Paediatr. Surg. Bangladesh 4(1): 32-35, 2013 (January

Proper Infant and young child feeding is crucial for growth and development of an infant and child under two years. In Bangladesh government has taken many initiatives for improving nutritional status of children less than two years. One of them is mass media campaign. To evaluate the effectiveness of media campaign on Infant and Young Child Feeding (IYCF) in rural Bangladesh. An ecological study was conducted in a rural setting of Bangladesh during 2011. Higher proportion of mothers in intervention area had the right knowledge on initiation of breastfeed-ing and right practice was also found better in intervention area (p=0.003). Compare to control correct knowledge of exclusive breastfeeding found significantly higher (p=0.02) in intervention area. Better EBF practice was found in intervention area, it was 79% and 71% in intervention and control area respectively. Compare to control area, significantly higher proportion of mothers in intervention area had correct knowledge of adequacy of breast milk till six month of child (P=0.000). Right knowledge regarding way of increase breast milk supply was also found significantly higher in intervention area (P=0.003). Correct knowledge regarding initiation of complementary feeding found significantly higher in intervention area (p=0.012), proportions were 53% and 41% in intervention and control area respectively. Animal food feeding practice was found higher in intervention area (P=0.015). Both knowledge and practices of mothers on IYCF found better in intervention area. This better effect suggests videoDOI: http://dx.doi.org/10.3329/seajph.v4i1.21835 South East Asia Journal of Public Health Vol.4(1) 2014: 25-29

Aim: The aim of the study was to assess the quality of life (QoL) in women suffering from cancer cervix before and after the treatment, to study various factors affecting the QoL in these women, and to evaluate the impact of treatment modalities on the QoL. Materials and Methods: Women with cervical cancer attending Department of Obstetrics and Gynecology and Department of Radiotherapy who met the eligibility criteria were interviewed with a structured questionnaire of QoL, the European Organization for Research and Treatment of Cancer QLQ30, and its Cervical Cancer Module (Cx24). The baseline observations were recorded when the patient first reported, second evaluation was done at 3 months posttreatment, and the third evaluation at 6 months posttreatment. QoL domains along with sociodemographic and clinicopathological variables were analyzed. Results: A total of ninety patients were included for analysis, of which 5 were lost to follow up. A statistically significant improvement was found in physical, emotional function, pain, fatigue, and vaginal symptoms of the participants; however, there was no significant improvement in social, cognitive, or role functioning, body image, sexual activity, or sexual enjoyment. Vaginal and sexual function worsened significantly. Multivariate analysis showed that young women and those with a higher level of education had better QoL. Stage and type of cancer had little impact on the general QoL, but participants with earlier stage and well-differentiated cancer had better cancer cervix-specific QoL. Conclusion: The QoL of the participants in terms of physical (P = 0.04) and emotional functioning (P = 0.001) improved with treatment. Women with a higher level of education and early stage of disease had better QoL.

Objective: The aim of good management for cancer survivors should not be limited to only clinical care, but rather it should also include best quality of life (QOL). The objective of this study was to find out various factors affecting QOL in cervical cancer patients so that by modifying these factors, the best QOL can be provided to them. Materials and Methods: This was a prospective cohort study conducted in the Department of Obstetrics and Gynaecology and Department of Radiotherapy, King George's Medical University (KGMU), Lucknow, from May 2015 to July 2016. The cases were selected from patients visiting the outpatient department or who were admitted to the Department of Obstetrics and Gynaecology and Department of Radiotherapy, KGMU. The data information was collected in the form of face-to-face interview using European Organization for Research and Treatment of Cancer general cancer QOL Score 30 (EORTC QLQ C-30) and EORTC QOL questionnaire cervical cancer module (QLQ CX-24) questionnaire. Results: QOL was assessed in 85 patients. Health-related QOL was separately studied in terms of overall general QOL and cancer cervix-specific QOL, and various factors affecting QOL were studied by multivariate analysis. Conclusion: Education, tobacco use, degree of differentiation of tumor, and size of tumor were the independent factors found to have statistically significant effect on QOL of cervical cancer survivors.

Background and Objectives A novel carbon dioxide (CO2) laser device employing ablative fractional resurfacing was tested on human skin in vivo for the first time. Study Design/Materials and Methods An investigational 30 W, 10.6 µm CO2 laser system was focused to a 1/e2 spot size of 120 µm to generate an array of microscopic treatment zones (MTZ) in human forearm skin. A range of pulse energies between 5 and 40 mJ was tested and lesion dimensions were assessed histologically using hematoxylin & eosin. Wound healing of the MTZ's was assessed immediately-, 2-day, 7-day, 1-month, and 3-month post treatment. The role of heat shock proteins was examined by immunohistochemistry. Results The investigational CO2 laser system created a microscopic pattern of ablative and thermal injury in human skin. The epidermis and part of the dermis demonstrated columns of thermal coagulation that surrounded tapering ablative zones lined by a thin eschar layer. Changing the pulse energy from 5 to 30 mJ resulted in a greater than threefold increase in lesion depth and twofold increase in width. Expression of heat shock protein (hsp)72 was detected as early as 2 days post-treatment and diminished significantly by 3 months. In contrast, increased expression of hsp47 was first detected at 7 days and persisted at 3 months post-treatment. Conclusion The thermal effects of a novel investigational ablative CO2 laser system utilizing fractional resurfacing were characterized in human forearm skin. We confirmed our previous ex vivo findings and show for the first time in-vivo, that a controlled array of microscopic treatment zones of ablation and coagulation could be deposited in human skin by varying treatment pulse energy. Immunohistochemical studies of heat shock proteins revealed a persistent collagen remodeling response lasting at least 3 months. We successfully demonstrated the first in-vivo use of ablative fractional resurfacing (AFR™) treatment on human skin. Lasers Surg. Med. 39:96–107, 2007. © 2007 Wiley-Liss, Inc.

In the 21st century, individuals with skin of color, including those of Hispanic, Asian, and African American descent, will account for more than half of the US population. Consequently, those individuals will constitute a significant patient population for the dermatology community. Dermatologists in major metropolitan centers as well as those in rural communities need to meet the diagnostic and therapeutic challenges posed by these patients by becoming familiar with dermatologic disease prevalence and presentation in skin of color. Commonly occurring cutaneous diseases, such as acne vulgaris, display histological and clinical differences in people with skin of color compared with Caucasians (whites). Additionally, the response to therapeutic agents may vary in people with skin of color. This article reviews data derived from a survey of skin of color patients with acne vulgaris seen at the Skin of Color Center, Department of Dermatology, St. Luke's-Roosevelt Hospital, in New York City. This information should help clinicians in their diagnosis and treatment of acne vulgaris for these patients.

Whereas previous investigations have shown that pharmacologic addition of gangliosides inhibits keratinocyte proliferation by downregulating epidermal growth factor receptor phosphorylation, the underlying biochemical basis and physiologic relevance are unknown. Using Scatchard and displacement plots, we have shown that supplemental purified gangliosides decrease the binding of (125)I-labeled epidermal growth factor to keratinocyte-derived SCC12 cells. Conversely, SCC12 cells transfected with sialidase and thus depleted of gangliosides show increased ligand binding to the epidermal growth factor receptor, which is consistent with their increased proliferation in response to epidermal growth factor and transforming growth factor-alpha, and increased phosphorylation of the epidermal growth factor receptor, and downstream signal transduction pathway components. The mechanism of the altered binding appears to involve primarily decreased numbers of available receptors within the intact membrane, but not altered receptor protein expression. These studies provide evidence that the effect of gangliosides on keratinocyte proliferation results, at least in part, from the direct binding of ganglioside to the receptor and disruption of the receptor-ligand interaction. Manipulation of membrane ganglioside content may be a powerful new means to alter epidermal growth factor receptor-dependent cell proliferation.

Background Laser therapies have been Food and Drug Administration approved for temporary nail plate clearance; however, there is minimal evidence of their long-term efficacy. Objective We sought to evaluate the clinical and mycological clearance of toenails treated with 1064-nm neodymium:yttrium-aluminum-garnet laser versus no treatment. Methods This was a randomized, controlled, single-center trial comparing 2 treatments with 1064-nm neodymium:yttrium-aluminum-garnet laser (fluence of 5 J/cm 2 , rate of 6 Hz) spaced 2 weeks apart versus no treatment in 27 patients (N = 125 affected nails) with clinical and mycological diagnosis of onychomycosis. At 3 months, patients were assessed with mycological cultures and proximal nail plate measurements. Patients treated with laser were also assessed with proximal nail plate measurements at 12 months. Results At 3 months, 33% of patients treated with laser achieved a negative mycological culture compared with 20% of the control group ( P = .49), and had more proximal nail plate clearance compared with control subjects (0.44 vs 0.15 mm, P = .18), which was not statistically significant. At 12 months, there was no difference in nail plate clearance between laser versus control subjects (0.24 vs 0.15 mm, P = .59). Limitations Our study was limited by the small sample size and number of treatments. Conclusions There was no significant mycological culture or clinical nail plate clearance with 1064-nm neodymium:yttrium-aluminum-garnet laser compared with control.

Poikiloderma, by definition, occurs in the setting of hyperpigmentation, hypopigmentation, atrophy, and telangiectasias. There are numerous entities where poikiloderma is present, the most common being a result of chronic photodamage and is termed poikiloderma of Civatte (PC). PC was initially described by Civatte in 1923. Recently, histologic evaluation has confirmed the aforementioned characteristics, in addition to degeneration of collagen bundles and solar elastosis.1

In vivo wound healing response post nonablative fractional laser treatment is evaluated. Seven healthy subjects receive treatments with a Fraxel re:store laser system on the forearm with pulse energies ranging from 10 to 70 mJ. The treatment sites are imaged at 1-h increments up to 40 h using confocal microscope z-stacks using 10-mum-depth spacing. At least five individual microscopic treatment zones are imaged per subject, time point, and treatment energy. Images are analyzed for tissue structure and morphology to classify each lesion as healed or not healed, depending on epidermal re-epithelialization at each time point and treatment energy. Probit analysis is used to statistically determine the ED(50) and ED(84) probabilities for a positive dose response (healed lesion) as a function of treatment energy. Confocal observations reveal epidermal keratinocyte migration patterns confirmed with histological analysis using hematoxylin and eosin (HE) and lactate dehydrogenase (LDH) staining at 10 mJ at 0, 7, 16, and 24-h post-treatment. Results indicate that more time is required to conclude re-epithelialization with larger lesion sizes (all less than 500 mum) corresponding to higher treatment energies. For the entire pulse energy range tested, epidermal re-epithelialization concludes between 10 to 22-h post-treatment for ED(50) and 13 to 28 h for ED(84).

Background and Objective: Due to the significant risk profile associated with traditional ablative resurfacing, a safer and less invasive treatment approach known as fractional deep dermal ablation (FDDA™) was recently developed. We report the results of the first clinical investigation of this modality for treatment of photo- damaged skin. Study Design/Materials and Methods: Twenty-four subjects received treatments on the inner forearm with a prototype fractional CO2laser device (Reliant Technologies Inc., Mountain View, CA) at settings of 5-40 mJ/MTZ and 400 MTZ/cm2. Clinical and histological effects were assessed by study investigators 1 week, 1 month, and 3 months following treatment. Thirty subjects were then enrolled in a multi-center study for treatment of photo- damage using the same device. Subjects received 1-2 treatments on the face and neck, with energies ranging from 10 to 40 mJ/MTZ and densities ranging from 400 to 1,200 MTZ/cm2. Study investigators assessed severity of post-treatment responses during follow-up visits 48 hours, 1 week, 1 month, and 3 months following treatment. Using a standard quartile improvement scale (0-4), subjects and investigators assessed improvement in rhytides, pigmentation, texture, laxity and overall appearance 1 and 3 months post-treatment. Results: Clinical and histologic results demonstrated that fractional delivery of a 10,600 nm CO2laser source offers an improved safety profile with respect to traditional ablative resurfacing, while still effectively resurfacing epidermal and dermal tissue. Forearm and facial treatments were well-tolerated with no serious adverse events observed. Eighty-three percent of subjects exhibited moderate or better overall improvement (50-100%), according to study investigator quartile scoring. Conclusions: FDDA™ treatment is a safe and promising new approach for resurfacing of epidermal and deep dermal tissue targets. Lasers Surg © 2009 Wiley-Liss, Inc.

BACKGROUND Treatments for hypopigmented scars have shown limited efficacy and variable safety profiles. OBJECTIVE This study evaluated the safety and efficacy of fractional resurfacing (1,550-nm Fraxel SR laser, Reliant Technologies, Mountain View, CA) for the treatment of hypopigmented scars on the face in seven patients. MATERIALS AND METHODS Seven patients with hypopigmented scars on the face received between two and four successive treatments at 4-week intervals with the 1,550-nm Fraxel SR laser. Energy settings ranged from 7 to 20 mJ and a total density of 1,000 to 2,500 microthermal zones per square centimeter. Digital photographs were taken before each treatment and at 4 weeks after the last treatment. Independent physician clinical assessments were performed. RESULTS Independent physician clinical assessment 4 weeks after the final Fraxel SR laser treatment revealed improvements of 51% to 75% in hypopigmentation in six of seven patients. One patient had only 26% to 50% improvement in hypopigmentation. Additionally, clinical improvements were noted in the overall texture of the treated skin. The patient's degree of satisfaction paralleled the physician's assessment of improvement. All patients reported improvement in hypopigmentation lasting greater than 3 months after the last treatment. Side effects were limited to mild pain during the treatment and mild posttreatment erythema and edema, which resolved in 2 to 4 days. CONCLUSION Fractional resurfacing is a potentially effective modality for the treatment of hypopigmented scarring on the face. No adverse effects were observed.

We present a 15-year-old girl with bilateral lower extremity discoloration of one-year duration while taking minocycline for acne vulgaris. The clinical characteristics best supported type II minocycline hyperpigmentation, but the histology revealed that the pigmentation was solely limited to the subcutaneous adipose tissue, completely sparing the dermis. Special stain for iron was negative. This is the first case to our knowledge with pigment exclusively located in the subcutaneous fat and with the unusual finding of a negative stain for iron.

Pseudofolliculitis barbae (PFB) is a chronic inflammatory and potentially disfiguring condition most often seen in men and women of African American and Hispanic origin who have tightly curled hair and who shave or tweeze hairs frequently. The etiology is multifactorial. The shape of the hair follicle, hair cuticle, and the direction of hair growth each play a role in the inflammatory response once the hair is shaven or plucked and left to grow. This reaction often produces painful, pruritic, and sometimes hyperpigmented papules in the beard distribution. The result is an unappealing cosmetic appearance, often with emotionally distressing consequences for affected individuals. The diagnosis is made clinically. Currently, prevention and early intervention are the mainstays of therapy. Many treatment options are available; however, none has been completely curative. In this review, the history, incidence, pathogenesis, clinical manifestations, dermatopathology, prevention, and treatment of PFB, including the most current surgical options, will be discussed. In addition, new data on patients with PFB from the Skin of Color Center will be presented. (J Am Acad Dermatol 2002;46:S113-9.)

We have studied the coercivity of magnetic nanonetworks as a function of thickness, nominal pore diameter, and surface/interface roughness in the thickness range of approximately 2 to 45 nm where a Neel-type domain wall has been theoretically predicted. Such magnetic nanonetworks have been prepared by sputtering iron on the walls of commercially available porous nano-channel alumina (NCA) membranes. The thickness dependence of coercivity has also been studied on films deposited on surface-oxidized Si and glass subtrates. These substrates are essentially non-porous and much smoother than NCAs. Our investigation shows that the coercivity of films deposited on Si and glass depends on the spatial fluctuation of thickness which arises from the roughness of the apparently smooth substrates. On the other hand, NCAs are found to be inherently quite rough, and films on NCAs show a complex thickness dependence which arises from the interplay between surface/interface roughness, domain pinning due to porosity, surface anisotropy, surface torques, and oxidation of the iron films. It was found that the growing films on NCA substrates led to partial filling up of the pore entrance, thereby reducing its effective diameter. The film growth also affects the roughness of the film, which in turn affects its coercivity. We propose a model for the thickness dependence of coercivity based on the pore fill-up geometry considering the effective pore diameter and the critical thickness at which the pore will be completely filled up. Experimental results on coercivity with thickness variation of iron network deposited on NCA generally agree with the suggested model.