Photodamage/Cosmetic Surgery Flashcards
Which lipid abnormality causes eruptive xanthomas?
Elevated Triglycerides
What condition can be associated with patients who have xanthelasma and normal lipid levels?
Sebaceous hyperplasia
This condition is caused by metabolic breakdown of lipids with deposition in the skin
Xanthelasma
How can you cosmetically destroy xanthomas?
Trichloacetic acid 70%, cryotherapy and CO2 or Q switched Nd:YAG laser
An appropriate treatment for telangiectasia is?
Intense Pulsed Dye Laser
Telangiectasias would most likely be observed in:
Patients with history of significant sun exposure
Which twrm describes a telangiectasia area that appears S a central lesion with “legs” radiating from the center?
Stellate
Key difference between a lentigo and ephelid is
Ephelides will fade in the absence of UV light
Solar lentigos are most commonly seen in
Caucasians
Puetz-Jefferson Sybdrome is associated with
Intestinal polyps
Reticulated reddish brown dyspigmented areas located on the anterior and lateral aspects of the neck sparing the area under the chin describes
Poikiloderma of Civatte
A 57 year old Caucasian male with long history of outdoor employment presents with complaints of acne. Physical exam notes general facial elastosis, open/closed comedones with keratitis material located in the temples and periocular areas. The appropriate diagnosis is
Favre-Racouchot
Elastosis would be noted in an elderly make with years of accumulated sun exposure in which locations
Back of neck, photo distributed pattern
First line treatment for elastosis is
Broad spectrum sunscreen
Second line treatment for elastosis is
Topical retinoid
Tuberose xanthomas would be located on
Elbows
This laser targets water of soft tissue to vaporize tissue and mostly involves the epidermis
Ablative
This type of laser has a high risk for infection, scarring, pigment changes and more downtime
Ablative
This type of laser mostly involves the dermis and collagen, targets water of soft tissue without vaporizing tissue
Non-ablative
This type of laser involves both the dermis and epidermis. Treats small islands of epidermis compared to a continuous wave of destruction.
Fractionated CO2
What patients should be excluded from laser treatment?
History of keloids/scarring, oral isotretinoin within past year, ectropion, Connective Tissue Disease and morphea
What colors are the easiest to remove with tattoo removal?
Dark blue and black
What is the mechanism of action for botulinum toxin type A?
Inhibits the release of acetylcholine in peripheral nerves into neuromuscular junction. Results in inability for muscle to contract.
What botulinum toxin type A injection is approved for BOTH glabella line and lateral canthal lines?
Onabotulinumtoxin A (Botox)
Leakage into what muscle can cause ptosis?
Frontalis
Botox is contraindicated in what patients
Prior history if muscle weakness. Motor neuron disease, myasthenia Gravis, infection near the area to be injected
Abotulinumtoxin A is contraindicated in patients with
Allergy to cow’s milk due to use of bovine protein
Treatment for eyelid ptosis includes
Alpha-andrenergic eye drops (0.5% apraclonidine)
Dermal fillers are only approved for
Lip and cheek augmentation for individuals over the age of 21.
What is not FDA approved for fillers?
Silicone, under eye areas, large scale body contouring
Examples of biodegradable filler
Hyaluronic acid, calcium hydroxyapatite, poly-l-lactic acid
Non biodegradable filler
Polyethylene methacrylate microspheres (PMMA)
Absolute contraindications for filler
Active skin infection, hypersensitivity to filler, connective tissue disease, graft vs hose, hoshimoto’s disease, hemophilia, thalassemia, anticoagulant therapy, pregnancy, breast feeding
What causes early onset of granulomas from filler
Usually injection technique
Delayed nodules following filler are usually caused by
Inflammatory reactions and may require hyaluronidase, lidocaine or massage
Sudden onset of skin color changes i.e. white blotching with severe pain indicates what when doing filler injections?
Arterial occlusion
Delayed onset with color changes of red/blue coloring after filler injection indicates what?
Venous occlusion
Treatment of vascular compromise with filler includes:
Warm compress to promote vasodilation, flooding area with hyaluronidase, doppler/ultrasound to assess damage, daily injections of hyaluronidase
What chemical peels done at 2-4 week intervals treat melasma?
Trichloroacetic acid, glycolic acid and alpha-hydroxyl acids
What lasers treat melasma?
Non-ablative fractional laser, PDL, IPL, Nd:YAG
