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Safe and Successful Administration of Deoxycholic Acid in a Patient With Chronic Active Liver Disease [Letter]

Eilers, Steven E; Torbeck, Richard; Krishnasamy, Shalini; Khorasani, Hooman
PMID: 32870612
ISSN: 1524-4725
CID: 5221542

Acellular Porcine Transitional Cell Matrix Xenograft for Genital Wounds [Letter]

Lin, Matthew J; Dubin, Danielle P; Khorasani, Hooman
PMID: 31403538
ISSN: 1524-4725
CID: 5221422

Intraoperative Electrosurgical Depilation of a Skin Graft

Dubin, Danielle P; Routt, Ethan T; Lin, Matthew J; Torbeck, Richard L; Khorasani, Hooman
Full-thickness skin grafts harvested from hair-bearing areas may negatively impact cosmetic outcomes if the recipient site is hairless. Intraoperative depilation of unwanted hair follicles using an electrosurgical device can permanently remove hair with a single treatment and improve overall cosmesis.
PMID: 33209009
ISSN: 0974-2077
CID: 5221562

Basal cell nevus syndrome: From DNA to therapeutics

Lin, Matthew J; Dubin, Danielle P; Khorasani, Hooman; Giordano, Cerrene N
Basal cell nevus syndrome, also known as Gorlin syndrome, is a hereditary cancer syndrome associated with multiple basal cell carcinomas, congenital defects, and nondermatologic tumors. This disease is autosomal dominant with variable expressivity and is caused by abnormalities in the sonic hedgehog signaling pathway. Management requires a multidisciplinary approach and should include the biopsychosocial needs of patients and their families. Genetic testing is necessary to confirm an unclear diagnosis, evaluate at-risk relatives, and assist with family planning.
PMID: 32972605
ISSN: 1879-1131
CID: 5221552

Utility of Preinjection Aspiration for Hyaluronic Fillers: A Novel In Vivo Human Evaluation

Wang, Jordan V; Hazan, Ezra; Hattier, Georgette; Torbeck, Richard L; Khorasani, Hooman; Saedi, Nazanin
BACKGROUND:Hyaluronic acid (HA) fillers have increased in popularity. While complications are rare, practitioners should focus on their prevention. Preinjection aspiration remains controversial as an effective safety checkpoint. OBJECTIVES/OBJECTIVE:Our study investigated the utility of preinjection aspiration as a safety checkpoint for HA fillers through comparison of physiochemical and rheological properties in a novel in vivo human model. METHODS:An in vivo human model consisted of a cannula inserted into a peripheral vein. Preinjection aspiration was evaluated using syringes of 10 commonly used HA fillers. The time required to visualize a flash was recorded. RESULTS:*) had significant relationships with time to flash, whereas pullback volume did not. However, when comparing pullback volume using a more appropriate paired analysis, 0.5 cc pullback volume had a significantly decreased time to flash than 0.2 cc. CONCLUSIONS:Preinjection aspiration for HA fillers has utility as a safety checkpoint. The times to visualize flashback decreased when using a human peripheral vein model compared to a previous in vitro model, suggesting that there may be real-time clinical utility of preinjection aspiration. Waiting times to visualize flashback may be affected by physiochemical and rheological properties. Additional studies would help to validate our results.
PMID: 32316755
ISSN: 1615-7109
CID: 5221492

Antibiotic Practices in Mohs Micrographic Surgery

Lin, Matthew J; Dubin, Danielle P; Giordano, Cerrene N; Kriegel, David A; Khorasani, Hooman
BACKGROUND:Mohs micrographic surgery is a safe procedure with low rates of infection. OBJECTIVE:To establish current antibiotic prescribing practices amongst Mohs surgeons. METHODS AND MATERIALS/METHODS:16-question survey sent to American College of Mohs Surgery members. RESULTS:305 respondents with collectively 7,634+ years of experience. The majority performed outpatient surgery (95.0%) and avoided oral or topical antibiotics for routine cases (67.7% and 62.8%, respectively). Prophylactic antibiotics were routinely prescribed for artificial cardiac valves (69.4%), anogenital surgery (53.0%), wedge excision (42.2%), artificial joints (41.0%), extensive inflammatory skin disease (40.1%), immunosuppression (38.9%), skin grafts (36.4%), leg surgery (34.2%), and nasal flaps (30.1%). A minority consistently swabbed the nares to check for staphylococcus aureus carriage (26.7%) and decolonized carriers prior to surgery (28.0%). CONCLUSION/CONCLUSIONS:Disparity exists in antibiotic prescribing practices amongst Mohs surgeons. There may be under-prescription of antibiotics for high risk factors like nasal flaps, wedge excisions, skin grafts, anogenital/lower extremity site, and extensive inflammatory disease. Conversely, there may be over-prescription for prosthetic joints or cardiac valves. Increased guideline awareness may reduce post-operative infections and costs/side effects from antibiotic over-prescription. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.4695.
PMID: 32484626
ISSN: 1545-9616
CID: 5221502

Response to Commentary on Intralesional Deoxycholic Acid as a Neoadjuvant Treatment of a Large Lipoma [Comment]

Dubin, Danielle P; Farberg, Aaron S; Lin, Matthew J; Khorasani, Hooman
PMID: 31490306
ISSN: 1524-4725
CID: 5221442

Intralesional Deoxycholic Acid as Neoadjuvant Treatment of a Large Lipoma [Letter]

Dubin, Danielle P; Farberg, Aaron S; Lin, Matthew J; Khorasani, Hooman
PMID: 31318828
ISSN: 1524-4725
CID: 5221402

Botulinum Toxin for Paramedian Interpolated Forehead Flaps

Lin, Matthew J; Dubin, Danielle P; Khorasani, Hooman
The forehead skin closely resembles the texture and color of the midface region. As such, the use of a paramedian forehead flap to repair a midface defect provides optimal cosmesis; however, the donor forehead site may be left with an undesirable scar in a highly visible region of the face. Cutaneous surgeons possess a variety of traditional techniques intended to minimize scarring. We have found that the addition of 50 units of botulinum toxin at the time of wound closure has improved scar outcomes for patients undergoing reconstruction with paramedian interpolated flaps. Possible mechanisms for the efficacy of botulinum toxin lie in its ability to chemically paralyze the frontalis muscle and glabella complex. This immobilization leads to a reduction in unwanted wound tension during the most vulnerable first few days of healing.
PMID: 32792781
ISSN: 0974-2077
CID: 5221532

Poly-L-Lactic Acid for Minimally Invasive Gluteal Augmentation

Lin, Matthew J; Dubin, Danielle P; Khorasani, Hooman
BACKGROUND:There is increased emphasis on the importance of the gluteal region in the perception of beauty. Biodegradable fillers provide a nonsurgical method of augmenting and rejuvenating this area. OBJECTIVE:To review pertinent aspects of anatomy, patient evaluation, injection technique, and complications for gluteal augmentation using injectable biodegradable fillers. METHODS:The authors review the literature for poly-L-lactic acid-based gluteal augmentation. RESULTS:Like many aesthetic procedures, there is a paucity of literature on this emerging treatment modality (Level 4, Centre for Evidence-Based Medicine, Oxford). However, the collective clinical experience is that poly-L-lactic acid fillers are an effective treatment for patients seeking noninvasive gluteal enhancement with minimal downtime. Physicians must understand gluteal anatomy and avoid injecting deeply in the danger triangle to prevent intravascular injection into the gluteal vessels or injury to the sciatic nerve. Other safety elements include the use of blunt cannulas, reduced pressures, smaller volumes, and retrograde delivery. CONCLUSION:Gluteal augmentation with fillers can safely and effectively improve gluteal firmness, shape, proportion, and projection. Practitioners injecting fillers in the gluteal region must be aware of appropriate patient selection, regional anatomy, and safe injection techniques. Given the increasing demand for this procedure, further high-quality studies are needed.
PMID: 31188150
ISSN: 1524-4725
CID: 5221392