Identification of titanium dioxide on the hair shaft of patients with and without frontal fibrosing alopecia: A pilot study of 20 patients

Abstract

Frontal fibrosing alopecia (FFA) has increased markedly in incidence since it was first reported in 1994. A possible role of cosmetic ingredients has been suspected, especially UV blockers, since these were added to products in the late 1980s. Daily, year‐round use of facial moisturizers, most of which contain a sunscreen, has been associated with FFA in both women and men, An additional large study has reported that the use of facial sunscreens is the only common risk factor for FFA in both males and females. Patch testing in FFA patients shows a high prevalence of sensitization to cosmetic ingredients but not to a specific culprit, possibly indicating that these patients utilize more cosmetic products than the general population.

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http://bit.ly/2TTgCdd

Voice outcome after unilateral ELS type III or bilateral type II resections for T1‐T2 glottic carcinoma: Results after 1 year

Abstract

Background

Voice outcome was assessed in patients with extended T1 and limited T2 glottic carcinoma, treated with a unilateral type III or a bilateral type II resection according to the European Laryngological Society (ELS) classification.

Methods

Objective evaluation (acoustic and aerodynamic parameters), perceptual evaluation (GRBAS), and patients' self‐assessment (voice handicap index [VHI]) were performed before and 1 year after treatment. Results were evaluated according to ELS resection type and the involvement of the anterior commissure.

Results

The majority of voice parameters in all resection subgroups showed an improvement of the mean score 1 year postoperatively. Grade of dysphonia varied between 1.15 and 1.66 postoperatively and VHI score varied from 23.3 to 24.5.

Conclusion

Voice outcome after ELS unilateral type III or a bilateral type II resection for extended T1 and limited T2 glottic carcinoma is good with mild to very moderate perceptive dysphonia and low self‐reported voice impairment.

http://bit.ly/2QU2kXF

Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma

Abstract

Background

Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non‐aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior.

Methods

Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004‐2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC.

Results

Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P < .001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28‐1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82‐0.99) (P < .001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86‐0.92 and aOR = 0.81, 95% CI: 0.79‐0.84) and higher odds of LNM and ETE than whites (P < .001).

Conclusions

Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

http://bit.ly/2VXaItc

Transoral robotic excision of laryngocele: Surgical considerations

Abstract

Background

Transoral robotic surgery (TORS) has emerged as a novel, safe, and feasible procedure for the resection of malignant supraglottic laryngeal cancers. The purpose of this study was to demonstrate the surgical technique with extension of the use of TORS to excise a laryngeal cyst.

Results

Laryngeal cyst resection, along with its tract, was accomplished with preservation of both false and true vocal cords. There was no perioperative or early postoperative complications. The patient was extubated immediately after surgery. Oral diet was initiated within 24 hours. No tracheostomy was required. A video demonstration of the surgical technique is included on Head & Neck's website.

Conclusion

TORS is a safe and feasible procedure for excision of selected laryngeal cysts.

http://bit.ly/2QTMVqo

Actigraphy‐measured nocturnal wrist movements and assessment of sleep quality in patients with bullous pemphigoid: a pilot case–control study

Summary

Background

Bullous pemphigoid (BP) is a distressing autoimmune bullous disease strongly associated with severe pruritus; however, data concerning pruritus in BP are still scarce. No clinical research evaluating the effect of BP on sleep quality has been conducted.

Aim

To evaluate the intensity of pruritus measured by nocturnal wrist movements (NWMs) and the sleep quality in patients with BP using actigraphy in comparison with nonpruritic healthy controls (HCs) with subsequent correlations with an itch visual analogue scale (VAS) as a subjective measure, disease severity [Bullous Pemphigoid Disease Area Index (BPDAI), urticaria/erythema, erosions/blisters] and serum total IgE level.

Methods

In total, 31 patients with newly diagnosed BP (mean ± SD age 75.4 ± 12.3 years) and 40 nonpruritic HCs (age 73.5 ± 11.7 years) were recruited. All participants wore a sleep monitor (ActiSleep+) on the dominant wrist.

Results

For patients with BP, median VAS score was 5.5 and median BPDAI was 43 (urticaria/erythema BPDAI was 16, erosions/blisters BPDAI was 29). Scratching, defined as bouts of NWMs, was significantly (P < 0.001) more intensive in patients with BP than in controls. Characteristic of BP was that scratching bouts corresponded with the slowest wrist movements. There were no correlations with VAS, BPDAI or total IgE level. Compared with HCs, patients with BP presented significant (P < 0.001) sleep disturbances, as determined by sleep efficiency, waking after sleep onset and average duration of awakening, and these were strongly correlated with urticaria/erythema BPDAI.

Conclusion

Nocturnal wrist movements measured by actigraphy are more intensive in patients with BP than in nonpruritic HCs, and characteristically slow movements. Actigraphy method showed very low sleep quality in patients with BP, thus severity of BP has a negative impact on sleep.

http://bit.ly/2Ru9ZBn

Association of interleukin‐6 gene promoter polymorphism with acne vulgaris and its severity

Summary

Background

Acne vulgaris (AV) is an inflammatory disorder with a possible genetic background. Different cytokines and mediators are involved in its pathogenesis.

Aim

Our aim was to investigate the interleukin (IL)‐6 572 polymorphism in patients with AV and its relation to patient sex and acne severity.

Methods

In total, 30 patients with acne and 20 healthy controls (HCs) were enrolled. The Global Acne Grading System was used to assess acne severity. The IL‐6 572 gene promoter polymorphism was assessed using the PCR–restriction fragment length polymorphism method.

Results

There was a significantly higher association of IL‐6 572 variants genotypes in patients with acne (93%) compared with the HC group (45%) (P < 0.001), with a higher incidence of the IL‐6 572 CC polymorphism in patients with acne. A significant difference (P < 0.001) between C and G alleles in patients vs. HCs was detected. There were no significant associations between the IL‐6 572 variant genotypes and either patient sex or AV severity.

Conclusion

IL‐6 gene promoter polymorphism might have a role in AV susceptibility but it is not related to AV severity.

http://bit.ly/2CoI7Ek

Blood Collection within the Maxillary Sinus following Orbital Fracture Repair: The Impact of Mesh Implants and Drains

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0038-1676636

This article aimed to assess the effects of (1) mesh (e.g., uncoated anatomic titanium plates) versus non-mesh (e.g., porous polyethylene-coated titanium sheets) implant materials and (2) drain placement on the accumulation of blood within the maxillary sinus following surgical repair of orbital floor fractures. Ninety-two patients who received orbital floor fracture repair between 2008 and 2014 were selected, with equal case numbers between categories: (1) non-mesh implant, without drain; (2) non-mesh implant, with drain; (3) mesh implant, without drain; and (4) mesh implant, with drain. Lesion-mapping software was used to measure blood and sinus volumes in postoperative computed tomographic images. Average postoperative maxillary sinus filling was 49% ± 29%. Average sinus filling was similar between mesh and non-mesh implant materials; this was true in cases with a drain (45 vs. 40%, respectively) and without (57 vs. 52%, respectively). Orbital drain placement was associated with a significant reduction (p = 0.048) in maxillary sinus filling of 12%. Mesh and non-mesh implant materials allow for similar drainage of orbital blood into the maxillary sinus postoperatively. In the majority of cases, space is available within the maxillary sinus to allow for drainage of orbital blood. Intraoperative drain placement is associated with reduced blood pooling within the maxillary sinus, suggesting it allows for drainage of orbital blood to the outside world.
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