Wednesday, September 22, 2010

SKIN IN GIT DISORDERS

SKIN IN DISEASES OF THE GASTROINTESTINAL TRACT

There are many diseases of the GIT that are associated with Cutaneous manifestations. They can be broadly grouped into following types:
1) Cutaneous manifestations of Malabsorption.
2) Cutaneous manifestations of Inflammatory Bowel Disease.
3) Cutaneous disorders associated with Gastrointestinal Bleeding.

· CUTANEOUS MANIFESTATION OF MALABSORPTION
Malabsorption is a condition characterized by decreased uptake of nutrient by the intestines associated with an increased fecal excretion of fat (Steatorrhea). These may lead to varying degree of deficiencies of proteins, minerals, trace elements, vitamins, carbohydrates and water.
It is associated with several disorders:
# Coeliac disease
# Scleroderma
# Whipple’s disease
# Diabetes mellitus
# Amyloidosis
# Cystic fibrosis of pancreas
# Chronis pancreatitis
Skin changes due to malabsorption includes:
· Acquired icthyosis
· Hyperpigmentation
· Skin texture & elasticity
· Eczematous & psoriasiform rashes
· Hair & nail changes

CUTANEOUS MANIFESTATIONS OF IBD:
Ulcerative colitis & Crohn’s disease are Inflammatory Bowel Disease that have many cutaneous manifestations. They includes;
· Fissures & fistulas
· Oral Crohn’s disease
· Pyoderma gangrenosum
· Erythema nodosum
· Apthous ulcers
· Vesiculo pustular eruptions
· Necrotising vasculitis
· Clubbing
· Vitiligo
· Psoriasis

CUTANEOUS DISORDERS ASSOCIATED WITH GI BLEEDING:

Various disorders may be associated with gastrointestinal bleeding.They includes;
· Scurvy
· Hematological disorders
· Kaposi’s sarcoma
· Primary Systemic Amyloidosis
· Curling’s ulcer
· Neurofibromatosis
· Ehlers-Danlos syndrome
BY:
DR CHETAN LALSETA
M.D.(Skin & V D)
DERMATOLOGIST & COSMETOLOGIST
SHRADDHA SKIN & COSMETIC CENTER
“DOCTOR HOUSE”,
2nd FLOOR, INDIRA CIRCLE CHOWK
RAJKOT
www.drlalseta.blogspot.com
chetanlalseta@gmail.com
Contact: 09825199585
Sponsored by the business degree web page.

Friday, July 24, 2009

HAIR TRANSPLANTATION

HAIR RESTORATION TREATMENT
Hair restoration treatment is the redistribution/rearrangement of the existing hair follicles in a particular techniques so as to cover the bald areas of alopecia and give a goo cosmetic camouflage.
The concept of Donor Dominance heralded the modern era of hair transplantation.
INDICATIONS:
1) Male Pattern Alopecia(Androgenetic Alopecia)
2) Female Androgenetic Alopecia
3) Cicatricial Alopecia
4) Reconstruction of Eyebrows & Eyelashes

TECHNIQUES OF HAIR RESTORATION SURGERY:
1) Punch Grafting
2) Single Hair grafting
3) Follicular Unit Grafting
4) Strip Grafting
5) Alopecia Reduction
6) Alopecia Reduction with Tissue Expansion
7) Transposition of Scalp flaps
8) Combination of the above techniques
9) Synthetic Hair Grafting

Depending on classification of Androgenetic Alopecia & patient selection criteria, an appropriate treatment modality is chosen which gives best possible result to the patient.

At C POINT, Hair restoration surgery is done electively by team of doctors specialized in treatment after thorough assessment of patient.
FAQ’s ABOUT HAIR RESTORATION SURGERY:

Why I need hair transplant i.e. surgery, when medication and other non-surgical means are available?

Medications:

Medication can thicken and lengthen (regrowth) hair in some and not in all who take them.
Medication is effective at the back (Vertex) and middle (Mid scalp) but almost ineffective in the front (esp. Hair line) where one needs the hair most.
Medication can work only until you keep taking if you stop taking medication the benefits achieved by medication soon start disappearing (because the hormones once again start working their ill effects). Medication although reasonably safe should be taken for lifetime –the idea normally puts off many.
Medications although fairly safe are not without any side effects.

Other Non- Surgical Means:

Wigs and Concealers are other possible solutions to baldness. Concealers are temporary hair cosmetics, good for thinning hair and as temporary solution such as before going to party. They require regular care and expense. They are not cheap either.

As for the wigs: 10 reasons why people don't choose wig!

· It gives constant feeling of weight and discomfort in hot days.
Sweat cannot be cleaned properly and bad hygiene can lead to skin problems.
· It’s fixing methods like weaving, bonding, pinning etc. can pull on the natural remaining hair and add to your hair loss and can even lead to scarring.
· It gives same look all the time that looks and feels artificial and unnatural. You have fixed style all hours of use.
· Its high level of detectability becomes a butt of jokes and teasing by the friends, colleagues and media.
· It’s cost run from few hundred dollars to many thousand dollars depending upon quality.
· You need regular maintenance every few weeks for the rest of your life.
· Attachment may become loose- constant state of low-level paranoia and anxiety about his public discovery.
· Long-term financial investment because of regular maintenance may be more than that of hair transplant. With life time maintenance & few monthly replacement & frequent visits to wig maker- it becomes very expensive
· You need to change it every few months.
· Not done by doctors.

Surgery by Follicular hair Transplant is better in many respects:

· Transplanted Hair Looks and feels natural unlike wig and concealer.
· Transplanted hair remain undetectable among the other hair.
· Transplanted hair grows and keeps growing permanently unlike the hair of wig and the regrown hair by medication.
· Do not require extra maintenance or care unlike wig, which require lifetime care.
· The Transplanted hair can be cut, colored and styled as well.
· Transplantation normally has one time expense unlike medication or wig which require lifetime expense.
· It is a One day Procedure performed by numbing your skin so you can talk with doctor, watch TV, listen to music, read, take a nap, have lunch and juice and even go to toilet.
· No bandages at the end.
· You can take shoulder bath from same day and can shampoo your hair from 3rd day.
· You can even do light office work from second day.

What is the guarantee that the implanted hair will grow? Why don't they too fall under the effect of hormones like other hair?

The Common Baldness or Pattern baldness in males and females is programmed by heredity or genes i.e. the hair in the top middle part of scalp become susceptible to the effect of the hormones and the fringe of hair at the side and back remain genetically immune to the effect of hormones. These hairs grow permanently or at least till late age and they also maintain their quality unlike the susceptible hair of middle, which shorten and thin out in caliber as well. These hairs are called permanent hair. If we remove the roots from permanent area and graft them in front or any other part of scalp or body they keep growing like they used to do in their native area. The hormones even in new area don't affect them. Over 90% of the implanted are destined to survive with modern techniques of transplanting.

Do I have to wait till all my hair fall out or can I under go the procedure to increase my density?

Like any medical problem, one should not wait till the last stage of manifestation of deformity of baldness. As the density of hairs gets down, one can safely plant the follicles in-between existing hairs, to compensate for the loss, without looking bald.

Can girls and women have this procedure?

Yes, girls and women can take benefit of this procedure for the correct indications.

Can it be done if there is no hair on head?

Usually the procedure is refused if there is no hair on the scalp. Body hair transplant can be an inferior possibility.

Can it be done for eyebrow, moustache, eyelashes or other body areas?

Thinning, total or partial loss of eyebrow, eyelashes, moustache or beard or sideburns since birth or due to other causes like injury or burns can be corrected cosmetically by Hair Transplant .

At what age one can have Hair Transplantation? Can a child undergo Hair Transplantation? Can a 70 years old person undergo Hair Transplantation?

Age is no bar for Scarring baldness. For pattern baldness unusually surgery is refused before 20 years and if the quality of donor hair is good even at late age transplant can be done .

Do I have to undergo tests before the procedure?

Yes usually they are 1. Complete blood count 2. HbSAg (Australian Antigen) 3. P.T & APTT 4. Blood Sugar (Fasting and Post prandial) 5. H.I.V.

What care do I take before Hair Transplantation?

Pre operative Care Before Procedure:

In order for us to provide you with the highest quality medical care; the following instructions are important for you to follow:
Medications: Do not take aspirin & other blood thinning agents, Betablockers (for Blood Pressure), anti-inflammatory (like Ibuprofen, etc), Tricyclic Anti depressants & MAO inhibitors, multivitamins including vitamin B, a week prior to your procedure.
Avoid Alcohol for a days prior, & tea or coffee on the day of operation- that may increase bleeding
Don't smoke at least 24 hours prior to operation –that will reduce healing
The morning of your procedure take a bath or shower and wash your hair thoroughly using regular shampoo. After shampooing, please rinse thoroughly and use a fresh clean towel to dry your hair. Do not apply sprays or gels to your hair. If you wear a wig, please make sure it is removed prior to your morning shower and not replaced before your procedure. Wear cap after shampoo to keep the hair free of dust.
Eat light breakfast the morning of your procedure
Wear comfortable clothing the day of your procedure avoid T shirt or thermal. Wear simple shirt.
You may be receiving medications during the procedure that can make you drowsy. Because of this we strongly recommend not to drive home the day of your procedure.


Can HT be done if I am Diabetic or if I have Blood Pressure or other medical problems?

Medical problems under good control by medication do not stop you from undergoing the procedure.

What are the side effects and complications?

It is one of the safest procedures devised by medical science and leaves you with hardly any long-term problems. Discomfort, swelling of forehead, numbness at the back trouble you only for a while. Serious complication in competent hand is unheard of.

Can hair from other parts of my body be transplanted?

Technically that is possible but hair follicle from the other parts of the body when planted on the head, does maintain its genetic characteristics, and hence it does not look, feel and grow as good as scalp hair.

How many follicles will I require?

Number of follicles required is based on factors that vary among individuals.

Degree & Progress of hair loss
Hair characteristics
Area where coverage is desired
Expectation by patient
The total number of hair on the head remains the same as before or after Hair Transplantation. The hair root from ‘permanent hair growing area” from the back and side of the head (medically known as Hair Bank or Donor Area) is transferred to the front and /or top of the head. In Hair Transplantation no new hair is grown. Only the transplanted hair roots are arranged in such a way that head looks fuller with hair.
We have approximately 1,00,000 hair on head. In the last stage of baldness i.e. Stage 7 baldness; he is left with almost 25,000 hair on the back and side of his head (medically known as Hair Bank or Donor Area). From this area, we can harvest up to 60 % or 15000 hairs, without looking obvious. One sq. cm of Donor Area contains 100 follicles, but each follicle (Root) may have either 1.2.3 or 4 number of hair. If you have more follicles containing 3 or 4 hair, you will have more density than one having 1 or 2 hair in each follicles. On an average each hair follicle contains 1.5-to2 hairs. So, on an average 100 follicles will contain up to 200 hairs. 15,000 hair means up to about 7 500 follicles are available for transplant from your donor site. These follicles are planted in such an artistic and Staggered pattern to create what is called an Organized Disorder Pattern over the bald area that head looks full of hair. It is the combination of Art and Science both, which gives most natural result.
Normally, you have density of 100 -follicles/sq cm on the head. We do not see the bald skin until we lose up to 60% of hair in the area. So in view of the limited availability of longer lasting follicles in the bank, we should aim for the maximum density of up to 40% plus /Sq.cm esp. in vital areas like frontal forelock. You do not get the same density all over, as before but you can make it look like near normal density.

What density will I get?

Hair Density (mass or fullness) is more with
Length of each hair
Thickness of hair
Number of hairs per sq.cm. (Density)
Acuteness of angle of exit of hair from the skin. This factor depend on the artistic ability of surgeon
More perpendicular (coronal) direction of hair to the hole while inserting hair follicle. This factor depend on the artistic ability of surgeon
Number of Hair per follicle like, 3-4 hair per follicle give more density
Curliness of hair
Low Contrast between color of hair and color of scalp
Time: Hair starts growing after about 8 to 12 weeks from plantation and continues to grow at the rate of 1 cm per month. So, only with the passage of time, the hair mass will increase.
Normally, you have density of 100 -follicles/sq cm on the head. We do not see the bald skin until we lose up to 60% of hair in the area. So in view of the limited availability of longer lasting follicles in the bank, we should aim for the maximum density of up to 40% plus /Sq.cm esp. in vital areas like frontal forelock. You do not get the same density all over, as before but you can make it look like near normal density.

What time it takes?

Only a day that you have to spare. It takes 2-8 hours usually depending upon the number of the follicles to be implanted

Will there be any effect on my mind?

This is one of the safest surgeries devised and it limits itself to the skin your brain remains much deep beneath and safely protected in the natural helmet of your skull.

How do you implant the hair? Do I have cuts and stitches?

There are micro punctures done but there are no big cuts or stitches taken at the site of grafting.

What is the after care of Hair Transplantation?
Post-operative instructions

You will leave the clinic on the same day with no bandages on - but you should wear a cap for a week to protect grafted from dust, sun & heat
Take medications as directed. (Avoid Aspirin for 2 weeks)
Sleep in the position in which you’re most comfortable but sleep with the head on 2-3 pillows for a few nights.
Place wrapped ice pack on your forehead & eyes but not on the graft sites for 48 hours to avoid swelling. Swelling will go away in few days. These days swelling is uncommon due to medications taken post operatively.
After 6 hours of the procedure shampoo the graft site & donor site gently without rubbing and wash the head with shower. Blow dry or dry without rubbing the graft site until all scabs fall out.
If bleeding occurs apply a light & steady pressure for 20-30 minutes with a clean cloth at the site of bleeding
Sutures in the donor area gets dissolved & need not be removed
Avoid Alcohol for 48 hours
Avoid smoking for as long as you can
No swimming in chlorinated water for 2 weeks
Rest for 1 day
Light work for a week
Heavy work, exercise or sex after 2 weeks
Visit your hair dresser for hair cut after 3 weeks & for hair styling after 6 weeks
Diet: Healthy nutritious diet with more proteins is beneficial. A diet that contains high quantities of animal fat can lead to an increase concentration of testosterone in the blood stream, increasing your risk of hair loss. High protein diet in pulses, milk, and white of egg, red meet and fish are good. Green vegetables and fruits are good source of minerals and antioxidants. A lot of water keeps your hair texture good.

How will it look?

Advantage of Follicular Hair Transplant is that the result is not only natural looking and natural feeling but it remains undetectable.

What time it takes to grow hair after Hair Transplantation?

The hair start sprouting by average 3-4 months and it takes 8-18 months for the hairs to grow in length and thickness.

What care will I have to take for the newly grown hair?

You don't need any special care for the newly grown hair after transplant, at least not more than your other hair.

What if the implanted hair falls?

Implanted hair fall within first month of transplant. The transplanted root form new hair in 3-4 months time. They become of combable length by 6-9 months and grow like any normal hair i.e. in cycle. So they may cyclically fall and in few weeks also start re-growth. The final result is achieved by 1 to 1 and a half year when the texture and thickness of transplanted hair becomes fully mature.

When can have my haircut? When can I shampoo, style, and colour my hair?

Haircut is possible after 3 weeks and colour and styling after 6 weeks of transplant.

Will I have bandages or dressing?

You leave the clinic with no bandage. But it would be wise to use baseball cape when outdoors, to protect from sun, dust and pollution for 2weeks
When can I work?

Usually from next day for the light work but heavy work is avoided for 7-10 days.
BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
SHRADDHA SKIN & COSMETIC CENTER,
"DOCTOR HOUSE",2nd FLOOR,INDIRA CIRCLE CHOWK,
RAJKOT-360005
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
09825199585

Sponsored by the business degree web page.

Friday, June 19, 2009

SWINE FLU---------TAKE CARE

Air Travel Guidelines are Needed to Prevent Flu's Spread.

India needs to announce flu prevention guidelines for airline travel. American Medical association has already framed their guideline on June 16 at its annual meeting held from June 13 to 17 in Chicago.
Suggested points
1. The confined nature of air travel raises the risk of influenza's spread.
2. It supports efforts to develop airline travel guidelines to help keep the flu -- including H1N1 swine flu -- from spreading.
3. If you must travel to an area that has reported cases of H1N1 flu (swine flu), stay informed. Follow local public health guidelines, including any movement restrictions and prevention recommendations.
4. Be aware that India is checking all exiting airline passengers for signs of H1N1 flu (swine flu). Exit screening may cause significant delays at airports.
5. The country should adopt policy of entry check also. As it?s the entry which causes the spread of illness to the fellow passengers.
6. Do not illegally import swine flu in the country by consuming drugs to help stop flu symptoms for a few hours. Drugs like anti allergics, steroids, pain killers, anti fever drugs, nasal anti allergic drops and anti cough syrups can all cover the symptoms for a few hours.
7. Antiviral medications for the prevention of H1N1 flu (swine flu) should be considered for travelers going to Mexico who are at high risk of severe illness from influenza. This would include persons with certain chronic medical conditions, persons aged 65 or older, children younger than 5 years old, and pregnant women. The recommended antiviral drugs for H1N1 flu (swine flu) are oseltamivir (brand name Tamiflu) nd zanamivir (brand name Relenza). Both are prescription drugs that fight against H1N1 flu (swine flu) by keeping it from reproducing in the body. These drugs can prevent infection if taken as a preventative.
8. Check if your health insurance plan will cover you abroad including for the swine flu. Consider purchasing additional insurance that covers medical evacuation in case you become sick.
9. The Indian embassies, consulates and military facilities may not have the legal authority, capability, and resources to evacuate or to give medications, vaccines or medical care to private Indian citizens overseas.

Practice healthy habits to help stop the spread of H1N1 flu (swine flu)
Wash your hands often with soap and water. This removes germs from your skin and helps prevent diseases from spreading.
Use waterless alcohol-based hand gels (containing at least 60% alcohol) when soap is not available and hands are not visibly dirty.
Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket.
If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.
Wash your hands after coughing or sneezing, using soap and water or an alcohol-based hand cleaner (with at least 60% alcohol) when soap and water are not available.
Avoid touching your eyes, nose, or mouth. Germs spread that way.
Try to avoid close contact with sick people (within 6 feet). Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
It is important to follow the advice of local health and government authorities. You may be asked to restrict your movement and stay in your home or hotel to contain the spread of H1N1 flu (swine flu).
BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005

http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
Sponsored by the business degree web page.

09825199585

Friday, May 29, 2009

SKIN MARKERS OF MALIGNANCY

SKIN MARKERS OF MALIGNANT DISEASE
Some skin disorders are precipitated by an underlying malignancy and others almost always indicative a visceral neoplasm. Early recognition may assist detection of the underlying neoplastic disease.

Disorders with a strong association with underlying malignancy:
1) NECROLYTIC MIGRATORY ERYTHEMA:

This is usually caused by a tumour of the pancreatic islet alpha cells that secrete glucagon, but it is sometimes caused by hyperplasia or benign adenomatosis of these cells. Rarely no underlying abnormality can be found. Areas of erythema, which becomes eroded and crusted, develop around the groins, on the lower trunk, around the flexures and at the sides of the mouth. They may temporarily remit at one site, to appear elsewhere. The skin disorder responds to removal of the underlying tumour, but usually complete removal is not possible.
Characteristically, there is degenerative change in the upper dermis. Blood tests reveal increased circulating glucagon, hyperglycemia and hypoaminoacidaemia and it is the last of these that may be responsible for this curious skin disorder.

2) ACANTHOSIS NIGRICANS:

Acanthosis nigricans may occur in association with endocrine disease and also, rarely, accompanies lipodystrophies. An identical clinical picture accompanies obesity and is then known as pseudo acanthosis nigricans.When the condition occurs in an adult unaccompanied by obesity or endocrine disease, an underlying neoplasm is usually the cause. The neoplasm involved is often a gastrointestinal adenocarcinoma.
There is a velvety thickening and increased rugosity of the skin of the flexures- the axilla and groin in particular. The sides and back of the neck and the sides of the mouth are also affected.
The thickened areas are also pigmented and bear skin tags and seborrhoeic warts. There may also be some generalized increase in pigmentation, as well as thickening and increased rugosity of the buccal mucosa and the palmar skin.
There is overall hypertrophy of all components of the skin of the affected areas. Insulin- like growth factors may be involved.

3) ERYTHEMA GYRATUM REPENS:

This is probably the rarest of the specific markers of visceral malignancy. This odd disorder is almost always a marker of a neoplasm, often carcinoma of the bronchus.

Large rings composed of reddened polycyclic bands are seen; the rings contain concentric rings; giving a wood-grain effect. The rings gradually enlarge and change shape. Rarely, other dramatic types of annular erythema may be signs of an internal malignancy.

4) SKIN METASTASES:

Carcinomas of the breast, bronchus, stomach, kidney and prostate are the most common visceral neoplasms to metastasize to the skin. Secondary deposits on the skin may be the first sign of the underlying visceral cancer. The lesion themselves are usually smooth nodules, which are pink or smooth colored, but may be pigmented in deposits of melanoma.

5) ACQUIRED ICHTHYOSIS:

When generally scaling without erythema begins in adult life, it is quite likely that there is an underlying neoplasm, particularly in reticulosis. This has to be distinguished from mild dryness of the skin and the slight irritation seen in many chronic disorders, known as xeroderma.
Other causes of acquired ichthyosis include AIDS, sarcoidosis and leprosy, but if these can be excluded, a neoplastic cause is the most likely explanation.

Disorders that are sometimes associated with underlying malignancy:

1) BULLOUS PEMPHIGOID:

This subepidermal blistering disorder occurs mainly in those over 60 years of age, who are anyway more likely to be affected by a neoplasm. Nonetheless,there are a few patients with pemphigoid in whom the skin disorder is provoked by the malignancy and remits after the neoplasm has been removed.

2) DERMATOMYOSITIS:

Women over the age of 40 years with dermatomyositis may have 50% chance of malignant tumour of the genitourinary tract, but infants with the disease have no greater risk than a control group. Overall, even in adults, the association is not common and most cases of dermatomyositis occur without an identifiable cause. There is an impression that dermatomyositis provoked by malignant disease is more severe.

3) FIGURATE ERYTHEMA:

Rarely, annular erythema and erythema multiforme seem to be caused by underlying malignant disease.

BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005

http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
09825199585
Sponsored by the business degree web page.

Tuesday, May 26, 2009

SURGERY IN VITILIGO

VITILIGO SURGERY

INTRODUCTION:
In India, Vitiligo is considered a social stigma and the affected patient & family ostracized, hence it is important to treat and cure patient fully with all available modalities. Often we come across vitiligo patients who have stop responding to all possible medical therapies or who are responding very slowly to the same. Also, sometimes patient with clinically inactive lesions present for correction of their cosmetic deformity.
Apart from these, smaller group of secondary leucodermas (following thermal or chemical burns,etc) also need correction of the depigmented lesions.When inactive lesions occur on the unexposed, cosmetically unimportant areas, patients are ready to accept those lesions and hence can be left alone. However, frequently such hidden lesions also necessitate treatment, along with those occurring on the exposed sites. In such situations, camouflaging creams for daily application can be advised, but may not be acceptable to all, due to time consuming application, color mismatch, temporary action and cost factors. In such situation, one can think of surgical management of vitiligo.
Since 1964, various surgical techniques and modifications have been reported to treat recalcitrant but stable vitiligo with permanent and complete repigmentation.
Depigmentation in Vitiligo and secondary leucoderma results due to depletion of local melanocytes following their destruction by underlying disease. The various surgical procedures are designed with either of the following 4 aims;
1) Introduction of the artificial pigments into the lesions for permanent camouflage e.g. tattooing.
2) Removal of the depigmented areas forever e.g. Excision with primary closure.
3) Repopulation of the depleted melanocytes by various grafts e.g. Thierch’s grafts, ultra thin grafts, suction blister and miniature punch grafts, non cultured epidermal suspension or transplantation, epidermal and melanocyte cultures.
4) Therapeutically wounding the lesion so as to stimulate the melanocyte from the periphery and the black hair follicles to the proliferate, migrate and repigment the lesion e.g. therapeutic dermabrasion, laser ablation, cryosurgery, needling, local application of phenol or TCA.

SURGICAL MODALITIES FOR VITILIGO:

1) Cosmetic Tattooing
2) Excision & closure
3) Thin Thierch’s graft
4) Suction blister technique.
5) Miniature punch grafting.
6) Therapeutic wounding—Dermabrasion, Laser ablation,needling,cryosurgery,etc
7) Ultra thin grafting.
8) Grafting of non-cultured epidermal suspension.
9) Skin cultures—autologous, allologous or foetal; either epidermal containing both keratinocytes and melanocytes, or pure melanocytes only.
10) Others—Trypsinised autograft injection, single hair transplant homologous grafting, etc.

However, certain patient selection criteria should be strictly adhered to before taking any patient for surgical intervention.

PATIENT SELECTION CRITERIA:
1) Patient should have realistic expectations. Avoid psychologically unstable patients.
2) Patient not responding adequately to medical line of treatment.
3) Vitiligo lesions should be strictly stable for last two years i.e. existing lesions should not be expanding and no new lesion should have appeared in the interim.
4) The stability of the lesion should be confirmed by first doing trial grafting in a small vitiliginous area, 1-2 months before undertaking surgery of the entire lesion.

SUMMARY:

Good cosmetic end results will be obtained by strictly following the patient selection criteria and choosing appropriate surgical techniques depending on each individual case.
BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005

Monday, May 18, 2009

MICRODERMABRASION

MICRODERMABRASION: (SKIN POLISHING)
Microdermabrasion is an anti-aging and skin rejuvenating cosmetic procedure.It is widely used for a variety of cosmetic objectives ,including the improvement of Fine lines,Wrinkles,Photoaging,Acne,Scars and Stretch marks.
HOW MICRODERMABRASION WORKS?
In this method, a controlled flow of Aluminium oxide crystals is used to gently exfoliate the uppermost superficial dead layers of the skin It is a very effective skin polishing treatment using fine crystals that are directed on the skin through a vacuum tube and thus allowing a radiant translucent skin to emerge. This treatment removes dead surface skin cells to improve texture, softness, and brightness. It also stimulates cell and collagen production and reduces the appearance of large pores. Various defects in the surface of the skin can thus be addressed to reveal fresher, clearer skin in an effective and painless manner. Special Diamond tip Microdermabrasion is helpful in superficial to mediun depth scarring.This treatment or procedure can be done with other facial treatments to optimize results.
FAQ ABOUT MICRODERMABRASION:(SKIN POLISHING)
Why does one need Microdermabrasion or Skin Polishing? At what age can one start this service?


MICRODERMABRASION(SKIN POLISHING) is recommended for every one since at some point in time we are subjected to stress & increasing levels of environmental pollution. These factors cause our skin to get dull and pigmented. Due to over exposure to the sun, our skin gets damaged and one shows early signs of ageing. Such skin concerns need to get addressed and this is done with visible results through our service called C POINT Skin Polishing treatment.Practically in post pubertal age group,in both males & females, this treatment can be done safely & effectively
How is Microdermabrasion or Skin polishing different from facials?
The CPOINT Skin Polishing procedure has some advantages over facials;
It is useful in a wide range of skin problems like acne prone skin,fine wrinkles,photodamaged skin and superficial and medium depth acne scarring safely and effectively.
Removal of dead cells is uniform and is done very effectively and the service remains to be non-invasive
What is the procedure involved in MICRODERMABRSION or SKIN POLISHING?
Crystal Sensitivity Check: on your forearm.
Cleansing the face is then cleansed with the Cleansing gel.
Skin Polishing & Brightening: The dead, superficial skin cells on the uppermost layer of the skin are removed through a controlled flow of crystals.
Application of CPOINT products: After the procedure, a combination of products, which brighten the skin and improve skin tone are applied to your face. These products also have moisturizing & sun protection properties.

What is the chief skin concerns that CPOINT Microdermabrasion or Skin Polishing addresses?


CPOINT Skin Polishing & brightening addresses skin concerns such as dull skin,superficial & medium depth acne scars, fine lines and wrinkles & Sun damaged skin. This service can also be undertaken as part of your regular skin care and enhancement regime

Is the treatment for Microdermabrasion or Skin Polishing Safe?Yes,Microdermabrasion or Skin Polishing is an extremely safe procedure and is recommended for all skin types. At C POINT as an added precaution a crystal sensitivity check is done to rule out a rare case of sensitivity.

Are there any side effects whilst doing a Microdermabrasion or Skin Polishing?


C POINT skin polishing is absolutely safe,painless & non-invasive procedure and there are no side effects of it. However, very sensitive skin may become red due to the exfoliation action. However, this effect is transient. A cold compress is recommended in such a rare case.

What are the body parts for Microdermabrasion or Skin Polishing?


Most commonly employed body parts are face,neck,forearm & back,however in indicated person it can be done practically at any body parts.

How long does each session take?


The duration for Microdermabrasion or Skin Polishing usually lasts about 30 minutes per session.

Can I return to regular activities immediately after a session of Microdermabrasion or Skin Polishing?


C POINT Skin polishing requires no post procedure care. You can resume normal activities immediately. However in some cases of sensitive skin, direct sun exposure to excessive sunlight should be avoided and a sunscreen with a minimum SPF of 15 should be used regularly.

How many sessions are required to see best results?


Our skin is a dynamic organ. Excessive exposure to years of dust, pollution and harmful UV rays occurs continuously. Everyone has different skin and skin tones, with different levels of skin concerns. However at least 4 sessions are required to see visible results.Depending on indications, number of sessions and duration between session may vary accordingly.

Does this service have to be continued to maintain the results achieved?




Due to the exfoliation action, the immediate effect can be reddening of the skin, which subsides within hours. In extra sensitive skin, the effect lasts a day. Therefore Ideally you should get C POINT skin polishing procedure 2 to 3 days prior to occasion.

PHOTOGRAPHS OF PRE AND POST TREATMENTS.











BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005
http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
Sponsored by the business degree web page.

09825199585

MYTHS & REALITIES ABOUT DERMATO-COSMETOLOGY

MYTHS AND REALITIES IN DERMATOLOGY

INTRODUCTION

Quite often, we read or hear some cosmetic information which we may not always be able to substantiate by restoring to standard textbooks of dermatology. Hence, a compilation of common myths prevalent in our society are discussed here to provide scientific knowledge to those patients seeking cosmetic counseling.

MYTHS RELATED TO SKIN, HAIR AND NAIL CARE :

1) Soaps or shampoos which produce more lather have better cleansing action.

Reality : Lather productiom is dependent on addition of foam boosters to soaps or while cleansing is related to their detergent content. Hence, amount of lather produced is not proportional to cleansing activity of either soaps or shampoos, foam baths or bubble baths.

2) Foreign cosmetics are better than local ones.

Reality : The efficacy of these products depend on their basic contents and vary for individual. The fact that it is produced abroad with multiple additives does not certify any cosmetic to be better than it’s Indian counterpart.

3) Household cosmetics are harmless.

Reality : Home remedies can also irritate or sensitise the skin or have comedogenic potential and should be used with care.

4) Skin creams and moisturizers with vitamin A, E and other plant extracts prevent aging and skin wrinkling.

Reality
: Most of these substances are not absorbed topically and hence, carry no added advantage over a plain moisturizer. Some of them are humectants and thus act as moisturizers and temporarily improve wrinkles due to their plumping action.

5) Oil massage before bath gives a glowing skin.

Reality : Although, any massage improves the local circulation, the best results of oil application are obtained when applied on slightly moist skin, as during or after bath especially in those with dry skin. The regular use of oil massage in infants can produce folliculitis, especially if persons with poor hygiene are employed for this purpose.

6) Cleansing milks, facial packs and facials are more effective ways to clean the deep pores.

Reality : Soaps are equally effective for facial cleaning and above products, offer no significant advantage except for placebo effect.

7) Oily foods precipitate or aggravate acne.

Reality : Dietary factors are not involved in pathogenesis of acne and hence, food restrictions are unnecessary.

8) Regular steaming is good for skin.

Reality : Although, steaming hydrates the blocked pilosebaceous ducts so that comedone extraction become easier, it’s regular use in normal people can cause large, open pores. Even in acne patients, it should be used only for 1 – 2 minutes every 7 – 8 days. More frequent usage can result in damage to elastic fibres in long run causing premature aging.

9) Regular hair oil application prevents premature canities and prevents hairfall and give luxuriant hair growth.

Reality : Premature hair greying is genetically determined, it’s expression dependent on environmental factors, other than oil application. The only purposed served is probably improvement in local circulation, if massage is done after application, with improvement in hair growth.

10) Shaving the scalp or cutting hair improves growth in diffuse alopecia.

Reality : The rate of hair growth remains the same after these procedures. Also, no new hair follicles are formed by shaving or cutting the preexisting hair.

11). Shampoos with additives like pro-vitamin B5, keratin etc. are more effective in damaged hair.

Reality : Damaged hair due to abuse of hair styling techniques and hair products need a mild detergent shampoo with conditioner containing protein like hydrolysed animal protein are beneficial as they penetrates hair shaft and restores damaged hair protein structures. Various other additives only enhance commercial appeal, since they are not absorbed in scalp and hair shaft is dead cutaneous appendage.

12). Application of kajal improves eyesight and eyelashes growth.

Reality : Kajal contains carbon and apart from it’s cosmetic purpose of enhancing eye appeal, it serves no beneficial action. On the contrary, it’s application can cause contact dermatitis and conjunctivitis.

13).Use of castor oil increases growth of eyelashes and eyebrow hairs.

Reality : Application of any oil does not affect rate of hair growth; except for possible effects of ensuing massage action.

14).Trimming of cuticle is an essential part of nail care.

Reality : Cuticle is designed to protect underlying nail matrix from getting invaded by pathogens and irritant and allergen substances. The habit of trimming or pushing it back during manicure can damage the cuticle with resultant complication like acute and chronic paronychia.

15).Medicated soaps are better cleansing agents and good for diseased skin.

Reality : The normal skin flora acts as a defence against the pathogenic species and prevents their inhabitation of skin surface through bacterial interference. Medicated soaps with germ fighters destroy this beneficial flora; thereby allowing pathogenic bacterial invasion of the skin. Usually they also produce excessive dryness/irritation of the skin due to additional contents and hence should not be recommended excepts for recurrent skin infections/acne vulgaris.

16).The regular use of pumice stone and scrubbers cleans the skin better and reduces hyperpigmentation.

Reality : Bare hands and nails are enough to cleanse the skin along with a soap on daily basis. If pumice stone / scrubber are used vigorously they may dry the skin excessively. Also, bathing brush dermatitis with bilaterally symmetrical hyperpigmentation on bony prominence can follow years of usage of such products.

17).Costly branded cosmetics are more effective and cannot produce side effects.

Reality : The effectivity /adverse reaction of any cosmetic depends on it’s compounds eg. PPD in hair dyes and hence is present in both cheap and costly OTC products. Sometimes, costly product or branded cosmetics may contain additives like fragrances or preservatives to which side effects can develop.


SUMMARY
These are certain points which clarify wrong beliefs common in our society so that correct cosmetic usage and adoption of scientific techniques be followed by the patients.









BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005
http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
09825199585
Sponsored by the business degree web page.