Isaac Neuhaus

Guest Editor for the following articles:

Mar
2007
Vol. 26. No. 1

Bleeding Complications in Dermatologic Surgery

Eva A Hurst, MD | Isaac M Neuhaus, MD | Roy C Grekin, MD | Siegrid S Yu, MD

Although the overall incidence is low, bleeding complications in dermatologic surgery can occur and be the source of significant patient morbidity.

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Jun
2012
Vol. 31. No. 2

The Evolution of Melasma Therapy: Targeting Melanosomes Using Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminium Garnet Lasers

Arielle N.B. Kauvar, MD

Melasma is an acquired disorder of pigmentation that commonly affects women with
phototypes III-V, and it has a negative impact on the quality of life in affected individuals.
It presents clinically as symmetric tan or brown patches on the face, most often involving
the forehead, cheeks, perioral region, and periorbital region. On histologic examination,
there is increased melanin in the epidermis and/or an increased number of melanosomes
in the dermis, with a normal number of highly melanized and dendritic melanocytes. The
mainstay of treatment is the use of sunscreen along with topical medications that suppress
melanogenesis. Clearance is usually incomplete and recurrences or exacerbations are
frequent, probably because of the poor efficacy in clearing dermal melanosomes. Treatment
with high-energy pigment-specific lasers, ablative resurfacing lasers, and fractional lasers
results in an unacceptably high rate of postinflammatory hyper- and hypopigmentation and
rebound melasma. Recently, promising results have been achieved with low-fluence Qswitched
neodymium-doped yttrium aluminium garnet laser treatment, which can selectively
target dermal melanosomes without producing inflammation or epidermal damage, in
all skin phototypes. This article reviews the current treatment modalities for melasma, the
rationale for using and the clinical results of combination therapy with low-fluence Qswitched
neodymium-doped yttrium aluminium garnet lasers.
Semin Cutan Med Surg 31:126-132 © 2012 Elsevier Inc. All rights reserved.

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Mar
2007
Vol. 26. No. 1

Infectious Complications and Antibiotic Use in Dermatologic Surgery

Eva A Hurst, MD | Isaac M Neuhaus, MD | Roy C Grekin, MD | Siegrid S Yu, MD

Infection rates in dermatologic surgery are low, ranging on average from 1 to 3%. Studies have shown that many practitioners likely overuse antibiotics, both for prevention of wound infection and in endocarditis prophylaxis. This article discusses patient and environmental risk factors in would infection.

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Jun
2012
Vol. 31. No. 2

New Horizons in Treating Disorders of Hyperpigmentation in Skin of Color

Aanand N. Geria, MD | Rebat M. Halder, MD

Pigmentary abnormalities are among the most common reasons why patients with skin of
color visit a dermatologist. Hydroquinone has been a cornerstone for the treatment of
hyperpigmentation; however, concerns regarding adverse effects have prompted a search
for alternative agents. Some promising topical treatments include soy, licorice, rucinol,
mulberry, niacinamide, ellagic acid, resveratrol, and dioic acid. Oral agents, primarily used
for the prevention of postprocedural hyperpigmentation, include procyanidins, tranexamic
acid, and Polypodium leucotomos. Advances in Q-switched lasers, intense pulse light,
fractional photothermolysis, and the advent of tretinoin peeling add to the clinician’s
armamentarium for treating hyperpigmentation.
Semin Cutan Med Surg 31:133-139 © 2012 Elsevier Inc. All rights reserved.

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Jun
2012
Vol. 31. No. 2

Cutting Edge in Medical Management of Cutaneous Oncology

Adil Daud, MD | Kim Chong, MD | Sarah T Arron, MD, PhD

Traditional chemotherapy has resulted in only a modest response, if any, for the 3 most
common cutaneous malignancies of basal cell carcinoma, squamous cell carcinoma, and
melanoma. Recent advances in understanding of the defects in the pathways driving
tumorigenesis have changed the way that we think of these cancers and paved the way
to targeted therapy for specific tumors. In this review, we will introduce the novel
systemic treatments currently available for these cancers in the context of what is
understood about the tumor pathogenesis. We will also introduce ongoing studies that
will hopefully broaden our options for highly effective and tolerable treatment.
Semin Cutan Med Surg 31:140-149 © 2012 Elsevier Inc. All rights reserved.

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