Individual well-being and self-esteem related to appearance of patients with multiple seborrheic keratoses (MSK), as well asan original strategy for complete removal of all lesions with CO2 laser are discussed. Presented are examples from our dermatological practice illustrating negative psycho-social impact of multiple SK on individual well-being. Seborrheic keratosis is considered a widespread dermatosis, as well as a cosmetic issue for its presence creates an overall impression of prematurely aged, and a “shabby” looking skin. Individuals with multiple SK often suffer low self-esteem in terms of their appearance which may improve after the aesthetic CO2 laser complete elimination of MSK lesions.
Osteoma cutis, also called multiple miliary osteoma cutis is a rarely described dermatosis, and in cases that are not associated with Albright’s hereditary osteodystrophy, osteoma cutis is being defined as a skin type of hamartoma, with mesenchymal cell differentiation in bone tissue. Levels of biochemical parameters (such as serum calcium, alkaline phosphatase and parathormones) are usually within the reference range when dermal osteomas are found. When osteoma cutis formations are X-ray detected (as it often happens when a computer tomography for dental purposes is performed) they manifest as small nodules in the skin with bone density ranging from 1 to 3mm. The very few presence in literature of osteoma cutis cases is due to the fact that the condition is usually asymptomatic and/or its scarce expression is misdiagnosed as milia, fatty hyperplasia or fatty cysts. Reported in this paper are 14 (fourteen) cases of osteoma cutis. It is discussed their occurrence is due to chronic inflammatory processes (acne), and/or pathogenic behavior of skin injuring (patomimia) that unlock suppressed genes (paleo genes) to protect the skin, that are similar to the bone tiles (osteoderms) present in many vertebrates.
Two clinical cases of successful thin-layered CO2 laser ablation of localized form of granuloma annulare, are presented. Granuloma annulare is a rare dermatosis whose etiology is still unclear. Relation to various systemic diseases is assumed. Non-aesthetic lesions create discomfort, and may impede affected individuals’ social confidence, physical, and psycho-social functioning. In most cases lesions regress spontaneously, and therefore therapeutic minimalism is to be applied. Therapeutic modalities include laser therapy. Reports in literature of GA treatment with PDL, Fractional Thermolysis, as well as excimer laser indicate attempts at treatment of GA are being made not knowing the mechanisms behind etiology of GA. Presented bellow successfully treated cases with thin-layered CO2 laser ablation demonstrate treatment of GA with thin-layered laser ablation as therapeutically effective. The procedure is bloodless, relatively painless and completely aseptic, no postoperative pain. Possible impetiginization is easily avoided. Keywords: Granuloma Annulare; CO2 Laser; Thin-Layered Laser Ablation Abbreviations (CO2 laser) Carbon Dioxide Laser (GA) Granuloma Annulare (PDL) Pulsed Dye Laser (FT) Fractional Thermolysis
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