Planing for Precancerous Skin

Epstein, Ervin

doi:10.1001/archderm.1958.01560060042008

Cited by 16 publications

(6 citation statements)

References 2 publications

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“…It is interesting to note that the use of dermabrasion to prophylactically treat actinic keratosis and NMSC was described over 40 years ago [41]. A number of reports have demonstrated that dermabrasion can reduce the incidence of actinic keratosis and NMSC up to 95% in susceptible individuals for many years after treatment [42-44].…”

Section: Discussionmentioning

confidence: 99%

Reversing the aging stromal phenotype prevents carcinoma initiation

Lewis

Travers

Machado

et al. 2011

Aging

101

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The accumulation of senescent stromal cells in aging tissue changes the local microenvironment from normal to a state similar to chronic inflammation. This inflammatory microenvironment can stimulate the proliferation of epithelial cells containing DNA mutations which can ultimately lead to cancer. Using geriatric skin as a model, we demonstrated that senescent fibroblasts also alter how epithelial keratinocytes respond to genotoxic stress, due to the silencing of IGF-1 expression in geriatric fibroblasts. These data indicate that in addition to promoting epithelial tumor growth, senescent fibroblasts also can promote carcinogenic initiation. We hypothesized that commonly used therapeutic stromal wounding therapies can reduce the percentage of senescent fibroblasts and consequently prevent the formation of keratinocytes proliferating with DNA mutations following acute genotoxic (UVB) stress. Sun-protected skin on the lower back of geriatric human volunteers was wounded by dermabrasion and the skin was allowed to heal for three months. In geriatric skin, we found that dermabrasion wounding decreases the proportion of senescent fibroblasts found in geriatric dermis, increases the expression of IGF-1, and restores the appropriate UVB response to epidermal keratinocytes in geriatric skin. Therefore, dermal rejuvenation therapies may play a significant role in preventing the initiation of skin cancer in geriatric patients.

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Section: Discussionmentioning

confidence: 99%

Reversing the aging stromal phenotype prevents carcinoma initiation

Lewis

Travers

Machado

et al. 2011

Aging

101

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“…In 1958 Epstein 28 reported on planing for precancerous skin. In 1960 Burks and Brewer 29 presented results of planing for prevention of skin cancer in 58 patients with full‐face planing.…”

Section: Dermabrasion For Actinic Damagementioning

confidence: 99%

“…He again established the fibrogenic zone replacing solar elastosis and the development of new elastic fibers on histologic examination. In 1966 Epstein 30 published a 10‐year evaluation on planing for precancerous skin. He found no recurrences in four cases and partial success in four patients (recurrences but still a significant benefit).…”

Section: Dermabrasion For Actinic Damagementioning

confidence: 99%

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History of Dermabrasion

Lawrence

Yarborough

Alt

2000

Dermatologic Surgery

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“…Numerous studies since then have shown the efficacy of dermabrasion in addressing precancerous lesions. 12,19,20,21 In a series of 23 patients with actinic damages who underwent dermabrasion, 79% were cancer-free at 3 years, 64% at 4 years, and 54% at 5 years. These outcomes were superior to results observed from cryosurgery, 5-fluorouracil, or chemical peel as prophylactic treatment against actinic keratosis.…”

Section: Actinic Damagementioning

confidence: 99%

29 Dermabrasion and Microdermabrasion: Rationale, Application, Safety Concerns, and Complications

Truswell¹

2016

Lasers and Light, Peels and Abrasions

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The history of dermabrasion dates back to 1550 BC when Egyptian physicians used alabaster and pumice to smooth scars and skin blemishes. 1 They recognized that producing partial-thickness abrasion improved the appearance of skin. Modern era dermabrasion was pioneered in 1905 by Kromayer. 2 In 1953, Kurtin refined the dermabrasion technique with modified, powered dental equipment using topical refrigerants and a wire brush. 3 There are three main modalities for skin resurfacing: chemical peel, laser resurfacing, and mechanical dermabrasion. The contemporary trend favors the use of the laser-resurfacing technique. Many clinicians feel that laser resurfacing allows for more controlled thermal injury and more consistent outcomes with less operator-dependent variability. Whereas the newest laser technology has significantly reduced risk associated with thermal injury to surrounding tissues, in experienced hands, dermabrasion provides great manual control to the depth of destruction without spreading the thermal injury to deeper layers of the skin. MechanismThere are five layers of epidermis: stratum corneum at the surface followed by lucidum, granulosum, spinosum, and basalis. The thickness of epidermis varies depending on age of the patient and location of the skin. Average thickness of facial skin epidermis is approximately 100 µm thick, although at the eyelids it may be only 50 µm thick. 4 Four major cell types are found in the epidermis, including keratinocytes (80%), melanocytes, Langerhans cells, and Merkel cells. In the basalis layer, melanocytes generate skin pigmentation through the actions of the tyrosinase enzyme. 5 The rete ridges are projections of the epidermis into the dermis that help increase the surface area of contact between the two interfaces. In both processes of aging and scar formation, histological changes observed include loss of elastic fiber, atrophy of collagen bundles, and flattening of rete ridges. 6,7 The dermis consists of papillary and reticular layers. The papillary layer is located below the basement membrane and contains mostly loose collagen and fibrocytes. The reticular layer contains thicker, compact collagen, and the adnexal structures of the skin such as sweat glands, hair follicles, and sebaceous glands. On the hairless part of the face, such as the nose, the sebaceous unit is the predominant adnexal structure. Within the adnexal structures are the epithelial stem cells capable of differentiation and re-epithelialization. 8 The goal of dermabrasion is to mechanically remove the epidermis while preserving the adnexal structures (▶ Fig. 29.1). This is accomplished with the use of a motorized handpiece and a rotating tip composed of either a wire brush or diamond particle-coated fraise (▶ Fig. 29.2). The depth of injury is controlled by the surgeon carefully abrading the skin to the desired layer (▶ Fig. 29.2). Controlled injury to the epidermis and papillary dermis heals without scarring; however, if the injury penetrates deep into the reticular dermis where the adnexal struct...

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Planing for Precancerous Skin

Cited by 16 publications

References 2 publications

Reversing the aging stromal phenotype prevents carcinoma initiation

Reversing the aging stromal phenotype prevents carcinoma initiation

History of Dermabrasion

29 Dermabrasion and Microdermabrasion: Rationale, Application, Safety Concerns, and Complications

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