Facial scarring

Fig. 9.14. A 51-year-old patient with severe facial scarring before (a) and 2 months after (b) deep chemical peel combined with subcision and skin abrasion...

Mancuso A, Farber GA (1991) The abraded punch graft for pitted facial scars. J Dermatol Surg Oncol... 

Kye YC (1997) Resurfacing of pitted facial scars with a pulsed Er YAG laser. Dermatol Surg 23 880-883... 

Tsai RY, Wang CN, Chan HL (1995) Aluminum oxide crystal microdermabrasion. A new technique for treating facial scarring. Dermatol Surg 21 539-542... 

Nodules are associated with scarring in any case, but even papular or pustular acne lesions can lead to scars. Scars have to be considered a hallmark of acne. Facial scarring affects both sexes equally and occurs to some degree in 95% of cases. Scars that result in a loss of tissue are... 

Margit Szollosi-Janze. Fritz Haber 1868-1934 Eine Biographie. Munich Verlag C. H. Beck, 1998. This authoritative biography of Haber scrupulously sorts fact from fiction unfortunately there is no English translation of this 928-page book. Source for facial scar attempt to become reserve officer role of sanitariums and Habers stays in them Clara as chemist and professor s wife Haber s BASF contract Reform Movement Clara s despairing letter Prussian ideals Haber as Archimedes his responsibility for poison gas and wartime authoritarianism Clara and poison gas Sackur Haber leaves after Clara s suicide Haber s postwar depression, Nobel Prize, postwar gas research, and help for Weimar Republic April 1933 events to end and Zyklon B. 

Lichenoid photoeruptions have been reported not infrequently in HIV-positive people, often in association with photosensitizing drugs, especially NSAIDs (174). Facial scars have been described in adults and children treated with NSAIDs, usually in connection with sun exposure (175). 

Wallace CA, Farrow D, Sherry DD. Increased risk of facial scars in children taking nonsteroidal antiinflammatory... 

Peels are not indicated for hypertrophic scars. Some fine facial scars (from a face-Kft, for example) improve vastly after local application of some phenol peels others are improved by a combination of abrasion and peeling. Body peels produce fewer results and more problems that facial peels. 

Along with laser and abrasion treatment, a full-face phenol peel is certainly one of the best options for treating facial scars. It is not completely effective, however, and it is often necessary to use chemabrasion - that is, a combination of a phenol peel followed (immediately or the next day) by abrasion with a diamond fraise or sandpaper. See Chapter 30 for more information on the treatment of acne scars and phenol peel face lifts. 

The treatment of body scars is more complex than that of facial scars. The same technique described for stretch marks is used abrasion plus ETCA peel plus post-peel mask cream plus occlusion. The results, although not exceptional, are quite good, as can be seen in Figures 21.34 and 21.35. 

Confirm suitability to wear a respirator. Factors that may be considered as contraindicating respirator u.se include obstructive pulmonary disease, moderate cardiovascular di.sease, physical features that may result in poor fit (e.g., facial scars), and psychological problems such as claustrophobia and anxiety (Ballantync, 1981). 

Early attempts to control smallpox included inoculation with material from smallpox lesions. This practice, known as variolization, caused severe cases of smallpox in about 1 in 200 inoculations.84 In 1796, Jenner noted that milkmaids were free of the facial scars that marked most of the population during the smallpox epidemics of that time. The observation that they cannot take smallpox was attributed to the localized pox lesions that they developed on their hands. Jenner reasoned that infectious material (which he dubbed a virus ) from cowpox lesions provided protection from smallpox, and used it to vaccinate an 8-year-old boy. The boy later resisted variolation, demonstrating that an animal poxvirus that is not virulent for humans could be used as a potent vaccine against smallpox.85... 

Hughes K. Fatality, Facial Scarring and Blindness From Smallpox in Bangladesh. Geneva, Switzerland 1978. WHO/ SE/78.101. 

But the mainstay of therapy for skin resurfacing continues to be chemical peels together with abrasion [37 2], Chemical peels in use to improve facial scarring include alpha-hydroxy acid peels, trichloroacetic acid, and deep phenol-based methods [43 8], In this chapter, we discuss deep chemical peels for post-acne scars treatment. 

An additional fit test is required whenever there are changes in the employee s physical condition that cordd affect respirator fit (e.g., facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight). 

Skin Facial scarring can occur as a result of the use of phenol to peel the skin, particularly if it is preceded by CO2 laser treatment first, perhaps because the depths at which the phenol peel and laser ablation acts are additive when the laser is applied first and perhaps because the laser causes loss of the epithelial barrier, allowing the phenol solution to perfuse deep into the dermis and causing further tissue damage [29" ]. However, hypertrophic scarring has been described after a phenol peel alone in a 75-year-old woman [30 ]. 

User factors are medical conditions that may make usage of particular types of respirators difficult (e.g., high level of exertion, poor sense of smell, and physical characteristics such as facial scars that may cause difficulties with fit). 

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