Nicolas Balagué

Plastic surgery improves long-term weight control after bariatric surgery.

1. Balagué N, Combescure C, Huber O, Pittet-Cuénod B, Modarressi A. Plastic surgery improves long-term weight control after bariatric surgery. Plast Reconstr Surg. 2013;132: 826–833. 2. American Society of Plastic Surgeons. 2012 Plastic Surgery Statistics Report. Available at: http://www.plasticsurgery. org/Documents/news-resources/statistics/2012-PlasticSurgery-Statistics/body-contouring-after-massive-weight-loss. pdf. Accessed October 9, 2013. 3. Sarwer DB, Fabricatore AN. Psychiatric considerations of the massive weight loss patient. Clin Plast Surg. 2008;35:1–10. 4. Coon D, Michaels J V, Gusenoff JA, Purnell C, Friedman T, Rubin JP. Multiple procedures and staging in the massive weight loss population. Plast Reconstr Surg. 2010;125:691–698. 5. Coon D, Gusenoff JA, Kannan N, El Khoudary SR, Naghshineh N, Rubin JP. Body mass and surgical complications in the postbariatric reconstructive patient: Analysis of 511 cases. Ann Surg. 2009;249:397–401.

Non-tuberculous mycobacterial infections of the hand

UNLABELLED Non-tuberculous mycobacterial infections of the hand are difficult to treat and require a long time before remission. But how long should we wait to see an improvement? To answer this question, the published scientific literature was reviewed in English, French and German. Tuberculosis, arthritis and osteomyelitis cases were excluded. A total of 241 non-tuberculous mycobacterial hand infections in 38 scientific publications were retrieved. Most were case reports or series. The median age of the patients was 58years and one third was female. Patients were immunocompromised in 17 episodes. The most common species were Mycobacterium marinum in 198 episodes (82%), followed by M. chelonae in 13 cases (5%). There were no cases of mixed infection. Most infections were aquatic in origin and community-acquired, and were treated with a combination of surgical debridement and long-duration systemic combination antibiotic therapy (14 different regimens; no local antibiotics) for a median duration of 6months. The median number of surgical procedures was 2.5 (range 1-5). Clinical success was not immediate: a median period of 3months (range 2-6) was necessary before the first signs of improvement were observed. The majority (173 cases; 76%) remained entirely cured after a median follow-up time of 1.7years (range, 1-6). Only two microbiological recurrences occurred (1%). However, 49 patients (21%) had long-term sequelae such as pain, stiffness and swelling. The approach of long-duration antibiotic treatment in combination with repeated surgery for mycobacterial soft tissue infections of the hand leads to few recurrences. However, clinical success is not immediate and may take up to 3months. TYPE OF STUDY Therapeutic study: systematic review of level III studies. LEVEL OF EVIDENCE III.

Hyaluronic Acid Filler in HIV-Associated Facial Lipoatrophy: Evaluation of Tissue Distribution and Morphology with MRI

Objective: This prospective observational study evaluated magnetic resonance imaging (MRI) findings of hyaluronic acid (HA) injections used for the correction of HIV-associated facial lipoatrophy. Methods: Ten consecutive males underwent subdermal HA injection (mean 1.3 ± 0.6 ml per side) and MRI examinations prior to and then 1, 6 and 12 months after injection. Two radiologists blinded to the clinical data assessed morphologic and quantitative changes. Results: MRI revealed HA deposition in the subdermal and deep fat compartments. A significant HA volume increase was observed 1 month after injection (mean increase 331%, p < 0.0001) as compared to the injected amount. No volume reduction occurred at 12 months (p = 0.9961). The measured bound water content did not change (p > 0.9991), whereas skin thickness and tissue vascularization increased during the first 6 months (p = 0.01). Conclusion: Our data show that the cosmetic results of HA injections are caused by water binding in the deep facial fat and by a transient increase in vascularization and skin thickness.

Third degree formic acid chemical burn in the treatment of a hand wart: a case report and review of the literature

ObjectiveCutaneous warts are very common and a large variety of topical treatments and drugs can be employed to cure these skin injuries that can arise on any part of the body. But are these products really safe?MethodWe performed a case description and PubMed literature review using key words “wart,” “chemical burn,” and “formic acid.” All articles in English and French were selected.ResultsThis is the first report of a chemical burn by formic acid in the treatment of warts. Numerous topical treatments for cutaneous warts are available with many new drugs appearing every year. However, only a few treatments have proven their effectiveness, such as salicylic acid or cryotherapy with liquid nitrogen that are commonly used. Moreover, most cutaneous warts will resolve spontaneously without any treatment and several products, including topical acids and cryotherapy devices, presented adverse effects such as chemical burns or frostbites so demonstrating that even frequently used treatments can be harmful.ConclusionTopical treatments used for wart removal are not without risk even if some products are sold without prescription. For self-treatment products, we recommend enhanced warning by the pharmacist about the risks involved.

Contents Vol. 230, 2015

G. Argenziano, Reggio Emilia M. Augustin, Hamburg W.H. Boehncke, Geneva L. Borradori, Bern R.P. Braun, Zurich R. Cerio, London L. Cerroni, Graz O. Chosidow, Créteil A. Dupuy, Rennes J.W. Fluhr, Berlin L. French, Zurich F. Furukawa, Wakayama M. Gilliet, Lausanne A.K. Gupta, London, Ont. R. Happle, Freiburg R.J. Hay, London P. Itin, Basel G. Kaya, Geneva R.G.B. Langley, Halifax, N.S. J.M. Mascaro, Jr., Barcelona K. Matsunaga, Nagoya L. Naldi, Bergamo F. Nestle, London C. Paul, Toulouse T. Shiohara, Tokyo T. Simonart, Brussels H.P. Soyer, Brisbane, Qld. L. Thomas, Lyon R.M. Trüeb, Wallisellen T.J. Yoon, Jinju C.C. Zouboulis, Dessau International Advisory Board