Dermatosis Papulosa Nigra Case Series

Report
Dermatosis Papulosa Nigra
Case Series
Victoria Smith BSc (Hons) ITEC VTCT
Director of Aesthetics
Aim of Case Study
To conduct a study using Advanced
Electrolysis to remove Dermatosis Papulosa
Nigra effectively leaving little/no scar to the
skin
What is Dermatosis Papulosa
Nigra?
• Dome shaped- brown/black papules
• Benign lesions
• Usually found on upper body/face
cheeks, neck
• Measure 1mm-5mm in diameter
• Crusting, ulceration, flaking do not
occur
• Cosmetically unattractive
• Do not disappear without treatment
What causes Dermatosis
Papulosa Nigra?
• Exact cause is unknown
• Variation of seborrhoeic keratosis
• Genetically determined- 40-50% chance of
developing if there is a family history
• Possible pilosebaceous follicle that does not
develop properly
Who gets Dermatosis
Papulosa Nigra
•Affects all black skin types e.g. 35% African
American
•Affects Asian/Polynesian skin types- frequency
unknown
•More common in females
•Begins in adolescence- number and size increase
with age
Existing Treatments for
Dermatosis Papulosa Nigra
•Surgery
•Cryotherapy- Liquid Nitrogen
•Laser e.g. CO2, Nd YAG
•Trichloroacetic acid
•Natural Remedies e.g. homeopathy
•Camouflage Make Up
•Advanced Electrolysis
History of Electrolysis
•Invented by Dr Charles E Michel 1875
•Developed for Trichiasis
•Uses galvanic/short wave diathermy current
•Insertion of needle- emitting current
•FDA approved for permanent hair removal
Advanced Electrolysis
Methods have been developed to treat
lumps/bumps and lesions with this
technology
Skin tags
Milia
Telangiectasia
Seborrhoeic Keratosis
Xanthelasma
Age spots
The Procedure
•
•
•
Procedure is
conducted in a
clean but not sterile
environment
Using short wave
diathermy between
15-20 RF (Radio
frequency)- low to
medium diathermy
current
One piece stainless
steel needle
Procedure
•
•
Tip of needle is used to sever
the lesion from the skin,
using a scraping technique
As they are superficial, they
tend to lift off the skin easily
After Procedure
•No discomfort
•Occasional inflammation in area treated
•Slight erythema
•Sometimes bleeds- before scab forms
•Scab comes away at 5-7 days
•Regular application of witch hazel
•Aftercare advice given
Aftercare Advice Given
1.
2.
3.
4.
5.
Avoid picking/removing crusting/scabs
Avoid swimming, sun-beds, saunas and fake tans
for 48 hours
Avoid skin irritants e.g. perfume, deodorant,
perfumed body lotion in treated area for 48 hours
Avoid exfoliation until scabs have come away
Avoid direct sun exposure whilst skin is healing, to
prevent hyper/hypo pigmentation- wear a SPF3050 daily
Results so far
6 people treated so far (all females- ages 38-52
years)
•2 people have completed treatment
•4 people still continuing treatment
•Treatments all successful
• Patient follow up currently between 4wks1year post treatment
•Variance in scarring remaining dependant on
skin type, area treated and adherence to
aftercare
•All would have the treatment repeated
Results at 1 year
1 patient at 1 year
•No re-growth in treated area
•Slight scarring remains in some areas- faded
over time- usually where scabs have been
picked
•Skin is smooth
•Significant increase in patient self esteem
Before and After Image
Conclusion
• Advanced Electrolysis is an effective procedure
for the removal of Dermatosis Papulosa Nigra
• To reach a satisfactory summary further
treatment on different ethnic groups is
required
• Scarring is more likely to occur in some areas
than others e.g. abdomen
• Not following the aftercare instructions will
result in a higher risk of scarring
Developments for the Future
• To continue to monitor the long term
efficacy of treatment
• Work alongside doctor to record possible
health/genetic patterns
• Investigate different shaped probes for
removal techniques
• Variances on settings according to skin
type and colour
Thank you for reading
If you have any questions of would like to
discuss my case series and experience with
using this procedure for Dermatosis Papulosa
Nigra please do not hesitate to contact me
[email protected]

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