Objective:To compare the clinical efficacy and safety of water jet-assisted dermabrasion versus electric dermabrasion in combination with suction blister epidermal grafting in the treatment of vitiligo.Methods:A total of 60 vitiligo patients were enrolled from the Department of Dermatology, Xijing Hospital from March 2020 to March 2022. Thirty patients firstly received water jet-assisted dermabrasion, 30 firstly received electric dermabrasion, and then all were treated with suction blister epidermal grafting. Follow-up visits were conducted once a month, and the repigmentation of skin lesions and efficacy were evaluated and compared between the two groups 6 months after surgery.Results:There were 30 patients with 312 skin lesions in the water jet-assisted dermabrasion group, including 13 males and 17 females, with the ages and disease duration being 24.41 ± 3.12 years and 5.13 ± 2.34 years respectively; there were 30 patients with 301 skin lesions in the electric dermabrasion group, including 11 males and 19 females, with the ages and disease duration being 22.73 ± 5.11 years and 4.88 ± 2.21 years respectively. No significant differences were observed in the age, gender, disease duration, and dermabrasion sites between the two groups (all P > 0.05). Six months after the operation, 187 (59.94%) skin lesions were healed, 103 (33.01%) were markedly improved, and 22 (7.05%) were improved in the water jet-assisted dermabrasion group; in the electric dermabrasion group, 166 (55.15%) lesions were healed, 108 (35.88%) were markedly improved, and 27 (8.97%) were improved; there was no significant difference in the total response rate between the water jet-assisted dermabrasion group (92.95%) and the electric dermabrasion group (91.03%; χ2 = 0.27, P = 0.602). The water jet-assisted dermabrasion group showed significantly higher degree of repigmentation (90.47% ± 2.53%), matching degree of skin color (3.53 ± 0.21 points), and patient satisfaction scores (3.32 ± 0.27 points) compared with the electric dermabrasion group (82.40% ± 5.33%, 2.71 ± 0.32 points, 2.68 ± 0.41 points, t = 5.30, 8.28, 5.09, respectively, all P < 0.05). No adverse reactions/events were seen in either group. Conclusions:The water jet-assisted dermabrasion combined with suction blister epidermal grafting and electric dermabrasion combined with suction blister epidermal grafting showed similar efficacy in the treatment of vitiligo, with good safety profiles. However, the degree of repigmentation, matching degree of skin color, and patient satisfaction rates were all higher in the patients receiving water jet-assisted dermabrasion than those receiving electric dermabrasion.

Objective:To investigate the clinical efficacy of single-incision plus one-port three dimensional (3D) laparoscopic pancreaticoduodenectomy (SILPD+1).Methods:The retrospective cohort study was conducted. The clinicopathological data of 40 patients who underwent 3D laparos-copic pancreaticoduodenectomy in Affiliated Hospital of North Sichuan Medical College from January to October 2023 were collected. There were 24 males and 16 females, aged (63±10)years. Of the 40 patients, 18 cases undergoing SILPD+1 were divided into the SILPD+1 group, and 22 cases under-going conventional five-trocar 3D laparoscopic pancreaticoduodenectomy (CLPD) were divided into the CLPD group. Observation indicators: (1) surgical situations; (2) postoperative situations and complications. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the Mann-Whitney rank sum test. Results:(1) Surgical situa-tions. Seventeen patients of the SILPD+1 group completed surgery successfully, and the rest of one patient with an inflammatory mass of the pancreatic head was converted to open surgery due to unclear boundary with mesenteric blood vessels and severe adhesion of surrounding tissues. All patients of the CLPD group completed surgery successfully, without conversion to open surgery. There was no significant difference in conversion to open surgery between the two groups ( P>0.05), and there was no significant difference in the volume of intraoperative blood loss, intraoperative blood transfusion or operation time ( P>0.05). (2) Postoperative situations and complications. There was no significant difference in tumor diameter, the number of lymph node dissected, the number of positive lymph node, R 0 resection, tumor type, time to postoperative first flatus, time to postopera-tive first intake liquid food, tome to first out-of-bed activity, time to postoperative drainage tube removal, duration of postoperative hospital stay, postoperative bleeding, pancreatic fistula, chylous leakage, delayed gastric emptying, abdominal fluid collection, incision infection, classification of com-plications between the two groups ( P>0.05). Postoperative pain score of the SILPD+1 group and the CLPD group was 5.0(4.5,6.0) and 6.5(6.0,7.0), respectively, showing a significant difference ( Z=-3.61, P<0.05). Both groups of patients had no occurrence of biliary fistula or abdominal infection after surgery, and there was no readmission within 30 days after surgery or no death within 90 days after surgery. Conclusions:Compared with CLPD, SILPD+1 is safe and feasible, with less postoperative pain. While ensuring oncological outcomes, SILPD+1 does not increase surgical time, postoperative hospital stay, or incidence of postoperative complications.

Objective:To investigate the efficacy of autologous fat grafting in the treatment of stable linear scleroderma.Methods:A retrospective analysis was performed on 40 patients with stable linear scleroderma who received autologous fat grafting from October 2017 to November 2020 in the Department of Dermatology, Xijing Hospital, Air Force Medical University. There were 22 males and 18 females, aged 12 - 36 (18.2 ± 4.82) years. Skin lesions involved the forehead in 16 cases, the perioral area in 4, the lower jaw in 2, the cheek in 9, the trunk in 5, and the lower limb in 4, and the size of depressed skin defects was 3 - 24 cm 3. The patients′ subjective satisfaction rate, the decrease in the size of depressed skin defects, and the incidence of adverse reactions after autologous fat grafting were analyzed during the follow-up. Results:Six months after the grafting, 40 patients were followed up and evaluated, and the size of depressed skin defects markedly decreased. The satisfaction rate for appearance improvement after the first grafting was 60% (24/40) ; 35 patients received the second grafting, with a satisfaction rate of 88.6% (31/35) ; 17 received the third grafting, with a satisfaction rate of 94.1% (16/17) ; the total satisfaction rate was 87.5% (35/40). After the grafting, local skin unevenness was observed in the grafting area in 3 patients, and in the liposuction area in 2. The incidence rate of postoperative adverse reactions was 12.5% (5/40) .Conclusion:Autologous fat grafting was markedly effective in the treatment of stable linear scleroderma.

Objective:To analyze postoperative adverse reactions in patients with acne scars treated with punch elevation.Methods:Totally, 27 patients with moderate or severe acne scars, who were treated with punch elevation, were collected from the Department of Dermatology, Xijing Hospital, Air Force Medical University from June 2020 to March 2021. The patients received local infiltration anesthesia during the operation, and were cared for with tensile adhesive plaster bandaging, cold compresses, and waterproofing after the operation; telephone and face-to-face follow-up visits were conducted immediately, 3, 7, 14, 21, 30, and 60 days after the operation, and numerical rating scale (NRS) of intraoperative pain, postoperative swelling duration, postoperative erythema duration, and the incidence of post-inflammatory hyperpigmentation were recorded.Results:Among the 27 patients, the severity score of acne scars was 77.76 ± 43.76 points. The intraoperative pain NRS score was 3.75 ± 2.95 points after local infiltration anesthesia, the postoperative swelling lasted 3.42 ± 2.43 days, postoperative erythema lasted 4.74 ± 3.25 weeks, and the duration of postoperative erythema was not significantly correlated with the severity score of acne scars ( r = -0.13, P = 0.449). After the operation, post-inflammatory hyperpigmentation occurred in 2 patients, and no local infections or fulminant acne was observed. The patient satisfaction rate was 100% (27/27) . Conclusion:The main adverse reactions to punch elevation for acne scars were postoperative swelling and erythema, which subsided spontaneously about 1 month after the operation.

Objective:To investigate the efficacy of tumescent anesthesia combined with skin and soft tissue expansion for the repair of congenital giant melanocytic nevi.Methods:From July 2015 to December 2019, 41 patients with congenital giant melanocytic nevi, including 24 males and 17 females aged 7 - 45 years, were collected from the Department of Dermatology, Xijing Hospital, the Fourth Military Medical University. Skin lesions ranged from 5 cm × 12 cm to 12 cm × 18 cm in size, and were located on the scalp in 13 cases, on the face in 18 cases, as well as on the trunk in 10 cases. Before surgery, the composition of tumescent solution was adjusted according to the body weight, operation duration, skin lesion area, etc., and the total dose and peak plasma concentration of lidocaine should be below 35 mg/kg and 4 mg/L respectively. All the patients received tissue expander placement and second-stage flap transfer under tumescent anesthesia.Results:During surgery, satisfactory effect of tumescent anesthesia was achieved in all the 41 patients, the pain score assessed by a numerical rating scale was 1.82 ± 0.54. In addition, the surgical field and dissection levels were clear with little bleeding and no related complications. Follow-up of 3 - 36 months showed that the skin flaps matched the surrounding skin tissues well, with relatively concealed incision lines and soft flat scars.Conclusion:For the treatment of congenital giant melanocytic nevi, tumescent anesthesia is effective and safe, which combined with skin and soft tissue expansion can effectively reduce the incidence of postoperative complications, and this strategy is worthy of clinical promotion.

Although the incidence of melanoma is increasing rapidly, its proportion is relatively low among all the malignant tumors in China, and oncologists commonly pay little attention. The first consultation place for melanoma patients is mainly the department of dermatology. Dermatologists have unique advantages in the diagnosis and treatment of melanoma since they can comprehensively integrate clinical diagnosis, pathological diagnosis, surgical treatment and drug treatment. In recent years, Chinese scholars have made great progress in melanoma research, such as regulation of cell death, epigenetic modification, resistance to targeted drugs, tumor microenvironment and tumor immune regulation. Interferon α-1b, a unique new drug in China, not only can be used for adjuvant treatment of high-risk stage Ⅱ and Ⅲ melanoma, but also shows good efficacy in the treatment of stage Ⅳ melanoma, and adverse reactions to it are far less than those to interferon α-2b. Unlike the White population, the common subtypes of melanoma are acral and mucosal melanomas in the Asian population. The combination of interferon α-1b with programmed death receptor-ligand 1 inhibitor, targeted drugs or angiogenesis inhibitors is bringing hope for patients with stage IV melanoma.

Objective:To analyze clinicopathological characteristics of trauma-related melanoma and their relationship with the prognosis of patients.Methods:Clinical data were collected from 87 cases of trauma-related melanomas in Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from 2009 to 2020, and their clinicopathological characteristics were retrospectively analyzed. Mann-Whitney test was used to analyze the difference in Breslow thickness of tumors between patients of different ages or genders; Spearman rank correlation analysis was used to analyze the correlation between the time from trauma to the notice of melanoma and Breslow thickness, Kaplan-Meier survival analysis and Log-Rank test were employed to analyze the relationship between clinicopathological characteristics of melanoma and the prognosis of patients; Cox regression model was used to analyze risk factors for survival duration of patients with trauma-related melanoma.Results:Among the 87 patients with trauma-related melanoma, 47 (54.02%) were males and 40 (45.98%) were females. Among them, melanoma occurred in 50 (57.47%) cases after sharp injuries, and in 37 (42.53%) after blunt injuries. In addition, 31 (35.63%) cases presented with primary lesions on the hands, and 48 (55.17%) on the feet. The Breslow thickness of the primary tumors was significantly higher in the group aged > 55 years than in the group aged ≤ 55 years ( U= 623.500, P= 0.010) , but there was no significant difference between patients of different genders ( P= 0.138) . The time from trauma to the notice of melanoma was negatively correlated with the Breslow thickness of tumors ( r=-0.203, P= 0.037) . The age of patients, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor significantly affect the survival duration of patients with trauma-related melanoma ( P= 0.011, 0.031, 0.002 and 0.031, respectively) ; the gender, type of trauma and ulceration of tumor mass did not significantly affect the survival duration of patients ( P= 0.618, 0.114 and 0.379, respectively) . Cox regression model analysis showed that the Ki67 proliferation index and Breslow thickness were independent risk factors affecting the prognosis of trauma-related melanoma (risk ratio [ RR] and 95% confidence interval [ CI] were 1.946 (1.234, 4.217) and 1.839 (1.014, 3.332) , P= 0.039 and 0.045, respectively) . Conclusion:The Breslow thickness of trauma-related melanoma is related to the age of patients and time from trauma to the notice of melanoma; the age, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor all affect the survival duration of patients with melanoma, and Ki67 proliferation index and Breslow thickness are independent risk factors affecting prognosis.

Objective:To assess clinical efficacy of micro-punch combined with electron beam radiation for the treatment of keloids on the lower jaw.Methods:Clinical data were collected from 36 patients with keloids on the lower jaw, who received micro-punch combined with electron beam radiation at Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from January 2018 to January 2019, and analyzed retrospectively. There were 16 males and 20 females, with an average age of 23.80 years and a median disease duration of 32 months. The severity of keloids was evaluated before and 12 months after operation. A paired t test was used to compare keloid severity scores before and after treatment. Results:All of the 36 patients experienced primary wound healing. The keloid severity score was 7.11 ± 1.46 before operation, and significantly decreased to 2.33 ± 0.47 at 12 months after operation ( t=13.85, P=0.008) . Twelve months after the treatment, 15 patients were cured, 17 showed marked improvement, and 4 showed no response or experienced recurrence within 12 months after treatment, with a response rate of 88.89%. Conclusion:Micro-punch combined with electron beam radiation is effective for the treatment of keloids on the lower jaw.

Objective:To compare clinical efficacy and safety of microwave thermotherapy versus microneedling in the treatment of axillary bromhidrosis.Methods:From May 2018 to March 2019, 116 patients with different degrees of axillary bromhidrosis were collected from Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, including 56 treated with microwave thermotherapy by using a miraDry device, and 60 treated with microneedling by using a BodyTite device. These patients were followed up for 12 months after treatment, and clinical efficacy, complications and recurrence rate were evaluated.Results:After 12 months of follow-up, no significant difference in the response and recurrence rates were observed between the microwave group (94.64%[53 cases], 5.36%[3 cases], respectively) and microneedling group (93.33%[56 cases], 6.67%[4 cases], respectively; both χ2=0.088, P=0.767) . However, the incidence of postoperative complications was significantly lower in the microwave group (0) than in the microneedling group (6.67%, including 2 cases of skin burns and 2 cases of scars; χ2=3.867, P=0.049) . Conclusion:In the treatment of axillary bromhidrosis, microwave thermotherapy showed equivalent clinical efficacy with lower incidence of complications compared with microneedling.

Objective:To explore surgical treatment strategies and prognosis of early-stage nail apparatus melanoma.Methods:A total of 115 patients with early-stage nail apparatus melanoma receiving surgical treatment were collected from Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from July 2011 to December 2019, and surgical treatment strategies and outcomes were analyzed retrospectively.Results:According to the modified ABCDEF criteria and clinical manifestations (such as deformation of the nail plate, ulcers, nodules) , 73 patients with early-stage nail apparatus melanoma received extended surgical resection based on the resection principles of melanoma in situ, 22 based on the resection principles of stage I and II melanoma, 20 based on the resection principles of stage I and II melanoma with invasion risks. During the follow-up period of 6 months to 9 years, there was no recurrence of the primary tumors in any patients; no abnormalities were observed by the ultrasound examination of lymph nodes in 101 patients; metastases occurred in 2 patients receiving finger amputation, 1 of whom died; 12 patients were lost to follow-up. Conclusion:To select extended surgical resection strategies for early-stage nail apparatus melanoma based on clinical manifestations, can ensure adequate treatment and preserve the normal function of the extremities to the greatest extent without recurrence of the primary tumors.