Some publications of Dr Venkat are included here- he has a total of 80 publications

1)    Indian J Dermatol Venereol Leprol. 2016 Jan-Feb;82(1):1-6. doi: 10.4103/0378-6323.172902. Targeted phototherapy.Mysore V1, Shashikumar BM.

Abstract

BACKGROUND:

Targeted phototherapy is a new form of phototherapy which has many advantages and disadvantages over conventional phototherapy. This article reviews the different technologies and outlines recommendations based on current evidence.

METHODS:

A literature search was performed on targeted phototherapy to collect data. Relevant literature published till March 2014 was obtained from PubMed, EMBASE, and the Cochrane Library. Keywords like "targeted phototherapy", "excimer laser", "excimer lamp", "Nonchromatic ultraviolet light", "vitiligo", and "psoriasis", were used for literature search. All systematic reviews, meta-analysis, national guidelines, randomized controlled trials (RCT), prospective open label studies and retrospective case series in English were reviewed.

RESULTS:

Three hundred and forty studies were evaluated, 24 of which fulfilled the criteria for inclusion in the guidelines.

CONCLUSIONS AND RECOMMENDATIONS:

All forms of targeted phototherapy are useful in vitiligo. Good responses were seen in localized involvement, resistant lesions and in children in whom their use is more accepted and convenient (Level of evidence 2+, Grade of recommendation B). Similarly it is useful in psoriasis, either alone or in combination with drugs, even in resistant forms such as palmoplantar psoriasis. In view of expense and practical application, their use is limited to resistant lesions and localized disease. (Level of evidence 2+, Grade of recommendation B). But in other conditions there is no convincing evidence for its use. (Level of evidence 3+, Grade of recommendation C).

2) J Cutan Aesthet Surg. 2014 Apr;7(2):124-30. doi: 10.4103/0974-2077.138363. Buying a laser - tips and pearls. Aurangabadkar SJ1, Mysore V2, Ahmed ES3

.

Abstract

Lasers and aesthetic procedures have transformed dermatology practice. They have aided in the treatment of hitherto untreatable conditions and allowed better financial remuneration to the physician. The availability of a variety of laser devices of different makes, specifications and pricing has lead to confusion and dilemma in the mind of the buying physician. There are presently no guidelines available for buying a laser. Since purchase of a laser involves large investments, careful consideration to laser specifications, training, costing, warranty, availability of spares, and reliability of service are important prerequisites. This article describes various factors that are needed to be considered and also attempts to lay down criteria to be assessed while buying a laser system that will be useful to physicians before investing in a laser machine.

PRACTICE POINTS:

Meticulous planning of the type of machine, specifications, financial aspects, maintenance and warranties is important.It is wise to sign a contract or agreement between the buyer and seller before purchase of a laser which covers key aspects of installation, after sales service and maintenance of the machine.Adequate training is essential; understanding laser physics and laser-tissue interaction goes a long way in getting the best out of the machine.The credibility of the dealer and company should be ascertained in order to be assured of after-sales service.Buying used machines, sharing of equipment to offset high initial investments is a good option but even more care is required to ensure proper functioning and maintenance.

KEYWORDS:

Agreement of sale; annual maintenance contract; annual service visit; buying laser; laser; purchase contract; specifications

3) J Cutan Aesthet Surg. 2013 Apr;6(2):117-9. doi: 10.4103/0974-2077.112677. Successful treatment of laser induced hypopigmentation with narrowband ultraviolet B targeted phototherapy. Mysore V1, Anitha B, Hosthota A.

Abstract

Q-switched 1064 nm neodymium-doped yttrium aluminium garnet (Qs 1064 nm Nd: YAG) laser plays an important role in the treatment of pigmentary skin disorders, including tattoos. Although it has high efficacy and safety, adverse effect like hypopigmentation may occur causing anxiety to patients. We present a case report of Qs 1064 nm Nd: YAG laser induced hypopigmentation which was successfully treated with ultraviolet B targeted phototherapy, with rapid and satisfactory re-pigmentation.

KEYWORDS:

Laser induced hypopigmentation; Q-switched 1064 nm neodymium-doped yttrium aluminium garnet laser; targeted ultraviolet B phototherapy

4) J Cutan Aesthet Surg. 2013 Apr;6(2):113-6. doi: 10.4103/0974-2077.112676. Body hair transplantation: case report of successful outcome. Mysore V1.

Abstract

Transplantation of body hair in to scalp has been suggested as an option to treat extensive cases of baldness with poor donor scalp. However, evidence about its long-term efficacy is yet lacking, with very few published reports and the routine use of the technique is still controversial. We report the satisfactory outcome in a case of extensive baldness in whom hairs from different donor areas such as chest, abdomen, arms, thighs were transplanted on to scalp.

KEYWORDS: Body; hair; transplantation; yield

5) Indian Dermatol Online J. 2012 Jan;3(1):62-5. doi: 10.4103/2229-5178.93496. Finasteride and sexual side effects. Mysore V1.

Abstract

Finasteride, a 5-alpha reductase inhibitor, widely used in the medical management of male pattern hairloss, has been reported to cause sexual side effects. This article critically examines the evidence available and makes recommendations as to how a physician should counsel a patient while prescribing the drug.

KEYWORDS:

Androgenetic alopecia; finasteride; sexual side effects

6)J Cutan Aesthet Surg. 2012 Apr;5(2):141-3. doi: 10.4103/0974-2077.99459. Lichen Amyloidosis: Novel Treatment with Fractional Ablative 2,940 nm Erbium: YAG Laser Treatment. Anitha B1, Mysore V.

Abstract

Lichen amyloidosis (LA) is a type of primary localized cutaneous amyloidosis clinically characterized by persistent pruritic, hyperkeratotic papules commonly distributed on the shins and histopathologically characterized by amyloid deposits in the papillary dermis. The condition is difficult to treat though various treatment modalities have been tried. We report a case of LA treated successfully with Fractional ablative 2,940 nm Erbium: YAG Laser treatment. To the best of our knowledge, this is the first documented report of the successful use of fractional ablative laser in the treatment of LA.

KEYWORDS:

Erbium: YAG laser; fractional photothermolysis; lichen Amyloidosis

7) Indian J Dermatol Venereol Leprol. 2011 May-Jun;77(3):380-8. doi: 10.4103/0378-6323.79733. Nonablative lasers and nonlaser systems in dermatology: current status. Sachdev M1, Hameed S, Mysore V

AbstractNonablative lasers and nonlaser systems are newer systems used for skin rejuvenation, tightening, body sculpting, and scar remodeling.DEVICES:Different technologies such as lasers, Intense Pulsed Light (IPL), and radiofrequency have been introduced. Most nonablative laser systems emit light within the infrared portion of the electromagnetic spectrum (1000-1500 nm). At these wavelengths, absorption by superficial water containing tissue is relatively weak, thereby effecting deeper tissue penetration. A detailed understanding of the device being used is recommended.INDICATIONS:Nonablative technology have been used for several indications such as skin tightening, periorbital tissue tightening, treatment of nasolabial lines and jowl, body sculpting/remodeling, cellulite reduction, scar revision and remodeling and for the treatment of photodamaged skin.FACILITY:Nonablative laser and light modalities can be carried out in a physician treatment room or hospital setting or a nursing home with a small operation theater.PREOPERATIVE COUNSELING AND INFORMED CONSENT:The dermatologic consultation should include detailed assessment of the patient's skin condition and skin type. An informed consent is mandatory to protect the rights of the patient as well as the practitioner. All patients must have carefully taken preoperative and postoperative pictures.CHOICE OF THE DEVICE AND PARAMETERS:Depends on the indication, the area to be treated, the acceptable downtime for the desired correction, and to an extent the skin color.ANESTHESIA:These lasers are mostly pain-free and tolerated well by patients but may require topical anesthesia. In most cases, topical cooling and numbing using icepacks is sufficient, even in an apprehensive patient.POSTOPERATIVE CARE:The nonablative lasers, light sources and radiofrequency systems are safe, even in darker skin types, and postoperative care is minimal. Proper postoperative care is important in avoiding complications. Post-treatment edema and redness settle in a few hours to a few days. Postoperative sun avoidance and use of sunscreen is mandator

8) Indian J Dermatol Venereol Leprol. 2011 May-Jun;77(3):369-79. doi: 10.4103/0378-6323.79732. Fractional lasers in dermatology--current status and recommendations. Goel A1, Krupashankar DS, Aurangabadkar S, Nischal KC, Omprakash HM, Mysore V.

Abstract

INTRODUCTION:Fractional laser technology is a new emerging technology to improve scars, fine lines, dyspigmentation, striae and wrinkles. The technique is easy, safe to use and has been used effectively for several clinical and cosmetic indications in Indian skin.DEVICES:Different fractional laser machines, with different wavelengths, both ablative and non-ablative, are now available in India. A detailed understanding of the device being used is recommended.INDICATIONS:Common indications include resurfacing for acne, chickenpox and surgical scars, periorbital and perioral wrinkles, photoageing changes, facial dyschromias. The use of fractional lasers in stretch marks, melasma and other pigmentary conditions, dermatological conditions such as granuloma annulare has been reported. But further data are needed before adopting them for routine use in such conditions.PHYSICIAN QUALIFICATION:Any qualified dermatologist may administer fractional laser treatment. He/ she should possess a Master's degree or diploma in dermatology and should have had specific hands-on training in lasers, either during postgraduation or later at a facility which routinely performs laser procedures under a competent dermatologist or plastic surgeon with experience and training in using lasers. Since parameters may vary with different systems, specific training tailored towards the concerned device at either the manufacturer's facility or at another center using the machine is recommended.FACILITY:Fractional lasers can be used in the dermatologist's minor procedure room for the above indications.PREOPERATIVE COUNSELING AND INFORMED CONSENT:Detailed counseling with respect to the treatment, desired effects and possible postoperative complications should be provided to the patient. The patient should be provided brochures to study and also adequate opportunity to seek information. A detailed consent form needs to be completed by the patient. Consent form should include information on the machine, possible

postoperative course expected and postoperative complications. Preoperative photography should be carried out in all cases of resurfacing. A close-up front and 45-degree lateral photographs of both sides must be taken.LASER PARAMETERS:There are different machines based on different technologies available. Choice parameters depend on the type of machine, location and type of lesion, and skin color. Physician needs to be familiar with these requirements before using the machine.ANESTHESIA:Fractional laser treatment can be carried out under topical anesthesia with eutectic mixture of lidocaine and prilocaine. Some machines can be used without any anesthesia or only with topical cooling or cryospray. But for maximal patient comfort, a topical anesthetic prior to the procedure is recommended.POSTOPERATIVE CARE:Proper postoperative care is important in avoiding complications. Post-treatment edema and redness settle in a few hours to a few days. A sunscreen is mandatory, and emollients may be prescribed for the dryness and peeling that could occur.

9) Indian J Dermatol Venereol Leprol. 2011 Mar-Apr;77(2):232-7. doi: 10.4103/0378-6323.77479. Position paper on mesotherapy. Sarkar R1, Garg VK, Mysore V.

Abstract

Mesotherapy is a controversial cosmetic procedure which has received publicity among the lay people, in the internet and in the media. It refers to minimally invasive techniques which consist of the use of intra- or subcutaneous injections containing liquid mixture of compounds (pharmaceutical and homeopathic medications, plant extracts, vitamins and other ingredients) to treat local medical and cosmetic conditions. This position paper has examined the available evidence and finds that acceptable scientific evidence for its effectiveness and safety is lacking. IADVL taskforce, therefore would like to state that the use of this technique remains controversial at present. Further research and well-designed controlled scientific studies are required to substantiate the claims of benefit of this mode of therapy.

10) Int J Trichology. 2010 Jan;2(1):45-6. doi: 10.4103/0974-7753.66914. Mesotherapy in Management of Hairloss - Is it of Any Use?Mysore V1.

Abstract

Mesotherapy has received a lot of publicity in the media and internet about its possible role in androgenetic alopecia. However, the subject is controversial in view of lack of documented evidence. This article provides a critical commentary on the use of mesotherapy in the management of androgenetic alopecia.KEYWORDS:Mesotherapy; androgenetic alopecia; hair loss

11)Int J Trichology. 2010 Jan;2(1):42-4. doi: 10.4103/0974-7753.66913. Controversy: Synthetic Hairs and their Role in Hair Restoration? Mysore V1.

Abstract

The subject of artifical hair fibers is controversial, in view of their chequered history and the ban by federal drug administration (FDA) on their use. This article analyzes different aspects of their use.KEYWORDS:Artificial hair fibers; FDA; alopecia; hair restoration; synthetic hairs

12)J Cutan Aesthet Surg. 2010 Jan;3(1):20-2. doi: 10.4103/0974-2077.63257. Biofilms: their role in dermal fillers. Sadashivaiah AB1, Mysore V

Abstract

Fillers are commonly used in several aesthetic indications. Though considered safe, several side effects have been reported. The role of biofilms in the causation of some of these side effects has been elucidated only recently and this article presents a short review of the subject.

KEYWORDS:Aesthetics; biofilm; fillers

13). Indian J Dermatol Venereol Leprol. 2010 May-Jun;76(3):239-48. doi: 10.4103/0378-6323.62962. Invisible dermatoses. Mysore V1.

Abstract

'Invisible dermatoses' is a concept which has not received wide recognition, but is nevertheless very important both clinically and histologically. The term invisible dermatoses has been used in two contexts: a) Diseases, with out definite clinical features, and are therefore "invisible" to the clinician, but yet can be diagnosed by special investigations. b) Dermatoses which present with definite and obvious clinical features, but subtle or hidden histological features and are therefore "invisible" histologically. Diagnosis of such diseases represents a great challenge to both the dermatologist and dermatopathologist. This article discusses such diseases and offers clues and tools for their diagnosis. Diagnosis of such 'Invisible dermatoses' needs proper awareness, recognition of subtle features, special stains, special investigations such as immunofluorescence and histochemistry and proper clinicopathological correlation.

14)Indian J Dermatol. 2009;54(2):142-9. doi: 10.4103/0019-5154.53194. Cellular grafts in management of leucoderma. Mysore V1, Salim T.

Abstract

Cellular grafting methods constitute important advances in the surgical management of leucoderma. Different methods such as noncultured epidermal suspensions, melanocyte cultures, and melanocyte-keratinocyte cultures have all been shown to be effective. This article reviews these methods.KEYWORDS:Vitiligo; cellular grafts; grafts; leucoderma; melanocyte; transplantation

15) Indian J Dermatol Venereol Leprol. 2009 Mar-Apr;75(2):119-25. Targeted phototherapy. Mysore V1

Abstract

Phototherapy is one of the most important therapeutic modalities in dermatology. This field has seen several major advances in the recent years, the most recent being targeted phototherapy. Targeted phototherapy, which includes laser and nonlaser technologies, delivers light/laser in the ultraviolet spectrum, of specific wavelength, specifically targeted at the affected skin and thereby avoids many of the side effects of conventional phototherapy. The treatment has been claimed to be effective, quick, and needing fewer treatment sessions. The article reviews this new mode of phototherapy.

16) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S68-74. Standard guidelines of care: laser and IPL hair reduction. Buddhadev RM1; IADVL Dermatosurgery Task Force. Collaborators (16) 1NU Skin World & Nisarg Skin Lasers, Surat, Gujarat, India. buddhadev1@gmail.com

Abstract

Laser-assisted hair removal, Laser hair removal, Laser and light-assisted hair removal, Laser and light-assisted, long-term hair reduction, IPL photodepilation, LHE photodepilation; all these are acceptable synonyms. Laser (Ruby, Nd Yag, Alexandrite, Diode), intense pulse light, light and heat energy system are the different light-/Laser-based systems used for hair removal; each have its advantages and disadvantages. The word "LONG-TERM HAIR REDUCTION" should be used rather than permanent hair removal. Patient counseling is essential about the need for multiple sessions. PHYSICIANS' QUALIFICATIONS: Laser hair removal may be practiced by any dermatologist, who has received adequate background training during postgraduation or later at a centre that provides education and training in Lasers or in focused workshops providing such training. The dermatologist should have adequate knowledge of the machines, the parameters and aftercare. The physician may allow the actual procedure to be performed under his/her direct supervision by a trained nurse assistant/junior doctor. However, the final responsibility for the procedure would lie with the physician.FACILITY:The procedure may be performed in the physician's minor procedure room. Investigations to rule out any underlying cause for hair growth are important; concurrent drug therapy may be needed. Laser parameters vary with area, type of hair, and the machine used. Full knowledge about the machine and cooling system is important. Future maintenance treatments may be needed.

17) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S61-7. Standard guidelines of care: CO2 laser for removal of benign skin lesions and resurfacing. Krupashankar DS1; IADVL Dermatosurgery Task Force.

Abstract

Resurfacing is a treatment to remove acne and chicken pox scars, and changes in the skin due to ageing. MACHINES: Both ablative and nonablative lasers are

available for use. CO 2 laser is the gold standard in ablative lasers. Detailed knowledge of the machines is essential. INDICATIONS FOR CO 2 LASER: Therapeutic indications: Actinic and seborrheic keratosis, warts, moles, skin tags, epidermal and dermal nevi, vitiligo blister and punch grafting, rhinophyma, sebaceous hyperplasia, xanthelasma, syringomas, actinic cheilitis angiofibroma, scar treatment, keloid, skin cancer, neurofibroma and diffuse actinic keratoses. CO 2 laser is not recommended for the removal of tattoos. AESTHETIC INDICATIONS: Resurfacing for acne, chicken pox and surgical scars, periorbital and perioral wrinkles, photo ageing changes, facial resurfacing. PHYSICIANS' QUALIFICATIONS: Any qualified dermatologist (DVD or MD) may practice CO 2 laser. The dermatologist should possess postgraduate qualification in dermatology and should have had specific hands-on training in lasers either during postgraduation or later at a facility which routinely performs laser procedures under a competent dermatologist/plastic surgeon, who has experience and training in using lasers. For the use of CO 2 lasers for benign growths, a full day workshop is adequate. As parameters may vary in different machines, specific training with the available machine at either the manufacturer's facility or at another centre using the machine is recommended.FACILITY:CO 2 lasers can be used in the dermatologist's minor procedure room for the above indications. However, when used for full-face resurfacing, the hospital operation theatre or day care facility with immediate access to emergency medical care is essential. Smoke evacuator is mandatory.PREOPERATIVE COUNSELING AND INFORMED CONSENT:Detailed counseling with respect to the treatment, desired effects, possible postoperative complications, should be discussed with the patient. The patient should be provided brochures to study and also given adequate opportunity to seek information. Detailed consent forms need to be completed by the patients. Consent forms should include information on the machine used; possible postoperative course expected and postoperative complications. Preoperative photography should be carried out in all cases of resurfacing. Choice of the machine and the parameters depends on the site, type of lesion, result needed, and the physician's experience.ANESTHESIA:Localized lesions can be treated under eutectic mixture of local anesthesia (EMLA) cream anesthesia or local infiltration anesthesia. Full-face resurfacing can be performed under general anesthesia. Proper postoperative care is important to avoid complications.

18) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S54-60. Tumescent liposuction: standard guidelines of care. Mysore V1; IADVL Dermatosurgery Task Force

Abstract

DEFINITION:Tumescent liposuction is a technique for the removal of subcutaneous fat under a special form of local anesthesia called tumescent anesthesia. PHYSICIAN'S QUALIFICATIONS: The physician performing liposuction should have completed postgraduate training in dermatology or a surgical specialty and should have had adequate training in dermatosurgery at a center that provides training in cutaneous surgery. In addition, the physician should obtain specific liposuction training or experience at the surgical table ("hands on") under the supervision of an appropriately trained and experienced liposuction surgeon. In addition to the surgical technique, training should include instruction in fluid and electrolyte balance, potential complications of liposuction, tumescent and other forms of anesthesia as well as emergency resuscitation and care.FACILITY:Liposuction can be performed safely in an outpatient day care surgical facility, or a hospital operating room. The day care theater should be equipped with facilities for monitoring and handling emergencies. A plan for handling emergencies should be in place with which all nursing staff should be familiar. A physician trained in emergency medical care and acute cardiac emergencies should be available in the premises. It is recommended but not mandatory, that an anesthetist be asked to stand by.INDICATIONS:Liposuction is recommended for all localized deposits of fat. Novices should restrict themselves to the abdomen, thighs, buttocks and male breasts. Arms, the medial side of the thigh and the female breast need more experience and are recommended for experienced surgeons. Liposuction may be performed for non-cosmetic indications such as hyperhidrosis of axillae after adequate experience has been acquired, but is not recommended for the treatment of obesity.PREOPERATIVE EVALUATION:Detailed history is to be taken with respect to any previous disease, drug intake and prior surgical procedures. Liposuction is contraindicated in patients with severe cardiovascular disease, severe coagulation disorders including thrombophilia, and during pregnancy. Physical evaluation should be detailed and should include assessment of general physical health to determine the

fitness of the patient for surgery, as well as the examination of specific sites that need liposuction to check for potential problems.PREOPERATIVE INFORMED CONSENT:The patient should sign a detailed consent form listing details about the procedure and possible complications. The consent form should specifically state the limitations of the procedure and should mention whether more procedures are needed for proper results. The patient should be provided with adequate opportunity to seek information through brochures, computer presentations, and personal discussions. Preoperative laboratory studies to be performed include Hb%, blood counts including platelet counts, bleeding and clotting time (or prothrombin and activated partial thromboplastin time) and blood chemistry profile; ECG is advisable. Liver function tests, and pregnancy test for women of childbearing age are performed as mandated by the individual patient's requirements. Ultrasound examination is recommended in cases of gynecomastia.PREOPERATIVE MEDICATION:Preoperative antibiotics and non-sedative analgesics such as paracetamol are recommended. The choice of antibiotic and analgesic agents depends on the individual physician's preference and the prevailing local conditions.TYPE OF ANESTHETIC EMPLOYED:Lidocaine is the preferred local anesthetic; its recommended dose is 35-45 mg/kg and doses should not exceed 55 mg/kg wt. The recommended concentration of epinephrine in tumescent solutions is 0.25-1.5 mg/L. The total dosage of epinephrine should be minimized and should not exceed 50 microg/kg.SURGICAL TECHNIQUE/PROCEDURE:t is always advisable not to combine liposuction with other procedures to avoid exceeding the recommended dosage of lignocaine. However, such combinations may be attempted if the total required dose of lignocaine does not exceed the maximum dose indicated above. The recommended cannula size for liposuction is not to be larger than 3.5 mm in diameter. The recommended volume of fat removed is in proportion to the fat content and/or size and/or weight of the patient being treated. It is recommended that the volume of fat removed not exceed 5000 mL in a single operative session. arge volume liposuctions or mega-liposuctions are not recommended.INTRAOPERATIVE AND POSTOPERATIVE MONITORING:Baseline vital signs including blood pressure and heart rate, are recorded pre- and postoperatively. Pulse oximeter monitoring is essential in all cases.POSTOPERATIVE CARE:Postoperative antibiotics should be selected by the physician and taken for five days. Postoperative antiinflammatory drugs such as Cox 2 Inhibiters may be

given for 5-7 days; specialized compression garments, binders, and tape help to reduce bruising, hematomas, seromas, and pain. Generally, compression is recommended for two weeks although this is variable according to the needs of the individual patient.

19) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S5-12. Standard guidelines of care for chemical peels. Khunger N1; IADVL Task Force.Coordinator Venkataram Mysore

Abstract

Chemical peeling is the application of a chemical agent to the skin, which causes controlled destruction of a part of or the entire epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. Indications for chemical peeling include pigmentary disorders, superficial acne scars, ageing skin changes, and benign epidermal growths. Contraindications include patients with active bacterial, viral or fungal infection, tendency to keloid formation, facial dermatitis, taking photosensitizing medications and unrealistic expectations. PHYSICIANS' QUALIFICATIONS: The physician performing chemical peeling should have completed postgraduate training in dermatology. The training for chemical peeling may be acquired during post graduation or later at a center that provides education and training in cutaneous surgery or in focused workshops providing such training. The physician should have adequate knowledge of the different peeling agents used, the process of wound healing, the technique as well as the identification and management of complications.FACILITY:Chemical peeling can be performed safely in any clinic/outpatient day care dermatosurgical facility.PREOPERATIVE COUNSELING AND INFORMED CONSENT:A detailed consent form listing details about the procedure and possible complications should be signed by the patient. The consent form should specifically state the limitations of the procedure and should clearly mention if more procedures are needed for proper results. The patient should be provided with adequate opportunity to seek information through brochures, presentations, and personal discussions. The need for postoperative medical therapy should be emphasized. Superficial peels are considered safe in Indian patients. Medium depth peels should be performed with great caution, especially in dark skinned patients. Deep peels are not recommended for Indian skin. It is essential to do prepeel priming of the patient's skin with sunscreens, hydroquinone and

tretinoin for 2-4 weeks. ENDPOINTS IN PEELS: For glycolic acid peels: The peel is neutralized after a predetermined duration of time (usually three minutes). However, if erythema or epidermolysis occurs, seen as grayish white appearance of the epidermis or as small blisters, the peel must be immediately neutralized with 10-15% sodium bicarbonate solution, regardless of the duration of application of the peel. The end-point is frosting for TCA peels, which are neutralized either with a neutralizing agent or cold water, starting from the eyelids and then the entire face. For salicylic acid peels, the end point is the pseudofrost formed when the salicylic acid crystallizes. Generally, 1-3 coats are applied to get an even frost; it is then washed with water after 3-5 minutes, after the burning has subsided. Jessner's solution is applied in 1-3 coats until even frosting is achieved or erythema is seen. Postoperative care includes sunscreens and moisturizers Peels may be repeated weekly, fortnightly or monthly, depending on the type and depth of the peel.

20) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S46-53. Hair transplantation: standard guidelines of care. Patwardhan N1, Mysore V; IADVL Dermatosurgery Task Force

.Abstract

Hair transplantation is a surgical method of hair restoration.PHYSICIAN QUALIFICATION:The physician performing hair transplantation should have completed post graduation training in dermatology; he should have adequate background training in dermatosurgery at a centre that provides education training in cutaneous surgery. In addition, he should obtain specific hair transplantation training or experience at the surgical table(hands on) under the supervision of an appropriately trained and experienced hair transplant surgeon. In addition to the surgical technique, training should include instruction in local anesthesia and emergency resuscitation and care.FACILITY:Hair transplantation can be performed safely in an outpatient day case dermatosurgical facility. The day case theatre should be equipped with facilities for monitoring and handling emergencies. A plan for handling emergencies should be in place and all nursing staff should be familiar with the emergency plan. It is preferable, but not mandatory to have a standby anesthetist. Indication for hair transplantation is pattern hair loss in males and also in females. In female pattern hair loss, investigations to rule out any underlying cause for hair

loss such as anemia and thyroid deficiency should be carried out. Hair transplantation can also be performed in selected cases of scarring alopecia, eyebrows and eye lashes, by experienced surgeons.PREOPERATIVE COUNSELING AND INFORMED CONSENT:Detailed consent form listing details about the procedure and possible complications should be signed by the patient. The consent form should specifically state the limitations of the procedure and if more procedures are needed for proper results, it should be clearly mentioned. Patient should be provided with adequate opportunity to seek information through brochures, computer presentations, and personal discussions. Need for concomitant medical therapy should be emphasized. Patients should understand that proper hair growth can be expected after about 9 months after transplantation. Preoperative laboratory studies to be performed include Hb%, blood counts including platelet count, bleeding and clotting time (or prothrombin time and activated partial thromboplastin time), blood chemistry profile including sugar.METHODS:Follicular unit hair transplantation is the gold standard method of hair transplantation; it preserves the natural architecture of the hair units and gives natural results. Mini-micro-grafting is a method hair transplantation involving randomly assorted groups of hairs, with out consideration of their natural configuration of follicular units, under loupe or naked eye examination. Mini-grafts consist of 4-5-6 hairs while micro-grafts consist of 1-3 hairs. Punch gives ugly cosmetically unacceptable results and should no longer be used.PATIENT SELECTION:Hair transplantation can be performed in any person with pattern hair loss, with good donor area, in good general health and reasonable expectations. Caution should be exercised in, very young patients whose early alopecia is still evolving, patients with Norwood grade VI or VII with poor density, patients with unrealistic expectations, and patients with significant systemic health problems.MEDICAL THERAPY:Most patients will need concurrent medical treatment since the process of pattern hair loss is progressive and may affect the remaining hairs.MANPOWER:Hair transplantation is a team effort. Particularly, performing large sessions, needs a well trained team of trained assistants.ANESTHESIA:2% lignocaine with adrenaline is generally used for anesthesia; tumescent technique is preferred. Bupivacaine has been used by some authors in view of its prolonged duration of action.

DONOR DISSECTION:Strip dissection by single blade is recommended for donor area. Steromicroscopic dissection is recommended for dissection of hair units in follicular unit transplantation; mini-micro-grafting does not need microscopic dissection.RECIPIENT INSERTION:Different techniques and different instruments have been used for recipient site creation ;these depend on the choice of the operating surgeon and have been described in the guidelines. Graft preservation is important to ensure survival.

DENSITY: Minimum density of 35-45 units per sq cm is recommended. Results depend on donor characteristics, technique used and individual skills of the surgeon.

21) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S37-45. Standard guidelines of care for vitiligo surgery. Parsad D1, Gupta S; IADVL Dermatosurgery Task Force.

Abstract

Vitiligo surgery is an effective method of treatment for selected, resistant vitiligo patches in patients with vitiligo. PHYSICIAN'S QUALIFICATIONS: The physician performing vitiligo surgery should have completed postgraduate training in dermatology which included training in vitiligo surgery. If the center for postgraduation does not provide education and training in cutaneous surgery, the training may be obtained at the surgical table (hands-on) under the supervision of an appropriately trained and experienced dermatosurgeon at a center that routinely performs the procedure. Training may also be obtained in dedicated workshops. In addition to the surgical techniques, training should include local anesthesia and emergency resuscitation and care.FACILITY:Vitiligo surgery can be performed safely in an outpatient day care dermatosurgical facility. The day care theater should be equipped with facilities for monitoring and handling emergencies. A plan for handling emergencies should be in place, with which all nursing staff should be familiar. Vitiligo grafting for extensive areas may need general anesthesia and full operation theater facility in a hospital setting and the presence of an anesthetist is

recommended in such cases. INDICATIONS FOR VITILIGO SURGERY: Surgery is indicated for stable vitiligo that does not respond to medical treatment. While there is no consensus on definitive parameters for stability, the Task Force suggests the absence of progression of disease for the past one year as a definition of stability. Test grafting may be performed in doubtful cases to detect stability.PREOPERATIVE COUNSELING AND INFORMED CONSENT:A detailed consent form elaborating the procedure and possible complications should be signed by the patient. The patient should be informed of the nature of the disease and that the determination of stability is only a vague guide. The consent form should specifically state the limitations of the procedure, about the possible future progression of disease and whether more procedures will be needed for proper results. The patient should be provided with adequate opportunity to seek information through brochures and one-to-one discussions. The need for concomitant medical therapy should be emphasized and the patient should understand that proper results take time (a few months to a year). Preoperative laboratory studies include hemogram including platelet counts, bleeding and clotting time (or prothrombin and activated partial thromboplastin time), and blood chemistry profile. Screening for antibodies for hepatitis B surface antigen and HIV is recommended depending on individual requirements.ANESTHESIA:Lignocaine (2%) with or without adrenaline is generally used for anesthesia; infiltration and nerve block anesthesia are adequate in most cases. General anesthesia may be needed in patients with extensive lesions.POSTOPERATIVE CARE:Proper postoperative immobilization and care are very important to obtain satisfactory results.

22) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S28-36. Standard guidelines of care for acne surgery. Khunger N1; IADVL Task Force.

Abstract

Acne surgery is the use of various surgical procedures for the treatment of postacne scarring and also, as adjuvant treatment for active acne. Surgery is indicated both in active acne and post-acne scars. PHYSICIANS' QUALIFICATIONS: Any Dermatologist can perform most acne surgery techniques as these are usually taught during postgraduation. However, certain

techniques such as dermabrasion, laser resurfacing, scar revisions need specific "hands-on" training in appropriate training centers.FACILITY:Most acne surgery procedures can be performed in a physician's minor procedure room. However, full-face dermabrasion and laser resurfacing need an operation theatre in a hospital setting. ACTIVE ACNE: Surgical treatment is only an adjunct to medical therapy, which remains the mainstay of treatment. Comedone extraction is a process of applying simple mechanical pressure with a comedone extractor, to extract the contents of the blocked pilosebaceous follicle. Superficial chemical peel is a process of applying a chemical agent to the skin, so as to cause controlled destruction of the epidermis leading to exfoliation. Glycolic acid, salicylic acid and trichloroacetic acid are commonly used peeling agents for the treatment of active acne and superficial acne scars. CRYOTHERAPY: Cryoslush and cryopeel are used for the treatment of nodulocystic acne. Intralesional corticosteroids are indicated for the treatment of nodules, cysts and keloidal acne scars. Nonablative lasers and light therapy using Blue light, non ablative radiofrequency, Nd:YAG laser, IPL (Intense Pulsed Light), PDT (Photodynamic Therapy), pulse dye laser and light and heat energy machines have been used in recent years for the treatment of active inflammatory acne and superficial acne scars. Proper counseling is very important in the treatment of acne scars. Treatment depends on the type of acne scars; a patient may need more than one type of treatment. Subcision is a treatment to break the fibrotic strands that tether the scar to the underlying subcutaneous tissue, and is useful for rolling scars. Punch excision techniques such as punch excision, elevation and replacement are useful for depressed scars such as ice pick and boxcar scars. TCA chemical reconstruction of skin scars (CROSS) (Level C) is useful for ice pick scars. Resurfacing techniques include ablative methods (such as dermabrasion and laser resurfacing), and nonablative methods such as microdermabrasion and nonablative lasers. Ablative methods cause significant postoperative changes in the skin, are associated with significant healing time and should be performed by dermatosurgeons trained and experienced in the procedure. Fillers are useful for depressed scars. Proper case selection is very important in ensuring satisfactory results.

23)Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S23-7. Standard guidelines for the use of dermal fillers. Vedamurthy M1; IADVL Dematosurgery Task Force.

Abstract

Currently used fillers vary greatly in their sources, efficacy duration and site of deposition; detailed knowledge of these properties is essential for administering them. Indications for fillers include facial lines (wrinkles, folds), lip enhancement, facial deformities, depressed scars, periocular melanoses, sunken eyes, dermatological diseases-angular cheilitis, scleroderma, AIDS lipoatrophy, earlobe plumping, earring ptosis, hand, neck, décolleté rejuvenation. PHYSICIANS' QUALIFICATIONS: Any qualified dermatologist may use fillers after receiving adequate training in the field. This may be obtained either during postgraduation or at any workshop dedicated to the subject of fillers. The physicians should have a thorough knowledge of the anatomy of the area designated to receive an injection of fillers and the aesthetic principles involved. They should also have a thorough knowledge of the chemical nature of the material of the filler, its longevity, injection techniques, and any possible side effects.FACILITY:Fillers can be administered in the dermatologist's minor procedure room.PREOPERATIVE COUNSELING AND INFORMED CONSENT:Detailed counseling with respect to the treatment, desired effects, and longevity of the filler should be discussed with the patient. Patients should be given brochures to study and adequate opportunity to seek information. Detailed consent forms need to be completed by the patients. A consent form should include the type of filler, longevity expected and possible postoperative complications. Preoperative photography should be carried out. Choice of the filler depends on the site, type of defect, results needed, and the physician's experience. Injection technique and volume depend on the filler and the physician's preference, as outlined in these guidelines.

24) Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S13-22. Guidelines on the use of botulinum toxin type A. Shetty MK1; IADVL Dermatosurgery Task Force.

Abstract

Botulinum toxin is available as types A and B. These two different forms need different dosages and hence, the physician needs to be familiar with the formulations. A thorough knowledge of the anatomy and physiology of the muscles in the area to be injected is essential. INDICATIONS FOR BOTULINUM TOXIN: Dynamic wrinkles caused by persistent muscular contractions are the main aesthetic indications for the use of Botulinum toxin.

These include forehead lines, glabellar lines, crow's feet, bunny lines, perioral wrinkles, and platysmal bands. Non-aesthetic indications include hyperhidrosis of the palms, soles and axillae. PHYSICIANS' QUALIFICATIONS: Any qualified dermatologist may practice the technique after receiving adequate training in the field. This may be obtained either during post-graduation or at any workshops dedicated to this subject.FACILITY:Botulinum toxin can be administered in the dermatologist's minor procedure room.PREOPERATIVE COUNSELING AND INFORMED CONSENT:Detailed counseling with respect to the treatment, desired effects, and longevity of the results should be discussed with the patient. The patient should be given brochures to study and adequate opportunity to seek information. A detailed consent form needs to be completed by the patient. The consent form should include the type of botulinum toxin, longevity expected and possible postoperative complications. Pre- and postoperative photography is recommended. Dosage depends on the area, muscle mass, gender and other factors outlined in these guidelines. It is recommended that beginners should focus on the basic indications in the upper third of the face and that they treat the middle and lower parts of the face only after garnering adequate experience.

25) J Cutan Aesthet Surg. 2008 Jul;1(2):92-3. doi: 10.4103/0974-2077.44167. Hailey-hailey disease: a novel method of management by radiofrequency surgery. Nandini As1, Mysore V.

Abstract

Hailey-Hailey disease is a chronic, recurrent disease that causes considerable morbidity to the patient. While the medical line of treatment is only palliative, different surgical modalities have been reported to offer longer lasting remission. We report a case of Hailey-Hailey disease successfully treated with radiofrequency surgery.KEYWORDS:Hailey–Hailey disease; ablation; radiofrequency

26) Indian J Dermatol Venereol Leprol. 2007 Nov-Dec;73(6):377-83.

Microcannular tumescent liposuction. Jayashree V1, Mysore V

Abstract

Liposuction is a commonly performed procedure to remove localized deposits of fat. Liposuction under general anesthesia is associated with significant morbidity and risk of mortality. Dermatologic surgeons have made significant contributions in this field. Tumescent liposuction using microcannuale under local anesthesia, as practised by dermatologic surgeons is safe and effective. This article describes the procedure of microcannular tumescent liposuction.

27) Indian J Dermatol Venereol Leprol. 2002 Jan-Feb;68(1):28-32. Frictional amyloidosis in Oman--a study of ten cases Mysore V1, Bhushnurmath SR, Muirhead DE, Al-Suwaid AR.

Abstract

Macular amyloidosis is an important cause for cutaneous pigmentation, the aetiology of which is poorly understood. Friction has recently been implicated the causation of early lesions, referred to as frictional amyloidosis. Confirmation of diagnosis by the detect on of amyloid using histochemical stains is inconsistent. Ten patients with pigmentation suggestive of macular amyloidosis were studied with detailed history, clinical examination, biopsy for histochemistry and electron microscopy. Nine out of ten patients had a history of prolonged friction with various objects such as bath sponges, brushes, towels, plant sticks and leaves. Amyloid was demonstrated by histochemical staining in only six out of ten cases. In the remaining four cases, amyloid was detected by electron microscopy. These consisted of aggregates of non-branching, extracellular, intertwining fibres measuring between 200-500 nm in length and between 20-25 nm in diameter. The study confirms the role of friction in the causation of this condition. Histochemical stains are not always successful in the detection of amyloid and electron microscopy is helpful for confirming its presence. The term frictional amyloidosis aptly describes the condition.

28) Indian J Dermatol Venereol Leprol. 2006 Mar-Apr;72(2):103-11; quiz 112, 125. Changing trends in hair restoration surgery. Venkataram M1.

Abstract

Androgenetic alopecia is an important and common cause for baldness. Despite recent advances, the drug therapy of this condition remains unsatisfactory. Surgical hair restoration is the only permanent method of treating this condition. Introduction of recent techniques such as follicular unit transplantation have improved the cosmetic results and patient satisfaction. This article discusses the latest trends in hair restoration surgery.

29) Indian J Dermatol Venereol Leprol. 2006 Jan-Feb;72(1):5-7. Synthetic hairs: should they be used? Mysore V1.

Abstract

Artificial hair fibers have recently been marketed in India as an alternative method of hair restoration. However, the subject of artificial hairs is controversial, as FDA in the United States has banned them. Several side effects have been reported after their use and it is therefore important that dermatologists are aware of all aspects about these devices. This article presents the author's viewpoint on the subject and suggests guidelines for using them.