Artificial intelligence (AI) and large language models (LLMs) transform how patients inform themselves. LLMs offer potential as educational tools, but their quality depends upon the information generated. Current literature examining AI as an informational tool in dermatology has been limited in evaluating AI\'s multifaceted roles and diversity of opinions. Here, we evaluate LLMs as a patient-educational tool for Mohs micrographic surgery (MMS) in and out of the clinic utilizing an international expert panel.
The most common patient MMS questions were extracted from Google and transposed into two LLMs and Google\'s search engine. 15 MMS surgeons evaluated the generated responses, examining their appropriateness as a patient-facing informational platform, sufficiency of response in a clinical environment, and accuracy of content generated. Validated scales were employed to assess the comprehensibility of each response.
The majority of reviewers deemed all LLM responses appropriate. 75% of responses were rated as mostly accurate or higher. ChatGPT had the highest mean accuracy. The majority of the panel deemed 33% of responses sufficient for clinical practice. The mean comprehensibility scores for all platforms indicated a required 10th-grade reading level.
LLM-generated responses were rated as appropriate patient informational sources and mostly accurate in their content. However, these platforms may not provide sufficient information to function in a clinical environment, and complex comprehensibility may represent a barrier to utilization. As the popularity of these platforms increases, it is important for dermatologists to be aware of these limitations.

UNASSIGNED: Cicatricial alopecia (CA) poses a challenge for dermatologists due to irreversible hair follicle damage. While pharmacological treatments offer limited efficacy, surgical interventions aim to improve aesthetic outcomes. This article explores the serial excision technique (SET) as a viable option for stable cases of inflammatory CA.
UNASSIGNED: Three adult females with different forms of CA underwent staged surgeries to correct CA patches. Procedures included different incision and closure methods based on individual characteristics such as age, type and extent of alopecia, location, and tissue mobility in the scarred area.
UNASSIGNED: CA significantly impacts patients\' quality of life, demanding comprehensive treatment approaches. SET emerges as an encouraging possibility for stable cases, providing notable cosmetic improvements and enhancing patients\' well-being. This technique offers cost-effective benefits with potential standalone efficacy or in combination with hair transplantation, providing promising outcomes for individuals with CA.

UNASSIGNED: Nail glomus tumor is a well-known tumor, with well-defined clinical characteristics and surgical treatment; however, some of these lesions occur in different locations and sizes with difficult surgical resolution.
UNASSIGNED: Clinical and imaging tests help in the diagnosis and tumor localization.
UNASSIGNED: Adequate surgical knowledge for these cases ensures lower rates of recurrence and nail dystrophy.

UNASSIGNED: Dermatochirurgische Eingriffe finden überwiegend in Lokalanästhesie statt, jedoch gibt es nur wenig Studien zum perioperativen Schmerzmanagement ausgedehnter oder mehrzeitiger Operationen. Das Ziel dieser Erhebung ist die Erfassung von Schmerzen im Rahmen dermatochirurgischer Eingriffe, der Darstellung der perioperativen Schmerztherapie sowie der Identifizierung von Einflussfaktoren auf das Schmerzempfinden.
UNASSIGNED: In diese prospektive, monozentrische Studie wurden stationäre Patienten von April bis Dezember 2021 eingeschlossen, die einen dermatochirurgischen Eingriff in Lokalanästhesie erhielten. Präoperativ wurden demographische Fragen, ein Schmerzfragebogen und vier psychometrische Fragebögen (PCS, LOT‐R, SFQ, PHQ‐9) erhoben. Postoperativ empfundene Schmerzen und benötigte Schmerzmedikamente der ersten 24 Stunden wurden erhoben.
UNASSIGNED: 120 Patienten (mit insgesamt 191 Eingriffen) wurden eingeschlossen. Durchschnittliche postoperative Schmerzen wurden sehr niedrig (NRS < 2) angegeben. Präoperativ bestehende Schmerzen und postoperativ erwartete Schmerzen zeigten sich als prädiktive Merkmale für postoperativen Schmerz. Ein starker Zusammenhang zwischen Katastrophisieren und Angst vor der Operation (r = 0,65) sowie ein mittlerer Zusammenhang für Depression und Angst vor der Operation (r = 0,46) konnten dargestellt werden.
UNASSIGNED: Dermatochirurgische Eingriffe in Lokalanästhesie werden insgesamt als schmerzarm empfunden. Bei der präoperativen Aufklärung und Untersuchung sollte auf Patienten geachtet werden, die bereits Schmerzen angeben oder postoperativ Schmerzen erwarten, da sie ein erhöhtes Risiko für die Entwicklung postoperativer Schmerzen zeigten.

暂无摘要。

Pleomorphic dermal sarcomas can be clinically aggressive, with a higher tendency to cause local recurrence, metastasis, and death. Atypical fibroxanthoma and pleomorphic dermal sarcoma are histopathologically similar, and their distinction requires a systematic examination of the entire excised tumor. Since Mohs micrographic surgery is commonly utilized to treat atypical fibroxanthoma, a histopathologic evaluation of debulk specimens by permanent pathology is prudent to avoid underdiagnosing pleomorphic dermal sarcoma. This approach can improve risk assessment and treatment decisions, ultimately enhancing patient outcomes. Also, the proper distinction will facilitate the future development of accurate staging criteria and additional treatment modalities.

Trichoblastic carcinoma (TBC) is a rare adnexal neoplasm of follicular germ cell differentiation with the potential for local invasion and metastasis. Histologic features of trichoblastic carcinoma have significant overlap with trichoblastoma and basal cell carcinoma (BCC), making diagnosis difficult in some cases. Treatment strategies are not well defined and include surgical excision for localized tumors and systemic therapies for metastatic disease. We present a case of trichoblastic carcinoma clinically resembling a benign cyst that was ultimately treated with Mohs micrographic surgery (MMS).

BACKGROUND: Patients are often advised to keep the initial postoperative dressings dry and undisturbed for 24 to 72 hours. However, these requirements may result in significant disruption of patients\' activities of daily living, such as bathing, leisure, and exercise.
OBJECTIVE: Compare standard management of keeping wounds dry and covered (48 hours) with early (6 hours) postoperative water exposure.
METHODS: Investigator-blinded, randomized (1:1), controlled trial evaluating rate of infection and additional outcomes of interest.
RESULTS: Overall, 437 patients were randomized to either the early (6-hour) water exposure (n = 218) intervention group or the standard cohort (n = 219). The incidence of culture-proven infection in the intervention group (1.8%) was similar to the standard group (1.4%) (P > .99). There was also no difference in rates of bleeding or bruising. Scar assessment using the Patient and Observer Scar Assessment Scale revealed similar scar outcomes.
CONCLUSIONS: Single site, academic center.
CONCLUSIONS: Surgical wounds can be allowed to get wet in the immediate postoperative period with no increased incidence of infection or other complications and with similar cosmesis.

暂无摘要。

BACKGROUND: Dermatosurgical procedures are predominantly performed under local anesthesia, yet there are few studies on perioperative pain management for extensive or staged procedures under local anesthesia. The purpose of this study was to assess pain during dermatologic surgery, describe perioperative pain management, and identify factors that influence pain perception.
METHODS: This prospective, monocentric study included inpatients undergoing dermatologic surgery under local anesthesia from April to December 2021. Preoperative demographic data, a pain questionnaire, and four psychometric questionnaires (PCS, LOT-R, SFQ, PHQ-9) were collected. Postoperative pain and analgesic use during the first 24 hours were recorded.
RESULTS: A total of 120 patients (with a total of 191 interventions) were included in the study. Mean postoperative pain was reported to be very low (NRS < 2). Preoperative pain and expected postoperative pain were found to be predictive of postoperative pain. There was a strong correlation between catastrophizing and preoperative anxiety (r = 0.65) and a moderate correlation between depression and preoperative anxiety (r = 0.46).
CONCLUSIONS: Dermatologic surgery under local anesthesia is generally considered painless. During preoperative counseling and assessment, attention should be paid to patients who fear surgery, report pain, or anticipate postoperative pain, as they have an increased risk of experiencing postoperative pain.