Canadian Dermatology Today

Dermatologists perform more in-office cutaneous surgery than any other specialty. Given the regularity of surgical procedures and excisions, strategies around minimizing surgical scars may prove useful for both patient satisfaction and overall procedural outcomes. Whether doing a simple linear closure or complex flaps, fundamental principles remain consistent with regard to the minimization of scars.
This article aims to provide practical pearls that can be incorporated into every dermatologist’s toolbox to optimize surgical scars following in-office surgeries and excisions.

Dermatologists perform more in-office cutaneous surgery than any other specialty. Given the regularity of surgical procedures and excisions, strategies around minimizing surgical scars may prove useful for both patient satisfaction and overall procedural outcomes. Whether doing a simple linear closure or complex flaps, fundamental principles remain consistent with regard to the minimization of scars.
This article aims to provide practical pearls that can be incorporated into every dermatologist’s toolbox to optimize surgical scars following in-office surgeries and excisions.

Non-melanoma skin cancer (NMSC) is one of the most common forms of cancer in Canada with an estimated 76,100 cases in 2014, accounting for approximately 28% of all new cancer cases1. Cutaneous squamous cell carcinoma (cSCC) is the second most common type of NMSC and has a greater risk of metastases and death compared with the more common NMSC, basal cell carcinoma (BCC). The vast majority of cSCC are primary low risk; however, higher risk primary, locally advanced, regional or distant metastatic cases can result in a significant decrease in survival (Figure 1). In 2019, the first systemic therapy for cSCC, cemiplimab, was approved in Canada. The aim of this article is to review the epidemiology, risk stratification and available staging systems for cSCC to help clinicians better identify patients that may benefit from further work-up or treatment.

Dermatologists diagnose vascular lesions routinely in clinical practice. Many such lesions are benign neoplasms (e.g. cherry angiomas, venous lakes), while others occur in the setting of a dermatological condition (e.g. rosacea) that can be managed in part with an existing medical toolbox of treatment options. While some patients are reassured once a benign diagnosis has been established, some may seek elective treatment of these lesions. As dermatologists, we are in position to provide safe and effective elective treatment with various physical modalities. Vascular lasers are a group of devices that can target hemoglobin as a chromophore, providing treatment selectivity and the potential for scarless outcomes. This article aims to share practical pearls for the optimization of vascular laser treatments in clinical practice.

Inflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn’s disease (CD). This group of chronic inflammatory diseases has many extra-intestinal manifestations. Skin is the second most common extra-intestinal organ affected after the musculoskeletal system.1 The prevalence of cutaneous manifestations among IBD patients is estimated to be 15%. Some manifestations are more common in UC while others are in CD.2 This review provides a practical approach to the cutaneous manifestations among IBD patients to help guide investigation and management when patients with IBD are referred for a dermatology consult. The cutaneous manifestations of IBD are summarized in Table 1.

The patient population seeking aesthetic procedures is becoming increasingly more diverse. According to the American Society of Plastic Surgery, there has been a 50% increase in people of colour (POC) undergoing minimally invasive cosmetic treatments over the last decade.1,2 This is likely due to the increasing awareness, acceptance, and availability of aesthetic procedures, as well as demographic shifts. It is estimated that more than 20% of Canadians are POC.3 In addition, POC account for an increasing share in the national population: it is projected that POC will account for 33% of Canada’s population by 2036.4

Systemic isotretinoin is a commonly employed treatment for acne. Currently, the Health Canada approved product monograph contains a warning that aggressive chemical dermabrasion and cutaneous laser treatment be avoided in patients for a period of 5-6 months after the end of treatment because of the risk of hypertrophic scarring in atypical areas, and more rarely hyper- or hypo-pigmentation in treated areas.