Research Articles (Plastic Surgery)

Permanent URI for this collectionhttp://hdl.handle.net/2263/4950

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    The effects and safety of sequential high concentration glycolic acid and trichloroacetic acid chemical peels in skin photo-type IV-VI, a retrospective cross-sectional monocentric review
    Maruma, Frans; Dlova, Ncoza; Mofokeng, Thabiso R.P.; Ngwenya, Edward (Wolters Kluwer Health, 2025-10)
    BACKGROUND : Melasma is a common chronic form of cutaneous hyperpigmentation, particularly prevalent in individuals with Fitzpatrick skin phototypes IV-VI, and it predominantly affects the facial areas of women. The patients with melasma often experience a significant reduction in quality of life. Treating melasma is challenging, as no single gold-standard therapy exists, and higher concentrations (>30%) of trichloroacetic acid peels have been inadequately studied in darker skin phototypes due to the potential complications. PURPOSE : To evaluate the effectiveness and safety of a sequential chemical peel protocol for treating melasma in African patients. OBJECTIVE : To describe the clinical effects and safety parameters of African patients treated sequentially with glycolic acid and trichoroacetic acid chemical peels. METHODS : This retrospective, cross-sectional, single-center review analyzed medical records of patients with melasma who received a sequential peeling protocol. Data collected included patient demographics, adverse effects, visual analogue scale (VAS) pain scores, and modified melasma area and severity index scores at baseline, 12 weeks, and 24 weeks. Descriptive statistics, including interquartile range, analysis of variance, Pearson's correlation, and logistic regression, were applied to analyze treatment outcomes and tolerability. RESULTS : Records of patients with melasma were reviewed, with the majority being female (n = 37; 92.5%) and of skin phototype V (n = 31; 77.5%). At 12 weeks, modified melasma area and severity index scores showed statistically significant improvement (F[4.7235] = 4.72, P = .032). The most common adverse effects were irritation (77.5%), postpeel cracking (62.5%), and transient hyperpigmentation (12.5%), with no cases of scarring observed. However, the recurrence rate of melasma reached 70% by week 12 after treatment cessation. LIMITATIONS : Owing to the single-center setting as well as the retrospective nature of the study, the results of this study necessitate further prospective randomized controlled studies to validate these findings. CONCLUSION : Despite recurrences, this study found that a sequential chemical peel protocol using glycolic acid and trichloroacetic acid was effective in reducing melasma severity without causing scarring.
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    The exposome perspective : environmental and infectious agents as drivers of cancer disparities in low- and middle-income countries
    Dlamini, Zodwa; Alaouna, Mohammed; Marutha, Tebogo; Mkhize-Kwitshana, Zilungile; Mbodi, Langanani; Chauke-Malinga, Nkhensani; Luvhengo, Thifhelimbil E.; Marima, Rahaba; Hull, Rodney; Skepu, Amanda; Ntwasa, Monde; Duarte, Raquel; Damane, Botle Precious; Mosoane, Benny; Mbatha, Sikhumbuzo Z.; Phakathi, Boitumelo; Khaba, Moshawa; Chokwe, Ramakwana Christinah; Edge, Jenny; Mbita, Zukile; Khanyile, Richard; Molefi, Thulo (MDPI, 2025-08)
    Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), Helicobacter pylori (H. pylori), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis. These infectious agents contribute to increased cancer susceptibility and poor outcomes, particularly in immunocompromised individuals. Moreover, climate change, food insecurity, and barriers to healthcare access exacerbate these risks. This review adopts a population-level exposome approach to explore how environmental and infectious exposures intersect with genetic, epigenetic, and immune mechanisms to influence cancer incidence and progression in LMICs. We highlight the critical pathways linking chronic exposure and inflammation to tumor development and evaluate strategies such as HPV and HBV vaccination, antiretroviral therapy, and environmental regulation. Special attention is given to tools such as exposome-wide association studies (ExWASs), which offer promise for exposure surveillance, early detection, and public health policy. By integrating exposomic insights into national health systems, especially in regions such as sub-Saharan Africa (SSA) and South Asia, LMICs can advance equitable cancer prevention and control strategies. A holistic, exposome-informed strategy is essential for reducing global cancer disparities and improving outcomes in vulnerable populations.
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    Clinico-pathologic profile of skin cancers in oculocutaneous albinism at Universitas Academic Hospital
    Makuru, Molikuoa Harriet; Maruma, Frans; Ngwenya, Edward; Mponda, Kelvin (AOSIS, 2025-04)
    BACKGROUND : Oculocutaneous albinism (OCA) is a genetic disorder found worldwide. Skin cancer is a significant risk for people with albinism, particularly in Africa, where it is a major cause of death. Many patients delay seeking medical care until their skin lesions are in advanced stages. AIM : The aim of this study was to describe the clinico-pathological profile of skin cancers in patients with albinism at their initial presentation to our dermatology outpatient department. SETTING : This study was conducted at the dermatology department of Universitas Academic Hospital, Bloemfontein, South Africa. METHODS : A retrospective descriptive study covering June 2009 to July 2019 was conducted. Only records of oculo-cutaneous albinism patients diagnosed with skin cancer during their initial visit were included. RESULTS : Eighty-six patients with albinism were recorded, 37% (n = 32) of whom had skin cancer at their first visit. Females (81%) were more affected than males (19%). The majority of skin cancers were squamous cell carcinomas (SCCs) (54%) and basal cell carcinomas (BCCs) (46%). No melanomas were found. Most SCCs were classified as aggressive (80.4%), compared to 30.8% of BCCs. CONCLUSION : Almost 40% of OCA patients presented with skin cancer at their initial visit, highlighting the need for strengthening primary healthcare systems’ efficiency in ensuring early referrals for OCA patients. CONTRIBUTION : Education, socioeconomic support and awareness campaigns are sine qua non actionable factors that could help encourage early medical evaluation for all OCA patients.
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    Freeman-Sheldon syndrome : a functional and cosmetic correction of microstomia
    Neumann, Andri; Coetzee, Pieter F. (Elsevier, 2009-11)
    No abstract available