Sandy Milgraum - Academia.edu (original) (raw)

Papers by Sandy Milgraum

Australasian Journal of Dermatology, Jun 30, 2023

Facial intramuscular injections of Botulinum toxin (BoNT) injections are among the most common co... more Facial intramuscular injections of Botulinum toxin (BoNT) injections are among the most common cosmetic procedures in dermatology. Rarely, serious adverse reactions such as blepharoptosis, diplopia and periorbital hematoma may occur with improper administration technique. Here we report a case of painless diplopia 5 weeks post‐BoNT injection for ‘crow's feet’ likely due to inadvertent BoNT diffusion into the lateral rectus muscle causing a temporary palsy. This case aims to raise awareness of proper cosmetic BoNT injection techniques in the periorbital area to avoid ophthalmic complications.

Archives of Dermatology, Oct 1, 1985

Skinmed, 2016

A 33-year-old woman presented with more than 100 flesh-colored papules and nodules centrally loca... more A 33-year-old woman presented with more than 100 flesh-colored papules and nodules centrally located on the face (Figure 1). Since their first appearance at the age of 7, the lesions had increased in number and spread laterally from the nasolabial folds. She underwent surgical removal at age 10 with recurrence afterward. Her mother, maternal grandmother, and maternal great aunt have similar lesions on the face. Histopathologic examination confirmed the diagnosis of trichoepitheliomas and multiple familial trichoepithelioma (MFT).

Cutis, 1992

Pyogenic granuloma is a frequently diagnosed, benign vascular lesion common in children and young... more Pyogenic granuloma is a frequently diagnosed, benign vascular lesion common in children and young adults. Treatment of pyogenic granuloma consists of removal of the lesion for therapeutic as well as diagnostic purposes. Current treatment modalities include curettage with electrodesiccation, cryosurgery, chemical cauterization, and argon laser therapy. However, these methods are not without the risk of complications such as scarring and pigmentary changes. The recently reported success of the flashlamp-pumped pulsed dye laser for treating telangiectasias, hemangiomas, and port-wine stains led us to hypothesize that this same device, using different variables, such as multiple overlapping pulses, would be of benefit in the treatment of pyogenic granuloma. We describe three patients with pyogenic granuloma treated with the pulsed dye laser, with the total number of treatments and energy densities varying according to the size of the initial lesion. All three patients demonstrated compl...

New Jersey medicine : the journal of the Medical Society of New Jersey, 1993

Highly specific lasers provide an effective form of treatment for benign vascular and pigmented l... more Highly specific lasers provide an effective form of treatment for benign vascular and pigmented lesions. These lasers produce excellent cosmetic results while virtually eliminating adverse effects. With several laser treatments, clinicians can achieve dramatic results.

Journal of drugs in dermatology : JDD, 2015

INTRODUCTION As we enter a new age of increasing demand in novel cosmetic therapies, we are chall... more INTRODUCTION As we enter a new age of increasing demand in novel cosmetic therapies, we are challenged to provide excellent results with minimal downtime and safety in all skin types. In this open case series we are studying the improvement in rhytides by combining a novel, FDA-approved, non-ablative fractionated Q-switched ND: YAG 1,064-nm laser that acts in the deep dermis, with a topical containing plant stem cell extract and N-acetyl glucosamine (NAG) that acts in the superficial dermis. METHOD Six healthy females (Skin types III - V) were selected for the study with mean average age of 56 years +/- 11 years. The rhytides on the face and neck were assessed using a comprehensive grading scale. Patients were then divided into two groups, one received only laser treatment with the fractionated QSW 1,064 nm laser and the other group received combined treatment with the laser and topical. Patients were assessed again at 4 and 8 weeks. RESULTS We observed an enhanced anti-aging effect...

For diagnosis, see page 306 A n 8-year-old girl presented for evaluation of a rash present since ... more For diagnosis, see page 306 A n 8-year-old girl presented for evaluation of a rash present since infancy that had recently began spreading over her body. The eruption began on the central chest and gradually spread to the upper chest, and medial aspect of the arms, forearms, and thighs. The lesions were occasionally pruritic but otherwise asymptomatic. The patient was treated with a course of topical hydrocortisone valerate by her pediatrician with no change in the lesions. The patient had no significant past medical history and had met all developmental milestones appropriately. Family history was unremarkable with no similar rash noted in any other family members. Physical examination revealed a healthy, well-developed, 8-year-old girl. Evaluation of the skin revealed hundreds of tan-brown, 1- to 2-mm papules distributed on the upper chest, flexor sur faces of the arms, the forearms, and in a band-like distribution across the upper

Pediatric Dermatology, 2020

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital cutaneous vascular anomaly ... more Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital cutaneous vascular anomaly with a reticular marbled erythematous pattern, which can result in isolated benign skin lesions or less commonly be associated with systemic anomalies. Occasionally, the characteristic pattern of CMTC lesions is masked on initial presentation, creating a diagnostic conundrum that can result in unnecessary workups to rule out vasculopathy. We present the case of a female newborn with a red‐blue ulcerated skin lesion on the right leg and foot, which initially appeared as retiform purpura but evolved to exhibit the mottled pattern of CMTC by 5 days of age. Clinicians must be made aware of this potential diagnostic trap in early CMTC to avoid invasive skin biopsies and unnecessary laboratory testing in neonates.

JAMA pediatrics, May 1, 2015

A healthy 7-year-old girl presented with a 2-month history of an itchy rash on her elbows, knees,... more A healthy 7-year-old girl presented with a 2-month history of an itchy rash on her elbows, knees, hands, and feet. The patient was otherwise healthy with normal development and growth. She had no other medical problems and was not taking any medications. The rash started as small pink bumps on her knees and elbows, spreading to her hands and feet and progressively thickening. The patient’s history was otherwise unremarkable; she had no pets, had no recent travel outside the United States, and her vaccinations were up to

Cutis (New York, N.Y.), 2012

Telangiectases are lesions formed by persistent segmental dilatation of papillary plexus vessels ... more Telangiectases are lesions formed by persistent segmental dilatation of papillary plexus vessels of the skin that typically present as fine, bright, nonpulsatile red lines or netlike patterns. Palmar erythema commonly presents as symmetric, blanchable, slightly warm, nonscaling erythema, most frequently involving the thenar and hypothenar eminences of the palmar surface. Palmar telangiectases and palmar erythema both have primary cutaneous, systemic disease, neoplastic, infectious, and drug-induced etiologies. We describe a case of palmar telangiectases in a patient with Graves disease. We also describe the pathophysiology of palmar telangiectases and palmar erythema and present a literature review of their etiologies.

An asymptomatic enlargement of the medial clavicle is a condition that is often both missed and m... more An asymptomatic enlargement of the medial clavicle is a condition that is often both missed and misdiagnosed. We review the most common causes of an isolated and asymptomatic enlargement of the medial clavicle. Underlying aetiologies include osteoarthritis of the sternoclavicular joint, condensing osteitis, spontaneous dislocation of the sternoclavicular joint, and sternocostoclavicular hyperostosis. Key points in the history and physical examination as well as characteristic radiographic findings are sufficient for correct diagnoses. Treatment is conservative.

Cutis, 2008

Chronic myelomonocytic leukemia (CMML) is a hematologic stem cell disorder with myelodysplastic a... more Chronic myelomonocytic leukemia (CMML) is a hematologic stem cell disorder with myelodysplastic and myeloproliferative characteristics. Extramedullary leukemic infiltration of the skin, although uncommon in CMML, has prognostic relevance. We report a unique case of a patient with CMML who clinically presented with vitiligo that was histologically diagnosed as leukemia cutis. This case underscores the necessity of early recognition of skin changes in patients with hematologic disorders and the differentiation of nonspecific skin lesions from leukemia cutis.

Journal of drugs in dermatology : JDD, 2011

BACKGROUND Wound healing is a dynamic and complex process affected by tissue hydration, the prese... more BACKGROUND Wound healing is a dynamic and complex process affected by tissue hydration, the presence of bacteria, inflammation, and other variables. Oregano has potent antibacterial, antifungal, antioxidant, and anti-inflammatory properties. Studies of oregano ointment on wound healing are lacking. OBJECTIVE To determine the efficacy of 3% oregano extract ointment on wound healing. METHODS An investigator initiated, randomized, double-blind, petrolatum-controlled study was performed to determine the effects of oregano ointment on wound healing. Forty patients who underwent surgical excision were enrolled and randomized. Cultures were obtained on day 12 and scars were evaluated using the Patient and Observer Scar Assessment tool on day 12, 45, and 90. RESULTS The oregano ointment group had 19 percent of cultures test positive for Staphlococcus aureus compared to 41 percent in the petrolatum group. One patient in the oregano ointment group developed a cellulitis compared to three pati...

The Journal of clinical and aesthetic dermatology, 2012

OBJECTIVE To review the current therapy for granuloma annulare and report a case of refractory ge... more OBJECTIVE To review the current therapy for granuloma annulare and report a case of refractory generalized granuloma annulare successfully treated with excimer laser. A discussion about the characteristics of excimer laser and the mechanism of its effectiveness is presented. DESIGN Patient case report and literature review. SETTING Outpatient dermatology practice. PARTICIPANTS A 73-year-old woman suffering from generalized granuloma annulare for more than 40 years. MEASUREMENTS Change in clinical appearance of lesions. RESULTS Use of excimer laser therapy resulted in prompt and complete resolution in treated areas with no residual skin changes or side effects. CONCLUSION Excimer laser therapy is a powerful treatment modality with minimal side effects for patients with granuloma annulare. Further study is necessary to elucidate optimal dosing, long-term efficacy, and safety profile.

Cutis, 2018

To the Editor: A 13-year-old white adolescent girl presented with asymptomatic discrete hyperpigm... more To the Editor: A 13-year-old white adolescent girl presented with asymptomatic discrete hyperpigmented papules on the chest, back, arms, and upper legs of 7 months’ duration. The patient otherwise was in good health; her weight and height were on the 40th percentile on growth curves and she had no history of any medications. Treatments for the skin condition prescribed by outside dermatologists included minocycline 75 mg twice daily for 2 months, lactic acid lotion 12% daily, and ketoconazole 400 mg administered twice 1 week apart. Physical examination revealed more than 50 scattered hyperpigmented papules on the chest, back, arms, and upper legs ranging in size from 2 to 3.5 cm (Figure 1). Stroking of lesions failed to elicit Darier sign. A potassium hydroxide preparation and fungal culture were negative for pathogenic fungal organisms. The plasma insulin level was within reference range. A punch biopsy from the abdomen was obtained and sent for histopathologic examination. Histopa...

Contemporary pediatrics, 2006