Medical Pearl: Docetaxel-induced onycholysis

Abstract

ends of the 3-way tap are capped to prevent air entry in the syringe. Because of the negative pressure, the skin bulges inside the syringe increasing the contact surface between the skin and the syringe. Therefore, vacuum leak from the contact area between the syringe and the skin usually does not occur. Application of a thin layer of white soft paraffin on the contact surface may further make the syringe leak-proof. On measuring negative pressure after 1 or 2 hours, no or negligible change in the negative pressure was noted. In conclusion, we provide a reference table for the required volume of air to be aspirated from 5-, 10-, and 20-mL syringes to achieve the desired negative pressure. Because the manometer constitutes the main bulk of the syringe suction blister apparatus, using the reference table eliminates its need and further simplifies the suction blister apparatus. REFERENCES 1. Kiistala U, Mustakallio KK. In vivo separation of epidermis by production of suction blisters. Lancet 1964;1:1444-5. 2. Falabella R. Epidermal grafting: an original technique and its application in achromic and granulating areas. Arch Dermatol 1971;104:592-600. 3. Gupta S, Kumar B. Epidermal grafting in vitiligo: influence of age, site of lesions, and type of disease on outcome. J Am Acad Dermatol 2003;49:99-104. 4. Koga M. Epidermal grafting using the tops of suction blisters in the treatment of vitiligo. Arch Dermatol 1988;124:1656-8. 5. Kiistala U. Suction blister device for separation of viable epidermis from dermis. J Invest Dermatol 1968;50:129-37. 6. Mukhtar, Singh S, Shukla VK, Pandey SS. Surgical pearl: suction syringe for epidermal grafting. J Am Acad Dermatol 1997;37: 638-9. 7. Lewis EJ. The mechanism of ‘‘suction.’’ J Am Acad Dermatol 1998;39:664. 8. Gupta S, Shroff S, Gupta S. Modified technique of suction blistering for epidermal grafting in vitiligo. Int J Dermatol 1999; 38:306-9. 9. Gupta S, Kumar B. Suction blister induction time: 15 minutes or 150 minutes? Dermatol Surg 2000;26:754-7. J AM ACAD DERMATOL FEBRUARY 2005 350 Pearls