Abstract A clinical and histologic evaluation of the effects of planing of the senile and actinically damaged skin based upon five years' observation of 15 half-face planings indicates that planing prevents development of precancerous and cancerous lesions of the skin. The degree of improvement of planed over unplaned sides of the face based upon the opinions of seven inspectors was 85% cosmetically and 92% therapeutically. Actual dermatologic count of significant lesions of planed and unplaned sides showed fewer suspicious lesions on the planed sides of nine patients and the same number of lesions in four. Thus, no patient had more suspicious lesions on the planed side. Histologic observations indicated profound changes in planed skin which would probably account for favorable clinical effects. Apparently, wire brush planing produces a fibrogenic zone ultimately resulting in deposition of a wide band of new fibrous tissue and either replaces damaged tissue or places a broad band of new tissue between the area of solar degeneration and the epidermis. New elastic fibrils were readily demonstrated in this fibrogenic zone. Some were found vertical to the epidermis and some extended to and seemed to fuse with the "basement membrane." Epidermal changes were less striking than dermal ones. Melanocytes appeared to be present in the same number in planed as in unplaned skin. Hypopigmentation of planed skin may be due in part to failure to transfer melanin from melanocytes to surrounding epidermal cells. Planing has definite but limited value in the prophylaxis of precancerous lesions and is most effective when used before the appearance of extensive and advanced keratotic changes. References 1. Kurtin, A.: Corrective Surgical Planing of Skin , AMA Arch Derm Syph 68:389, 1953.Crossref 2. Luikart, R., II; Ayres, S., III; and Wilson, J. W.: Surgical Skin Planing , New York J Med 59:3413-3447, 1959. 3. Burks, J. W., Jr.; Brewer, J. M., Jr.; and Chernosky, M. E.: Surgical Planing for the Prevention of Cancer of the Skin , Southern Med J 53: 86-91, 1960.Crossref 4. Epstein, E.: Planing for Precancerous Skin: Follow-Up Study , AMA Arch Derm Syph 77:676-681, 1958.Crossref 5. Jones, W. N.; Derbes, V. J.; and Burks, J. W.: A Study of the Basic Reactivity of Planed Skin , J Invest Dermat 34:259-262, 1960. 6. Ayres, S., III; Wilson J. W.; Luikart, R., III: Dermal Changes Following Abrasion , AMA Arch Derm 79:553-568, 1959.Crossref 7. Burks, J. W., Jr., and Krafchuk, J.: Dermal Planing: Investigative Therapeutic Applications , Southern Med J 53:17-23, 1960.Crossref 8. Hall, D. A.: The Fibrous Components of Connective Tissue with Special Reference to the Elastic Fiber , Int Rev Cytol 8:211-251, 1959.
Archives of Dermatology – American Medical Association
Published: Nov 1, 1963