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An Evaluation

JAMES W. BURKS, MD; JOHN MARASCALCO, MD; WALLACE H. CLARK, JR., MD

Arch Dermatol. 1963;88(5):572-585.

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.

Author Affiliations
NEW ORLEANS; GREENVILLE, MISS; BOSTON

From the Division of Dermatology, Department of Medicine, Tulane University School of Medicine and Charity Hospital of Louisiana at New Orleans (Dr. Burks and Dr. Marascalco) and the Department of Pathology, Harvard Medical School, Boston (Dr. Clark).

Footnotes
Read before the 83rd annual meeting of the American Dermatological Association, Inc., Hot Springs, Va, April 16, 1963.

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ABSTRACT