Dermabrasion-Loo-punch-excision technique for the treatment of acne-induced osteoma cutis.

Three patients with chronic osteoma cutis secondary to acne vulgaris were treated with the dermabrasion-Loo-punch-excision technique. Under regional nerve block with lidocaine-bipuvacaine (50:50) a uniform dermabrasion was performed across the entire face, including the hairline and 1 cm below the jawline. This exposed the foci of osteoma cutis. Then the appropriate sized Loo punch (usually the 2.0- or the 2.5-mm punch) was used to excise the bluish-gray miliary lesions. The majority of the foci were removed in one operation. Following excision, the lesions were closed with 7-0 prolene suture. To prevent crust formation postoperatively, Aloe-vera-soaked polyethylene oxide gel dressings (Vigilon) were changed twice daily following an ice water compress. Sutures were removed rapidly in 5 to 7 days to prevent the appearance of suture lines. Although one patient required an additional procedure, the cosmetic results were excellent. Only a few small residual blue "dot" lesions remained in these three cases.