title: Dermatography (Medical Tattooing) for Scars and Skin Grafts in Head and Neck Patients to Improve Appearance and Quality of Life.
abstract: OBJECTIVE
  Dermatography (medical tattooing) is often overlooked as an adjuvant procedure to improve color mismatch in the head and neck area, and its effect on patient satisfaction and quality of life has not been evaluated, to our knowledge.
  
  
  OBJECTIVE
  To analyze the effect of dermatography on the subjective perception of the appearance of scars and skin grafts and the quality of life in head and neck patients.
  
  
  METHODS
  Case series of patients undergoing dermatography at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, between July 1, 2007, and April 1, 2015. Participants were invited to respond to 2 questionnaires measuring their scar or graft appearance and their quality of life before and after dermatography as an adjuvant treatment for benign or malignant head and neck tumors.
  
  
  METHODS
  Use of dermatography.
  
  
  METHODS
  Two questionnaires evaluating a visual analog scale score (range, 0-10) and multiple questions on a 5-point scale focusing on satisfaction with the appearance and the quality of life.
  
  
  RESULTS
  Among 76 patients, 56 (74%) were included in the study. The mean (SD) age of the study cohort was 56.5 (16.0) years, and 42 (75%) were female. The mean improvement in scar or skin graft perception on the visual analog scale of the modified Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty before and after dermatography was 4 points. On the modified Patient Scar Assessment Questionnaire, uniform improvement of approximately 1 point across 9 questions was observed. The answers to all patient satisfaction and quality-of-life questions on both questionnaires improved significantly after dermatography.
  
  
  CONCLUSIONS
  Dermatography is an effectual adjuvant procedure to improve the subjective perception of scar and skin graft appearance and the quality of life in head and neck patients.
  
  
  METHODS
  4.
authors.affiliation: Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam.
authors.forename: Brigitte H
authors.initials: BH
authors.lastname: Drost
authors.affiliation: Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam2Center for Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Diakonessen Hospital, Utrecht, the Netherlands.
authors.forename: Rick
authors.initials: R
authors.lastname: van de Langenberg
authors.affiliation: Center for Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Diakonessen Hospital, Utrecht, the Netherlands.
authors.forename: Olivia R
authors.initials: OR
authors.lastname: Manusama
authors.affiliation: Department of Dermatology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam.
authors.forename: A Soe
authors.initials: AS
authors.lastname: Janssens
authors.affiliation: Department of Biometrics, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam.
authors.forename: Karolina
authors.initials: K
authors.lastname: Sikorska
authors.affiliation: Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam.
authors.forename: C Lot
authors.initials: CL
authors.lastname: Zuur
authors.affiliation: Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam.
authors.forename: Willem M C
authors.initials: WM
authors.lastname: Klop
authors.affiliation: Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam2Center for Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Diakonessen Hospital, Utrecht, the Netherlands.
authors.forename: Peter J F M
authors.initials: PJ
authors.lastname: Lohuis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044964:Cervicoplasty / Q000523:psychology*; D002921:Cicatrix / Q000523:psychology* / Q000628:therapy*; D004954:Esthetics; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D012878:Skin Neoplasms / Q000523:psychology* / Q000601:surgery*; D016038:Skin Transplantation / Q000523:psychology*; D011795:Surveys and Questionnaires; D013653:Tattooing / Q000379:methods* / Q000523:psychology*; D064232:Visual Analog Scale; D055815:Young Adult