A comparative clinical and histopathological pilot study of different fractional CO2 laser parameters in treatment of atrophic linear scars.

BACKGROUND: Atrophic scars cause significant patient morbidity. Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different etiologies. AIMS: To assess the efficacy and safety of different fractional ablative CO2 laser parameters in treatment of linear atrophic depressed post-traumatic facial scars in adult male patients. METHODS: A prospective pilot study of 20 adult male patients (skin types Π- Ⅳ, aged 18-45) with post-traumatic atrophic linear scars were divided into 2 groups each comprising 10 patients receiving different fractional CO2 laser parameters. Both groups received 3 laser sessions, one month apart, and were followed for 2 months after the last treatment session. Clinical and histological assessments were done to all patients before treatment and 2 months after the last treatment session. Also, patient satisfaction and side effects were recorded. RESULTS: The study showed statistically significant reduction in average scar volume in both groups (P < .01), with reduction in depth more obvious than reduction in width or length in both groups. There was a highly significant difference in overall scar improvement represented by scar volume between both groups (P < .01) with an average reduction in scar volume of 42.85% in group (a) compared with 35.29% in group (b). Also, there was a highly statistically significant increase in both epidermal and papillary and reticular dermis thickness in both groups after treatment. However, the difference between both groups was nonsignificant. Side effects were mild, well tolerated, and transient. CONCLUSION: Fractional CO2 laser can be utilized as a safe and effective modality in treatment of post-traumatic linear atrophic scars of the face. Adjusting parameters toward increasing depth of penetration and decreasing thermal coagulative effect gives better results.

Intralesional vitamin D3 versus Candida antigen immunotherapy in the treatment of multiple recalcitrant plantar warts: A comparative case-control study.

Intralesional immunotherapy is one of the therapeutic tools of warts. Intralesional Candida antigen was reported as successful treatment of warts. Topical and intralesional vitamin D have been used recently for wart treatment. We aim to evaluate the efficacy and safety of intralesional injection of vitamin D3 in treatment of multiple recalcitrant plantar warts in comparison with intralesional Candida antigen. Sixty patients were divided into three groups: Group I received intralesional vitamin D3, Group II intralesional Candida antigen, and Group III intralesional saline (control group). Injection was done every 3 weeks until clearance of warts or a maximum of three treatments. There was a statistically significant more reduction of warts numbers after treatment in Group I than in the other groups (p < .05). Group I showed better clinical response than Group II (p = .021). In both Groups I and II, clinical response was less favorable in patients with longer disease duration (p = .026). There was also limitation as it is a small study population. Intralesional vitamin D3 injection in multiple recalcitrant plantar warts is a simple, safe, cost effective treatment modality with minimal side effects, and superior results compared with intralesional injection of Candida antigen.