Nonablative fractional laser resurfacing for the treatment of hypertrophic scars: a randomized controlled trial.

BACKGROUND: Nonablative fractional laser (NAFL) therapy is a noninvasive procedure that has been suggested as a treatment option for hypertrophic scars. OBJECTIVES: To evaluate the efficacy and safety of 1540-nm NAFL therapy in the treatment of hypertrophic scars. MATERIALS AND METHODS: An intraindividual randomized controlled trial (RCT) with split lesion design and single-blinded outcome evaluations. Patients received four NAFL treatments at monthly intervals. Primary endpoint was a blinded on-site visual and palpable Physician Global Assessment (PhGA). Adverse event registration and pain evaluation were used to evaluate safety. Patient global assessment (PGA) was a secondary endpoint to additionally evaluate efficacy. RESULTS: The PhGA did not find a statistically significant difference between the treated and untreated control side of 18 patients, although there was significant difference on the PGA 1 (p = .006) and 3 (p = .02) months after last treatment (Wilcoxon signed rank test). Patients experienced moderate pain during treatment and mild adverse events. CONCLUSION: In this trial, blinded PhGA could not confirm the clinical efficacy of 1540-nm nonablative fractional laser in the treatment of hypertrophic scars, but the treatment is safe, and patients judged that the treated part had a better global appearance.

A multileveled approach in psoriasis assessment and follow-up: A proposal for a tailored guide for the dermatological practice.

BACKGROUND: Psoriasis is a complex and heterogeneous disease resulting from interactions between genetic, immunological, and environmental factors. To make the most optimal treatment decision, the dermatologist must therefore have a detailed overview of the patient's history and lifestyle. OBJECTIVES: We sought to offer an overview of the various relevant aspects in clinical dermatological assessment of psoriasis patients, emphasizing the importance of a multidisciplinary and integrated clinical approach. METHODS: We gathered information on psoriasis management and developed a tailored checklist covering all health-related aspects associated with psoriasis. RESULTS: Demographics, personal and family history were elaborately described as well as drug history to discuss how they affect psoriasis management. Relevant patient information such as the vaccination status or cardiovascular profile were included in the checklist as well and treatment recommendations were adapted and updated in accordance with evidence-based literature. This checklist also emphasizes the importance of drug surveillance, proper follow-up and specialist referral, and why the dermatologist needs to address these health-related aspects when assessing psoriasis patients, going beyond optimal skin care. CONCLUSIONS: Our comprehensive overview can be used as a consultation checklist for good clinical practice in psoriasis patient management and aid in treatment decision.