Visible and Quantifiable Improvement in Skin Roughness and Texture Using a High Power Non-ablative 1540-nm Fractional Erbium: Glass Laser.

Background: Non-ablative fractional laser treatments for improving skin tone and rejuvenation have become increasingly popular due to short downtime and fewer side effects compared to ablative treatments. Objective: We sought to determine the efficacy of a non-ablative 1540-nm fractional erbium: glass laser in improving skin roughness and skin texture. Methods: The forehead, cheek, and nasal areas of 15 patients were treated for five monthly sessions using a 7x7 pixel tip (1.21cm2 affective area, approximately 300 microns diameter per pixel), fluence of 2,500 to 3,000 mJ/pulse (40-62 mJ/Pixel), and three stacked pulses were emitted at a rate of 1Hz for three passes per treatment session. Measurements of skin roughness, skin roughness area, and maximum skin depth were collected using a 3D imaging system. Improvement in skin parameters was calculated by comparing the measurements prior to treatment and 12 weeks after completion. Results: All 15 patients showed significant improvement in all three measured parameters (p<0.001) with no significant side effects. Limitations: The limitations of this study include the small number of patients and the narrow range of skin tone (Fitzpatrick Skin Types II-IV). Conclusion: Our results suggest that monthly treatments with a non-ablative 1540-nm fractional Erbium:glass laser appear to be safe and effective for skin texture and roughness.

Infections in Moderate to Severe Psoriasis Patients Treated with Biological Drugs Compared to Classic Systemic Drugs: Findings from the BIOBADADERM Registry.

Information regarding the safety of biological drugs prescribed to psoriasis patients on daily and long-term bases is insufficient. We used data from the BIOBADADERM registry (Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases) to generate crude rates of infection during therapy with systemic drugs, including biological drugs (infliximab, etanercept, adalimumab, and ustekinumab) and nonbiological drugs (acitretin, cyclosporine, and methotrexate). We also calculated unadjusted and adjusted risk ratios (RRs) (with propensity score adjustment) of infection, serious infections, and recurrent infections of systemic therapies compared with methotrexate, using Poisson regression. Our study included records of 2,153 patients (7,867.5 person-years). The adjusted RR of overall infection was significantly increased in the groups treated with adalimumab with methotrexate (adjusted RR = 2.13, 95% confidence interval [CI] = 1.2-3.7), infliximab (adjusted RR = 1.71, 95% CI = 1.1-2.65), cyclosporine (adjusted RR = 1.58, 95% CI = 1.17-2.15), ustekinumab with methotrexate (adjusted RR = 1.56, 95% CI = 1.08-2.25), and etanercept (adjusted RR = 1.34, 95% CI: 1.02-1.76) compared with methotrexate alone. Cyclosporine had a significant risk of serious infection (adjusted RR = 3.12, 95% CI = 1.1-8.8), followed by adalimumab combined with methotrexate (adjusted RR = 3.28, 95% CI = 0.8-13.5). Adalimumab in combination with methotrexate had the highest risk of infection recurrence (adjusted RR = 4.33, 95% CI = 2.27-8.24).