Successful treatment of primary cutaneous localized amyloidosis with a combined therapy of ablative fractionated CO2 laser, topical retinoid, corticosteroids and levovitamin C: Five cases with two-year follow-up.

Primary cutaneous localized amyloidosis (PCLA) is a pruritic disorder with no radical cure. We trialed a combined therapy of ablative fractionated CO2 laser, topical retinoid, corticosteroids and levovitamin C on five patients. All patients responded with no intolerant signs. Two-year follow-up visit showed no recurrence. This might be a effective method awaiting more samples for further stronger evidence.

Efficacy and Safety of a Sublative Bipolar Fractional Radiofrequency System Combined With Topical Tretinoin in Treating Striae Gravidarum: A Randomized Pilot Study.

BACKGROUND: Striae gravidarum is a common skin condition resulting after pregnancy, caused by fibroblast dysfunction. Although not considered a disease, it may be considered cosmetically unpleasant to sufferers and remains as a therapeutic challenge to date. OBJECTIVE: To evaluate the efficacy and safety of a sublative bipolar fractional radiofrequency (FRF) system, associated with 0.1% topical tretinoin, in treating striae gravidarum. MATERIALS AND METHODS: Eighteen Chinese women with striae gravidarum on the abdomen were enrolled in the study. The target area of each patient was divided into 4 sites randomly: control, tretinoin, FRF, and tretinoin and FRF. Fractional RF was used 3 times, with 3-month intervals. Changes to striae gravidarum were evaluated through subjective scaling and objective measures, using both high-frequency ultrasound and histological study. RESULTS: Both subjective assessment and skin thickness differences demonstrated significant improvement in the combination site (p < .001). Average optical density and density percentage of neocollagen and elastic fibers were also markedly increased in the combination site (p < .05). The adverse effects of FRF were limited to mild pain and transient erythema, edema, and microcrusts. CONCLUSION: The combined therapy of FRF and topical tretinoin may be a potential method in treating striae gravidarum, with satisfactory efficacy and limited side effects.

Application of a new fractional radiofrequency device in the treatment of photoaging skin in Chinese patients.

Background and objectives: Fractional radiofrequency (FRF) has been used in the treatment of photoaged skin for a long time. This study was intended to examine the efficacy and safety of electrode pin FRF in the treatment of photoaged skin in Chinese patients. Materials and methods: Twenty healthy Chinese subjects with facial photoaged skin were enrolled in this study. Each subject received three FRF treatments at 4-week intervals. Changes of photoaging were analyzed by a global evaluation, subjective Assessment, a Mexameter, and VISIA. Results: In total, 12 of 18 patients (66.7%) and 11 of 18 patients (61.1%) had good or excellent improvement respectively according to investigator A and investigator B. Also, 13 of 18 patients (72.2%) rated their satisfaction of the overall improvement as satisfied or very satisfied. Mean melanin index and erythema index values significantly decreased between baseline and 12-week follow up (P < 0.05). The average wrinkle percentile was increased at 12-week follow-up (79.0 ± 8.4) compared to baseline (58.8 ± 10.2). Adverse effects were limited to erythema, tiny scabs and mild pain. Conclusions: FRF is a safe and effective method for photoaging skin in Chinese patients.

Infrared-induced adult colloid milium treated with fractionated CO2 laser.

Adult colloid milium is a rare cutaneous deposition disorder that frequently involves areas of chronic sun exposure. The most common clinical presentation exhibits multiple, firm, and amber-colored papules that cluster to form large plaques. Histologically, there are masses of amorphous, eosinophilic material expanding the papillary dermis, and at times extending into the mid-dermis, with adjacent solar elastosis. When this disorder affects the face, disfiguring is of great concern and treatment is often sought. Attempts to safely remove colloid milium are generally unsuccessful. Dermabrasion has been reported to be effective. The present authors present a case with extensive facial colloid milium successfully ablated by the fractionated CO2 laser.

Split-face comparison of ultrapulse-mode and superpulse-mode fractionated carbon dioxide lasers on photoaged skin.

BACKGROUND: Both ultrapulse-mode and superpulse-mode fractional CO2 lasers (UPCO2 and SPCO2) could be successfully used in treating photoaged skin. OBJECTIVE: This evidence-based study was intended to compare the therapeutic and adverse effects of UPCO2 and SPCO2 in treating photoaged skin in Chinese subjects. METHODS: Eighteen Chinese subjects with Fitzpatrick skin type IV were enrolled in a randomized, split-face trial. Subjects received SPCO2 on one half of the face and UPCO2 on the other half. Before and after photos, skin color, epidermal water content, sebum level, periorbital wrinkles, skin roughness, and self-esteem questionnaires were used. RESULTS: Global evaluation and subjects' self-esteem assessments showed a similar trend at 1-month and 3-month follow-up visits on both sides. The UPCO2 laser has a shorter downtime of 6.25±2.71 days compared with 6.41±2.67 days for SPCO2, but has a higher incidence of edema, spot bleeding, prolonged redness and postinflammatory hyperpigmentation. More subjects prefer SPCO2 treatment because of similar efficacy and fewer adverse effects. CONCLUSION: The effectiveness of the SPCO2 laser in treating photoaged skin is very similar to the UPCO2 laser, with less erythema, but more crusting and longer downtime.

Split-face study of topical 23.8% L-ascorbic acid serum in treating photo-aged skin.

BACKGROUND: L-ascorbic acid has been widely used to treat photo-aged skin. However, its aqueous formula is prone to oxidation. Therefore, a new formula that contains 23.8% L-ascorbic acid and a chemical penetration enhancer was developed. OBJECTIVE: Observe the efficacy and safety of topical 23.8% L-ascorbic acid serum on photo-aged skin. METHODS: Twenty Chinese women with photo-aged skin were enrolled in this split-face study. They were treated with topical L-ascorbic acid serum with iontophoresis on one side of the face once a day for 2 weeks; the other side of the face was spared treatment through participants' self-control. Changes in photo-aged skin were evaluated using a global evaluation, an overall self-assessment, a spectrophotometer, the phase-shift rapid in vivo measurement of skin (PRIMOS) 3D, and a corneometer. RESULTS: Sixteen of 20 patients (80%) experienced a score decrease of 2 or 3 grades, according to the dermatologist. Fifteen patients (75%) rated their overall satisfaction as excellent or good. Dyspigmentation, surface roughness, and fine lines on the treated side improved significantly. CONCLUSION: Topical 23.8% L-ascorbic acid serum is effective for the treatment of photo-aged skin and does not cause any obvious side effects.

Immunohistological evaluation of skin responses after treatment using a fractional ultrapulse carbon dioxide laser on back skin.

BACKGROUND AND OBJECTIVE: Fractional photothermolysis (FP) lasers have been widely used in treating photo-aged skin, acne scars, and other skin conditions. Although plenty of clinical data have demonstrated the efficacy of the FP laser, only limited histologic studies have been available to observe serial short- to long-term skin responses. METHODS: Seven healthy Chinese women received one pass of fractional carbon dioxide laser treatment on the left upper back. Biopsies were taken at the baseline and 4 hours, 1 day, 5 days, 1 month, 3 months, 6 months, and 1 year after the procedure for hematoxylin and eosin stains, immunohistochemical evaluation (for heat shock proteins and elastin), and Verhoeff-iron-hematoxylin stains (for collagen and elastic fiber). RESULTS: Remarkably greater expression of heat shock protein (HSP)70 could be observed 4 hours after the procedure, which diminished significantly by 3 months, 6 months, and 1 year after the procedure. HSP47 reached its peak expression 1 month after the procedure, especially around microscopic thermal zones, and maintained its high level of expression 3 and 6 months after the procedure. Distinct new formation and remodeling of collagen and elastic fibers could be observed 3 and 6 months after procedure. CONCLUSION: FP-induced HSP expression and new formation of collagen and elastic fibers lasted as long as 6 months, longer than the previously acknowledged 3 months.