Objective and Long-Term Evaluation of the Efficacy and Safety of a 1064-nm Picosecond Laser With Fractionated Microlens Array for the Treatment of Atrophic Acne Scar in Asians.

BACKGROUND AND OBJECTIVE: Fractional 1064-nm picosecond-domain laser has recently been utilized for the treatment of atrophic acne scars and showed promising results. However, data on the safety and efficacy of this procedure in dark-skinned patients are limited. This prospective, self-controlled study was conducted to objectively evaluate the safety and efficacy of a 1064-nm picosecond laser coupled with a microlens array (MLA) for the treatment of atrophic acne scars on Asian skin. STUDY DESIGN/MATERIALS AND METHODS: Twenty-six subjects of Fitzpatrick skin types (FSTs) III and IV with atrophic acne scars were enrolled. All subjects were treated with a 1064-nm picosecond laser (spot size of 8 mm, fluence of 1.0 J/cm2 , a repetition rate of 10 Hz) in combination with the MLA handpiece for an average of three passes, for 6 monthly sessions. Objective (measurement of scar volume using three-dimensional (3D) photography and skin roughness analysis using ultraviolet A-light video camera) and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline and at 1, 3, and 6 months after the final treatment. RESULTS: Statistically significant reduction of the scar volume from baseline at 1, 3, and 6 months after the final treatment were observed by 3D photography and ultraviolet A-light video camera. At the 6-month follow-up, 50% (13 of 26) of the subjects were rated as having at least 50% improvement of the scars. The rate of improvement significantly increased from the 1-month follow-up to the 6-month follow-up (P = 0.013). Similarly, at the 6-month follow-up, the scar volume (P = 0.024) and skin roughness (P = 0.001) also significantly improved, in comparison with the baseline. Mild postinflammatory hyperpigmentation (PIH) was observed to develop in approximately 18% of all the treatment sessions. All cases of PIH were temporary and resolved within 4 weeks on average. CONCLUSIONS: The 1064-nm picosecond laser with MLA is a safe therapeutic alternative for the treatment of atrophic acne scars in dark-skinned individuals. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Skin manifestation of Thai HIV infected patients in HAART era.

BACKGROUND: Skin and mucocutaneous disease changed its spectrum after Highly Active Antiretroviral Therapy (HAART) had been introduced. Previous publication showed opportunistic infections (OIs) related skin disease was a major presentation in pre-HAART era, whereas non-infected skin disease became emerging in HAART era. There is no report describing skin disease in HAART era among Thai HIV-infected patients. OBJECTIVE: To describe the prevalence of skin and mucocutaneous disease in Thai HIV-infected patients after using HAART MATERIAL AND METHOD: A cross-sectional retrospective study analyzed skin diseases of 237 HIV-infected patients who were currently on HAART who attended the out-patient skin clinic at Bamrasnaradura Infectious Diseases Institute between September 1, and October 31, 2010. There were 312 lesions. The skin diseases were diagnosed by dermatologists and grouped into four groups as infectious skin disease, non-infectious inflammatory skin disease, tumor and miscellaneous group. Percentage was calculated in each of skin disease prevalence. RESULTS: The results showed 155 (65%) were men, and mean (SD) of age was 41 (8.8). Median (IQR) of CD4 count was 330 (178, 527) cell/mm3. The regimens of HAART in the population were 79% for NNRTI based, 20% for PI based, and 1% for tripled NRTI. The time between initial HAART and date of diagnosis of most patients (52%) was more than three years. Non-infected skin disease (61%) was the most common skin disorder prevalence, followed by infectious disease (31%), tumor (0.96%), miscellaneous (6.09), respectively. The most common skin disease was eczema (21%). Four subjects developed drug eruption, all from Efavirenz. Atypical presentation specifically to HIV patients as chronic hypertrophic erosive herpes genitalis (one of IRIS) was found in four patients (20% of all HSV infectious prevalence). CONCLUSION: Non-infectious inflammatory skin disease is the most common skin prevalence in HIV-infected patients after receiving HAART Eczema was the most diagnosed skin disease. There were skin diseases related to immune restoration after using HAART and from HAART itself but in low prevalence.