Retrospective photographic review of nontattoo indications treated by picosecond laser.

BACKGROUND: Picosecond (PS) lasers were approved by the US FDA in 2012 after being shown to remove tattoos with more success and fewer treatments compared with traditional methods. PS lasers were shown to be versatile, indicated for the treatment of lentigines, café-au-lait macules (CALMs), and acne scars and skin rejuvenation. OBJECTIVE: We report our experience treating our patients for different indications using a PS laser. METHODS: We performed a retrospective chart and photographic review of all patients seen between 2016 and 2018 that were treated in our centers with a PS laser for nontattoo indications. Clinical outcomes were evaluated using side-by-side comparisons of the clinical photographs by two blinded, independent physicians using a visual analog scale consisting of six levels of treatment response. RESULTS: A total of 233 patients were studied. Most sought treatment for solar lentigo (27%) and skin rejuvenation (14%). Epidermal nevi exhibited the greatest improvement with treatment, while acne scarring demonstrated the least. Only 24% of patients experienced noteworthy, transient adverse effects. CONCLUSION: Picosecond lasers were efficacious and safe for a variety of indications. They were effective in treating epidermal nevi and pigmented lesions, such as Lentigines and CALMs.

Peripheral osteoma of the nasal bone after laser treatment: A case report.

INTRODUCTION: Peripheral osteoma, which arises from the periosteum, commonly develops in the head and neck region and is found frequently in the mandible, maxilla, and paranasal sinuses. However, osteoma of the face, especially from the nasal bone, is quite rare. PATIENT CONCERNS: A 34-year-old female visited our outpatient department with a small mass on the nose. She had n laser treatment of nevus at the same spot 14 years before, and it had enlarged slowly since 10 years before. DIAGOSIS: Computed tomography scan revealed a 0.7 × 0.5 cm sized radio-opaque tumor of the nasal bone. INTERVENTIONS: Under general anesthesia, surgical excision was performed through a transcolumellar and infracartilaginous incision. The excised tumor was a 0.7 × 0.5 cm sized hard mass. OUTCOMES: Biopsy confirmed it as a peripheral osteoma. After tumor removal, structural stability of nasal framework including bone and cartilage was maintained, and symmetry of the nasal dorsum was acquired. CONCLUSION: Chronic osteoma can compress the abutting structures. In the case of the nose, either structural instability or asymmetry can occur. By applying open rhinoplasty techniques, postoperative scars could be hidden and additional correction of the affected structure could be carried out if necessary. As a result, the surgeon can achieve the functional and esthetic outcomes simultaneously.

Impact of UV-irradiation on electrical impedance spectroscopy of benign nevi: study protocol for a prospective, controlled, clinical study.

INTRODUCTION: The clinical and histological changes of nevi after ultraviolet (UV) irradiation have been studied in detail. In contrast, the impact of UV irradiation on electrical impedance spectroscopy scores of nevi has not been investigated. However, for physicians, it is essential to know the extent to which changes in electrical impedance spectroscopy scores of nevi may be attributed to seasonal effects of UV irradiation. METHODS: This is a prospective, controlled, clinical study evaluating the impact of UV irradiation on the electrical impedance spectroscopy scores of benign nevi in 50 patients undergoing phototherapy. To this end, benign nevi of patients with a medical indication for phototherapy will be measured by electrical impedance spectroscopy before, during and after UV irradiation. At the same time, non-irradiated nevi of the same patient will be measured to account for changes over time that are independent of direct UV irradiation. ETHICS AND DISSEMINATION: Ethical approval was obtained from the ethics committee of the medical faculty of the University of Heidelberg (ethics approval number S-279/2017). The design and the final results of the study will be published and made available to the public. TRIAL REGISTRATION NUMBER: DRKS00012456; Pre-results.

Lasers for nevi: a review.

A nevus is described as a benign, often pigmented, skin growth that can be congenital or acquired. Different types of nevi are located at different depths within the skin. Traditional treatments for nevi include topical treatments, dermabrasion, and excision, which are generally ineffective, invasive, and often result in scars and dyspigmentation. Lately, laser therapy has been used as an alternative. Based on the theory of selective photothermolysis, melanin can be specifically targeted, minimizing adverse effects and increasing effectiveness of laser treatments. Several types of lasers and lights have been studied for this purpose without a concise agreement as to which is the best. In general, quality-switched lasers are preferred for the treatment of pigmented lesions. However, there is controversy about this therapy because certain nevi may have malignant potential. This article serves as a comprehensive review of available laser treatments for nevi and discusses the appropriate measures that should be taken before and after laser therapy. Based on the reviewed literature, laser treatment has generally been proven to be a safe and effective therapy for nevi with minimal side effects.

Hypertrichosis in Becker's nevus: effective low-fluence laser hair removal.

Becker's nevus is cosmetically bothersome both due to the hyperpigmentation and due to the hypertrichosis which can accompany it, particularly in males. Laser hair removal can be considered, but the pigmented background of the Becker's nevus makes the treatment more challenging. Fifteen patients with Becker's nevus underwent eight sessions of hair removal with low-fluence high-repetition-rate diode lasers (808-810 nm). All participants experienced significant hair reduction at 6 and 12 months. No adverse events were reported. The study supports the use of low fluence with high-repetition-rate diode laser hair removal as a safe and effective method for the management of hypertrichosis in Becker's nevus.

Treatment of faun-tail naevus with intense pulsed light.

BACKGROUND: Faun tail is a rare cutaneous marker of spinal dysraphism. This neurological abnormality may lead to difficulties such as severe pain and burning sensations in treatment of hypertrichosis of faun tail with laser or laser-like devices. OBJECTIVE: We evaluated outcomes of an intense pulsed light source in two patients with faun tail. METHODS: The Lumina intense pulsed light system [650-nm handpiece (550-1100 nm)] was used for the treatment. Magnetic resonance imaging and neurological examination were done. RESULTS: Tethered cord syndrome was detected as a neurological abnormality. The patients were treated with an energy fluence of 18- 26 J/cm(2), pulse sequencing of 3 to 4, and a delay time of 20-35 ms. Local anesthesia was applied in one patient during treatment for severe pain sensation. A mean of 85% hair reduction was achieved. CONCLUSION: A good cosmetic result with intense pulsed light treatment was achieved in the patients with faun tail. Local anesthesia may be required before treatment of faun tail with laser or laser-like systems due to associated neurological abnormalities.

Laser treatment of pigmented lesions in clinical practice: a retrospective case series and patient satisfaction survey.

Lasers are frequently used to treat pigmented skin lesions; however, there is little published data from routine clinical practice. We performed a retrospective review of patients treated between January 2003 and January 2004 to describe the patients, methods used and the clinical outcome. The long-term result was determined by a patient questionnaire. In total, 67 patients with 76 pigmented lesions were treated (22 males and 45 females, mean age 22 years); 27% had Fitzpatrick skin types IV-VI. The Q-switched Nd:YAG, and erbium:YAG lasers were used in 75% and 24% of cases, respectively, with an average of 5.4 treatments/patient. The physician-rated outcome at the end of treatment was 'very positive' in 45% and 'mostly positive' in 30% of cases. The patient-rated outcome at an average of 21 months post-treatment was 'excellent' in 29.5%, 'good' in 25%, and 'fair' in 22.7% of the 44 cases. About 50% of patients with the three most common lesions (congenital naevi, other/unspecified naevi and naevus of Ota) achieved good or excellent long-term results.

Unilateral nevoid telangiectasia--response to pulsed dye laser.

BACKGROUND: Unilateral nevoid telangiectasia (UNT) is a unique vascular dermatosis of ambiguous etiology. The therapeutic role of pulsed dye laser in this condition, especially in individuals with skin types III and IV, has not been elucidated completely. The aim of this study was to assess the response to flash-lamp pulsed dye laser of UNT in Indian patients. METHODS: A detailed analysis of nine confirmed cases of UNT patients was undertaken to determine the possible etiologic association of this disease. Six cases were treated with pulsed dye laser in combination with cryogen cooling using the following parameters: spot size, 7 mm; fluence, 5-7.5 J/cm2; wavelength, 585 nm; pulse duration, 450 micros. The procedure was repeated every 4-6 weeks and the response was assessed both clinically and photographically before each session. RESULTS: The cases had a mean age of presentation of 20.6 years with an age of onset varying from 2.5 to 23 years. The lesions were located on the head and neck region in four patients, upper limb in four, and lower limb in one. No significant etiologic association could be established. Of the six cases treated with pulsed dye laser, a moderate response (26-50% lightening) was achieved in all cases after a mean of 2.33 sessions, a good response (51-75% lightening) was observed in four patients after 3.25 sessions, and an excellent response (>75% lightening) was found in three patients after 3.66 sessions. Mild and reversible pigmentary alterations occurred in five cases, with mild textural change in one case. There was no scarring. No recurrence was observed. CONCLUSION: Pulsed dye laser is a useful modality for treating UNT in Indian patients. Reversible pigmentary changes are the major side-effects.