Treatment of acne scars in Asian patients using a 2,790-nm fractional yttrium scandium gallium garnet laser.

BACKGROUND: Treatment of atrophic scars using a fractional laser resurfacing technique has demonstrated favorable outcomes. OBJECTIVE: To evaluate the efficacy and safety of 2,790-nm-wavelength ablative fractional resurfacing on atrophic acne scars in Asian individuals. METHODS: Twenty participants (8 female, 12 male, mean age 26) with skin phototype IV and atrophic acne scars were treated with two sessions of 2,790-nm ablative fractional resurfacing laser at a 6-week interval. Objective and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline and 1 and 3 months after the final treatment. RESULTS: At the 3-month follow-up, 70% of the participants were rated as having at least 50% to 89% improvement of scars. Mild erythema was the most common adverse effect, observed in 30% of participants, but resolved completely in an average of 5 days. CONCLUSIONS: Yttrium scandium gallium garnet ablative fractional resurfacing (2,790-nm) appears to be effective and well tolerated for the treatment of atrophic acne scars in Asians. The authors have indicated no significant interest with commercial supporters.

Treatment of pigmented keratosis pilaris in Asian patients with a novel Q-switched Nd:YAG laser.

BACKGROUND: Treatment for most cases of keratosis pilaris requires simple reassurance and general skin care recommendations. Many Asian patients find lesions due to pigmented keratosis pilaris to be cosmetically unappealing. Treatment of post-inflammatory hyperpigmentation using a 1064-nm Q-switched Nd:YAG laser with low fluence is reported. OBJECTIVE: To investigate the efficacy of a novel Q-switched Nd:YAG laser for the treatment of pigmented keratosis pilaris in Asian patients. METHODS: Ten patients with pigmented keratosis pilaris underwent five weekly treatments using a Q-switched Nd:YAG laser (RevLite(®); HOYA ConBio(®), Freemont, CA, USA) at 1064 nm with a 6-mm spot size and a fluence of 5.9 J/cm(2). Photographic documentation was obtained at baseline and 2 months after the final treatment. RESULTS: Clinical improvement was achieved in all 10 patients with minimal adverse effects. CONCLUSION: For the treatment of keratosis pilaris, the use of a Q-switched Nd:YAG laser can be helpful for improving cosmetic appearance as it can improve pigmentation.

Treatment of procedure-related postinflammatory hyperpigmentation using 1064-nm Q-switched Nd:YAG laser with low fluence in Asian patients: report of five cases.

Postinflammatory hyperpigmentation (PIH) developing after cosmetic procedures, such as chemical peeling and laser therapies, are always a concern, especially in Asians. Some cases of PIH tend to be spontaneously regressed; however, certain forms of PIH need to be treated with several therapeutic attempts, including bleaching creams, several kinds of Q-switched lasers, and erbium-doped fractional photothermolysis system, with various treatment outcomes. A 1064-nm Q-switched Nd:YAG laser with low-fluence therapy is easily applicable, and the therapeutic trial in our case was revealed to have minimal downtime without post-therapy bleeding or crust formation; the post-therapy erythema spontaneously resolved within a few hours. The 1064-nm Q-switched Nd:YAG laser with low-fluence treatment should be considered in the treatment of PIH caused by procedures like laser surgery and chemical peeling in Asian patients.

Clinical trial of dual treatment with an ablative fractional laser and a nonablative laser for the treatment of acne scars in Asian patients.

BACKGROUND: Many methods have been proposed for the treatment of acne scars, with variable cosmetic results. Nonablative skin resurfacing is one method that has been proposed. Because of a need for more noticeable clinical improvements, the ablative fractional laser was recently introduced. OBJECTIVE: To reduce complications and improve the results of ablative fractional laser resurfacing by combining this treatment of acne scars with nonablative lasers. METHODS: A series of 20 patients (skin phototypes IV-V) with atrophic facial acne scars were randomly divided into two groups that received three successive monthly treatments with an ablative fractional laser using high (group A) and low (group B) energy on one facial half and an ablative fractional laser with low energy plus a nonablative resurfacing laser on the other facial half. Patients were evaluated using digital photography at each treatment visit and at 3 months postoperatively. Clinical assessment scores were determined at each treatment session and follow-up visit. RESULTS: Although the use of the ablative fractional laser with high energy resulted in an improvement in patients' acne scars, the combination of ablative fractional laser resurfacing and nonablative laser resurfacing yielded the best results, as assessed in photographs as well as by the overall appearance of the acne scars. With the combination method, fewer complications were observed.

Clinical trial of pin-point photodynamic therapy using an optic fiber for the improvement of enlarged facial pores: a case study.

BACKGROUND: There are few publications on the treatment options for facial pore size reduction. A focused therapy is needed. OBJECTIVE: To evaluate the efficacy of selective photodynamic therapy (PDT) using an optic fiber for the size reduction of large facial pores. METHODS: A series of five patients (skin phototypes IV-V) with large facial pores received two successive weekly treatments with an 810-nm diode laser using a fine optic fiber after indocyanine green (ICG) was applied selectively to enlarged pores. Patients were evaluated using digital photography at each treatment session, and at 3 months post-operation. Clinical assessment scores were determined at each treatment session and follow-up visit. Patient satisfaction surveys were obtained at the end of the study. RESULTS: All five participants who completed the 3-month follow-up gave a subjective assessment of reduction of facial pore size. Modest to excellent improvement was achieved. CONCLUSION: This study demonstrates that treatment with pin-point PDT using an optic fiber is a well-tolerated and effective regimen for the reduction of facial pore size.

Simvastatin inhibits cigarette smoking-induced emphysema and pulmonary hypertension in rat lungs.

RATIONALE: In cigarette smoking-induced chronic obstructive pulmonary disease, structural and functional derangements are characterized by parenchymal destruction and pulmonary hypertension. Statins are 3-hydroxy-3-methyl-glutaryl-coenzyme-A reductase inhibitors that have been used as lipid-lowering agents. These drugs also have additional pharmacologic properties, including antiinflammation, scavenging reactive oxygen species, restoring endothelial function, and antithrombogenesis, all of which can counteract the harmful effects of cigarette smoking. OBJECTIVE: We performed assays to determine whether simvastatin could attenuate lung damage induced by chronic cigarette smoking in rats. METHODS: In Sprague-Dawley rats exposed to cigarette smoke for 16 weeks, morphologic changes in the lungs and pulmonary arterial pressure were examined. MAIN RESULTS: Simvastatin inhibited lung parenchymal destruction and development of pulmonary hypertension, and also inhibited peribronchial and perivascular infiltration of inflammatory cells and induction of matrix metalloproteinase-9 activity in lung tissue. Simvastatin additionally prevented pulmonary vascular remodeling and the changes in endothelial nitric oxide synthase expression induced by smoking. In human lung microvascular endothelial cells, simvastatin increased expression of endothelial nitric oxide synthase mRNA. CONCLUSIONS: Simvastatin ameliorated the structural and functional derangements of the lungs caused by cigarette smoking, partly by suppressing inflammation and matrix metalloproteinase-9 induction and preventing pulmonary vascular abnormality. These findings indicate that statins may play a role in the treatment of cigarette smoking-induced chronic obstructive pulmonary disease.

Recurrent pigmented macules after q-switched alexandrite laser treatment of congenital melanocytic nevus.

BACKGROUND: Q-switch-mode laser treatment of congenital nevi does not result in complete histological clearance, and many patients have partial repigmentation within several months. In addition, the number of recurrent pigmented macules (RPMs) may increase, a major drawback to good cosmetic results. While the mechanism of recurrence is not known. OBJECTIVE: To help elucidate the mechanism of RPM development, we evaluated the expression of TNF-alpha and E-cadherin on RPM after treatment of congenital nevi with a Q-switched alexandrite laser (QSAL). METHODS: Thirteen Korean subjects with congenital nevi received QSAL treatment at intervals ranging from 2 to 6 months (mean, 4.5 treatments). Two-millimeter punch biopsy specimens were obtained at their first visit and from RPMs 3-6 months after the last treatment. Expression of E-cadherin and TNF-alpha were determined histochemically in the original nevi and RPM. In addition, one RPM was examined by electron microscopy. RESULTS: Reduced pigmentation in the treated areas was seen in all cases, but partial repigmentaion was seen as black spots within 6 months after the last QSAL treatment. Compared to the original nevi, the RPMs had increased numbers of melanocytes in the epidermis and reduced nevomelanocytic nests in the dermis. The expression of TNF-alpha and E-cadherin was downregulated in the RPMs compared to the original nevi. Electron microscopy confirmed the increase in melanocytes in the epidermis of RPMs. CONCLUSION: Our findings suggest that the down-regulation of E-cadherin and TNF-alpha may induce the proliferation of melanocytes, resulting in the formation of RPMs.