Terapia fotodinámica / Photodynamic therapy

La terapia fotodinámica se basa en la interacción de un agente fotosensibilizante que cuando es estimulado por la longitud de onda apropiada inducela formación de radicales libres que causan necrosis celular. Es una de las técnicas más recientes empleada en el tratamiento de algunos tipos de cáncer,aunque actualmente ya se ha demostrado su eficacia en otras enfermedades inflamatorias. En dermatología su principal indicación es el carcinomabasocelular, pero también se ha empleado en carcinoma escamoso in situ —enfermedad de Bowen— y más recientemente en acné, rosácea, varices,fotorejuvenecimiento, liquen, liquen escleroso y atrófico y leshmaniasis, entre otras dermatosis1

Photodynamic therapy is based in the interaction of a photoactive agent that when is properly stimulated by a specific wavelength it induces free radi-cals that lead to cellular necrosis. This is one of the newest treatments for some types of cancer and other inflammatory diseases. In dermatology, pho-todynamic therapy is used for malignant neoplasias such as basal cell carcinoma, Bowen disease —in situ squamous cell carcinoma— and morerecently it has been applied to inflammatory skin diseases such as acne, rosacea, lichen plannus, lichen sclerosus et atrophicus, and other conditions —leishmaniasis, photodamaged skin, telagiectasias1

Long-lasting hypopigmentation induced by long-pulsed alexandrite laser photo-epilation.

BACKGROUND: Long-lasting hypopigmentation induced by laser hair removal systems has been reported. OBJECTIVE. : To evaluate clinical aspects of a female Caucasian that developed long-lasting hypopigmentation in the arms and forearms after photodepilation with a long-pulsed alexandrite laser. METHOD: A 29-year-old Caucasian female (phototype III) with localized hypertrichosis in the upper limbs was submitted to long-pulsed alexandrite laser-assisted hair removal. One treatment session was done with these laser parameters: a pulse width of 2 ms, a spot of 7 mm, and fluence energy of 18 J/cm2. RESULTS: The patient developed long-lasting hypopigmentation (more than 6 months) in the arms and forearms after a single treatment session of photodepilation. CONCLUSION: Long-pulsed alexandrite laser may induce reversible melanocyte suppression and long-lasting hypopigmentation.

Side-effects after IPL photodepilation.

BACKGROUND: Intense pulsed light (IPL) has been successfully used as an efficient hair removal system; however, possible side-effects have been not specifically addressed in the literature. OBJECTIVE: To assess all possible side-effects after IPL hair removal in a series of 49 females with facial hirsutism during a total of 390 treatment sessions of IPL photodepilation. METHODS: Immediate post-treatment clinical, photography evaluation, and a two-month post-treatment questionnaire were done in 49 females with facial hirsutism submitted to photodepilation with an IPL source (EpiLight trade mark, ESC, Israel). RESULTS: Side-effects observed were: transient erythema (n = 30), late evanescent erythema (n = 3), mild pain (n = 43), moderate pain (n = 6), crust formation (n = 9), superficial burning (n = 1), isolated vesicles (n = 3), transient hyperpigmentation (n = 8), transient hypopigmentation (n = 1), paradoxical effect (n = 5), persistent local heat sensation (n = 1), and minimal scar (n = 1). CONCLUSION: Even though common, most side-effects secondary to IPL photodepilation are mild and transient. Permanent side-effects such as scars are unlikely but they may occur. Growth of new, fine and dark hair may be seen in untreated areas in close proximity to the treatment area, especially in the neck, a side-effect that is reported for the first time in the literature.

Intense pulsed light for hairy grafts and flaps.

BACKGROUND: Intense pulsed light (IPL) is an effective and safe method of hair removal. OBJECTIVE: To evaluate the clinical response of hairy grafts and flaps of different anatomic areas to an IPL source. METHODS: Four patients (three men, one woman; 17-72 years old) with hairy skin grafts (n = 2) or flaps (n = 2) were included. Donor skin areas included the forehead (n = 1), supraclavicular (n = 1), abdomen (n = 1), and groin (n = 1). Excisional surgery was performed because of basal cell carcinoma (BCC) of the nasal wall (n = 1), squamous cell carcinoma (SCC) of the forehead (n = 1), congenital nevus of the malar region (n = 1), and breast carcinoma (n = 1). The treatment was IPL with the following parameters: wavelength 695-755 nm, pulse width 3.8-4.5 msec, delay 20-30 msec, spot size 10 mm x 45 mm, fluence 38-42 J/cm2, and an interval of 4 weeks. A total of one to six treatment sessions were administered. RESULTS: A progressive decrease in terminal hair and delayed hair growth rate (more than 8 months) were observed in all the patients. Improvement of skin coarseness, pigmentation, and erythema was also observed in the graft and its periphery in one patient. Persistent erythema (more than 48 hours) was the only side effect, observed in one patient. CONCLUSION: IPL is an effective method to depilate hairy grafts and flaps.

Utilidad del láser de alejandrita (755 nm, 100 ns) en el tratamiento de las lesiones pigmentadas / Alexandrite laser (755 nm, 100 ns) for removal of pigmented lesions

El láser de alejandrita (755 nm, 100 ns) ha demostrado ser de utilidad en el tratamiento de lesiones melanocíticas superficiales, tales como léntigos simples y solares, lentiginosis y el componente superficial del nevo de Spilus, nevo de Becker y mancha café con leche. Las lesiones melanocíticas dérmicas como el nevo de Ota, nevo melanocítico adquirido y congénito, el componente profundo de las entidades ya señaladas y los pigmentos exógenos de color negro, azul y verde pueden igualmente ser tratados con esta técnica. El grado de aclaramiento depende de múltiples factores, entre los que cabe destacar la densidad de energía, el número de tratamientos aplicados y el tipo de lesión (AU)