High power Q-switched 1064 nm / 532 nm Nd:YAG Laser in tattoo removal: A systematic review.

Q-switched 1064 nm/532 nm Nd: YAG Lasers present important characteristics which can contribute toward the removal of tattoos, for having the ability to reach only specific targets with minimal damage to the tissue. Despite reports of their clinical benefits, only a few scientific studies demonstrate the efficacy and safety of these types of lasers in the short and long term. To substantiate the effects, benefits, and safety of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers, a systematic review was carried out from September to December of 2019, about the studies which report their use in the removal of tattoos, published in the last 20 years. Randomized clinical trials in humans were considered, as long as they evaluated the efficacy, safety, and benefits of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers in the removal of black and color tattoos in different skin phototypes. One hundred and twenty-two articles were identified after the titles, abstracts were read, and duplicates were removed; six articles were left, which were included in the research (188 individuals). The Q-switched 1064 nm/532 nm Nd: YAG lasers seem promising in the short term, with minimal adverse effects; however, the efficacy and safety in the long term still present limitations. Consequently, future research is necessary, with better methodological standardization applied and with a follow-up for a longer period of evaluation of possible permanent adverse effects, to determine the standardization and safety of the therapy with the lasers Nd: YAG de 1064 nm/532 nm Q-switched.

Efficacy, safety, and guidelines of application of the fractional ablative laser erbium YAG 2940 nm and non-ablative laser erbium glass in rejuvenation, skin spots, and acne in different skin phototypes: a systematic review.

Non-ablative and ablative fractional erbium lasers are among the most frequently used resources in dermatology for facial rejuvenation and for treating dermatological disorders. This type of erbium laser can be found at wavelengths of 1540 or 1550 nm, which are classified as non-ablative erbium glass, and at 2940 nm, classified as ablative erbium YAG. Despite the reports of their clinical benefits, few scientific studies have demonstrated the efficacy and safety of these lasers in the short or long term. In order to substantiate the effects, benefits, and safety of applying the erbium glass and erbium YAG lasers, a systematic review was carried out from August to December 2019 about studies published in the last 20 years. Randomized clinical trials in humans were considered that evaluated the efficacy, safety, and benefits of applying the fractional lasers erbium glass and erbium YAG to facial rejuvenation, skin spots, and atrophic acne scars. A total of 338 articles were identified; 76 articles remained after their titles and abstracts were read, and 42 articles were selected after removing the duplicates. After the articles were read in full, 17 of these articles were included in the systematic review (453 patients). The erbium glass and erbium YAG lasers seem promising in the short term, with minimal adverse effects; however, the long-term efficacy and safety still present limitations. Consequently, future research is needed, with better methodological standardization and a follow-up with a longer evaluation period for possible permanent adverse effects to determine the standardization and safety of therapy with erbium glass and erbium YAG lasers.

Efficacy and safety of ND:YAG 1064 nm lasers for photoepilation: a systematic review.

Using light sources in phototherapy has presented promising results regarding several types of facial and body skin affections for centuries. The neodymium-doped yttrium aluminum garnet (ND:YAG) 1064 nm laser has become a standard treatment in dermatology for dermatological disturbances related to the pilous follicle and the structures surrounding it. Despite the reports of its clinical benefits, few scientific studies show its actual safety and efficacy. To substantiate the effects, benefits, and safety of applying an ND:YAG 1064 laser in the epilation process during esthetic treatment, a systematic review was carried out between October 2018 and January 2019, on studies published in the last 20 years. Randomized clinical trials in humans were considered that evaluated the efficacy, safety, and benefits of ND:YAG laser application at 1064 nm wavelengths for hair removal. A total of 198 articles were identified; 58 articles remained after their titles and abstracts were read; and 21 articles were selected after the removal of duplicates. After the integral reading, 13 of these articles were included in the systematic review (734 patients). The ND:YAG 1064 nm laser presents safety and promising, beneficial effects in epilation. However, further scientific studies with better methodologic quality are necessary to better standardize ND:YAG laser therapy and clarify its parameters for photoepilation.

Expression of estrogen, androgen, and glucocorticoid receptors in recent striae distensae.

BACKGROUND: Stretch marks or striae distensae (SD) can be considered a common skin disorder, but their physiopathogenic mechanisms have not been totally clarified. Although it is considered an esthetic complaint, it may have serious psychosocial consequences besides the local and systemic alterations of the conjunctive tissue. This study aims at assessing and quantifying the estrogen, androgen and glucocorticoid receptors in skin samples with striae and comparing with normal skin. METHODS: Skin samples for biopsy were obtained from eight patients with SD and eight patients without lesions. The samples were frozen at -80 degrees C and underwent processing to obtain proteic extract to quantify the estrogen, androgen and glucocorticoid receptors with the Western Blot method. RESULTS: When the estrogen receptor in the skin with SD was compared with healthy skin, it was observed to have increased twice as much (P = 0.00001). The androgen and glucocorticoid receptors in the SD skin had also increased (P = 0.00015 and P = 0.00083, respectively). CONCLUSIONS: These findings indicate that under certain conditions there is an increase in hormonal receptor expression, suggesting that regions that undergo greater mechanical stretching of the skin may express greater hormonal receptor activity. This activity may influence the metabolism of the extracellular matrix, causing the formation of SD. Alterations in hormone receptors occur within a well-defined time period during the formation of SD; however, there are differences in the functionality of hormone receptors during different stages in the development of the lesions. The preliminary results appear to be relevant and represent an initial step towards an understanding of the pathophysiology of SD.

Striae distensae: fisiopatologia / Striae distensae: physiopathology

Introdução: A estria atrófica cutânea ou striae distensae (SD) é uma afecção muito comum que, apesar de ser considerada queixa estética, pode trazer importantes consequências psicossociais. Além disso, o seu surgimento pode refletir alteração do tecido conjuntivo e expressar condições patológicas locais e sistêmicas. Considerandose a multiplicidade de fatores envolvidos, a literatura é divergente e inconclusiva. Objetivo: Estudar os aspectos fisiopatológicos das estrias que já foram pesquisados através de revisão sistemática da literatura. Método: Foram realizadas buscas por meio de três bases de dados: Medline(1966-2009), Biblioteca Cochrane e Lilacs, nos idiomas português, inglês e espanhol, além de pesquisa das palavras-chave no PubMed, exame das referências bibliográficas dos artigos encontrados e busca manual dos principais periódicos de Dermatologia. Resultados: Foram detectados 113 artigos, sendo 101 no Medline, 12 na Biblioteca Cochrane e nenhum no Lilacs, referentes a striae distensae. Destes, 25 publicações foram consideradas para fins descritivos, tendo sido analisados individualmente dez estudos que eram controlados (comparados com amostras de pele sã) ou comparativos (estrias recentes e antigas). Conclusões: Há poucas pesquisas de boa qualidade sobre a fisiopatologia das estrias cutâneas. A maior parte dos trabalhos sobre estrias prioriza a terapêutica, havendo pouco interesse no entendimento da fisiopatologia. O conhecimento da fisiopatologia das SD é importante não somente para o desenvolvimento de métodos preventivos e terapêuticos mais eficazes, como para a melhor compreensão de alterações locais e sistêmicas relacionadas ao tecido conectivo.

Introduction: Cutaneous atrophic striae or striae distensae (SD) is a very common disease. Although SD is considered an aesthetic complaint, it can have important psychosocial consequences. Moreover, its occurrence may refl ect changes in tissue, and express local and systemic pathological conditions. Considering the multiplicity of factors involved, the literature is divergent and inconclusive. Objective: To investigate striae physiopathological aspects, which have been studied, through systematic review of the literature. Method: We conducted searches using three databases: MEDLINE (1966-2009), Cochrane Library and LILACS, in Portuguese, English and Spanish, besides search for keywords in PubMed, review of bibliographic references of the articles found, and manual search of the main Dermatology journals. Results: We identifi ed 113 articles, 101 in MEDLINE, 12 in Cochrane Library and none in LILACS, for striae distensae. Of these, 25 publications were considered for descriptive purposes, were analyzed 10 studies that were individually controlled (compared with samples of healthy skin) or comparative (recent and old striae). Conclusions: There are few researches of good quality on the physiopathology of cutaneous striae. The priority of most studies is on therapy, with little interest in understanding the physiopathology. The knowledge of SD physiopathology is not only important for the development of preventive methods and more effective treatment, but also for better understanding of local and systemic changes related to the connective tissue.