Fractional Carbon Dioxide Laser and its Combination with Subcision in Improving Atrophic Acne Scars.

BACKGROUND: Acne is a very common skin disease in which scars are seen in 95% of the patients. Although numerous treatments have been recommended, researchers are still searching for a single modality to treat the complication due to its variety in shape and depth. We compared the effects of fractional carbon dioxide (CO2) laser alone and in combination with subcision in the treatment of atrophic acne scars. MATERIALS AND METHODS: This clinical trial study was performed in Skin Diseases and Leishmaniasis Research Center (Isfahan, Iran) during 2011-2012. Eligible patients with atrophic acne scars were treated with fractional CO2 laser alone (five sessions with 3-week interval) on the right side of the face and fractional CO2 laser plus subcision (one session using both with four sessions of fractional CO2 laser, with 3-week interval) on the left side. The subjects were visited 1, 2, and 6 months after the treatment. Patient satisfaction rate was analyzed using SPSS 20 software. RESULTS: The average of recovery rate was 54.7% using the combination method and 43.0% using laser alone (P < 0.001). The mean patient satisfaction was significantly higher with the combination method than laser alone (6.6 ± 1.2 vs. 5.2 ± 1.8; P < 0.001). Bruising was only seen with the combination method and lasted for 1 week in 57.0% and for 2 weeks in 43.0%. Erythema was seen in both methods. Postinflammatory pigmentation and hyperpigmentation were associated with combination method. No persistent side effects were seen after 6 months. CONCLUSION: Using a combination of subcision and laser had suitable results regarding scar recovery and satisfaction rate.

A Comparison between the Effects of Glucantime, Topical Trichloroacetic Acid 50% plus Glucantime, and Fractional Carbon Dioxide Laser plus Glucantime on Cutaneous Leishmaniasis Lesions.

Background. Cutaneous leishmaniasis is an endemic disease in Iran. Pentavalent antimonial drugs have been the first line of therapy in cutaneous leishmaniasis for many years. However, the cure rate of these agents is still not favorable. This study was carried out to compare the efficacies of intralesional glucantime with topical trichloroacetic acid 50% (TCA 50%) + glucantime and fractional carbon dioxide laser + glucantime in the treatment of cutaneous leishmaniasis. Methods. A total of 90 patients were randomly divided into three groups of 30 to be treated with intralesional injection of glucantime, a combination of topical TCA 50% and glucantime, or a combination of fractional laser and glucantime. The overall clinical improvement and changes in sizes of lesions and scars were assessed and compared among three groups. Results. The mean duration of treatment was 6.1 ± 2.1 weeks in all patients (range: 2-12 weeks) and 6.8 ± 1.7, 5.2 ± 1.0, and 6.3 ± 3.0 weeks in glucantime, topical TCA plus glucantime, and fractional laser plus glucantime groups, respectively (P = 0.011). Complete improvement was observed in 10 (38.5%), 27 (90%), and 20 (87%) patients of glucantime, glucantime + TCA, and glucantime + laser groups, respectively (P < 0.001). Conclusion. Compared to glucantime alone, the combination of intralesional glucantime and TCA 50% or fractional CO2 laser had significantly higher and faster cure rate in patients with cutaneous leishmaniasis.

Macroscopic effect of blue light cure on wound healing in NMRI mice NMRI.

BACKGROUND: Wound healing is a complex process and has been an ongoing challenge all over the world. Some studies have suggested light cure as a modality to accelerate wound repair. It can induce fibroblast proliferation, increase collagen synthesis and activate cellular processes involved in expression of procollagen type I and III mRNA. This study was designed to assess the macroscopic effect of halogen dental curing blue light on full-thickness open wound healing in NMRI mice. MATERIALS AND METHODS: Forty male NMRI mice were divided into control and treatment groups. A full-thickness wound of 6 mm in diameter was induced on the lower back of all mice under general anesthesia and sterile conditions. The mice of the treatment group received a 5-min exposure of halogen light Coltolux II (QHL), 420-500 nm, daily for 7 days. The diameter of the wound was measured in both the treatment and the control groups every second day up to Day 14. Data were analyzed by SPSS version 12 software using Student's t-test. A significance level of P ≤ 0.05 was considered for each comparison. RESULTS: There was a significant difference in wound diameter between the control and the treatment groups at all measurements after Day 3 (P ≤ 0/05). CONCLUSION: The results of this study suggest improvement of full-thickness wound healing by daily irradiation of halogen dental curing blue light of 420-500 nm for 7 days.

Comparison the efficacy of ablative CO2 laser and fractional CO2 laser on the healing of cutaneous leishmaniasis scars.

BACKGROUND: The aim of this study is to compare ablative CO2 laser with fractional CO2 laser on healing of the wound and the size of cutaneous leishmaniasis scars. MATERIALS AND METHODS: This prospective randomized clinical trial study was done on 120 patients in two groups evaluated in Sedigheh Tahereh Hospital in Isfahan. The patients in case group underwent one session ablative CO2 laser for treatment of leishmaniasis scars and the patients in control group underwent six 3-weeks interval sessions fractional CO2 laser for treatment of leishmaniasis scars. All cases were evaluated from size and other aspects of scar by a questionnaire, and before and 6 months after photos were evaluated by blinded dermatologist. The data collected in the check list was then analyzed by t-test and Chi-square with SPSS 20. RESULTS: There were 60 people in case group and 60 in control group. The mean age was 27.21 ± 11.2. Our results show that fractional CO2 laser is better than ablative CO2 laser in various aspect of treatment of leishmaniasis scars (P < 0.05). CONCLUSIONS: Fractional CO2 laser is better than ablative CO2 laser in variants aspect of treatment of leishmaniasis scars.

Effect of topical honey application along with intralesional injection of glucantime in the treatment of cutaneous leishmaniasis.

BACKGROUND: Leishmaniasis is an endemic disease in Iran. Although many treatments have been suggested for this disease, there hasn't been an effective and safe treatment yet. Regarding the healing effect of honey in the chronic ulcers and its reported therapeutic effect in cutaneous leishmaniasis, we performed a study to better evaluate the efficacy of honey in cutaneous leishmaniasis and its final scar. METHODS: In a prospective clinical trial, 100 patients with confirmed cutaneous leishmaniasis were selected and randomized into 2 groups. Group A were treated with topical honey twice daily along with intralesional injection of glucantime once weekly until complete healing of the ulcer or for maximum of 6 weeks. Group B were treated with intralesional injection of glucantime alone until complete healing of the ulcer or for a maximum of 6 weeks, too. The patients were followed for 4 months. The collected data were analyzed statistically using statistical tests including Chi-square, Mann Whitney and Kaplan-Mayer tests. RESULTS: In this study, 45 patients that had cutaneous leishmaniasis were treated with intralesional glucantime alone and 45 patients were treated with topical honey and glucantime. Ten patients left out the study. In the glucantime alone treated group, 32 patients (71.1%) had complete cure whereas in the group treated with both glucantime & topical honey, 23 patients (51.1%) achieved complete cure. This difference was significant statistically (p = 0.04). CONCLUSION: Further studies to better clarify the efficacy of honey in cutaneous leishmaniasis is needed. We suggest that in another study, the efficacy of honey with standardized level of antibacterial activity is evaluated against cutaneous leishmaniasis.