Resurfacing of atrophic facial acne scars with a multimodality CO2 and 1570 nm laser system.

BACKGROUND: Scarring is one of the most prevalent long-term complications of acne vulgaris and has cosmetic, psychological, and social burdens. Contemporary management programs integrate multiple modalities to best address the multiple factors underlying their development and persistence. This work assessed the impact of sequential multimodal laser therapy on acne scar geometrics and texture. METHODS: Adult patients (n = 16) with Fitzpatrick skin type II-IV and presenting with facial acne scars, underwent three combination ablative (CO2), and nonablative (1570 nm) laser treatment sessions at two-month intervals. Treatment was delivered using a ProScan Hybrid applicator, with each regimen including illumination with both ablative and a nonablative lasers applied in a grid mode sequence. Scar microtopography was assessed at baseline and 6 months after the last treatment session. RESULTS: At baseline, all patients had both box and rolling scars, while only three had icepick scars. Six months following treatment, mean scar volume improved from 5.7 ± 5.2 mm3 at baseline to 3.1 ± 3.0 mm3 and mean affected area improved from 165.6 ± 134.0 mm2 94.0 ± 80.1 mm2, translating to 47.0 ± 7.9% and 43.2 ± 8.6% reductions from baseline, respectively. Patients were highly satisfied with treatment outcomes, and no serious adverse reactions were documented during the course of treatment or follow-up. CONCLUSION: Multimodal CO2 and 1570-nm laser treatment improved the surface profilometry of patients with atrophic facial acne scars. Customization of both treatment intervals and laser settings to cosmetic regions, scar profiles and skin phototypes may further enhance treatment outcomes and expand its applicability to additional skin deformities.

Feasibility and Safety of Using Combined Light-Emitting Diodes Versus Intense Pulsed Light Technology for the Improvement of Facial Hypervascularization in Adult Patients.

Background: Superficial facial vascular lesions can be an aesthetic problem and a symptom of different skin diseases. Objective: It was to compare the efficacy and safety profiles of Dermalux® Tri-Wave MD, based on three combined light-emitting diodes (LEDs) technology and intense pulsed light (IPL) for reducing the excess of facial vascularization due to superficial cutaneous vascular lesions. Materials and methods: The study had a single-center, proof-of-concept, open-label, and prospective design. Two groups of adult patients were treated for facial hypervascularization, LED-Group with an LED device combining 633 and 830 nm and IPL-Group with an IPL (555-950 and 530-750 nm). Variables assessed were hemoglobin hyperconcentration (HH), hemoglobin-affected area (HAA) through Antera 3D®, and pain using the Numeric Pain Rating Scale. Results: Twenty subjects were included, 10 by group (50% female). LED-Group: Mean age 32.1 years (range, 21-46). IPL-Group: Mean age 34.5 years (range, 25-49). HH: LED-Group 100% had a moderate improvement; in the IPL-Group, 10% was moderate, and 90% was marked. HAA: LED-Group 10% had a slight improvement, 70% moderate, and 20% marked; in the IPL-Group, 100%, the improvement was marked. Seventy percent of LED-Group patients reported no pain, 30% mild; in the IPL-Group, 100% of patients reported severe pain. Conclusions: Treatment with combined red and near-infrared LEDs effectively reduced the excess of facial vascularization with moderate outcomes compared with IPL, but without secondary effects and no pain. This treatment could represent an effective, safe, and well-tolerated approach for facial vascular lesions.

Visible and Quantifiable Improvement in Skin Roughness and Texture Using a High Power Non-ablative 1540-nm Fractional Erbium: Glass Laser.

Background: Non-ablative fractional laser treatments for improving skin tone and rejuvenation have become increasingly popular due to short downtime and fewer side effects compared to ablative treatments. Objective: We sought to determine the efficacy of a non-ablative 1540-nm fractional erbium: glass laser in improving skin roughness and skin texture. Methods: The forehead, cheek, and nasal areas of 15 patients were treated for five monthly sessions using a 7x7 pixel tip (1.21cm2 affective area, approximately 300 microns diameter per pixel), fluence of 2,500 to 3,000 mJ/pulse (40-62 mJ/Pixel), and three stacked pulses were emitted at a rate of 1Hz for three passes per treatment session. Measurements of skin roughness, skin roughness area, and maximum skin depth were collected using a 3D imaging system. Improvement in skin parameters was calculated by comparing the measurements prior to treatment and 12 weeks after completion. Results: All 15 patients showed significant improvement in all three measured parameters (p<0.001) with no significant side effects. Limitations: The limitations of this study include the small number of patients and the narrow range of skin tone (Fitzpatrick Skin Types II-IV). Conclusion: Our results suggest that monthly treatments with a non-ablative 1540-nm fractional Erbium:glass laser appear to be safe and effective for skin texture and roughness.

Three wavelengths integrated: Efficacy and safety of a novel combination for hair removal.

BACKGROUND: Laser hair removal is one of the most popular aesthetic procedures. AIMS: The study aimed to assess the efficacy and safety of a novel applicator combining three wavelengths (1064 nm, 810 nm, and 755 nm) for hair removal. PATIENTS/METHODS: This prospective study included a four-session hair removal treatment with three wavelengths combined and emitted simultaneously using an in-motion technique. Patients were treated in eight-week intervals between each session and a follow-up of 3 months. RESULTS: Twenty-two men (mean age 41.5 years, SD = 6.1) were included: two (9.1%) Fitzpatrick skin type II, 19 (86.4%) type III, and one (4.5%) type IV. Treated areas were two abdomens (14%), fourteen backs (64%), and five thoraxes (23%). Hair characteristics were evaluated with a dermatoscopic imaging system. Three months after the last session, the mean decrease in the hair count was of 75.6% (SD 5.9) (p < 0.0001), in hair density of 75.6% (SD 5.9) (p < 0.0001), in the terminal hair number of 60.1% (SD 55.0) (p < 0.0001), and in the vellus hair number of 39.7% (SD 72.9) (p = 0.0001). CONCLUSION: The combined three different wavelengths in a single device provided a wide range of absorption and penetration, allowing for a safe and effective treatment.

Efficient treatment of upper-lip rhytidosis by pneumatic administration of hyaluronic acid.

Three female patients with extensive upper lip rhytidosis were successfully treated with kinetic energy-based injections of hyaluronic acid.

Leiomioma parauretal / Leiomyoma paraurethral

Se reporta un caso de leiomioma parauretral en una paciente femenina, con síntomas de cuerpo extraño en vagina y dificultad para micción, El examen físico revela masa en pared anterior de vagina. El diagnóstico fue realizado por ultrasonido transperineal. La escisión quirúrgica fue realizada sin lesionar tracto urinario. Se realiza revisión de la literatura.

A case of paraurethral leiomyoma is reported in a female patient, with symptoms of a foreign body in the vagina and difficulty in urination. Physical examination reveals mass in the anterior wall of the vagina. The diagnosis was made by transperineal ultrasound. Surgical excision was performed without injuring urinary tract. Systematic literature review is performed.

Caracterización del tumor ovárico en la mujer centroamericana / Characterization of ovarian tumor in American women

El diagnóstico de una masa anexial es uno de los hallazgos más frecuentes en la práctica clínica de un ginecólogo. De los tumores ováricos el 80% son benignos y se presentan generalmente en mujeres menores de 45 años, el 20% son malignos y se presentan principalmente en mujeres postmenopáusicas...

Pentalogía de Cantrell / Pentalogy of Cantrell

La Pentalogía de Cantrell es un raro desorden caracterizado por una combinación de defectos severos de esternón, diafragma, corazón y paredes abdominales, en ocasiones asociado a una multiciplicidad de anomalías congénitas. Afecta a 5.5 infantes por un millón de nacimientos. Son más afectados los varones en una proporción de 2:1 y suelen tener signo sintomatología mas severa que en las mujeres...

Síndrome Asherman / Síndrome Asherman

El síndrome de Asherman también llamado sinequias uterinas o adherencias uterinas es una condición que se caracteriza por la presencia de adherencias y/o fibrosis en la cavidad uterina debido a cicatrices. Se han utilizado otros términos para referirse esta entidad como adherencias intrauterinas traumáticas, atresia cervical/uterina, esclerosis endometrial, y otros...

Masa abdomino pélvica gigante: reporte de un caso / Abdomino pelvic mass giant: a case report

Los tumores benignos de ovario son mas comunes en pacientes jóvenes en edad reproductiva a diferencia de la mayor parte de las neoplasias malignas de ovario que se presentan en pacientes de mas edad. Las masas anexiales benignas son unilaterales, pueden llegar a alcanzar grandes tamaños y generan poca sintomatología a las pacientes...

Síndrome de Mayer-Rokitansky-Küster-Hauser / Mayer-Rokitansky-Kuster-Hauser

Las agenesias de Müller también se conocen como síndrome de Mayer-Rokitansky-Küster-Hauser y se presenta como amenorrea primaria y desarrollo de características sexuales secundarias. El síndrome se presenta en 1 en 5000 mujeres. El 5% puede tener pequeñas cantidades de endometrio, y raramente presentan menstruación asociado a dolor cólico cíclico mensual. Este es un caso de una paciente de 16 años, con historia de dolor pélvico cíclico que posteriormente se fue intensificando...

Caracterización de la paciente con incontinencia urinaria que consulta al Hospital General San Juan de Dios / Characterization of patients with urinary incontinence who consulted the Hospital General San Juan de Dios

Describir las características de las pacientes con incontinencia urinaria que consultan al Hospital General San Juan de Dios y de esta forma poder conocer un perfil físico, epidemiológico y médico de estas pacientes. Diseño del estudio: se seleccionó aleatoriamente 67 pacientes de la clínica de uroginecología, con diagnóstico de incontinencia urinaria durante el período de enero 2006 a mayo de 2007. A estas pacientes se les entrevistó utilizando una boleta de recolección de datos...

Inversión uterina secundaria a legrado por aspiración de embarazo molar en una paciente adolescente / Uterine inversion secondary to suction curettage of molar pregnancy in an adolescent patient

La inversión uterina puerperal es una condición médica rara que ocurre con una frecuencia de 1 en 2,000 embarazos, sin embargo la inversión uterina no puerperal es aún más rara y se encuentra frecuentemente en pacientes mayores de 45 años y asociada a tumores. Se presenta el caso de una paciente de 15 años, primigesta, a quien se le realizó un legrado por aspiración endouterina por un embarazo molar y durante el procedimiento presentó inversión uterina. La paciente formo un anillo de constricción, por lo que la inversión fue resuelta con la técnica de Hualtain...

Uso de antimicrobianos profilácticos en cirugía y gineco-obstetricia / Use of prophylactic antibiotics in surgery and obstetrics and gynecology

El concepto de guías terapéuticas no es nuevo y aunque se conocen las limitaciones en el uso de las mismas a nivel clínico, se considera como una de las herramientas adecuadas para promover el uso adecuado de antimicrobianos, el cual se considera una de las herramientas básicas para la prevención de la diseminación de la resistencia bacteriana. La Oficina Sanitaria Panamericana promovió durante los años 2001 y 2002 la creación de una Guía Genérica de tratamiento de las enfermedades infecciosas más comunes en el continente americano. Un grupo de especialistas latinoamericanos desarrolló el concepto y logró...