Tratamiento de la hiperpigmentación periocular con fuentes de luz / Treatment of periorbital hyperpigmentation using light devices

El tratamiento de la ojera supone una de las demandas más habituales en la consulta de estética para mejorar la imagen de cansancio, tristeza o envejecimiento que perciben nuestros pacientes. Además, se trata de un problema de etiología multifactorial y frente al que disponemos de un amplio abanico de tratamientos.El objetivo de la presente revisión es analizar la mejor evidencia disponible para el tratamiento de la ojera hiperpigmentada con fuentes de luz. Se han revisado 208 artículos que cumplían los criterios de búsqueda, incluyendo finalmente 14 para dar plena consideración en la revisión.Múltiples fuentes de luz han demostrado ser eficaces para el tratamiento de la pigmentación periorbitaria. Los resultados más prometedores se obtienen con luz pulsada intensa y láser rubí en combinación con despigmentantes. Para el tratamiento de la pigmentación junto con redensificación y disminución de arrugas destacan el láser CO2 y el láser erbium:yttrium scandium gallium garnet. Los láseres neodymium-doped yttrium aluminium garnet, alejandrita y diodo fueron los que reportaron resultados más moderados con su uso aislado. El tratamiento adyuvante con despigmentantes mejora resultados y reduce la incidencia de hiperpigmentación postinflamatoria.Es necesaria una mejor estandarización en la medida de los resultados en los cambios de la pigmentación. Además, sería recomendable realizar ensayos clínicos con resultados objetivables y que combinen varias fuentes de luz para el tratamiento no solo de la pigmentación periorbitaria, sino de la ojera de forma integral. (AU)

The treatment of dark circles is one of the most common request from the patients attending to the esthetics clinic. A tired, sad or aged appearance is perceived by our patients. Moreover, it is a multifactorial problem and we could treat it with a wide range of treatments.With this systematic review, we want to check the best available evidence regarding the treatment of periorbital hyperpigmentation using light devices. We have reviewed 208 papers, including 14 of them for full consideration.Several light sources have demonstrated to be effective treating pigmented dark circles. The best results have been reported using intense pulsed light and rubi laser together with depigmenting substances. If we want to treat periocular hyperpigmentation, soft wrinkles, rhytides and skin density we should use carbon dioxide laser or erbium:yttrium scandium gallium garnet. The neodymium-doped yttrium aluminium garnet, alexandrite and diode lasers were the ones giving the worst outcome regarding pigmentation treatment. The concomitant use of depigmenting treatment may help getting better results and reducing the rate of post-inflammatory hyperpigmentation.A better standardization and measuring of the obtained results is needed regarding pigmentation changes. We must keep on investigating on this topic with new clinical trials measuring objective results and combining different light devices for a multifactorial treatment of the dark circles. (AU)

Treatment of periorbital hyperpigmentation using light devices.

The treatment of dark circles is one of the most common request from the patients attending to the esthetics clinic. A tired, sad or aged appearance is perceived by our patients. Moreover, it is a multifactorial problem and we could treat it with a wide range of treatments. With this systematic review, we want to check the best available evidence regarding the treatment of periorbital hyperpigmentation using light devices. We have reviewed 208 papers, including 14 of them for full consideration. Several light sources have demonstrated to be effective treating pigmented dark circles. The best results have been reported using intense pulsed light and rubi laser together with depigmenting substances. If we want to treat periocular hyperpigmentation, soft wrinkles, rhytides and skin density we should use carbo dioxide laser or Erbium:Yttrium Scandium Gallium Garnet. The Neodymium-Doped Yttrium Aluminium Garnet, alexandrite and diode lasers were the ones giving the worst outcome regarding pigmentation treatment. The concomitant use of depigmenting treatment may help getting better results and reducing the rate of post inflammatory hyperpigmentation. A better standardization and measuring of the obtained results is needed regarding pigmentation changes. We must keep on investigating on this topic with new clinical trials measuring objective results and combining different light devices for a multifactorial treatment of the dark circles.

Luz pulsada intensa combinada con expresión de las glándulas de Meibomio para el tratamiento del chalación / Intense pulsed light combined with meibomian gland expression for chalazion management

Objetivo Investigar la eficacia y la seguridad del protocolo de luz pulsada intensa (IPL) combinando el protocolo de tratamiento con IPL para la disfunción de las glándulas de Meibomio/enfermedad de ojo seco con IPL aplicada directamente en los párpados, asociada a la expresión de las glándulas de Meibomio (GM) para el tratamiento del chalación. Material y métodos Estudio retrospectivo de serie de casos. Los pacientes que presentaron chalación, recibieron un tratamiento combinado de terapia con IPL que consistió en usar el protocolo habitual de IPL para disfunción de las glándulas de Meibomio/enfermedad de ojo seco empleando una fluencia de acuerdo al tipo de piel según Fitzpatrick, seguido de una segunda fase (en la misma sesión) de aplicación IPL directamente sobre los párpados de ambos ojos empleando una fluencia de 10J/cm2. A continuación, todos los pacientes recibieron expresión de las GM, higiene de los párpados, antibiótico tópico y medicación ocular antiinflamatoria tópica. Los efectos adversos relacionados con este protocolo se evaluaron en cada sesión de IPL. Resultados Se incluyeron 26 chalaciones de diecinueve pacientes (24 ojos) con una edad media de 49,89±20,43 años. Fueron necesarias 2,07±0,97 sesiones de IPL de media para la resolución del chalación. El tratamiento combinado de protocolo IPL y expresión de GM mostró un 96,15% de eficacia y no se observaron efectos adversos. Conclusiones El tratamiento combinado de IPL para disfunción de las glándulas de Meibomio/enfermedad de ojo seco con IPL aplicado directamente sobre los párpados y expresión de GM podría ser eficaz y seguro para el tratamiento de los chalaciones (AU)

Objective To investigate the efficacy and safety of an intense pulsed light (IPL) combined IPL treatment protocol for meibomian gland dysfunction (MGD)/dry eye disease (DED) with IPL applied directly to the eyelids, associated with meibomian gland (MG) expression for the treatment of chalazion. Material and Methods Retrospective case series study. Patients presenting with chalazion received a combined IPL therapy treatment consisting of using the usual IPL protocol for DGM/EOS using a fluence according to skin type according to Fitzpatrick, followed by a second phase (in the same session) of IPL application directly on the eyelids of both eyes using a fluence of 10 J/cm2. All patients then received GM expression, eyelid hygiene, topical antibiotic and topical ocular anti-inflammatory medication. Adverse effects related to this protocol were assessed at each IPL session. Results Twenty-six chalazions from nineteen patients (24 eyes) with a mean age of 49.89 ± 20.43 years were included. An average of 2.07 ± 0.97 IPL sessions were required for chalazion resolution. The combined treatment of IPL protocol and GM expression showed 96.15% efficacy and no adverse effects were observed. Conclusions Combined IPL treatment for DGM/EOS with IPL applied directly on the eyelids and GM expression could be effective and safe for the treatment of chalazions (AU)

Uso de tecnologias a laser e luz intensa pulsada no tratamento da ocronose exógena: uma revisão da literatura / Use of laser technologies and intense pulsed light in the treatment of exogenous ochronosis: a literature review

A ocronose exógena é um quadro de hiperpigmentação cutânea por acúmulo de substâncias derivadas de fenol na pele ou mucosas, sem acometimento de outros tecidos. Ocorre, principalmente, por uso de clareadores, sendo mais frequente a hidroquinona como despigmentante. As lesões apresentam difícil tratamento, sendo resistentes a diversas abordagens. Por vezes, é necessário utilizar tecnologias com laser ou luz intensa pulsada para atingir algum grau de melhora. O presente trabalho realizou revisão de literatura entre janeiro de 1990 e julho de 2020, organizando publicações acerca do uso destas tecnologias na ocronose exógena

Exogenous ochronosis is a cutaneous hyperpigmentation condition caused by the accumulation of substances derived from phenol on the skin or mucous membranes without affecting other tissues. It occurs mainly due to the use of bleaching agents, most frequently hydroquinone. The lesions are difficult to treat, being resistant to several approaches. Sometimes it's necessary to use laser technologies or intense pulsed light to achieve some degree of improvement. The present work consists of a literature review of publications on these technologies in exogenous ochronosis from January 1990 to July 2020.

Evaluación funcional de los parámetros del Oculus KERATOGRAPH 5M posterior a la realización de luz pulsada intensa (IPL). Pacientes con disfunción de la glándula de Meibomio (período de enero a diciembre del 2018). En el Instituto Scorsetti / FUNCTIONAL EVALUATION OF THE PARAMETERS OF OCULUS KERATOGRAPH 5M AFTER THE REALIZATION OF INTENSE PULSED LIGHT in patients with gland dysfunction Mebomio during the period January-December 2018 in the Institute Scorsetti

Objetivo: Evaluar los cambios funcionales obtenidos en el KERATOGRAPH 5M posterior a la terapia de luz pulsada intensa (IPL), durante el periodo de enero a diciembre del 2018 en el Instituto Scorsetti de la Ciudad de Buenos Aires ­ Argentina Introduccion: El ojo seco es una patología crónica muy frecuente en la edad adulta que puede ocasionar disminución en la productividad y es de muy alto costo en nuestro medio, existen diferentes terapias para el manejo del ojo seco (1); Este trabajo está enfocado al ojo seco de tipo evaporativo con disfunción de la glándulas de Meibomio y su manejo con la terapia de luz pulsada intensa con el equipo Thermaeyes que ha mostrado muy buenos resultados en algunos artículos científicos (Toyos R,Mcgill W, Briscoe D. . Tratamiento con luz pulsada intensa para la enfermedad de ojo seco debido a disfunción de la glándula de Meibomio)(2) Diseño: Estudio retrospectivo de cohorte trasversal de fuentes secundarias. Materiales y métodos: Este estudio fue realizado en el Instituto Scorsetti de la Ciudad de Buenos Aires ­ Argentina de la base de dato del OCULUS KERATOGRAPH 5M durante el año 2018, que incluyo 50 ojos de 25 paciente con antecedentes de ojo seco evaporativo y disfunción de la glándulas de Meibomio con un rango de edad de 50-80 años, de diferentes sexos, que realizaron terapia completa de IPL durante el periodo del 2018. Resultados: En la medición de la altura del menisco lagrimal: El 64% presentaron mejoría posterior a la terapia con luz pulsada, 24% no mostraron cambios significativos y 12% empeoraron. En el tiempo de ruptura de la lagrimal: 52% mostraron una mejoría posterior a la terapia con luz pulsada, 40% no obtuvo cambio y 8% empeoraron. En el enrojecimiento conjuntival: el 48% mostraron una mejoría posterior a la terapia con luz pulsada, 48% no obtuvo cambio y 4% empeoró. Y en la encuesta sintomática (DEQ ): el 48% mostraron una mejoría posterior a la terapia con luz pulsada, 32% no obtuvo cambio y 20% empeoraron. Conclusiones: La terapia de IPL es una excelente opción de tratamiento del el ojo seco evaporativo con disfunción de la glándula de meibonio mostrando mejoría objetiva con estabilización de la película lagrimal, en la altura del menisco lagrimal, enrojecimiento conjuntival, tinción de superficie, así como también mejoría subjetiva en los síntomas.

Objective: To evaluate the functional changes obtained in the KERATOGRAPH 5M after intense pulsed light therapy (IPL), during the period from January to December 2018 in the Ophthalmological Institute Prof. Dr. Daniel Scorsetti of the City of Buenos Aires ­ Argentina Introduction: The dry eye is a chronic pathology very frequent in adulthood that can cause decrease in productivity and is very high cost in our environment, there are different therapies for the management of dry eyes; This work is focused on evaporative dry eye with dysfunction of the meibomian glands and its management with intense pulsed light therapy with Thermaeyes equipment that has shown very good results in some scientific articles. Design: Retrospective study of cross-sectional cohort of secondary sources. Materials and methods: This study was conducted in the Ophthalmological Institute Prof. Dr. Daniel Scorsetti of the City of Buenos Aires - Argentina of the data base of OCULUS KERATOGRAPH 5M during the year 2018, which included 50 eyes of 25 patients with a history of evaporative dry eye and dysfunction of the meibomian glands with an age range of 50-80 years, of different sexes, who performed complete IPL therapy during the period of 2018. Results: In the measurement of tear meniscus height: 64% showed improvement after pulsed light therapy, 24% did not show significant changes and 12% worsened. At the time of rupture of the lacrimal: 52% showed a subsequent improvement to the therapy with pulsed light, 40% did not obtain change and 8% worsened. In the conjunctival redness: 48% showed an improvement after the pulsed light therapy, 48% did not change and 4% got worse. And in the symptomatic survey (DEQ ): 48% showed an improvement after pulsed light therapy, 32% did not change and 20% worsened. Conclusions: IPL therapy is an excellent treatment option for evaporative dry eye with dysfunction of the meibonio gland, showing objective improvement with stabilization of the lacrimal film, in the height of the lacrimal meniscus, conjunctival reddening, surface staining, as well as also subjective improvement in symptoms.

Intense pulsed light: results in chronic dry eye syndrome after LASIK. / Luz pulsada intensa: resultados en ojo seco crónico tras LASIK.

A report is presented on the visual and clinical results from a retrospective case series of patients with chronic, evaporative, dry eye syndrome (DES), after refractive surgery, and treated with intense pulsed light treatment (IPL). Four sessions were performed, and the Ocular Surface Disease Index (OSDI) questionnaire was completed before initiating treatment and after the last session. Pre- and post-treatment data included: visual acuity (VA), refraction, clinical evaluation (DEWS severity grading, and Oxford corneal staining), and Orbscan topography. Twenty eyes were treated and the following data recorded: SchirmerI 14.7±5.6; 15.6±3.4mm, tear breakup time (TBUT) 3.4±1.6; 5.1±1.2s (P>.003), DEWS 3.4±0.5; 1.6±0.7 (P<.003), Oxford grade 0.8±0.77; 0.4±0.75 (P>.003), VA 0.67±0.26; 0.90±0.15 (P<.0001), best corrected VA 0.83±0.18; 0.92±0.14 (P>.003), spherical equivalent -0.31±0.6; -0.08±0.38D (P>.003), OSDI 34±16; 28±11.0 points (P>.003), frequency artificial tear use 3.4±2.0; 2.5±1.9 times/day (P>.03). A significant clinical and visual improvement was observed, together with a decreased frequency in artificial tear use, in LASIK patients with chronic DES after IPL treatment.

Tratamento de necrobiose lipoídica no antebraço esquerdo com associação entre luz intensa pulsada e laser Erbium-YAG 2940nm / Treatment of Necrobiosis Lipoidica in the left forearm with association of Intense Pulsed Light and Erbium-Yag Laser 2940nm

A necrobiose lipoídica (NL) é uma dermatose granulomatosa, que acomete principalmente diabéticos devido à degeneração do colágeno. Embora existam diferentes tratamentos, todos apresentam pouca resposta. Dentre as opções, a luz intensa pulsada (LIP) e o laser Erbium-YAG permitem aumentar a produção e remodelamento do colágeno tratando a atrofia, além de diminuir o eritema pela coagulação de vasos sanguíneos. Relata-se caso de mulher, 24 anos, com diabetes mellitus tipo I, submetida a tratamento de NL no antebraço esquerdo em sete sessões com a associação entre LIP e laser Erbium-YAG 2940nm. Observou-se melhora da atrofia central e do eritema.

Necrobiosis Lipoidica (NL) is a granulomatous dermatosis, mainly affecting people with diabetes due to collagen degeneration. Although there are different treatments, all have little response. Among the options, the Intense Pulsed Light (IPL) and the Laser Erbium-YAG enhance the production and remodeling of the collagen treating the atrophy, besides reducing the erythema by the coagulation of blood vessels. We report a case of a 24-year-old woman with type I Diabetes Mellitus who underwent NL treatment on her left forearm in seven sessions with the association of IPL and 2940 nm Erbium-YAG laser. We observed improvement in central atrophy and erythema

Associação de luz intensa pulsada e laser Erbium: Yag 2940nm para tratamento de lentigo na face / Association of intense pulsed light and Erbium: Yag 2940 nm laser for treatment of lentigo on the face

O lentigo solar está presente em 90% da população com mais de 50 anos de idade, apresentando-se como manchas hipercrômicas em regiões fotoexpostas, que aumentam com o envelhecimento e são mais frequentes em peles claras. Há diversas modalidades terapêuticas com melhores resultados quando associadas. Descrevemos o caso de um homem de 62 anos, fototipo II de Fitzpatrick, com queixa de máculas acastanhadas em dorso nasal há oito anos. Foi submetido à biópsia de pele, e o estudo histológico confirmou ser lentigo solar. O paciente foi tratado com seis sessões de luz intensa pulsada associada a laser de Erbium: YAG 2940nm, com bom resultado clínico

Solar lentigo is present in 90% of the population over 50 years of age andcharacterizes as hyperchromic spots in photoexposed regions. It increases with aging and is more frequent in light skin. There are several therapeutic modalities, which achieve better results whenassociated. We describe the case of a 62-year-old man with Fitzpatrick skinphototype II, complaining of brownish macules in nasal dorsum for eight years. The patient underwent a skin biopsy, and the histological study confirmed solar lentigo. The patient was treated with six sessions of Intense Pulsed Light associated with Erbium-Yag2940 nm Laser with a good clinical result

O papel do uso de tecnologias combinadas na abordagem de uma paciente com microstomia / The role of the use of combined technologies in the approach to a patient with microstomia

A microstomia ocorre em 70% dos pacientes com esclerose sistêmica e há poucas opções terapêuticas. Descrevemos caso de mulher de 39 anos com diagnóstico de esclerose sistêmica em 2010, em uso de micofenolato de mofetil e rituximabe, apresentando microstomia. Foram realizadas duas sessões de luz intensa pulsada e sete sessões de laser fracionado ablativo Erbium:YAG de 2940nm, com resposta clínica importante. A formação e reorganização de fibras colágenas e elásticas foram responsáveis pela melhora da microstomia. Há poucos estudos com o uso de tecnologias para a abordagem da microstomia. Este é o primeiro com Er:YAG 2940nm para esta finalidade

Facial surgeries are often challenging for surgeons due to their complex anatomy, aesthetic and functional importance. Interventions in the cosmetic subunit that comprises the eyebrows can be particularly difficult. This case report aims to demonstrate the use of island flap in this region. We performed the excision of melanocytic nevus, with a good outcome and absence of postoperative complications. This technique is commonly used for facial reconstruction; however, the literature describes only a few cases using this method for eyebrow reconstruction.

Complicaciones y manejo de procedimientos dermatoestéticos: una actualización para el dermatólogo / Complications associated with cutaneous aesthetic procedures: an update for the dermatologist

En las últimas décadas se han desarrollado nuevas técnicas e indicaciones de los procedimientos estéticos mínimamente invasivos, presentando cada vez mejores resultados con un alto nivel de seguridad, sin embargo, estos no se encuentran exentos de complicaciones, las que pueden ser transitorias o permanentes. El conocimiento, abordaje, tratamiento y prevención de las distintas complicaciones son esenciales para los dermatólogos y cirujanos plásticos. Los procedimientos más utilizados son: administración de rellenos, peeling químicos, láser, luz pulsada intensa y ultrasonido de alta frecuencia. La siguiente revisión tiene como objetivo reconocer las principales complicaciones de estos procedimientos y su manejo.

In recent decades, new techniques and indications of minimally invasive aesthetic procedures have been developed, presenting increasingly better results with a high level of safety, however these are not exempt from complications, which may be transient or permanent. The knowledge, approach, treatment and prevention of the different complications are essential for the dermatologist and plastic surgeons. The most used procedures are the administration of fillers, chemical peels, lasers, intense pulsed light and high frequency ultrasound. The following review aims to recognize the main complications of these procedures and their management.

Tratamento bem-sucedido do angioma serpiginoso com luz intensa pulsada / Successful treatment of angioma serpiginosum with intense pulsed light

Angioma serpiginoso é um ectasia vascular rara e benigna que se apresenta clinicamente como pontos vermelhos ou arroxeados pequenos com uma configuração serpiginosa. Luzes de pulso controladas ou luz intensa pulsada (IPL), é uma fonte de luz pulsada que emite luz de alta energia com o espectro de ondas contínuas de 500 a 1200 nm. Entre as suas características estão indicações para lesões vasculares, que é o pigmento do cromóforo oxihemoglobina. Apresentamos uma paciente de 12 anos de idade com um angioma serpinginoso no braço direito que atingiu a remissão após 6 sessões de IPL.

Angioma serpiginosum is a rare and benign vascular ectasia that clinically arises as small red or purple dots, with serpiginous configuration. Controlled light pulses or intense pulsed light is the light source that emits high energy light within the continuous waves spectrum from 500nm to 1,200nm. Among its characteristics is the indication for the treatment of vascular lesions, which is the oxyhemoglobin chromophore's pigment. This paper describes a case of a 12-year-old patient with angioma serpiginosum on the right arm that receded after 6 intense pulsed light sessions.

Luz intensa pulsada: revisão das indicações clínicas / Intense Pulsed Light: review of clinical indications

A luz intensa pulsada é um dispositivo que emite luz de alta intensidade, policromática, não coerente e não colimada. Sua versatilidade permite combinar parâmetros e tratar vários tipos de lesões cutâneas vasculares e melanocíticas, além da realização da epilação e do fotorrejuvenescimento não ablativo. Embasado na literatura médica, o presente artigo descreve indicações clássicas e inovadoras do uso da luz intensa pulsada.

Intense pulsed light is a device that emits high intensity, polychromatic, non-coherent and not collimated light. IPL versatility allows combining parameters to treat a variety of skin vascular and melanocytic lesions, epilation and non ablative photorejuvenation. This article describes classic and innovative indications for intense pulsed light use based on medical literature.

Terapia tríplice no tratamento do queloide na face anterior do tórax / Triple therapy in the treatment of keloids located in the anterior thoracic region

Queloides apresentam impacto funcional, estético e psicológico podendo influenciar a qualidade de vida desses pacientes. Além disso, diante da alta taxa de recorrência, particularmente em lesões de grandes dimensões e localizadas na face anterior do tórax, são mais difíceis de tratar. Este artigo relata tratamento de sucesso para queloide na face anterior do tórax utilizando nova técnica que combina luz intensa pulsada, toxina botulínica tipo A e tratamento convencional com infiltração de corticosteroide.

Keloids have functional, aesthetic and psychological impacts that can influence the patients' quality of life. Moreover, given the high rate of recurrence ­ particularly in large lesions located in the anterior thoracic region ­ they are more difficult to treat. This paper reports a successful treatment for keloids in this area using a new technique that combines intense pulsed light, botulinum toxin type A and the conventional treatment with injection of corticosteroids.

Histochemical Evaluation of the Vessel Wall Destruction and Selectivity After Treatment with Intense Pulsed Light in Capillary Malformations.

BACKGROUND: Among the different approaches for improving the effectiveness in the treatment of Capillary Malformations type Port Wine Stain (CM type PWS) are the intense pulsed light sources. There are few clinical studies prove useful in the treatment of CM. Furthermore, no studies have been published yet demonstrating the histological effects of IPL in CM. OBJECTIVES: To assess the histological effects of pulsed light in capillary malformations type port wine stain. We wanted to compare epidermal, dermal and vessel wall damage after treatment with different combinations of IPL parameters. MATERIAL AND METHODS: Fifty-five post-treatment biopsies were performed in 15 consenting patients with CM and stained with nitroblue-tetrazolium chloride (NBTC). Patients had not been treated previously. RESULTS: Fifteen patients with CM, with a median age of 39 years-old were enrolled in this study. In this series, the patients with the most severe epidermal damage were those with a darker phototype. Pink CM were especially resistant to treatment, even using high fluences, short pulse durations and stacking pulses. Longer intra- and interpulse delays were effective in purple CM, achieving adequate vessel destruction. CONCLUSIONS: IPL devices provide a vast amount of treatment possibilities and further studies are necessary to optimize therapeutic approaches to CM. In this study we have observed the histological effects of different pulses on the MC type PWS.

Tratamento de rosácea com duas faixas de comprimento de onda de luz intensa pulsada num mesmo disparo / Treatment of rosacea with dual-band wavelength intense pulsed light in a single shot

Introdução: A rosácea é doença crônica que geralmente se manifesta como flushing, eritema facial persistente, telangiectasias, pápulas e pústulas. A luz intensa pulsada é usada para tratamento de lesões vasculares de rosácea telangiectásica facial. Objetivos: Avaliar a melhora clínica e dermatoscópica do eritema facial e rubor, e o clareamento dos vasos à dermatoscopia após o uso de luz intensa pulsada. Métodos: Foram selecionados nove pacientes, com rosácea telangiectásica facial, com idade entre 36 e 59 anos, e fototipo I a III, sem qualquer tipo de tratamento nos últimos seis meses. O tratamento consiste em aplicações da luz intensa pulsada com dual-band, 535-680nm e 860-1200nm, no mesmo disparo. Por favorecer o alvo da hemoglobina, há maior proteção para a epiderme. Foram realizadas três sessões a intervalos de um mês. Resultados: Após o tratamento, 87,5% dos pacientes notaram redução de flushing e telangiectasias, e os médicos avaliadores, grande (> 75%) melhora clínica em 50% dos pacientes e melhora moderada (51%-75%) em 28,6%. Os efeitos adversos foram mínimos e transitórios. Conclusões: Até o momento nenhum tratamento mostrou-se completo para a rosácea telangiectásica. Este estudo demonstrou que o tratamento com luz intensa pulsada utilizando a tecnologia dual band é eficaz no tratamento da rosácea.

Introduction: Rosacea is a chronic disease that usually manifests as flushing, persistent facial erythema, telangiectasia, papules and pustules. Intense Pulsed Light (IPL) is reported for treatment of vascular lesions of facial telangiectasia rosacea. Objective: To assess clinical and dermoscopy improvement of facial erythema and flushing, and the clearing of vessels to dermoscopic after using IPL. Methods: Nine patients were selected, with facial telangiectasic rosacea, aged between 36 and 59 years, with skin types I to III, without any treatment in the past six months. The treatment consisted in applications of the Intense Pulsed Light(IPL) with dual-band, 535-680 nm and 860-1200 nm, in one single shot. To favor the target hemoglobin, there is a greater protection for the skin. Three sessions were conducted within the interval of 1 month. Results: After treatment, 87.5% of patients noticed reduction in flushing and telangiectasia. Adverse events were minimal and transient. To date no treatment was complete for telangiectasia rosacea. Conclusions: This study demonstrated that treatment with IPL technology using "dual-band" is effective in obtaining a large (>75%) clinical improvement in 50% of patients and moderate improvement (51% to 75%) in 28.6% of patients.

Current indications and new applications of intense pulsed light.

Intense pulsed light (IPL) systems have evolved since they were introduced into medical practice 20 years ago. Pulsed light is noncoherent, noncollimated, polychromatic light energy emitted at different wavelengths that target specific chromophores. This selective targeting capability makes IPL a versatile therapy with many applications, from the treatment of pigmented or vascular lesions to hair removal and skin rejuvenation. Its large spot size ensures a high skin coverage rate. The nonablative nature of IPL makes it an increasingly attractive alternative for patients unwilling to accept the adverse effects associated with other procedures, which additionally require prolonged absence from work and social activities. In many cases, IPL is similar to laser therapy in effectiveness, and its versatility, convenience, and safety will lead to an expanded range of applications and possibilities in coming years.

Biological effects produced by intense pulsed light (Xe-Cl) on the cartilage of the tongue chick embryo using various filters / Efectos biológicos producidos por la luz pulsada intensa (Xe-Cl) sobre el cartílago lingual del embrión de pollo usando diversos filtros

The Laser used correctly in the medical practice offers clear advantages compared with traditional therapies. The improvement and even the elimination of many significant skin lesions can be achieved with reduced risks to patients. However, it is important to keep security measures and understand the possible effects on an experimental model. The chick embryo is a good model to evaluate the direct effects of non-ionizing radiation for its easy handling and availability. The purpose of this communication is to show our histological findings in organs of the chick embryo with and without protective barrier to be subjected to radiation excimer. We used the following issuers: intense pulsed light (excimer Xe-Cl laser of 308 nm wavelength). It was irradiated embryos through an open window on eggshells. Aseptically the eggs were kept for 24 hours in an incubator. The protective barriers were used with and without colored glass, latex, cellophane, paper, polycarbonate of different colors and thicknesses. The most outstanding results, with no barrier and barriers with transparent and green were intense marked congestion in capillaries, edema and focus the necrosis. We concluded that the tissue changes observed are consistent with possible side effects of these radiations fototérmicos we warned about possible side effects when they are applied indiscriminately. We believe it is important to explore different means to safeguard the safety of operators and patients.

El láser utilizado correctamente en la práctica médica ofrece claras ventajas cuando se compara con las terapias tradicionales. La mejoría e incluso la eliminación significativa de muchas lesiones cutáneas se pueden lograr con riesgos reducidos para los pacientes. Sin embargo, es importante guardar medidas de seguridad y conocer los posibles efectos en un modelo experimental. El embrión de pollo es un buen modelo para evaluar los efectos directos de radiaciones no ionizantes por su fácil manipulación y disponibilidad. El objetivo del presente trabajo es comunicar los cambios histopatológicos en órganos del embrión de pollo con y sin barrera de protección al ser sometido a radiación excimer. Se utilizó el siguiente elemento emisor: luz pulsada intensa (Xe-Cl excimer laser de 308 nm de longitud de onda. Se irradiaron los embriones a través de una ventana abierta en la cáscara del huevo. Los huevos fueron mantenidos asépticamente por 24 hs en una incubadora. Las barreras de protección utilizadas fueron vidrio con y sin color, latex, celofán, papel, policarbonato de diferentes colores y espesores. Los resultados más sobresalientes, sin barrera y con barreras transparentes y de color verde fueron: intensa vasocongestión, edema y focosde necrosis. Se concluye que las modificaciones tisulares observadas son compatibles con posibles efectos fototérmicos colaterales de estas radiaciones los que nos advierten sobre posibles efectos adversos cuando las mismas se aplican indiscriminadamente. Creemos que es de importancia estudiar los diferentes medios que permitan resguardar la seguridad de los pacientes y operadores.