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Dermatol Surg ; 45(10): 1245-1252, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30893166


BACKGROUND: Striae gravidarum is a common skin condition resulting after pregnancy, caused by fibroblast dysfunction. Although not considered a disease, it may be considered cosmetically unpleasant to sufferers and remains as a therapeutic challenge to date. OBJECTIVE: To evaluate the efficacy and safety of a sublative bipolar fractional radiofrequency (FRF) system, associated with 0.1% topical tretinoin, in treating striae gravidarum. MATERIALS AND METHODS: Eighteen Chinese women with striae gravidarum on the abdomen were enrolled in the study. The target area of each patient was divided into 4 sites randomly: control, tretinoin, FRF, and tretinoin and FRF. Fractional RF was used 3 times, with 3-month intervals. Changes to striae gravidarum were evaluated through subjective scaling and objective measures, using both high-frequency ultrasound and histological study. RESULTS: Both subjective assessment and skin thickness differences demonstrated significant improvement in the combination site (p < .001). Average optical density and density percentage of neocollagen and elastic fibers were also markedly increased in the combination site (p < .05). The adverse effects of FRF were limited to mild pain and transient erythema, edema, and microcrusts. CONCLUSION: The combined therapy of FRF and topical tretinoin may be a potential method in treating striae gravidarum, with satisfactory efficacy and limited side effects.

Ceratolíticos/administração & dosagem , Complicações na Gravidez/terapia , Terapia por Radiofrequência/métodos , Estrias de Distensão/terapia , Tretinoína/administração & dosagem , Adulto , Eritema/diagnóstico , Eritema/etiologia , Feminino , Humanos , Ceratolíticos/efeitos adversos , Pessoa de Meia-Idade , Dor/diagnóstico , Dor/etiologia , Medição da Dor , Satisfação do Paciente , Projetos Piloto , Gravidez , Complicações na Gravidez/diagnóstico por imagem , Terapia por Radiofrequência/efeitos adversos , Terapia por Radiofrequência/instrumentação , Pele/diagnóstico por imagem , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Creme para a Pele/administração & dosagem , Creme para a Pele/efeitos adversos , Estrias de Distensão/diagnóstico por imagem , Resultado do Tratamento , Tretinoína/efeitos adversos , Ultrassonografia
Lasers Surg Med ; 51(3): 230-238, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30480320


BACKGROUND AND OBJECTIVE: Striae distensae (SD) are cutaneous lesions that often occur on the breasts, abdomen, hips, and thighs. The aim of this study is to evaluate the effectiveness of a new technique using a non-invasive Er:YAG laser combined with Spatially Modulated Ablation (SMA) module for the treatment of SD. STUDY DESIGN/MATERIALS AND METHODS: This prospective pilot clinical study included 20 patients with skin phototypes I to IV who are affected by SD. The Er:YAG 2940 nm laser with SMA module was used in scanning mode with fluences of 2.3 J/cm2 , frequency of 3 Hz, and pulse duration of 0.3 milliseconds. The laser beam is split into several microspots and penetrates only by 50 µm in the epidermis thickness. This technology induces also the generation of acoustic waves to stimulate tissue regeneration. Each patient underwent six laser sessions. An objective and subjective assessment of SD were used. All adverse events were reported. RESULTS: Most patients reported good improvement and expressed their satisfaction with the treatment. Cutometric analysis showed significant improvement in skin elasticity at the end of study. Moreover, ultrasound analysis revealed an increase in dermal thickness (P < 0.01). POSAS scores decreased significantly at 3 and 6 months, reflecting improved skin quality. The average recovery time was 5 days, with no adverse effects reported. CONCLUSION: Using Er:YAG laser (2,940 nm) with SMA technology to treat SD resulted in improved volume and textural appearance without side effects. The elasticity and thickness of the dermis also improved. The Er:YAG laser with SMA module may be considered as a novel and effective technique to treat SD lesions with minimal time recovery. Lasers Surg. Med. 51:230-238, 2019. © 2018 Wiley Periodicals, Inc.

Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade , Estrias de Distensão/radioterapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Projetos Piloto , Estudos Prospectivos , Estrias de Distensão/diagnóstico por imagem , Estrias de Distensão/patologia , Resultado do Tratamento , Adulto Jovem
Minerva Ginecol ; 70(5): 629-634, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30293400


BACKGROUND: This registry study evaluates the effects of oral Centellicum®, a new preparation of Centella asiatica (CA) on cutaneous stretchmarks (SMs) on the lower abdominal wall in comparison with the topical treatment with a specific antistretch cream. This cream is used for pregnancy SMs. The aim of the management was to give back to the structurally damaged skin areas (apparent as SMs) a normal elasticity and resistance and improving the local microcirculation. METHODS: We selected 78 healthy women with SMs at least 6 months postpartum available to follow the registry plan. The subjects were evaluated in three treatment groups: Clarins, stretch mark minimizer, the hydrating control cream and Centellicum® 3X225 mg/day for 6 weeks. RESULTS: The three registry groups of otherwise healthy subjects were comparable at inclusion and 6 weeks: 25 women used the SMs cream 1 (mean age 34.4;3.2); 28 control women (age 35.2;2) used the hydrating control cream. The third group (25 women; mean age 35.3;1.5) used the hydrating control cream and oral Centellicum® as a supplementary management. Standard management was used in all groups. As for the safety issue, no allergy, no side effects and no tolerability problems were observed. The compliance was very good and there were no drop outs. No other drug or treatment was used during the registry period. Skin thickness (ultrasound, measuring at the edge of at the largest visible stretchmark) increased significantly more at 6 weeks with Centellicum® in comparison with both controls (P<0.05). Skin thickness at the center of the SM (skin was less dense at this level) was also increased more with the supplement in comparison with the other managements (P<0.05). The grey scale median improved more (increased) with Centellicum at 6 weeks (P<0.05). The skin included more collagen components and become whiter or denser at ultrasound. Skin perfusion measured by laser Doppler showed a higher improvement with Centellicum® (P<0.05). Skin temperature, considered a function of nutritional and thermoregulatory dermal perfusion, improved more with the supplement (P<0.05). Elasticity (measured by elastosonography) was improved more with the supplement (P<0.05). The subjective evaluation with an analogue score resulted better (the SMs were less visible and the score decreased) with Centellicum® (P<0.05). The number of visible SMs was decreased more with Centellicum® (P<0.05). CONCLUSIONS: Oral supplementation with Centellicum® appears to improve SMs in a relatively short period of time. Larger studies are needed to evaluate the protective and repairing potentials of CA.

Período Pós-Parto , Pele/metabolismo , Estrias de Distensão/tratamento farmacológico , Triterpenos/administração & dosagem , Administração Cutânea , Administração Oral , Adulto , Colágeno/metabolismo , Elasticidade , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Fluxometria por Laser-Doppler , Gravidez , Sistema de Registros , Pele/irrigação sanguínea , Pele/diagnóstico por imagem , Estrias de Distensão/diagnóstico por imagem , Estrias de Distensão/etiologia , Fatores de Tempo , Resultado do Tratamento , Triterpenos/efeitos adversos , Triterpenos/farmacologia , Ultrassonografia
Lasers Surg Med ; 45(2): 81-8, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23280369


BACKGROUND: Striae distensae (SD) treatment still remains a therapeutic challenge to dermatologists. Ablative fractional laser and radiofrequency (RF) enhance skin-drug permeability for SD treatment. OBJECTIVE: To clinically evaluate the efficacy and safety as well as patient's satisfaction in relation to a method using ablative fractional RF associated with retinoic acid 0.05% cream and an acoustic pressure wave ultrasound (US) in patients with alba-type SD on the breast. METHODS AND MATERIALS: Eight patients with alba-type SD on the breast were treated with three step procedure: (1) fractional ablative RF for skin perforation; (2) topical application of retinoic acid 0.05% on the perforated skin; and (3) US was applied to enhance the retinoic acid penetration into the skin. Other eight patients with alba-type SD on the abdominal area were submitted to RF treatment isolated without retinoic acid or US. Three of them were submitted to skin biopsies. RESULTS: Three patients with SD on the breast area improved from "severe" to "moderate;" two patients improved from "severe" to "mild;" two patients from "moderate" to "mild;" one patient from "marked" to "mild." Clinical assessment demonstrated significant improvement in the appearance of SD in all patients treated with RF associated with retinoic acid 0.05% cream and US (P = 0.008), with low incidence of side effects and high level of patient's satisfaction. Among the patients treated only with RF, two patients improved from "severe" to "marked;" one patient from "marked" to "moderate;" and one patient improved from "marked" to "mild." Four patients did not show any sort of improvement. Clinical assessment demonstrated no significant improvement in the appearance of SD treated with RF isolated with low incidence of side effects, but low-level of patient's satisfaction. CONCLUSION: Ablative fractional RF and acoustic pressure US associated with retinoic acid 0.05% cream is safe and effective for alba-type SD treatment.

Ablação por Cateter , Sistemas de Liberação de Medicamentos/métodos , Ceratolíticos/administração & dosagem , Estrias de Distensão/tratamento farmacológico , Tretinoína/administração & dosagem , Terapia por Ultrassom , Administração Cutânea , Adolescente , Adulto , Terapia Combinada , Feminino , Humanos , Ceratolíticos/uso terapêutico , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Índice de Gravidade de Doença , Método Simples-Cego , Estrias de Distensão/diagnóstico por imagem , Estrias de Distensão/terapia , Resultado do Tratamento , Tretinoína/uso terapêutico , Ultrassonografia , Adulto Jovem