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1.
J Drugs Dermatol ; 18(11): 1180-1182, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741363

RESUMO

Background: Significant advances have been made in using lasers and intense pulse light sources to treat common vascular lesions such as telangiectasias. However, the treatment of leg telangiectasia, specifically, is more challenging because it involves the clearing of smaller veins as well as the larger feeding veins. The latest guidelines recommend use of short wavelength pulse-dyed lasers (PDL) as an option to treat telangiectasia cases that are unresponsive to sclerotherapy. Methods: A 29-year-old white woman presented with persistent telangiectasia, with multiple telangiectasias ranging from 1 cm to 20 cm in size involving the dorsal feet and both ankles and legs, which developed 10 years prior, associated with paresthesia. Test spots were treated with a 585-nm pulsed dye laser with various energy settings, and treatment was performed at 5.5 J/cm2 with spot size 10 mm and 0.5ms pulse duration. Results: Near complete clearance was achieved 1 month after the single treatment without adverse effects. Optical coherence tomography (OCT) imaging demonstrated a reduction of cutaneous blood flow after treatment. Discussion: We report successful treatment despite using settings that were previously reported to lack efficacy. This treatment resulted in considerable improvement in aesthetics and symptomatology. Also, OCT confirmed decreased vascular flow and bulging. Conclusion: Our results suggest there is still much to learn about the use of PDL in treating telangiectasias of the lower extremities, and that the ideal parameters warrant further investigation. Moreover, the novel use of OCT in auxiliary imaging for identification of treatment spots, as well as monitoring response at a microvascular level, holds great potential for wider application. J Drugs Dermatol. 2019;18(11):1180-1182.


Assuntos
Lasers de Corante/uso terapêutico , Perna (Membro)/irrigação sanguínea , Terapia com Luz de Baixa Intensidade , Telangiectasia/radioterapia , Adulto , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Tomografia de Coerência Óptica
2.
J Dermatol ; 46(10): 843-848, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31389056

RESUMO

Phakomatosis pigmentovascularis is a rare syndrome characterized by widespread capillary malformation and pigmented nevus. The objective of this study was to evaluate its characteristics and treatment. Fifty-two patients presenting between 2003 and 2017 were retrospectively reviewed. Type IIa (port-wine stain and dermal melanocytosis with oculocutaneous involvement) was most common. Systemic involvement was observed in 17.3% and it was not significantly correlated to extent of capillary malformation or pigmented nevus. However, systemic involvement was significantly frequent in patients with nevus of Ota and in patients with pigmented nevus located on the head and neck (P = 0.004 and 0.035, respectively). Capillary malformation was almost cleared in 28.6% of patients using pulsed dye laser, whereas pigmented nevus was almost cleared in 23.7% and completely cleared in 42.1% of patients using Q-switched neodymium:yttrium-aluminum-garnet laser. Treatment outcome score showed significant inverse correlation with the extent of port-wine stain or pigmented nevus (P = 0.047, ρ = -0.308 and P = 0.011, ρ = -0.410, respectively). Pigmented nevus demonstrated better treatment response to lasers than did capillary malformation. Smaller lesions tended to show better treatment outcomes for both capillary malformation and pigmented nevus.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Síndromes Neurocutâneas/diagnóstico , Nevo de Ota/diagnóstico , Mancha Vinho do Porto/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/instrumentação , Masculino , Pessoa de Meia-Idade , Síndromes Neurocutâneas/complicações , Síndromes Neurocutâneas/radioterapia , Nevo de Ota/etiologia , Nevo de Ota/radioterapia , Mancha Vinho do Porto/etiologia , Mancha Vinho do Porto/radioterapia , Estudos Retrospectivos , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/radioterapia , Resultado do Tratamento , Adulto Jovem
3.
Cutis ; 103(5): 292-297;E1;E2;E3, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31233573

RESUMO

Although Mohs micrographic surgery (MMS) is the gold standard for treatment of nonmelanoma skin cancers (NMSCs), laser management has been an emerging treatment option that continues to be studied. Nonablative laser therapy is a noninvasive alternative. This study used a combined pulsed dye laser (PDL) and fractional laser approach to treat basal cell carcinomas (BCCs) in conjunction with noninvasive imaging such as reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) to enhance efficacy rates.


Assuntos
Carcinoma Basocelular/radioterapia , Neoplasias Faciais/radioterapia , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias Cutâneas/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/patologia , Dermoscopia , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Faciais/patologia , Humanos , Microscopia Confocal , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Neoplasia Residual , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Tomografia de Coerência Óptica , Resultado do Tratamento
5.
Photochem Photobiol Sci ; 18(7): 1660-1668, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31124550

RESUMO

There are many vascular anomalies which are often a diagnostic and therapeutic challenge. They are classified in vascular tumors (e.g. infantile hemangioma) or vascular malformations (e.g. port-wine-stain). Moreover there are several other and rare vascular disregulations and diseases in the field of dermatology. Many laser systems focus on the therapy of vascular pathologies. We use a pulsed dye laser (595 nm) on its own or in combination with a Neodym:YAG-laser (1064 nm) to treat those vascular diseases. This paper points out the advantages and side effects of these two laser systems and describes the limitations of those.


Assuntos
Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Dermatopatias/radioterapia , Adolescente , Adulto , Idoso , Criança , Feminino , Hemangioma/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Mancha Vinho do Porto/radioterapia
6.
J Cosmet Dermatol ; 18(3): 747-754, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31074085

RESUMO

INTRODUCTION: The purpose of this manuscript is to investigate the treatment of skin soft tissue embolization or vascular occlusion after the injection of hyaluronic acid (HA) for Injection Rhinoplasty (IR) in Asians with a special interest in the time occurrence of the occlusion. METHODS: A total of 35 cases were evaluated after receiving HA injections for IR who presented with a vascular occlusive event. They were divided into three stages based on the time to embolization. Immediate, ≤5 hours; early, ≤3 days; and late, >3 days. There were two cases of immediate, 28 deemed early, and five late. Methods to prevent tissue necrosis are reviewed in the manuscript based on these stages. RESULTS: Skin color gradually recovered to normal after 11 treatments in 11 patients with mild embolization. No ischemic aggravation or skin necrosis was observed in 19 patients with moderate embolization; red scarring was seen in two and hypertrophic scar with uneven skin color in one patient. The five patients in the severe category had longer healing, more red scars, and more hypertrophic scarring. CONCLUSION: The treatment of skin soft tissue embolization or vascular occlusion after HA IR in Asians can be effected by identifying the stage and degree of embolization and treating appropriately with the outlines presented in this manuscript.


Assuntos
Cicatriz Hipertrófica/terapia , Preenchedores Dérmicos/efeitos adversos , Embolia/terapia , Ácido Hialurônico/efeitos adversos , Rinoplastia/efeitos adversos , Adulto , Anti-Inflamatórios/administração & dosagem , Grupo com Ancestrais do Continente Asiático , Cicatriz Hipertrófica/etiologia , Preenchedores Dérmicos/administração & dosagem , Embolia/etiologia , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Hialuronoglucosaminidase/administração & dosagem , Injeções Subcutâneas/efeitos adversos , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade/instrumentação , Terapia com Luz de Baixa Intensidade/métodos , Masculino , Massagem , Necrose/etiologia , Necrose/terapia , Rinoplastia/métodos , Pele/patologia , Fatores de Tempo , Vasodilatadores/administração & dosagem , Adulto Jovem
7.
Pediatr Dermatol ; 36(4): 524-527, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31134637

RESUMO

Sturge-Weber syndrome (SWS) is characterized by facial capillary malformation, leptomeningeal capillary malformations, and choroidal and episcleral vascular malformations. These malformations produce neurologic and ophthalmological symptoms including seizures and glaucoma. A premature male newborn without prenatal diagnosis presented with severe bilateral SWS and was started on systemic sirolimus and aspirin. The patient has remained seizure-free for 23 months and demonstrated an excellent response to pulsed dye laser treatment.


Assuntos
Aspirina/uso terapêutico , Recém-Nascido Prematuro , Convulsões/prevenção & controle , Sirolimo/uso terapêutico , Síndrome de Sturge-Weber/diagnóstico , Síndrome de Sturge-Weber/tratamento farmacológico , Administração Oral , Quimioterapia Combinada , Eletroencefalografia/métodos , Humanos , Recém-Nascido , Lasers de Corante/uso terapêutico , Imagem por Ressonância Magnética/métodos , Masculino , Mancha Vinho do Porto/diagnóstico , Mancha Vinho do Porto/cirurgia , Prevenção Primária/métodos , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Síndrome de Sturge-Weber/diagnóstico por imagem , Resultado do Tratamento
8.
Lasers Med Sci ; 34(9): 1881-1887, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31025209

RESUMO

Light-based modalities appear to be effective for ameliorating surgical scar appearance; however, protocols for achieving such outcomes have yet to be established. We studied the safety and efficacy of a combination of pulsed dye laser (PDL) and fractional ablative CO2 laser (FACL) for the attenuation of post-lumpectomy scarring. We conducted a prospective, evaluator-blinded, comparative split-scar study in post-lumpectomy patients. One-half of the scar was treated with three sessions of 595-nm PDL and FACL at 1-month intervals, starting within 6 weeks after suture removal. The entire scar was also treated with standard moisturizers and silicone gels. Six months after the last treatment, the two halves of the scar were assessed by three uninvolved physicians who used the Observer Scar Assessment Scale as well as by the patients who used the Patient and Observer Scar Assessment Scale. Eighteen female patients (mean age, 51.3 years) with a mean scar length of 7.8 cm completed the treatment and follow-up. Six months after the last treatment, both the physician evaluators and the patients noted significant improvements for all assessed scar parameters in the laser-treated scar area compared with the untreated scar area. The treatment was well tolerated, and no remarkable adverse events were reported. All 18 participants were satisfied with the treated scar areas. A combination PDL and FACL protocol starting up to 6 weeks after suture removal is a safe and effective method for the attenuation of post-lumpectomy scar formation.


Assuntos
Cicatriz/etiologia , Cicatriz/cirurgia , Lasers de Corante/uso terapêutico , Lasers de Gás/uso terapêutico , Mastectomia Segmentar/efeitos adversos , Cicatriz/patologia , Feminino , Humanos , Lasers de Corante/efeitos adversos , Lasers de Gás/efeitos adversos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Resultado do Tratamento
9.
Dermatol Surg ; 45(10): 1253-1259, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30882500

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of combination therapy with sclerotherapy and dual-wavelength pulsed dye laser (PDL) & Nd:YAG for infantile hemangiomas (IHs). PATIENTS AND METHODS: Fifty-nine patients with IH received treatment with sclerotherapy and dual-wavelength PDL & Nd:YAG treatment at 4-week intervals. Observers assessed the size and color of IH using a size rating scale and color rating scale before and after treatments. RESULTS: The study showed that IH improved significantly after several sessions of treatment. Sclerotherapy reduced the size of IH, whereas dual-wavelength laser lightened the color of IH. No serious adverse effects occurred. CONCLUSION: Combined sclerotherapy and dual-wavelength laser treatment is an effective and safe option for IH.


Assuntos
Hemangioma Capilar/terapia , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Escleroterapia/métodos , Neoplasias Cutâneas/terapia , Grupo com Ancestrais do Continente Asiático , Cor , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Feminino , Humanos , Lactente , Lasers de Corante/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/instrumentação , Masculino , Escleroterapia/efeitos adversos , Pele/irrigação sanguínea , Pele/efeitos da radiação , Resultado do Tratamento
10.
JAMA Dermatol ; 155(4): 435-441, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30865245

RESUMO

Importance: Recent concerns regarding repetitive use of general anesthesia in children younger than 3 years have placed greater importance on the controversy surrounding the timing of the initiation of port-wine stain (PWS) laser treatment. Objective: To evaluate the use of PWS treatments at the age of 1 year or younger in the office setting without general anesthesia. Design, Setting, and Participants: Retrospective cohort study based on medical record reviews at a single, high-volume laser center for children who started pulsed dye laser treatment at the age of 1 year or younger for their PWS between 2000 and 2017. The data cutoff was at 1 year after the initial treatment to have comparable data points. Main Outcomes and Measures: The primary outcome was improvement of PWSs using before and after photographs, which were reviewed by 4 physicians independently and graded using the following 5-point visual analog scale (VAS): poor (grade 1: 0%-25% improvement), fair (grade 2: 26%-50% improvement), good (grade 3: 51%-75% improvement), excellent (grade 4: 76%-99% improvement), and complete (grade 5: 100% improvement) clearance. Results: Of the 197 patients (73 [37.1%] boys; 124 [62.9%] girls), most (149 [75.6%]) had facial lesions. The mean age at the time of first treatment was 3.38 months (range, 5-355 days) and the mean number of treatments was 9.8 (range, 2-23; median, 10). Per the mean physician VAS grading of 197 patients, 51 patients (25.9%) showed 100% clearance (mean [range] VAS score of 4.78 [4.5 - 5]); 81 patients (41.1%) showed 76 to 99% improvement (mean [range] VAS score of 3.91 [3.5 to <4.5]); 44 patients (22.3%) showed 51% to 75% improvement (mean [range] VAS score of 2.86 [2.5 to <3.5]); 13 patients (6.6%) showed 26% to 50% improvement (mean [range] VAS score of 2.12 [1.5 to <2.5]); and 8 patients (4.1%) showed 0 to 25% improvement (mean [range] VAS score of 0.78 [0 to <1.5]). The presence of a V1 (first branch of the trigeminal nerve [ophthalmic nerve]) lesion was associated with a statistically significantly higher clearance rate by a VAS grade of 0.55 (95% CI, 0.25-0.84; P < .001). The mean (SD) VAS grade for all patients was 3.65 (1.26), corresponding to excellent clearance. None of the patients experienced scarring or permanent pigmentary change. Conclusions and Relevance: In this study, treatment of PWSs in infancy was both safe and effective. Early intervention allows for treatment without general anesthesia, maximizing the chance to achieve clearance before school age and thereby minimizing the negative outcome of PWSs for both the patient and the family.


Assuntos
Lasers de Corante/uso terapêutico , Mancha Vinho do Porto/cirurgia , Feminino , Humanos , Lactente , Lasers de Corante/efeitos adversos , Masculino , Estudos Retrospectivos , Resultado do Tratamento
11.
Artigo em Inglês | MEDLINE | ID: mdl-30901061

RESUMO

INTRODUCTION: Erythematotelangiectatic rosacea is a common condition in Caucasians. The most frequently used lasers to treat this condition are pulsed dye laser (PDL) and neodymium:yttrium-aluminum-garnet laser (Nd:YAG). This study compares the treatment efficacy of purpuragenic PDL with that of sequential emission of 595 nm PDL and 1,064 nm Nd:YAG (multiplexed PDL/Nd:YAG). METHODS: We performed a prospective, randomized, and controlled split-face study. Both cheeks were treated, with side randomization to receive treatment with PDL or multiplexed PDL/Nd:YAG. Efficacy was evaluated by spectrophotometric measurement, visual photograph evaluation, the Dermatology Quality of Life Index questionnaire, and a post-treatment questionnaire. RESULTS: Twenty-seven patients completed the study. Treatment was associated with a statistically significant improvement in quality of life (p < 0.001). PDL and multiplexed PDL/Nd:YAG modalities significantly reduced the erythema index (EI; p < 0.05). When comparing the degree of EI reduction, no differences were observed between the two treatment modalities. PDL was associated with a higher degree of pain and a higher percentage of purpura. Multiplexed PDL/Nd:YAG modality was associated with fewer side effects and greater global satisfaction, and 96.3% of the patients would recommend this treatment to a friend. CONCLUSIONS: Both laser modalities are efficacious in the treatment of erythematotelangiectatic rosacea. The multiplexed PDL/Nd:YAG modality was preferred by the patients.


Assuntos
Dermatoses Faciais/radioterapia , Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Satisfação do Paciente/estatística & dados numéricos , Rosácea/radioterapia , Método Duplo-Cego , Estética , Dermatoses Faciais/patologia , Dermatoses Faciais/fisiopatologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Qualidade de Vida , Medição de Risco , Rosácea/patologia , Rosácea/fisiopatologia , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Artigo em Inglês | MEDLINE | ID: mdl-30901065

RESUMO

INTRODUCTION: Genital warts are a troublesome therapeutic issue. Pulsed-dye laser (PDL) is a non-ablative therapeutic tool for viral warts. Intralesional Candida albicans (C. albicans) immunotherapy has yielded promising results in treatment of various types of warts. We aimed to evaluate the effectiveness of PDL versus C. albicans immunotherapy for treatment of genital warts. METHODS: Forty adult patients with genital warts were divided into two equal groups; the first was treated using PDL and the second using intralesional C. albicans antigen injection. Treatments were performed at 3-week intervals until complete lesion resolution or for a maximum of three sessions. RESULTS: PDL yielded higher complete clearance rates (95%) than C. albicans antigen (50%; p = 0.001), which in turn had the advantage of treating distant and internal genital warts. Apart from pain during the session in PDL, both modalities were well tolerated with no recurrence in cured patients during the 16-week follow-up period. CONCLUSIONS: PDL and C. albicans antigen injection are safe and effective treatment alternatives for genital warts. PDL yielded better frequencies of clearance, but C. albicans antigen has additional advantages, including a single injection site and treating distant and internal mucosal uninjected warts, which are usually difficult to treat.


Assuntos
Antígenos de Fungos/uso terapêutico , Condiloma Acuminado/terapia , Terapia a Laser/métodos , Lasers de Corante/uso terapêutico , Adulto , Candida albicans/imunologia , Estudos de Coortes , Condiloma Acuminado/diagnóstico , Egito , Feminino , Humanos , Imunoterapia/métodos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
13.
J Eur Acad Dermatol Venereol ; 33(7): 1369-1377, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30908756

RESUMO

BACKGROUND: Since the early '80s, the pulsed dye laser has been the standard treatment tool for non-invasive port wine stain (PWS) removal. In the last three decades, a considerable amount of research has been conducted to improve clinical outcomes, given that a fraction of PWS patients proved recalcitrant to laser treatment. Whether this research actually led to increased therapeutic efficacy has not been systematically investigated. OBJECTIVE: To analyse therapeutic efficacy in PWS patients globally from 1986 to date. METHODS: PubMed was searched for all available PWS trials. Studies with a quartile percentage improvement scale were included, analysed and plotted chronologically. Treatment and patient characteristics were extracted. A mean clearance per study was calculated and plotted. A 5-study simple moving average was co-plotted to portray the trend in mean clearance over time. The data were separately analysed for multiple treatment sessions in previously untreated patients. RESULTS: Sixty-five studies were included (24.3% of eligible studies) comprising 6207 PWS patients. Of all patients, 21% achieved 75-100% clearance. Although a few studies reported remarkably good outcomes in a subset of carefully selected patients, there was no upward trend over time in mean clearance. CONCLUSION: The efficacy of PWS therapy has not improved in the past decades, despite numerous technical innovations and pharmacological interventions. With an unwavering patient demand for better outcomes, the need for development and implementation of novel therapeutic strategies to clear all PWS is as valid today as it was 30 years ago.


Assuntos
Lasers de Corante/uso terapêutico , Mancha Vinho do Porto/terapia , Humanos , Terapia a Laser/métodos , Terapia a Laser/tendências , Fotoquimioterapia , Resultado do Tratamento
14.
Dermatol Ther ; 32(3): e12861, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30758903

RESUMO

An increasing number of minimally invasive cosmetic procedures, such as filler or botulinum toxin injections, are performed annually. These procedures are associated with a high risk of post-procedure bruising or ecchymosis. Ecchymoses arise following hemorrhage and extravasation of red blood cells into the subcutaneous tissue, leading to local skin discoloration. Although ecchymoses generally resolve within 14 days, their appearance is cosmetically bothersome, and they may be painful and cause major distress to patients. Recent clinical evidence suggests that light/laser technology with pulsed dye laser (PDL) or intense pulsed light (IPL) can dramatically alleviate and minimize bruising when delivered within 24-72 hr of the injection. This article, will review reports of treatment of ecchymosis by lasers and IPL.


Assuntos
Equimose/terapia , Terapia a Laser/métodos , Fototerapia/métodos , Técnicas Cosméticas/efeitos adversos , Equimose/etiologia , Humanos , Injeções , Terapia de Luz Pulsada Intensa/métodos , Lasers de Corante/uso terapêutico , Fatores de Tempo
16.
J Cosmet Laser Ther ; 21(4): 228-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30260709

RESUMO

There are several ways to prevent and treat hypertrophic scars. In recent years, lasers have been quite extensively used in treating scars. For example, Pulsed Dye Laser (PDL) and Intense Pulsed Light (IPL) can accelerate mutation of scar, whereas non-ablative and ablative fractional laser can improvescar texture. Dual-wave-length laser treatment is extensively used for blood vessel diseases but is rarely used and less reported for treatment of hypertrophic scars. Our study focuses on the efficacy and safety of dual-wave-length PDL and Nd:YAG in treatment of hypertrophic scars. Twenty-five patients in our study complaining of hypertrophic scars were treated with combined PDL/Nd:YAG laser at 4-6 weeks intervals. Following this, the patients and observers assessed these scars by using Patient Scar Assessment Scale (PSAS) and Observer Scar Assessment Scale (OSAS). The resultsshowed that hypertrophic scar was significantly improved after several laser treatments, and no severe adverse effects were observed. Considering the safety and satisfactory effects of dual-wave-length laser treatment, it can be regarded as a good method for treating hypertrophic scars. This study clearly demonstrates that combined PDL/Nd:YAG laser treatment is an effective, safe and well-tolerated treatment option for hypertrophic scars.


Assuntos
Cicatriz Hipertrófica/radioterapia , Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Adolescente , Adulto , Criança , China , Feminino , Humanos , Masculino
17.
J Cosmet Laser Ther ; 21(3): 123-126, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29883220

RESUMO

BACKGROUND: Recently, treatment with acaricides, which is aimed at reducing excessive proliferation of demodex mites, has gained popularity due to its providing a significant improvement in the symptoms of diseases, such as rosacea, seborrhoeic dermatitis, and perioral dermatitis. The effect of IPL on demodex mites was reported in skin biopsy specimens in three patients; however, to the best of our knowledge, no study exists to date, which evaluates the effect of pulsed dye laser (PDL) on demodex density (Dd) in larger patient group. We aim here in to observe the Dd before and after PDL therapy with two different skin biopsy techniques. MATERIAL AND METHODS: Thirty-one patients diagnosed with rosacea were included in the study who received PDL treatment. Dds which were measured by using both the SSSB (standardized skin surface biopsy) and CTM (cellophane tape method) techniques before and after 3 weeks of PDL therapy were evaluated. RESULTS AND DISCUSSION: The Dd of patients before PDL treatment was 13.0 (interquartile range (IQR): 5.0-28.0) and after 3 weeks of PDL treatment it was 6.0 (IQR: 3.0-12.0) with SSSB. After PDL treatment, the Dd was significantly lower than pretreatment the Dd (p = 0.002). The present study shows that PDL significantly reduced Dd in facial skin with one session.


Assuntos
Dermatoses Faciais/cirurgia , Lasers de Corante/uso terapêutico , Ácaros/efeitos da radiação , Rosácea/cirurgia , Adulto , Animais , Biópsia/métodos , Face/patologia , Dermatoses Faciais/patologia , Feminino , Seguimentos , Humanos , Lasers de Corante/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Rosácea/patologia , Pele/patologia , Estatísticas não Paramétricas , Resultado do Tratamento
18.
J Cosmet Laser Ther ; 21(1): 17-18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29461125

RESUMO

A 57-year-old female was presented with an irrepressible case of Necrobiosis Lipoidica considering the possibility of a surgical skin graft. Instead, a pulsed dye laser treatment was used as an alternate treatment. Previous case studies have been found in the literature on the effect of pulsed dye laser on Necrobiosis Lipoidica. The use of a pulsed dye laser in this case resulted in rendering the lesions asymptomatic for pain and a reduction in volume. Prolonged control was exhibited. From this case, we conclude that pulsed dye laser therapy is effective when increasing the number of treatments of laser therapy, and can be used as a treatment for Necrobiosis Lipoidica.


Assuntos
Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Necrobiose Lipoídica/radioterapia , Feminino , Humanos , Pessoa de Meia-Idade
19.
J Dermatolog Treat ; 30(1): 81-86, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29676592

RESUMO

PURPOSE: To evaluate the efficacy and safety of pulsed-dye laser (PDL) for discoid lupus erythematosus (DLE) in a double blinded, randomized, controlled fashion. METHOD: Forty-eight DLE lesions from nine patients were recruited. The lesions on one side of the body were randomized into the treatment group and the other side served as a control. Treatments with the PDL (595 nm) were delivered every four weeks for four consecutive months. The patients were evaluated at weeks 0, 4, 8, 12, 16 and 24. Erythema index (EI) and Texture index (TI) were obtained by Antera3D®. Modified Cutaneous Lupus Erythematosus Disease Area and Severity Index (mCLASI) and physician global assessment (PGA) scores were assessed in every visit. Lesional skin biopsies before and after the PDL treatment were taken from four patients. RESULTS: The lesions treated with the PDL demonstrated significantly more decreases in EI, TI and improvement in PGA scores compared to the control. Though there was improvement of mCLASI in the laser group, the significance difference was not observed. Interestingly, real-time polymerase chain reaction showed a reduction in CXCL-9, 10, IFN-γ, IL-1ß, TNF-α and TGF-ß. Additionally, post-treatment DLE lesions demonstrated decreased CD3, CD4, CD8 and CXCR3-positive cells. CONCLUSIONS: Improvements of DLE can be achieved with PDL.


Assuntos
Lasers de Corante/uso terapêutico , Lúpus Eritematoso Discoide/cirurgia , Adulto , Método Duplo-Cego , Feminino , Humanos , Lúpus Eritematoso Discoide/patologia , Masculino , Pessoa de Meia-Idade , Radioterapia Adjuvante/métodos
20.
J Cosmet Laser Ther ; 21(3): 171-178, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30052093

RESUMO

BACKGROUND: The 595-nm pulsed dye laser (PDL) has been used to treat vascular anomalies for about 30 years; however, there are insufficient data in Chinese patients concerning therapeutic efficacy, optimized parameters, and procedure techniques. OBJECTIVE: To study the efficacy and relevant factors in PDL therapy for vascular anomalies in Chinese patients. METHOD: We enrolled 431 patients with 8 different vascular anomalies and no previous treatment in this retrospective study. A detailed classification of vascular anomalies and various parameters and techniques of PDL were studied. The clinical outcomes were analysed using the Investigator Global Assessment. RESULTS: Improvements were significantly correlated with infantile haemangioma (IH) subtypes (p < 0.05). A significant correlation between efficacy and lesion colour, anatomical sites, and hypertrophic-type port-wine stain (PWS) was found (p < 0.05). There was no significant correlation between efficacy and age or sex (p > 0.05). CONCLUSION: PDL is an effective and safe therapeutic modality for managing vascular anomalies in Chinese patients. We determined that differentiating and identifying IH subtypes prior to treatment could be a useful parameter for predicting therapeutic results.  Lesion colour, sites, and hypertrophic changes in PWS are relevant therapeutic factors. PDL parameters and techniques differ according to the various vascular anomalies to achieve optimal results.


Assuntos
Hemangioma Capilar/radioterapia , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/métodos , Mancha Vinho do Porto/radioterapia , Neoplasias Cutâneas/radioterapia , Telangiectasia/radioterapia , Adolescente , Adulto , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fotografação , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
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