Treatment of hypertrophic scars and keloids with an LBO laser (532 nm) and silicone gel sheeting.

BACKGROUND: Keloid scars continue to be a complex and poorly understood subject. The main problem faced by researchers is the lack of an animal model because keloids affect only humans. Traditional techniques for keloids and hypertrophic scars are still available. More recently, lasers have gained an increasing role in the treatment of hypertrophic scars and keloids. METHODS: A total of 37 consecutive patients (31 females and six males; F:M=5:1 ratio) with 48 scars (34 hypertrophic and 14 keloids) were included in this study. Patients ranged in age from 8 to 67 years (mean age 34 years) with Fitzpatrick skin types II-IV. The age of scars ranged from 3 to 35 months (average 9 months). The scars were classified according to the Vancouver Scars Scale (VSS). Clinical digital photography was performed under standard and cross-polarized illumination. Laser treatment was performed in association with silicone gel sheeting. RESULTS: Overall, excellent resolution of the scars was achieved, with an initial average VSS score of 12.6 and a mean VSS final score of 3.3. CONCLUSION: The combined use of silicone gel sheeting and a 532-nm millisecond laser is an effective and safe treatment for hypertrophic scars and keloids.

Treatment of hypertrophic scars and keloids with a fractional CO2 laser: a personal experience.

Keloids and hypertrophic scars are both abnormal wound responses in predisposed individuals but they differ in that keloids extend beyond the original wound and almost never regress, while hypertrophic scars remain within the original wound and tend to regress. How keloids grow is not totally clear because there is no animal model; in fact, keloids affect only humans. Different injuries can result in keloids, including burns, surgery, ear piercing, lacerations, abrasions, tattooing, vaccinations, injections, insect bites and any process causing skin inflammation (chicken pox, acne, folliculitis, zoster). Skin or wound tension is considered a critical factor in the formation of keloids and hypertrophic scars. This study is based on eight consecutive patients (four females and four males, F:M = 1:1) with a total of 12 keloids. All of whom were treated monthly with a MiXto SX CO(2) laser, using 13 W of power, 8 SX of index and 40% coverage (density) in combination with Same Plast Gel(®) twice a day. Each scar required 12 treatments, and all the patients, followed up for 1 year after the last treatment, had optimum results and no recurrence.

Right-left comparison study of hydrogel pad versus transparent fluid gel in patients with dermo-cosmetic lesions undergoing non-ablative laser therapy.

OBJECTIVE: The aim of this study was to compare the cooling properties of a transparent hydrogel pad and a fluid gel in patients with dermo-cosmetic lesions undergoing non-ablative laser therapy. METHODS: Patients enrolled in this prospective, open, randomized study had vascular or pigmented lesions in the face, v-neck or hands. The assigned test product was applied to the skin on the left side of the lesion whereas the other product was applied to the opposite side. Primary endpoints were the maximal pain intensity during laser treatment and the number of blisters and crusts after laser treatment. RESULTS: Twenty-one patients were enrolled and underwent laser procedures using a hydrogel pad and fluid gel (16 patients with vascular and five with pigmented lesions). Maximal local pain severity was lower in all 21 patients on the side where the transparent hydrogel pad was applied (p<0.001); the transparent hydrogel pad was associated with a more cooling effect (p<0.001) and less erythema (p = 0.027). The number of crusts was similar for both test products. CONCLUSION: Overall, laser therapy was more convenient for the patients on the side where the transparent hydrogel pad was applied. The transparent hydrogel pad offers an alternative skin cooling method worth considering for non-ablative laser therapy.

SPANX-B and SPANX-C (Xq27 region) gene dosage analysis in Sicilian patients with melanoma.

The incidence of melanoma has dramatically increased in many countries (it is 4.5 cases every 100 000 inhabitants in Sicily) and Xq27 region contains genes important in cancer like the SPANX (sperm protein associated with the nucleus in the X chromosome) gene family. These genes, made up of two exons separated by an intron of about 650 base pair, are expressed in sperm cells and in many tumours, including melanoma. These observations suggested that SPANX genes, or some of them, may be involved in melanoma development. The aim of this study was to investigate the genetic variability of SPANX-B and SPANX-C in a sample of Sicilian male population including patients with melanoma of the skin and controls. A total of 99 patients were enrolled in this study. They included: 17 male patients with cutaneous melanoma and 82 normal males. Semiquantitative fluorescent multiplex PCR dosage analysis was carried out to identify the variety of classes of SPANX-B and SPANX-C genes. Sixteen and 13 genetic classes were detected for SPANX-B and SPANX-C genes, respectively. A statistical significant difference for a particular class of SPANX-C gene was found comparing patients with melanoma and controls (P=0.011). Further investigations should be conducted to confirm these observations and to evaluate the possible implication of other genes of the region Xq27-28 in melanoma.