Efficacy of intense pulse light and M22-ResurFx fractional laser on lateral crow＇s feet / 中华医学美学美容杂志

Objective:To evaluate the efficacy and patients＇ satisfaction of the intense pulse light (IPL) and M22-Resur Fx non-ablative fractional laser (NAFL) for the treatment of lateral static crow＇s feet.Methods:A prospective split-face, randomized, controlled study of 60 consecutive patients with lateral static crow＇s feet was performed. The patients aged 30 to 55 years, who were enrolled in the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University from January 2018 to January 2020. The two sides of each patient＇s face were randomized to receive different treatment, and according to their treatment, the patients were divided into 3 groups with 20 cases each: Group A, in which 20 patients＇ one side face was treated with IPL, and other side was treated with NAFL; Group B, in which one side face was treated with IPL, and another side was treated with IPL immediately followed by NAFL; Group C, in which one side face was treated with NAFL, and another side was treated with IPL immediately followed by NAFL. The improvements including the water content of stratum corneum of skin and the patients＇ satisfaction, as well as the improvement of the lateral static crow＇s feet were evaluated.Results:The IPL plus NAFL combined treatment group and the NAFL treatment group showed the effective rate of the improvement for lateral static crow＇s feet of patients on days 60 and 90 was statistically significant ( P<0.05) compared with that before the treatment. And the improvement for lateral static crow＇s feet of patients on days 60 and 90 in combined treatment side was significantly different from either NAFL side ( P<0.05). 60 days and 90 days after treatment, the satisfaction of combined treatment side was significantly higher than that of either NAFL side or IPL side ( P<0.05). Conclusions:The treatment with an optimized IPL immediately followed by a NAFL is clinically superior to those with the NAFL or IPL alone for improving the lateral static crow＇s feet of patients. The satisfaction treated by NAFL combined with IPL is higher than using the NAFL or IPL alone.

Terapia combinada de laser de CO2 e luz intensa pulsada no tratamento de lesões vasculares / Combined CO2 laser and intense pulsed light therapy in the treatment of vascular lesions

As lesões vasculares congênitas podem ser divididas em: tumores e malformações. Os hemangiomas são tumores vasculares benignos decorrentes da proliferação anormal de células endoteliais; já as manchas em vinho do Porto são malformações vasculares de provável herança autossômica dominante. Até o presente momento, não há estudos sobre a associação entre luz intensa pulsada e laser de CO2 como forma terapêutica destas patologias. A presente série de casos apresenta 10 casos de lesões vasculares tratadas com a combinação destas formas de irradiação. Conclui-se que esta terapia combinada pode ser efetiva na redução da espessura das lesões ou na atenuação da coloração

Congenital vascular lesions can be subdivided into tumors and malformations. Hemangiomas are benign vascular tumors resulting from the abnormal proliferation of endothelial cells, whereas port-wine stains are vascular malformations of a possible autosomal dominant inheritance. To date, there are no studies associating the use of intense pulsed light and CO2 laser as a therapeutic form for these pathologies. We present a series of 10 cases of vascular injuries treated with the combination of these forms of irradiation. This combined therapy can be effective in reducing the thickness of the lesions or in attenuating the color.

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.

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.

Efficacy of intense pulsed light combined with hydroquinone cream to treat melisma / 中华医学美学美容杂志

Objective To evaluate the efficacy and safety of intense pulsed light (IPL) combined with hydroquinone cream for melasma treatment.Methods Thirty-five patients with melasma were treated between February 2015 and February 2017,20 patients treated with IPL combined with hydroquinone cream and 15 patients with IPL alone.All cases were female patients with Fitzpatrick skin types Ⅲ and Ⅳ,and subjected to 4 weeks treatment 1 time,5 times for a course of treatment.All patients were followed up for six months and the efficacy and safety of the treatment were analyzed comprehensively by subjective satisfaction and physician evaluation.Results All the patients were treated without discomfort and treated patients were effectively followed up.The satisfactory rate of IPL treatment group was 73.3％,and that of combined with hydroquinone cream group was 100％.Two groups of satisfactory rates were higher in IPL combined with hydroquinone cream.The total effective rate of the IPL treatment group was 53.3％ compared with that of the 35 patients before and after treatment;in IPL combined with hydroquinone cream treatment group the total effective rate was 85.0％.IPL combined with hydroquinone cream treatment group was significantly more effective than the treatment group (P＜0.05).All treatment patients did not present with tissue damage,pigmentation and other adverse reactions.Conclusions IPL combined with hydroquinone cream is a safe and effective treatment of melasma,and patients get a higher rate of satisfaction.

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.

Intense Pulsed Light Alone and in Combination with Erbium Yttrium-Aluminum-Garnet Laser on Small-to-Medium Sized Congenital Melanocytic Nevi: Single Center Experience Based on Retrospective Chart Review

BACKGROUND: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. OBJECTIVE: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. METHODS: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. RESULTS: Seventeen patients completed treatment and were followed-up. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. CONCLUSION: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.

Intense Pulsed Light Alone and in Combination with Erbium Yttrium-Aluminum-Garnet Laser on Small-to-Medium Sized Congenital Melanocytic Nevi: Single Center Experience Based on Retrospective Chart Review

BACKGROUND: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. OBJECTIVE: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. METHODS: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. RESULTS: Seventeen patients completed treatment and were followed-up. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. CONCLUSION: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.

Intense Pulsed Light and Q-Switched 1,064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment for the Scarring Lesion of Discoid Lupus Erythematosus

Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus that can cause permanent scarring. Treatment of DLE includes protection from sunlight and artificial sources of ultraviolet light, as well as systemic and topical medications. The first-line standard therapies are antimalarials and topical steroids. Other systemic therapies include systemic steroid, azathioprine, dapsone, and immunosuppressive agents. Topical tacrolimus and pimecrolimus have also been evaluated. Recent studies reported that several treatments, including pulsed dye laser, CO₂ laser, intense pulsed light (IPL), and 1,064-nm long-pulse neodymium-doped yttrium aluminum (Nd:YAG) have been used for the cosmetic treatment of DLE. Here, we report a case of a DLE scar that was successfully treated with a combination therapy of IPL and Q-switched 1,064-nm Nd:YAG laser.

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.

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.

The Efficacy of Intense Pulsed Light for Treating Erythematotelangiectatic Rosacea Is Related to Severity and Age

BACKGROUND: Rosacea is a chronic cutaneous disease. Therapeutic modalities should be chosen based on the identified sub-types and clinical features in each patient. Vascular lasers, including intense pulsed light (IPL), are reportedly safe and effective in treating erythematotelangiectatic rosacea (ETR). OBJECTIVE: In this study, we assess the comparative efficacy of IPL related to several factors including clinical severity and the age of patients with ETR. METHODS: Patients with ETR were classified into two groups according to the National Rosacea Society Severity Guideline. Severity score and erythema index (EI) were measured using a clinical scorecard and mexameter. For additional evaluation of therapeutic efficacy, investigator and patient global assessments (IGA, PGA) were checked. Efficacy of IPL was analyzed according to severity score, EI, IGA, and PGA related to sex, age, lactic acid stinging test, and severity. RESULTS: Analyses of the efficacy of IPL according to severity score, EI, IGA, and PGA based on sex, age, lactic acid stinging test, and severity revealed significant differences with age and severity only. CONCLUSION: This study supports the efficacy of IPL treatment for patients with ETR. IPL may be more effective in patients with more severe ETR and in younger patients with ETR.