Photoelectric therapy for rosacea / 中华皮肤科杂志

Rosacea is a chronic inflammatory dermatosis mostly occurring on the central face, and its pathogenesis is still unclear. Currently, drug treatment is the first-line therapy for rosacea. In recent years, photoelectric therapy has showed a favorable therapeutic effect on rosacea by selective photothermolysis. This review summarizes latest advances in photoelectric therapy for rosacea.

What do Cochrane systematic reviews say about congenital vascular anomalies and hemangiomas? A narrative review

ABSTRACT BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients' lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.

Efficacy of CO2 dot matrix laser combined with 595 nm pulsed dye laser on cesarean section skin scar / 中华医学美学美容杂志

Objective To investigate the clinical efficacy of CO2 lattice laser combined with 595 nm pulsed dye laser in the treatment of cesarean section skin scar.Methods A total of 60 patients with cutaneous scar after cesarean section in our hospital from June 2015 to October 2017 were enrolled.The patients were divided into observation group and control group according to the order of hospitalization.Each group had 30 cases.Both CO2 lattice and 595 nm pulsed dye lasers were used in study group.Only CO2 lattice laser was used in control group.Vancouver scar scale (VSS) and adverse reactions were analyzed after treatment in both groups.Results The two groups were compared at 3 months and 6 months after treatment.The VSS scores of the study group were (52.00± 1.31) and (3.81±1.38),which was significantly lower than that of the control group (6.30±1.21) and (5.00± 1.38).The difference was statistically significant (t =3.175,3.35,P ＜0.05).There were no significant differences in adverse reactions between the two groups (P＞0.05).Conclusions CO2 dot laser combined with 595 nm pulsed dye laser for the treatment of cesarean section skin scar is more effective than CO2 dot matrix laser alone.

Childhood molluscum contagiosum treated with 585 nm pulsed dye laser: a clinical observation / 中华皮肤科杂志

Objective To evaluate the efficacy and safety of 585 nm pulsed dye laser for the treatment of molluscum contagiosum in children.Methods Between September 2016 and February 2017,50 children with confirmed molluscum contagiosum were enrolled from Maternal and Child Health Care Hospital of Zibo.These children were treated with 585 nm pulsed dye laser at energy of 6.0-9.0 J/cm2,pulse width of 0.5 ms and spot size of 5 mm.If a patient was not cured after 1 session of the laser treatment,another session of the laser treatment would be performed 1 month after the first treatment.If the proportion of regressed skin lesions was less than 30％ after more than 2 consecutive sessions of the laser treatment,the treatment would be stopped.After the treatment,the patients were followed up for 6 months.During the follow-up,clinical efficacy was evaluated according to regression of skin lesions,and adverse reactions and recurrence were recorded.Results All the patients completed the trial.After the treatment,44 (88％)patients were cured,and the response rate was 94％ (47/50).After 1 session of the treatment,32 (64％)patients were cured.After the laser treatment,purpura occurred instantly,hyperpigmentation and hypopigmentation occurred in a short-term period,and no obvious long-term adverse reactions were observed.During the follow-up,no new wart was found at the site of regressed warts after the treatment.Conclusion The 585 nm pulsed dye laser shows good efficacy,safety and tolerance in the treatment of molluscum contagiosum.

Clinical effect of 595 nm tunable pulsed pulsed dye laser treatment of fresh trauma scars / 中国医师杂志

Objective To investigate the clinical effect of 595 nm tunable pulsed dye laser (PDL) in treating fresh trauma scars.Methods 85 patients had been selected,of which,117 sites were treated with a 595 nm tunable PDL one time or two times at a fluence of 7-15 J/cm2 and pulse widths of 1.5-3 ms,7 mm spot size.Nursing skill of burn wound was also used on treatment area after laser treatment.Scars were evaluated for melanin,height,vascularity and pliability using the Vancouver Scar Scale (VSS) before treatment and after the last treatment 8weeks.Results Total score of 117 sites decreased from (8.30 ± 2.63) to (2.70 ± 1.25),melanin decreased from (1.60 ± 0.84) to (0.60 ± 0.97),height decreased from (1.30 ± 0.82) to (0.40 ± 0.51),vascularity decreased from (2.40 ± 0.52) to (0.40 ±0.52),pliability decreased from (2.80 ± 1.32) to (1.30 ±0.48),with statistical significance between before treatment and after treatment (P ＜ 0.05).Conclusions 595 nm tunable pulsed dye laser appears to have a beneficial clinical effect on patient's fresh trauma scar.

Clinical study of pulsed dye laser fine therapy for hypertrophic scar / 中国医师杂志

Objective To compare the efficacy and safety of pulsed dye laser with different parameters in the treatment of hypertrophic scar after burn.Methods From January 2016 to June 2016,122 patients with hypertrophic scar after burn were treated in our unit.The data were analyzed retrospectively.According to the pulse width and energy of pulsed dye laser treatment,there were 31 cases with 0.45 ms-low energy,28 cases with 0.45 ms-high energy,37 cases with 1.5 ms-low energy and 26 cases with 1.5 ms-high energy,which were treated once every 3-4 weeks.The Vancouver Scar Scale (VSS) was used to evaluate the scar condition before and after treatment,and the pain of patients was scored by VAS before and after treatment.The blood flow of scar site was monitored before and 12 months after treatment,and the blood perfusion was recorded.The patients'satisfaction was recorded 3 to 6 months after treatment,and the satisfaction rate was calculated.Results (1) The VSS scores of 0.45 ms-low energy,0.45 ms-high energy,1.5 ms-low energy and 1.5 ms-high energy groups after treatment were significantly lower than those before treatment in each group (t =11.3,9.0,14.1,12.7,P ＜ 0.05).After treatment,the VSS scores of each group decreased by (5.8 ± 1.1),(5.2 ± 1.4),(4.1 ±0.8) and (4.0 ±0.9),respectively,with significant differences among the four groups (F =4.2,P ＜ 0.05).Except for 1.5 ms pulse width,there was no significant difference in the effect of low-energy and high-energy treatment (P ＞ 0.05),but there was significant difference in the effect of other treatment groups(t =7.29,4.81,6.91,5.11,4.74,P ＜0.05).(2)The VAS scores of the 4 groups after treatment were significantly lower than those before treatment in each group (t =7.1,5.2,4.1,6.6,P ＜ 0.05);the VAS scores of each group after treatment decreased by 3.9 ± 1.3,5.1 ± 0.9,3.5 ± 0.6,4.9 ± 0.9,respectively,with significant statistical differences among the four groups (F =8.8,P ＜ 0.05).Regardless of the pulse width of 0.45 ms or 1.5 ms,the pain degree of scar improved more in the high energy group than in the low energy group (t =6.4,2.2,3.4,4.74,P ＜0.05).(3) Four groups of scar blood perfusion decreased.(4) The satisfaction of the four groups were 82.3％,79.1％,84.5％,77.7％,respectively.There was no significant difference in satisfaction evaluation among the four groups (P ＞ 0.05).Conclusions The therapeutic effect of pulsed dye laser on hypertrophic scar is very exact,and the treatment parameters of 0.45 ms pulse width and low energy 4-6 J/cm2 are recommended,which provide clinical basis for the prevention and treatment of scar and the application of pulsed dye laser.It is worthy of clinical application.

Clinical efficacy of propranolol and 595 nm pulsed dye laser in treatment of infantile hemangioma / 中华医学美学美容杂志

Objective To observe the clinical efficacy of propranolol and 595 nm pulsed dye la ser (PDL) in treatment of infantile hemangioma.Methods 26 infants admitted to our hospital from January 2013 to January 2015 with hemangioma underwent oral propranolol 2 mg/(kg · d) treatment after excluding of taboos.The daily doses were divided equally to two parts,taken on the time of 8:00 and 20:00,when the electrocardiograph and pulse oxygen were monitored and recorded persistently.The patients were discharged from the hospital when it was stable,with review of blood routine examination,fasting blood glucose,liver and kidney function,and the change of size,character and color of hemangioma were recorded,and taken photos every two weeks after discharge.The 595 nm PDL was used to treat the hemangioma faded incompletely when the propranolol was terminated.Results The tension and color of all hemangioma decreased in varying degrees in taking propranolol for 72 hours,and evaluated the efficacy as recovery completely 19 cases;signifivantly effective in 3 cases and partial efficacy in 4 cases;the latter 7 cases were further treated with 595 nm PDL.Followed-up for 6-12 months showed that efficacy of recovery reached 100％.10 cases showed heart rate was mild reversibly slow,with no special treatment.5 cases had diarrhea,and healed with symptomatic treatment.No adverse reactions like liver and kidney dysfunction and so on were found.Conclusions Propranolol and 595 nm PDL can effectively treat infantile hemangioma,and thus it can be used as the recommended treatment of infantile hemangioma.

Safety and efficacy of 595-nm pulsed dye laser combined with topical timolol maleate 0.5％ solution for the treatment of superficial infantile hemangioma / 中华皮肤科杂志

Objective To evaluate the clinical efficacy and safety of 595-nm pulsed dye laser with topical timolol maleate 0.5％ solution for the treatment of superficial infantile hemangioma (IH).Methods Complete clinical data were collected from 156 infants with superficial IH,who received treatment with 595-nm pulsed dye laser combined with topical timolol maleate 0.5％ solution in the Department of Dermatology of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from July 2015 to July 2016,and analyzed retrospectively.Of the 156 patients,44 were males,and 112 were females,with an average age of 3.8 ± 0.7 months (range,24 days-1 year).These patients were treated with 595-nm pulsed dye laser every 5 weeks and topical application of timolol maleate solution twice a day.Each treatment with timolol maleate solution lasted 30 minutes.When the hemangioma regressed generally,the treatment with laser and timolol maleate solution was stopped.At weeks 5,10,15 and 30,the visual analogue scale (VAS) was used to evaluate the efficacy,and adverse reactions were recorded.These patients were followed up till 6 months after the end of treatment.The relationships of area and thickness of hemangioma with treatment duration,treatment sessions and VAS scores were analyzed.Results After 5-30 weeks of treatment,hemangiomas regressed to different extents,and the cure rate was 93.59％ (146/156).At weeks 5,10,15 and 30,the VAS scores were 3.12 ± 0.23,4.45 ± 0.52,5.45 ± 0.71 and 7.59 ± 1.64 respectively.Repeated-measures analysis of variance showed that the VAS scores all significantly increased over time (F =189.35,P ＜ 0.05) in the 3 groups with different initial thickness of hemangiomas (＜ 1 mm,1-3 mm,and ＞ 3 mm),and significantly differed among the above 3 groups at different time points (F =215.56,P ＜ 0.05),and the group with the initial thickness of hemangiomas ＜ 1 mm showed the highest VAS scores.The total treatment duration was significantly shorter in the group with the initial thickness of hemangiomas ＜ 1 mm (2.71 ± 0.58 months) than in those with the initial thickness of hemangiomas 1-3 mm (8.22 ± 0.67 months,P ＜ 0.05) and ＞ 3 mm (11.03 ± 0.72 months,P ＜ 0.05).The VAS scores also significantly differed among the 3 groups with different initial area of hemangiomas (＜ 3 cm2,3-9 cm2 and ＞ 9 cm2),and significantly increased over time in these groups;Kruskal-Wallis H test showed that there was a significant difference in the treatment sessions among the above 3 groups (H =10.45,P ＜ 0.01),and the group with the initial area of hemangiomas ＜ 3 cm2 showed the least treatment session.The adverse reactions were mild,and no adverse cardiovascular or respiratory events were observed.Conclusion The 595-nm pulsed dye laser combined with topical timolol maleate 0.5％ solution is effective and safe for the treatment of superficial IH.

Nail psoriasis treated with pulsed dye laser

Abstract: Nail changes are present in about 50% of psoriasis patients and tend to be refractory to conventional treatments. Pulsed dye laser has emerged as an alternative therapy. Our aim is to evaluate the efficacy of pulsed dye laser in nail psoriasis and the impact of treatment on quality of life. Fourteen patients were treated in monthly sessions for three months. The outcome assesment was made by the Nail Psoriasis Severity Index (NAPSI). The median improvement in the scores of the overall NAPSI, nail bed NAPSI, and nail matrix NAPSI were 44.2% (P = 0.002), 50% (P = 0.033) and 65.1% (P = 0.024), respectively.

A comparative split-face study of intense pulsed light versus 595-nm pulsed dye laser in the treatment of post-acne erythema / 中华皮肤科杂志

Objective To evaluate and compare the clinical efficacy and safety of intense pulsed light (IPL) versus 595-nm pulsed dye laser (PDL) for the treatment of post-acne erythema.Methods A randomized split-face clinical trial was conducted.A total of 20 patients with post-acne erythema were enrolled,and randomized to receive treatment with IPL on one half of the face and 595-nm PDL on the other facial side once every 4 weeks for 3 sessions.Digital photographs were taken using the VISIA,and erythema index was recorded before each treatment and one month after the last treatment.The severity of bilateral facial erythema was evaluated based on a 4-point grading scale before the first treatment and after the last treatment.Pain scores and adverse reactions were recorded using a visual analogue scale (VAS) after each treatment,and a patient satisfaction survey was conducted by questionnaire at the last follow-up.Results The mean erythema index on the IPL side before and after treatment was 472.25 ± 86.02 and 357.15 ±82.71 respectively,and that on the PDL side before and after treatment was 476.40 ± 74.25 and 360.05 ± 64.83 respectively.Repeated measures analysis of variance (ANOVA) showed that the erythema indices on both treated sides significantly decreased over time (F =197.666,P ＜ 0.001),and the efficacy of IPL was better than that of PDL (F =1 173.909,P ＜ 0.001).Erythema severity grades on the IPL side as well as on the PDL side significantly differed between before and after treatment (Z =28.735,31.450,respectively,both P ＜ 0.001).As VAS showed,the pain score on the PDL side was significantly lower than that on the IPL side (t =2.468,P ＜ 0.05).Among the 20 patients,17 and 15 assessed their improvement as good or excellent after PDL and IPL treatment respectively,but there was no significant difference between the two groups (Z =2.696,P ＞ 0.05).The adverse reactions included erythema,burning sensation,tense sensation,blistering and hyperpigmentation on IPL-treated side,and erythema and purpuric reactions on the PDL-treated side,which all disappeared in a few hours to several days.Conclusions Both IPL and 595-nm PDL are effective and safe for the treatment of post-acne erythema,and are worthy of clinical promotion and application.IPL shows superiority in the efficacy,but elicits higher pain sensation compared with PDL.

Diagnostic and therapeutic value of blue laser endoscopy combined with endoscopic submucosal dissection for low grade intraepithelial neoplasia / 中华消化内镜杂志

Objective To evaluate the blue laser imaging (BLI) magnifying endoscopy combined with endoscopic submucosal dissection (ESD) in diagnosis and treatment of low grade intraepithelial neoplasia detected by normal endoscopic biopsy.Methods A total of 76 patients were diagnosed as having LGIN by preoperative biopsy.But 3 months later,BLI endoscopic re-examination showed that the lesions did not heal or even worsened.Patients who received ESD therapy were included in the retrospective study during January 2014 to January 2016 in Remin Hospital of Wuhan University.The efficacy and complications of ESD,and the consistence rate of diagnosis between general endoscopic biopsy,BLI magnifying endoscopy and pathologic diagnosis of total tumor after ESD were analyzed.Results The complete resection rate and curative rate of ESD were 100.0％ (76/76) and 97.4％ (74/76) respectively.The incidences of hemorrhage and perforation during the operation were 3.9％ (3/76) and 1.3％ (1/76),and there was no delayed bleeding or perforation.The consistence rates of diagnosis of common endoscopic biopsy and BLI were 55.3％ (42/76) and 92.1％ (70/76) respectively,with significant difference (x2 =51.987,P＜0.001).Conclusion Low-grade intraepithelial neoplasia of the upper digestive tract may be easily underestimated by ordinary endoscopy biopsy.For these underestimated low-grade intraepithelial neoplasia lesions,ESD can not only be used to confirm the diagnosis,but also give safe and effective treatment.The examination of BLI combined with magnifying endoscopy is recommended before ESD,because BLI endoscopy classification of the lesions has positive effects on ESD of upper gastrointestinal mucosa lesions.

The 595 nm pulsed dye laser in the treatment of clinical study of pigmentation / 中国医师杂志

Objective To explore the efficacy of the 595 nm pulsed dye laser in the treatment of clinical study of pigmentation,and its advantages in clinical application.Methods Sixty-eight cases with skin pigmentation and without other skin diseases were divided into treatment group (n =34) and control group (n =34).In treatment group,the patients were given pulsed dye laser in,while in control group,retinoic acid cream in the topical 2％ hydroquinone cream and 0.1％.The effects in two groups were observed and compared.Results All particpants completed treatment and followup.The effect in two groups was 91.18％,and 64.71％ with significant difference (P ＜ 0.05).The effect of pulsed dye laser on the pigmentation was better than that of the control group.Conclusions The 595nm pulsed dye laser treatment of traumatic skin color deposition has a good effect,and can shorten the treatment time and adverse reactions,which is suitable for clinical application and promotion.

Surgical Excision Followed by Pulsed Dye Laser Sessions for the Successful Treatment of Glomangiomatosis on the Left Flank: A Case Report and Literature Review

Glomus tumors are benign neoplasms that are usually found in the subungual area, and are painful upon palpation. The typical treatment of choice is surgical excision. In rare cases, glomus tumors are observed as large-sized clusters, and are classified as atypical tumors known as glomangiomatosis. While surgical excision is the accepted standard of care, this proves difficult because of the tumors' large size and satellite lesions. We present the successful treatment of asymptomatic glomangiomatosis is situated on the left flank area by a combination of surgical excision and pulsed dye laser, which minimized the risk of scar formation.