ABSTRACT
Objective:To investigate the efficacy and safety of dual wavelength pulsed dye laser combined with 30% supramolecular salicylic acid in the treatment of moderate and severe facial acne.Methods:Sixty patients with moderate and severe acne that visited the Dermatology Department of the First Affiliated Hospital of Chongqing Medical University from May 2020 to January 2021, were selected and randomly divided into observation group and control group, with 30 patients in each group. The observation group was given dual-wavelength pulsed dye laser combined with 30% supramolecular salicylic acid. 30% supramolecular salicylic acid was used once every two weeks, for a total of six times. Dual-wavelength pulsed dye laser was given once a month, for a total of three times. The control group was only given dual-wavelength pulsed dye laser, once a month, a total of three times.Results:Twenty-two cases (73.33%) in the observation group were effective, while 14 cases (46.67%) in the control group were effective. The efficacy of the observation group was better than that of the control group, and the difference was statistically significant (χ 2=4.44, P<0.05). There were no obvious adverse reactions in both groups. Conclusions:Dual-wavelength pulsed dye laser combined with 30% supramolecular salicylic acid is effective and safe in the treatment of moderate and severe facial acne, which is worth popularizing.
ABSTRACT
Background: Basal cell carcinoma is the most common form of skin cancer worldwide. It has a specialized microvasculature system that can be targeted by the pulsed dye laser using the theory of selective photothermolysis. Objective: To evaluate the efficacy and safety of single session versus two sessions of pulsed dye laser in the treatment of basal cell carcinoma. Methods: A total of 22 patients with basal cell carcinoma were collected in this randomized controlled trial. The patients were divided into two groups: Group I – 11 patients were treated by one session of pulsed dye laser, and Group II – 11 patients received two sessions of pulsed dye laser 2 weeks apart. The patients were assessed clinically and histopathologically after end of the treatment. Results: There was a significant improvement of basal cell carcinoma clinically and histopathologically. Maximal histological clearance rate was achieved in superficial basal cell carcinoma type, small-sized basal cell carcinoma <0.7 cm and in cases with strong inflammatory response after laser treatment. Treatment of basal cell carcinoma with two sessions of pulsed dye laser was more effective than one session treatment. Limitations: The small sample size of patients and the limited location of the lesions on the head compared with trunk and extremities. Also, the lack of adequate study power may prevent generalization of results. Conclusion: Pulsed dye laser proved to be a safe, effective and noninvasive modality for the treatment of basal cell carcinoma that can be used as a monotherapy in small-sized lesions. Also, it can be used to debulk large-sized lesions before surgery.
ABSTRACT
Objective To observe the clinical efficacy of 595 nm pulsed dye laser and 595 nm pulsed dye laser combined with glycolic acid on patients with acne vulgaris.Methods From October 2017 to October 2018,60 patients with acne vulgaris (28 men,32 women,average age of 24.25 years) were divided randomly into two groups:one group was treated by 595 nm pulsed dye laser only,and other group used 595 nm pulsed dye laser combined with glycolic acid.Results The total effective rates of two groups were 50.00％ (15/30 cases) and 77.00％ (23/30 cases),respectively,and there was a significant statistic difference between the two groups (x2 =4.59,P＜0.05).Conclusions Patients with acne vulgaris have more significant benefits from 595 nm pulsed dye laser combind with glycolic acid than the laser alone.
ABSTRACT
Objective To observe the effect of E light combined with 595 nm pulsed dye laser in patients with erythromelanosis follicularis of face and neck. Methods The clinical data of 44 patients with erythromelanosis follicularis of face and neck from 2015 to 2017 in Dalian Dermatosis Hospital were retrospectively analyzed. Among the patients, 22 patients were treated with 595 nm pulsed dye laser (control group) and 22 cases were treated with E light combined with 595 nm pulsed dye laser (treatment group). Efficacy was assessed 1 month after treatment, including telangiectasia, pigmentation and follicular papule. Results The total effective rates of telangiectasia, pigmentation and follicular papule in treatment group were significantly higher than those in control group: 86.4% (19/22) vs. 68.2% (15/22), 54.5% (12/22) vs. 9.1% (2/22) and 50.0% (11/22) vs. 13.6% (3/22), and there were statistical differences (P＜0.05). No significant adverse reactions occurred during and after treatment in 2 groups. Conclusions E light combined with 595 nm pulsed dye laser is better and safer than 595 nm pulsed dye laser alone in the treatment of erythromelanosis follicularis of face and neck.
ABSTRACT
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.
ABSTRACT
Las manchas de vino de oporto son un tipo de malformación capilar que afecta del 0,3 al 0,5% de la población. Están presentes desde el nacimiento como máculas o placas eritematosas en la piel o mucosas. Sin tratamiento, las lesiones tienden a oscurecerse con la edad, tornándose rojizas o color púrpura, y pueden desarrollar engrosamiento nodular o un granuloma piógeno asociado. Los tratamientos con láser proporcionan mejoría mediante la destrucción selectiva de la vasculatura. Se han utilizado una variedad de láseres vasculares selectivos, pero el tratamiento de primera elección es el láser de colorante pulsado. Los mejores resultados se obtienen cuando el tratamiento es instaurado tempranamente. (AU)
Port wine stains are a type of vascular malformation that affects 0.3% to 0.5% of the population. They are present from birth as erythematous macules or plaques on the skin or mucous membranes. Without treatment, these lesions tend to darken with age, becoming reddish or purple and may develop nodular thickening or an associated pyogenic granuloma. Laser treatments might provide an improvement by selective destruction of the vasculature. A variety of selective vascular lásers may be employed, with the pulsed dye laser as the gold standard treatment. Better results are obtained when the treatment is established early. (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Port-Wine Stain/therapy , Facial Injuries/therapy , Lasers, Dye/therapeutic use , Port-Wine Stain/classification , Port-Wine Stain/diagnosis , Port-Wine Stain/etiology , Port-Wine Stain/genetics , Port-Wine Stain/prevention & control , Port-Wine Stain/psychology , Cooling Agents , Facial Injuries/diagnosis , Facial Injuries/psychology , Lasers, Dye/adverse effectsABSTRACT
Objective@#To observe the clinical effects of sequential treatments of pulsed dye laser (PDL) and ablative fractional carbon dioxide laser on early stage hypertrophic burn scars.@*Methods@#From January 2016 to December 2017, 221 patients with 228 hypertrophic scars in all parts of body within 6 months post healing, conforming to the study criteria and treated in our department, were included in this prospective study. They were first treated by PDL, repeated at an interval of one month until the vascularity score of scar fell below 2 points, and then treated by ablative fractional carbon dioxide laser, repeated at an interval of 3 months. Their start time and numbers of treatment and follow-up time were recorded. Before the first treatment (hereinafter referred to as before treatment) and at the last follow-up (hereinafter referred to as after treatment), the vascularity, thickness, and pliability of scars were scored by a self-made scar rating scale. The scores of patients with the observation time between 6 to18 months post healing were compared among scars of patients grouped by age, body site of scar, starting time of treatment and numbers of treatment. The laser speckle contrast imaging technique was used to measure the blood flow value of scars. The itching symptom of the scars was evaluated by the Verbal Rating Scale. The satisfaction to the final effects of the doctors and patients was investigated and scored separately by Likert scale after treatment. The therapeutic or adverse reactions were recorded during the treatment. Data were processed with paired t test, Mann-Whitney U test, Wilcoxon signed rank sum test, Kruskal-Wallis H test, and Spearman rank correlation analysis.@*Results@#(1) The patients were treated on (64±36) d post healing, by PDL for (2.5±1.3) times and by ablative fractional carbon dioxide laser for (2.2±1.2) times. The follow-up time was (331±189) d. (2) The vascularity, thickness, pliability scores and total scores of scars were (1.4±0.9), (2.0±0.8), (1.7±0.8), and (5.0±2.1) points respectively after treatment, which were significantly lower than those before treatment [(4.1±0.7), (3.1±0.8), (3.0±0.9), and (10.2±2.0) points respectively, t=43.332, 24.968, 28.063, 46.394, P<0.01]. (3) Among the 123 scars from 120 patients with observation time between 6 to 18 months post healing, there were no statistically significant differences in the vascularity, thickness, pliability scores and total scores of scars among patients with different ages after treatment (χ2=4.339, 1.826, 1.375, 2.879, P>0.05). There was only significant difference in the pliability scores of scars among different body sites (χ2=13.530, P<0.05). There were statistically significant differences in the vascularity, thickness, pliability scores and total scores of scars with different starting time of treatment (χ2=30.725, 25.233, 25.119, 35.798, P<0.01). There were significantly positive correlation between starting time of treatment and the vascularity, thickness, pliability scores and total scores of scars (r=0.492, 0.442, 0.446, 0.532, P<0.01). There were statistically significant differences in the vascularity, pliability scores and total scores of scars with different numbers of treatment (Z=4.883, 4.910, 5.049, P<0.05). There were significantly negative correlation between number of treatment and the vascularity, thickness, pliability scores and total scores of scars (r=-0.176, -0.131, -0.191, -0.201, P<0.05). (4) The blood flow values were determined in 18 scars of 18 patients. The results showed that the blood flow values of scars after treatment were significantly decreased compared with those before treatment (t=7.230, P<0.01). (5) The pruritus scores of scars of patients after treatment were significantly decreased compared with those before treatment (Z=12.818, P<0.01). (6) There were significant differences between the satisfaction scores of doctors and the scores of patients after treatment (t=12.130, P<0.01). (7) After PDL treatment, there were some edema and purpura reactions for all the patients, and 11 (5.0%) patients had blisters. After ablative fractional carbon dioxide laser treatment, 4 (1.8%) patients had blisters, 5 (2.3%) patients suffered inflammatory reaction and erosion, and 9 (4.1%) patients suffered pigmentation.@*Conclusions@#The scores of hypertrophic burn scars can be obviously improved by sequential treatments of PDL and ablative fractional carbon dioxide laser. The effects can be more obvious with the earlier starting time and more numbers of treatment. The laser treatments can also decrease the blood flow values and alleviate the pruritus of scars, with high satisfaction of both patients and doctors.
ABSTRACT
Objective@#To compare the efficacy and safety of pulsed dye laser (PDL) and ultra-pulsed fractional carbon dioxide laser (UFCL) in treating hypertrophic scars after burns.@*Methods@#Two hundred and twenty one patients with hypertrophic scar after burns conforming to the study criteria were admitted to our unit from February 2015 to October 2017, and their data were retrospectively analyzed. Patients were divided into group PDL (n=122) and group UFCL (n=99) according to the treatment method. Patients in group PDL were treated with PDL once every 3-4 weeks. Patients in group UFCL were treated with UFCL once every 6-12 weeks. Patients in both groups were treated until 12 months after having scar. Scars were scored by Vancouver Scar Scale (VSS) before and after treatment. Patients′ pain was evaluated by Visual Analogue Scale (VAS) method before and after treatment. Blood flow in scar was monitored and recorded before treatment and in treatment months 6 and 12. Satisfaction degree of patients was recorded 3-6 months after treatment, and the satisfaction rate was calculated. Adverse reactions including duration of erythema/purpura, VAS in treatment, and loss of working time were recorded. Data were processed with one-way analysis of variance, t test, and Chi-square test.@*Results@#(1) VSS scores of patients in groups PDL and UFCL after treatment were significantly lower than those before treatment in the same group (t=11.34, 12.77, P<0.05). The decreasing VSS scores of patients after treatment in groups PDL and UFCL were (5.8±1.1) and (6.0±1.4) points, respectively, and there was no statistically significant difference between the two groups (t=1.91, P>0.05). (2) VAS of patients in groups PDL and UFCL after treatment were significantly lower than those before treatment in the same group (t=7.12, 5.23, P<0.05). The decreasing VAS of patients after treatment in groups PDL and UFCL were (4.0±0.6) and (3.2±1.3) points, respectively, and there was no statistically significant difference between the two groups (t=1.93, P>0.05). (3) Scar blood flow of patients in group PDL in treatment months 6 had no obvious change compared with that before treatment (t=1.59, P>0.05), while that in treatment months 12 significantly decreased compared with that before treatment and that in treatment months 6 (t=3.17, 6.96, P<0.05). Scar blood flow of patients in group UFCL in treatment months 6 significantly increased compared with that before treatment (t=6.01, P<0.05), while that in treatment months 12 significantly decreased compared with that in treatment months 6 (t=4.52, P<0.05), but had no obvious change compared with that before treatment (t=0.92, P>0.05). (4) The satisfaction degree of patients in group PDL was 80.3% (98/122), which in group UFCL was 76.8% (76/99), and there was no statistically significant difference between the two groups (χ2=0.97, P>0.05). (5) The duration of erythema/purpura of patients in group PDL was (5.2±0.7) d, significantly shorter than (6.1±0.5) d in group UFCL (t=2.49, P<0.05). The VAS of patients in group PDL during treatment was (1.9±0.9) points, significantly lower than (4.7±0.4) points in group UFCL (t=4.85, P<0.05). Loss of working time of patients in group UFCL was (9.17±0.72) d, which was significantly longer than (3.96±0.23) d in group PDL (t=3.17, P<0.05).@*Conclusions@#PDL and UFCL have definite effects on hypertrophic scar, while PDL with light pain, minor wound, and fast recovery time, is safe and effective for treatment of early hypertrophic scar and worthy of clinical promotion and application, especially for children and patients with poor pain tolerance.
ABSTRACT
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.
ABSTRACT
BACKGROUND: The recurrence rate of rosacea was not known very well, but has been reported as 60% in 6 months after withdrawal of the drug. It is not known which treatment can reduce relapses of rosacea effectively. OBJECTIVE: The objective was to identify whether 595 nm-pulsed dye laser (PDL) treatment reduced recurrence rate among rosacea patients who were treated with oral minocycline. METHODS: One hundred and seven Korean patients with rosacea who started treatment with oral minocycline (100 mg/d) with or without PDL (2∼4 sessions) were evaluated retrospectively. The recurrence rate was estimated using the Kaplan-Meier method, and difference was evaluated using the log-rank test. Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals (CIs) of risk factors for the recurrence of rosacea. RESULTS: The recurrence-free survival analysis revealed that the group with oral minocycline plus PDL was significantly different compared with the group with oral minocycline alone (p=0.011). Cox proportional hazards model showed that the combined use of PDL with oral minocycline appeared to be a significant protective factor for the hazard of recurrence of rosacea (hazard ratio, 0.492; 95% CI, 0.257∼0.941; p=0.032). CONCLUSION: PDL can be used added to oral minocycline to reduce relapses among rosacea patients who are undergoing oral minocycline treatment.
Subject(s)
Humans , Lasers, Dye , Methods , Minocycline , Proportional Hazards Models , Protective Factors , Recurrence , Retrospective Studies , Risk Factors , RosaceaABSTRACT
BACKGROUND: The anterior neck is the site of open thyroidectomy and where postoperative scarring can cause distress to patients. Both fractional and pulsed-dye lasers are effective and safe methods for preventing and improving surgical scars. OBJECTIVE: This study evaluated the improvement in scar appearance with laser intervention during the wound healing process. We evaluated the effect of nonablative fractional and pulsed-dye lasers on fresh thyroidectomy scars. METHODS: Patients were treated 3 times at 4-week interval with a follow-up visit at the 6th month. Scars were divided into 2 halves for each optional treatment. At every visit, a questionnaire evaluating the scar and patient satisfaction was completed. RESULTS: Thirty patients completed the 6-month process. The mean Vancouver Scar Scale scores improved significantly from 8.0 to 4.6 and 8.2 to 4.7 with nonablative fractional and pulsed-dye lasers, respectively (p<0.001). However, there was no significant difference between the 2 methods (p=0.840). CONCLUSION: There remains no consensus on the optimal treatment of scars. The present study indicates nonablative fractional and pulsed-dye lasers significantly improve scars. Nonablative fractional lasers are non-inferior to pulsed-dye lasers. Further studies are required to corroborate this finding.
Subject(s)
Humans , Cicatrix , Consensus , Follow-Up Studies , Laser Therapy , Neck , Patient Satisfaction , Thyroidectomy , Wound Healing , Surveys and QuestionnairesABSTRACT
Nail psoriasis is a common finding in psoriatic patients and is associated with substantial adverse effects on the patient's quality of life. Although several treatment options are available, nail psoriasis tends to be persistent and refractory to therapy. Pulse dye laser (PDL) has been demonstrated to be effective for plaque-type psoriasis, but there are no reports on nail psoriasis being successfully treated with PDL in the Korean literature. We here report on a 46-year-old woman presenting with nail psoriasis recalcitrant to conventional treatment modalities, showing pitting, nail bed discoloration, and crumbling. We successfully treated the symptoms with 595 nm PDL, supporting the hypothesis that PDL may be a safe and effective therapeutic option in patients with recalcitrant nail psoriasis.
Subject(s)
Female , Humans , Middle Aged , Lasers, Dye , Psoriasis , Quality of LifeABSTRACT
Objective To evaluate the efficacy and side-effects of 595 nm pulsed dye laser (PDL) in the treatment of cutaneous vascular diseases.Methods We analyzed 572 cases of cutaneous vascular diseases treated with 595 nm PDL retrospectively and compared the efficiency among different type of diseases.Results There were totally 243 cases of infantile hemangioma,186 cases of port wine stain,69 cases of telangiectasis,42 cases of spider angioma and 32 cases of rhinophyma.The efficiency was 93.8％,54.3％,95.7％,100％ and 56.3％,respectively,with 2.27％ of side-effect rate.The efficacy was correlated to age,type and location of the diseases.Conclusions 595 nm PDL is a safe option for cutaneous vascular diseases with high efficacy and low side-effect rate.
ABSTRACT
Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy (SMHL) is a benign histiocytic proliferative disorder of unknown etiology. The disease is usually accompanied by massive bilateral lymphadenopathy, fever, elevated erythrocyte sedimentation rate, leukocytosis with neutrophilia, and polyclonal hypergammaglobulinemia. Histopathologic examinations showed characteristically large histiocytes exhibiting emperipolesis. On immunohistochemical stains, histiocytes are positive for CD68 and S-100 protein, but negative for CD1a. The lymph node involvement is typical, but it may also involve other systemic organs in one third of the cases such as skin, upper respiratory tract, bones and so on. Patients with purely cutaneous Rosai-Dorfman diseases are of older age at onset of the disease with a reversed male/female ratio, thus, cutaneous Rosai-Dorfman disease is recognized as a distinct entity from the Rosai-Dorfman disease. Herein, we present a 50-year-old man with erythematous papules and indurated plaques on both cheeks, diagnosed as cutaneous Rosai-Dorfman disease. The lesions were treated with isotretinoin 10 mg bid for 9 months with pulsed dye laser.
Subject(s)
Humans , Blood Sedimentation , Cheek , Coloring Agents , Emperipolesis , Fever , Histiocytes , Histiocytosis, Sinus , Hypergammaglobulinemia , Isotretinoin , Lasers, Dye , Leukocytosis , Lymph Nodes , Lymphatic Diseases , Respiratory System , S100 Proteins , SkinABSTRACT
BACKGROUND: The current modality of choice for the treatment of Port-wine stains (PWS) is laser photocoagulation. Laser therapy for the treatment of PWS, especially with a pulsed dye laser (PDL), has been proven safe and effective; however, because penetration of the PDL is too shallow for an effective ablation of the blebs, treatment of blebbed PWS, using PDL, may be insufficient. OBJECTIVE: We demonstrated the clinical efficacy of a 1,064 nm long pulsed Nd:YAG laser with contact cooling device for blebbed PWS. METHODS: Twenty one patients with blebbed PWS (Fitzpatrick skin types II-V) underwent a treatment, using a 1,064 nm long pulsed Nd:YAG laser with a contact cooling device at 8-week intervals. Treatments were done using 5~6 mm spot sizes at 20~30 ms and 95~170 J/cm2. Laser parameters were adjusted in order to meet the needs of each individual patient's lesions. RESULTS: All subjects tolerated the treatments well, and showed clinical improvement from blebs. Of the 21 patients, 18 of them experienced either moderate or excellent response. CONCLUSION: Use of a 1,064 nm long pulsed Nd:YAG laser results in a greater depth of vascular coagulation. A 1,064 nm long pulsed Nd:YAG laser with contact cooling device may be regarded as a promising therapeutic option for the treatment of blebbed PWS.
Subject(s)
Humans , Blister , Laser Therapy , Lasers, Dye , Light Coagulation , Port-Wine Stain , SkinABSTRACT
BACKGROUND: Port wine stains (PWSs) are commonly treated with pulsed dye laser (PDL) as a standard therapy. However, it is not easy to predict the minimal effective dose in the first treatment session. OBJECTIVE: The aim of this study was to assess whether dermoscopic findings before and after laser irradiation corresponded with the clinical improvement of PWS in patients undergoing PDL therapy. METHODS: Seven untreated PWSs in 6 patients (a male and 5 females), who presented to our hospital between May 2008 to January 2010, were assessed in this study. The mean age was 36.3 years, ranging from 14 to 57 years. A PDL with a wavelength of 585 nm and a spot size of 7 mm was used. Before and after test irradiation, patients underwent dermoscopy and clinical photography, and we assessed whether the dermoscopic findings corresponded with clinical improvement after 3 months. RESULTS: There were no obvious differences observed in the clinical photographs between each test level immediately after irradiation. However, dermoscopic photographs showed differences as the irradiated energy increased. These changes corresponded to the clinical improvement after 3 months. CONCLUSION: Our study indicates that the minimal effective fluence can be predicted by observing dermoscopic change immediately after irradiation. We think that examining the dermoscopic findings immediately after irradiation allows the laser surgeon to predict the minimal effective fluence and this prevents adverse effects of the skin.
Subject(s)
Humans , Male , Dermoscopy , Lasers, Dye , Photography , Port-Wine Stain , SkinABSTRACT
BACKGROUND: Viral warts are benign epithelial proliferations induced by the human papillomavirus (HPV) and they affect 7~10% of the population. Some warts such as periungual warts are resistant to various treatment modalities, including cryotherapy, surgical excision, carbon dioxide laser therapy and immune therapy. Thus, some studies have reported that pulsed dye laser has been effectively used for treating recalcitrant warts. OBJECTIVE: The purpose of this study was to evaluate the therapeutic response and safety of pulsed dye laser using high fluence for the treatment of periungual warts. METHODS: 66 periungual warts on 28 patients were treated with pulsed dye laser. The treatment parameters were a spot size of 5.0 mm, a pulse duration of 0.45~1.5 ms and a fluence of 14.0~15.0 J/cm2. The warts were evaluated at 2~3 week intervals to assess the clearance rate and side effects. RESULTS: Complete clearance was achieved for 47 out of 66 periungual warts (71.2%). The average number of treatment sessions was 2 (range: 1~6). After the first session, complete clearance was achieved for 24 out of 66 warts (36.4%). No significant side effects were observed except for pain during and after the procedure. During a median follow up period of 7 months (range: 3~15 months), 10 periungual warts on 3 patients recurred. CONCLUSION: Pulsed dye laser using high fluence could be used as a safe and successful treatment for recalcitrant periungual warts.
Subject(s)
Humans , Cryotherapy , Follow-Up Studies , Lasers, Dye , Lasers, Gas , WartsABSTRACT
BACKGROUND: Despite the physical disfigurement, bothersome symptoms and psychological problemsfrom the proliferative scarring process of keloids and hypertrophic scars, there is currently no consensus regarding the best management of these lesions. OBJECTIVE: The purpose of this study was to determine the therapeutic efficacy and safety of intralesional corticosteroid injection combined with 5-fluorouracil (5-FU) and/or pulsed dye laser (PDL) in Koreans with keloids or hypertrophic scars. METHODS: Twenty-five patients with keloids and/or hypertrophic scars over 2 cm in size or who had more than 3 separated lesions were included in this study. Each scar was divided equally into 2 or more segments and these were treated with 1 of the following 3 different modalities: (1) intralesional injection of triamcinolone acetonide (TCA: 20 mg/ml weekly), (2) intralesional injection of TCA 0.1 ml (40 mg/ml) mixed with 5-FU 0.9 ml (50 mg/ml) weekly and (3) treatment #2 combined with PDL (585 nm, 5~7.5 J/cm2) at baseline and at the 3rd and 7th weeks. We estimated the change of the height, the erythema, the pliability, the pruritus, the pain/tenderness scores, the patient-self assessment and the complications. This study was an 8-week prospective study and the assessment of relapse was done at 4 and 12 weeks after the last treatment. RESULTS: There was a statistically significant improvement of the clinical signs and symptoms in all the treated groups. However, the 5-FU-treated groups had more sustained effects compared to the group that underwent TCA monotherapy with respect to flattening and pliability. Complications such as ulcerations, crusts and hyperpigmentation were more frequent in the 5-FU-treated groups. CONCLUSION: Although 5-FU may be preferable to TCA for improving the symptoms of keloids and hypertrophic scars, we believe it is prone to induce more complications in Koreans.