Efficacy of long-pulsed 1 064-nm Nd:YAG laser combined with a topical emulsion containing Camellia reticulata and Radix Notoginseng in the treatment of melasma / 中华皮肤科杂志

Objective:To evaluate the efficacy of long-pulsed 1 064-nm Nd:YAG laser combined with a topical emulsion containing Camellia reticulata and Radix Notoginseng in the treatment of melasma. Methods:A total of 80 patients with melasma were enrolled from Department of Dermatology, People′s Hospital of Ningxia Hui Autonomous Region from June 2019 to June 2020, and randomly and equally divided into control group and observation group by using a random number table: 40 patients in the control group were treated with long-pulsed 1 064-nm Nd:YAG laser once every 2 weeks for 6 sessions as a course of treatment; another 40 in the observation group were treated with the same laser therapy as the control group and a topical emulsion containing Camellia reticulata and Radix Notoginseng twice a day for 3 months as a course of treatment. Melasma area and severity index (MASI), clinical efficacy, patient satisfaction rate and safety were compared between the 2 groups before and/or after treatment. Results:After 4- and 8-week treatment, there was no significant difference in the MASI score between the observation group (14.57 ± 3.22 points, 10.00 ± 2.94 points, respectively) and control group (14.74 ± 3.11 points, 11.31 ± 3.00 points, respectively; both P>0.05). After 12-week treatment, the MASI score was significantly lower in the observation group (4.80 ± 2.78 points) than in the control group (7.07 ± 3.22 points, t = -3.38, P<0.01). After 3-month treatment, the response rate was significantly higher in the observation group (36 cases, 90%) than in the control group (31 cases, 77.5%; χ2 = 4.58, P < 0.001) ; however, there was no significant difference in the patient satisfaction rate between the observation group (87.5%) and control group (72.5%, χ2 = 7.26, P = 0.06). In addition, no significant difference in the occurrence of adverse reactions was observed between the observation group (5 cases, 12.5%) and control group (7 cases, 17.5%; P > 0.05) . Conclusion:Compared with the long-pulsed 1 064-nm Nd:YAG laser alone, the topical emulsion containing Camellia reticulata and Radix Notoginseng in combination with the long-pulsed 1 064-nm Nd:YAG laser is more effective for the treatment of melasma, with higher patient satisfaction and less adverse reactions.

Severe Papulopustular Rosacea with Demodicosis in a 47-year-old Filipino female: A case report

Introduction@# Rosacea is a chronic relapsing inflammatory facial dermatosis often characterized by flare-ups and remissions exclusively affecting the centrofacial skin.@*Case report@#This is a case of multiple symmetric intensely erythematous papules, pustules, and plaques over both cheeks in a 47-year-old Filipino female. Dermoscopy showed brown-yellowish structureless areas, straight vessels in a polygonal pattern, dilated follicles, follicular plugs, ill-defined white rosettes, and non-specific scales. Skin punch biopsy showed spongiosis of the epidermis and demodex folliculorum within the follicular infundibulum. The dermis revealed telangiectasia of blood vessels and dense inflammatory infiltrates. Hypertrophy of sebaceous lobules was also seen. The patient was initially treated with oral lymecycline 300mg twice a day for 2 weeks without improvement. Due to the persistence of centrofacial erythema, papules and pustules, the patient was given prednisone 10mg once a day for 1 month and low dose isotretinoin 10mg once a day for 8 months which resulted in significant decrease in erythema and number of existing lesions. To further decrease the inflammation con- tributed by demodex mites, permethrin 5% cream twice a day for 1 month was applied. Long-pulsed Neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064 nm laser for a total of 10 sessions together with Isotretinoin 10 mg every other day effectively maintained remission for 1 year and 5 months. Gentle skin care measures, sunscreen, metronidazole 0.75% cream once a day, and desonide 0.05% cream twice a day for 1 week in cases of acute flares were maintained during the treatment course.@*Conclusion@#An armamentarium of topical and oral antibiotics, corticosteroids, isotretinoin and non-ablative long-pulsed Nd:YAG 1064 nm laser showed significant improvement in the inflammatory papules, pustules, and centrofacial erythema of rosa- cea and proves to be beneficial in the maintenance of its long-term remission.

Long-pulsed 1064 nm Nd: YAG laser combined with terbinafine against chromoblastomycosis caused by and the effect of laser therapy in a Wistar rat model / 南方医科大学学报

We report a case of chromoblastomycosis caused by , which was successfully treated by long-pulsed 1064 nm Nd: YAG laser combined with terbinafine. A 60-year-old man was admitted for the presence of a 30 mm×40 mm erythematous plaque on the dorsum of his right hand for about 10 months without any subjective symptoms. Both microscopic examination and tissue biopsy of the lesion showed characteristic sclerotic bodies of chromoblastomycosis. Lesion tissue culture on SDA at 26 ℃ for 2 weeks resulted in a black colony, and slide culture identified the isolate as Fonsecaea species. ITS sequence analysis of the isolate showed a 99% homology with strain KX078407. The susceptibility of the isolate to 9 antifungal agents was determined using the microdilution method according to the guidelines of CLSI M38-A2 protocol, and terbinafine showed the lowest MIC (0.125 μg/ml). We subsequently established a Wistar rat model of chromoblastomycosis using the clinical isolate and treated the rats with long-pulsed 1064 nm Nd: YAG laser (pulse width of 3.0 ms, fluence of 24 J/cm, spot size of 3 mm, frequency of 4 Hz, repeated 3 times at an interval of 30 s) twice a week for a total of 8 sessions. Although the laser treatment alone was not able to eliminate the fungi, histopathological examination showed the aggregation of numerous lymphocytes in the local affected tissue, indicating an immune response that consequently facilitate the regression of the lesion. The patient was successfully treated by long-pulsed 1064 nm Nd: YAG laser once a week combined with terbinafine (0.25 /bid) for 8 weeks, and follow-up for 20 months did not reveal any signs of recurrence.

Clinical Efficacy of Long-pulsed 1064 nm Laser Combined with Amorolfine Hydrochloride in the Treatment of Patients with Onychomycosis / 中国药师

Objective:To investigate the clinical efficacy of long-pulsed 1064nm laser combined with amorolfine hydrochloride in the treatment of patients with onychomycosis. Methods:Totally 106 cases of patients with onychomycosis were randomly divided into the observation group (n=53) and the control group(n=53) according to the random number table. The control group was given 5%amorolfine hydrochloride liniment, while the observation group was treated with long-pulsed 1064nm laser additionally. The course of treatment was 6 months. The clinical efficacy, length of deck in ward areas, length of deck in health zone, clearance of mycology and adverse reactions were compared between the groups. Results:The total effective rate of the observation group(90. 57%) was signifi-cantly higher than that of the control group(75. 47%, P<0. 05). After the treatment, the length of deck in ward areas in both groups were significantly decreased, while the length of deck in health zone were significantly increased (P<0. 05). The length of deck in ward areas in the observation group was significantly lower than that in the control group, while the length of deck in health zone was significantly higher than that in the control group(P<0. 05). The clearance rate of mycology in the observation group (86. 79%) was significantly higher than that in the control group (67. 92%, P<0. 05). There were no serious adverse reactions during the treatment course. Conclusion:Long-pulsed 1064nm laser combined with 5% amorolfine hydrochloride liniment in the treatment of patients with onychomycosis has remarkable, safe and reliable clinical effects, which shows important study value.

Efficacy and Safety of Hair Removal with a Long-Pulsed Diode Laser Depending on the Spot Size: A Randomized, Evaluators-Blinded, Left-Right Study

BACKGROUND: The efficacy of the long-pulsed diode laser (LPDL) in hair removal is determined with various physical parameters. Recently, LPDLs with a larger spot size are commercially available; however, the independent effect of spot size on hair removal has not been studied. OBJECTIVE: This study aimed to compare the efficacy of the LPDL in hair removal depending on the spot size. METHODS: A randomized, evaluators-blind, intrapatient comparison (left vs. right) trial was designed. Ten healthy Korean women received three hair removal treatment sessions on both armpits with the 805-nm LPDL and followed for 3 months. A 10x10 mm handpiece (D1) or a 10x30 mm handpiece (D3) was randomly assigned to the right or left axilla. The fluence, pulse duration, and epidermal cooling temperature were identical for both armpits. Hair clearance was quantified with high-resolution photos taken at each visit. Postprocedural pain was quantified on a visual analogue scale. Adverse events were evaluated by physical examination and the patients' self-report. RESULTS: The mean hair clearance at 3 months after three treatment sessions was 38.7% and 50.1% on the armpits treated with D1 and D3, respectively (p=0.028). Procedural pain was significantly greater in the side treated with D3 (p=0.009). Serious adverse events were not observed. CONCLUSION: Given that the pulse duration, fluence, and epidermal cooling were identical, the 805-nm LPDL at the three times larger spot size showed an efficacy improvement of 29.5% in axillary hair removal without serious adverse events.

Efficacy and Safety of Hair Removal with a Long-Pulsed Diode Laser Depending on the Spot Size: A Randomized, Evaluators-Blinded, Left-Right Study

BACKGROUND: The efficacy of the long-pulsed diode laser (LPDL) in hair removal is determined with various physical parameters. Recently, LPDLs with a larger spot size are commercially available; however, the independent effect of spot size on hair removal has not been studied. OBJECTIVE: This study aimed to compare the efficacy of the LPDL in hair removal depending on the spot size. METHODS: A randomized, evaluators-blind, intrapatient comparison (left vs. right) trial was designed. Ten healthy Korean women received three hair removal treatment sessions on both armpits with the 805-nm LPDL and followed for 3 months. A 10x10 mm handpiece (D1) or a 10x30 mm handpiece (D3) was randomly assigned to the right or left axilla. The fluence, pulse duration, and epidermal cooling temperature were identical for both armpits. Hair clearance was quantified with high-resolution photos taken at each visit. Postprocedural pain was quantified on a visual analogue scale. Adverse events were evaluated by physical examination and the patients' self-report. RESULTS: The mean hair clearance at 3 months after three treatment sessions was 38.7% and 50.1% on the armpits treated with D1 and D3, respectively (p=0.028). Procedural pain was significantly greater in the side treated with D3 (p=0.009). Serious adverse events were not observed. CONCLUSION: Given that the pulse duration, fluence, and epidermal cooling were identical, the 805-nm LPDL at the three times larger spot size showed an efficacy improvement of 29.5% in axillary hair removal without serious adverse events.

1,064 nm Long-Pulsed Nd:YAG Laser for the Treatment of Onychomycosis / 대한의진균학회지

BACKGROUND: Onychomycosis is the most common disease of the nails. The traditional treatment of onychomycosis requires long term medication of antifungal agent that is associated with drug interaction, so many patients had been limited its use. OBJECTIVE: The aim of this study was to evaluate the treatment of onychomycosis with 1,064 nm long-pulsed Nd:YAG laser. METHODS: Between April 2012 and March 2013, we selected 18 nails (14 toenails, 4 fingernails) and treat over three to eight sessions every 4 weeks. RESULTS: For all 10 patients with 18 affected nails, 88.9% mycological (culture) clearance was observed after sixth sessions. At their final follow-up visit, 9 of 18 nails had more than 50% efficacy and the others had 30~50% clinical improvement. The overall average improvement rate was 55.5%. CONCLUSION: The results demonstrates that a 1,064 nm long-pulsed Nd:YAG laser may represent a safe and viable option for the treatment of onychomycosis. The optimal regimen for each patient needs to be determined.

Prevention and treatment of the complications caused by long-pulsed alexandrite laser on hair removal / 中华医学美学美容杂志

Objective To investigate the causes and treatment methods of complications induced by the long-pulsed alexandrite laser on hair removal. Methods A total of 2 562 patients (3 279 sites) with unwanted hairs were treated by the long-pulsed alexandrite laser. Wave length was 755 nm. With 20 msec pulse width. 12. 5 mm spot size, 12. 0-16. 5 J/cm2 treatment energy, and 50-60 days intermitted between each treatment. Results There were 242 patients with complications such as erythema, eruption, blister, bulla, hyperpigmentation, hypopigmentation, and scar. Conclusion The long-pulsed alexandrite laser on hair removal is effective and safe, and the correct procedures of treatment can reduce the complications.

Efficacy of long-pulsed 1064 nm Nd : YAG laser on 207 pediatric cutaneous hemangiomas / 中华医学美学美容杂志

Objective To assess the efficacy of a long-pulsed 1064 nm Nd :YAG laser system in treating pediatric cutaneous hemangiomas. Methods 207 patients (20 days-10 years old,164 cases in pro-liferative phase and 43 in stationary phase) with cutaneous hemangiomas were divided into 2 groups ac-cording lesions. Group A contained 142 patients with lesions located in skin completely. Group B con-tained 65 patients, in which the lesions involved in subcutaneous portion. All patients were treated with single pulse shots by a long-pulsed 1 064 nm Nd :YAG laser, with 2 mm and 6 mm spot size in diameter, and with related energies from 50 to 90 J/cm~2 and pulse lengths of 10, 40 and 60 ms, respectively. All treatments were given at 1-month interval. Results After 1-6 times of treatment, there was no statistic significance of effective rate between group A and group B. Both general effective rates were 100%. The rate of side effects was 11.6 %, all of which recovered gradually. Conclusions The long-pulsed 1064 nm Nd : YAG laser offers efficient treatment of pediatric superficial cutaneous hemangiomas and side effects are minimal and transient.

Treatment of Facial Rhytides with Long-pulsed Er:YAG Laser(CO3)

Facial rhytides are a common problem that often presents for treatment. Laser facial skin resurfacing has become a method of treatment for photoaging and pigmentary conditions. Although excellent results can be obtained by high-energy, pulsed carbon dioxide(CO2) laser, significantly morbidity exists due to the considerable thermal damage to the skin. Long-pulsed Er:YAG laser (CO3 laser, Cynosure) combines the performance of a CO2 system with the safety and convenience of an Er:YAG. Yet the CO3 laser is more than the combination of two complementary resurfacing lasers. It brings thermal management to skin resurfacing. The CO3 effect is due to a wide range of pulse durations, up to 20 times longer than those delivered by conventional Er:YAG lasers. With the CO3 laser, the user chooses the correct depth of thermal effect for maximum safety and efficacy. The purpose of this study was to evaluate the results of the CO3 laser in the treatment of facial wrinkles. Forty-three patients, aged between 35 and 70 years, with facial wrinkles, were evaluated. Wrinkle improvement was evaluated by the patient's satisfaction, clinical improvement, and photographic analysis before and after the resurfacing procedure. The long-pulsed Er: YAG laser for facial wrinkles is a safe and effective mode for laser skin resurfacing.

Treatment of Facial Scars with CO3 Laser

Numerous modalities have been used to treat facial scars. Although excellent results can be obtained by high-energy, pulsed carbon dioxide(CO2) laser, significant morbidity exists due to the considerable thermal damage to the skin. CO3 Laser combines the performance of a CO2 system with the safety and convenience of an Er:YAG laser. The CO3 effect is due to a wide range of pulse durations, up to 20 times longer than those delivered by conventional Er:YAG lasers. The result is a thermally tunable laser, with a zone of thermal effect up to 100micrometer in depth. With the CO3 laser, the user chooses the correct depth of thermal effect for maximum safety and efficacy. This study was performed to evaluate the effect of the long-pulsed Er:YAG CO3 laserbrasion in treatment of scars and propose that it can be a effective method to improve cosmetic results. The authors treated 47 cases (8 males and 39 females) including acne scar(n=8), annular atrophic scar(n=9), posttraumatic scar(n=19), postsurgical scar (n=11) with CO3 laser. Questionaire were completed for clinical assessment by the patients and clinicians. Excellent and good results were achieved in 87.3% of scars in clinician's assessments and in 78.8% of scars in patient's assessments. In conclusion, resurfacing with a long-pulsed Er:YAG laser is a safe and very effective treatment modality for facial scars.

The Effect of 1320 nm Nd: YAG Laser and Long-pulsed 1064 nm Nd: YAG Laser Irradiation on Hairless Mouse Skin / 대한피부과학회지

BACKGROUND: The treatment of facial rhytides has traditionally centered around methods that involve removal of the epidermis and superficial dermis, encouraging the production of a new epidermis with collagenesis and remodelling. But all of the resurfacing techniques lead to postoperative complications such as oozing, bleeding, infections, "downtime" as the skin begins to reepithelialize, and the occasional incidence of posttreatment, postinflammatory pigmentary changes. 1320nm and 1064nm wavelengths are nonspecifically absorbed in the human dermis and are unique for its significant horizontal scattering. These wavelengths, when used for localized facial areas, have been shown to produce new collagen formation and improvement in the quality of treated skin. OBJECTIVE: The purpose of this study was to examine the effect of 1320nm Nd: YAG laser and long-pulsed 1064nm Nd: YAG laser irradiation on hairless mouse skin and rat skin. METHODS: In this study, the effect of 1320nm Nd: YAG laser and long-pulsed 1064nm Nd: YAG laser irradiation were examined by Hematoxylin and eosin (H&E) stain, Masson's trichrome stain, immunohistochemical stain for type I collagen and dot-blot hybridization for alpha1(I) procollagen mRNA. RESULTS: In the H&E stain, Masson's trichrome stain, and immunohistochemical stain of the hairless mouse skin, the number of collagen fibers with a greater density of fibers increased, compared to the non-irradiated controls on both the 1320nm Nd: YAG laser and the long-pulsed 1064nm Nd: YAG laser. In the dot-blot hybridization in the hairless mouse, levels of alpha1(I) procollagen mRNA were increased 3.0-fold, 4.8-fold and 5.2-fold at each 1 week, 4 weeks and 12 weeks after irradiation in 1320nm Nd: YAG laser and 1.8-fold and 2.1-fold at each 4 weeks and 12 weeks after irradiation in long-pulsed 1064nm Nd: YAG laser, compared to the non-irradiated controls. But in the 1320nm Nd: YAG laser irradiation on the rat, there is no significant change in the number and density of collagen fibers, compared to the non- irradiated controls. CONCLUSION: These results indicate that the 1320nm Nd: YAG laser and the long-pulsed 1064nm Nd: YAG laser may be a powerful up-regulator of collagen synthesis through significant dermal damage and the 1320nm Nd: YAG laser is better than the long-pulsed 1064nm Nd: YAG laser for collagen synthesis. Therefore, the 1320nm Nd: YAG laser can be more effective clinically than the long-pulsed 1064nm Nd: YAG laser for the treatment of photodamaged skin.