ABSTRACT
Las cicatrices por quemadura suponen una elevada morbilidad en forma de contracturas, desfiguración corporal y prurito, así como un elevado impacto emocional que disminuye la calidad de vida de estos pacientes. Los dispositivos láser se han mostrado eficaces para su tratamiento, por encima de los tratamientos tópicos y complementarios a la cirugía, sin generar tanta morbilidad. Sin embargo, su uso en los departamentos de dermatología hospitalarios todavía está poco extendido. El láser más utilizado es el láser CO2 para tratar el grosor de la cicatriz, alteraciones texturales, y la posible contractura asociada, restaurando la movilidad de estos pacientes cuando se encuentra alterada. El láser de colorante pulsado es especialmente útil ante las cicatrices de quemaduras recientes con componente eritematoso y para prevenir el desarrollo de cicatrices hipertróficas posteriores. La hiperpigmentación puede mejorar con láseres de pigmento en modalidades de pulso corto (nano- y picosegundos). Revisamos la evidencia de estos dispositivos para el tratamiento de las cicatrices por quemaduras y aportamos una propuesta de algoritmo terapéutico (AU)
Burn scars cause high morbidity in the form of contractures, body disfigurement, and itching, and they also have a high emotional impact that adversely affects patient quality of life. Laser therapy has proven effective in this setting. It is superior to topical treatments and can be used in conjunction with surgery, helping to reduce morbidity. The use of lasers in hospital dermatology departments, however, is still limited. Carbon dioxide laser resurfacing is the most widely used modality for reducing scar thickness, improving textural abnormalities, and treating contractures. Treatments improve mobility for patients with constrictions. Pulsed dye laser treatments are particularly useful for reducing erythema in recent burn scars and preventing subsequent hypertrophy. Pigment laser treatments with short pulse durations (nanoseconds or picoseconds) can improve hyperpigmentation. In this article, we review the evidence for the use of laser therapy for burn scars and propose a treatment algorithm (AU)
Subject(s)
Humans , Laser Therapy/methods , Burns/therapy , Cicatrix/therapyABSTRACT
Burn scars cause high morbidity in the form of contractures, body disfigurement, and itching, and they also have a high emotional impact that adversely affects patient quality of life. Laser therapy has proven effective in this setting. It is superior to topical treatments and can be used in conjunction with surgery, helping to reduce morbidity. The use of lasers in hospital dermatology departments, however, is still limited. Carbon dioxide laser resurfacing is the most widely used modality for reducing scar thickness, improving textural abnormalities, and treating contractures. Treatments improve mobility for patients with constrictions. Pulsed dye laser treatments are particularly useful for reducing erythema in recent burn scars and preventing subsequent hypertrophy. Pigment laser treatments with short pulse durations (nanoseconds or picoseconds) can improve hyperpigmentation. In this article, we review the evidence for the use of laser therapy for burn scars and propose a treatment algorithm (AU)
Las cicatrices por quemadura suponen una elevada morbilidad en forma de contracturas, desfiguración corporal y prurito, así como un elevado impacto emocional que disminuye la calidad de vida de estos pacientes. Los dispositivos láser se han mostrado eficaces para su tratamiento, por encima de los tratamientos tópicos y complementarios a la cirugía, sin generar tanta morbilidad. Sin embargo, su uso en los departamentos de dermatología hospitalarios todavía está poco extendido. El láser más utilizado es el láser CO2 para tratar el grosor de la cicatriz, alteraciones texturales, y la posible contractura asociada, restaurando la movilidad de estos pacientes cuando se encuentra alterada. El láser de colorante pulsado es especialmente útil ante las cicatrices de quemaduras recientes con componente eritematoso y para prevenir el desarrollo de cicatrices hipertróficas posteriores. La hiperpigmentación puede mejorar con láseres de pigmento en modalidades de pulso corto (nano- y picosegundos). Revisamos la evidencia de estos dispositivos para el tratamiento de las cicatrices por quemaduras y aportamos una propuesta de algoritmo terapéutico (AU)
Subject(s)
Humans , Laser Therapy/methods , Burns/therapy , Cicatrix/therapyABSTRACT
Burn scars cause high morbidity in the form of contractures, body disfigurement, and itching, and they also have a high emotional impact that adversely affects patient quality of life. Laser therapy has proven effective in this setting. It is superior to topical treatments and can be used in conjunction with surgery, helping to reduce morbidity. The use of lasers in hospital dermatology departments, however, is still limited. Carbon dioxide laser resurfacing is the most widely used modality for reducing scar thickness, improving textural abnormalities, and treating contractures. Treatments improve mobility for patients with constrictions. Pulsed dye laser treatments are particularly useful for reducing erythema in recent burn scars and preventing subsequent hypertrophy. Pigment laser treatments with short pulse durations (nanoseconds or picoseconds) can improve hyperpigmentation. In this article, we review the evidence for the use of laser therapy for burn scars and propose a treatment algorithm.
Subject(s)
Burns , Cicatrix, Hypertrophic , Contracture , Laser Therapy , Lasers, Gas , Humans , Cicatrix/etiology , Cicatrix/radiotherapy , Cicatrix/surgery , Cicatrix, Hypertrophic/etiology , Cicatrix, Hypertrophic/radiotherapy , Cicatrix, Hypertrophic/surgery , Lasers, Gas/therapeutic use , Burns/complications , Burns/surgery , Quality of Life , Laser Therapy/adverse effects , Contracture/surgery , Contracture/complications , Treatment OutcomeABSTRACT
El síndrome Capillary vascular malformation of the lower lip, Lymphatic malformations of the head and neck, Asymmetry and Partial/generalized Overgrowth (CLAPO) es una entidad recientemente descrita, con muy pocos casos publicados en la literatura, y sin tratamiento estandarizado. El objetivo de nuestro estudio fue evaluar la eficacia y seguridad del láser de colorante pulsado (PDL) en los pacientes con este síndrome. Tratamos a siete pacientes con dos a cuatro sesiones de PDL a longitud de onda de 595 nm. La terapia láser fue realizada utilizando un tamaño de spot de 7 a 10 mm, una duración del pulso de 0,5 a 1,5 ms, y una fluencia de 6 a 8 J/cm2. Se realizaron fotografías clínicas antes del tratamiento y tres semanas tras el procedimiento. La supresión del eritema fue > 75% en cuatro pacientes. La púrpura transitoria estuvo presente en todos los pacientes durante alrededor de dos semanas, presentando un paciente con hipopigmentación postinflamatoria. A modo de conclusión consideramos que el PDL parece ser un tratamiento seguro y efectivo para las malformaciones capilares propias del síndrome CLAPO. Se logró una notable reducción del eritema en todos los pacientes, con baja incidencia de efectos secundarios (AU)
CLAPO syndrome (Capillary vascular malformation of the lower lip, Lymphatic malformations of the head and neck, Asymmetry and Partial/generalized Overgrowth) is a recently described entity, with very few published cases in the literature, and no standardized treatment. The objective of our study was to assess the efficacy and safety of PDL in patients with this syndrome. Seven patients were treated with two to four sessions of PDL at 595-nm wavelength. Laser therapy was performed using a spot size of 7 to 10 mm, a pulse duration of 0,5 to 1,5 ms and a fluence from 6 to 8 J/cm2. Clinical photographs were taken before treatment and 3 weeks after procedure. Clearance of the erythema was > 75% in 4 patients. Transient purpura was present in all patients for about 2 weeks and 1 patient presented post inflammatory hypopigmentation. In conclusion we consider that PDL seems to be a safe and effective treatment for capillary malformations of the CLAPO syndrome. A marked reduction in erythema was achieved in all patients with a low incidence of side effects (AU)
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Lasers, Dye/therapeutic use , Hair Diseases/therapy , Vascular Malformations/therapy , Treatment Outcome , SyndromeABSTRACT
CLAPO syndrome (Capillary vascular malformation of the lower lip, Lymphatic malformations of the head and neck, Asymmetry and Partial/generalized Overgrowth) is a recently described entity, with very few published cases in the literature, and no standardized treatment. The objective of our study was to assess the efficacy and safety of PDL in patients with this syndrome. Seven patients were treated with two to four sessions of PDL at 595-nm wavelength. Laser therapy was performed using a spot size of 7 to 10 mm, a pulse duration of 0,5 to 1,5 ms and a fluence from 6 to 8 J/cm2. Clinical photographs were taken before treatment and 3 weeks after procedure. Clearance of the erythema was > 75% in 4 patients. Transient purpura was present in all patients for about 2 weeks and 1 patient presented post inflammatory hypopigmentation. In conclusion we consider that PDL seems to be a safe and effective treatment for capillary malformations of the CLAPO syndrome. A marked reduction in erythema was achieved in all patients with a low incidence of side effects (AU)
El síndrome Capillary vascular malformation of the lower lip, Lymphatic malformations of the head and neck, Asymmetry and Partial/generalized Overgrowth (CLAPO) es una entidad recientemente descrita, con muy pocos casos publicados en la literatura, y sin tratamiento estandarizado. El objetivo de nuestro estudio fue evaluar la eficacia y seguridad del láser de colorante pulsado (PDL) en los pacientes con este síndrome. Tratamos a siete pacientes con dos a cuatro sesiones de PDL a longitud de onda de 595 nm. La terapia láser fue realizada utilizando un tamaño de spot de 7 a 10 mm, una duración del pulso de 0,5 a 1,5 ms, y una fluencia de 6 a 8 J/cm2. Se realizaron fotografías clínicas antes del tratamiento y tres semanas tras el procedimiento. La supresión del eritema fue > 75% en cuatro pacientes. La púrpura transitoria estuvo presente en todos los pacientes durante alrededor de dos semanas, presentando un paciente con hipopigmentación postinflamatoria. A modo de conclusión consideramos que el PDL parece ser un tratamiento seguro y efectivo para las malformaciones capilares propias del síndrome CLAPO. Se logró una notable reducción del eritema en todos los pacientes, con baja incidencia de efectos secundarios (AU)
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Lasers, Dye/therapeutic use , Hair Diseases/therapy , Vascular Malformations/therapy , Treatment Outcome , SyndromeABSTRACT
CLAPO syndrome (Capillary vascular malformation of the lower lip, Lymphatic malformations of the head and neck, Asymmetry and Partial/generalized Overgrowth) is a recently described entity, with very few published cases in the literature, and no standardized treatment. The objective of our study was to assess the efficacy and safety of PDL in patients with this syndrome. Seven patients were treated with two to four sessions of PDL at 595-nm wavelength. Laser therapy was performed using a spot size of 7 to 10 mm, a pulse duration of 0,5 to 1,5 ms and a fluence from 6 to 8 J/cm2. Clinical photographs were taken before treatment and 3 weeks after procedure. Clearance of the erythema was > 75% in 4 patients. Transient purpura was present in all patients for about 2 weeks and 1 patient presented post inflammatory hypopigmentation. In conclusion we consider that PDL seems to be a safe and effective treatment for capillary malformations of the CLAPO syndrome. A marked reduction in erythema was achieved in all patients with a low incidence of side effects.
Subject(s)
Lasers, Dye , Vascular Malformations , Arteriovenous Malformations , Capillaries/abnormalities , Erythema/etiology , Humans , Lasers, Dye/therapeutic use , Lymphatic Diseases , Treatment Outcome , Vascular Malformations/complications , Vascular Malformations/radiotherapy , Vascular Malformations/surgeryABSTRACT
BACKGROUND: Due to a large variety in treatment outcomes reported in therapeutic trials and lacking patient-relevant outcomes, it is hard to adequately compare and improve current therapies for patients with capillary malformations (CMs). The Core Outcome Set for Capillary Malformations (COSCAM) project aims to develop a core outcome set (COS) for use in future CM trials, in which we will first develop a core outcome (sub)domain set (CDS). Here, we describe the methods for the development of a CDS and present the results of the first development stage. METHODS: The COSCAM project is carried out according to the recommendations of the Cochrane Skin Core OUtcomes Set INitiative (CS-COUSIN) and the Core Outcome Measures in Effectiveness Trials (COMET) initiative. During the first stage, we identified all potentially relevant outcome subdomains based on a systematic review, two focus group sessions and input from patient representatives of Dutch patient organizations and the COSCAM-founding group. In stage two, we will present the subdomains in a three-round e-Delphi study and online consensus meeting, in which CM patients, parents/caregivers and CM experts worldwide rate the importance of the proposed subdomains, hereby finalizing the core outcome (sub)domains of the CDS. RESULTS: A total of 67 potential outcome subdomains were included; sixteen were previously used in the literature, 20 were proposed by Dutch patients and their parents/caregivers (n = 13) in focus group sessions and 38 were suggested by the experts of the COSCAM-founding group. Seven were excluded because of overlap. CONCLUSION: The final CDS may serve as a minimum standard in future CM trials, thereby facilitating adequate comparison of treatment outcomes. After this CDS development, we will select appropriate outcome measurement instruments to measure the core outcome subdomains.
Subject(s)
Outcome Assessment, Health Care , Research Design , Capillaries/abnormalities , Delphi Technique , Endpoint Determination , Humans , Systematic Reviews as Topic , Treatment Outcome , Vascular MalformationsSubject(s)
Mite Infestations , Mites , Animals , Humans , Microscopy, Confocal , Mite Infestations/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Models, Theoretical , Dermatology/education , Deep Learning , Machine Learning , TeledermatologySubject(s)
Deep Learning , Dermatology , Skin Diseases , Humans , Machine Learning , Models, TheoreticalABSTRACT
Las últimas evidencias científicas y la incorporación de nuevos fármacos al arsenal terapéutico de la rosácea hacen necesario revisar y actualizar los criterios y estrategias de tratamiento. Con este fin, un grupo de 15 dermatólogos expertos en esta enfermedad aportaron y discutieron acerca de las diferentes terapias y los criterios de respuesta y cambio de tratamiento. Partiendo de la revisión crítica de la bibliografía y de la exposición de los hábitos de los dermatólogos españoles en su práctica clínica, se formularon distintas propuestas que fueron debatidas teniendo en consideración tanto la experiencia profesional como las preferencias de los pacientes o los criterios de equidad. Una vez validadas las propuestas, se formularon las recomendaciones finales que, junto con la evidencia aportada por las principales guías y estudios internacionales, dieron lugar al presente documento. El objetivo de este consenso es ofrecer al dermatólogo un enfoque práctico para abordar la rosácea
Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea
Subject(s)
Humans , Consensus , Algorithms , Rosacea/therapy , Rosacea/epidemiology , Surveys and Questionnaires , Quality of Life , Erythema/therapy , Telangiectasis/therapy , Administration, Topical , Delphi TechniqueABSTRACT
No disponible
Subject(s)
Lupus Erythematosus, Cutaneous/surgery , Lasers, Dye/therapeutic use , Lasers, Dye , Skin/injuriesABSTRACT
Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea.
Subject(s)
Algorithms , Consensus , Rosacea/therapy , Anti-Bacterial Agents/therapeutic use , Brimonidine Tartrate/therapeutic use , Delphi Technique , Doxycycline/therapeutic use , Humans , Laser Therapy , Metronidazole/therapeutic use , Practice Guidelines as Topic , Quality of Life , Rosacea/classification , Rosacea/drug therapyABSTRACT
No disponible
