Diode lasers for the treatment of genital warts.

Human papillomavirus (HPV) infections are the most common sexually transmitted diseases leading to genital warts. Developing lesions start off as small papules, which then grow larger and protrude, eventually coalescing into plaque-like formations. The aim of this study was to evaluate the efficacy of diode laser coagulation as a treatment for genital warts relative to their number, size, localisation, and recurrence rate. Altogether, 45 patients were evaluated in this study. Patients were initially assigned to one of two groups, depending on the size and number of their genital warts, and received a maximum of two laser treatments. Patients were assessed up to three months after intervention. A cure was defined as the complete removal of condylomata. In Group I, 84% of the patients (21/25) were free of recurrence after three months (last follow-up visit). In Group II, 60% of the patients were free of recurrence after three months (12/20 patients); 25% after the first and 35% after the second treatment. Overall, a cure rate of 73% was achieved (33/45 patients). By splitting the laser treatment for multiple, extensive, and/or coalescing genital warts into two sessions, thereby being less destructive to the surrounding tissue, it was possible to achieve comparable cure rates between the two groups. This study indicates that laser treatment is an effective therapy option. Further studies including larger patient cohorts are necessary to ultimately confirm the advantages of laser treatment.

Treatment of striae distensae using an ablative Erbium: YAG fractional laser versus a 585-nm pulsed-dye laser.

Abstract Striae distensae (SD) represent a common disfiguring cutaneous condition characterized by linear reddish smooth bands of atrophic-appearing skin. Most often SD develop in areas of dermal damage produced by stretching. Numerous treatment modalities have been applied with varying success. Novel approaches include treatments with various types of lasers with the flashlamp-pumped pulsed dye laser (PDL; 585 nm) being the most commonly reported. Very recently, fractional photothermolysis has been suggested as an effective method for the treatment of SD. Here, we report on the effect of an ablative Erbium:YAG fractional laser in two cases of axillary SD in comparison with a 585-nm PDL.

Treatment of leg vein telangiectases: 1-year results with a new 940 nm diode laser.

BACKGROUND: Short-term results obtained with a 940 nm diode laser indicate that this laser is effective in the treatment of leg vein telangiectasia. Long-term studies are needed to evaluate the definitive clinical end results. OBJECTIVE: To evaluate long-term results in the treatment of leg vein telangiectasia with a 940 nm diode laser and to compare these with short-term results. METHODS: Twenty patients were treated with 940 nm diode laser, 300-350 J/cm2, 40-70 msec, 1 mm spot, single pass. Photographs for evaluation of clearance were taken before treatment and 4 weeks and 12 months after the last treatment. RESULTS: At 12 months follow-up, clearing rates were greater than 75% in 15 patients (75%) and 50-75% in 5 patients. In 7 patients (35%) the clearing rate had improved considerably during follow-up. CONCLUSION: Definitive results with the 940 nm laser occur only after prolonged follow-up. They are considerably better than the short-term results.

Single-cell analysis of CD30+ cells in lymphomatoid papulosis demonstrates a common clonal T-cell origin.

Lymphomatoid papulosis (LyP) represents an intriguing cutaneous T-cell lymphoproliferative disorder with a histologic appearance resembling malignant lymphoma. This finding strongly contrasts with the benign clinical course of the disease. However, in 10% to 20% of cases, LyP can precede, coexist with, or follow malignant lymphoma. In these cases, the same T-cell population has been shown to be present in the LyP as well as in the associated lymphoma. In most LyP cases, there is-despite the sometimes extremely long course of the disease-no evolution of a secondary lymphoma. The investigation of these uncomplicated LyP cases for the presence of clonal T-cell receptor rearrangements has produced heterogeneous results. This might be explained by biologic or technical reasons arising from analyzing whole tissue DNA extracts. To definitively clarify whether the large atypical CD30(+) cells in LyP without associated lymphoma all belong to the same clone or represent individually rearranged T cells, we analyzed the T-cell receptor-gamma rearrangements of single CD30+ as well as of single CD30- cells isolated from 14 LyP lesions of 11 patients. By using this approach we could demonstrate that the CD30+ cells represent members of a single T-cell clone in all LyP cases. Moreover, in 3 patients the same CD30+ cell clone was found in anatomically and temporally separate lesions. In contrast, with only a few exceptions, the CD30- cells were polyclonal in all instances and unrelated to the CD30+ cell clone. Our results demonstrate that LyP unequivocally represents a monoclonal T-cell disorder of CD30+ cells in all instances.