ABSTRACT
BACKGROUND: Hypertrophic scars are common problems and represent a challenging condition to treat. Fractional photothermolysis has been effective at resurfacing photodamaged skin, acne scars, and atrophic scars, but there are few reports on its use for hypertrophic scars. OBJECTIVE: To evaluate the safety and efficacy of 1,550-nm erbium-doped fiber laser treatment of hypertrophic scars in eight patients. METHODS: Eight patients (skin phototypes II-IV) with hypertrophic scars received monthly treatments with a 1,550-nm erbium-doped fiber laser. Energy settings ranged from 35 to 50 mJ, and eight to 10 passes were applied with treatment levels 6 to 8. An independent physician evaluator assessed the treatment response by comparing pre- and posttreatment clinical photographs using a quartile grading scale (grade 1, < or =25%=minimal to no improvement; grade 2, 26-50%=moderate improvement; grade 3, 51-75%=marked improvement; grade 4, >75%=near total improvement. RESULTS: At four weeks after the last treatment session, a mean grade of 2.4 was achieved based on an independent physician's clinical assessment. Improvement in pigmentation occurred in all hyperpigmented scars. CONCLUSION: Hypertrophic scars can be effectively and safely improved with 1,550-nm erbium-doped fiber laser treatment.
Subject(s)
Cicatrix, Hypertrophic/drug therapy , Cicatrix, Hypertrophic/radiotherapy , Lasers, Solid-State/therapeutic use , Low-Level Light Therapy/methods , Photosensitizing Agents/therapeutic use , Phototherapy/methods , Adult , Aged , Cicatrix, Hypertrophic/pathology , Dose Fractionation, Radiation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Time Factors , Treatment Outcome , Young AdultABSTRACT
Necrolytic migratory erythema is a rare skin condition that consists of migrating areas of erythema with blisters that heal with hyperpigmentation. It usually occurs in patients with an alpha islet cell tumor of the pancreas-or glucagonoma-and when associated with glucose intolerance, anemia, hyperglucagonemia, and weight loss defines the glucagonoma syndrome. We describe a 52-year-old female patient with necrolytic migratory erythema associated with glucagonoma syndrome who had metastatic disease at presentation and passed away one week after her admission. The autopsy showed a tumor in the body of the pancreas, which was diagnosed as a neuroendocrine tumor and confirmed by immunohistochemistry. The diagnosis of necrolytic migratory erythema is a matter of great importance, since it might be an auxiliary tool for the early detection of glucagonoma
