ABSTRACT
BACKGROUND: LONGER WAVELENGTH LASERS SUCH AS ND: YAG are considered to be the best for darker skin phototypes. OBJECTIVES: The aim of this study was to investigate the safety and efficacy of long-pulsed, 1064 nm Nd:YAG laser-assisted hair removal in relation to multiple treatment sessions and different hair types in Indian patients. METHOD: Fifty-nine adult women with skin phototypes IV and V were treated with a long-pulsed Nd: YAG laser (1064 nm, 10 mm spot size, fluence of 30-50 J/cm(2), pulse duration 15-30 ms). Six consecutive treatment sessions were given at 4-6 week intervals. The modified Ferriman Gallway system of scoring was used to grade the hairs before each treatment session and six weeks after the last therapy. Based on this grading, three main hair types were recognised: thin vellus (Grade 1), intermediate (Grade 2), and terminal hair (Grades 3 and 4). Patients were divided into three groups: achievers who converted to thin vellus hair (Grade I), responders who shifted to a lower grade but were short of reaching grade 1, and failures who did not show any change throughout the six laser sessions. RESULTS: Six weeks after six laser treatment sessions, the achievers totaled 56%, responders 23%, and failures 20% of the patient population. At the end of the 3(rd), 4(th), 5(th), and 6(th) sessions, achievers were 5, 15, 25, and 56% respectively of all the patients (P < 0.001, which was statistically significant). Achievers for terminal hair were 57.5% while it was 53.8% for intermediate hair (P = 0.9, nonsignificant). There were no permanent side effects. There were no failures in the terminal group while nearly 50% of the patients were failures in the intermediate group. CONCLUSION: Six multiple laser treatment sessions with a long-pulsed, 1064 nm Nd: YAG laser with contact cooling were found to be safe and effective for hair reduction in Indian patients with both terminal and intermediate hair. The success rate was found to improve with successive sessions. However, terminal hairs responded better than intermediate hairs.
ABSTRACT
Post-kala-azar dermal leishmaniasis (PKDL) as the name suggests, develops usually after 1-2 years of treated kala azar (KA).1 Infrequently, cases may be seen later than 2 years. A case of PKDL occurring after 10 years of treated KA is herein reported. Such a long disease-free interval may be forgotten by the patient, and if not carefully elicited in the history, the diagnosis of PKDL may be missed.