Novel 532-nm Q-switched Nd: YAG laser for the treatment of melasma and rejuvenation: a prospective, randomized controlled comparison with 1,064-nm Q-switched Nd: YAG laser.

BACKGROUND: Melasma is a common pigmentary and photoaging disorder. Although various treatments, including 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QS-Nd: YAG) laser toning, are available for melasma, results are often unsatisfactory. OBJECTIVE: We aimed to determine the efficacy and safety of 532-nm QS-Nd: YAG laser (shortwave toning) in patients with melasma and facial rejuvenation. METHODS: Fifty-two patients were recruited to receive either 1,064-nm QS-Nd: YAG laser or 532-nm QS-Nd: YAG laser every 2 weeks for 8 sessions and a 2-month follow-up visit in a randomized controlled double-blinded study. The primary outcome measure was the Melasma Area and Severity Index (MASI) score. Dermoscope and high-frequency ultrasound (HFUS) were used to assess the improvement of melasma and photoaging. RESULTS: 532-nm QS-Nd: YAG laser achieved significantly higher improvement in the MASI score (P = 0.000). The Dermoscopic melasma score (DMS) displayed significant change and confirmed the improvement. HFUS showed a significant decrease in the thickness of the subepidermal low-echogenic band (SLEB) and increases in dermal thickness and dermal density in both groups (P = 0.000 for all). The rate of very satisfied responses was significantly higher in the 532-nm laser group (P = 0.001). There was no significant difference in the visual analog scale pain assessment score (P = 0.248) and recurrence rate (P = 0.734) between the two groups. CONCLUSION: 532-nm QS-Nd: YAG laser (shortwave toning) proved to be an effective and safe treatment for melasma and rejuvenation. Shortwave toning was significantly better for pigmentation clearance, while 1,064-nm laser showed better improvement in skin rejuvenation.

A prospective study on the treatment of immediate post-operative scar with narrowband intense pulsed light under polarized dermoscopy.

(a) To evaluate the efficacy and safety of narrow-band intense-pulsed light (DPL) in immediate post-operative scar. (b) To observe the process of scar formation under dermoscopy in the first 6 months. Nine patients with postoperative scars were enrolled in the randomized, prospective, split-scar study. Patients were treated in one half of the scar with DPL for cosmetic improvement at a wavelength of 500-600 nm and the other half was not treated as control. The laser treatments were initiated 2 weeks after the surgery and were given 3 times over a 4-week period. All patients were followed-up for 3 months from the last treatment. Photographs and dermoscopy digital images were collected each time. (a) Neither DPL or control produce statistically significant improvements in Vancouver Scar Scale. Moreover, comparatively, there was no statistical difference in Vancouver Scar Scale between DPL or control. However, 6 out of 9 patients treated with DPL had reduced scores in vascularity sooner compared with control. (b) Under dermoscopy, redness, and swelling were obvious from 2 weeks after surgery, but were gradually alleviated. The surface of the scar gradually became uneven and rough. DPL might be beneficial in early recovery of immediate post-operative scar.

IFN­Î³ induces apoptosis in human melanocytes by activating the JAK1/STAT1 signaling pathway.

The present study aimed to investigate the role of janus kinase (JAK)1/STAT1 in interferon (IFN)­Î³­induced apoptosis in human melanocytes. Following IFN­Î³ treatment, the viability of human melanocytes were analyzed using a Cell Counting Kit­8 assay and the apoptotic rate was determined using flow cytometry. Western blotting was also performed to analyze the phosphorylation levels of JAK1, JAK2 and the transcriptional factor STAT1, as well as the expression levels of Bcl­2, Bax, Bcl­2 homologous antagonist killer (Bak) and cleaved caspase­3. Finally, following the pretreatment with the STAT1 inhibitor fludarabine, human melanocytes were treated with IFN­Î³ and flow cytometry was used to detect the apoptotic rate. The results revealed that IFN­Î³ reduced the proliferation and induced the apoptosis of human melanocytes. In addition, IFN­Î³ treatment led to decreased expression levels of Bcl­2 and increased expression levels of Bax, Bak and cleaved caspase­3, alongside the activation of the JAK1/STAT1 signaling pathway. Conversely, the pretreatment with the STAT1 inhibitor fludarabine decreased the apoptotic rate of human melanocytes following IFN­Î³ induction. In conclusion, the findings of the present study suggested that IFN­Î³ may induce the apoptosis of human melanocytes by activating the JAK1/STAT1 signaling pathway, alongside increasing the expression levels of Bax, Bak and cleaved caspase­3, and decreasing the expression levels of Bcl­2.

Efficacy of 595nm pulsed dye laser therapy for Mibelli angiokeratoma.

OBJECTIVE: To retrospectively study the clinical efficacy of 595nm pulsed dye laser therapy for Mibelli angiokeratoma. METHODS: 50 cases of Mibelli angiokeratoma, from 10 to 41 year-old，were treated with the 595nm pulsed dye laser. The parameters were as follows: a wavelength of 595 nm, pulse duration of 10ms, spot size of 7 mm and energy fluency of 12.0-13.5 J/cm(2). The treatments were repeated at intervals of 4-6 weeks until the lesion was cleared, or the parents discontinued the treatment. Detailed demographics and the assessment of the degree of lesion clearance were statistically analyzed through SASS18.0. RESULTS: All the 50 patients were treated 1-4 times. The total rate of significant improvement was 80%, and the rate of full recovery was 30%. We failed to find statistical significance between genders, or the size and color of lesions, which might be due to limited sample size. The most common adverse effects after treatment were purpura and edema, which usually lasted for 12 h to several days. Temporary pigment alterations were not common. Other side effects such as scar or skin texture change were not observed. CONCLUSION: Our experience confirmed the clinical efficacy and safety of the 595 nm pulse dye laser in the treatment of Mibelli angiokeratoma.