Imaging directed photothermolysis through two-photon absorption demonstrated on mouse skin - a potential novel tool for highly targeted skin treatment.

One-photon absorption based traditional laser treatment may not necessarily be selective at the microscopic level, thus could result in un-intended tissue damage. Our objective is to test whether two-photon absorption (TPA) could provide highly targeted tissue alteration of specific region of interest without damaging surrounding tissues. TPA based laser treatments (785 nm, 140 fs pulse width, 90 MHz) were performed on ex vivo mouse skin using different average power levels and irradiation times. Reflectance confocal microscopy (RCM) and combined second-harmonic-generation (SHG) and two-photon fluorescence (TPF) imaging channels were used to image before, during, and after each laser treatment. The skin was fixed, sectioned and H & E stained after each experiment for histological assessment of tissue alterations and for comparison with the non-invasive imaging assessments. Localized destruction of dermal fibers was observed without discernible epidermal damage on both RCM and SHG + TPF images for all the experiments. RCM and SHG + TPF images correlated well with conventional histological examination. This work demonstrated that TPA-based light treatment provides highly localized intradermal tissue alteration. With further studies on optimizing laser treatment parameters, this two-photon absorption photothermolysis method could potentially be applied in clinical dermatology.

Long-term removal of unwanted hair using light.

Laser (or light) hair removal, also referred to as photoepilation, is the most commonly used laser or light-based cosmetic medical procedure. The extended theory of selective photothermolysis is the basic principle for destruction of hair follicles using light. In this type of laser application the chromophore is follicular melanin. Several types of lasers and light sources have been effective for hair reduction, including the ruby, alexandrite, diode, and neodymium:yttrium-aluminum-garnet lasers and broadband, intense pulsed light sources. This article provides a broad overview of how hair can be removed using light, with an emphasis on practical considerations.

UVA1 phototherapy: a concise and practical review.

High intensity long-wavelength ultraviolet A (340-400 nm; UVA1) lamps were initially developed as skin research tools; over time they have proven to be useful for treating a number of chronic dermatoses. UVA1 units and dosimetry are strikingly different from conventional UV phototherapy. The therapeutic effect of UVA1 is related to the fact that its long wavelength penetrates the dermis more deeply than UVB. UVA1 radiation induces collagenase (matrix metalloproteinase-1) expression, T-cell apoptosis, and depletes Langerhans and mast cells in the dermis. UVA1 exposure stimulates endothelial cells to undergo neovascularization. Ultraviolet A1 exerts significant therapeutic effects in atopic dermatitis and morphea; there is also evidence for its use in other skin diseases, including cutaneous T-cell lymphoma and mastocytosis.

A new cardiac manifestation associated with woolly hair: report of two cases of woolly hair, palmoplantar keratoderma, and mitral valve regurgitation.

Two siblings (a 24-year-old woman and a 14-year-old girl) with congenital woolly hair, epidermolytic palmoplantar keratoderma, and mitral valve regurgitation are described. An interesting additional feature in one of the patients (the 14-year-old girl) was posterior subcapsular cataract. The association of woolly hair and mitral valve regurgitation has not been reported previously. The occurrence of cataract in one of our patients is also a new ophthalmologic finding in this hair shaft anomaly.

Determination of survival and hazard functions for pemphigus patients in Kerman, a southern province of Iran.

BACKGROUND: Pemphigus has in the past been associated with a high mortality rate. However, with the discovery of corticosteroids, patient median survival has improved. Our purpose was to assess median survival after confirmed diagnosis of pemphigus in patients in Kerman, a southern province of Iran. METHODS: All patients who were either admitted to the hospital or treated as outpatients in Kerman from 22 September 1987 to 22 September 1999 and who had confirmed pemphigus were included in the study. Survival was estimated using the Kaplan-Meier method, and the following variables were evaluated in a univariate analysis for an association with survival: age, sex, type of pemphigus, and type of therapy. RESULTS: A total of 55 patients (38 female and 17 male) were identified. No significant differences were found between genders. The mean age at the time of diagnosis was 46.0 years. Older groups had a lower survival rate than younger groups (P < 0.001). The majority (82%) of cases were vulgaris/vegetans, and no significant differences were found in 10-year survival for type of pemphigus (P > 0.05). The patients who had been treated with corticosteroids alone had longer median survival times than those who had been treated with corticosteroids plus azathioprine (P < 0.001). A total of 11 patients died; the median follow-up time for those still alive was 5.9 years (range 2-12 years). Estimated survival at 2, 6 and 10 years was 92.7, 86.8 and 61.5%, respectively. CONCLUSION: Overall median survival rate in patients with pemphigus was 10 years, regardless of gender or subtype of pemphigus. Survival was adversely affected by late onset. Those patients treated with immunosuppressives and corticosteroids also appeared to have reduced survival times when compared to those treated with corticosteroids alone.