Effect of Laser and Energy-based Device Therapies to Minimize Surgical Scar Formation: A Systematic Review and Network Meta-analysis.

Utilization of lasers and energy-based devices for surgical scar minimization has been substantially evaluated in placebo-controlled trials. The aim of this study was to compare reported measures of efficacy of lasers and energy-based devices in clinical trials in preventing surgical scar formation in a systematic review and network meta-analyses. Five electronic databases, PubMed, Scopus, Embase, ClinicalTrials.gov, and the Cochrane Library, were searched to retrieve relevant articles. The search was limited to randomized controlled trials that reported on clinical outcomes of surgical scars with treatment initiation no later than 6 months after surgery and a follow-up period of at least 3 months. A total of 18 randomized controlled trials involving 482 participants and 671 postsurgical wounds were included in the network meta-analyses. The results showed that the most efficacious treatments were achieved using low-level laser therapy) (weighted mean difference -3.78; 95% confidence interval (95% CI) -6.32, -1.24) and pulsed dye laser (weighted mean difference -2.46; 95% CI -4.53, -0.38). Nevertheless, low-level laser therapy and pulsed dye laser demonstrated comparable outcomes in surgical scar minimization (weighted mean difference -1.32, 95% CI -3.53, 0.89). The findings of this network meta-analyses suggest that low-level laser therapy and pulsed dye laser are both effective treatments for minimization of scar formation following primary closure of surgical wounds with comparable treatment outcomes.

Early Treatment Initiation Improves Outcomes in Nevus of Ota: A 10-Year Retrospective Study.

BACKGROUND: Nevus of Ota is a psychologically burdensome facial pigmentation birthmark common in Asian populations. Laser therapy is currently the first-line treatment, but no guidelines on when to initiate treatment have yet been established. OBJECTIVES: Our objective was to determine the correlation between treatment efficacy and safety, risk of recurrence, and age of treatment initiation in patients receiving laser therapy for nevus of Ota. METHODS: We conducted a 10-year (2008-2018) retrospective cohort study of all patients who completed a minimum of five laser treatments at Siriraj Skin Laser Center, Mahidol University, Bangkok, Thailand. RESULTS: A total of 84 patients (aged 4 months-50 years) with nevus of Ota lesions were enrolled in the study. All patients were treated with a 1064-nm Q-switched Nd:YAG or a 755-nm or 1064-nm picosecond-domain laser (or a combination thereof). Our analysis identified that initiation of laser therapy before the age of 5 years was a significant factor in reducing the number of sessions necessary to achieve aesthetic improvement (P < 0.01; 95% confidence interval [CI] 1.06-3.21). In total, 18 patients (21.4%) initiating treatment before the age of 5 years required an average of 2, 4, and 7 treatment sessions to achieve > 25, 50, and 75% of pigment lightening, respectively, whereas 66 patients (78.6%) initiating treatment after the age of 5 years required an average of 3, 7, and 11 sessions to achieve comparable clearance. The risk of postinflammatory hyperpigmentation was significantly lower in patients starting treatment before the age of 5 years (P < 0.01; 95% CI - 43.76 to - 11.94). Recurrences were not observed in patients achieving > 95% clearance. CONCLUSIONS: In our patient cohort, initiation of laser treatment for nevus of Ota before the age of 5 years significantly improved therapeutic outcomes and reduced the risk of adverse events and recurrence. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov PRS number: NCT04481178.

Squamous Cell Carcinoma within a Congenital Nevus Sebaceous: Case Report and Literature Review.

Nevus sebaceous (NS) is a benign hamartoma that typically occurs on the head and neck area at birth. Occasionally, secondary neoplasms can develop on top of the original nevus, which usually occur in the middle age. Squamous cell carcinoma (SCC) arising in NS may occur but is very rare. We report the case of a 44-year-old female with an asymptomatic erythematous papule arising within a hairless yellowish plaque on the left parietal area of her scalp for a month. An excisional biopsy was done, and the histopathologic examination revealed SCC arising in the NS.