RESUMO
Background: Acne is very common among adolescents, which may sometimes persist into adulthood, and acne scars continue to have a profoundly negative impact on quality of life. Of all the various modalities available, fractional lasers have shown effective results. Aims and Objectives: The aim of this study was to assess the efficacy and safety of fractional carbon dioxide (CO2) laser resurfacing in atrophic facial acne scars. Materials and Methods: The study included 104 subjects aged ≥18 years with atrophic acne scars on face of more than 6 months of duration recruited over a period of 1 year. All the patients were treated with fractional CO2 laser (600 W power and wavelength 10,600 nm). Four sessions of fractional CO2 laser resurfacing were done at 6-week intervals in each patient. We compared the improvement rate of scars after every session at 6-week interval, 2 weeks after the last session, and finally 6 months after the last laser session. Results: The difference between the mean baseline score (3.43) and mean final score (1.83) using Goodman and Baron's qualitative scar scale was found to be statistically significant (P = 0.001). Mean improvement increased from first treatment session to the end of the treatment course from 0.56 to 1.62 indicating the role of the number of sessions in the overall improvement of acne scars. With regard to overall satisfaction, maximum number of patients were either very satisfied (55.8%) or satisfied (25%) as compared to those who were only slightly satisfied (11.5%) or completely unsatisfied (7.7%). Conclusion: Fractional ablative laser gives excellent results in the management of acne scars and has emerged as an appealing non-invasive option for this indication. Being a safe and effective option for atrophic acne scar treatment, it can be recommended wherever available.
RESUMO
Background: Systemic sclerosis is a multisystem auto-inflammatory disease-causing fibrosis in the skin and internal organs. A frequent complication of systemic sclerosis is the limited mouth opening (LMO), a difficult-to-treat condition with only a few treatment options available. Aims and Objectives: The aim of this study was to evaluate the response of fractional carbon dioxide (CO2) laser resurfacing in LMO associated with systemic sclerosis. Materials and Methods: This was a hospital-based prospective study in which diagnosed cases of systemic sclerosis were taken. Patients who had significant LMO and who gave informed consent were included in the study. Fractional CO2 laser treatment was performed in the perioral area. Patients were assessed at baseline, after three and six sessions, and 3 months after the last session. Assessment was done by measurement of the interincisor distance (IID) using a ruler and calculation of the mouth handicap in systemic sclerosis (MHISS) scale. Results: Improvement in IID occurred 3 months after the first session with a mean gain of +5 mm (range 2-7). At 6 months, a mean gain of +8.5 mm (range 7-10) in IID was observed (P < 0.001). The MHISS score decreased by a mean of 14 (range 11-17) (P < 0.001). All patients showed improvement of mouth opening, which allowed the patients to have better phonation and the patients were able to have proper dental care posttreatment in the form of brushing of teeth and other dental procedures. The adverse effects noted in these patients included erythema that resolved spontaneously or after icing posttreatment. Other adverse effects noted were stinging and burning sensations that were mild and transient. Conclusion: Fractional CO2 laser forms a safe, effective, and well-tolerated treatment modality for improvement of LMO in systemic sclerosis. Limitations: The limitations of this study were less number of patients and no long-term follow-up.
