Real-time, in vivo skin cancer triage by laser-induced plasma spectroscopy combined with a deep learning-based diagnostic algorithm.

BACKGROUND: Although various skin cancer detection devices have been proposed, most of them are not used owing to their insufficient diagnostic accuracies. Laser-induced plasma spectroscopy (LIPS) can noninvasively extract biochemical information of skin lesions using an ultrashort pulsed laser. OBJECTIVE: To investigate the diagnostic accuracy and safety of real-time noninvasive in vivo skin cancer diagnostics utilizing nondiscrete molecular LIPS combined with a deep neural network (DNN)-based diagnostic algorithm. METHODS: In vivo LIPS spectra were acquired from 296 skin cancers (186 basal cell carcinomas, 96 squamous cell carcinomas, and 14 melanomas) and 316 benign lesions in a multisite clinical study. The diagnostic performance was validated using 10-fold cross-validations. RESULTS: The sensitivity and specificity for differentiating skin cancers from benign lesions using LIPS and the DNN-based algorithm were 94.6% (95% CI: 92.0%-97.2%) and 88.9% (95% CI: 85.5%-92.4%), respectively. No adverse events, including macroscopic or microscopic visible marks or pigmentation due to laser irradiation, were observed. LIMITATIONS: The diagnostic performance was evaluated using a limited data set. More extensive clinical studies are needed to validate these results. CONCLUSIONS: This LIPS system with a DNN-based diagnostic algorithm is a promising tool to distinguish skin cancers from benign lesions with high diagnostic accuracy in real clinical settings.

Lip Lifting Efficacy of Hyaluronic Acid Filler Injections: A Quantitative Assessment Using 3-Dimensional Photography.

The study aimed to compare the volume enhancement and the lifting capacity of two different hyaluronic acid gels for lip injection. Thirty-six Korean female patients were randomized into two groups according to the cross-linking degree of the hyaluronic acid filler injected. Using a fixed injection protocol, patients were injected with 1 mL of hyaluronic acid filler in the lips and followed up at four and 12 weeks after injection. Lip volume, lip projection, and columella-labial angle were measured using a 3-dimensional imaging system at each time point. Follow-up values were compared with baseline. Compared with pre-treatment values, there was a statistically significant increase in mean lip volume and lip projection at four and 12 weeks after injection, with no significant differences between the two groups. Lips injected with hyaluronic acid filler of intermediate cross-link density resulted in more acute angles than lips injected with lightly cross-linked hyaluronic acid. The difference was statistically significant at each follow-up time point. No serious complications were observed throughout the study period. Our results imply that in patients who want a prominent upper lip lift, lip injections using hyaluronic acid fillers with intermediate cross-linking density can be a good option due to their lift capacity. The degree of cross-linking may not be a significant determinant of simple lip volume augmentation when other variables are constant.

Energy-based devices for the treatment of Acne Scars: 2022 International consensus recommendations.

BACKGROUND AND OBJECTIVES: Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. STUDY DESIGN/MATERIALS AND METHODS: An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. RESULTS: The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. CONCLUSION: Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.

Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations.

BACKGROUND AND OBJECTIVES: There is currently intense multidisciplinary interest and a maturing body of literature regarding laser treatments for traumatic scars, but international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the tremendous potential of laser techniques, offer recommendations for safe and efficacious treatment, and promote wider patient access guided by future high-quality research. STUDY DESIGN/MATERIALS AND METHODS: An international panel of 26 dermatologists and plastic and reconstructive surgeons from 13 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the laser treatment of traumatic scars. A three-step modified Delphi method took place between March 2018 and March 2019 consisting of two rounds of emailed questionnaires and supplementary face-to-face meetings. The panel members approved the final manuscript via email correspondence, and the threshold for consensus was at least 80% concurrence among the panel members. RESULTS: The manuscript includes extensive detailed discussion regarding a variety of laser platforms commonly used for traumatic scar management such as vascular lasers and ablative and non-ablative fractional lasers, special considerations such as coding and laser treatments in skin of color, and 25 summary consensus recommendations. CONCLUSIONS: Lasers are a first-line therapy in the management of traumatic scars and contractures, and patients without access to these treatments may not be receiving the best available care after injury. Updated international treatment guidelines and reimbursement schemes, additional high-quality research, and patient access should reflect this status. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Therapeutic efficacy and safety of a 1927-nm fractionated thulium laser on pattern hair loss: an evaluator-blinded, split-scalp study.

Laser- or light-assisted therapies have been used to improve the perifollicular environment by upregulating the expression of growth factors and signaling molecules for hair restoration. The aim of our study was to preclinically and clinically evaluate the therapeutic efficacy and safety of a 1927-nm fractionated thulium laser on pattern hair loss (PHL). An in vivo hairless mouse study and an in vivo human skin environmental scanning electron microscopy (ESEM) study were performed with different power and energy settings. Thereafter, an evaluator-blinded, split-scalp study was conducted to evaluate hair thickness and density in 10 PHL patients treated with 12 sessions of fractionated thulium laser treatment with or without post-laser treatment application of a growth factor-containing (GF) solution. In in vivo hairless mouse skin, inverted cone-shaped zones of thulium laser-induced tissue coagulation (LITC) were noted immediately after treatment in the epidermis and upper to mid-dermis without remarkable ablative tissue injury. The ESEM study revealed round to oval-shaped zones of non-ablative LITC on the surface of the stratum corneum of a human subject immediately after laser irradiation. In PHL patients, 12 sessions of thulium laser monotherapy at 1-week intervals resulted in significantly increased hair density and thickness. Post-laser treatment application of GF solution offered additional therapeutic efficacy by improving hair density and thickness on the split scalp. The use of a fractionated thulium laser with or without post-laser therapy application of GF solution to treat PHL elicited remarkable improvements in hair thickness and hair counts.

Histological and molecular analysis of the long-pulse 1,064-nm Nd:YAG laser irradiation on the ultraviolet-damaged skin of hairless mice: In association with pulse duration change.

BACKGROUND: Nonablative lasers have been widely used to improve photodamaged skin, although the mechanism underlying dermal collagen remodeling remains unclear. OBJECTIVE: To investigate the effects and the molecular mechanisms of long-pulse neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiation on dermal collagen remodeling in association with different pulse durations. MATERIAL AND METHODS: Five hairless mice were pretreated with ultraviolet B irradiation for 8 weeks. The dorsal quadrant of each mouse was then irradiated twice at 1-week intervals at a pulse duration of 1 ms, 12 ms, or 50 ms, and a constant fluence of 20 J/cm(2). The levels of dermal collagen, mRNAs of procollagens, matrix metalloproteinases (MMPs), tissue inhibitor of metalloproteinases (TIMPs), and various growth factors were analyzed after 4 weeks. RESULTS: Long-pulse Nd:YAG treatment increased the dermal collagen level. A substantial increase in the level of procollagens, MMPs, TIMPs, and various growth factors was also observed irrespective of pulse duration, with a trend toward maximal increase at a pulse duration of 12 ms. CONCLUSION: Long-pulse 1,064-nm Nd:YAG laser irradiation promotes wound-healing process, which is characterized by the induction of growth factor expression and subsequent increase in MMPs and TIMPs, followed by matrix remodeling as confirmed by new procollagen production.

Laser-Assisted Liposuction Using the Novel 1,444-nm Nd:YAG Laser for the Treatment of Gynecomastia: A Pilot Study.

BACKGROUND: Laser-assisted liposuction (LAL) is currently widely used to reduce localized fat. A novel Nd:YAG laser that uses a wavelength of 1,444 nm, which is better absorbed by fat, has recently been introduced. In this study, we investigated the efficacy of 1,444-nm Nd:YAG LAL for the treatment of gynecomastia. PATIENTS AND METHODS: Thirteen Korean male patients (20-28 years, mean age 23 years) diagnosed with gynecomastia were enrolled in this study. All patients were treated by LAL with 1,444-nm Nd:YAG laser (100 µs pulse width, 40 Hz frequency, 300 mJ pulse energy and 12 W power with continuous emission) after tumescent anesthetic infiltration and were then evaluated. Outcome was assessed using the following 4 methods: (1) clinical assessment with photographs obtained before and 12 weeks after LAL treatment, (2) comparison of pre- and postoperative patient chest circumferences, (3) computed tomography (CT) scans to evaluate changes in breast thickness and (4) a patient satisfaction survey at the end of the study. RESULTS: After 12 weeks, most patients (84.5%) showed an improvement greater than 50%. Mean chest circumference was significantly reduced from 109.6 ± 8.2 to 101.2 ± 4.4 cm 12 weeks after LAL (p < 0.001). CT scans showed a significant reduction in mean breast thickness from 22.7 ± 3.2 to 15.6 ± 2.4 mm (p = 0.016). Side effects (pain, edema, numbness and ecchymosis) were minimal and disappeared shortly after the first manifestation. CONCLUSION: Gynecomastia can be safely treated with 1,444-nm Nd:YAG LAL to reduce fatty tissue and total breast volume.

Hair regrowth through wound healing process after ablative fractional laser treatment in a murine model.

BACKGROUND AND OBJECTIVE: Alopecia is one of the most common dermatological problems in the elderly; however, current therapies for it are limited by low efficacy and undesirable side effects. Although clinical reports on fractional laser treatment for various alopecia types are increasing, the exact mechanism remains to be clarified. The purposes of this study were to demonstrate the effect of ablative fractional laser treatment on hair follicle regrowth in vivo and investigate the molecular mechanism after laser treatment. MATERIALS AND METHODS: Ablative CO2 fractional laser was applied to the shaved dorsal skin of 7-week-old C57BL/6 mice whose hair was in the telogen stage. After 12 mice were treated at various energy (10-40 mJ/spot) and density (100-400 spots/cm(2) ) settings to determine the proper dosage for maximal effect. Six mice were then treated at the decided dosage and skin specimens were sequentially obtained by excision biopsy from the dorsal aspect of each mouse. Tissue samples were used for the immunohistochemistry and reverse transcription polymerase chain reaction assays to examine hair follicle status and their related molecules. RESULTS: The most effective dosage was the 10 mJ/spot and 300 spots/cm(2) setting. The anagen conversion of hair was observed in the histopathological examination, while Wnt/ß-catenin expression was associated with hair regrowth in the immunohistochemistry and molecular studies. CONCLUSIONS: Ablative fractional lasers appear to be effective for inducing hair regrowth via activation of the Wnt/ß-catenin pathway in vivo. Our findings indicate that fractional laser treatment can potentially be developed as new treatment options for stimulating hair regrowth.

Treatment of periorbital syringoma by the pinhole method using a carbon dioxide laser in 29 Asian patients.

BACKGROUND: Pinhole method has been used to treat various types of scars and dermal tumors by making multiple small holes in target tissues of the deep dermis using an ablative 10,600-nm carbon dioxide (CO2) laser. OBJECTIVES: We prospectively investigated the efficacy and safety of using a CO2 laser to treat periorbital syringomas via the pinhole method. METHODS: A total of 29 patients with periorbital syringomas were treated with two sessions of CO2 laser treatment using the pinhole method at two-month intervals. Laser fluences were delivered under the following settings: pulse duration of 200 µs, frequency of 50 Hz, on time of 0.04, and an off time of 0.01. RESULTS: Among the 29 patients, 13 patients (44.8%) presented with small discrete papular syringomas, 10 (34.5%) had plaque-type lesions, and six (20.7%) had mixed lesions. Evaluation of the clinical results at 2 months after the second treatment session revealed marked clinical improvement (51-75%) in 10 of the 29 patients (34.5%), moderate clinical improvement (26-50%) in eight (27.6%), near-total improvement (≥ 75%) in seven (24.1%), and minimal improvement (0-25%) in four patients (13.8%). CONCLUSIONS: Our observations indicated that application of the pinhole method using a CO2 laser exerts positive therapeutic effects in Asian patients with periorbital syringomas.

Treatment of early-stage erythematotelangiectatic rosacea with a Q-switched 595-nm Nd:YAG laser.

Erythematotelangiectatic rosacea presents as persistent erythema and telangiectasia with frequent flushing and blushing on the facial and extrafacial skin. Additionally, papulopustular rosacea shows acneiform papules, pustules, and nodules with persistent plaque-form edema. Despite garnering only grade-C or -D level recommendations, a 585-nm or 595-nm flashlamp-pumped pulsed-dye laser can be considered as an effective therapeutic modality for the treatment of rosacea in patients who are refractory to topical and/or systemic treatments. In this report, treatment with a Q-switched 595-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with low non-purpuragenic fluence proved to be safe and effective in treating early-stage erythematotelangiectatic rosacea in two female Korean patients. Laser treatment for rosacea was delivered with the settings of pulse energy of 0.4-0.5 J/cm(2), pulse duration of 5-10 ns, 5-mm spot size, 5 Hz, and 500 shots. Additionally, we found that remarkable therapeutic effects were achieved for both rosacea and melasma by combining Q-switched quick pulse-to-pulse 1,064-nm Nd:YAG and Q-switched 595-nm Nd:YAG laser treatments, which required only the changing of handpieces equipped with solid dye. In conclusion, we suggest that treatment with a Q-switched 595-nm Nd:YAG laser with low fluence may provide an additional therapeutic option for treating early-stage erythematotelangiectatic rosacea.

Long pulsed 1064 nm Nd:YAG laser treatment for wrinkle reduction and skin laxity: evaluation of new parameters.

INTRODUCTION: Among non-ablative devices for wrinkle reduction and skin laxity, long pulsed 1064 nm Nd:YAG laser (LPND) has considerable effectiveness. It can penetrate to deep dermis due to its longer wavelength. This study assesses the efficacy and safety of LPND applying new parameters for skin rejuvenation in Korean subjects. METHODS: A prospective randomized split-faced study was done (n = 20). Half of the face was treated with three passes of LPND at a spot size of 12 mm, 20-24 J/cm(2) fluence, 12 ms width, and frequency of 2 Hz, for three sessions, every four weeks. Outcomes were measured by wrinkle evaluation of blinded investigators, subjects' self-assessment, objective measurements of elasticity, and skin biopsy. RESULTS: Four weeks after the final treatment sessions, the average wrinkle grades of the treated side were reduced by 45.1%. Skin elasticity was significantly increased. The increment of collagen and elastic fiber in papillary dermis was confirmed histologically. No adverse reaction was reported. Pain on the treated side was mild without needing anesthesia. DISCUSSION: The authors studied new parameters for LPND for improvement of wrinkles and skin laxity with fewer treatment sessions without serious complications. Histologic findings corresponded to clinical improvement. CONCLUSION: New parameters of LPND can achieve wrinkle improvement with few side effects.

Up-regulation of fibroblast growth factor (FGF) 9 expression and FGF-WNT/ß-catenin signaling in laser-induced wound healing.

Fibroblast growth factor (FGF) 9 is secreted by both mesothelial and epithelial cells, and plays important roles in organ development and wound healing via WNT/ß-catenin signaling. The aim of this study was to evaluate FGF9 expression and FGF-WNT/ß-catenin signaling during wound healing of the skin. We investigated FGF9 expression and FGF-WNT/ß-catenin signaling after laser ablation of mouse skin and adult human skin, as well as in cultured normal human epidermal keratinocytes (NHEKs) upon stimulation with recombinant human (rh) FGF9 and rh-transforming growth factor (TGF)-ß1. Our results showed that laser ablation of both mouse skin and human skin leads to marked overexpression of FGF9 and FGF9 mRNA. Control NHEKs constitutively expressed FGF9, WNT7b, WNT2, and ß-catenin, but did not show Snail or FGF receptor (FGFR) 2 expression. We also found that FGFR2 was significantly induced in NHEKs by rhFGF9 stimulation, and observed that FGFR2 expression was slightly up-regulated on particular days during the wound healing process after ablative laser therapy. Both WNT7b and WNT2 showed up-regulated protein expression during the laser-induced wound healing process in mouse skin; moreover, we discerned that the stimulatory effect of rhFGF9 and rhTGF-ß1 activates WNT/ß-catenin signaling via WNT7b in cultured NHEKs. Our data indicated that rhFGF9 and/or rhTGF-ß1 up-regulate FGFR2, WNT7b, and ß-catenin, but not FGF9 and Snail; pretreatment with rh dickkopf-1 significantly inhibited the up-regulation of FGFR2, WNT7b, and ß-catenin. Our results suggested that FGF9 and FGF-WNT/ß-catenin signaling may play important roles in ablative laser-induced wound healing processes.

Antifungal effects of a 1444-nm neodymium:Yttrium-aluminum-garnet laser on onychomycosis: a pilot study.

Investigations of laser- or light-assisted antibacterial and antifungal treatments have been introduced. In the present study, we investigated the antifungal activities of 1444-nm Nd:YAG lasers against onychomycosis by microbiologic analysis and scanning electron microscopy. Scraped toenails from 20 participants with mycologically confirmed onychomycosis were prepared on polystyrene weighing dishes and treated with a 1444-nm Nd:YAG laser. The samples were analyzed for the presence of colony-forming units (CFUs) and scanning electron microscopy was performed using an toenail treated with the 1444-nm Nd:YAG laser. The mean reduction rate achieved by treatment with a total energy of 300 J was 75.9% (range: 33.3-100), and by treatment with 450 J was 85.5% (range: 66.7-100). However, the difference in CFU reduction rates between the laser settings of 300 J and 450 J was not significant. Analysis by scanning electron microscope revealed numerous disintegrated spores on the lower portions of the nail plate treated with the 1444-nm laser, while the upper portion of the nail plate presented only a few small and greatly disintegrated fungal spores. Our results suggest that a Nd:YAG laser with a wavelength of 1444 nm has antifungal effects on onychomycosis. However, further investigations should be performed to determine the long-term clinical and microbiologic effects of this treatment.

Histometric changes and epidermal FGF9 expression in carbon photoenhancer-assisted Nd:YAG laser treatment.

Fibroblast growth factor (FGF)-9 plays an important role in wound healing. However, the effects of non-ablative laser treatment on the expression of FGF9 have not been fully investigated. Non-ablative 1064-nm quasi-long pulsed and Q-switched Nd:YAG laser treatments were delivered to hairless mice with and without a carbon photoenhancer. For histological and immunohistochemical analyses, sections were stained with hematoxylin and eosin as well as FGF9 antibody. Significantly, increased epidermal and dermal thickness was noted in mice treated with carbon photoenhancer-assisted quasi-long pulsed or Q-switched laser treatments compared to those treated without a carbon photoenhancer. Expression of FGF9 was observed in both the epidermis and dermis in all groups of mice during the healing process. Earlier and more pronounced expression of FGF9 was detected in mice treated with carbon photoenhancer-assisted quasi-long pulsed laser therapy. In addition, two peaks of pronounced FGF9 expression were observed, especially in mice that underwent carbon photoenhancer-assisted 1064-nm quasi-long pulsed Nd:YAG laser treatment. A carbon photoenhancer seems to enhance the effect of quasi-long pulsed and Q-switched Nd:YAG laser treatment. In addition, expression of FGF9 may play an important role in the healing process after laser treatments and could contribute to histometric changes.

Histometric analysis of skin-radiofrequency interaction using a fractionated microneedle delivery system.

BACKGROUND: Fractionated microneedle radiofrequency (RF) devices have been reported to be effective in treatment of various dermatologic disorders. OBJECTIVES: To analyze histometric changes in skin-RF interactions using a fractionated microneedle delivery system. MATERIALS AND METHODS: RF energies were delivered using a fractionated microneedle device to an in vivo minipig model with penetration depths of 0.5, 1.0, 1.5, 2.0, 2.5, and 3.5 mm; RF conduction times of 20, 50, 100, and 1,000 ms; and energy levels of 5.0, 10.0, 20.0, 25.0, 37.5, and 50.0 V. RESULTS: Immediately after treatment, skin samples showed that the RF-induced coagulated columns in the dermis formed a cocoon-shaped zone of sublative thermal injury. Four days after the treatment, skin specimens demonstrated reepithelialization, and the dermal RF-induced coagulated columns showed mixed cellular infiltration, neovascularization, and granulation tissue formation. Microneedle depth and RF conduction times, but not energy level, significantly affected histometric values of RF-induced dermal coagulation. Microneedle RF treatment affected adnexal structures by coagulating follicular epithelium and perifollicular structures. CONCLUSIONS: Our data may be of use as an essential reference for choosing RF parameters in treatment of various skin conditions.

830 nm light-emitting diode low level light therapy (LED-LLLT) enhances wound healing: a preliminary study.

BACKGROUND AND AIMS: The application of light-emitting diodes in a number of clinical fields is expanding rapidly since the development in the late 1990s of the NASA LED. Wound healing is one field where low level light therapy with LEDs (LED-LLLT) has attracted attention for both accelerating wound healing and controlling sequelae. The present study evaluated LED-LLLT in 5 wounds of various etiologies. SUBJECTS AND METHODS: There were 5 patients with ages ranging from 7 to 54 years, comprising 2 males and 3 females. The study followed 5 wounds, namely 2 acute excoriation wounds; 1 acute/subacute dog bite with infection; 1 subacute post-filler ulcerated wound with necrotic ischemic tissue and secondary infection; and 1 subacute case of edema and infection of the lips with herpes simplex involvement after an illegal cosmetic tattoo operation. All patients were in varying degrees of pain. All wounds were treated with multiple sessions (daily, every other day or twice weekly) using an LED-LLLT system (830 nm, CW, irradiance of 100 mW/cm(2) and fluence of 60 J/cm(2)) till improvement was achieved. RESULTS: Full wound healing and control of infection and discomfort were achieved in all patients, with wound condition-mediated treatment periods ranging from 1 to 8 weeks. No recurrence of the herpes simplex case was seen in a 4-month follow-up. CONCLUSIONS: 830 nm LED-LLLT successfully brought about accelerated healing in wounds of different etiologies and at different stages, and successfully controlled secondary infection. LED-LLLT was easy and pain-free to apply, and was well-tolerated by all patients. The good results warrant the design of controlled studies with a larger patient population.

Clinical effects of non-ablative and ablative fractional lasers on various hair disorders: a case series of 17 patients.

BACKGROUND AND OBJECTIVES: Both ablative and non-ablative fractional lasers have been applied to various uncommon hair disorders. The purpose of this study was to demonstrate the clinical effects of fractional laser therapy on the course of primary follicular and perifollicular pathologies and subsequent hair regrowth. MATERIALS AND METHODS: A retrospective review of 17 patients with uncommon hair disorders - including ophiasis, autosomal recessive woolly hair/hypotrichosis, various secondary cicatricial alopecias, pubic hypotrichosis, frontal fibrosing alopecia, and perifolliculitis abscedens et suffodiens - was conducted. All patients had been treated with non-ablative and/or ablative fractional laser therapies. RESULTS: The mean clinical improvement score in these 17 patients was 2.2, while the mean patient satisfaction score was 2.5. Of the 17 subjects, 12 (70.6%) demonstrated a clinical response to non-ablative and/or ablative fractional laser treatments, including individuals with ophiasis, autosomal recessive woolly hair/hypotrichosis, secondary cicatricial alopecia (scleroderma and pressure-induced alopecia), frontal fibrosing alopecia, and perifolliculitis abscedens et suffodiens. Conversely, patients with long-standing ophiasis, surgical scar-induced secondary cicatricial alopecia, and pubic hypotrichosis did not respond to fractional laser therapy. CONCLUSION: Our findings demonstrate that the use of non-ablative and/or ablative fractional lasers promoted hair growth in certain cases of uncommon hair disorders without any remarkable side effects.

A fractional 2940 nm short-pulsed, erbium-doped yttrium aluminium garnet laser is effective and minimally invasive for the treatment of photodamaged skin in Asians.

BACKGROUND: Although ablative fractional laser for the facial photodamaged skin was effective and safe, there have been only limited reports regarding the efficacy and safety of fractional Er:YAG laser treatments for photodamaged facial skin in Asians. OBJECTIVE: Our objective was to assess the efficacy and safety of the Er:YAG laser (2940 nm) using the ''ablative'' fractional resurfacing mode to treat photodamaged facial skin. METHODS: A total of 29 Korean patients were treated for photodamaged facial skin using a fractional Er:YAG laser. The number of treatments was mean 2.3 sessions at two-week intervals. Independent investigators assessed the efficacy using standardized photographs. The patients' satisfaction rate was also evaluated. RESULTS: For dyspigmentation, 62.5% of the treated patients showed improvement greater than 26%. Regarding wrinkles, 50% of the treated patients showed improvement greater than 26%. All patients showed various degrees of improvement in skin laxity. Assessing the overall features, 62.5% of the study subjects showed improvement greater than 26%, and most of them (91.7%) reported that their subjective satisfaction rate was above 'slight satisfaction'. Downtime accounted for approximately one week in most patients. CONCLUSIONS: A fractional Er:YAG laser can deliver an effective and minimally invasive treatment for photodamaged facial skin in Asians.

Immunotherapy of malignant melanoma with tumor lysate-pulsed autologous monocyte-derived dendritic cells.

PURPOSE: Dendritic cell (DC) vaccination for melanoma was introduced because melanoma carries distinct tumor-associated antigens. The purpose of this study was to investigate the efficacy and safety of DC vaccination for melanoma in Korea. MATERIALS AND METHODS: Five patients with stage IV and one with stage II were enrolled. Autologous monocyte-derived DCs (MoDCs) were cultured and pulsed with tumor-lysate, keyhole limpet hemocyanin, and cytokine cocktail for mature antigen-loaded DC. DC vaccination was repeated four times at 2-week intervals and 2-4×107 DC were injected each time. RESULTS: Reduced tumor volume was observed by PET-CT in three patients after DC vaccination. Delayed type hypersensitivity responses against tumor antigen were induced in five patients. Tumor antigen-specific IFN-γ-producing peripheral blood mononuclear cells were detected with enzyme-linked immunosorbent spot in two patients. However, the overall clinical outcome showed disease progression in all patients. CONCLUSION: In this study, DC vaccination using tumor antigen-loaded, mature MoDCs led to tumor regression in individual melanoma patients. Further standardization of DC vaccination protocol is required to determine which parameters lead to better anti-tumor responses and clinical outcomes.