Evaluation of clinical improvement in acne scars and active acne in patients treated with the 1540-nm non-ablative fractional laser.

INTRODUCTION: Acne is a characteristic condition of puberty; however, adults who continue to have acne outbreaks frequently attend dermatology clinics. Two conditions-active acne and residual scarring-often co-occur in these patients. The objective of the present study was to evaluate the improvement in scarring and active acne after treatment with a 1540-nm erbium: glass fractional laser. MATERIAL AND METHODS: The authors treated 20 patients with acne and scarring. Each patient received panfacial treatment in four sessions with a 1-month interval between sessions. Patients, the treating physician and a blinded observer evaluated the results in four areas: improvement in scars, improvement in pores, improvement in acne, and improvement in sebum secretion. Improvements were graded using the Global Aesthetic Improvement Scale. The evaluation was made 12 weeks after treatment finished. RESULTS: Patients presented an improvement in both acne and scars. In 80 percent of cases, patients felt that the appearance of the scars had improved, and the improvement was classified as very much improved in 40 percent. In 85 percent of cases, patients felt that active acne had improved, and the improvement was classified as very much improved in 45 percent. Pore size was evaluated as improved by 75 percent of patients. Sebum secretion improved in 80 percent of cases. CONCLUSION: A 1540-nm non-ablative fractional laser provides effective treatment of acne scars. Patient satisfaction is high and active acne lesions improve significantly. Treatment of this mixed condition (scarring and active acne) with a single device is reliable, with a favorable safety profile and a high degree of patient acceptance.

Periocular vitiligo with onset around a congenital divided nevus of the eyelid.

Leukoderma in association with congenital melanocytic nevi is a rare phenomenon; nevertheless several reports have been published in the literature. We present a 15-year-old boy born with a pigmented lesion on the lower and upper eyelid diagnosed as a congenital divided nevus of the eyelid. At the age of 13, he developed a depigmented area around the nevus and was diagnosed at first as having a halo nevus in a congenital nevus. Over the next two years, an area of depigmentation appeared around the contralateral eye. At the present time, the patient has bilateral periocular depigmentation. Congenital divided nevus of the eyelid is a rare lesion, and no reports have been published to date of depigmentation in association with this lesion. Our patient presented with depigmentation around the nevus as in a halo nevus phenomenon, although at the present time, the depigmented area has a symmetric periocular distribution, and therefore can be labeled as periocular vitiligo associated with a congenital divided nevus.

Reacción cutánea secundaria a tratamiento con Iressa (ZD1839) / Skin reaction secondary to treatment with Iressa (ZA1839)

Iressa (gefitinib) es un nuevo agente antineoplásico utilizado en varios tumores sólidos. Actúa inhibiendo la actividad del receptor del factor de crecimiento epidérmico (EGFR), concretamente impidiendo la activación de la tirosinquinasa de dicho receptor. Presentamos un paciente varón de 78 años, diagnosticado de carcinoma epidermoide no microcítico de pulmón en estadio avanzado, que comenzó tratamiento con Iressa. A los pocos días de iniciar este tratamiento aparecieron lesiones pustulosas y papulosas localizadas en cara, nuca, tórax y axilas. La biopsia de una de ellas fue compatible con una foliculitis pustulosa. La suspensión temporal del tratamiento con Iressa indujo una rápida mejoría de las lesiones. Al reintroducir el fármaco las lesiones no volvieron a ser tan intensas, lo que permitió continuar con el tratamiento. Se desconoce el mecanismo por el que aparece una foliculitis pustulosa en pacientes tratados con Iressa (AU)