Long-pulsed Nd: YAG laser (1064 nm) versus intralesional botulinum toxin type (A) in acne vulgaris therapy: a split face study.

BACKGROUND: Acne can be considered more than a cosmetic concern due to its large impact on patients' quality of life. There are various therapeutic options for inflammatory acne, but inconvenience and undesirable side effects prompted a search for more acceptable treatments. This study aimed to compare the clinical efficacy and safety of long-pulsed Nd: YAG laser 1064 nm versus intralesional botulinum toxin type-A (BTX-A) in inflammatory acne therapy. METHODS: A prospective randomized split-face comparative study involved 30 patients with inflammatory acne. Each patient received long-pulsed Nd: YAG 1064 nm laser on one side, and intralesional BTX-A on the other side, monthly until improvement or maximum three sessions. Cases were assessed by acne lesions counting and grading of severity by Investigator's Global Assessment of acne (IGAs) at baseline, each session, and after 3 months follow-up. RESULTS: A highly statistically significant improvement in lesions count and IGAs for both sides was observed, with statistically non-significant difference between both sides at end of treatment sessions. While, after 3 months follow-up, there was a more significant improvement at laser side. CONCLUSION: Both long-pulsed Nd: YAG laser 1064 nm and intralesional BTX-A are safe and effective for acne therapy. Nd-YAG laser has a more prolonged efficacy and lower recurrence rate than intralesional BTX-A.

A combined subcision approach with either fractional CO2 laser (10,600 nm) or cross-linked hyaluronic acid versus subcision alone in atrophic post-acne scar treatment.

Different treatment options for post-acne scars exist, but with varying clinical efficacy, side effects, and prolonged downtime. This study aims to compare the efficacy and safety of combined subcision with either fractional CO2 laser or cross-linked hyaluronic acid filler (HA) versus subcision alone in the treatment of facial atrophic post-acne scars. Forty patients with atrophic post-acne scars were subjected to subcision on both sides of the face, then were randomly divided into three groups. Group I (20 patients): subcision combined with cross-linked HA filler injection at one side of the face; group II (20 patients): subcision followed by fractional CO2 at the other side of the face; and group III (20 patients): with subcision only as a control group. Treatment sessions were every month until clinical improvement or for maximum three sessions. The treatment's efficacy was assessed by Goodman and Baron's qualitative and quantitative grading systems. The two blinded investigator scores showed significant improvement in both the filler side versus subcision (p value = 0.015), and the fractional laser side versus subcision (p value < 0.001), with no statistically significant difference between both sides (p value = 0.171). Qualitative grading by Goodman and Baron scores showed that the percentage of patients with excellent improvement was higher in group 1 and group 2 than in group 3 with p value = 0.031; also the mean percentage of reduction in quantitative grading was higher in group 1 and group 2 than in group 3 with p value < 0.00. Either combined subcision with fractional CO2 laser or with cross-linked HA filler achieved superior improvement in facial atrophic post acne scars treatment with no serious side effects in this study. However, subcision only by blunt canula also had modest improvement.

Intralesional combined furosemide and digoxin in cutaneous warts treatment: A randomized controlled clinical trial.

Although being a benign lesion, Warts can affect the quality of life by causing discomfort, disfigurement, and social embarrassment besides the tendency to spread. Cutaneous wart treatment faces many challenges as the development of an antiviral drug that can eradicate the human papilloma virus (HPV) is difficult. This clinical study aimed to assess the efficacy and safety of intralesional combined furosemide and digoxin in the treatment of multiple cutaneous warts. This double blinded randomized clinical trial included 80 adult patients with multiple cutaneous warts (≥2 warts) who were randomized into two groups, Group I (40 patients) treated with intralesional combined furosemide and digoxin and Group II (40 patients) who were treated with intralesional normal saline solution as a control group, weekly till improvement or for maximum five sessions. Clinical and dermoscopic evaluation at baseline, every session, and monthly for 6 months after the last session to detect any recurrence was performed. Complete wart clearance was observed in 92.5% of patients in the intralesional combined furosemide and digoxin group (Group I) compared with 10.0% in saline group (Group II), with highly statistically significant difference (P-value = 0.000). Pain during injection in 95.0% and 45.0% of patients in Group I and Group II respectively, treatment group was superior compared to control group. Intralesional injection of combined furosemide and digoxin can be a safe and effective treatment option in multiple cutaneous warts with minimal side effects in this study.