Veterinary Dental Photobiomodulation: Assessing Post-Treatment Gingival Inflammation in Canines.

Objective: This research aims to determine the effect photobiomodulation treatment has on oral inflammation after routine dental prophylaxis in canines. Background: Photobiomodulation therapy after dental procedures has been documented to reduce inflammation in human and animal models. Methods: Canines were randomly assigned into three groups: control group (CG; n = 15), left side treated group (LTG; n = 15), and right side treated group (RTG; n = 15). The canines in the treatment groups received four points of irradiation [GaAlInP-650 nm, continuous wave (CW), 0.1 W, 0.2 W/cm2, 100 sec, 10 J, 20 J/cm2]. The gingiva was evaluated by a veterinary investigator blinded to the treatment groups for erythema and edema on the day following treatment. Student's t-test and Student's paired t-test were used for data analysis. Results: Reductions in composite inflammation (p = 0.008) and erythema (p = 0.030) were observed in the LTG relative to the CG at the location of the left dental arcade. Reductions in composite inflammation (p = 0.025) and erythema (p = 0.013) were also observed in the combined treated arcades of the LTG and RTG when compared to the CG. Conclusions: The results indicate that the canines who received a single photobiomodulation treatment on the left dental arcade demonstrated a decrease in inflammation and erythema.

Prospective study of Q-switched Nd:YAG laser treatment of hyperpigmented split-thickness skin grafts.

Hyperpigmentation of split-thickness skin grafts (STSGs) is commonly found among Asians, and it is also challenging to treat. Although the 1064-nm Q-switched Nd:YAG laser has been used as a standard treatment for skin hyperpigmented lesions, there are limited number of reports focusing on the treatment of hyperpigmentation of STSGs. We aimed to evaluate the efficacy of 1064-nm Q-switched Nd:YAG laser for treatment of hyperpigmented STSGs. Half of each STSGs was treated with the 1064-nm Q-switched Nd:YAG laser, while the remaining was left untreated as comparison. The laser was applied for 4 times with 2-4-week interval. The treatment outcomes were compared by measurement of melanin index, erythema index, and photographs of STSGs at prior to enrollment, before each treatment session, and after 1 month of treatment completion. Five patients with 11 skin graft lesions were enrolled. The melanin index was significantly improved after the 2nd session and after treatment completion in laser-treated area (p = 0.006 and p = 0.001, respectively). There was non-significant difference in erythema index. The photographic comparison showed brightened of laser-treated area after treatment completion and improved skin texture. The 1064-nm Q-switched Nd:YAG laser can significantly reduce melanin index of STSGs and can be an alternative treatment for hyperpigmentation of STSGs.

Therapeutic effects of a new invasive pulsed-type bipolar radiofrequency for facial erythema associated with acne vulgaris and rosacea.

Facial erythema from rosacea and acne is one of the most common problems encountered in dermatologic clinics. Effective therapeutic interventions for persistent erythema, which can cause patients frustration and psychological distress, are needed. The aim of this study was to evaluate the efficacy and safety of an invasive short pulsed-type bipolar radiofrequency device (IPBRF) for the treatment of intractable facial erythema. Thirty-one patients who had been diagnosed with rosacea or acne vulgaris and combined erythema underwent at least two IPBRF treatment sessions (maximum: 5) at 2-week intervals. Treatment outcomes were evaluated by investigator global assessment (IGA) based on clinical photographs, patient global assessment (PGA) score, and skin biophysical parameters including erythema index (EI), melanin index (MI), and transepidermal water loss (TEWL). Most patients showed significant clinical improvement. IGA scores for erythema, pores and smoothness improved after treatment. PGA also showed a trend toward improvement. Mean EI was significantly improved after the second treatment compared to baseline, which maintained until the study period. MI and TEWL showed a tendency toward improvement. There were no serious adverse events reported during the study. IPBRF led to rapid clinical improvement in facial erythema associated with rosacea and acne vulgaris and could be an effective and safe treatment option.

Local and systemic effects of low-level light therapy with light-emitting diodes to improve erythema after fractional ablative skin resurfacing: a controlled study.

Therapy with light-emitting diodes (LED) has been associated with the reduction of erythema and accelerated wound healing. LED phototherapy has been used in various clinical practices including post-laser wound healing enhancement. Fractional laser resurfacing is one of the popular dermatological procedures; however, the duration and degree of downtime may limit daily life activity and studies on the effect of LED low-level light therapy (LED-LLLT) on post-ablative laser wound care are still limited. To evaluate local and systemic effects of LED-LLLT on post-ablative laser erythema and wound healing acceleration after fractional ablative laser resurfacing. The study was divided into two arms. First, a prospective split-face randomized controlled and single-blinded study involved 17 patients (split-face group) to determine the local and systemic effect of LED-LLLT. Patients with acne scars or rhytides were treated with a single session of fractional CO2 laser followed by 830/590 nm LED-LLLT on one side of their faces. The duration of post-laser erythema, the erythema index, and transepidermal water loss were collected at baseline, and compared with 7-daily follow-up visits posttreatment for the non LED- and LED-treated sides. The second controlled arm of the study was performed on an additional 19 subjects (CO2 group). The patients received a single fractional CO2 laser treatment without any LED-LLLT with the same follow-up protocol. All measurements were compared with the results from the patients from the split-face group. In the split-face group, the duration of erythema post laser was equal (7.4 ± 2.8 days). No significant reduction in the erythema index and transepidermal water loss was seen in the LED-treated vs the non-treated side (p values = 0.99 and 0.78 respectively). For the second part of the study that compared the results between the split-face group and the control CO2 only group, the duration of the post-laser erythema was comparable (p value = 0.32). However, the percentage difference of the erythema index from baseline in the split-face group was significantly lower than the CO2 group on days 1, 4, 5, and 7 post-laser treatment (p value = 0.03 on days 1, 4, 5, and 0.04 on day 7) and the LED-treated side provided the lowest percentage difference of the erythema index followed by the non LED-treated side compared with the control CO2 only group. 830/590 nm LED-LLLT may provide both local and systemic effects on the degree of post-ablative laser erythema in human skin, however, appropriate protocol settings should be considered to achieve a significant clinical outcome.

Use of a novel 589-nm solid-state laser for treatment of facial erythema.

OBJECTIVE: To evaluate the efficacy and safety associated with use of a 589-nm solid-state laser for treatment of facial erythema. METHODS: A prospective, IRB-approved study was conducted. Participants who were interested in treatment for facial erythema were recruited. They received four monthly treatments with the 589-nm laser. Erythema of the right and left face was graded on a scale of 0-4, 4 being most severe, by both investigators and participants prior to each treatment and at follow-up. Safety was assessed by any reported side effects. RESULTS: Twenty-four participants enrolled in the study, 16 women (67%) and 8 men (33%), with an average age of 51.1 years. Investigator grades showed a statistically significant improvement in erythema of 31% for both the right and left face. Participant grades showed a statistically significant improvement in erythema of 23.2% for the right face and 22.8% for the left face. Side effects were limited to transient erythema posttreatment. CONCLUSION: A 589-nm solid-state laser achieved a modest improvement in facial erythema when evaluating results 1 month after four monthly treatments. No major safety issues were reported.

Comparison of efficacy between long-pulsed Nd:YAG laser and pulsed dye laser to treat rosacea-associated nasal telangiectasia.

BACKGROUND: Rosacea is characterized by erythema on face, especially erythema and linear telangiectasia on the nose. Currently, various vascular lasers are used for treatment, and among them, are long-pulsed Nd:YAG(LPNY) and pulsed dye laser (PDL). OBJECTIVES: This study compared the efficacy of LPNY and PDL in treating rosacea-associated nasal telangiectasia. METHODS: Patients with rosacea who showed erythema and telangiectasia on the nose were included. Each patient was treated with PDL on the left side of the nasal bridge, and LPNY on the right side, three times with 4-week intervals. At the end of the treatment, two independent dermatologists evaluated overall treatment response compared with baseline. RESULTS: The physician's assessment of treatment concluded that good improvement was seen in six PDL and seven LPNY patients, and excellent improvement five PDL and four LPNY patients. There was no significant difference (p = 0.62, 95%CI) between the groups. Overall improvement was similar; however, LPNY induced a greater response in thick, dilated vessels, while erythema with mild telangiectasia was more responsive to PDL. CONCLUSION: Both LPNY and PDL are effective in treating rosacea-associated nasal telangiectasia. If LPNY is used properly to avoid side effects with careful consideration, it can also be used as a good modality.

Granuloma annulare treated with narrowband UVB phototherapy.

Granuloma annulare is a benign cutaneous inflammatory disease, whose lesions have spontaneous improvement in two years in 50% of cases, but there is recurrence in 40% of patients. Treatment may be topical, intralesional or systemic. The use of phototherapy with narrowband UVB is highlighted, whose mechanism of action in this disease is still unclear, probably related to the inhibition of T lymphocytes. Herein, a case of a disseminated granuloma annulare of difficult therapeutic management is described. It was treated with narrowband UVB phototherapy twice a week for six months, with good clinical improvement, being a good low-risk therapeutic option and that, in this case, provided quick and satisfactory response.

Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood.

The high prevalence of acne vulgaris in teenagers has increased comorbidities. Lasers offer alternative options for acne treatment because they have rapid action, low systemic adverse effects, and do not require everyday treatment. To study the efficacy and patients' satisfaction of 595-nm pulse dye laser (PDL) treatment of acne vulgaris and acne erythema in adolescents and early adulthood, we designed a blocked-randomized, split-faced 595-nm PDL (fluence 8 J/cm3 pulse duration 10 ms, spot size 7 mm, 2 session every 2 weeks) study in patients with mild to moderate acne by comparing the laser-treated and non-treated side. The acne lesion counts, acne erythema grading, and acne severity grading were evaluated at baseline and 2, 4, and 8 weeks. Thirty patients were recruited. The results showed no statistically significant difference except the papule count at week 4 which was -1.828 on the treated side and 0.103 on the non-treated side of the face, P-value 0.0018. There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face. The mean scores of patients' satisfaction on the laser-treated side were 75, 81, and 81%, respectively. The PDL treatment in this study reveals no significant improvement in acne therapy; however, the patients were satisfied with this laser treatment.

Granuloma annulare treated with narrowband UVB phototherapy

Abstract Granuloma annulare is a benign cutaneous inflammatory disease, whose lesions have spontaneous improvement in two years in 50% of cases, but there is recurrence in 40% of patients. Treatment may be topical, intralesional or systemic. The use of phototherapy with narrowband UVB is highlighted, whose mechanism of action in this disease is still unclear, probably related to the inhibition of T lymphocytes. Herein, a case of a disseminated granuloma annulare of difficult therapeutic management is described. It was treated with narrowband UVB phototherapy twice a week for six months, with good clinical improvement, being a good low-risk therapeutic option and that, in this case, provided quick and satisfactory response.

Single-center experience with potassium titanyl phosphate (KTP) laser for superficial cutaneous vascular lesions in face.

BACKGROUND AND OBJECTIVES: Superficial cutaneous vascular lesions (SCVLs) are quite common. Several types of lasers have been used to treat these lesions; however, there are no dedicated treatment guidelines and few studies in the literature addressed their treatment. AIMS: In this paper, we aimed to report our clinical experience with potassium titanyl phosphate (KTP) laser treatment on different types of facial SCVLs including telangiectasia, spider angioma, and erythema. METHODS: Data were retrospectively collected from 146 patients with SCVLs, who had been treated with the 532-nm wavelength laser at our outpatient dermatology clinic. Treatment responses were graded as four groups: clearance (> 75% improvement compared with the previous session), marked improvement (50-75%), partial improvement (25-50%), and no response (< 25%). RESULTS: The rate of clearance plus marked improvement (favorable outcome) was 66.1% for telangiectasia group, 93.5% for spider angioma group, and 26.7% for erythema group. Mean number of treatments was 2.9 ± 1.4 for telangiectasia group, 1.4 ± 0.8 for spider angioma group, and 2.9 ± 1.7 for facial erythema group. Only minimal adverse effects related to treatment procedure were detected in 5 out of 146 (3.4%) patients. CONCLUSIONS: Our results demonstrated that KTP laser might be a safe and effective laser modality for SCVLs, which may be associated with physiological problems due to cosmetic concerns.

A review of the quality of life following pulsed dye laser treatment for erythemotelangiectatic rosacea.

Rosacea is a chronic condition, affecting up to 10% of the population. It has a negative impact on patients' quality of life (QOL), leading to loss of self-confidence, emotional distress and withdrawal from normal societal interactions. Erythemotelangiectatic (ET) rosacea is a frequent reason for consultation and difficult to treat, as vascular signs such as flushing, erythema and telangiectasia often persist despite medical therapy. Several studies have demonstrated objective improvements in vascular signs following pulsed dye laser (PDL) treatment, but very few have investigated improvement in QOL. We reviewed the current literature to find evidence for the effect of PDL on QOL in ET rosacea.

Comparison of 532 nm Potassium Titanyl Phosphate Laser and 595 nm Pulsed Dye Laser in the Treatment of Erythematous Surgical Scars: A Randomized, Controlled, Open-Label Study.

BACKGROUND: The pulsed dye laser (PDL) has long been used for treatment of erythematous and hypertrophic scars. Its effectiveness has been attributed in large part to its vascular-specificity. The vascular-specific potassium titanyl phosphate (KTP) laser has also been reported to be clinically effective for scars, but has not been compared to the PDL. OBJECTIVE: To compare the safety and clinical efficacy of a 532-nm KTP laser versus a 595-nm PDL in improving the appearance of erythematous surgical scars. METHODS: Twenty patients with matched bilateral erythematous surgical scars or a single linear erythematous scar measuring longer than 5 cm were enrolled in the study. Single scars were divided into equal halves with each half randomized to receive 3 successive treatments at 6-week intervals with either a 532-nm KTP laser (Excel V; Brisbane, CA) or a 595-nm PDL (Cynergy; Cynosure Inc., Chelmsford, MA) at equivalent laser parameters. Bilateral matched scars were similarly randomized to receive three 532-nm KTP or 595-nm PDL treatments. Clinical efficacy was evaluated 12 weeks after the third (final) laser treatment by independent, blinded photographic scar assessments. Secondary evaluations included final investigator and subject treatment/satisfaction assessments, Vancouver scar scale (VSS) scores, subject scar symptoms, intraoperative pain scores, and incidence of side effects. RESULTS: Clinical improvement of erythematous surgical scars was observed with both 532-nm KTP and 595-nm PDL systems. No statistically significant differences between the 2 treatment arms were noted in the independent, blinded photographic scar assessments, investigator and subject treatment/satisfaction assessments, subject scar symptoms, and intraoperative pain scores. The KTP arm produced statistically significant improvement for the vascularity component of the VSS only. Side effects were limited to mild treatment discomfort and minimal transient post-treatment erythema and purpura. No vesiculation, infection, scarring or other adverse events were experienced. Subject satisfaction surveys mirrored the observed clinical effects. CONCLUSION: The-532 nm KTP laser is comparable in efficacy and safety to the 595-nm PDL laser in the treatment of erythematous surgical scars.

Eosinophilic annular erythema: successful response to ultraviolet B therapy.

Eosinophilic annular erythema (EAE) is a rare and relatively newly described eosinophil-rich dermatosis. Debate still exists as to whether it represent a subtype of Well syndrome or a separate disease entity. We report an 8-year-old boy with a 4-year history of recurrent, asymptomatic annular lesions, which were diagnosed after clincopathological correlation as EAE. This condition usually runs a relapsing and remitting course with resistance to multiple treatments. Prednisolone and hydroxychloroquine have been reported as successful but the response to these was limited in this case. Complete resolution occurred after treatment with ultraviolet B (UVB) therapy. To our knowledge, this is the first report of a favourable response of EAE to such therapy.

Low-fluence 585 nm Q-switched Nd:YAG laser: a novel laser treatment for post-acne erythema.

BACKGROUND: Persistent post-acne erythema is one of the most common aesthetic sequelae to arise after active acne resolves. The treatment remains challenging due to lack of effective laser modalities. OBJECTIVES: To evaluate the safety and efficacy of a low-fluence 585 nm Q-switched Nd:YAG laser for the treatment of post-acne erythema. MATERIALS & METHODS: Twenty-five patients with post-acne erythema were treated with a low-fluence Q-switched Nd:YAG laser using the 585 nm Gold Toning™ handpiece (5 mm spot size, 5-10 ns, 0.30-0.55 J/cm(2) , 2-4 passes) for three sessions at 2-week intervals. Erythema lesion (macules) count, inflammatory acne (papules, pustules) count, erythema index, degree of post-acne erythema and overall improvement in post-acne erythema and acne scar were assessed at baseline, every 2 weeks and 6 weeks after the last treatment. Subjective degrees of satisfaction were also evaluated. Adverse events were recorded and pain was scored using a visual analog scale (VAS). RESULTS: At 6 weeks after 3 sessions of laser treatment, all patients demonstrated clinical improvement. Erythema lesion counts decreased by 20.1% (versus baseline) after the first treatment (P = 0.004), by 32.7% after the second treatment, by 46.5% at 2 weeks after the third treatment and by 58.7% at the 6-week follow-up (all P < 0.001). Significant improvements were also noted in erythema indices (22.29 ± 2.4 to 17.51 ± 1.8) and mean post-acne erythema scores after the first treatment (both P < 0.001). The mean scores of independent physician assessments were 4.04 ± 0.9 in term of the improvement of post-acne erythema and 3.44 ± 0.9 in the improvement of scarring. In addition, we could observe a significant decrease in inflammatory acne lesion counts after two laser treatments with a decrease in mean lesion counts by 67% at the 6-week follow-up. Treatment was well-tolerated and adverse effects were limited to transient erythema and edema at treatment sites. CONCLUSIONS: Low-fluence 585 nm Q-switched Nd:YAG laser treatment is safe and effective for the treatment of post-acne erythema with minimal discomfort and quantifiable improvement in the appearance of early acne scarring and inflammatory acne.

[Efficacy of pulsed-dye laser on residual red lesions of cutaneous leishmaniasis]. / Efficacité du laser à colorant pulsé sur les lésions résiduelles rouges de la leishmaniose cutanée.

BACKGROUND: Cutaneous leishmaniasis caused by Leishmania tropica can leave troublesome and unsightly lesions. Treatment of these scars remains difficult. Pulsed-dye laser (PDL) is one therapeutic approach that may improve the clinical appearance of erythematosus lesions. The purpose of this retrospective study was to evaluate the effectiveness of PDL on the residual red lesions of erythematous facial leishmaniasis in three patients. PATIENTS AND METHODS: Case no. 1: a 14-year-old girl presented an ulcerative and erythematous nodular lesion on her left cheek. One month after treatment, an erythematous lesion measuring 3 cm persisted on the patient's cheek, without atrophy or hyperpigmentation. PDL 595nm was used at the following settings: duration: 3ms; spot size: 7mm; energy: 8 j/cm(2). Case no. 2: a 43-year-old woman presented an erythematous papular lesion on her right cheek. Following treatment, a 4-cm hypertrophic, red telangiectasic lesion remained. PDL 595nm was used with the following settings: pulse duration: 3 ms; spot-size: 10mm; energy: 8 j/cm(2). Case no. 3: a 60-year-old woman presented an erythematous papular lesion on her cheek. After treatment, an infiltrated erythematous macule with surface telangiectasia measuring 3.5cm remained. PDL 595nm was also given using the following settings: pulse duration: 3 ms; spot size: 10mm; energy: 8 j/cm(2). All three patients underwent three sessions of PDL. The erythematous and telangiectasic lesions showed improvement after the initial session and had completely disappeared after the third session. Post-laser purpura subsided within around 10 days. Therapeutic response was assessed clinically by comparing photographs taken before and after treatment and follow-up lasted 12 months. DISCUSSION: Cutaneous leishmaniasis caused by L. tropica is endemo-epidemic in Morocco. A number of treatments are available for red residual lesions but thanks to its effect on erythematous and vascular lesions, PDL has been shown to provide the most reproducibly good results and is the laser method of choice for this type of scar. A recent study of the dermoscopic features of DL identified the presence of vascular patterns in 100% of cases in this infection, which may account for the efficacy of PDL. PDL results in selective thermolysis that destroys small vessels. Our study showed improvement with PDL regarding scar size, pliability, erythema and texture. Further larger-scale studies could better determine the place of PDL in treating the sequelae of cutaneous leishmaniasis.

Comparative effectiveness of nonpurpuragenic 595-nm pulsed dye laser and microsecond 1064-nm neodymium:yttrium-aluminum-garnet laser for treatment of diffuse facial erythema: A double-blind randomized controlled trial.

BACKGROUND: Facial erythema is a common symptom that responds to vascular laser treatment, but there are few comparative studies. OBJECTIVE: We sought to compare the effectiveness of microsecond 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser with nonpurpuragenic 595-nm pulsed dye laser (PDL) for diffuse facial erythema. METHODS: This was a split-face, double-blind randomized controlled trial. Bilateral cheeks received 4 treatments each at one month intervals with PDL or Nd:YAG. Spectrophotometer measurements, digital photographs, pain scores, and patient preferences were recorded. RESULTS: Sixteen patients enrolled and 2 dropped out. Fourteen patients, all skin types I to III, 57% women, mean age 42 years, completed the study and were analyzed. Spectrophotometer readings changed after both PDL (8.9%) and Nd:YAG (2.5%), but varied by treatment type, with PDL reducing facial redness 6.4% more from baseline than Nd:YAG (P = .0199; 95% confidence interval -11.6 to -1.2). Pain varied (P = .0028), with Nd:YAG associated with less pain, at 3.07, than PDL at 3.87. Subjects rated redness as improved by 52% as a result of PDL, and 34% as a result of Nd:YAG (P = .031; 95% confidence interval -34.6 to -1.94). No serious adverse events were observed. LIMITATIONS: Lasers settings are not standardized across devices. CONCLUSION: Facial erythema is safely and effectively treated with PDL and Nd:YAG. Nonpupuragenic PDL may be more effective for lighter-skinned patients, but microsecond Nd:YAG may be less painful.