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Journal of Cosmetic Dermatology Sep 2017Light-based devices have been used to treat cutaneous vascular lesions almost since the original development of the laser. After the introduction of the initial... (Review)
Review
BACKGROUND
Light-based devices have been used to treat cutaneous vascular lesions almost since the original development of the laser. After the introduction of the initial continuous wave and pulsed laser systems, the pulsed lasers became the gold standard device. Since then, new devices and methods to treat patients have been introduced.
OBJECTIVE
To review and summarize the current literature specific to treatment of cutaneous vascular lesions with light-based devices.
METHODS
A review of the current literature of light-based devices used for the treatment of vascular lesions.
RESULTS AND CONCLUSIONS
New systems continue to be developed to treat vascular lesions with advantages and disadvantages compared to older devices. Nonlaser sources such as intense pulsed light and radiofrequency devices can also be used in the treatment of these patients. Newer approaches may lead to even better results.
Topics: Humans; Laser Therapy; Lasers, Dye; Lasers, Solid-State; Skin Diseases, Vascular
PubMed: 28703427
DOI: 10.1111/jocd.12370 -
International Journal of Dermatology Feb 2022The current scenario and position of laser and light-based therapies (LLBT) in the therapeutic rosacea scheme are lacking evidence-based recommendations and comparisons... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The current scenario and position of laser and light-based therapies (LLBT) in the therapeutic rosacea scheme are lacking evidence-based recommendations and comparisons on efficacy and tolerability among different devices. This article aimed to systematically compare the efficacy, acceptability, and tolerability of the pulsed dye laser (PDL) versus other devices.
METHOD
A literature search was conducted in March 2020. Four domains were analyzed throughout the following six outcomes: Spectrophotometer erythema index and percentage of reduction for background erythema, telangiectasia grading scale for telangiectasias, visual analog scale for pain, and physician's assessment and patient's satisfaction for treatment success.
RESULTS
Our search yielded 423 potentially relevant studies. After removing the excluded and duplicated records, 12 records were assessed for eligibility in the meta-analysis. Erythema (RR:0.38 95%CI: -0.20-0.95), telangiectasias (RR:0.54 95%CI: -0.87-1.94), and the treatment success throughout the physician's assessment (RR:1.23 95%CI: 0.74-2.04) and the patient's satisfaction (RR:1.15 95%CI: 0.73-1.82) were not significantly different between pulsed dye laser and other LLBT. In the pain domain, PDL was as painful as other LLBT (RR:-0.23 95%CI: -0.96-0.49) but more painful than neodymium: yttrium-aluminum-garnet laser (RR:0.84 95%CI: 0.53-1.14) and less than intense pulsed light (RR:-1.18 95%CI: -1.56-0.80).
CONCLUSION
This work based on previously published literature demonstrates that the quality of evidence to support any recommendation on LLBT in rosacea is low-to-moderate. Among all the available devices, PDL holds the most robust evidence, although in the meta-analysis the effectiveness was comparable to other LLBT, such as neodymium: yttrium-aluminum-garnet laser (Nd-YAG) or IPL.
Topics: Erythema; Humans; Lasers, Dye; Lasers, Solid-State; Low-Level Light Therapy; Rosacea
PubMed: 34089264
DOI: 10.1111/ijd.15680 -
Journal of Cosmetic Dermatology Sep 2021To compare the efficacy and complication of minimal invasion and combined pulsed dye laser/Nd:YAG laser and traditional surgical excision in the treatment of facial...
OBJECTIVES
To compare the efficacy and complication of minimal invasion and combined pulsed dye laser/Nd:YAG laser and traditional surgical excision in the treatment of facial epidermoid cyst.
METHODS
A total of 100 patients with facial epidermoid cyst aged from 16 to 65 years and cyst diameter ranged from 0.3 to 3.0 cm were treated and followed up. Patients were divided into the minimal invasion and combined pulsed dye laser/Nd:YAG laser treatment group and traditional surgical excision group. All patients were followed up for 12 months including scar size, recurrence rate, incidence of complications, and patient global satisfaction.
RESULTS
The mean operative time in the minimal invasion and combined pulsed dye laser/Nd:YAG laser treatment was 15.23 ± 7.02 minutes, which is significantly shorter than that of surgical excision (27.26 ± 10.12 minutes, P < .05). After 12 months, the average scar size in minimal invasion and combined pulsed dye laser/Nd:YAG laser group was 0.54 ± 0.35 cm, while that of traditional surgical excision group was 1.77 ± 0.81 cm (P < .05). No statistical difference was found between two groups in the wounds split, hematoma, early and late recurrence rates (P > .05), while the patients' global satisfaction in the pulsed dye laser/Nd:YAG laser group is much higher than that of the traditional surgical excision group.
CONCLUSION
The treatment of minimal invasion and combined pulsed dye laser/Nd:YAG laser is effective and safe for medium-size facial epidermoid cysts. For facial epidermoid cyst ranging for 0.3 cm to 3.0 cm, considering the cosmetic factors, minimal invasion and combined pulsed dye laser/Nd:YAG laser should be particularly recommended.
Topics: Epidermal Cyst; Humans; Lasers, Dye; Lasers, Solid-State; Neoplasm Recurrence, Local; Pilot Projects; Treatment Outcome
PubMed: 33569899
DOI: 10.1111/jocd.13994 -
Cutis Jul 2014Rosacea is a chronic inflammatory disease that predominantly affects facial skin in light-skinned individuals and can be divided into 4 subtypes. Patients can display... (Review)
Review
Rosacea is a chronic inflammatory disease that predominantly affects facial skin in light-skinned individuals and can be divided into 4 subtypes. Patients can display signs of more than 1 subtype. Diffuse facial erythema is a common finding in rosacea patients and can lead to persistent erythema. Although there is no cure for rosacea, reduction of signs and symptoms can be achieved via various treatment modalities. This article reviews devices and topical agents currently available for the management of rosacea.
Topics: Administration, Cutaneous; Adrenergic alpha-Agonists; Dermatologic Agents; Evidence-Based Medicine; Humans; Intense Pulsed Light Therapy; Lasers, Dye; Lasers, Solid-State; Niacinamide; Photochemotherapy; Quality of Life; Rosacea; Sunscreening Agents; Treatment Outcome; Vitamin B Complex
PubMed: 25101340
DOI: No ID Found -
Dermatologic Surgery : Official... Apr 2021
Topics: Face; Humans; Lasers; Lasers, Dye; Phototherapy; Postoperative Complications; Rhytidoplasty; Telangiectasis
PubMed: 32205743
DOI: 10.1097/DSS.0000000000002374 -
QJM : Monthly Journal of the... Jun 2015Infantile hemangiomas (IH) are common pediatric tumors. This meta-analysis was performed to review the therapeutic efficacy and safety of pulsed dye laser (PDL) in the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Infantile hemangiomas (IH) are common pediatric tumors. This meta-analysis was performed to review the therapeutic efficacy and safety of pulsed dye laser (PDL) in the treatment of IH.
METHODS
Seven databases were searched, including PubMed, OvidSP, Karger, Elsevier, EMBASE, Web of Science and Wiley Online Library. The review collected the characteristics of year of publication, hemangiomas cases, prior treatment, laser parameters, adverse side, pretreatment symptom, and number of response from all articles.
RESULTS
A total of 1580 studies were identified, the first round search retrieved 39 articles met inclusion criteria. Of those, only 13 articles with 1529 hemangiomas were included in the meta-analysis. This meta-analysis demonstrated an overall resolution rate of 89.1% with 6.28% incidence of adverse effect.
CONCLUSION
PDL may be the effective modality to decrease the proliferative phase and accelerate rates of involution and resolution with few adverse events.
Topics: Female; Hemangioma; Humans; Infant; Lasers, Dye; Male; Skin Neoplasms; Treatment Outcome
PubMed: 25376585
DOI: 10.1093/qjmed/hcu206 -
Archives of Dermatological Research Nov 2023Port-Wine Stains are a congenital vascular malformation that affect 0.3-0.5% of newborns. It is a benign capillary malformation that commonly occurs on the head and... (Review)
Review
Port-Wine Stains are a congenital vascular malformation that affect 0.3-0.5% of newborns. It is a benign capillary malformation that commonly occurs on the head and neck. It is formed by progressive dilation of the post-capillary venules, and as the patient ages it may be associated with hypertrophy and nodularity which can lead to cosmetic disfigurement and psychological aggravation. There are many choices of treatment such as cryosurgery, cosmetic tattooing, and dermabrasion, amongst others. The treatment of choice is pulse dye laser (PDL) because it is both effective and safe to use. In darker skin types (Fitzpatrick skin types IV-VI), treatment is more difficult. Caution when treating darker skin types with PDL comes from the fact that there is an inverse correlation between vessel specificity of the PDL and skin pigmentation. In this review, we will be reviewing the literature and discussing the manuscripts that describe the treatment of PWS on patients with fitzpatrick skin type IV-VI. Authors searched the PubMed Medline in the English language from database inception through December 2022 for eligible articles. The keywords searched included "PDL," "pulse dye laser," "skin of color," "Fitzpatrick skin types IV-VI," "fitzpatrick," "pigmented skin," "Port-wine stain," "PWS", and "pulse dye laser." The articles that were included discussed PDL in the treatment of PWS in patients of skin of color. Any additional similar articles that were cited in our search were also included. Articles that were excluded did not discuss Fitzpatrick skin types IV-VI, darker skin type, or PDL. Data collected from each article included the number of participants, Fitzpatrick skin type, age, and laser parameters. There were 120 articles that were reviewed from our search and a total of nine articles met inclusion criteria with 241 patients that were considered Fitzpatrick skin type IV-VI. The patients were of a wide range of ages from 1 month to 74 years old. In our review, patients who are treated at a younger age had better results than when treated at an older age. The results show that darker skin individuals have better results when treated at a younger age compared to adults, they can experience complete resolution. Adults who were treated saw a variation of results, from improvements in the appearance to hyperpigmentation/hypopigmentation or scarring of the treated area. Patients who are Fitzpatrick skin type IV-VI are at higher risk of adverse events when treated with PDL for PWS when compared to patients of other skin types. Studies show that PDL can be beneficial for PWS in patients of skin of color; however, there are risks of hyperpigmentation, hypopigmentation, and scarring that are important to take into consideration when treating these patients. Further research is warranted to improve the understanding of PDL for PWS in patients of skin of color.
Topics: Adult; Humans; Infant, Newborn; Port-Wine Stain; Lasers, Dye; Cicatrix; Albinism, Oculocutaneous; Hyperpigmentation; Treatment Outcome
PubMed: 37253863
DOI: 10.1007/s00403-023-02640-3 -
Skin Research and Technology : Official... Aug 2023The Flash-lamp pulsed dye laser (FPDL) is nowadays considered the most precise laser currently on the market for treating superficial vascular lesions. In this study, we...
INTRODUCTION
The Flash-lamp pulsed dye laser (FPDL) is nowadays considered the most precise laser currently on the market for treating superficial vascular lesions. In this study, we gathered data from 10 years of experience regarding dye laser treatment of patients presenting vascular malformations such as telangiectasia, rhinophyma, port-wine stain, cherry and spider angioma and vascular tumours.
METHODS
Subjects were enrolled from 2013 to 2023 based on the vascular anomalies they presented. They underwent different treatment sessions with the FPDL device.
RESULTS
The age-range distribution by vascular anomaly confirmed that haemangiomas are typical in children while rhinophyma is a condition very common in older adults. A difference in sex distribution showed that pathologies such as telangiectasias typically affect women whereas rhinophyma is more frequent in men. Most of the treatments interested the face area but no permanent side effects were registered.
CONCLUSIONS
Our 10 years of experience with FPDL demonstrated good results in a wide range of applications for the treatment of different vascular anomalies. The absence of long-term side effects and bearable pain during the treatment makes it a valuable solution for the resolution of benign tumours also in very young patients.
Topics: Female; Humans; Male; Lasers, Dye; Retrospective Studies; Rhinophyma; Hemangioma; Vascular Malformations
PubMed: 37632184
DOI: 10.1111/srt.13427 -
Dermatologic Therapy May 2021Melasma is a recalcitrant pigmentary disease with a complex pathogenesis. Monotherapy often results in unsatisfactory results with high recurrence rate. In this review... (Review)
Review
Melasma is a recalcitrant pigmentary disease with a complex pathogenesis. Monotherapy often results in unsatisfactory results with high recurrence rate. In this review article, we evaluate efficacy of energy-based devices combination therapy for melasma. We reviewed published literature since 2010 up to November 2020 regarding adjuvant therapy of energy-based devices with other treatment modalities in the treatment of melasma. After final selection, we assessed 49 articles. Energy-based devices include lasers, non-coherent lights, radiofrequency, iontophoresis, sonophoresis, microneedling, and microdermabrasion. Adjuvant therapies other than energy-based devices were lightening agents, chemical peels, platelet rich plasma (PRP) and mesotherapy. Combination of Q-switched neodymium-doped: yttrium, aluminum, and garnet (QSNY) with either intense pulsed light therapy (IPL) or pulsed-dye laser (PDL) are recommended in recalcitrant melasma in patients with light skin photo types and with dilated skin vessels (especially with PDL). Combination of fractional microneedling radiofrequency or microneedling with QSNY leads to promising results and is a safe treatment modality, especially in darker skin types. Application of topical lightening agents in combination with laser therapy leads to higher efficacy with less adverse effects (post-inflammatory hyperpigmentation) and rebound of melasma. Combination of ablative techniques with QSNY is not recommended, due to the high risk of permanent adverse effects such as guttate hypopigmentation and exacerbation of melasma.
Topics: Combined Modality Therapy; Humans; Lasers, Dye; Lasers, Solid-State; Low-Level Light Therapy; Melanosis; Treatment Outcome
PubMed: 33665885
DOI: 10.1111/dth.14927 -
Journal of Cosmetic and Laser Therapy :... Jun 2016
Topics: Cosmetic Techniques; Humans; Laser Therapy; Lasers, Dye; Low-Level Light Therapy
PubMed: 27158801
DOI: 10.3109/14764172.2016.1174032