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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 -
ACS Applied Materials & Interfaces Jun 2020Optofluidic lasers are an emerging technology for the development of miniaturized light sources and biological and chemical sensors. However, most optofluidic lasers...
Optofluidic lasers are an emerging technology for the development of miniaturized light sources and biological and chemical sensors. However, most optofluidic lasers demonstrated to date are operated at the single optical cavity level, which limits their applications in high-throughput biochemical sensing, high-speed wavelength switching, and on-chip spectroscopic analysis. Here, we demonstrated an optofluidic droplet laser array on a silicon chip with integrated microfluidics, in which four individual droplet optical cavities are generated and controlled by a 2 × 2 nozzle array. Arrays of droplets with a diameter ranging from 115 to 475 μm can be generated, removed, and regenerated on demand. The lasing threshold of the droplet laser array is in the range of 0.63-2.02 μJ/mm. An image-based lasing threshold analysis method is developed, which enables simultaneous lasing threshold measurement for all laser units within the laser array using a low-cost camera. Compared to the conventional spectrum-based threshold analysis method, the lasing threshold obtained from the image-based method showed consistent results. Our droplet laser array is a promising technology in the development of cost-effective and integrated coherent light source on a chip for point-of-care applications.
Topics: Lasers; Lasers, Dye; Microfluidics; Silicon; Spectrum Analysis
PubMed: 32437123
DOI: 10.1021/acsami.0c05967 -
Dermatologic Surgery : Official... Jun 2018Port wine stains (PWS) pose a therapeutic challenge. Pulsed dye laser (PDL) is the treatment of choice; however, treatment is often ineffective and recurrences are... (Review)
Review
BACKGROUND
Port wine stains (PWS) pose a therapeutic challenge. Pulsed dye laser (PDL) is the treatment of choice; however, treatment is often ineffective and recurrences are common.
OBJECTIVE
This article provides a review of topical therapies that have been investigated to improve efficacy of PDL for the treatment of PWS.
MATERIALS AND METHODS
A literature search was performed through PubMed, EMBASE, Web of Science, and CINAHL, using the search terms "port wine stain," "pulsed dye laser," and "topical."
RESULTS
Clinical trials have investigated the topical agents, timolol, imiquimod, and rapamycin (RPM) in combination with PDL for the treatment of PWS. Topical timolol with PDL failed to show improved efficacy compared with PDL alone. Two clinical trials using imiquimod and PDL showed enhanced blanching of PWS compared with controls. Rapamycin and PDL were more effective than controls for facial PWS, but not for nonfacial PWS.
CONCLUSION
Topical imiquimod and RPM have shown some efficacy in treating PWS with PDL, but to date there is no topical adjuvant to PDL that reliably improves results for PWS.
Topics: Administration, Cutaneous; Aminoquinolines; Clinical Trials as Topic; Combined Modality Therapy; Dermatologic Agents; Humans; Imiquimod; Lasers, Dye; Port-Wine Stain; Randomized Controlled Trials as Topic; Sirolimus; Timolol; Treatment Outcome
PubMed: 29799824
DOI: 10.1097/DSS.0000000000001507 -
Annals of Plastic Surgery Sep 2020Hypertrophic scars are commonly seen in children and associated with pruritus, pain, functional impairment, and aesthetic disfigurement. Ablative fractional CO2 and...
BACKGROUND
Hypertrophic scars are commonly seen in children and associated with pruritus, pain, functional impairment, and aesthetic disfigurement. Ablative fractional CO2 and pulse dye laser are emerging techniques to improve scar quality. Only limited data are available on children, nonburn scars, and patient-reported outcome. We aimed to investigate safety and outcome of repeated laser therapy for hypertrophic scars originating from burns and other conditions by means of patient- and physician-reported outcome measures.
METHODS
This was a retrospective before-after analysis of laser treatments in children with hypertrophic scars. Outcome was measured using Patient and Observer Scar Assessment Scale, Vancouver Scar Scale and Itch Man Scale. With respect to safety, laser- and anesthesia-related complications were analyzed.
RESULTS
Seventeen patients, aged 11.37 ± 4.82 years with 27 scars, underwent 102 distinct laser treatments, mainly combined CO2 and pulse dye laser (94%), with few CO2 only (6%). Vancouver Scar Scale total score before the first and after the first session decreased significantly from 7.65 ± 2.12 to 4.88 ± 1.73; Patient and Observer Scar Assessment Scale observer overall opinion also dropped from 5.88 ± 1.57 to 4.25 ± 1.70. Pruritus improved significantly. Patient age and timing of laser intervention did not have an impact on treatment response. Complications related to laser treatment were seen in 2% (wound infection, n = 2) and to anesthesia in 4% (insignificant n = 2, minor n = 1).
CONCLUSIONS
Combined laser therapy significantly improves quality, pain, and pruritus of hypertrophic scars in children. When provided by experienced laser and anesthesia teams, it is safe with a low rate of complications.
Topics: Adolescent; Carbon Dioxide; Child; Cicatrix, Hypertrophic; Humans; Lasers, Dye; Lasers, Gas; Male; Patient Reported Outcome Measures; Physicians; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 32349082
DOI: 10.1097/SAP.0000000000002377 -
The Journal of Dermatological Treatment Mar 2021No topical and systemic treatment is proven to be effective on Cutaneous Macular Amyloidosis (CMA). The physical removal of the deposited protein by lasers may be a... (Comparative Study)
Comparative Study
BACKGROUND
No topical and systemic treatment is proven to be effective on Cutaneous Macular Amyloidosis (CMA). The physical removal of the deposited protein by lasers may be a better choice.
OBJECTIVE
To compare the efficacy of different lasers including Pulsed dye laser (PDL), 1064 mode of Q-Switched Nd-YAG, CO, and combined CO and Q-Switched Nd:YAG lasers for the treatment of CMA.
PATIENTS AND METHOD
17 adult female patients with clinical CMA and histopathological confirmation were included in this study. Four close 1 by 1 cm areas were treated simultaneously with PDL, Q-Switched Nd-YAG, CO and combined CO and Nd-YAG Lasers. The energy used for 585 nm PDL were 9 J/cm with the spot size of 5 mm. The energy used for 1064 nm mode of Nd-YAG laser was 5 Joules/cm, with the spot size of 4 mm, and the frequency of 10 hertz. The energies used for CO laser were 4 and 3.5 Micro Joules for the first and second Passes.
RESULTS
No desirable result obtained after PDL therapy. The Q-Switched Nd-YAG was effective in only 3 patients. All areas treated with CO laser were cleared.
CONCLUSION
The CO laser is seems to be the most effective laser treatment of CMA.
Topics: Adult; Amyloidosis; Cicatrix; Female; Humans; Hyperpigmentation; Lasers, Dye; Lasers, Gas; Lasers, Solid-State; Low-Level Light Therapy; Treatment Outcome
PubMed: 31415215
DOI: 10.1080/09546634.2019.1654071 -
Annals of Surgery Dec 2022To assess the effectiveness and safety of combined pulsed-dye laser (PDL) and NAFL for treatment of surgical scars. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To assess the effectiveness and safety of combined pulsed-dye laser (PDL) and NAFL for treatment of surgical scars.
SUMMARY BACKGROUND DATA
PDL and NAFL have not been compared to healing by time alone.
METHODS
Randomized controlled, single-blinded clinical trial at an urban, university hospital. Healthy adults' status post skin surgery with primary closure were randomized to either 3 sessions of combination PDL and NAFL every 2 to 8 weeks, or control of no treatment. At baseline and 36-week follow-up, Patient and observer Scar Assessment Scale and Scar Cosmesis Assessment and Rating were completed by participants and blinded physicians. The primary outcome was scar improvement, as measured by the score difference over time.
RESULTS
Of 76 participants, 52 completed the study (July 2017 to June 2019). No severe adverse events were reported. Patient and observer Scar Assessment Scale assessments demonstrated improvement in total score in the laser group compared to controls, as reported by patients [mean difference (standard deviation), laser: 12.86 (6.91) vs control: 7.25 (6.34); P = 0.004] and blinded physicians [18.32 (8.69) vs 13.08 (9.63); P = 0.044]. Patients observed a greater improvement in scar thickness [3.68 (2.04) vs 1.88 (1.85); P = 0.002] and stiffness [3.57 (2.78) vs 1.50 (2.11); P = 0.004] with lasers, and physicians reported greater improvement in vascularity [3.71 (1.98) vs 1.71 (1.52); P = 0.0002]. The live Scar Cosmesis Assessment and Rating subscore for erythema improved significantly with lasers [1.04 (0.79) vs 0.42 (0.50); P = 0.001].
CONCLUSIONS AND RELEVANCE
Combined PDL and NAFL resulted in scar improvement. Scar thickness, stiffness, and erythema were improved.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT03057964).
Topics: Adult; Humans; Cicatrix; Treatment Outcome; Lasers, Dye; Wound Healing; Erythema
PubMed: 35081564
DOI: 10.1097/SLA.0000000000005377 -
Lasers in Medical Science Dec 2023Pulsed dye laser (PDL) is the most commonly used method for port-wine stain (PWS); however, no studies have reported the safety of PDL. This review aimed to collect and... (Meta-Analysis)
Meta-Analysis Review
Pulsed dye laser (PDL) is the most commonly used method for port-wine stain (PWS); however, no studies have reported the safety of PDL. This review aimed to collect and summarize complications reported in relevant literature, assess complication rates in treating PWS with PDL, and explore the relevant influencing factors. A systematic review and meta-analysis were conducted to search for related studies in PubMed, Embase, and the Cochrane Library until August 2022. Two reviewers independently evaluated the risk of bias of included studies. Stata Software version 17.0 was used for the analysis. All complications reported in the literature are divided into acute phase complications and long-term complications. Overall pooled purpura, edema, crusting, blistering, hyperpigmentation, hypopigmentation, and scarring rates were 98.3%, 97.6%, 21.5%, 8.7%, 12.8%, 0.9%, and 0.2%, respectively. Although the acute adverse reactions were found to be common, the long-term permanent complications clearly have a lower frequency, and the occurrence of scarring is much lower than that initially thought. This indicates that effective protective measures after treatment are very important for preventing scar formation. Overall, PDL treatment for PWS shows a high level of safety and low chances of causing long-term complications.
Topics: Humans; Port-Wine Stain; Treatment Outcome; Lasers, Dye; Cicatrix; Combined Modality Therapy
PubMed: 38141129
DOI: 10.1007/s10103-023-03961-5 -
Clinics in Plastic Surgery Oct 2017In this review, the authors discuss the use of laser photothermolysis and laser resurfacing in the management of hypertrophic burn scars. They provide details regarding... (Review)
Review
In this review, the authors discuss the use of laser photothermolysis and laser resurfacing in the management of hypertrophic burn scars. They provide details regarding preoperative selection, intraoperative decision making, and postoperative care.
Topics: Burns; Cicatrix, Hypertrophic; Female; Humans; Laser Therapy; Lasers, Dye; Lasers, Gas; Male; Postoperative Care; Skin
PubMed: 28888301
DOI: 10.1016/j.cps.2017.05.007 -
Journal of Cosmetic Dermatology Apr 2021Generalized essential telangiectasia (GET) is a rare, clinically benign condition but a source of cosmetic concern for affected patients. There is a dearth of...
Generalized essential telangiectasia (GET) is a rare, clinically benign condition but a source of cosmetic concern for affected patients. There is a dearth of publications and known treatment options for GET. This case report reviews the clinical course of a 54-year-old woman who presented with a long-standing history of telangiectatic patches on her dorsal feet and ankles with progressive spread to the lower extremities consistent with GET. The patient proceeded with two pulsed dye laser (PDL) treatments and had complete resolution of her skin findings maintained at her 1.5-year follow-up appointment.
Topics: Female; Foot; Humans; Lasers, Dye; Lower Extremity; Middle Aged; Telangiectasis
PubMed: 33405306
DOI: 10.1111/jocd.13938 -
Lasers in Surgery and Medicine Oct 2015Different subspecialists treat benign intraoral lesions using various approaches including surgical excision, medical therapy, sclerotherapy, and laser photocoagulation....
BACKGROUND AND OBJECTIVE
Different subspecialists treat benign intraoral lesions using various approaches including surgical excision, medical therapy, sclerotherapy, and laser photocoagulation. The goal of this study was to establish whether lasers could effectively target and destroy oral lesions containing endogenous chromophores, while minimizing injury to unaffected adjacent tissues and critical structures.
MATERIALS AND METHODS
This retrospective study involved 26 cases of benign oral lesions, both vascular and pigmented, which were addressed by means of selective laser treatment. Pathologies were port-wine stains, hereditary hemorragic teleangectasia, hemangiomas, venous and arteriovenous malformations, pyogenic granuloma, and hairy reconstructive flaps. Electronic medical records and photographic documentation were reviewed. Three blinded staff personnel not involved with patient care in this study evaluated photographs taken prior to the first and after the final laser treatments. Observers rated the percentage clearance of the lesions or the ablation of bleeding, and the assessed values were averaged for each patient.
RESULTS
An average of 30-95% lightening was observed in the intraoral port-wine stains, 90% in the hemangiomas, 70% in arteriovenous malformations, 81% for venous malformations, 86% for venous lakes, and 100% for the pyogenic granuloma. Bleeding was ablated in all hereditary hemorrhagic telangiectasia lesions treated using the pulsed dye laser with or without the Alexandrite laser. Intraoral hair growing on the skin paddle of microvascular flaps was completely removed in one of the three cases treated using the Alexandrite laser. In the two remaining cases, some hair removal was achieved, but because the residual hairs were grey or white (absence of melanocytic chromophore), photocoagulation was less effective.
CONCLUSION
Lasers are a safe and effective means to selectively destroy specific chromphores. Such specific targeting ensures complete destruction of pathological tissue, decreasing the possibility of relapse and/or recurrence. Selective laser treatment of benign intraoral lesions represents a niche application that fills a gap in the multidisciplinary management of several conditions such as oral vascular anomalies and hairy reconstructive flaps.
Topics: Adult; Child; Female; Granuloma, Pyogenic; Hemangioma; Humans; Lasers, Dye; Lasers, Solid-State; Male; Mouth Diseases; Photography; Port-Wine Stain; Retrospective Studies; Single-Blind Method; Telangiectasia, Hereditary Hemorrhagic; Treatment Outcome; Vascular Malformations
PubMed: 26308664
DOI: 10.1002/lsm.22404