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Lasers in Medical Science Jul 2017Verrucae are benign epithelial proliferations, characteristically 1-20 mm in diameter, caused by human papilloma virus (HPV) infection occurring on the skin and mucosa... (Meta-Analysis)
Meta-Analysis Review
Verrucae are benign epithelial proliferations, characteristically 1-20 mm in diameter, caused by human papilloma virus (HPV) infection occurring on the skin and mucosa (Photomed Laser Surg 33(6):338-42, 2015; Lasers Med Sci 29(3):1111-6, 2014). Prevalence of verrucae is 5-20% in children and young adults with peak incidence reported during teenage years (Lasers Med Sci 29(3):1111-6, 2014; J Am Acad Dermatol 22(4):547-66, 1990; J Korean Med Sci 24(5):889-93, 2009). Patients often express significant displeasure with quality of life due to this cosmetic insecurity, as well as functional problems and physical discomfort when they occur on palms of hands and soles of feet. Traditional therapeutic options for warts, such as topical salicyclic acid, topical imiquimod, bleomycin injections, cryotherapy, surgical excision, and electrocautery, have proven somewhat effective but often lead to high recurrence rates or scarring (Photomed Laser Surg 33(6):338-42, 2015). Laser therapy offers an alternative solution by employing selective tissue destruction with minimal risks. We performed a broad literature search in PubMed to obtain all available published articles that studied the treatment of verrucae on the skin with 1064-nm neodymium-doped yttrium aluminum garnet laser. This laser is specifically suited for verruca treatment due to its deeply penetrating 1064-nm wavelength and relatively low risk of pigmentation changes in dark skin types (Photomed Laser Surg 33(6):338-42, 2015). Laser therapy is effective in the treatment of verrucae and has enabled clinicians to provide direct, targeted treatment of warts.
Topics: Adult; Child; Cryotherapy; Female; Humans; Hyperthermia, Induced; Lasers, Dye; Lasers, Solid-State; Low-Level Light Therapy; Quality of Life; Warts; Young Adult
PubMed: 28466193
DOI: 10.1007/s10103-017-2219-5 -
Dermatologic Therapy Jan 2021Bleomycin is a useful treatment option for recalcitrant verrucae. Several different methods of bleomycin delivery have been described, including intralesional injection,... (Review)
Review
Bleomycin is a useful treatment option for recalcitrant verrucae. Several different methods of bleomycin delivery have been described, including intralesional injection, intralesional injection combined with laser, microneedling, multiple puncture and adhesive tape. We reviewed the literature to evaluate the various methods of bleomycin administration to treat warts, including the different doses, instruments and procedures used. Intralesional injection (cure rate ranged from 67.8% to 99.23%) and topical bleomycin with multipuncture or microneedling methods (63.6% to 100%) were found to be effective in the treatment of warts. Overall, pain is significantly less with microneedling and multipuncture techniques compared with intralesional injection. Bleomycin injection combined with pulsed dye laser, electroporation, or by other methods, such as, microneedle patches or adhesive tape do not seem to be more beneficial than bleomycin administered by intralesional injection, multipuncture or microneedling techniques.
Topics: Administration, Cutaneous; Bleomycin; Humans; Injections, Intralesional; Lasers, Dye; Warts
PubMed: 33040473
DOI: 10.1111/dth.14401 -
Lasers in Surgery and Medicine Jan 2024The current gold standard treatment for port-wine stains (PWS) is pulsed dye laser (PDL). However, multiple treatment sessions may be necessary and complete resolution...
OBJECTIVES
The current gold standard treatment for port-wine stains (PWS) is pulsed dye laser (PDL). However, multiple treatment sessions may be necessary and complete resolution is often not achieved. Neoangiogenesis can occur soon after treatment and is thought to be a major factor contributing to treatment failure. Adjuvant antiangiogenic topical therapies may therefore improve the efficacy of pulsed dye laser treatment of port-wine stains.
MATERIAL AND METHODS
Following PRISMA guidelines, we searched PubMed, Embase, Web of Science, and clinicaltrials.gov using "port-wine stain," "nevus flammeus," "capillary malformation," "sturge weber," and "pulsed dye laser" as keywords and medical subject heading (MeSH) terms. Articles were included if they (1) were a randomized controlled trial (RCT); (2) studied patients with PWS; and (3) investigated topical adjuvant therapies with PDL. Bias was assessed using the Critical Appraisal Skills Programme (CASP) Randomized Controlled Trial Standard Checklist.
RESULTS
1835 studies were identified, with six studies meeting inclusion criteria. The total number of patients studied was 103 (range: 9-23), with 8-36 week follow-up. The average age ranged from 11 to 33.5 years old. Three studies examined adjuvant topical sirolimus (n = 52), two examined timolol (n = 29), and one studied imiquimod (n = 22). Two of three RCTs reported no improvement through colorimetric analysis with topical sirolimus; however, one of these studies did show a significant improvement through Investigator Global Assessment (IGA) score. The last sirolimus study showed significant improvement through digital photographic image scoring (DPIA). Studies examining topical timolol reported no change in PWS appearance compared to placebo. The addition of 5% adjuvant imiquimod cream did lead to significant improvement. A variety of outcome measures were used. Imiquimod and sirolimus led to mild cutaneous adverse events, while timolol caused no side effects. None of the adverse events led to treatment discontinuation. Study quality was moderate in three, high in two, and low in one.
CONCLUSION
The efficacy of adjuvant topical therapy was unclear. Limitations included variation in concentration and duration of adjuvant therapies, differences in follow-up time, and inconsistent outcome measure reporting. Given their potential clinical promise, larger prospective studies examining topical adjuvant therapies should be considered.
Topics: Humans; Child; Adolescent; Young Adult; Adult; Port-Wine Stain; Imiquimod; Timolol; Lasers, Dye; Sirolimus; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 37431532
DOI: 10.1002/lsm.23706 -
Dermatologic Surgery : Official... Jun 2022
Topics: Cicatrix; Erythema; Humans; Laser Therapy; Lasers, Dye; Lasers, Solid-State; Pigmentation Disorders
PubMed: 35316250
DOI: 10.1097/DSS.0000000000003429 -
Lasers in Medical Science Jun 2019Spider nevi (SN) are one of common vascular diseases. Different treatment techniques have been described for SN previously, including electrocoagulation, argon laser,... (Clinical Trial)
Clinical Trial
Spider nevi (SN) are one of common vascular diseases. Different treatment techniques have been described for SN previously, including electrocoagulation, argon laser, pulsed dye lasers (PDL), pulsed potassium titanylphosphate laser (KTP), and 1064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser. These methods are effective but may require good technical management, multiple treatments, and often result in scarring or pigmentation. Multi-wavelength laser combined with 595-nm PDL followed by 1064-nm Nd:YAG and can be selectively absorbed by hemoglobin in vessels. The 595-nm laser can target shallow vessels whereas the 1064-nm laser may target deeper vessels due to the different penetration capacities of these wavelengths. Moreover, Nd:YAG absorption is remarkable increased following by PDL treatment. Multi-wavelength laser treatments have been successfully used for vascular diseases but there is little experience in SN therapy. Consequently, these treatment parameters have not been established for SN, particularly in Asian patients with Fitzpatrick skin type (FST) IV. Report experience with using multi-wavelength laser for SN treatment in Asian patients with FST IV. Forty-three SN lesions received multi-wavelength laser treatments via a PDL followed by an Nd:YAG laser. The treatment was performed at 7 mm spot size at 9.5-11 J/cm, 10 ms with PDL, followed by Nd:YAG at 40-50 J/cm, 15 ms. The laser treatments were performed with a single pass without overlap. Complete resolution was observed in 40 lesions and an 80-90% improvement in the other three lesions after one treatment session. One patient had superficial scarring. Four patients had hyperpigmentation that resolved within 3 months. Multi-wavelength laser treatments are fast and effective interventions for SN treatment in Asian patients with minimal adverse effects when appropriate parameters are set.
Topics: Adolescent; Adult; Asian People; Child; Child, Preschool; Female; Humans; Lasers, Dye; Lasers, Solid-State; Male; Middle Aged; Nevus; Treatment Outcome; Young Adult
PubMed: 30311087
DOI: 10.1007/s10103-018-2652-0 -
Journal of Drugs in Dermatology : JDD Nov 2014Molluscum contagiosum (MC) is a benign contagious viral skin infection that typically resolves without treatment within months. For cases where treatment is recommended... (Review)
Review
BACKGROUND
Molluscum contagiosum (MC) is a benign contagious viral skin infection that typically resolves without treatment within months. For cases where treatment is recommended or requested, a number of options are available. Over the last 2 decades, a number of case reports and case series have described cases of MC lesions that were successfully treated with pulsed dye laser (PDL); however, a review of these studies has not been reported in the dermatologic literature.
OBJECTIVES
To review the use of PDL for the treatment of MC.
MATERIALS AND METHODS
A search of the National Library of Medicine's PubMed Database and the SCOPUS Database was performed to find articles that detailed the treatment of MC with PDL.
RESULTS
Eight articles met criteria for inclusion in this review. These articles represented 161 patients with over 4200 MC lesions that were treated with PDL. Each article was reviewed and summarized in a table.
LIMITATIONS
The main limitation of this review is the small number of published studies, which reflects the importance of this review of the dermatology literature.
CONCLUSIONS
PDL offers a novel and effective treatment for MC. However, the articles reviewed herein suggest PDL is a safe, effective, quick and well-tolerated treatment for clearing MC lesions that does not cause scarring or permanent pigment change.
Topics: Cicatrix; Humans; Lasers, Dye; Molluscum Contagiosum; Treatment Outcome
PubMed: 25607701
DOI: No ID Found -
Journal Der Deutschen Dermatologischen... Sep 2020Infantile hemangiomas can be successfully treated by both systemic propranolol and neodymium:YAG (Nd:YAG)-dye laser combination therapy. In this retrospective study, the...
Combination therapy of oral propranolol and combined Nd:YAG/pulsed dye laser therapy in infantile hemangiomas: a retrospective analysis of 48 treated hemangiomas in 30 children.
BACKGROUND AND AIMS
Infantile hemangiomas can be successfully treated by both systemic propranolol and neodymium:YAG (Nd:YAG)-dye laser combination therapy. In this retrospective study, the efficacy and safety of sequential and parallel therapy of complicated hemangiomas treated with both methods were evaluated.
PATIENTS AND METHODS
30 children with 48 complicated hemangiomas were treated with propranolol and Nd:YAG-dye laser combination therapy. Using photo comparison, the percentage remission rate was evaluated by three investigators on a four-step scale (I: 0-25 %, II: 26-50 %, III: 51-75 % and IV: 76-100 %).
RESULTS
Eleven children received propranolol and laser therapy in parallel (A), twelve children received laser therapy after propranolol (B) and seven children received propranolol after laser therapy (C). Due to emigration abroad, one child was lost to follow-up. A strong improvement (IV) was observed in 23/29 (79.3 %) of all treated children (A: 90.9 %, B 75 %, C 66.7 %). The mean duration of propranolol therapy in all children was 8.6 months (A: 8.9 months, B: 8.2 months, C: 8.9 months). On average, 2.33 laser treatments were performed per hemangioma (A: 1.95, B: 3.2, C: 1.91). Serious side effects caused by propranolol and laser therapy were not observed.
CONCLUSIONS
Propranolol and Nd:YAG-dye laser combination therapy can be used sequentially or in parallel safely and effectively. They complement each other in a meaningful manner.
Topics: Administration, Oral; Hemangioma; Humans; Infant; Laser Therapy; Lasers, Dye; Propranolol; Retrospective Studies; Treatment Outcome
PubMed: 32856787
DOI: 10.1111/ddg.14184 -
Sensors (Basel, Switzerland) Aug 2021In this report, using two-dimensional photonic crystals (PhC) and a one-dimensional PhC nano-beam cavity, we realized the development of all-polymeric dye-lasers on a...
In this report, using two-dimensional photonic crystals (PhC) and a one-dimensional PhC nano-beam cavity, we realized the development of all-polymeric dye-lasers on a dye-doped, suspended poly-methylmethacrylate film with a wavelength-scale thickness. In addition to the characterization of basic lasing properties, we also evaluated its capacity to serve as an attachable strain sensor. Through experimentation, we confirmed the stable lasing performances of the dye-laser attaching on a rough surface. Moreover, we also theoretically studied the wavelength responses of the utilized PhC resonators to stretching strain and further improved them via the concept of strain shaping. The attachability and high strain sensing response of the presented thin film PhC dye-lasers demonstrate their potential as attachable strain sensors.
PubMed: 34450773
DOI: 10.3390/s21165331 -
Journal of Cosmetic Dermatology Jun 2023Different devices are currently used for treating facial vascular lesions (FVL). This paper presents the aesthetic outcomes using different light-based and laser...
OBJECTIVE
Different devices are currently used for treating facial vascular lesions (FVL). This paper presents the aesthetic outcomes using different light-based and laser devices, including narrow band spectrum intense pulsed-light dye (NB-Dye-VL), Pulsed dye laser (PDL)-neodymium-doped yttrium-aluminum-garnet (Nd:YAG) dual-therapy, and either PDL or LP Nd:YAG for treating FVL in a clinical setting.
METHODS
A retrospective and single-center study conducted on subjects ≥18 years with FVL. Patients underwent treatment with either PDL + LP Nd:YAG dual-therapy, NB-Dye-VL, PDL, or LP Nd:YAG, according to the patient and lesion characteristics. The primary outcome was the weighted degree of satisfaction.
RESULTS
The cohort consisted of fourteen patients, nine women (64.3%) and five men (35.7%). The most prevalent FVL types treated were rosacea (28.6%; 4/14) and spider hemangioma (21.4%; 3/14). Seven patients underwent PDL + Nd:YAG (50.0%), three were treated with NB-Dye-VL (21.4%), and PDL or LP Nd:YAG was performed in two patients each (14.3%). Eleven patients rated their treatment outcome as excellent (78.6%), and three as very good (21.4%). Practitioners 1 and 2 classified treatment results as excellent in eight cases (57.1%) each. No serious or permanent adverse events were reported. Two (14.3%) patients, one treated with PDL and the other with PDL + LP Nd:YAG dual-therapy, had post-treatment purpura, which was successfully resolved with topical treatment after 5 and 7 days, respectively.
CONCLUSIONS
NB-Dye-VL and the PDL + LP Nd:YAG dual-therapy devices achieve excellent aesthetic outcomes for treating a wide range of FVL.
Topics: Female; Humans; Lasers, Solid-State; Retrospective Studies; Rosacea; Face; Treatment Outcome; Lasers, Dye
PubMed: 37318787
DOI: 10.1111/jocd.15772 -
Journal of Biomechanics Dec 2021Laser therapy has been widely used in the treatment of hypertrophic scars (HPS), but whether the mechanical properties of HPS tissue after laser treatment can be...
Laser therapy has been widely used in the treatment of hypertrophic scars (HPS), but whether the mechanical properties of HPS tissue after laser treatment can be restored to those of normal skin remains unclear. In this paper, the relationship between the evolution of compressive mechanical properties and histological changes of HPS tissues following three successive combined pulsed dye laser (PDL) and fractional CO laser (CO) treatments was investigated by compression tests and histological analysis. The early HPS model of rabbit ear was established by CO laser ablation. The loading-unloading tests and strain creep tests under the compression forces of 1 N, 2 N, and 3 N were carried out for normal skin, untreated HPS and HPS after different treatment times, respectively. The results showed that the compression ratio λ of all tissues revealed force dependence and rose with the increasing compression force, which was similar to the trend of most biological soft tissues. The histological changes of HPSs following laser treatment have a significant influence on the compressive mechanical response. Compared with the normal skin, the toughness and anti-deformation ability of HPS reduced due to the proliferation of collagen fibers and the destruction of elastic fibers, resulting in higher energy dissipation, compression ratio λ, and stable creep rate D, and lower elastic modulus. After three successive combined PDL/ CO laser treatments, the compressive mechanical properties and creep properties of HPS gradually approached that of the normal skin owing to the gradual restoration of the amount and distribution of collagen and elastic fibers in HPS. The results provide a new method for evaluating the clinical efficacy of laser therapy for treatment of HPS tissue.
Topics: Animals; Cicatrix, Hypertrophic; Lasers, Dye; Lasers, Gas; Low-Level Light Therapy; Rabbits; Treatment Outcome
PubMed: 34662757
DOI: 10.1016/j.jbiomech.2021.110783