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Actas Dermo-sifiliograficas Mar 2024Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium: Yttrium-Aluminium-Garnet Versus Neodymium: Yttrium-Aluminium-Garnet Laser Alone: A Double-Blind Randomized Controlled Study With Quality-of-Life...
BACKGROUND
Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet.
OBJECTIVE
To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy.
METHODS
A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction.
RESULTS
111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported.
CONCLUSIONS
DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.
Topics: Humans; Aluminum; Lasers, Dye; Lasers, Solid-State; Neodymium; Prospective Studies; Quality of Life; Telangiectasia, Hereditary Hemorrhagic; Telangiectasis; Treatment Outcome; Yttrium
PubMed: 38185205
DOI: 10.1016/j.ad.2024.01.003 -
Actas Dermo-sifiliograficas Mar 2024Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium: Yttrium-Aluminium-Garnet Versus Neodymium: Yttrium-Aluminium-Garnet Laser Alone: A Double-Blind Randomized Controlled Study With Quality-of-Life...
BACKGROUND
Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet.
OBJECTIVE
To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy.
METHODS
A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction.
RESULTS
111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported.
CONCLUSIONS
DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.
Topics: Humans; Aluminum; Lasers, Dye; Lasers, Solid-State; Neodymium; Prospective Studies; Quality of Life; Telangiectasia, Hereditary Hemorrhagic; Telangiectasis; Treatment Outcome; Yttrium
PubMed: 37913989
DOI: 10.1016/j.ad.2023.10.017 -
Journal of Drugs in Dermatology : JDD Nov 2023
Topics: Humans; Lasers, Dye; Pemphigus, Benign Familial
PubMed: 37943260
DOI: 10.36849/JDD.7733 -
Lasers in Surgery and Medicine Sep 2023A clinical study to investigate the effectiveness of pulsed dye laser (PDL) versus Nd:YAG laser in the treatment of telangiectasias, spider veins and cherry angiomas....
OBJECTIVES
A clinical study to investigate the effectiveness of pulsed dye laser (PDL) versus Nd:YAG laser in the treatment of telangiectasias, spider veins and cherry angiomas. Dynamic optical coherence tomography (D-OCT) was introduced as an innovative follow-up tool for evaluation of blood flow within superficial vessels and to allow visualization of morphological changes of the vasculature in vivo. The final aim of this study was to demonstrate a possible treatment benefit comparing both laser types.
MATERIALS AND METHODS
Vessel structures of 102 skin lesions were documented photographically and dermoscopically. Subsequently, lesions were imaged using optical coherence tomography before laser therapy (a), directly after the treatment (p) and after a follow-up 4-6 weeks after laser treatment. All lesions were treated using either a 595 nm PDL or a 1064 nm Nd:YAG laser. Two main vessel parameters, namely density and diameter, and their possible changes during follow-up were observed in 150/300/500 µm penetration depth using D-OCT and were subsequently compared between both treatment groups. Other analyzed vessel parameters were depth of the plexus, mean diameter, mean density, top edge of the vessel, columns, and spikes.
RESULTS
Both laser types are suitable options for the treatment of vascular skin lesions, with the most significant effect on cherry angiomas. PDL shows better results treating smaller vessels in upper skin regions, in comparison to Nd:YAG laser, achieving better results on deeper vessels, like spider veins. Using the applied laser settings, there was no statistically significant effect on telangiectasias.
CONCLUSION
D-OCT represents a new, noninvasive imaging method to evaluate blood flow and vessel morphology in the follow-up of telangiectasias, spider veins, and cherry angiomas, which underwent laser therapy.
Topics: Humans; Tomography, Optical Coherence; Laser Therapy; Telangiectasis; Lasers, Solid-State; Hemangioma
PubMed: 37264994
DOI: 10.1002/lsm.23676 -
The Laryngoscope Apr 2024Transoral laser microsurgery represents the primary surgical modality for early laryngeal cancers with oncologic outcomes equivalent to radiotherapy. Accurate tumor...
Transoral laser microsurgery represents the primary surgical modality for early laryngeal cancers with oncologic outcomes equivalent to radiotherapy. Accurate tumor mapping and margin assessment can be difficult, however, particularly during piecemeal or ablative resections, and for tumors with a wider geographic footprint. Tumor-targeted fluorescence-guided surgery in patients with head and neck cancer has empirically improved tumor and margin identification; this case details, for the first time, a fluorescence-guided surgical resection of a T2N0M0 transglottic tumor using panitumumab-IRDye800, an epidermal growth factor receptor monoclonal antibody covalently linked to near-infrared (NIR) dye. Laryngoscope, 134:1837-1841, 2024.
Topics: Humans; Laryngeal Neoplasms; Panitumumab; Carcinoma, Squamous Cell; Microsurgery; Laser Therapy; Lasers; Glottis; Retrospective Studies; Neoplasm Staging; Indoles
PubMed: 37860983
DOI: 10.1002/lary.31078 -
PloS One 2023The study aims to identify whether factors such as time to initiation of laser therapy following scar formation, type of laser used, laser treatment interval and...
AIM
The study aims to identify whether factors such as time to initiation of laser therapy following scar formation, type of laser used, laser treatment interval and presence of complications influence burn scar outcomes in adults, by meta-analysis of previous studies.
METHODS
A literature search was conducted in May 2022 in seven databases to select studies on the effects of laser therapy in adult hypertrophic burn scars. The study protocol was registered with PROSPERO (CRD42022347836).
RESULTS
Eleven studies were included in the meta-analysis, with a total of 491 patients. Laser therapy significantly improved overall VSS/POSAS, vascularity, pliability, pigmentation and scar height of burn scars. Vascularity improvement was greater when laser therapy was performed >12 months (-1.50 [95%CI = -2.58;-0.42], p = 0.01) compared to <12 months after injury (-0.39 [95%CI = -0.68; -0.10], p = 0.01), the same was true for scar height ((-1.36 [95%CI = -2.07; -0.66], p<0.001) vs (-0.56 [95%CI = -0.70; -0.42], p<0.001)). Pulse dye laser (-4.35 [95%CI = -6.83; -1.86], p<0.001) gave a greater reduction in VSS/POSAS scores compared to non-ablative (-1.52 [95%CI = -2.24; -0.83], p<0.001) and ablative lasers (-0.95 [95%CI = -1.31; -0.59], p<0.001).
CONCLUSION
Efficacy of laser therapy is influenced by the time lapse after injury, the type of laser used and the interval between laser treatments. Significant heterogeneity was observed among studies, suggesting the need to explore other factors that may affect scar outcomes.
PubMed: 37756273
DOI: 10.1371/journal.pone.0292097 -
Applied Optics Dec 2023We report the modified and improved whispering gallery mode laser emission from a hollow polymer optical fiber doped with 1,4-Bis(2-methyl styryl) benzene (Bis-MSB), a...
We report the modified and improved whispering gallery mode laser emission from a hollow polymer optical fiber doped with 1,4-Bis(2-methyl styryl) benzene (Bis-MSB), a high-quantum yield dye with a blue emission, with the introduction of an Ag nanoparticle-doped microring. In the presence of the Ag-doped microring, the laser emission was enhanced, and a reduction in the laser threshold from 40 to 15 µJ was attained, along with a small redshift in the emission spectrum. The quality factor of the microring embedded hollow polymer optical fiber was found to be 1.3×10. Moreover, the introduction of an Ag-doped microring inside the hollow polymer optical fiber helps enhance certain lasing modes. The observations open the way for the development of low-threshold polymer optical fiber lasers in the blue region.
PubMed: 38108696
DOI: 10.1364/AO.504341 -
RSC Advances Apr 2024As a rising star among metal oxide nanomaterials, titanium dioxide (TiO) has been widely investigated and employed in optical applications because of its excellent...
As a rising star among metal oxide nanomaterials, titanium dioxide (TiO) has been widely investigated and employed in optical applications because of its excellent optical properties. In this work, we demonstrate the efficient and broadband nonlinear photonic properties of methylene blue (MB)-loaded reduced TiO (TiO-MB) and explore the performance of a TiO-MB-microfiber photonic device in broadband ultrafast photonics. Within an erbium-doped fiber laser (EDFL) system, utilizing the TiO-MB-microfiber photonic device as a saturable absorber (SA), steady mode-locked pulses together with chaotic pulses were successfully achieved at the wavelength of 1.55 μm. Furthermore, by incorporating the TiO-MB SA into a thulium-doped fiber laser (TDFL) system, an ultrashort single pulse and multiple pulses were obtained at 2.0 μm. These results indicate that TiO-MB is an excellent nanomaterial for use in mode-locked lasers, being an alternative candidate for ultrafast fiber lasers exploiting the chemical and physical properties of oxide nanomaterials.
PubMed: 38605890
DOI: 10.1039/d3ra08925h -
Journal of Lasers in Medical Sciences 2023Benign fibroproliferative scars that are larger than the initial lesion are called keloids. Keloids treatment in clinical practice is still difficult. Although there...
Benign fibroproliferative scars that are larger than the initial lesion are called keloids. Keloids treatment in clinical practice is still difficult. Although there are various therapy choices, none is embraced by everyone or is relapse-free. Various treatment modalities such as intralesional corticosteroid injection with 5-fluorouracil (5-FU), fractional Er:YAG laser, pulsed dye laser (PDL), and others can be used either as monotherapies or combined therapies. Therefore, efforts should be made to select the treatment that will provide the best results. A 6-year-old boy with keloids on the lower lips extending to the chin was successfully treated with a 2940-nm fractional Er:YAG laser alternated with a 595-nm long-PDL followed by the combined intralesional injection of corticosteroid and 5-FU. The patient was followed up for 1 year with no lesion recurrence. Our case supports a combined therapy to successfully treat a patient with a keloid on the chin. Therapy using a combination of these four modalities seems safe and effective and may have a synergistic effect with minimal downtime.
PubMed: 37744013
DOI: 10.34172/jlms.2023.30 -
Lasers in Medical Science Feb 2024The tendency to use less-invasive laser-based methods with far more obvious effectiveness has been taken into consideration today for improvement of burning scars. The... (Randomized Controlled Trial)
Randomized Controlled Trial
The efficacy, satisfaction, and safety of carbon dioxide (CO2) fractional laser in combination with pulsed dye laser (PDL) versus each one alone in the treatment of hypertrophic burn scars: a single-blinded randomized controlled trial.
The tendency to use less-invasive laser-based methods with far more obvious effectiveness has been taken into consideration today for improvement of burning scars. The present study thus aimed to assess the efficacy of two laser-based techniques including pulsed dye laser (PDL) and ablative fractional CO2 laser (AFCL) and its combination on improving different aspects of burning scars regardless of the types of scar as hypertrophic or keloid scars. This randomized single-blinded clinical trial was performed on patients suffering hypertrophic or keloid burning scars. The patients were randomly assigned into three groups scheduling for treatment with PDL alone, AFCL alone, or its combination. All patients were visited before and 40 days after the last treatment session, and their scars were assessed. In all groups, significant improvement was revealed in the Vancouver scar scale (VSS) score, the color of scar, vascular bed in the scar, the and height of scar and its pliability; however, the improvement in each item was more highlighted in the group receiving a combination therapy with PDL and AFCL techniques. In this regard, the highest improvement was found in vascular bed and pliability in the combination therapy group as compared to other groups. Although the superiority of the combined group was not statistically significant, due to the high percentage of improvement in total VSS and most of its indicators, it can be clinically significant. The efficacy of the treatment protocols was different considering subgroups of mature and immature scars (less than 1 year), so that more improvement in pliability of scar, vascularity, and color of scar was found in the group scheduling for PDL + AFCL as compared to those who were treated with PDL alone in immature scar group but not in mature scar group. Combined treatment can be much more effective in improving the appearance and pathological characteristics of scars than each individual treatment. This effectiveness can be seen mainly in immature scars.
Topics: Humans; Carbon Dioxide; Keloid; Lasers, Dye; Cicatrix, Hypertrophic; Hypertrophy; Burns; Personal Satisfaction
PubMed: 38376542
DOI: 10.1007/s10103-024-03976-6