-
Dermatologic Surgery : Official... Nov 2020Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease....
BACKGROUND
Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease. Topical treatments often yield ineffective and temporary results.
OBJECTIVE
The objective of this article is to review and assess all the studies that used light and laser devices to treat KP and its variants.
MATERIAL AND METHODS
On January 15, 2017, an online search of the MEDLINE, Embase, and Cochrane databases was performed using the following combination of keywords: "keratosis pilaris" and "treatment."
RESULTS
Seventeen studies related to light and laser treatments were retained for analysis. The total number of treated patients was 175. Of which, 22 patients had KP atrophicans faciei, 17 patients had KP rubra, and 136 patients had KP.
CONCLUSION
Light and laser devices have been emerging as promising therapeutic options for a disfiguring disease that still lacks, until today, an effective long-term treatment.
Topics: Abnormalities, Multiple; Clinical Trials as Topic; Darier Disease; Eyebrows; Humans; Intense Pulsed Light Therapy; Lasers, Dye; Lasers, Gas; Lasers, Semiconductor; Lasers, Solid-State; Low-Level Light Therapy; Severity of Illness Index; Treatment Outcome
PubMed: 32804891
DOI: 10.1097/DSS.0000000000002441 -
The Journal of Dermatological Treatment Jun 2022
Meta-Analysis
Topics: Erythema; Humans; Lasers, Dye; Low-Level Light Therapy; Rosacea; Treatment Outcome
PubMed: 34291712
DOI: 10.1080/09546634.2021.1959507 -
Lasers in Medical Science Dec 2021The pulsed dye laser (PDL) is the standard treatment for port-wine stains (PWS). Maximal improvement occurs after multiple treatment sessions; however, the optimal... (Meta-Analysis)
Meta-Analysis
The pulsed dye laser (PDL) is the standard treatment for port-wine stains (PWS). Maximal improvement occurs after multiple treatment sessions; however, the optimal treatment interval has yet to be determined. The aim of this study was to review whether there is an association between PDL treatment interval and outcome of PWS. Six databases were searched by three reviewers for publications investigating treatment of PWS with PDL. The 75% improvement rates (75IR) were extracted for quantitative analysis. Meta-regression was used to investigate the association between treatment intervals and 75IR. The systematic review included 1 RCT and 33 cohort studies (7 prospective cohorts and 26 retrospective cohorts), with a total of 3777 patients. The pooled 75IR was 37% (95% CI 29-45%; I = 95%). Light Fitzpatrick skin type (p = 0.04), facial anatomic location (p = 0.01), and young age (p = 0.008) were associated with 75IR. In an unadjusted (p = 0.42) and multivariable adjusted (p = 0.98) meta-regression, no association was found between time interval between treatments and 75IR. These results persisted in a sensitivity analysis of studies with a mean patient age of ≤ 1. The majority of included studies were heterogeneous and retrospective. Based on cohort studies of low-to-moderate quality, time intervals between PDL treatments are not associated with PWS outcome.
Topics: Humans; Lasers, Dye; Port-Wine Stain; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 33580846
DOI: 10.1007/s10103-021-03264-7 -
Dermatologic Surgery : Official... Feb 2022Previous reports have shown that pulsed dye laser (PDL) is promising for the treatment of acne; however, results provide conflicting evidence. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Previous reports have shown that pulsed dye laser (PDL) is promising for the treatment of acne; however, results provide conflicting evidence.
OBJECTIVE
To determine the efficacy of PDL in treating acne vulgaris.
METHODS
A systematic review and meta-analysis of studies published before March 31, 2020 was conducted. Randomized controlled trials and case series were analyzed. The meta-analysis estimated the standardized mean difference (SMD) in acne severity score changes in patients treated by PDL versus control and also the SMD of the acne severity scores and comedone counts changes before and after PDL treatment.
RESULTS
Eleven studies were included in this systematic review. Six studies were included in the meta-analysis. Pulsed dye laser treatment was not found to be superior to the control group in treating acne vulgaris (SMD: -0.285; 95% confidence interval [CI], -0.886 to 0.317). However, single-arm studies revealed a significantly improved acne severity score after PDL therapy (SMD, -1.321; 95% CI, -2.057 to -0.586), especially when a multiple-session treatment and a longer pulse duration were employed. The comedone counts were significantly decreased after PDL therapy (SMD, -0.596; 95% CI, -1.137 to -0.054).
CONCLUSION
When treatment consisted of 4 or more sessions or longer pulse duration, PDL could significantly decrease the acne severity score.
Topics: Acne Vulgaris; Humans; Immunotherapy; Lasers, Dye; Treatment Outcome
PubMed: 34923532
DOI: 10.1097/DSS.0000000000003345 -
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 -
Italian Journal of Dermatology and... Jun 2023Facial erythema can be seen in many patients. Despite various clinical trials exploring the effect of intense pulsed light (IPL) in treating facial erythema,... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Facial erythema can be seen in many patients. Despite various clinical trials exploring the effect of intense pulsed light (IPL) in treating facial erythema, comprehensive evidence about the specific outcomes remains lacking.
EVIDENCE ACQUISITION
We searched published studies in the Web of Science, PubMed, Embase, and Cochrane Library databases based on established inclusion criteria. We calculated odds ratios (OR) to evaluate the effectiveness of IPL in patients with facial erythema. We used Review Manager 5.4.1 software for statistical data analyses with a 95% confidence interval (CI).
EVIDENCE SYNTHESIS
This review includes seven studies with 219 patients, of which five compared the efficacy of IPL with pulsed dye laser (PDL). IPL significantly improved facial erythema compared to no treatment (OR=56.64, 95% CI: 22.70-141.33; P<0.00001). However, there was no significant difference between IPL and PDL treatment (OR=1.00, 95% CI: 0.31-3.22; P=1.00). Moreover, there was no significant difference in patients with a >50% reduction in telangiectasias between IPL and PDL treatment (OR=1.00, 95% CI: 0.39-2.56; P=1.00). Furthermore, IPL therapy had no apparent adverse effects for most people besides transitory edema and erythema.
CONCLUSIONS
Our meta-analysis indicated that IPL could effectively and safely improve facial erythema with similar efficacy to PDL. Based on its comprehensive function, light side effects, and long curative effect, IPL appears to be a good alternative for treating facial erythema. However, further prospective and high-quality studies are required.
Topics: Humans; Treatment Outcome; Erythema; Intense Pulsed Light Therapy; Lasers, Dye; Telangiectasis
PubMed: 37166752
DOI: 10.23736/S2784-8671.23.07499-6 -
Skin Research and Technology : Official... Jan 2023
Meta-Analysis
Topics: Humans; Lasers, Dye; Treatment Outcome
PubMed: 36537074
DOI: 10.1111/srt.13237 -
Dermatologic Surgery : Official... Apr 2024Warts are one of the most common benign neoplasms caused by human papillomavirus infection and often pose a therapeutic challenge.
BACKGROUND
Warts are one of the most common benign neoplasms caused by human papillomavirus infection and often pose a therapeutic challenge.
OBJECTIVE
To summarize the current evidence on the safety and efficacy of laser and energy-based devices for the treatment of cutaneous verrucae.
METHODS
A comprehensive systematic review of the literature on laser and energy-based devices for the treatment of cutaneous verrucae was performed.
RESULTS
A total of 904 unique studies were identified, of which 109 were included in this review. The most commonly used lasers as a single treatment modality for verrucae included the long-pulsed Nd:Yag (n = 20) and pulsed dye (n = 18) lasers. Other modalities included the CO2 ablative laser (n = 10), photodynamic therapy (n = 11), local hyperthermia (n = 11), microwave therapy (n = 2), and nanopulse stimulation (n = 1). Other studies combined energy-based modalities with additional treatments, such as retinoids, imiquimod, and intralesional bleomycin. Overall, such devices were generally well-tolerated, with only a mild side effect profile.
CONCLUSION
Overall, the use of laser and energy-based devices is a safe and well-tolerated option for cutaneous verrucae that is relatively less invasive than surgical interventions. Future studies using more consistent outcome assessment tools will be valuable to help clinicians develop device-specific protocols and treatment regimens to ensure replicable and effective outcomes.
Topics: Humans; Treatment Outcome; Warts; Skin; Bleomycin; Hyperthermia, Induced; Lasers, Solid-State
PubMed: 38551277
DOI: 10.1097/DSS.0000000000004069