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Lasers in Medical Science Dec 2019Light-based modalities appear to be effective for ameliorating surgical scar appearance; however, protocols for achieving such outcomes have yet to be established. We... (Randomized Controlled Trial)
Randomized Controlled Trial
Early intervention with pulse dye and CO ablative fractional lasers to improve cutaneous scarring post-lumpectomy: a randomized controlled trial on the impact of intervention on final cosmesis.
Light-based modalities appear to be effective for ameliorating surgical scar appearance; however, protocols for achieving such outcomes have yet to be established. We studied the safety and efficacy of a combination of pulsed dye laser (PDL) and fractional ablative CO laser (FACL) for the attenuation of post-lumpectomy scarring. We conducted a prospective, evaluator-blinded, comparative split-scar study in post-lumpectomy patients. One-half of the scar was treated with three sessions of 595-nm PDL and FACL at 1-month intervals, starting within 6 weeks after suture removal. The entire scar was also treated with standard moisturizers and silicone gels. Six months after the last treatment, the two halves of the scar were assessed by three uninvolved physicians who used the Observer Scar Assessment Scale as well as by the patients who used the Patient and Observer Scar Assessment Scale. Eighteen female patients (mean age, 51.3 years) with a mean scar length of 7.8 cm completed the treatment and follow-up. Six months after the last treatment, both the physician evaluators and the patients noted significant improvements for all assessed scar parameters in the laser-treated scar area compared with the untreated scar area. The treatment was well tolerated, and no remarkable adverse events were reported. All 18 participants were satisfied with the treated scar areas. A combination PDL and FACL protocol starting up to 6 weeks after suture removal is a safe and effective method for the attenuation of post-lumpectomy scar formation.
Topics: Cicatrix; Female; Humans; Lasers, Dye; Lasers, Gas; Mastectomy, Segmental; Middle Aged; Observer Variation; Prospective Studies; Treatment Outcome
PubMed: 31025209
DOI: 10.1007/s10103-019-02788-3 -
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 -
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 -
The British Journal of Dermatology May 2013Port-wine stains (PWS) are among the most common congenital vascular malformations. Unlike capillary haemangiomas, these lesions do not involute spontaneously but rather... (Review)
Review
Port-wine stains (PWS) are among the most common congenital vascular malformations. Unlike capillary haemangiomas, these lesions do not involute spontaneously but rather become progressively more disfiguring as the patient ages. While benign in nature, the cosmetic deformity and attendant psychological and emotional distress prompt the majority of those afflicted to seek treatment. The pulsed dye laser (PDL) has long been considered the treatment of choice for these vascular lesions; however, very few patients achieve total clearance with PDL therapy and a significant number of lesions fail to respond at all. In order to address these recalcitrant cases, the mechanisms that contribute to treatment resistance must be understood and novel laser and light therapies must be employed. This review will address what is currently known about lesion-specific characteristics of PDL-resistant PWS as well as discuss current and future treatment options.
Topics: Age Factors; Angiogenesis Inhibitors; Humans; Lasers, Dye; Lasers, Solid-State; Low-Level Light Therapy; Port-Wine Stain; Time Factors; Treatment Outcome
PubMed: 23290045
DOI: 10.1111/bjd.12204 -
Current Opinion in Otolaryngology &... Dec 2007To describe the current support in the literature for in-office surgery using the 585-nm pulsed dye laser. (Review)
Review
PURPOSE OF REVIEW
To describe the current support in the literature for in-office surgery using the 585-nm pulsed dye laser.
RECENT FINDINGS
There are substantial cost savings (US$5000) and patient comfort when in-office surgery is performed with the pulsed dye laser. The pulsed dye laser can be used in the office and operating room to activate aminolevulinic acid for photodynamic treatment of recalcitrant laryngeal keratosis, with long-term eradication of keratosis without the prolonged photosensitivity of previous photodynamic agents. The site of the cleavage plane created in the true vocal fold mucosa has now been elucidated.
SUMMARY
The 585-nm pulsed dye laser allows safe, medically effective and cost-effective in-office surgery for a host of laryngeal lesions such as papillomatosis, keratosis, Reinke's edema, granulomas and other vascular lesions. The pulsed dye laser can activate aminolevulinic acid for laryngeal photodynamic therapy. Of the lasers currently in use it has the longest track record of safety and, to the satisfaction of many, continues in service at 23 centers around the world.
Topics: Ambulatory Surgical Procedures; Aminolevulinic Acid; Cost Savings; Humans; Laryngeal Diseases; Larynx; Lasers, Dye; Photochemotherapy; Photosensitizing Agents
PubMed: 17986876
DOI: 10.1097/MOO.0b013e3282f19ef2 -
Dermatologic Therapy Nov 2017Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and... (Review)
Review
Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium-doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium-doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas. Twenty-five studies were included. Quality ratings were assigned using the Oxford Centre for Evidence-Based Medicine scheme. Several laser modalities are effective in treating multiple variants of angiokeratomas. Vascular lasers like PDL, Nd:YAG, and argon are the most studied and of these, PDL offers the safest side effect profile. Nd:YAG may be more effective for hyperkeratotic angiokeratomas. Combination treatment with multiple laser modalities has also demonstrated some success. Lasers are a promising treatment option for angiokeratomas, but current use is limited by the lack of treatment guidelines. There are limited high quality studies comparing laser treatments to each other and to non-laser options. Additional studies are needed to establish guidelines and to optimize laser parameters.
Topics: Angiokeratoma; Equipment Design; Humans; Laser Therapy; Lasers, Dye; Lasers, Gas; Lasers, Solid-State; Skin Neoplasms; Treatment Outcome
PubMed: 29152831
DOI: 10.1111/dth.12558 -
Clinical and Experimental Dermatology Mar 2010Port-wine stains (PWS) are congenital capillary malformations that persist throughout life. Laser therapy is a common treatment for PWS, and pulsed-dye laser is the... (Comparative Study)
Comparative Study
BACKGROUND
Port-wine stains (PWS) are congenital capillary malformations that persist throughout life. Laser therapy is a common treatment for PWS, and pulsed-dye laser is the current treatment of choice.
AIM
To compare the clinical results on untreated PWS of two dye lasers with different wavelengths and pulse duration: a flashlamp-pumped dye laser (FPDL) and a long-pulse-duration dye laser (LPDL).
METHODS
In total, 24 patients were treated on 4-6 test areas with both laser types using high-energy and low-energy fluences. An FPDL with 0.45 ms pulse duration tuned to 585 nm was compared with an LPDL with 1.5 or 3.0 ms pulse duration tuned to 595 nm. Twelve weeks later the degree of lightening was evaluated by a blinded assessor. Pain was assessed directly after treatment with both lasers, using a visual analogue scale.
RESULT
There was no significant difference overall between the two systems in lightening of the lesion or in patient-reported pain.
CONCLUSION
Both laser systems are equivalent in terms of efficacy and pain.
Topics: Adolescent; Adult; Analysis of Variance; Child; Female; Humans; Lasers, Dye; Male; Middle Aged; Pain; Port-Wine Stain; Treatment Outcome; Young Adult
PubMed: 19874340
DOI: 10.1111/j.1365-2230.2009.03399.x -
Journal of Cosmetic and Laser Therapy :... Jun 2015Acne vulgaris is a common condition which remains challenging to treat in some cases. Laser and light-based therapies offer an alternative to medical therapies with the... (Review)
Review
Acne vulgaris is a common condition which remains challenging to treat in some cases. Laser and light-based therapies offer an alternative to medical therapies with the advantage of high compliance and relatively low side-effect profile. Light-based therapies in acne exert their effects through photochemical, photothermal, or a combination of both mechanisms. This article explains the mode of action for each light-based modality and examines the current evidence in this field.
Topics: Acne Vulgaris; Humans; Infrared Rays; Lasers, Dye; Low-Level Light Therapy; Phosphates; Photochemotherapy; Phototherapy; Titanium; Ultraviolet Rays
PubMed: 25415371
DOI: 10.3109/14764172.2014.988727 -
International Journal of Dermatology Apr 2016Granuloma annulare (GA) is a benign asymptomatic dermatosis that typically manifests in papules arrayed in annular arrangements. Many methods of treatment have been used... (Review)
Review
Granuloma annulare (GA) is a benign asymptomatic dermatosis that typically manifests in papules arrayed in annular arrangements. Many methods of treatment have been used with variable degrees of success, but finding a consistent and long-term treatment has proven a challenge. This study was conducted in order to review and evaluate the latest published research on the use of lasers in the treatment of GA. A systematic search of the National Library of Medicine's PubMed database was performed to identify relevant articles. Seven reports met the inclusion criteria for the review. Evidence for the use of pulsed dye laser, fractional photothermolysis, and excimer laser in the treatment of GA was found. Findings are limited by a lack of well-designed clinical trials objectively evaluating the use of lasers in the treatment of GA. The literature review found a number of case reports and case series that report successful outcomes of the use of lasers in the treatment of GA. The promising results reported in the literature, coupled with the lack of a well-designed review on this topic, reflect the importance of this article to the dermatologic literature as it emphasizes the need for larger and better-designed studies on the use of lasers to treat GA.
Topics: Granuloma Annulare; Humans; Lasers, Dye; Lasers, Excimer
PubMed: 26474922
DOI: 10.1111/ijd.13069 -
Expert Review of Medical Devices Nov 2012Keloids and hypertrophic scars affect millions of patients. In spite of the widely accepted clinical efficacy of pulsed dye laser (PDL) in the treatment of these scars,... (Meta-Analysis)
Meta-Analysis Review
Keloids and hypertrophic scars affect millions of patients. In spite of the widely accepted clinical efficacy of pulsed dye laser (PDL) in the treatment of these scars, a summary of the evidence comparing the use of PDL with conventional treatment modalities has not yet been undertaken. The objective of this review is to assess the efficacy of 585-nm PDL in the treatment of hypertrophic and keloid scars compared with conventional treatment modalities. This review includes eight randomized controlled trials. Results show that treatment with PDL may be superior to conventional modalities in improving overall scar appearance, but results were comparable when scar parameters were evaluated separately. More parallel comparison trials with standardized methods of treatment and outcome assessment are recommended to evaluate long-term treatment effects and recurrence rates.
Topics: Cicatrix, Hypertrophic; Humans; Keloid; Lasers, Dye; Quality of Life; Treatment Outcome
PubMed: 23249157
DOI: 10.1586/erd.12.56