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Dermatologic Surgery : Official... Apr 2021
Topics: Face; Humans; Lasers; Lasers, Dye; Phototherapy; Postoperative Complications; Rhytidoplasty; Telangiectasis
PubMed: 32205743
DOI: 10.1097/DSS.0000000000002374 -
Dermatologic Therapy May 2019An increasing number of minimally invasive cosmetic procedures, such as filler or botulinum toxin injections, are performed annually. These procedures are associated... (Review)
Review
An increasing number of minimally invasive cosmetic procedures, such as filler or botulinum toxin injections, are performed annually. These procedures are associated with a high risk of post-procedure bruising or ecchymosis. Ecchymoses arise following hemorrhage and extravasation of red blood cells into the subcutaneous tissue, leading to local skin discoloration. Although ecchymoses generally resolve within 14 days, their appearance is cosmetically bothersome, and they may be painful and cause major distress to patients. Recent clinical evidence suggests that light/laser technology with pulsed dye laser (PDL) or intense pulsed light (IPL) can dramatically alleviate and minimize bruising when delivered within 24-72 hr of the injection. This article, will review reports of treatment of ecchymosis by lasers and IPL.
Topics: Cosmetic Techniques; Ecchymosis; Humans; Injections; Intense Pulsed Light Therapy; Laser Therapy; Lasers, Dye; Phototherapy; Time Factors
PubMed: 30758903
DOI: 10.1111/dth.12861 -
Lasers in Surgery and Medicine Mar 2016To systematically review studies of laser treatment of infantile hemangioma (IH). (Review)
Review
BACKGROUND AND OBJECTIVE
To systematically review studies of laser treatment of infantile hemangioma (IH).
STUDY DESIGN/METHODS AND MATERIALS
We searched multiple databases including MEDLINE® and EMBASE from 1982 to June 2015. Two investigators independently screened studies against predetermined criteria and extracted key data. Investigators independently assessed study risk of bias and the strength of the evidence of the body of literature.
RESULTS
We identified 29 studies addressing lasers: 4 randomized controlled trials, 8 retrospective cohort studies, and 17 case series. Lasers varied across studies in type, pulse width, or cooling materials. Most comparative studies (n = 9) assessed variations of pulsed dye laser (PDL) and examined heterogeneous endpoints. Most studies reported on treatment of cutaneous lesions. Overall, longer pulse PDL with epidermal cooling was the most commonly used laser for cutaneous lesions; Nd:YAG was the most commonly used intralesionally. Most studies reported a higher success rate with longer pulse PDL compared with observation in managing the size of IH, although the magnitude of effect differed substantially. CO2 laser was used for subglottic IH in a single study, and was noted to have a higher success rate and lower complication rate than both Nd:YAG and observation. Studies comparing laser with β-blockers or in combination with β-blockers reported greater improvements in lesion size in combination arms versus β-blockers alone and greater effects of lasers on mixed superficial and deep IH. Strength of the evidence for outcomes after laser treatments ranged from insufficient to low for effectiveness outcomes. Strength of the evidence was insufficient for the effects of laser compared with β-blockers or in combination with β-blockers as studies evaluated different agents and laser types. Studies assessing outcomes after CO2 and Nd:YAG lasers typically reported some resolution of lesion size, but heterogeneity among studies limits our abilities to draw conclusions.
CONCLUSION
Studies of laser treatment of IH primarily addressed different laser modalities compared with observation or other laser modalities. PDL was the most commonly studied laser type, but multiple variations in treatment protocols did not allow for demonstration of superiority of a single method. Most studies reported a higher success rate with longer pulse PDL compared to observation in managing the size of IH, although the magnitude of effect differed substantially. Studies generally found PDL more effective than other types of lasers for cutaneous lesions. When first introduced as a primary treatment for IH, various laser modalities generally offered superior outcomes compared with steroid therapy and observation. In the era of β-blocker therapy, laser treatment may retain an important role in the treatment of residual and refractory lesions.
Topics: Child, Preschool; Hemangioma, Capillary; Humans; Infant; Lasers, Dye; Lasers, Gas; Lasers, Solid-State; Skin Neoplasms; Treatment Outcome
PubMed: 26711436
DOI: 10.1002/lsm.22455 -
The British Journal of Dermatology Mar 2015Vbeam(®) and Cynergy(®) are 595-nm pulsed-dye laser (PDL) equipment options, both extensively used in the clinical treatment of port-wine stains (PWS). However, there... (Comparative Study)
Comparative Study
BACKGROUND
Vbeam(®) and Cynergy(®) are 595-nm pulsed-dye laser (PDL) equipment options, both extensively used in the clinical treatment of port-wine stains (PWS). However, there has been no study conducted of the differences in PWS therapeutic outcomes across both devices.
OBJECTIVES
To compare the efficacy and safety of Vbeam and Cynergy equipment in the treatment of PWS.
METHODS
Twenty-two patients with PWS were included in this study and were treated with both Vbeam and Cynergy. Patients underwent three treatment sessions. Treatment parameters used were as follows: (i) Cynergy(®) , Cynosure Corp., 595-nm wavelength, radiant exposure of 11 J cm(-2) , 2-ms pulse duration, 7-mm spot size, cold-air cooling system of level 3. (ii) Vbeam(®) , Candela Corp., 595-nm wavelength, radiant exposure of 11 J cm(-2) , 1·5-ms pulse duration, 7-mm spot size, cryogen spray cooling (30 ms of cooling with a 20-ms delay). Clinical efficacy outcomes were evaluated by chromameter and visual assessment 2 months post-treatment.
RESULTS
All patients were treated by both Vbeam and Cynergy on adjacent sites. Chromameter evaluation showed that the average blanching rate was 21·24% for Cynergy sites and 36·42% for Vbeam sites. This difference was statistically significant (P = 0·05), which suggests that PWS respond better to Vbeam than to Cynergy at the settings used in this study. No patients developed scarring or permanent pigmentation change.
CONCLUSIONS
Compared with Cynergy, Vbeam may be more effective in the treatment of PWS. Despite using supposedly equivalent fluences in 595-nm PDLs, equivalent clinical results cannot be guaranteed.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Laser Therapy; Lasers, Dye; Male; Port-Wine Stain; Prospective Studies; Treatment Outcome; Young Adult
PubMed: 25130205
DOI: 10.1111/bjd.13356 -
Journal of Cosmetic and Laser Therapy :... Jun 2016
Topics: Cosmetic Techniques; Humans; Laser Therapy; Lasers, Dye; Low-Level Light Therapy
PubMed: 27158801
DOI: 10.3109/14764172.2016.1174032 -
JAMA Dermatology Sep 2016Although cutaneous warts are common lesions, full remission is not always achieved with conventional therapies. Laser modalities including carbon dioxide (CO2),... (Review)
Review
IMPORTANCE
Although cutaneous warts are common lesions, full remission is not always achieved with conventional therapies. Laser modalities including carbon dioxide (CO2), erbium:yttrium-aluminum-garnet (Er:YAG), pulsed dye (PDL), and Nd:YAG have been investigated as alternative treatments for warts.
OBJECTIVE
To review the use and efficacy of lasers for treating nongenital cutaneous warts.
EVIDENCE REVIEW
Published randomized clinical trials (RCTs), cohort studies, case series, and case reports involving laser treatment of nongenital warts were retrieved by searching PubMed with no date limits. Quality ratings of studies were based on a modified version of the Oxford Centre for Evidence-Based Medicine scheme for rating individual studies. A higher emphasis was placed on RCTs and prospective cohort studies with large sample sizes and detailed methodology.
FINDINGS
There were 35 studies published between 1989 and 2015 that comprised an aggregate of 2149 patients. Simple and recalcitrant nongenital warts treated with lasers show variable response rates (CO2 laser, 50%-100%; Er:YAG laser, 72%-100%; PDL, 47%-100%; and Nd:YAG laser, 46%-100%). Current RCTs suggest that PDL is equivalent to conventional therapies such as cryotherapy and cantharidin. Combination therapies with lasers and other agents including bleomycin, salicylic acid, and light-emitting diode have shown some success.
CONCLUSIONS AND RELEVANCE
Lasers can be an effective treatment option for both simple and recalcitrant warts. The lasers most studied for this purpose are CO2, PDL, and Nd:YAG, and of these, PDL has the fewest adverse effects. Currently, use of lasers for wart treatment is limited by lack of established treatment guidelines. Future studies are needed to compare laser modalities with each other and with nonlaser treatment options, and to establish optimal treatment protocols.
Topics: Humans; Lasers, Dye; Lasers, Gas; Lasers, Solid-State; Skin Diseases; Treatment Outcome; Warts
PubMed: 27119270
DOI: 10.1001/jamadermatol.2016.0826 -
Pathologica Oct 2007Granuloma faciale is a rare, benign skin condition that usually occurs on the face. Using an exemplary case of granuloma faciale, we will present the clinical and...
Granuloma faciale is a rare, benign skin condition that usually occurs on the face. Using an exemplary case of granuloma faciale, we will present the clinical and histological characteristics of this dermatosis. A 49-year-old man presented with a 6-month history of a 10 mm-diameter asymptomatic papulo-nodular red-brown lesion of the nose. A biopsy specimen led to the diagnosis of granuloma faciale. The patient received a session of pulsed-dye laser therapy, which led to significant improvement. This benign and usually isolated dermatosis can more rarely be extrafacial. It may often be mistaken for other benign dermatoses (sarcoidosis, discoid lupus erythematosus) as well as for malignant dermatoses (lymphoma, basal cell carcinoma). Histology is
Topics: Diagnosis, Differential; Facial Dermatoses; Facial Neoplasms; Granuloma; Humans; Lasers, Dye; Male; Middle Aged; Nose Diseases
PubMed: 18354952
DOI: No ID Found -
Pediatric Dermatology Sep 2017Molluscum contagiosum (MC) is an infectious dermatosis that commonly presents in children and immunocompromised individuals. Although lesions usually resolve... (Review)
Review
Molluscum contagiosum (MC) is an infectious dermatosis that commonly presents in children and immunocompromised individuals. Although lesions usually resolve spontaneously after several months, they can be symptomatic and cause psychosocial distress. We review the evidence underlying treatment methods available for MC lesions, including potassium hydroxide, salicylic acid, hydrogen peroxide, retinoids, cantharidin, cryotherapy, curettage, and pulsed dye laser to aid practicing dermatologists in therapy selection.
Topics: Cantharidin; Cryotherapy; Curettage; Humans; Hydrogen Peroxide; Hydroxides; Lasers, Dye; Molluscum Contagiosum; Potassium Compounds; Retinoids; Salicylic Acid
PubMed: 28884917
DOI: 10.1111/pde.13228 -
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 -
Cutis Mar 2023
Topics: Humans; Lasers, Dye; Telangiectasis
PubMed: 37224500
DOI: 10.12788/cutis.0735