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Journal of Cosmetic and Laser Therapy :... 2016Rosacea is a chronic condition, affecting up to 10% of the population. It has a negative impact on patients' quality of life (QOL), leading to loss of self-confidence,... (Review)
Review
Rosacea is a chronic condition, affecting up to 10% of the population. It has a negative impact on patients' quality of life (QOL), leading to loss of self-confidence, emotional distress and withdrawal from normal societal interactions. Erythemotelangiectatic (ET) rosacea is a frequent reason for consultation and difficult to treat, as vascular signs such as flushing, erythema and telangiectasia often persist despite medical therapy. Several studies have demonstrated objective improvements in vascular signs following pulsed dye laser (PDL) treatment, but very few have investigated improvement in QOL. We reviewed the current literature to find evidence for the effect of PDL on QOL in ET rosacea.
Topics: Erythema; Flushing; Humans; Lasers, Dye; Low-Level Light Therapy; Quality of Life; Rosacea; Telangiectasis
PubMed: 26836241
DOI: 10.3109/14764172.2015.1063663 -
Burns : Journal of the International... Aug 2014The purpose of this review is to investigate the use of Pulsed Dye Laser (PDL) as a therapeutic tool for hypertrophic burns scarring. The difference between keloids and... (Review)
Review
The purpose of this review is to investigate the use of Pulsed Dye Laser (PDL) as a therapeutic tool for hypertrophic burns scarring. The difference between keloids and hypertrophic scars is first described. The review then outlines the progress and assessment of hypertrophic scars for burns patients and the problem of their clinical management. The assessment using both objective and subjective measurements for complete account of hypertrophic scars is explained. The efficacy of PDL for both prevention and treatment is summarised for all hypertrophic scarring and the various laser treatment protocols in previous research is studied. The differentiation between prevention and treatment is discussed in relation to scar duration and the need for prevention rather than treatment is then proposed for intervention using PDL. The paper concludes with recommendations for future research through a prospective randomised, controlled study using 595 nm PDL in the prevention of scars with less than 6 month duration.
Topics: Burns; Cicatrix, Hypertrophic; Humans; Lasers, Dye; Low-Level Light Therapy
PubMed: 24439925
DOI: 10.1016/j.burns.2013.12.017 -
Lasers in Surgery and Medicine Jan 2014Basal cell carcinomas (BCCs) have supporting vasculature that serves as a target for vascular selective lasers. The objective of this study was to determine the effect... (Clinical Trial)
Clinical Trial
BACKGROUND AND OBJECTIVE
Basal cell carcinomas (BCCs) have supporting vasculature that serves as a target for vascular selective lasers. The objective of this study was to determine the effect of repeated treatment with a combined 585 nm pulsed dye laser (PDL) and 1,064 nm Neodymium Yttrium Aluminum Garnet (Nd:YAG) laser on BCCs of superficial and nodular subtypes of varying diameters.
STUDY DESIGN/MATERIALS AND METHODS
Ten subjects with 13 biopsy-proven BCCs received four combined PDL and Nd:YAG at treatments 2-4 week intervals. None of the BCCs met the criteria for Mohs micrographic surgery. The tumor and 4 mm of peripheral skin were treated using standardized parameters delivered with a 7 mm spot with 10% overlap. The treated area was excised and evaluated histologically for residual tumor. The primary study endpoint was histologic clearance of tumor. The secondary study endpoint was blinded investigator assessment of clinical endpoint and adverse effects.
RESULTS
Approximately half of all tumors showed a complete response to four combined PDL and Nd:YAG treatments (n = 7/12, 58%). When stratified by size, 75% of all tumors <1 cm in diameter (n = 6/8) showed complete response. Tumor histologic types among the complete responders included superficial and nodular BCCs. All subjects with incompletely responding BCCs were on various forms of anticoagulation, which we hypothesize, may inhibit laser-mediated thrombosis necessary for the clinical effect. Blinded investigator assessment suggests that biopsy related erythema improves with subsequent laser treatments.
CONCLUSIONS
Combined PDL and Nd:YAG laser is an effective means of reducing tumor burden in patients with BCC and may be a promising, emerging alternative therapy. Factors influencing treatment response includes the concomitant use of anticoagulation. Further studies are needed to investigate and optimize the utility of this treatment protocol.
Topics: Adult; Aged; Carcinoma, Basal Cell; Female; Humans; Lasers, Dye; Lasers, Solid-State; Male; Middle Aged; Prospective Studies; Single-Blind Method; Skin Neoplasms; Treatment Outcome
PubMed: 24272664
DOI: 10.1002/lsm.22201 -
Experimental Dermatology Jul 2023Pulsed dye laser (PDL) therapy can be effective in treating psoriasis, with a long duration of remission. Although PDL therapy, albeit on a modest scale, is being used...
Pulsed dye laser (PDL) therapy can be effective in treating psoriasis, with a long duration of remission. Although PDL therapy, albeit on a modest scale, is being used for decades now, the underlying mechanisms responsible for the long-term remission of psoriasis remain poorly understood. The selective and rapid absorption of energy by the blood causes heating of the vascular wall and surrounding structures, like perivascular nerves. Several studies indicate the importance of nerves in psoriatic inflammation. Interestingly, denervation leads to a spontaneous remission of the psoriatic lesion. Among all dermal nerves, the perivascular nerves are the most likely to be affected during PDL treatment, possibly impairing the neuro-inflammatory processes that promote T-cell activation, expression of adhesion molecules, leukocyte infiltration and cytokine production. Repeated PDL therapy could cause a prolonged loss of innervation through nerve damage, or result in a 'reset' of neurogenic inflammation after temporary denervation. The current hypothesis provides strong arguments that PDL treatment affects nerve fibres in the skin and thereby abrogates the persistent and exaggerated inflammatory process underlying psoriasis, causing a long-term remission of psoriasis.
Topics: Humans; Lasers, Dye; Treatment Outcome; Psoriasis; Skin; Low-Level Light Therapy
PubMed: 37083107
DOI: 10.1111/exd.14816 -
Anais Brasileiros de Dermatologia 2017Nail changes are present in about 50% of psoriasis patients and tend to be refractory to conventional treatments. Pulsed dye laser has emerged as an alternative therapy.... (Clinical Trial)
Clinical Trial
Nail changes are present in about 50% of psoriasis patients and tend to be refractory to conventional treatments. Pulsed dye laser has emerged as an alternative therapy. Our aim is to evaluate the efficacy of pulsed dye laser in nail psoriasis and the impact of treatment on quality of life. Fourteen patients were treated in monthly sessions for three months. The outcome assesment was made by the Nail Psoriasis Severity Index (NAPSI). The median improvement in the scores of the overall NAPSI, nail bed NAPSI, and nail matrix NAPSI were 44.2% (P = 0.002), 50% (P = 0.033) and 65.1% (P = 0.024), respectively.
Topics: Adult; Humans; Lasers, Dye; Middle Aged; Nail Diseases; Psoriasis; Quality of Life; Reproducibility of Results; Severity of Illness Index; Surveys and Questionnaires; Time Factors; Treatment Outcome
PubMed: 29364458
DOI: 10.1590/abd1806-4841.20175918 -
Advances in Wound Care Jan 2023Hypertrophic scarring is a challenging issue for patients and clinicians. The prevalence of hypertrophic scarring can be up to 70% after burns, and patients suffer from... (Review)
Review
Hypertrophic scarring is a challenging issue for patients and clinicians. The prevalence of hypertrophic scarring can be up to 70% after burns, and patients suffer from pain, itching, and loss of joint mobility. To date, the exact mechanisms underlying hypertrophic scar formation are unclear, and clinical options remain limited. Several studies have demonstrated that pathological scars are a type of hyperactive vascular response to wounding. Scar regression has been found to be accompanied by microvessel occlusion, which causes severe hypoxia, malnutrition, and endothelial dysfunction, suggesting the essential roles of microvessels in scar regression. Therefore, interventions that target the vasculature, such as intense pulsed light, pulsed dye lasers, vascular endothelial growth factor antibodies, and Endostar, represent potential treatments. In addition, the mass of scar-associated collagen is usually not considered by current treatments. However, collagen-targeted therapies such as fractional CO laser and collagenase have shown promising outcomes in scar treatment. Traditional modalities used in current clinical practice only partially target scar-associated microvessels or collagen. As a result, the effectiveness of current treatments is limited and is too often accompanied by undesirable side effects. The formation of scars in the early stage is mainly affected by microvessels, whereas the scars in later stages are mostly composed of residual collagen. Traditional therapies do not utilize specific targets for scars at different stages. Therefore, more precise treatment strategies are needed. Scars should be classified as either "vascular-dominant" or "collagen-dominant" before selecting a treatment. In this way, strategies that are vascular-targeted, collagen-targeted, or a combination thereof could be recommended to treat scars at different stages.
Topics: Humans; Cicatrix, Hypertrophic; Vascular Endothelial Growth Factor A; Carbon Dioxide; Lasers, Dye; Collagen; Hypertrophy
PubMed: 34328823
DOI: 10.1089/wound.2020.1348 -
Facial Plastic Surgery : FPS Dec 2009Many techniques have been described to improve facial scars. In this review we address nonoperative strategies to manage facial scarring. Scar characteristics and... (Review)
Review
Many techniques have been described to improve facial scars. In this review we address nonoperative strategies to manage facial scarring. Scar characteristics and anatomic location are discussed. The following nonoperative techniques are comprehensively examined: pulsed dye laser (PDL), subcision, fat transplantation, collagen injection, dermabrasion, steroid injection, and fillers. The PDL is advocated to flatten and decrease the volume of hypertrophic scars while improving texture and pliability. Dermabrasion is used to blend acne scars into the surrounding facial skin by subtly improving their contour. Fat transplantation, collagen, and filler injection is recommended in the treatment of acne depressed scars and traumatic scars with resulting contour deformity.
Topics: Adipose Tissue; Cicatrix; Collagen; Cosmetic Techniques; Cosmetics; Dermabrasion; Face; Humans; Injections, Intralesional; Lasers, Dye; Rejuvenation; Steroids
PubMed: 20024872
DOI: 10.1055/s-0029-1243079 -
Journal of Cosmetic Dermatology Dec 2015One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our...
BACKGROUND
One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our knowledge, laser therapy for steroid-induced atrophic scars has not been investigated to date.
OBJECTIVE
The aim of this study was to evaluate the efficacy and safety of pulsed dye laser in the treatment of steroid-induced atrophic scars.
METHODS
In this pilot study, 15 patients with at least one atrophic patch were treated with the 585-nm pulsed dye laser at 4-week interval sessions until achieving complete improvement or until patient were lost to follow-up. Clinical outcome was assessed via standard photographic method before each treatment session and after the final visit. An independent dermatologist evaluated the photographs.
RESULT
All of the patients (13 females and two males) with 25-59 years of age experienced some degree of improvement, except one patient who withdrew from the treatment after three sessions. The treatment was well tolerated.
CONCLUSION
The results of our study indicated that pulsed dye laser therapy could be employed as a new method in the treatment of steroid-induced atrophic scars. Pulsed dye laser might affect the lesions through inducing collagen deposition and production of more superficial dermal elastin as well as less unidirectional collagen in clusters.
Topics: Adrenal Cortex Hormones; Adult; Atrophy; Cicatrix; Female; Humans; Lasers, Dye; Low-Level Light Therapy; Male; Middle Aged; Pilot Projects; Skin
PubMed: 26282056
DOI: 10.1111/jocd.12158 -
Journal Der Deutschen Dermatologischen... Oct 2023
Topics: Humans; Port-Wine Stain; Lasers, Dye; Laser Therapy; Health Services; Germany; Treatment Outcome
PubMed: 37550854
DOI: 10.1111/ddg.15181 -
Treatment of leg veins with combined pulsed dye and Nd:YAG lasers: 60 patients assessed at 6 months.Lasers in Surgery and Medicine Nov 2010Leg telangiectasias have been reported to have been treated with a variety of lasers. This study was designed to measure response to treatment of leg telangiectasias...
INTRODUCTION
Leg telangiectasias have been reported to have been treated with a variety of lasers. This study was designed to measure response to treatment of leg telangiectasias with a unique coupled 585 nm and 1064 nm pulse.
METHODS
Sixty female patients (24-62 y.o., skin types II-IV) with leg vein varicosities were treated with pulses of a combined 585 nm long pulsed dye (LPDL) and 1064 nm Nd:YAG lasers, which were delivered sequentially using a novel dual laser device. Pulses were placed along the entire length of the targeted veins. A beam diameter of 7 mm with pulses of 10 ms and 9 J/cm² of fluence for LPDL, and pulses of 30 ms and 80 J/cm² for the 106 nm Nd:YAG were utilized and these remained uniform. Time delays between sequential LPDL and Nd:YAG pulses were 125 ms, 250 ms and 500 ms depending on vein diameter of 4, 3 and 2 mm respectively. One or two treatments were given at 2 month intervals, with post-treatment assessments at 6 months following the final treatment. Patients subjectively assessed the treatment and their results were used to draw up a satisfaction index (SI). Objective assessment was based on clinical photography and computer-generated data using a vein clearance detection computer program.
RESULTS
The overall patient satisfaction rate was 47 of 60 patients and the objective assessments, based on blinded evaluation of clinical photography as well as computer assessment, demonstrated good to very good improvement in 47 by photograph evaluation and 49 of 60 patients by computer edge detection data.
CONCLUSIONS
The combination of LPDL and Nd:YAG laser pulses offered efficient treatment of leg veins irrespective of skin type. Results were better on blue and vessels larger than 1 mm. Side effects were minimal and transient.
Topics: Adult; Cohort Studies; Female; Humans; Lasers, Dye; Lasers, Solid-State; Leg; Low-Level Light Therapy; Middle Aged; Patient Satisfaction; Retrospective Studies; Telangiectasis; Treatment Outcome; Young Adult
PubMed: 20976800
DOI: 10.1002/lsm.20972