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Liu C, Huang HY, Chang YY, Sun CK, Chia SH, Liao YH. Optical Effects of Focused Fractional Nanosecond 1064-nm Nd:YAG Laser: Techniques of Application on Human Skin. Lasers Surg Med 2024; 56:557-563. [PMID: 38890780 DOI: 10.1002/lsm.23812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/06/2024] [Accepted: 05/21/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Considering the pulse widths of picosecond and nanosecond lasers used in cutaneous laser surgery differ by approximately one order of magnitude, can nanosecond lasers produce the optical effect in human skin similar to laser-induced optical breakdown (LIOB) caused by picosecond lasers? METHODS Cutaneous changes induced by a focused fractional nanosecond 1064-nm Nd:YAG laser were evaluated by VISIA-CR imaging, histological examination, and harmonic generation microscopy (HGM). RESULTS A focused fractional nanosecond 1064-nm Nd:YAG laser can generate epidermal vacuoles or dermal cavities similar to the phenomenon of LIOB produced by picosecond lasers. The location and extent of photodisruption can be controlled by the laser fluence and focus depth. Moreover, laser-induced shock wave propagation and thermal degeneration of papillary collagen can be observed by HGM imaging. CONCLUSION Focused fractional nanosecond lasers can produce an optical effect on human skin similar to LIOB caused by picosecond lasers. With techniques of application, the treatment can induce epidermal and dermal repair mechanisms in a tunable fashion to improve skin texture, wrinkles, scars, and dyspigmentation, without disrupting the epidermal surface.
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Affiliation(s)
- Connie Liu
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dermatology, Taipei City Hospital, Taipei, Taiwan
| | - Hsin-Yi Huang
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Yang Chang
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chi-Kuang Sun
- Department of Electrical Engineering and Graduate Institute of Photonics and Optoelectronics, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Shih-Hsuan Chia
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Bachelor Program in Digital Healthcare and Interdisciplinary Program for Undergraduates, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Hua Liao
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Rojas-Orrego M, Carreño N, Feuerhake T, Navarrete-Dechent C. In Vivo Evaluation of Laser-Induced Optical Breakdown (LIOBS) by 1064-nm Nd:YAG Fractional Picosecond Laser With Reflectance Confocal Microscopy and Precise Histopathologic Correlation. Lasers Surg Med 2024. [PMID: 39072796 DOI: 10.1002/lsm.23829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Picosecond lasers with a microlens array can cause laser-induced optical breakdown (LIOBS) and LIC (Intradermal laser-induced cavitation) within high-fluence areas. This study aimed to describe the clinical, reflectance confocal microscopy (RCM), histopathological findings, and the characteristics of vacuoles caused by LIOBS and LIC in individuals with skin types III and IV. MATERIALS AND METHODS This study was performed on six Chilean healthy volunteers, males and females, aged 35-65 years old with Fitzpatrick skin phototypes III-IV. The laser was applied in the inner proximal area of the nondominant arm. RCM evaluation was performed 24 h later; 48 h later, skin biopsies were performed on the laser-treated areas. Clinical, histological, and RCM findings were recorded. RESULTS Every individual developed a 10 mm2 area of clinical erythema in the treated area. Under RCM, all six volunteers had hyporeflective spherical structures at the level of the epidermis, consistent with intraepidermal vacuoles. Histopathological evaluation revealed different sizes of vacuoles in both the epidermis and dermis. CONCLUSION The LIOBS and LIC processes and the secondary production of vacuoles could be highly valuable for effective dermal remodeling treatment and aid in promoting the production of new collagen, elastic fibers, and growth factors that could improve skin texture. These structures were visible under RCM and histopathological evaluation.
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Affiliation(s)
- Maritza Rojas-Orrego
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nestor Carreño
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Teo Feuerhake
- Department of Pathology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Liu X, Zeng R, Liu Y, Guo L, Zhang M, Zheng H, Wu Q, Ge Y, Lin T. Comparison of the 1064-nm picosecond laser with fractionated microlens array and 1565-nm non-ablative fractional laser for the treatment of enlarged pores: a randomized, split-face, controlled trial. Lasers Med Sci 2024; 39:80. [PMID: 38396012 DOI: 10.1007/s10103-024-04028-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE This split-face randomized study compared the efficacy and safety between 1064-nm picosecond laser with fractionated microlens array (MLA) and 1565-nm nonablative fractional laser to treat enlarged pores. METHODS Participants with enlarged facial pores were enrolled and underwent three consecutive sessions at 2-week intervals with either a 1064-nm picosecond laser with MLA or a 1565-nm nonablative fractional laser. Images were captured at each visit. Objective (pore number) and subjective assessments, including patient self-evaluations and quartile improvement scales, were used to evaluate the treatment efficacy. The pain levels and adverse effects were recorded at each subsequent visit. RESULTS The participants were 3 men and 22 women with enlarged facial pores. At the initial and 2-month checkups after the last treatment, the pore numbers were significantly decreased bilaterally for both lasers. The respective quartile improvement scale scores for the 1064-nm picosecond and 1565-nm fractional lasers were 2.22 ± 1.06 and 2.14 ± 1.11, while those for patient self-assessment were 3.72 ± 0.74 and 3.68 ± 0.75. The pore number, quartile improvement scale score, and patients' self-assessments did not differ significantly between the two lasers. Treatment with the 1064-nm picosecond laser better reduced pain compared with the 1565-nm nonablative fractional laser (4.11 ± 1.33 vs. 4.83 ± 1.17). The occurrence of pigmentation did not differ significantly between the lasers. CONCLUSION Both the 1064-nm picosecond laser with MLA and the 1565-nm nonablative fractional laser are viable options for treating enlarged pores, and showed comparable respective efficacies; however, the former was less likely to cause hyperpigmentation and was better tolerated.
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Affiliation(s)
- Xing Liu
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China
| | - Rong Zeng
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China.
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, 650021, No. 120 Guanghua Rd, Kunming, 650021, China.
| | - Yuzhen Liu
- Department of dermatology, Nanjing Jiangning Hospital, Nanjing, 211100, China
| | - Lifang Guo
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China
| | - Mengli Zhang
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China
| | - Huiying Zheng
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China
| | - Qiuju Wu
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China
| | - Yiping Ge
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China
| | - Tong Lin
- Department of laser surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042, China.
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Shiu J, Lentsch G, Polleys CM, Mobasher P, Ericson M, Georgakoudi I, Ganesan AK, Balu M. Non-invasive Imaging Techniques for Monitoring Cellular Response to Treatment in Stable Vitiligo. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.15.553419. [PMID: 37645823 PMCID: PMC10462045 DOI: 10.1101/2023.08.15.553419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Punch grafting procedures, where small pieces of normal skin are transplanted into stable vitiligo patches, results in repigmentation in only half of patients treated, yet the factors that determine whether a patient responds to treatment or not are still unknown. Reflectance confocal microscopy (RCM) is adept at visualizing melanocyte migration and epidermal changes over large areas while multiphoton microscopy (MPM) can capture metabolic changes in keratinocytes. With the overall goal of identifying optical biomarkers for early treatment response, we followed 12 vitiligo lesions undergoing punch grafting. Dendritic melanocytes adjacent to the graft site were observed before clinical evidence of repigmentation in treatment responsive patients but not in treatment non-responsive patients, suggesting that the early visualization of melanocytes is indicative of a therapeutic response. Keratinocyte metabolic changes in vitiligo skin adjacent to the graft site also correlated with treatment response, indicating that a keratinocyte microenvironment that more closely resembles normal skin is more hospitable for migrating melanocytes. Taken together, these studies suggest that successful melanocyte transplantation requires both the introduction of new melanocytes and modulation of the local tissue microenvironment.
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Affiliation(s)
- Jessica Shiu
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA, USA
| | | | - Pezhman Mobasher
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Marissa Ericson
- Biostatistics, Epidemiology and Research Design, University of California, Irvine, Irvine, CA, USA
| | - Irene Georgakoudi
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
| | - Anand K Ganesan
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
- Skin Biology Resource Center, University of California, Irvine, Irvine, CA, USA
| | - Mihaela Balu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Skin Biology Resource Center, University of California, Irvine, Irvine, CA, USA
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Disphanurat W, Charutanan N, Sitthiwatthanawong P, Suthiwartnarueput W. Efficacy and safety of fractional 1064-nm picosecond laser for atrophic traumatic and surgical scars: A randomized, single-blinded, split-scar-controlled study. Lasers Surg Med 2023. [PMID: 37130437 DOI: 10.1002/lsm.23675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/05/2023] [Accepted: 04/22/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVE A fractional 1064-nm picosecond laser is an efficient and safe treatment for atrophic acne scars. However, evidence of using a picosecond laser for atrophic posttraumatic and surgical scar therapy is lacking. This study aimed to evaluate the efficacy and safety of using a 1064-nm picosecond laser with a microlens array (MLA) for the treatment of atrophic posttraumatic and surgical scars. METHODS This was a prospective, intraindividual, single-blinded, randomized split-lesion-controlled trial. Twenty-five subjects with atrophic traumatic or surgical scars that existed for more than 1 year were enrolled. All atrophic scars were divided at the midline into two halves and randomly assigned to a treatment or control side. The treatment group was treated with a 1064-nm picosecond laser with an MLA handpiece (spot size: 6-8 mm, fluence: 1.0-1.2 J/cm2 , repetition rate: 5 Hz, three passes) for 3 monthly sessions. The scar volumes were objectively measured using a three-dimensional (3D) photograph at baseline, 1 month after the first and second treatments, and 3 and 6 months after the final treatment. Subjective assessments were conducted by a blinded dermatologist and patients' self-assessment to evaluate improvements at 3 months after the final treatment. RESULTS The treated sides exhibited a significant volume reduction, with statistically significant improvements over the control group at 1 month after the first and second treatments and at 3 months after the final treatment (p = 0.024, 0.005, and 0.019, respectively). At 3 months after the final treatment, a blinded dermatologist correctly identified the treated side in 24 of 25 patients (96%). The patients rated the improvements as excellent (>75%) and marked (50%-75%) in 36% and 48% of patients, respectively. CONCLUSION At 3 months, the 1064-nm picosecond laser with a fractionated MLA can significantly reduce the posttraumatic and postsurgical atrophic scar volume in patients with Fitzpatrick skin types III-V. Insufficient data preclude inferences regarding efficacy at 6 months.
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Affiliation(s)
- Wareeporn Disphanurat
- Department of Medicine, Division of Dermatology, Thammasat University, Pathum Thani, Thailand
| | - Nipathorn Charutanan
- Department of Medicine, Division of Dermatology, Thammasat University, Pathum Thani, Thailand
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Nguyen L, Schneider SW, Herberger K. [Picosecond lasers in dermatology]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00105-023-05144-3. [PMID: 37099130 DOI: 10.1007/s00105-023-05144-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND The picosecond laser is one of the latest laser systems in dermatology and was originally developed to optimize tattoo removal. Advances in this technology has expanded the use of the picosecond laser to numerous other indications. OBJECTIVES This article provides an overview of the technical background as well as the indications of the picosecond laser in dermatological laser medicine and elucidates the possibilities and limits of this laser system. MATERIALS AND METHODS The article is based on a review of the current literature as well as experience from clinical practice in a university laser department. RESULTS The picosecond laser enables a particularly gentle and effective treatment due to ultra-short pulses and the principle of laser-induced optical breakdown. Compared to Q‑switched lasers, the picosecond laser has fewer side effects and is associated with lower pain intensity and shorter downtime. In addition to the removal of tattoos and pigmentary disorders, it is also used in the treatment of scars and rejuvenation. CONCLUSIONS The picosecond laser has a wide range of indications in dermatological laser medicine. The current data indicate that the laser is an effective method with few side effects. Further prospective studies have to be conducted to assess the efficacy, tolerability and patient satisfaction in an evidence-based manner.
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Affiliation(s)
- Lynhda Nguyen
- Laserabteilung, Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Stefan W Schneider
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Katharina Herberger
- Laserabteilung, Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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7
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Liu C, Wu PJ, Chia SH, Sun CK, Liao YH. Characterization of picosecond laser-induced optical breakdown using harmonic generation microscopy. Lasers Surg Med 2023. [PMID: 37051896 DOI: 10.1002/lsm.23664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/10/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND AND OBJECTIVES By creating microinjuries usually confined to the epidermis, a fractional picosecond 1064-nm Nd:YAG laser that delivers an array of highly focused beamlets can be effectively used for facial rejuvenation or resurfacing. However, the mechanism of dermal remodeling underlying this nonablative treatment remains unclear. METHODS Five participants having skin phototype III-IV were recruited for intervention using a fractional picosecond 1064-nm Nd:YAG laser system equipped with a holographic diffractive beam-splitting optic. The laser-induced histopathological changes on human skin were examined in vivo using a harmonic generation microscopy (HGM), visualizing second harmonic generation (SHG), and third harmonic generation (THG) contrasts dichromatically. SHG refers for collagen distribution, while THG represents for epidermal components in the HGM signal. RESULTS Histological hematoxylin and eosin staining and in vivo HGM imaging studies revealed the presence of epidermal vacuoles below the stratum granulosum along with keratinocyte degeneration or cytolysis. In addition to the epidermal vacuoles, HGM imaging exclusively demonstrated laser-induced shock wave propagation arranged as a THG-bright concentric pattern in the epidermis and loss of SHG signals in the papillary dermis immediately beneath the epidermal vacuoles. CONCLUSIONS Alongside generating epidermal vacuoles, the fractional picosecond 1064-nm Nd:YAG laser induced collagen changes. These collagen changes may lead to dermal remodeling and neocollagenesis underlying the fractional picosecond laser treatment.
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Affiliation(s)
- Connie Liu
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dermatology, Taipei City Hospital, Taipei, Taiwan
| | - Pei-Jhe Wu
- Department of Electrical Engineering, Graduate Institute of Photonics and Optoelectronics, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Shih-Hsuan Chia
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chi-Kuang Sun
- Department of Electrical Engineering, Graduate Institute of Photonics and Optoelectronics, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Yi-Hua Liao
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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8
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Zhou Y, Hamblin MR, Wen X. An update on fractional picosecond laser treatment: histology and clinical applications. Lasers Med Sci 2023; 38:45. [PMID: 36658259 PMCID: PMC9852188 DOI: 10.1007/s10103-022-03704-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/29/2022] [Indexed: 01/21/2023]
Abstract
Picosecond lasers have a very short pulse duration and a high peak power density. When fractional optical delivery systems are attached to picosecond lasers, they generate an array of concentrated microspots with a high fluence surrounded by areas with a low fluence. This article discusses the histologic characteristics and clinical applications of fractional picosecond laser treatment. Fractional picosecond laser produces laser-induced optical breakdown (LIOB) and laser-induced cavitation (LIC) in the epidermis and dermis respectively, and can encourage skin regeneration and dermal remodeling. It has been shown that fractional picosecond laser has a positive effect on facial photoaging, enlarged facial pores, dyspigmentation, wrinkles, and atrophic scars. Further research is still needed to confirm the benefits of fractional picosecond lasers.
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Affiliation(s)
- Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, 610041, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, 2028, South Africa
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, 610041, China.
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Shiu J, Zhang L, Lentsch G, Flesher JL, Jin S, Polleys CM, Jo SJ, Mizzoni C, Mobasher P, Kwan J, Rius-Diaz F, Tromberg BJ, Georgakoudi I, Nie Q, Balu M, Ganesan AK. Multimodal analyses of vitiligo skin identifies tissue characteristics of stable disease. JCI Insight 2022; 7:154585. [PMID: 35653192 PMCID: PMC9310536 DOI: 10.1172/jci.insight.154585] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/25/2022] [Indexed: 11/24/2022] Open
Abstract
Vitiligo is an autoimmune skin disease characterized by the destruction of melanocytes by autoreactive CD8+ T cells. Melanocyte destruction in active vitiligo is mediated by CD8+ T cells, but the persistence of white patches in stable disease is poorly understood. The interaction between immune cells, melanocytes, and keratinocytes in situ in human skin has been difficult to study due to the lack of proper tools. We combine noninvasive multiphoton microscopy (MPM) imaging and single-cell RNA-Seq (scRNA-Seq) to identify subpopulations of keratinocytes in stable vitiligo patients. We show that, compared with nonlesional skin, some keratinocyte subpopulations are enriched in lesional vitiligo skin and shift their energy utilization toward oxidative phosphorylation. Systematic investigation of cell-to-cell communication networks show that this small population of keratinocyte secrete CXCL9 and CXCL10 to potentially drive vitiligo persistence. Pseudotemporal dynamics analyses predict an alternative differentiation trajectory that generates this new population of keratinocytes in vitiligo skin. Further MPM imaging of patients undergoing punch grafting treatment showed that keratinocytes favoring oxidative phosphorylation persist in nonresponders but normalize in responders. In summary, we couple advanced imaging with transcriptomics and bioinformatics to discover cell-to-cell communication networks and keratinocyte cell states that can perpetuate inflammation and prevent repigmentation.
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Affiliation(s)
- Jessica Shiu
- Department of Dermatology, University of California, Irvine, Irvine, United States of America
| | - Lihua Zhang
- Department of Mathematics, University of California, Irvine, Irvine, United States of America
| | - Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, United States of America
| | - Jessica L Flesher
- Department of Dermatology, Massachusetts General Hospital, Boston, United States of America
| | - Suoqin Jin
- Department of Mathematics, University of California, Irvine, Irvine, United States of America
| | - Christopher M Polleys
- Department of Biomedical Engineering, Tufts University, Medford, United States of America
| | - Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Craig Mizzoni
- Department of Biomedical Engineering, Tufts University, Medford, United States of America
| | - Pezhman Mobasher
- Department of Dermatology, University of California, Irvine, Irvine, United States of America
| | - Jasmine Kwan
- Department of Biomedical Engineering, Tufts University, Medford, United States of America
| | - Francisca Rius-Diaz
- Department of Preventive Medicine and Public Health, University of Malaga, Malaga, Spain
| | - Bruce J Tromberg
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, United States of America
| | - Irene Georgakoudi
- Department of Biomedical Engineering, Tufts University, Medford, United States of America
| | - Qing Nie
- Department of Mathematics, University of California, Irvine, Irvine, United States of America
| | - Mihaela Balu
- Department of Surgery, Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, United States of America
| | - Anand K Ganesan
- Department of Dermatology, University of California, Irvine, Irvine, United States of America
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Lentsch G, Baugh EG, Lee B, Aszterbaum M, Zachary CB, Kelly KM, Balu M. Research Techniques Made Simple: Emerging Imaging Technologies for Noninvasive Optical Biopsy of Human Skin. J Invest Dermatol 2022; 142:1243-1252.e1. [PMID: 35461534 PMCID: PMC9802025 DOI: 10.1016/j.jid.2022.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/07/2022] [Accepted: 01/18/2022] [Indexed: 01/03/2023]
Abstract
Over the past few years, high-resolution optical imaging technologies such as optical coherence tomography (OCT), reflectance confocal microscopy (RCM), and multiphoton microscopy (MPM) have advanced significantly as new methodologies for clinical research and for real-time detection, diagnosis, and therapy monitoring of skin diseases. Implementation of these technologies into clinical research and practice requires clinicians to have an understanding of their capabilities, benefits, and limitations. This concise review provides insights on the application of OCT, RCM, and MPM for clinical skin imaging through images acquired in vivo from the same lesions. The presented data are limited to pigmented lesions and basal cell carcinoma.
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Affiliation(s)
- Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
| | - Erica G. Baugh
- Department of Dermatology, University of California, Irvine, California, USA
| | - Bonnie Lee
- Department of Dermatology, University of California, Irvine, California, USA
| | - Michelle Aszterbaum
- Department of Dermatology, University of California, Irvine, California, USA
| | | | - Kristen M. Kelly
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA,Department of Dermatology, University of California, Irvine, California, USA
| | - Mihaela Balu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
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11
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Chen SX, Cheng J, Watchmaker J, Dover JS, Chung HJ. Review of Lasers and Energy-Based Devices for Skin Rejuvenation and Scar Treatment With Histologic Correlations. Dermatol Surg 2022; 48:441-448. [PMID: 35165220 DOI: 10.1097/dss.0000000000003397] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lasers and energy-based devices (EBD) are popular treatments for skin rejuvenation and resurfacing. Achieving desired outcomes and avoiding complications require understanding the effects of these devices at a histologic level. Currently, no comprehensive review summarizing the histologic effects of laser and energy-based treatments exists. OBJECTIVE To describe how lasers and EBD alter skin histology and improve the overall understanding of these devices. MATERIALS AND METHODS A PubMed search was conducted for studies with histologic analysis of fractional picosecond laser, fractional radiofrequency microneedling, nonablative lasers, and ablative lasers. RESULTS Fractional picosecond lasers induce intraepidermal and/or dermal vacuoles from laser-induced optical breakdown. Fractional radiofrequency microneedling delivers thermal energy to the dermis while sparing the epidermis, making it safer for patients with darker skin phototypes. Fractional nonablative lasers induce conical zones of coagulation of the epidermis and upper dermis. Ablative lasers vaporize the stratum corneum down to the dermis. Traditional ablative lasers cause diffuse vaporization while fractional ablative lasers generate columns of tissue ablation. CONCLUSION Lasers and EBD are effective for skin resurfacing and rejuvenation and have different mechanisms with disparate targets in the skin. Safe and effective use of devices requires understanding the histologic laser-tissue interaction.
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Affiliation(s)
- Stella X Chen
- Harvard Combined Dermatology Residency Program, Boston, Massachusetts
| | - Judy Cheng
- Department of Dermatology, Northwestern Medical Group, Chicago, Illinois
| | | | - Jeffrey S Dover
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Hye Jin Chung
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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12
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In Vivo Identification of Skin Photodamage Induced by Fractional CO2 and Picosecond Nd:YAG Lasers with Optical Coherence Tomography. Diagnostics (Basel) 2022; 12:diagnostics12040822. [PMID: 35453872 PMCID: PMC9027631 DOI: 10.3390/diagnostics12040822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 12/04/2022] Open
Abstract
Fractional laser treatment is commonly used for dermatological applications, enabling effective induction of collagen regeneration and significantly reducing recovery time. However, it is challenging to observe laser-induced photodamage beneath the tissue surface in vivo, making the non-invasive evaluation of treatment outcomes difficult. For in vivo real-time study of the photodamage induced by fractional pulsed CO2 and Nd:YAG lasers commonly utilized for clinical therapy, a portable spectral-domain optical coherence tomography (SD-OCT) system was implemented for clinical studies. The photodamage caused by two lasers, including photothermal and photoacoustic effects, was investigated using OCT, together with the correlation between photodamage and exposure energy. Additionally, to investigate the change in the optical properties of tissue due to photodamage, the attenuation coefficients and damaged areas of normal skin and laser-treated skin were estimated for comparison. Finally, the recovery of the exposed skin with both lasers was also compared using OCT. The results show that OCT can be a potential solution for in vivo investigation of laser-induced tissue damage and quantitative evaluation.
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13
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Cai S, Wu Y, Chen G. A Novel Elastomeric UNet for Medical Image Segmentation. Front Aging Neurosci 2022; 14:841297. [PMID: 35360219 PMCID: PMC8961507 DOI: 10.3389/fnagi.2022.841297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Medical image segmentation is of important support for clinical medical applications. As most of the current medical image segmentation models are limited in the U-shaped structure, to some extent the deep convolutional neural network (CNN) structure design is hard to be accomplished. The design in this study mimics the way the wave is elastomeric propagating, extending the structure from both the horizontal and spatial dimensions for realizing the Elastomeric UNet (EUNet) structure. The EUNet can be divided into two types: horizontal EUNet and spatial EUNet, based on the propagation direction. The advantages of this design are threefold. First, the training structure can be deepened effectively. Second, the independence brought by each branch (a U-shaped design) makes the flexible design redundancy available. Finally, a horizontal and vertical series-parallel structure helps on feature accumulation and recursion. Researchers can adjust the design according to the requirements to achieve better segmentation performance for the independent structural design. The proposed networks were evaluated on two datasets: a self-built dataset (multi-photon microscopy, MPM) and publicly benchmark retinal datasets (DRIVE). The results of experiments demonstrated that the performance of EUNet outperformed the UNet and its variants.
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Affiliation(s)
- Sijing Cai
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
- School of Electronic & Electrical Engineering and Physics, Fujian University of Technology, Fuzhou, China
| | - Yi Wu
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
- Fujian Provincial Engineering Technology Research Center of Photoelectric Sensing Application, Fujian Normal University, Fuzhou, China
| | - Guannan Chen
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China
- Fujian Provincial Engineering Technology Research Center of Photoelectric Sensing Application, Fujian Normal University, Fuzhou, China
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14
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Donati V, Peres C, Nardin C, Scavizzi F, Raspa M, Ciubotaru CD, Bortolozzi M, Pedersen MG, Mammano F. Calcium Signaling in the Photodamaged Skin: In Vivo Experiments and Mathematical Modeling. FUNCTION 2021; 3:zqab064. [PMID: 35330924 PMCID: PMC8788836 DOI: 10.1093/function/zqab064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 01/07/2023] Open
Abstract
The epidermis forms an essential barrier against a variety of insults. The overall goal of this study was to shed light not only on the effects of accidental epidermal injury, but also on the mechanisms that support laser skin resurfacing with intra-epidermal focal laser-induced photodamage, a widespread medical practice used to treat a range of skin conditions. To this end, we selectively photodamaged a single keratinocyte with intense, focused and pulsed laser radiation, triggering Ca2+ waves in the epidermis of live anesthetized mice with ubiquitous expression of a genetically encoded Ca2+ indicator. Waves expanded radially and rapidly, reaching up to eight orders of bystander cells that remained activated for tens of minutes, without displaying oscillations of the cytosolic free Ca2+ concentration ([Formula: see text]). By combining in vivo pharmacological dissection with mathematical modeling, we demonstrate that Ca2+ wave propagation depended primarily on the release of ATP, a prime damage-associated molecular patterns (DAMPs), from the hit cell. Increments of the [Formula: see text] in bystander cells were chiefly due to Ca2+ release from the endoplasmic reticulum (ER), downstream of ATP binding to P2Y purinoceptors. ATP-dependent ATP release though connexin hemichannels (HCs) affected wave propagation at larger distances, where the extracellular ATP concentration was reduced by the combined effect of passive diffusion and hydrolysis due to the action of ectonucleotidases, whereas pannexin channels had no role. Bifurcation analysis suggests basal keratinocytes have too few P2Y receptors (P2YRs) and/or phospholipase C (PLC) to transduce elevated extracellular ATP levels into inositol trisphosphate (IP3) production rates sufficiently large to sustain [Formula: see text] oscillations.
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Affiliation(s)
- Viola Donati
- Department of Physics and Astronomy “G. Galilei”, University of Padova, 35131 Padova, Italy
- Institute of Biochemistry and Cell Biology (IBBC)-CNR, 00015 Monterotondo (RM), Italy
| | - Chiara Peres
- Institute of Biochemistry and Cell Biology (IBBC)-CNR, 00015 Monterotondo (RM), Italy
| | - Chiara Nardin
- Institute of Biochemistry and Cell Biology (IBBC)-CNR, 00015 Monterotondo (RM), Italy
| | - Ferdinando Scavizzi
- Institute of Biochemistry and Cell Biology (IBBC)-CNR, 00015 Monterotondo (RM), Italy
| | - Marcello Raspa
- Institute of Biochemistry and Cell Biology (IBBC)-CNR, 00015 Monterotondo (RM), Italy
| | | | - Mario Bortolozzi
- Department of Physics and Astronomy “G. Galilei”, University of Padova, 35131 Padova, Italy
- Institute of Biochemistry and Cell Biology (IBBC)-CNR, 00015 Monterotondo (RM), Italy
- Foundation for Advanced Biomedical Research, Veneto Institute of Molecular Medicine (VIMM), 35129 Padova (PD), Italy
| | - Morten Gram Pedersen
- Department of Information Engineering, University of Padova, 35131 Padova (PD), Italy
- Department of Mathematics “Tullio Levi-Civita”, University of Padova, 35121 Padova (PD), Italy
| | - Fabio Mammano
- Department of Physics and Astronomy “G. Galilei”, University of Padova, 35131 Padova, Italy
- Institute of Biochemistry and Cell Biology (IBBC)-CNR, 00015 Monterotondo (RM), Italy
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15
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Watchmaker J, Kandula P. Hyperpigmentation From Fixed Drug Eruption Successfully Treated With a Low-Fluence 1064 nm Nd:YAG Picosecond Laser. Dermatol Surg 2021; 47:1529-1530. [PMID: 34699446 DOI: 10.1097/dss.0000000000003216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Ahn HJ, Hye Suh D, Kang IH, Jun Lee S, Kyung Shin M, Yong Song K. Interaction of skin with fractional picosecond laser in Asian patients. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:14-15. [PMID: 34980953 PMCID: PMC8675342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Hye-Jin Ahn
- Drs. Suh and Lee are with Arumdaun Nara Dermatologic Clinic in Seoul, Korea
- Drs. Ahn, Kang, and Shin are with the Department of Dermatology, College of Medicine at Kyung Hee University in Seoul, Korea
- Dr. Song is with the Department of Pathology at Kuro Sungsim Medical Center in Seoul, Korea
| | - Dong Hye Suh
- Drs. Suh and Lee are with Arumdaun Nara Dermatologic Clinic in Seoul, Korea
- Drs. Ahn, Kang, and Shin are with the Department of Dermatology, College of Medicine at Kyung Hee University in Seoul, Korea
- Dr. Song is with the Department of Pathology at Kuro Sungsim Medical Center in Seoul, Korea
| | - In-Hye Kang
- Drs. Suh and Lee are with Arumdaun Nara Dermatologic Clinic in Seoul, Korea
- Drs. Ahn, Kang, and Shin are with the Department of Dermatology, College of Medicine at Kyung Hee University in Seoul, Korea
- Dr. Song is with the Department of Pathology at Kuro Sungsim Medical Center in Seoul, Korea
| | - Sang Jun Lee
- Drs. Suh and Lee are with Arumdaun Nara Dermatologic Clinic in Seoul, Korea
- Drs. Ahn, Kang, and Shin are with the Department of Dermatology, College of Medicine at Kyung Hee University in Seoul, Korea
- Dr. Song is with the Department of Pathology at Kuro Sungsim Medical Center in Seoul, Korea
| | - Min Kyung Shin
- Drs. Suh and Lee are with Arumdaun Nara Dermatologic Clinic in Seoul, Korea
- Drs. Ahn, Kang, and Shin are with the Department of Dermatology, College of Medicine at Kyung Hee University in Seoul, Korea
- Dr. Song is with the Department of Pathology at Kuro Sungsim Medical Center in Seoul, Korea
| | - Kye Yong Song
- Drs. Suh and Lee are with Arumdaun Nara Dermatologic Clinic in Seoul, Korea
- Drs. Ahn, Kang, and Shin are with the Department of Dermatology, College of Medicine at Kyung Hee University in Seoul, Korea
- Dr. Song is with the Department of Pathology at Kuro Sungsim Medical Center in Seoul, Korea
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17
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Kim S, Le VH, Kim B, Kim CJ, Im SH, Kim KH. Longitudinal Label-Free Two-Photon Microscopy of Cellular Healing Processes in Non-Ablative Fractional Laser Wounds. Lasers Surg Med 2021; 53:1413-1426. [PMID: 34139024 DOI: 10.1002/lsm.23445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Wound healing is an important biomedical problem with various associated complications. Although cutaneous wound healing has been studied in vivo extensively using various optical imaging methods, early-stage cellular healing processes were difficult to study due to scab formation. The objective of this study is to demonstrate that minimal laser wounds and optical microscopy can access the detailed cellular healing processes of cutaneous wounds from the early stage. STUDY DESIGN/MATERIALS AND METHODS A non-ablative fractional laser (NAFL) and label-free two-photon microscopy (TPM) were used to induce minimal cutaneous wounds and to image the wounds in three-dimension. Sixteen hairless mice and a single human volunteer were used. NAFL wounds were induced in the hindlimb skin of the mice and in the forearm skin of the human subject. The NAFL wounds were longitudinally imaged during the healing period, starting from an hour post wound induction in the earliest and until 21 days. Cells in the wound and surrounding normal skin were visualized based on two-photon excited auto-fluorescence (TPAF), and cellular changes were tracked by analyzing longitudinal TPM images both qualitatively and quantitatively. Damage and recovery in the skin dermis were tracked by using the second harmonic generation (SHG) signal of collagen. Immunofluorescence and hematoxylin and eosin histology analysis were conducted to validate the TPM results of the murine skin. RESULTS Cellular healing processes in NAFL wounds and surroundings could be observed by longitudinal TPM. In the case of murine skin, various healing phases including inflammation, re-epithelization, granulation tissue formation, and late remodeling phase including collagen regeneration were observed in the same wounds owing to minimal or no scab formation. The re-epithelization process was analyzed quantitatively by measuring cell density and thickness of the epithelium in the wound surroundings. In the case of the human skin, the access inside the wound was blocked for a few days post wound induction due to scabs but the cellular changes in the wound surroundings were observed from the early stage. Cellular healing processes in the NAFL wound of the human skin were similar to those in murine skin. CONCLUSIONS The minimal NAFL wound model and label-free TPM demonstrated the cell level assessment of wound healing processes with applicability to human subjects. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Seonghan Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Viet-Hoan Le
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea
| | - Bumju Kim
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea
| | - Chan Johng Kim
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea
| | - Sin-Hyeog Im
- Department of Life Sciences & Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, 37673, Republic of Korea.,ImmunoBiome Inc. Bio Open Innovation Center, 47 Jigok-ro, Nam-gu, Pohang, Gyeongbukdo, 37673, Republic of Korea
| | - Ki Hean Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
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18
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O Connor K, Cho SB, Chung HJ. Wound Healing Profile After 1064- and 532-nm Picosecond Lasers With Microlens Array of In Vivo Human Skin. Lasers Surg Med 2021; 53:1059-1064. [PMID: 33644902 DOI: 10.1002/lsm.23390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/17/2020] [Accepted: 01/24/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study is to histologically characterize the wound healing process of in vivo human skin treated with 1064- and 532-nm microlens array (MLA)-type picosecond lasers. STUDY DESIGN/MATERIALS AND METHODS Three patients (Fitzpatrick skin types II-IV), who were undergoing future cosmetic abdominoplasties, were treated with 1064- and 532-nm MLA-type lasers under different fluence settings. Treatments were performed 2 weeks, 1 week, and immediately prior to surgery. Skin samples were harvested from the resected tissue with 8 mm punch biopsies immediately after the abdominoplasties were performed. RESULTS The study demonstrates that intraepidermal vacuoles, created from tissue damage induced by the laser, are histologically resolved within 1 week without persistent damage to the dermoepidermal junction or vasculature. After 2 weeks, all foci of microscopic epidermal necrotic debris had either resolved or migrated to more superficial levels in the stratum corneum. There was no evidence of persistent vascular damage, increased melanophages, or accumulation of melanin in the dermis at 2 weeks. Furthermore, the 1064-nm picosecond laser with the high fluence setting demonstrated the capacity to fractionally ablate the epidermis and induce multifocal fibrosis in the papillary dermis in lighter skin types. CONCLUSION This is the first study to demonstrate the wound healing profile of in vivo human skin after treatment with the picosecond 1064- and 532-nm MLA-type lasers. It shows that laser-induced tissue damage is histologically resolved within 2 weeks, clinically reflecting a favorable safety profile and short downtime. The study also shows that the picosecond laser can be used to induce either fractional ablative or non-ablative effects, depending on the fluence settings used. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Kelly O Connor
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Sung Bin Cho
- Yonsei Seran Dermatology and Laser Clinic, Seoul, South Korea
| | - Hye Jin Chung
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, 02215
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19
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Pedrelli V, Azzopardi E, Azzopardi E, Tretti Clementoni M. Picosecond laser versus historical responses to Q-switched lasers for tattoo treatment. J COSMET LASER THER 2021; 22:210-214. [PMID: 33594939 DOI: 10.1080/14764172.2021.1886307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BackgroundTattooing is increasingly common among adolescents and young adults. This study explores the clinical efficacy of picosecond laser for the correction of tattoos. Literature suggests that 25-47% of the population have had a tattoo at some point in their life (1). The incidence is slightly higher in adults 18-35 years (22-47%) compared to college students (18-25 years of age(1, 2). Recent surveys report 25% of tattooed adults expressing regret, while 4% of tattooed students had already undergone some form of tattoo-removal procedure (3). A common request for tattoo removal includes poorly executed tattoos, avoidance of stigmatization, trauma, socially inappropriate, and employment. Several procedures have been proposed to remove tattoos including cryosurgery, thermal cautery, or surgical resection (4). A major disadvantage of these methods is that they are all highly operator dependent, and carry a very high risk of residual scarring, residual pigment being left behind "ghosting" (3). In addition, some opt to cover the unwanted tattoo with another design, which results in layered tattoos that are substantially harder to manage. Laser surgery, in skilled hands, is an effective method for tattoo removal and traditionally, this is performed with Quality-Switched Laser, where energy liberatred in the nanosecond range results in a selective photothermal effect (5). Picosecond laser is a more recent innovation that results in energy released in a picosecond timescale (a time interval 1000 times shorter).One potential disavantage of laser therapy for the effacement of cutaneous tattoos is the length of treatment and associated cost, which might dissuade the patient from following through to completion of treatment, limiting potential benefits whilst still being exposed to risk of harm. (5, 6). Recent studies suggest that picosecond laser result in substantially reduced treatment times, whilst achieving an identical or more effective end result (7-9). However, these studies are limited by very small sample size and follow-up.
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Affiliation(s)
| | | | - Ernest Azzopardi
- Laserplast Stl Stp, Milan, Italy.,Swansea Bay University Hospitals Board, NHS, Swansea, Wales, UK.,Dept of Anatomy, University of Malta Faculty of Medicine & Surgery, Tal Qroqq, Malta.,University College London, London, UK
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20
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Zhang M, Guan Y, Huang Y, Zhang E, Lin T, Wu Q. Histological Characteristics of Skin Treated With a Fractionated 1064-nm Nd: YAG Picosecond Laser With Holographic Optics. Lasers Surg Med 2021; 53:1073-1079. [PMID: 33565087 DOI: 10.1002/lsm.23389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/16/2020] [Accepted: 01/24/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVES Picosecond lasers (PSL) constitute a significant technological advancement and exert rejuvenating effects upon the skin. This study was conducted to investigate changes in the skin upon treatment with the fractionated 1064-nm Nd: YAG PSL through in vivo and ex vivo human histological analysis. STUDY DESIGN/MATERIALS AND METHODS In vivo back skin specimens were treated with a fractionated 1064-nm PSL at 1.3, 2.1, and 2.9 mJ fluence for two passes, and 2.9 mJ for 10 passes, and then stained with hematoxylin and eosin (H&E). Ex vivo foreskin specimens after circumcision surgery were treated with a PSL at 1.3, 2.1, and 2.9 mJ fluence for two and 10 passes, followed by H&E staining. Ex vivo skin tissue sections treated with a PSL at 2.9 mJ fluence for 10 passes were also immunostained for Melan-A and CD31. RESULTS Intraepidermal vacuoles were observed, along with pigment accumulation and inflammatory cell infiltration in the vacuoles at 24 hours after PSL treatment in the in vivo skin specimens. The vacuoles expanded as the fluence increased. Numerous intraepidermal vacuoles were observed, with dermal hemorrhage and inflammatory cell infiltration upon high-fluence, multi-pass PSL treatment in the in vivo skin specimens. PSL treatment yielded both epidermal and dermal vacuoles in ex vivo skin specimens. Melan-A-positive cells were seen in the cystic wall of vacuoles in the epidermal basal layer, whereas CD31-positive cells were detected in the cystic wall of some dermal vacuoles. CONCLUSIONS The fractionated 1064-nm PSL produced epidermal vacuoles and dermal lesions, with histological differences between the in vivo and ex vivo skin specimens. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Mengli Zhang
- Department of Cosmetic Laser Surgery, Hospital for Skin Disease, Institute of Dermatology, Peking Union Medical College (PUMC), Chinese Academy of Medical Sciences (CAMS), Jiangwangmiao Street 12, Xuanwu District, Nanjing, Jiangsu, 210042, China
| | - Yang Guan
- Department of Dermatovenereology, Shenzhen Center for Chronic Disease Control, Buxin Road 2021, Luohu District, Shenzhen, Guangdong, 518020, China
| | - Yuqing Huang
- Department of Cosmetic Laser Surgery, Hospital for Skin Disease, Institute of Dermatology, Peking Union Medical College (PUMC), Chinese Academy of Medical Sciences (CAMS), Jiangwangmiao Street 12, Xuanwu District, Nanjing, Jiangsu, 210042, China
| | - Erjia Zhang
- Department of Cosmetic Laser Surgery, Hospital for Skin Disease, Institute of Dermatology, Peking Union Medical College (PUMC), Chinese Academy of Medical Sciences (CAMS), Jiangwangmiao Street 12, Xuanwu District, Nanjing, Jiangsu, 210042, China
| | - Tong Lin
- Department of Cosmetic Laser Surgery, Hospital for Skin Disease, Institute of Dermatology, Peking Union Medical College (PUMC), Chinese Academy of Medical Sciences (CAMS), Jiangwangmiao Street 12, Xuanwu District, Nanjing, Jiangsu, 210042, China
| | - Qiuju Wu
- Department of Cosmetic Laser Surgery, Hospital for Skin Disease, Institute of Dermatology, Peking Union Medical College (PUMC), Chinese Academy of Medical Sciences (CAMS), Jiangwangmiao Street 12, Xuanwu District, Nanjing, Jiangsu, 210042, China
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21
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Kim H, Hwang JK, Jung M, Choi J, Kang HW. Laser-induced optical breakdown effects of micro-lens arrays and diffractive optical elements on ex vivo porcine skin after 1064 nm picosecond laser irradiation. BIOMEDICAL OPTICS EXPRESS 2020; 11:7286-7298. [PMID: 33408996 PMCID: PMC7747895 DOI: 10.1364/boe.410991] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 05/04/2023]
Abstract
The current study aims to investigate the effects of micro-lens arrays (MLA) and diffractive optical elements (DOE) on skin tissue via intra-dermal laser-induced optical breakdown (LIOB) after irradiation of 1064-nm picosecond laser light at high energy settings. Irradiation with MLA and DOE was tested on dimming paper, tissue-mimicking phantom, and dark pigmented porcine skin to quantitatively compare distributions of micro-beams, micro-bubbles, and laser-induced vacuoles in the skin. DOE yielded more uniform distributions of the micro-beams on the paper and laser-induced micro-bubbles in the phantom, compared to MLA. The ex vivo skin test confirmed that the DOE-assisted irradiation accompanied more homogeneous generation of the micro-beams on the tissue surface (deviation of ≤ 3%) and a high density of small laser-induced vacuoles (∼78 µm) in the dermis than the MLA-assisted irradiation (deviation of ∼26% and ∼163 µm). The DOE-assisted picosecond laser irradiation may help to achieve deep and uniformly-generated vacuolization under the basal membrane after intra-dermal LIOB for effective fractional skin treatment.
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Affiliation(s)
- Hyeonsoo Kim
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Jewan Kaiser Hwang
- Mymirae Research Institute for Dermatologic Science, Seoul, Republic of Korea
| | - Minjung Jung
- Department of Pathology, Kosin University Hospital, Busan, Republic of Korea
| | - Jongman Choi
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
- Research and Development, Bluecore Company, Busan, Republic of Korea
| | - Hyun Wook Kang
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
- Department of Biomedical Engineering, Pukyong National University, Busan, Republic of Korea
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22
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Fast A, Lal A, Durkin AF, Lentsch G, Harris RM, Zachary CB, Ganesan AK, Balu M. Fast, large area multiphoton exoscope (FLAME) for macroscopic imaging with microscopic resolution of human skin. Sci Rep 2020; 10:18093. [PMID: 33093610 PMCID: PMC7582965 DOI: 10.1038/s41598-020-75172-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023] Open
Abstract
We introduce a compact, fast large area multiphoton exoscope (FLAME) system with enhanced molecular contrast for macroscopic imaging of human skin with microscopic resolution. A versatile imaging platform, FLAME combines optical and mechanical scanning mechanisms with deep learning image restoration to produce depth-resolved images that encompass sub-mm2 to cm2 scale areas of tissue within minutes and provide means for a comprehensive analysis of live or resected thick human skin tissue. The FLAME imaging platform, which expands on a design recently introduced by our group, also features time-resolved single photon counting detection to uniquely allow fast discrimination and 3D virtual staining of melanin. We demonstrate its performance and utility by fast ex vivo and in vivo imaging of human skin. With the ability to provide rapid access to depth resolved images of skin over cm2 area and to generate 3D distribution maps of key sub-cellular skin components such as melanocytic dendrites and melanin, FLAME is ready to be translated into a clinical imaging tool for enhancing diagnosis accuracy, guiding therapy and understanding skin biology.
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Affiliation(s)
- Alexander Fast
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd., Irvine, CA, 92612, USA
| | - Akarsh Lal
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd., Irvine, CA, 92612, USA
| | - Amanda F Durkin
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd., Irvine, CA, 92612, USA
| | - Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd., Irvine, CA, 92612, USA
| | - Ronald M Harris
- Department of Dermatology, University of California, Irvine, 1 Medical Plaza Dr., Irvine, CA, 92697, USA
| | - Christopher B Zachary
- Department of Dermatology, University of California, Irvine, 1 Medical Plaza Dr., Irvine, CA, 92697, USA
| | - Anand K Ganesan
- Department of Dermatology, University of California, Irvine, 1 Medical Plaza Dr., Irvine, CA, 92697, USA
| | - Mihaela Balu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd., Irvine, CA, 92612, USA.
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23
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Mehrabi JN, Doong J, Lentsch G, Mesinkovska N. Imaging of in vivo pseudoxanthoma elasticum via multiphoton microscopy and optical coherence tomography. JAAD Case Rep 2020; 6:702-704. [PMID: 32715054 PMCID: PMC7369454 DOI: 10.1016/j.jdcr.2020.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Kirsanova L, Araviiskaia E, Rybakova M, Sokolovsky E, Bogantenkov A, Al-Niaimi F. Histological characterization of age-related skin changes following the use of picosecond laser: Low vs high energy. Dermatol Ther 2020; 33:e13635. [PMID: 32436343 DOI: 10.1111/dth.13635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
Fractional lasers have become widespread in dermatology owing to their efficacy and safety. Comparative analysis of histological features after laser rejuvenation using a 1064-nm fractionated handpiece picosecond laser with different energy fluence levels (1.1 or 2.1 J/cm2 ). An open-label, study of 28 women aged 36 to 60 years with signs of age-related photodamage and skin changes of the face and neck was conducted using a fractional picosecond 1064 nm laser in low vs high fluence. The clinical assessment at 3 weeks showed more pronounced effect on facial skin rejuvenation with the higher fluence of 2.1 J/cm2 compared to 1.1 J/cm2 . The effect and safety of laser rejuvenation using a picosecond laser has been shown with more pronounced histological effects at higher fluences.
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Affiliation(s)
- Lesia Kirsanova
- First Pavlov Saint-Petersburg Medical University, saint-Petersburg, Russia.,Saint-Petersburg's Institute of Beauty Galaxy, saint-Petersburg, Russia
| | - Elena Araviiskaia
- First Pavlov Saint-Petersburg Medical University, saint-Petersburg, Russia.,Saint-Petersburg's Institute of Beauty Galaxy, saint-Petersburg, Russia
| | - Margarita Rybakova
- First Pavlov Saint-Petersburg Medical University, saint-Petersburg, Russia.,Saint-Petersburg's Institute of Beauty Galaxy, saint-Petersburg, Russia
| | - Evgeny Sokolovsky
- First Pavlov Saint-Petersburg Medical University, saint-Petersburg, Russia
| | - Alexey Bogantenkov
- First Pavlov Saint-Petersburg Medical University, saint-Petersburg, Russia
| | - Firas Al-Niaimi
- Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark.,152 Harley street clinic, London, United Kingdom
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25
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Kim JE, Hong JY, Lee HJ, Lee SY, Kim HJ. Picosecond‐Domain Fractional Laser Treatment Over Hyaluronic Acid Fillers: In Vivo and Clinical Studies. Lasers Surg Med 2020; 52:928-934. [DOI: 10.1002/lsm.23254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Jung E. Kim
- Department of Dermatology Soonchunhyang University Cheonan Hospital 31, Suncheonhyang 6‐gil Cheonan Chungcheongnam‐do 31151 Republic of Korea
| | - Jeong Y. Hong
- Department of Dermatology Soonchunhyang University Cheonan Hospital 31, Suncheonhyang 6‐gil Cheonan Chungcheongnam‐do 31151 Republic of Korea
| | - Ho J. Lee
- Department of Dermatology Soonchunhyang University Cheonan Hospital 31, Suncheonhyang 6‐gil Cheonan Chungcheongnam‐do 31151 Republic of Korea
| | - Sung Y. Lee
- Department of Dermatology Soonchunhyang University Cheonan Hospital 31, Suncheonhyang 6‐gil Cheonan Chungcheongnam‐do 31151 Republic of Korea
| | - Hyun J. Kim
- CNP Skin Clinic, Cheonan 147, Gosokcheol‐daero Asan Chungcheongnam‐do 31470 Republic of Korea
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26
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Wu DC, Goldman MP, Wat H, Chan HHL. A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med 2020; 53:9-49. [PMID: 32282094 DOI: 10.1002/lsm.23244] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence-based recommendations are developed for the use of picosecond laser in dermatology. STUDY DESIGN/MATERIALS AND METHODS A comprehensive search of the English language literature was performed up to and including November 2019. Relevant citations were individually evaluated, synthesized, and categorized based on the Level of Evidence. With the addition of the authors' combined clinical experience, clinical recommendations were developed. RESULTS After application of inclusion and exclusion criteria, a total of 77 unique studies were evaluated. Treatment of benign pigmented lesions was associated with level I-IV evidence; rejuvenation was associated with level II evidence; melasma was associated with level II evidence; scar revision was associated with level II-III evidence; tattoo removal was associated with level I evidence. CONCLUSION Picosecond laser is a safe and effective treatment modality for an increasing range of dermatologic indications. Further development of this technology is warranted. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Douglas C Wu
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Heidi Wat
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
| | - Henry H L Chan
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
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27
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Kim HK, Kim HJ, Hong JY, Park J, Lee HC, Lyu H, Cho SB. Interactive tissue reactions of 1064-nm focused picosecond-domain laser and dermal cohesive polydensified matrix hyaluronic acid treatment in in vivo rat skin. Skin Res Technol 2020; 26:683-689. [PMID: 32180275 DOI: 10.1111/srt.12853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 03/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Picosecond-domain laser treatment using a microlens array (MLA) or a diffractive optical element (DOE) generates micro-injury zones in the epidermis and upper dermis. OBJECTIVE To investigate interactive tissue reactions between MLA-type picosecond laser pulses and cohesive polydensified matrix hyaluronic acid (CPMHA) filler in the dermis. METHODS In vivo rats with or without CPMHA pretreatment were treated with a 1064-nm picosecond-domain neodymium:yttrium-aluminum-garnet (Nd:YAG) laser using an MLA or DOE. Skin samples were obtained at post-treatment days 1, 10, and 21 and histologically and immunohistochemically analyzed. RESULTS Picosecond-domain Nd:YAG laser treatment with an MLA-type or a DOE-type handpiece generated fractionated zones of pseudo-cystic cavitation along the lower epidermis and/or upper papillary dermis at Day 1. At Day 21, epidermal thickness, dermal fibroblasts, and collagen fibers had increased. Compared to CPMHA-untreated rats, rats pretreated with CPMHA showed marked increases in fibroblasts and collagen fibers in the papillary dermis. Immunohistochemical staining for the hyaluronic acid receptor CD44 revealed that MLA-type picosecond laser treatment upregulated CD44 expression in the basilar epidermis and dermal fibroblasts. CONCLUSIONS We suggest that the hyaluronic acid-rich environment associated with CPMHA treatment may enhance MLA-type picosecond-domain laser-induced tissue reactions in the epidermis and upper dermis.
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Affiliation(s)
- Hee Kyung Kim
- Department of Pathology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | | | - Jeong Yeon Hong
- Department of Dermatology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | | | | | - Herin Lyu
- R&D Center, Lutronic Corporation, Goyang, Korea
| | - Sung Bin Cho
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.,Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea
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28
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Kim B, Le H, Oh BH, Kim KH. High-speed combined reflectance confocal and moxifloxacin based two-photon microscopy. BIOMEDICAL OPTICS EXPRESS 2020; 11:1555-1567. [PMID: 32206428 PMCID: PMC7075626 DOI: 10.1364/boe.385763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
Reflectance confocal microscopy (RCM) is a non-invasive high-resolution optical imaging technique used in clinical settings as a diagnostic method. However, RCM has limited diagnostic ability by providing non-specific morphological information only based on reflection contrast. Various multimodal imaging techniques have been developed to compensate the limitations of RCM, but multimodal techniques are often slow in imaging speed compared to RCM alone. In this report, we combined RCM with moxifloxacin based two-photon microscopy (TPM) for high-speed multimodal imaging. Moxifloxacin based TPM used clinically compatible moxifloxacin for cell labeling and could do non-invasive cellular imaging at 30 frames/s together with RCM. Performance of the combined microscopy was characterized in the imaging of mouse skin and cornea, in vivo. Detail tissue microstructures including cells, extra-cellular matrix (ECM), and vasculature were visualized. The combined microscopy was applied to human skin cancer specimens, and both cells and ECM in the skin cancer and normal skin regions were visualized at high imaging speeds. The combined microscopy can be useful in the clinical applications of RCM by providing multiple contrasts.
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Affiliation(s)
- Bumju Kim
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
| | - Hoan Le
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
| | - Byung-ho Oh
- Department of Dermatology, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Ki Hean Kim
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
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29
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Smokelin IS, Mizzoni C, Erndt-Marino J, Kaplan DL, Georgakoudi I. Optical changes in THP-1 macrophage metabolism in response to pro- and anti-inflammatory stimuli reported by label-free two-photon imaging. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-14. [PMID: 31953928 PMCID: PMC7008597 DOI: 10.1117/1.jbo.25.1.014512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/23/2019] [Indexed: 06/01/2023]
Abstract
Temporal changes in macrophage metabolism are likely crucial to their role in inflammatory diseases. Label-free two-photon excited fluorescence (TPEF) and fluorescence lifetime imaging microscopy are well suited to track dynamic changes in macrophage metabolism. We performed TPEF imaging of human macrophages following either pro- or an anti-inflammatory stimulation. Two endogenous fluorophores, NAD(P)H and FAD, coenzymes involved in key metabolic pathways, provided contrast. We used the corresponding intensity images to determine the optical redox ratio of FAD to FAD + NAD(P)H. We also analyzed the intensity fluctuation patterns within NAD(P)H TPEF images to determine mitochondrial clustering patterns. Finally, we acquired NAD(P)H TPEF lifetime images to assess the relative levels of bound NAD(P)H. Our studies indicate that the redox ratio increases, whereas mitochondrial clustering decreases in response to both pro- and anti-inflammatory stimuli; however, these changes are enhanced in pro-inflammatory macrophages. Interestingly, we did not detect any significant changes in the corresponding NAD(P)H bound fraction. A combination of optical metabolic metrics could be used to classify pro- and anti-inflammatory macrophages with high accuracy. Contributions from alterations in different metabolic pathways may explain our findings, which highlight the potential of label-free two-photon imaging to assess nondestructively macrophage functional state.
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Affiliation(s)
- Isabel S. Smokelin
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Craig Mizzoni
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Josh Erndt-Marino
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - David L. Kaplan
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Irene Georgakoudi
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
- Tufts University, Sackler School of Graduate Biomedical Sciences, Cell, Molecular, and Developmental Biology Program, Boston, Massachusetts, United States
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30
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Yim S, Lee YH, Choi YJ, Kim WS. Split-face comparison of the picosecond 1064-nm Nd:YAG laser using a microlens array and the quasi-long-pulsed 1064-nm Nd:YAG laser for treatment of photoaging facial wrinkles and pores in Asians. Lasers Med Sci 2019; 35:949-956. [DOI: 10.1007/s10103-019-02906-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/18/2019] [Indexed: 12/28/2022]
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31
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Li J, Lin P, Tan Y, Cheng JX. Volumetric stimulated Raman scattering imaging of cleared tissues towards three-dimensional chemical histopathology. BIOMEDICAL OPTICS EXPRESS 2019; 10:4329-4339. [PMID: 31453014 PMCID: PMC6701556 DOI: 10.1364/boe.10.004329] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/12/2019] [Accepted: 07/22/2019] [Indexed: 05/18/2023]
Abstract
Thin tissue slice based histology has been used as a gold standard for disease diagnosis since over a hundred years ago. However, histopathological evaluation on two-dimensional slides suffers from large variations due to limited sampling. To improve the diagnostic accuracy, three-dimensional (3D) histology is performed through serial sectioning, staining, imaging and reconstruction of individual slices, which is highly time-consuming and labor intensive. We developed a volumetric stimulated Raman scattering (SRS) imaging method, which provides histology-like information in 3D context without the need for staining with dyes. Using a small molecule clearing agent, formamide, we performed tissue clearing within 30 min and achieved an imaging depth up to 500 µm in highly scattered tissues, including brain, kidney, liver and lung. Through a two-color SRS imaging scheme, we obtained histology-like images in cleared brain tissue slices. Our method has the potential for 3D tissue histopathology to improve the accuracy of histopathological examination.
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Affiliation(s)
- Junjie Li
- Department of Electrical and Computer Engineering, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
| | - Peng Lin
- Department of Electrical and Computer Engineering, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
| | - Yuying Tan
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
| | - Ji-Xin Cheng
- Department of Electrical and Computer Engineering, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
- Photonics Center, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
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32
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Chang H, Jang WH, Lee S, Kim B, Kim MJ, Kim WO, Ryoo YW, Oh BH, Kim KH. Moxifloxacin Labeling-Based Multiphoton Microscopy of Skin Cancers in Asians. Lasers Surg Med 2019; 52:373-382. [PMID: 31338864 DOI: 10.1002/lsm.23138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Although multiphoton microscopy (MPM) can visualize both cell and extracellular matrix (ECM) structures of the skin in high-contrast without exogenous labeling, label-free MPM is usually too slow to image clinically relevant large regions. A high-speed MPM method would be beneficial for evaluating clinical skin specimens by increasing the imaging area. In this study, moxifloxacin labeling-based MPM (moxifloxacin MPM) was characterized in various human skin cancer specimens. STUDY DESIGN/MATERIALS AND METHODS Moxifloxacin ophthalmic solution was used for cell-labeling and MPM imaging was conducted afterwards. Moxifloxacin MPM was characterized in ex vivo normal human skin and skin cancer specimens in comparison with the label-free MPM and fluorescence confocal microscopy (FCM) using acridine orange as a labeling agent. Then, moxifloxacin MPM was applied to various ex vivo human skin cancer specimens including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dermatofibrosarcoma protuberans (DFSP). Results of moxifloxacin MPM were compared with bright-field clinical and histopathologic findings. RESULTS Moxifloxacin MPM imaged both cells and collagen in the skin, similarly to label-free MPM, but with enhanced fluorescence intensities in cells and enhanced imaging speeds. Moxifloxacin MPM imaged cells in the skin similarly to acridine orange-based FCM. Moxifloxacin MPM of various human skin cancer specimens imaged their specific cellular features. The microscopic features detected in moxifloxacin MPM were confirmed with histological images. CONCLUSIONS This observational pilot study demonstrated that moxifloxacin MPM could detect specific cellular features of various skin cancers in good correlation with histopathological images in Asian patients at the higher imaging speed than label-free MPM. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Hoonchul Chang
- Division of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Won Hyuk Jang
- Division of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Seunghun Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Bumju Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Myoung Joon Kim
- Department of Ophthalmology, Asan Medical Center, Asan University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Won Oh Kim
- Department of Dermatology, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Young Wook Ryoo
- Department of Dermatology, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Byung Ho Oh
- Department of Dermatology, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ki Hean Kim
- Division of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea.,Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
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33
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Fernandez E, Marull‐Tufeu S. 3D imaging of human epidermis micromorphology by combining fluorescent dye, optical clearing and confocal microscopy. Skin Res Technol 2019; 25:735-742. [DOI: 10.1111/srt.12710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/14/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Eric Fernandez
- Yves Rocher – Direction Innovation & Développement – Laboratoire Application Cutanée Issy les Moulineaux France
| | - Sylvie Marull‐Tufeu
- Yves Rocher – Direction Innovation & Développement – Laboratoire Application Cutanée Issy les Moulineaux France
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34
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A 1064-nm Neodymium-doped Yttrium Aluminum Garnet Picosecond Laser for the Treatment of Hyperpigmented Scars. Dermatol Surg 2019; 45:725-729. [DOI: 10.1097/dss.0000000000001917] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Pattern analysis of 532- and 1,064-nm picosecond-domain laser-induced immediate tissue reactions in ex vivo pigmented micropig skin. Sci Rep 2019; 9:4186. [PMID: 30862808 PMCID: PMC6414522 DOI: 10.1038/s41598-019-41021-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 02/22/2019] [Indexed: 11/09/2022] Open
Abstract
Optical pulses from picosecond lasers can be delivered to the skin as single, flat-top beams or fractionated beams using a beam splitter or microlens array (MLA). In this study, picosecond neodymium:yttrium aluminum garnet laser treatment using a single flat-top beam and an MLA-type beam at the wavelengths of 532 nm and 1,064 nm were delivered on ex vivo genotype-regulated, pigmented micropig skin. Skin specimens were obtained immediately after treatment and microscopically analyzed. Single flat-top beam treatment at a wavelength of 532 nm and a fluence of 0.05-J/cm2 reduced melanin pigments in epidermal keratinocytes and melanocytes, compared to untreated controls. Additionally, 0.1 J/cm2- and 1.3 J/cm2-fluenced laser treatment at 532 nm elicited noticeable vacuolation of keratinocytes and melanocytes within all epidermal layers. Single flat-top beam picosecond laser treatment at a wavelength of 1,064 nm and a fluence of 0.18 J/cm2 also reduced melanin pigments in keratinocytes and melanocytes. Treatment at 1,064-nm and fluences of 1.4 J/cm2 and 2.8 J/cm2 generated increasing degrees of vacuolated keratinocytes and melanocytes. Meanwhile, 532- and 1,064-nm MLA-type, picosecond laser treatment elicited fractionated zones of laser-induced micro-vacuolization in the epidermis and dermis. Therein, the sizes and degrees of tissue reactions differed according to wavelength, fluence, and distance between the microlens and skin.
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36
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Chung HJ, Lee HC, Park J, Childs J, Hong J, Kim H, Cho SB. Pattern analysis of 532- and 1064-nm microlens array-type, picosecond-domain laser-induced tissue reactions in ex vivo human skin. Lasers Med Sci 2019; 34:1207-1215. [DOI: 10.1007/s10103-018-02711-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
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37
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Lentsch G, Balu M, Williams J, Lee S, Harris RM, König K, Ganesan A, Tromberg BJ, Nair N, Santhanam U, Misra M. In vivo multiphoton microscopy of melasma. Pigment Cell Melanoma Res 2018; 32:403-411. [PMID: 30506627 DOI: 10.1111/pcmr.12756] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/05/2018] [Accepted: 10/21/2018] [Indexed: 11/29/2022]
Abstract
Melasma is a skin disorder characterized by hyperpigmented patches due to increased melanin production and deposition. In this pilot study, we evaluate the potential of multiphoton microscopy (MPM) to characterize non-invasively the melanin content, location, and distribution in melasma and assess the elastosis severity. We employed a clinical MPM tomograph to image in vivo morphological features in melasma lesions and adjacent normal skin in 12 patients. We imaged dermal melanophages in most dermal melasma lesions and occasionally in epidermal melasma. The melanin volume fraction values measured in epidermal melasma (14% ± 4%) were significantly higher (p < 0.05) than the values measured in perilesional skin (11% ± 3%). The basal keratinocytes of melasma and perilesions showed different melanin distribution. Elastosis was predominantly more severe in lesions than in perilesions and was associated with changes in melanin distribution of the basal keratinocytes. These results demonstrate that MPM may be a non-invasive imaging tool for characterizing melasma.
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Affiliation(s)
- Griffin Lentsch
- Beckman Laser Institute, Laser Microbeam and Medical Program, University of California, Irvine, California
| | - Mihaela Balu
- Beckman Laser Institute, Laser Microbeam and Medical Program, University of California, Irvine, California
| | - Joshua Williams
- Beckman Laser Institute, Laser Microbeam and Medical Program, University of California, Irvine, California
| | - Sanghoon Lee
- Beckman Laser Institute, Laser Microbeam and Medical Program, University of California, Irvine, California.,Department of Dermatology, Soonchunhyang University, Seoul, Korea
| | - Ronald M Harris
- Department of Dermatology, University of California, Irvine, California
| | - Karsten König
- Department of Biophotonics and Laser Technology, Saarland University, Saarbrucken, Germany
| | - Anand Ganesan
- Department of Dermatology, University of California, Irvine, California
| | - Bruce J Tromberg
- Beckman Laser Institute, Laser Microbeam and Medical Program, University of California, Irvine, California
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38
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Lentsch G, Balu M, Koenig K, Tromberg BJ, Zachary CB, Smith J. In vivo multiphoton microscopy of scabies. JAAD Case Rep 2018; 4:985-987. [PMID: 30417058 PMCID: PMC6218693 DOI: 10.1016/j.jdcr.2018.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Lin P, Liu X, Wang S, Li X, Song Y, Li L, Cai S, Wang X, Chen J. Diagnosing pituitary adenoma in unstained sections based on multiphoton microscopy. Pituitary 2018; 21:362-370. [PMID: 29594837 DOI: 10.1007/s11102-018-0882-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE If we can find a new method that can achieve rapid diagnosis of adenoma during operation, it will help surgeon shorten the operation time and enhance the treatment efficacy. This study discusses the feasibility of multiphoton microscopy (MPM) in diagnosing pituitary adenoma. METHOD MPM, based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) is performed for the diagnosis of pituitary adenoma in unstained sections. RESULTS Our results show that MPM can reveal the variation of reticulin fiber by SHG signals of collagen, combined with the measurement of area of acinus, thickness of collagen fiber and collagen percentage. MPM can further reflect the change of meshwork in normal pituitary and hyperplasia quantitatively. And the characteristics of typical growth patterns of pituitary adenoma are demonstrated by the overlay of SHG and TPEF images. What's more, we can identify the boundary of normal pituitary, hyperplasia and adenoma from MPM images. And the experiment also results verify the feasibility of this method in frozen sections. CONCLUSION These results indicated that MPM can make a diagnosis of pituitary adenoma by the morphological changes without routine pathological processing including hematoxylin-eosin (H&E) staining and other special staining. Therefore, this technique is expected to help diagnosis of pituitary adenoma during operation.
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Affiliation(s)
- Peihua Lin
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, People's Republic of China
| | - Xueyong Liu
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Shu Wang
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, People's Republic of China
| | - Xiaoling Li
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Yankun Song
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Lianhuang Li
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, People's Republic of China
| | - Shanshan Cai
- Department of Pathology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, People's Republic of China
| | - Xingfu Wang
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China.
| | - Jianxin Chen
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, People's Republic of China.
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Gold MH. Dual wavelength treatment protocol with a picosecond laser for the reduction of facial wrinkles. J COSMET LASER THER 2018; 21:147-151. [PMID: 29883215 DOI: 10.1080/14764172.2018.1481514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The potential of a dual wavelength picosecond laser, as a new modality for treating photoaged skin, was investigated in this clinical study. MATERIAL AND METHODS Subjects with bilateral mild-to-moderate facial wrinkling received four picosecond laser treatments, at 3-8 weeks apart, with a double-pass of both 532-nm and 1064-nm split-beam handpieces. Blinded evaluation of clinical photography, by two independent physicians, using the Fitzpatrick Elastosis Scale, was performed at 12 weeks after the fourth treatment. RESULTS Twenty subjects (19 females; mean age 55 ± 7 years, Fitzpatrick Skin Types II-IV) were treated. Blinded evaluation demonstrated 75% (15/20) of the treated faces had improvement of at least one point. Investigator assessments showed a 100% improvement rate in the appearance of wrinkles and a mean elastosis score (ES) improvement of 2.1 ± 0.8 points. Subject satisfaction rate was 74%. Treatments were associated with no to mild discomfort with a mean score of 3.7 ± 1.9 on a scale of 0 (no pain) to 10. Common treatment responses included erythema (98%) and edema (7.5%) that generally resolved within several hours of treatment. CONCLUSION In this study, picosecond laser treatments resulted in significant improvement in facial wrinkles. There were no complications with treatment and minimal downtime.
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Affiliation(s)
- Michael H Gold
- a Tennessee Clinical Research Center, Gold Skin Care Center , Nashville , TN, USA
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Treatment of flat and elevated pigmented disorders with a 755-nm alexandrite picosecond laser: clinical and histological evaluation. Lasers Med Sci 2018; 33:1827-1831. [PMID: 29423841 DOI: 10.1007/s10103-018-2459-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/29/2018] [Indexed: 10/18/2022]
Abstract
The novel picosecond lasers, initially developed for faster tattoo removal, have also shown great efficacy in endogenous pigmentary disorders. To describe the efficacy and safety profile of an alexandrite (755-nm) picosecond laser in a wide range of pigmented flat and elevated cutaneous lesions. A retrospective study was performed in which we collected all the clinical images of patients treated with the 755-nm alexandrite picosecond laser for 12 months (November 2016-November 2017). Clinical features were obtained from their medical charts. Patients treated for tattoo removal were excluded. All the images were analyzed by three blind physicians attending to a visual analogue scale (VAS) from 0 to 5 (0, no change; 1, 1-24% clearance; 2, 25-49% clearance; 3, 50-74% clearance; 4, 75-99% clearance; 5, complete clearance). Patient satisfaction was obtained from a subjective survey including four items: very satisfied, satisfied, non-satisfied, and totally dissatisfied. Thirty-seven patients were included (12 males; 25 females). The mean age of the study was 42.35 years. Twenty-five patients (68%) were treated for different pigmented flat disorders such as solar and mucosal lentigines (5), stasis dermatitis (4), or nevus of Ota (4), among other diagnoses. Twelve patients (32%) were treated for epidermal elevated lesions such as warts (5), epidermal nevi (2), and seborrheic keratosis (3), among other elevated lesions. Mean number of laser treatment was 3.02 sessions while mean follow-up after last laser treatment was 4.02 months. Mean VAS score of the three observers was 3.44 (61% of clearance) for pigmentary flat disorders and 3.60 (67%) for elevated lesions. Adverse effects reported were mild blistering in the first 2-5 days following laser treatment in some of the patients. Overall satisfaction among the patients included was high. The novel 755-nm picosecond alexandrite laser is effective not only for the resolution of pigmented flat lesions of different nature but also for the treatment of the more difficult elevated pigmented lesions.
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Quantification of Collagen Organization after Nerve Repair. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1586. [PMID: 29632766 PMCID: PMC5889458 DOI: 10.1097/gox.0000000000001586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/13/2017] [Indexed: 01/09/2023]
Abstract
Background: Clinical outcomes after nerve injury and repair remain suboptimal. Patients may be plagued by poor functional recovery and painful neuroma at the repair site, characterized by disorganized collagen and sprouting axons. Collagen deposition during wound healing can be intrinsically imaged using second harmonic generation (SHG) microscopy. The purpose of this study was to develop a protocol for SHG imaging of nerves and to assess whether collagen alignment can be quantified after nerve repair. Methods: Sciatic nerve transection and epineural repair was performed in male rats. The contralateral nerves were used as intra-animal controls. Ten-millimeter nerve segments were harvested and fixed onto slides. SHG images were collected using a 20× objective on a multiphoton microscope. Collagen fiber alignment was calculated using CurveAlign software. Alignment was calculated on a scale from 0 to 1, where 1 represents perfect alignment. Statistical analysis was performed using a linear mixed-effects model. Results: Eight male rats underwent right sciatic nerve repair using 9-0 Nylon suture. There were gross variations in collagen fiber organization in the repaired nerves compared with the controls. Quantitatively, collagen fibers were more aligned in the control nerves (mean alignment 0.754, SE 0.055) than in the repairs (mean alignment 0.413, SE 0.047; P < 0.001). Conclusions: SHG microscopy can be used to quantitate collagen after nerve repair via fiber alignment. Given that the development of neuroma likely reflects aberrant wound healing, ex vivo and/or in vivo SHG imaging may be useful for further investigation of the variables predisposing to neuroma.
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Dierickx C. Using normal and high pulse coverage with picosecond laser treatment of wrinkles and acne scarring: Long term clinical observations. Lasers Surg Med 2017; 50:51-55. [PMID: 29140537 PMCID: PMC5813159 DOI: 10.1002/lsm.22763] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The picosecond 755 nm alexandrite laser using a diffractive lens array has demonstrated consistent clinical efficacy for improving the appearance of acne scarring and wrinkles amongst other benefits. This small pilot study is to assess the difference, if any, in clinical benefit if a higher than the standard protocol for number of pulses delivered to a tissue area is used compared to the standard protocol guidelines. METHOD Seven subjects received treatment to one side of the face with a standard protocol number of laser pulses with the other side of the face receiving higher than standard number of pulses from the same 755 nm picosecond laser using an additional diffractive lens array. Photographs at final follow up were compared to baseline by two blinded Board Certified Dermatologists and assessed for improvements to acne scarring using a 6-point grading score, for wrinkles using the Fitzpatrick Wrinkle & Elastosis 3-point grading scale and a Global Aesthetic Improvement Scale assessment. Subjects also completed a satisfaction questionnaire. RESULTS For the acne scarring subjects, the average improvement from baseline to final follow up was 4.0 +/- 1.0 for the standard treated side and 4.5 +/- 0.5 for the high pulse side. There was no statistically significant difference between the two treated sides (P > 0.05, n = 3 paired t-test). For the wrinkle subjects, the average grading of the standard pulse side improved from 2.0 +/- 0.82 to 1.75 +/- 1.0 from baseline to final follow-up. The high pulse side improved from 1.5 +/- 1.0 to 1.125 +/- 0.25 from baseline to final follow-up. There was no statistically significant difference between the improvement of the standard and high pulse treatment sides (P > 0.05, n = 4 paired t-test). The comparison of baseline to final follow-up images of each subject found both sides to be Much or Very Much improved with no statistically significant difference between the standard and high pulse sides (P > 0.05, n = 7 paired t-test). Six of the seven subjects did not note any difference between the effect on different sides of the face and four of the seven rated their overall improvement after treatment as Good, three subjects as Reasonable and one subject with Slight Improvement. All subjects found the treatment comfortable and easy to tolerate and there was no increased incidence of side effects other than the mild occurrences typically observed for this type of treatment. CONCLUSION This is a small pilot study with limited subject numbers and further data is needed to be able to make firm conclusions of observed trends, which suggest that the use of higher than standard suggested protocol number of pulses with the diffractive lens array and the 755 nm picosecond laser does not appear to offer any additional benefit over that that can already be achieved with the standard number of pulses, but also does not increase risk of detrimental post treatment effects either. Lasers Surg. Med. 50:51-55, 2018. © 2017 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Tanghetti MD E, Jennings J. A comparative study with a 755 nm picosecond Alexandrite laser with a diffractive lens array and a 532 nm/1064 nm Nd:YAG with a holographic optic. Lasers Surg Med 2017; 50:37-44. [DOI: 10.1002/lsm.22752] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 11/11/2022]
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Bernstein EF, Schomacker KT, Basilavecchio LD, Plugis JM, Bhawalkar JD. Treatment of acne scarring with a novel fractionated, dual-wavelength, picosecond-domain laser incorporating a novel holographic beam-splitter. Lasers Surg Med 2017; 49:796-802. [PMID: 28960395 PMCID: PMC5656887 DOI: 10.1002/lsm.22734] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2017] [Indexed: 02/06/2023]
Abstract
Background and Objectives Fractional treatment with a dual wavelength 1,064 and 532 nm picosecond‐domain laser, delivering a 10 × 10 array of highly focused beamlets via a holographic optic, was investigated for the treatment of acne scars. Study Twenty‐seven of 31 subjects completed the study, 19 were treated using 1,064 nm and 8 were treated at 532 nm, all having four‐monthly treatments. Blinded evaluation of digital images by three physician evaluators comparing pre‐ and 3‐month post‐treatment images measured efficacy using a 10‐point scale. Subject self‐assessment of treatment effects were also recorded. Safety was measured by recording subject discomfort scores and adverse effects. Results Blinded reviewers correctly identified the baseline image in 61 of the 81 image sets (75%), and baseline acne scar scores were 1.8 ± 0.7 and 1.8 ± 0.5 for the 1,064 and 532 nm cohorts, and decreased to 1.1 ± 0.5 (P < 0.001) and 1.1 ± 0.0 (P < 0.005), respectively. Post‐treatment erythema, mild edema, and petechiae were the only side effects noted. Conclusion The 1,064 and 532 nm picosecond‐domain laser incorporating a 10 × 10 holographic beam‐splitting handpiece was found to be safe and effective for the treatment of facial acne scars. The treatments were well tolerated and the subjects experienced little to no downtime. Lasers Surg. Med. 49:796–802, 2017. © 2017 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
| | - Kevin T Schomacker
- Syneron-Candela Corporation, 530 Boston Post Road, Wayland, Massachusetts 01778
| | | | | | - Jayant D Bhawalkar
- Syneron-Candela Corporation, 530 Boston Post Road, Wayland, Massachusetts 01778
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Pal R, Edward K, Ma L, Qiu S, Vargas G. Spectroscopic characterization of oral epithelial dysplasia and squamous cell carcinoma using multiphoton autofluorescence micro-spectroscopy. Lasers Surg Med 2017; 49:866-873. [PMID: 28677822 DOI: 10.1002/lsm.22697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Multiphoton autofluorescence microscopy (MPAM) has shown potential in identifying features that are directly related to tissue microstructural and biochemical changes throughout epithelial neoplasia. In this study, we evaluate the autofluorescence spectral characteristics of neoplastic epithelium in dysplasia and oral squamous cell carcinoma (OSCC) using multiphoton autofluorescence spectroscopy (MPAS) in an in vivo hamster model of oral neoplasia in order to identify unique signatures that could be used to delineate normal oral mucosa from neoplasia. MATERIALS/METHODS A 9,10-dimethyl-1,2-benzanthracene (DMBA) hamster model of oral precancer and OSCC was used for in vivo MPAM and MPAS. Multiphoton Imaging and spectroscopy were performed with 780 nm excitation while a bandpass emission 450-650 nm was used for MPAM. Autofluorescence spectra was collected in the spectral window of 400-650 nm. RESULTS MPAS with fluorescence excitation at 780 nm revealed an overall red shift of a primary blue-green peak (480-520 nm) that is attributed to NADH and FAD. In the case of oral squamous cell carcinoma (OSCC) and some high-grade dysplasia an additional prominent peak at 635 nm, attributed to PpIX was observed. The fluorescence intensity at 635 nm and an intensity ratio of the primary blue-green peak versus 635 nm peak, showed statistically significant difference between control and neoplastic tissue. DISCUSSION Neoplastic transformation in the epithelium is known to alter the intracellular homeostasis of important tissue metabolites such as NADH, FAD, and PpIX, which was observed by MPAS in their native environment. A combination of deep tissue microscopy owing to higher penetration depth of multiphoton excitation and depth resolved spectroscopy could prove to be invaluable in identification of cytologic as well as biomolecular spectral characteristic of oral epithelial neoplasia. Lasers Surg. Med. 49:866-873, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Rahul Pal
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555.,Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Kert Edward
- Department of Physics, University of the West Indies, UWI Mona, Kingston 7, Mona, Jamaica
| | - Liang Ma
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Suimin Qiu
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Gracie Vargas
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555.,Department of Neuroscience and Cell Biology, The University of Texas Medical Branch, Galveston, Texas, 77555
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