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Omar SS, Elmulla KF, Aly RG, Elkaffas A, Ismail A. A triple combination of latanoprost, fractional CO 2 laser, and platelet-rich plasma in localized vitiligo: A clinical and histopathologic study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12944. [PMID: 38288773 DOI: 10.1111/phpp.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Several treatment modalities are available for the treatment of vitiligo due to the lack of a uniformly effective therapy. Topical latanoprost 0.005% is an effective topical treatment. Fractional CO2 laser alone or combined with platelet-rich plasma (PRP) has been proposed as effective adjunctive therapies. OBJECTIVES We aimed to compare the efficacy of topical latanoprost 0.005% (Ioprost®, Orchidia, Egypt) combined with either add-on fractional CO2 laser or fractional CO2 -PRP versus topical latanoprost monotherapy in the treatment of localized stable vitiligo. PATIENTS/METHODS The study included 60 patients randomly assigned into three equal groups. Group A patients received topical latanoprost drops only. Group B patients received topical latanoprost drops and fractional CO2 laser sessions at 2-week interval for 3 months. Group C patients received topical latanoprost drops and fractional CO2 laser sessions combined with PRP at a 2-week interval for 3 months. The mean improvement score by the physician was calculated 4 months after the start of the study. Punch skin biopsies were obtained before treatment and 4 months from the beginning of the study and stained with H&E and HMB-45 antibody for evaluation of pigmentation. RESULTS Significant clinical improvement of vitiligo lesions with significant increase of re-pigmentation were reported in the three treated groups. Latanoprost in combination with fractional CO2 and PRP was associated with more significant therapeutic outcomes than either combined latanoprost and fractional CO2 or latanoprost alone. CONCLUSION Fractional CO2 laser-PRP enhances the therapeutic efficacy of latanoprost 0.005% in the treatment of localized stable vitiligo.
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Affiliation(s)
- Salma Samir Omar
- Department of Dermatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Khaled Fawzy Elmulla
- Department of Dermatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rania Gaber Aly
- Department of Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Aliaa Ismail
- Department of Dermatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Jablon K, Theisen E, Hsu SH, Dover JS, Chung HJ. Fractional non-ablative assisted bimatoprost delivery: A synergistic approach for treating post-inflammatory hypopigmentation following cosmetic procedures in skin of color patients. Lasers Surg Med 2024; 56:11-13. [PMID: 38018657 DOI: 10.1002/lsm.23744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023]
Affiliation(s)
- Kelli Jablon
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Erin Theisen
- Harvard Combined Dermatology Residency Training Program, Harvard Medical School, Boston, Massachusetts, USA
| | - Sarah H Hsu
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeffrey S Dover
- SkinCare Physicians, Boston, Massachusetts, USA
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Hye Jin Chung
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
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Meguid AMA, Ghazally A, Ahmed AM, Bakr RM. Fractional carbon dioxide laser alone and as an assisted drug delivery for treatment of alopecia areata: a clinical, dermoscopic and immunohistochemical study. Arch Dermatol Res 2023; 315:1675-1688. [PMID: 36809409 PMCID: PMC10338624 DOI: 10.1007/s00403-023-02565-x] [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: 12/22/2022] [Revised: 12/22/2022] [Accepted: 02/01/2023] [Indexed: 02/23/2023]
Abstract
Alopecia areata (AA) is a common cause of hair loss with no available universally successful treatment. Thus, new innovative treatments are urgently needed. This research aimed to evaluate the effectiveness of fractional carbon dioxide laser (FCL) alone or combined with triamcinolone acetonide (TA) solution, platelet-rich plasma (PRP), or vitamin D3 solution in treating AA. Sixty-four AA patients with 185 lesions were recruited and divided into four treatment groups. All patients received FCL either alone (group A, n = 19) or followed by topical TA (group B, n = 16) or PRP (group C, n = 15), or vitamin D3 solution (group D, n = 14). The response was assessed using Alopecia Areata Severity Index (AASI), MacDonald Hull and Norris grading, and trichoscopy. Histopathological features and immunohistochemical decorin expression were studied. All groups showed significant improvement in AASI compared to the baseline, with insignificant differences between them. Post-treatment, trichoscopic features of disease activity significantly decreased in all groups. Compared to control biopsies, both anagen follicles and decorin expression were significantly decreased in all pretreatment specimens. After treatment, all groups showed significantly increased anagen follicles and decorin expression compared to the baseline. Accordingly, FCL is an effective treatment for AA alone or combined with TA, PRP, or vitamin D3 solution. In AA, Decorin expression was downregulated, while enhanced expression following successful treatment occurred. This suggests the role of decorin in AA pathogenesis. However, further research is still recommended to clarify the exact role of decorin in AA pathogenesis and to investigate the therapeutic benefits of decorin-based therapy.
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Affiliation(s)
- Azza Mahfouz Abdel Meguid
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Assiut University, Assiut, 71515 Egypt
| | - Alaa Ghazally
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Assiut University, Assiut, 71515 Egypt
| | - Asmaa M. Ahmed
- Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Radwa M. Bakr
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Assiut University, Assiut, 71515 Egypt
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Tang G, Chang Y, Wu H, Liang X, Liu Y, Zhuo F. Efficacy and Safety of Fractional CO 2 Laser Combined with Halometasone Cream for Treatment of Moderate-to-Severe Chronic Hand Eczema: A Prospective, Single-Center, Parallel-Group, Open-Label Randomized Trial. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00944-w. [PMID: 37354295 PMCID: PMC10366065 DOI: 10.1007/s13555-023-00944-w] [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: 03/28/2023] [Accepted: 05/19/2023] [Indexed: 06/26/2023] Open
Abstract
INTRODUCTION The purpose of this study was to assess the efficacy and safety of fractional CO2 laser combined with halometasone cream in patients with moderate-to-severe chronic hand eczema (CHE). METHODS A prospective, single-center, parallel-group, open-label randomized trial including 67 patients with moderate-to-severe CHE was carried out. Patients were randomly assigned to group A (n = 33, fractional CO2 laser once every 4 weeks 1-2 times and halometasone cream twice daily for 8 weeks) or group B (n = 34, halometasone cream alone twice daily for 8 weeks). The primary endpoint was the proportion of patients achieving treatment success at week 12 in each group. Secondary endpoints included differences between groups in the change of hand eczema severity index (HECSI), patient global assessment (PaGA), dermatology life quality index (DLQI), and quality of life in hand eczema questionnaire (QOLHEQ) from baseline to week 12. Relapse rate and adverse effects were also recorded. RESULTS A total of 29 patients in each group completed the trial. At week 12, the treatment success rate was 62.1% (18/29) in group A and 27.6% (8/29) in group B (p = 0.009). At week 12, HECSI, PaGA, DLQI, and QOLHEQ all decreased compared with baseline in both groups (p < 0.05). HECSI, DLQI, and QOLHEQ decreased more in group A than group B (p = 0.014, 0.010, and 0.014, respectively), but there was no significant difference in change of PaGA between the two groups (1.0 versus 3.0, p = 0.419). Among patients achieving treatment success, 11.1% (2/18) patients in group A and 50.0% (4/8) patients in group B relapsed at week 24 (p = 0.011). Skin pigmentation was the most common adverse effect. CONCLUSIONS For patients with moderate-to-severe CHE, fractional CO2 laser combined with halometasone cream is more effective than halometasone cream alone, with few adverse effects. TRIAL REGISTRATION NUMBER ChiCTR2100051948.
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Affiliation(s)
- Gongfeng Tang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, China
| | - Yuan Chang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, China
| | - Haixuan Wu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, China
| | - Xuelei Liang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, China
| | - Yi Liu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, China
| | - Fenglin Zhuo
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, China.
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Bonan P, Pieri L, Fusco I, Madeddu F, Zingoni T, Conforti C, Piccolo D. Ex Vivo Human Histology Fractional Treatment with a New CO 2 Scanner: A Potential Application on Deep Scarring. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1117. [PMID: 37374321 DOI: 10.3390/medicina59061117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: For many years, fully ablative laser treatments, particularly those performed with a carbon dioxide (CO2) laser, were regarded as the gold standard for resurfacing. This study's goal is to assess the depth that can be reached by a new CO2 scanner system, through a skin model with greater dermal thickness, to use in the treatment of deep scarring. Materials and Methods: Male human skin tissue was laser-treated using a CO2 fractional laser and a new scanning system, and all samples were fixed in 10% neutral buffered formalin, dehydrated using a series of crescent alcohol, embedded in paraffin, sectioned in series (4-5 µm thick), stained with haematoxylin and eosin (H&E), and then analysed under an optical microscope. Results: From the epidermis through the underlying papillary and reticular dermis to various depths of the dermis, microablation columns of damage and coagulated microcolumns of collagen were observed. The reticular dermis was fully penetrated up to 6 mm at higher energy levels (210 mJ/DOT), resulting in deeper tissue injury. Although the laser might penetrate further, the skin stops there, leaving just the fat and muscular tissue. Conclusions: The deep layers of the dermis can be penetrated by the CO2 laser system throughout the entire dermal thickness when using the new scanning system, suggesting that this laser's potential impact, at the selected settings, covers all skin targets required to perform superficial or deep treatments on any dermatological issue. Finally, patients who have problems, such as morbid scar-deep complications, which affect their quality of life, are more likely to profit from this innovative technique.
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Affiliation(s)
- Paolo Bonan
- Laser Cutaneous Cosmetic and Plastic Surgery Unit, Villa Donatello Clinic, 50019 Florence, Italy
| | | | | | | | | | - Claudio Conforti
- Dermatology Clinic, University of Trieste, Piazza dell'Ospitale 1, 34125 Trieste, Italy
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Zhao Y, Voyer J, Li Y, Kang X, Chen X. Laser microporation facilitates topical drug delivery: a comprehensive review about preclinical development and clinical application. Expert Opin Drug Deliv 2023; 20:31-54. [PMID: 36519356 PMCID: PMC9825102 DOI: 10.1080/17425247.2023.2152002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Topical drug delivery is highly attractive and yet faces tissue barrier challenges. Different physical and chemical methods have been explored to facilitate topical drug delivery. AREAS COVERED Ablative fractional laser (AFL) has been widely explored by the scientific community and dermatologists to facilitate topical drug delivery since its advent less than two decades ago. This review introduces the major efforts in exploration of AFL to facilitate transdermal, transungual, and transocular drug delivery in preclinical and clinical settings. EXPERT OPINION Most of the preclinical and clinical studies find AFL to be safe and highly effective to facilitate topical drug delivery with little restriction on physicochemical properties of drugs. Clinical studies support AFL to enhance drug efficacy, shorten treatment time, reduce pain, improve cosmetic outcomes, reduce systemic drug exposure, and improve safety. Considering most of the clinical trials so far involved a small sample size and were in early phase, future trials will benefit from enrolling a large group of patients for thorough evaluation of the safety and efficacy of AFL-assisted topical drug delivery. The manufacturing of small and less costly AFL devices will also facilitate the translation of AFL-assisted topical drug delivery.
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Affiliation(s)
- Yiwen Zhao
- Biomedical & Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Avedisian Hall, Room 480, Kingston, RI 02881, USA
| | - Jewel Voyer
- Biomedical & Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Avedisian Hall, Room 480, Kingston, RI 02881, USA
| | - Yibo Li
- Biomedical & Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Avedisian Hall, Room 480, Kingston, RI 02881, USA
| | - Xinliang Kang
- Biomedical & Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Avedisian Hall, Room 480, Kingston, RI 02881, USA
| | - Xinyuan Chen
- Biomedical & Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Avedisian Hall, Room 480, Kingston, RI 02881, USA
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Scarcella G, Pieri L, Fusco I. Skin Fractional Scar Treatment with a New Carbon Dioxide Scanner: Histological and Clinical Evaluation. Photobiomodul Photomed Laser Surg 2022; 40:424-432. [DOI: 10.1089/photob.2021.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Giuseppe Scarcella
- General Secretary and National Head of Laser Department of ISPLAD, International-Italian Society of Plastic-Regenerative and Oncologic Dermatology, Verona, Italy
| | | | - Irene Fusco
- Department of Pharmacology, University of Florence, Florence, Italy
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Li N, Qin Y, Dai D, Wang P, Shi M, Gao J, Yang J, Xiao W, Song P, Xu R. Transdermal Delivery of Therapeutic Compounds With Nanotechnological Approaches in Psoriasis. Front Bioeng Biotechnol 2022; 9:804415. [PMID: 35141215 PMCID: PMC8819148 DOI: 10.3389/fbioe.2021.804415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Psoriasis is a chronic, immune-mediated skin disorder involving hyperproliferation of the keratinocytes in the epidermis. As complex as its pathophysiology, the optimal treatment for psoriasis remains unsatisfactorily addressed. Though systemic administration of biological agents has made an impressive stride in moderate-to-severe psoriasis, a considerable portion of psoriatic conditions were left unresolved, mainly due to adverse effects from systemic drug administration or insufficient drug delivery across a highly packed stratum corneum via topical therapies. Along with the advances in nanotechnologies, the incorporation of nanomaterials as topical drug carriers opens an obvious prospect for the development of antipsoriatic topicals. Hence, this review aims to distinguish the benefits and weaknesses of individual nanostructures when applied as topical antipsoriatics in preclinical psoriatic models. In view of specific features of each nanostructure, we propose that a proper combination of distinctive nanomaterials according to the physicochemical properties of loaded drugs and clinical features of psoriatic patients is becoming a promising option that potentially drives the translation of nanomaterials from bench to bedside with improved transdermal drug delivery and consequently therapeutic effects.
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Affiliation(s)
- Ning Li
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yeping Qin
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dan Dai
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Pengyu Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mingfei Shi
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Junwei Gao
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinsheng Yang
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Xiao
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, China
- *Correspondence: Wei Xiao, ; Ping Song, ; Ruodan Xu,
| | - Ping Song
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Wei Xiao, ; Ping Song, ; Ruodan Xu,
| | - Ruodan Xu
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- Interdisciplinary of Nanoscience Center (iNANO), Aarhus University, Aarhus, Denmark
- *Correspondence: Wei Xiao, ; Ping Song, ; Ruodan Xu,
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A study to assess the efficacy of fractional carbon dioxide laser with topical platelet-rich plasma in the treatment of androgenetic alopecia. Lasers Med Sci 2022; 37:2279-2286. [PMID: 34981272 DOI: 10.1007/s10103-021-03496-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
Abstract
Owing to the inadequate response to and limitations of the approved medications for androgenetic alopecia, novel therapies are warranted to enhance outcomes. The objective of this paper is to ascertain the effectiveness of fractional carbon dioxide laser followed by platelet-rich plasma application on hair regrowth and to compare the two laser settings. Seven participants were enrolled in this half-head pilot study based on different laser pulse energy and density values (12 mJ, 800 spots/cm2 and 22 mJ, 400 spots/cm2). Ten treatment sessions were performed every 2 weeks with 12-week follow-up. The evaluation methods were based on hair density from standardized phototrichograms, global photographic assessment, and patient satisfaction. Significantly increased total and terminal hair densities were observed during treatment in both groups as compared with baselines. The mean total hair density has weekly increased significantly with high pulse energy (1.42 hair/cm2) as compared to low pulse energy (1.04 hair/cm2) throughout the study period (p = 0.023; 4.89 hair/cm2). Global photographs and patient satisfaction scores demonstrated improvement, but only the latter showed statistical significance (p = 0.029). The average pain intensity scores were not different between the groups (p = 0.760) all over the procedure. The adverse events were minor and well tolerated. This synergistic treatment remarkably leads to hair restoration and high patient satisfaction. The parameters of 22-mJ beam energy with 400 spots/cm2 density are appropriate and superior to 12-mJ beam energy with 800 spots/cm2. Albeit higher energy, no more pain is indicated in the high pulse energy group. Trial registration number (TRN): TCTR20180619004, Thai Clinical Trials Registry (TCTR) since 2018-05-15 13:39:48.
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Nazary Abrbekoh F, Salimi L, Saghati S, Amini H, Fathi Karkan S, Moharamzadeh K, Sokullu E, Rahbarghazi R. Application of microneedle patches for drug delivery; doorstep to novel therapies. J Tissue Eng 2022; 13:20417314221085390. [PMID: 35516591 PMCID: PMC9065468 DOI: 10.1177/20417314221085390] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/17/2022] [Indexed: 12/14/2022] Open
Abstract
In the past decade, microneedle-based drug delivery systems showed promising approaches to become suitable and alternative for hypodermic injections and can control agent delivery without side effects compared to conventional approaches. Despite these advantages, the procedure of microfabrication is facing some difficulties. For instance, drug loading method, stability of drugs, and retention time are subjects of debate. Besides, the application of novel refining fabrication methods, types of materials, and instruments are other issues that need further attention. Herein, we tried to summarize recent achievements in controllable drug delivery systems (microneedle patches) in vitro and in vivo settings. In addition, we discussed the influence of delivered drugs on the cellular mechanism and immunization molecular signaling pathways through the intradermal delivery route. Understanding the putative efficiency of microneedle patches in human medicine can help us develop and design sophisticated therapeutic modalities.
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Affiliation(s)
| | - Leila Salimi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Saghati
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Amini
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sonia Fathi Karkan
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Keyvan Moharamzadeh
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Emel Sokullu
- Koç University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| | - Reza Rahbarghazi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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11
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Manuskiatti W, Yan C, Artzi O, Gervasio MKR, Wanitphakdeedecha R. Efficacy and safety of thermomechanical fractional injury-assisted corticosteroid delivery versus intralesional corticosteroid injection for the treatment of hypertrophic scars: A randomized split-scar trial. Lasers Surg Med 2021; 54:483-489. [PMID: 34913497 DOI: 10.1002/lsm.23511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/28/2021] [Accepted: 12/04/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Disruption of the natural skin barrier in a controlled manner may be used to deliver drugs that enhance scar resolution. OBJECTIVE To compare the efficacy and safety of thermomechanical fractional injury (TMFI)-assisted topical corticosteroid delivery with corticosteroid injection in the treatment of hypertrophic scar (HTS). MATERIALS AND METHODS This was a randomized, split-scar, double-blinded study. Twenty-one subjects with HTS on the abdomen received five split-scar treatments of TMFI + Steroid and steroid injection alone. Changes in scar thickness, scar volume, and Vancouver Scar Scale (VSS) were analyzed. Patient self-assessment, VAS scores, and adverse effects were also evaluated. RESULTS Scar thickness, volume, and VSS scores of both segments improved significantly compared to baseline. On every follow-up visit, there were no significant differences in mean scar thickness reduction between the two treatment groups except at the 6-month follow-up where the mean scar thickness reduction of the steroid injection segment was significantly lower than that of the TMFI + Steroid segment (95% confidence interval [CI], 0.09-0.35; p = 0.002). Scar volume, VSS scores, and patient self-assessment also showed no significant differences between both segments on all visits. The steroid injection segment was significantly more painful than the TMFI + Steroid segment (95% CI, -2.16 to -1.29; p < 0.001). Adverse effects of skin atrophy, telangiectasia, and post-inflammatory hyperpigmentation were noted in the steroid injection segment, while no adverse effects were observed at the TMFI + Steroid segment. CONCLUSIONS TMFI-assisted topical corticosteroid delivery is an effective treatment for HTS with a lower risk of adverse effects compared with corticosteroid injection.
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Affiliation(s)
- Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ofir Artzi
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Mia Katrina R Gervasio
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Jyothi S, Krishna K, Ameena Shirin V, Sankar R, Pramod K, Gangadharappa H. Drug delivery systems for the treatment of psoriasis: Current status and prospects. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102364] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Benzaquen M, Fongue J, Pauly V, Collet-Villette AM. Laser-Assisted Hyaluronic Acid Delivery by Fractional Carbon Dioxide Laser in Facial Skin Remodeling: A Prospective Randomized Split-Face Study in France. Lasers Surg Med 2021; 53:1166-1172. [PMID: 33792961 DOI: 10.1002/lsm.23403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/06/2021] [Accepted: 03/15/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Combining the efficacy of ablative fractional carbon dioxide lasers (AFXL) to laser-assisted hyaluronic acid delivery (LAHAD) has not yet been studied. The objective of our study was to evaluate the safety and the efficacy of laser-assisted hyaluronic acid (HA) delivery with AFXL in facial skin remodeling. STUDY DESIGN/MATERIALS AND METHODS We conducted a prospective, double-blinded, randomized split-face study on 20 patients from 30 to 70 years old, with a skin phototype from I to IV. Each patient received full-face treatment with AFXL, immediately followed by the application in droplets into the fractional ablative tunnels of 1 ml of HA gel on one hemiface and 1 ml of physiological saline on the other hemiface. To evaluate postlaser aftermath, the intensity of erythema, edema, and crusts was graded. To assess facial skin remodeling, we scored the improvement of skin texture, firmness, fine lines, and skin radiance from baseline. Patients were evaluated on the 3rd and 7th day, 1st and 3rd month using clinical evaluations, photographs, and patient questionnaires. RESULTS We showed equivalence in postlaser aftermath between HA-treated and nontreated hemiface. Trend data analyses at the 3rd month suggested that immediate application of HA after AFXL resulted in a greater improvement in facial skin remodeling, especially for skin texture (mean score of 2.60 vs. 2.45) and skin firmness (mean score of 2.55 vs. 2.40). Skin radiance showed the best improvement, reaching almost a score of 5/10. CONCLUSIONS LAHAD with AFXL is a safe treatment showing promising results in facial skin remodeling. These findings need to be confirmed by a larger study to evaluate the value of LAHAD in daily clinical practice. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Michael Benzaquen
- Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - Jessica Fongue
- Dermatologic Laser Center, Hôpital de la Conception, Aix-Marseille Univ., APHM, 13005, Marseille, France
| | - Vanessa Pauly
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille Univ., Marseille, 13005, France.,Department of Medical Information, APHM, Marseille, 13005, France
| | - Anne-Marie Collet-Villette
- Dermatologic Laser Center, Hôpital de la Conception, Aix-Marseille Univ., APHM, 13005, Marseille, France
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14
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Conforti C, Vezzoni R, Giuffrida R, Fai A, Fadda S, Marangi GF, Persichetti P, Piccolo D, Segreto F, Zalaudek I, Dianzani C. An overview on the role of CO 2 laser in general dermatology. Dermatol Ther 2021; 34:e14692. [PMID: 33351990 DOI: 10.1111/dth.14692] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/18/2020] [Accepted: 12/11/2020] [Indexed: 12/27/2022]
Abstract
Among different laser types, the carbon dioxide (CO2 ) laser remains one of the most used by dermatologists. Its usefulness has been demonstrated both for therapeutic and cosmetic purposes. This review aims to provide an overview of the applications of CO2 laser in dermatology, focusing on the treatment of infective, neoplastic, and antiaesthetic lesions.
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Affiliation(s)
- Claudio Conforti
- Dermatology and Venereology Department, University of Trieste, Ospedale Maggiore di Trieste, Trieste, Italy
| | - Roberta Vezzoni
- Dermatology and Venereology Department, University of Trieste, Ospedale Maggiore di Trieste, Trieste, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Annatonia Fai
- Plastic and Reconstructive Surgery Department, Dermatology Section, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Sara Fadda
- Plastic and Reconstructive Surgery Department, Dermatology Section, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Giovanni Francesco Marangi
- Plastic and Reconstructive Surgery Department, Dermatology Section, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Paolo Persichetti
- Plastic and Reconstructive Surgery Department, Dermatology Section, Campus Bio-Medico, University of Rome, Rome, Italy
| | | | - Francesco Segreto
- Plastic and Reconstructive Surgery Department, Dermatology Section, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Iris Zalaudek
- Dermatology and Venereology Department, University of Trieste, Ospedale Maggiore di Trieste, Trieste, Italy
| | - Caterina Dianzani
- Plastic and Reconstructive Surgery Department, Dermatology Section, Campus Bio-Medico, University of Rome, Rome, Italy
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15
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Searle T, Ali FR, Al-Niaimi F. Lessons Learned from the First Decade of Laser-Assisted Drug Delivery. Dermatol Ther (Heidelb) 2021; 11:93-104. [PMID: 33464473 PMCID: PMC7858718 DOI: 10.1007/s13555-020-00478-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Indexed: 11/29/2022] Open
Abstract
Laser-assisted drug delivery augments the distribution and penetration of topically applied treatments, leading to enhanced delivery and bioavailability. We discuss the therapeutic application of laser-assisted drug delivery in clinical practice in cases of non-melanoma skin cancer, vitiligo, melasma, scarring, and alopecia (female pattern hair loss, male pattern hair loss, alopecia areata) as well as for vaccination, local anaesthesia, analgesia, viral warts, infantile haemangiomas and cosmetic uses, and we review clinical studies that have used this technique over the last decade. Our review shows that the application of laser-assisted drug delivery enhances topical agent efficacy, potentially reducing the agent concentration and duration of topical treatment required. Future research into the use of laser-assisted drug delivery before topical therapies is needed to establish the optimal techniques to enhance drug delivery and thus improve patient outcomes.
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Affiliation(s)
| | - Faisal R Ali
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Vernova Healthcare CIC, Macclesfield, UK
| | - Firas Al-Niaimi
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK. .,Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark.
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16
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Neinaa YMEH, Al-Khayat LAE, Suliman GAM, Ameen TES. Fractional carbon dioxide laser-assisted delivery of lyophilized-growth factors is a promising treatment modality of post-acne scars. Dermatol Ther 2020; 33:e14488. [PMID: 33131170 DOI: 10.1111/dth.14488] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/18/2020] [Accepted: 10/26/2020] [Indexed: 12/13/2022]
Abstract
Lyophilized-growth factors (L-GFs), is a new platelet rich plasma (PRP) preparation that is standardized in growth factors concentrations. The aim of this study was to compare the therapeutic efficacy of ablative fractional CO2 laser in combination with L-GFs vs PRP in post-acne scars. This study was conducted on 45 patients presented with facial post-acne scars. Each patient received three sessions of fractional CO2 laser on both sides of the face followed by topical application of L-GFs on one side and conventional PRP on the other side. Assessment was done before and after treatment semiquantitatively by Echella d'Èvaluation Clinique des Cicatrices d'Acné (ECCA) score and qualitatively by Goodman and Baron's qualitative scar (GBQS) scale, in addition to dermoscopic evaluation. The current study reported significant clinical improvement of post-acne scars on both sides of the face evidenced by significant reduction of both ECCA score and GBQS scale with minimal side effects. The degree of clinical improvement and patients' satisfaction were significantly higher with shorter downtime in response to fractional CO2 laser combined with L-GFs rather than its combination with PRP. In conclusion, laser assisted delivery of L-GFs via fractional CO2 laser could be considered a novel successful therapeutic modality for post-acne scars.
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Affiliation(s)
| | | | | | - Tarek El-Sayed Ameen
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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17
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Ablative fractional laser treatment of hypertrophic burn and traumatic scars: a systematic review of the literature. Arch Dermatol Res 2020; 313:301-317. [PMID: 32926192 DOI: 10.1007/s00403-020-02135-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/13/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
Hypertrophic scars (HTS) following burns and other trauma and are associated with significant functional and psychosocial impairment. Ablative fractional lasers (AFLs) are increasingly being applied in the treatment of HTS supported by a rapidly expanding multidisciplinary base of literature. The multidisciplinary authors sought to evaluate existing literature, provide context and identify gaps, and make recommendations for a path forward. A systematic review was conducted to identify literature pertinent literature through September 2019. Retrospective cohort, randomized controlled trials, quasi-randomized controlled trials, observational prospective cohort, or case series with five or more subjects with hypertrophic scars incurred from burns and related trauma were considered. Twenty-two of the 23 evaluated studies documented statistically significant and/or meaningful qualitative improvements in nearly all outcome measures. Adverse events were generally infrequent and minor. Significant heterogeneity was observed among the studies included in this systematic review, precluding metaanalysis of pooled data. There is abundant existing literature on the use of AFLs in the management of HTS but study heterogeneity limits generalizability. Future studies should prioritize standardized protocols including assessments of function and quality of life.
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18
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Ghandehari R, Robati RM, Niknezhad N, Hajizadeh N, Tehranchinia Z. Efficacy and safety of fractional CO 2 laser and tranexamic acid versus microneedling and tranexamic acid in the treatment of infraorbital hyperpigmentation. J DERMATOL TREAT 2020; 33:1391-1396. [PMID: 32893707 DOI: 10.1080/09546634.2020.1819527] [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] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of microneedling and fractional CO2 laser in combination with tranexamic acid (TA) in the treatment of infra-orbital hyperpigmentation. PATIENTS AND METHODS This split-face clinical trial performed on 30 volunteers. The patients were randomly assigned to treat with fractional CO2 laser and microneedling, both combined with TA topically. Three monthly treatment sessions were performed. Two blinded dermatologists evaluated the response after each treatment session and one and three months after the last session. We also asked patients to evaluate their overall satisfaction at the final follow up. Adverse effects have also been documented. RESULTS Both methods showed significant improvement in all sessions comparing with the baseline state (p value <.05). There were no significant differences between two methods on the days 30, 90, and 150. But the laser showed significantly higher improvement on day 60. The patients' satisfaction did not reveal any significant difference between the two sides. Adverse events were temporary with no significant difference between both sides except for erythema that lasts longer with microneedling. CONCLUSIONS Both fractional CO2 laser and microneedling in combination with topical TA seem to be effective modalities in the treatment of infraorbital hyperpigmentation with no significant side effects.
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Affiliation(s)
- Reza Ghandehari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza M Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Niknezhad
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Hajizadeh
- Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Tehranchinia
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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19
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Levenberg A, Vinshtok Y, Artzi O. Potentials for implementing pressure-controlled jet injection in management of keloids with intralesional 5FU and corticosteroids. J Cosmet Dermatol 2020; 19:1966-1972. [PMID: 32603031 DOI: 10.1111/jocd.13522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Needle-free jet injection implements kinetic energy of liquid jet for transcutaneous delivery of drugs into soft tissues. Combination therapy of intralesional 5-fluorouracil and triamcinolone offers efficacious treatment for keloids with a reduced adverse effect of the drug monotherapy. This study evaluates safety and efficacy of the drug combination administered to keloid scars via intralesional jet injections. METHODS A retrospective analysis of the keloid treatments was performed. Efficacy was assessed by reviewing pre- and post-treatment scores of the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) and by comparing baseline and photographs taken 3 months after the treatments. Safety and tolerability were collected and analyzed. RESULTS Twenty-one subjects (M/F = 11/10) with 39 keloids received the treatments. Treatments were well-tolerated by all patients at mean injection pain of 2.0 ± 1.0 per Numeric Pain Rating Scale (NPRS). Self-resolved lesion ulceration was observed in 4 patients. Post-treatment evaluation demonstrated a 53% decrease in total VSS score (P < 0.05) and in all sub-categories. Mean patient score of POSAS decreased in the color, stiffness, thickness, and irregularity components. Pain and pruritus lessened by 69% and 79% (P < 0.05 in both), respectively, among the patients with complaints prior to the treatment. Independent reviewers reported an average 51%-75% reduction in keloids. CONCLUSIONS Improved appearance of keloids and symptomatic relief was achieved by intralesional administration of combined 5-fluorouracil and corticosteroid through the high-pressure jet injections. The synergy between the drug combination and the jet physical impact provided clinical effect.
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Affiliation(s)
- Alex Levenberg
- Department of Plastic Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Ofir Artzi
- Center for Aesthetic Dermatology, Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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20
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Steeb T, Wessely A, Leiter U, French L, Berking C, Heppt M. The more the better? An appraisal of combination therapies for actinic keratosis. J Eur Acad Dermatol Venereol 2020; 34:727-732. [DOI: 10.1111/jdv.15998] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/25/2019] [Indexed: 12/30/2022]
Affiliation(s)
- T. Steeb
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - A. Wessely
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - U. Leiter
- Department of Dermatology Center for Dermatooncology University Hospital Tübingen Tübingen Germany
| | - L.E. French
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - C. Berking
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - M.V. Heppt
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
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21
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del Río-Sancho S, Castro-López V, Alonso MJ. Enhancing cutaneous delivery with laser technology: Almost there, but not yet. J Control Release 2019; 315:150-165. [DOI: 10.1016/j.jconrel.2019.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 12/30/2022]
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22
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Baumann ME, Blackstone BN, Malara MM, Clairmonte IA, Supp DM, Bailey JK, Powell HM. Fractional CO 2 laser ablation of porcine burn scars after grafting: Is deeper better? Burns 2019; 46:937-948. [PMID: 31767253 DOI: 10.1016/j.burns.2019.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 10/01/2019] [Accepted: 10/04/2019] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Fractional CO2 lasers have been used in clinical settings to improve scarring following burn injury. Though used with increasing frequency, the appropriate laser settings are not well defined and overall efficacy of this therapy has not been definitively established. As it has been proposed that for thick hypertrophic scars proportionally greater fluence and thus deeper ablation into the scar tissue would be most effective, the goal of this study was to examine the role of ablation depth on scar outcomes in a highly-controlled porcine model for burn scars-after grafting. METHODS Properties of laser ablated wells were quantified on ex vivo pig skin as a function of laser energy (20, 70 or 150mJ). Full-thickness burn wounds were created on the dorsum of red Duroc pigs with the eschar excised and grafted with a split-thickness autograft meshed and expanded 1.5:1. After four weeks of healing, sites were treated with either 20, 70, or 150mJ pulse energy from a fractional CO2 laser at 5% density or left untreated as a control. Sites were treated every four weeks with three total sessions. Scar area, pigmentation, erythema, roughness, histology, and biomechanics were evaluated prior to each laser treatment at day 28, 56, and 83, as well as four weeks after the final laser treatment, day 112. Additional biopsies were collected at day 112 for gene expression analysis. RESULTS The depth of the laser ablated wells increased with increasing pulse energy while the width of the wells was smaller in the 20mJ group and not significantly different in the 70 and 150mJ groups. Scar properties (area, color, biomechanics) were not significantly altered by laser therapy at any of the laser energies tested versus controls. Average scar roughness was improved by laser therapy in a dose dependent manner with scars treated with 150mJ of energy having the smoothest surface; however, these changes were not statistically significant. Assessment of matrix metalloproteinase 9 gene expression showed a slight upregulation in scars treated with 70 or 150mJ versus control scars and scars treated with 20mJ pulse energy. CONCLUSION The current study demonstrated that the properties of the ablative well (depth and width) are not linearly correlated with laser pulse energy, with only a small increase in well depth at energies between 70 and 150mJ. Overall, the study suggests that there is little difference in outcomes as a function of laser energy. Fractional CO2 laser therapy did not result in any statistically significant benefit to scar properties assessed by quantitative, objective measures, thus highlighting the need for additional clinical investigation of laser therapy efficacy with non-treated controls and objective measures of outcome.
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Affiliation(s)
- Molly E Baumann
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States
| | - Britani N Blackstone
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States
| | - Megan M Malara
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States
| | - Isabelle A Clairmonte
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States
| | - Dorothy M Supp
- Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States; Department of Surgery, University of Cincinnati, Cincinnati, OH, United States
| | - J Kevin Bailey
- Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States; Department of Surgery, Division of Critical Care, Trauma and Burns, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Heather M Powell
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States; Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States; Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States.
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23
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A systematic review of the safety and effectiveness of platelet-rich plasma (PRP) for skin aging. Arch Dermatol Res 2019; 312:301-315. [DOI: 10.1007/s00403-019-01999-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 01/07/2023]
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24
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Hsiao CY, Yang SC, Alalaiwe A, Fang JY. Laser ablation and topical drug delivery: a review of recent advances. Expert Opin Drug Deliv 2019; 16:937-952. [DOI: 10.1080/17425247.2019.1649655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Chien-Yu Hsiao
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Research Center for Food and Cosmetic Safety and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Aesthetic Medical Center, Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Chun Yang
- Department of Cosmetic Science, Providence University, Taichung, Taiwan
| | - Ahmed Alalaiwe
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Jia-You Fang
- Research Center for Food and Cosmetic Safety and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Taoyuan, Taiwan
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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25
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FXCO2 laser therapy of existing burn scars does not significantly improve outcomes in a porcine model. BURNS OPEN 2019. [DOI: 10.1016/j.burnso.2019.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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26
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Dabek RJ, Roh DS, Ozdemir D, Austen WG, Bojovic B. Fractional Laser-assisted Hair Regrowth and Microneedling for the Treatment of Alopecia Areata: A Review. Cureus 2019; 11:e4943. [PMID: 31453018 PMCID: PMC6701901 DOI: 10.7759/cureus.4943] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Alopecia areata (AA) affects approximately 2.1% of the population, with women being affected more often than men. Current therapies consisting of topical corticosteroids or intralesional injections are often the first choices for treatment, but are limited by unsatisfactory outcomes or risks to patients. Recently, fractional lasers and microneedling, with or without the addition of topical agents, have been examined as treatment options. A literature review was performed to evaluate the efficacy of fractional lasers in the treatment of AA. A total of six fractional lasers and two microneedling studies consisting of small prospective and retrospective studies, and case reports were reviewed. The number of trials and participants are limited, but evidence suggests that fractional lasers and microneedling may be effective therapeutic approaches when coupled with topical agents. Larger studies are required to better understand the effects of these treatment modalities for AA.
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Affiliation(s)
- Robert J Dabek
- Plastic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Daniel S Roh
- Plastic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Derman Ozdemir
- Internal Medicine, Saba University School of Medicine, The Bottom, Caribbean Netherlands, NLD
| | - William G Austen
- Plastic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Branko Bojovic
- Plastic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, USA
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27
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Post-irradiation recovery time strongly influences fractional laser-facilitated skin absorption. Int J Pharm 2019; 564:48-58. [DOI: 10.1016/j.ijpharm.2019.04.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/16/2019] [Accepted: 04/14/2019] [Indexed: 12/15/2022]
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28
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Hu AC, Hong EM, Toubat O, Sivoraphonh R, Barnes C, Moy WJ, Krasieva TB, Wong BJF. Multiphoton Microscopy of Collagen Structure in Ex Vivo Human Skin Following Electrochemical Therap
y. Lasers Surg Med 2019; 52:196-206. [DOI: 10.1002/lsm.23094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Allison C. Hu
- School of MedicineUniversity of CaliforniaIrvine California 92617
- Beckman Laser Institute and Medical ClinicUniversity of CaliforniaIrvine California 92612
- Department of Biomedical EngineeringUniversity of CaliforniaIrvine California 92617
| | - Ellen M. Hong
- Beckman Laser Institute and Medical ClinicUniversity of CaliforniaIrvine California 92612
- Department of Biomedical EngineeringUniversity of CaliforniaIrvine California 92617
| | - Omar Toubat
- Keck School of Medicine of USCLos Angeles California 90033
| | - Ryan Sivoraphonh
- Beckman Laser Institute and Medical ClinicUniversity of CaliforniaIrvine California 92612
- Department of Biomedical EngineeringUniversity of CaliforniaIrvine California 92617
| | - Christian Barnes
- Beckman Laser Institute and Medical ClinicUniversity of CaliforniaIrvine California 92612
- Department of Biomedical EngineeringUniversity of CaliforniaIrvine California 92617
- Department of Otolaryngology–Head and Neck SurgeryUniversity of CaliforniaIrvine, Orange California 92868
| | - Wesley J. Moy
- Beckman Laser Institute and Medical ClinicUniversity of CaliforniaIrvine California 92612
- Department of Biomedical EngineeringUniversity of CaliforniaIrvine California 92617
| | - Tatiana B. Krasieva
- Beckman Laser Institute and Medical ClinicUniversity of CaliforniaIrvine California 92612
| | - Brian J. F. Wong
- Beckman Laser Institute and Medical ClinicUniversity of CaliforniaIrvine California 92612
- Department of Biomedical EngineeringUniversity of CaliforniaIrvine California 92617
- Department of Otolaryngology–Head and Neck SurgeryUniversity of CaliforniaIrvine, Orange California 92868
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29
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Kuehlmann B, Stern-Buchbinder Z, Wan DC, Friedstat JS, Gurtner GC. Beneath the Surface: A Review of Laser Remodeling of Hypertrophic Scars and Burns. Adv Wound Care (New Rochelle) 2019; 8:168-176. [PMID: 31832273 DOI: 10.1089/wound.2018.0857] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/15/2018] [Indexed: 02/01/2023] Open
Abstract
Significance: Hypertrophic scars, keloids, and burn injuries of the skin have a significant impact on patients' lives and impact the health care system tremendously. Treating skin wounds and lesions can be challenging, with a variety of choices available for treatment. Scar and burn managements range from invasive, surgical options such as scar excision to less invasive, nonsurgical alternatives such as laser therapy or topical drug application. Recent Advances: Laser treatment has become increasingly popular, with a growing body of research supporting its use for scars and burns. Numerous methods are available for the treatment of these skin diseases, including different nonsurgical laser therapies. Critical Issues: To date, the optimal treatment method for scars, keloids, and burn injuries of the skin has not yet been established, although it is an area of increasing clinical concern. Future Directions: This review provides an updated summary of the treatment of scars and burn wounds of the skin using different laser treatments, including the most recent technologies. It addresses their indications, mechanisms of action, differences, efficacies, and complications.
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Affiliation(s)
- Britta Kuehlmann
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
- Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef, Regensburg, Germany
| | - Zachary Stern-Buchbinder
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Derrick C. Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Jonathan S. Friedstat
- Sumner M. Redstone Burn Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Geoffrey C. Gurtner
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
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30
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Leng X, Wang P, Chen Z, Li D, Wen J, Zhang X, Qian H, Guo J, Wu X. Dissociated skin cells regenerate hair follicles in a microwound, “The Punch Assay”. Exp Dermatol 2018; 29:349-356. [DOI: 10.1111/exd.13753] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 07/18/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Xue Leng
- Shandong Provincial Key Laboratory of Oral Tissue RegenerationSchool of StomatologyShandong University Jinan Shandong China
- Laboratory for Tissue Engineering and RegenerationSchool of StomatologyShandong University Jinan Shandong China
| | - Ping Wang
- Department of Out‐patient SurgeryQilu HospitalShandong University Jinan Shandong China
| | - Zhihong Chen
- Department of Urinary SurgeryQilu Children's Hospital of Shandong University Jinan Shandong China
| | - Dingyang Li
- Shandong Provincial Key Laboratory of Oral Tissue RegenerationSchool of StomatologyShandong University Jinan Shandong China
- Laboratory for Tissue Engineering and RegenerationSchool of StomatologyShandong University Jinan Shandong China
| | - Jie Wen
- Shandong Provincial Key Laboratory of Oral Tissue RegenerationSchool of StomatologyShandong University Jinan Shandong China
- Laboratory for Tissue Engineering and RegenerationSchool of StomatologyShandong University Jinan Shandong China
| | - Xuan Zhang
- Shandong Provincial Key Laboratory of Oral Tissue RegenerationSchool of StomatologyShandong University Jinan Shandong China
- Laboratory for Tissue Engineering and RegenerationSchool of StomatologyShandong University Jinan Shandong China
| | - Hua Qian
- Shandong Provincial Key Laboratory of Oral Tissue RegenerationSchool of StomatologyShandong University Jinan Shandong China
- Laboratory for Tissue Engineering and RegenerationSchool of StomatologyShandong University Jinan Shandong China
| | - Jing Guo
- Shandong Provincial Key Laboratory of Oral Tissue RegenerationSchool of StomatologyShandong University Jinan Shandong China
| | - Xunwei Wu
- Shandong Provincial Key Laboratory of Oral Tissue RegenerationSchool of StomatologyShandong University Jinan Shandong China
- Laboratory for Tissue Engineering and RegenerationSchool of StomatologyShandong University Jinan Shandong China
- Suzhou Institute of Shandong University Suzhou Jiangsu China
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31
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Wolf DA, Beeson W, Rachel JD, Keller GS, Hanke CW, Waibel J, Leavitt M, Sacopulos M. Mesothelial Stem Cells and Stromal Vascular Fraction for Skin Rejuvenation. Facial Plast Surg Clin North Am 2018; 26:513-532. [PMID: 30213431 DOI: 10.1016/j.fsc.2018.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The use of stem cells in regenerative medicine and specifically facial rejuvenation is thought provoking and controversial. Today there is increased emphasis on tissue engineering and regenerative medicine, which translates into a need for a reliable source of stem cells in addition to biomaterial scaffolds and cytokine growth factors. Adipose tissue is currently recognized as an accessible and abundant source for adult stem cells. Cellular therapies and tissue engineering are still in their infancy, and additional basic science and preclinical studies are needed before cosmetic and reconstructive surgical applications can be routinely undertaken and satisfactory levels of patient safety achieved.
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Affiliation(s)
- David A Wolf
- Johnson Space Center, Houston, TX, USA; EarthTomorrow, Inc, 1714 Neptune Lane, Houston, TX 77062, USA; Purdue University, West Lafayette, IN, USA
| | - William Beeson
- Facial Plastics, Indianapolis, IN, USA; Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
| | | | - Gregory S Keller
- Facial Plastics, Santa Barbara, CA, USA; Facial Plastics, Los Angeles, CA, USA
| | - C William Hanke
- Dermatology, Indianapolis, IN, USA; Laser and Skin Center of Indiana, 13400 North Meridian Street, Suite 290, Carmel, IN 46032, USA; ACGME Micrographic Surgery, Dermatologic Oncology Fellowship Training Program, St. Vincent Hospital, Indianapolis, IN, USA; University of Iowa-Carver College of Medicine, Iowa City, IA, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jill Waibel
- Dermatology, Miami Dermatology and Laser Institute, 7800 Southwest 87th Avenue, Suite B200, Miami, FL 33173, USA; Baptist Hospital of Miami, Miami, FL, USA; Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Matt Leavitt
- Dermatology, Orlando, FL, USA; Advanced Dermatology and Cosmetic Surgery, The Hair Foundation, 260 Lookout Place Suite 103, Maitland, FL 32751, USA; University of Central Florida, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA; Nova Southeastern University, 4850 Millenium Boulevard, Orlando, FL 32839, USA
| | - Michael Sacopulos
- Medical Risk Management, Medical Risk Institute, 676 Ohio Street, Terre Haute, IN 47807, USA
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32
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Genouw E, Verheire B, Ongenae K, De Schepper S, Creytens D, Verhaeghe E, Boone B. Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablativeCO2laser mode. J Eur Acad Dermatol Venereol 2018; 32:1897-1905. [DOI: 10.1111/jdv.14989] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 03/14/2018] [Indexed: 12/14/2022]
Affiliation(s)
- E. Genouw
- Faculty of Medicine and Health Sciences Ghent University Ghent Belgium
| | - B. Verheire
- Faculty of Medicine and Health Sciences Ghent University Ghent Belgium
| | - K. Ongenae
- Department of Dermatology Ghent University Hospital Ghent Belgium
| | - S. De Schepper
- Department of Dermatology Ghent University Hospital Ghent Belgium
| | - D. Creytens
- Department of Pathology Ghent University Hospital Ghent Belgium
- CRIG, Cancer Research Institute Ghent Ghent University Ghent Belgium
| | - E. Verhaeghe
- Department of Dermatology Ghent University Hospital Ghent Belgium
| | - B. Boone
- Department of Dermatology Ghent University Hospital Ghent Belgium
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