Laser treatment of acne, psoriasis, leukoderma, and scars

Treatment of cutaneous larva migrans with a single session of carbon dioxide laser: a study of ten cases in the Philippines

BACKGROUND

Cutaneous larva migrans (CLM) has a detrimental effect on patients' emotional and physical quality of life. Due to local unavailability of gold standard oral treatments for CLM, carbon dioxide laser was attempted. We present a case series where a single session of carbon dioxide laser treatment was associated with cessation of signs and symptoms of CLM.

AIMS

The aim of this study was to assess the efficacy of a single session of carbon dioxide laser in the treatment of CLM.

MATERIALS AND METHODS

Ten cases (eight patients) with CLM were treated with one session of carbon dioxide laser treatment and followed up daily for the first week with photographic documentation and then weekly for the next 3 weeks to complete a 4 week follow-up period.

RESULTS

The first cases in our series, who received one to two passes of fractional CO₂ laser, experienced further larval migration for 2-3 days, after which no more progression was noted. For the next seven cases, we increased the number of CO₂ laser passes to 3-4, and noted no further larval migration. At the end of the 4-week follow-up period, all CO₂ laser-treated areas were completely healed, leaving postinflammatory hyperpigmentation of the serpiginous track.

CONCLUSION

The results of this case series indicate the efficacy of a single session of CO₂ laser in treating CLM. Further studies are required to identify the minimum number of passes required to effectively control CLM.

Pseudoxanthoma Elasticum Treatment with Fractional CO2 Laser

SUMMARY

Pseudoxanthoma elasticum (PE) is a rare genetic disease characterized by calcification and fragmentation of elastic fibers of the skin, retina, and cardiovascular system. We report a case of PE in which fractional carbon dioxide laser treatment was successfully used to achieve improvement of the cervical skin with 2-year follow-up, in a patient with Fitzpatrick skin type IV. After the fifth session, the patient presented with a local herpes infection. The postlaser reaction of the PE skin was similar to that of the normal skin, in terms of the duration of redness, pain, swelling, and duration of crusting. The overall cosmetic result was satisfactory, with improvement in skin texture, irregularity, volume, and distensibility. The herpetic infection reinforces the value of antiviral prophylaxis during laser treatment of extrafacial areas.

Pulse dye and other laser treatments for vocal scar

PURPOSE OF REVIEW

Vocal fold scar is a challenging clinical problem, resulting in a spectrum of voice-related complaints. While there are a variety of treatment options available, it is rare to obtain outcomes similar to the perfectly normal voice. The pulsed dye and other lasers are an emerging treatment option for cutaneous scar and have shown promise for the treatment of vocal fold scarring. The purpose of this review is to summarize the theory, and describe clinical outcomes from both cutaneous and vocal fold scarring treated with lasers.

RECENT FINDINGS

There are a growing number of papers in the literature substantiating the use of pulsed dye and other lasers used to treat cutaneous scars. Some experimental models describe potential mechanisms of laser effect, which include the development of a sub-basement membrane cleavage plane, as well as up-regulation of proteins which may actively modulate continued fibrosis. One prospective pilot study of 11 patients with vocal fold scarring treated with the pulsed dye laser has also shown statistically significant improvement in subjective and objective voice measures, as well as laryngeal stroboscopy findings after treatment.

SUMMARY

The pulsed dye and other lasers have shown effectiveness and potential in treating cutaneous and vocal scarring.