1
|
Paasch U, Zidane M, Baron JM, Bund T, Cappius HJ, Drosner M, Feise K, Fischer T, Gauglitz G, Gerber PA, Grunewald S, Herberger K, Jung A, Karsai S, Kautz G, Philipp C, Schädel D, Seitz AT, Nast A. S2k guideline: Laser therapy of the skin. J Dtsch Dermatol Ges 2022; 20:1248-1267. [PMID: 36098675 DOI: 10.1111/ddg.14879] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This guideline aims to improve the efficiency and safety of lasers and optical radiation sources with similar effects (especially IPL). Laser therapy of skin lesions with an increased amount of melanocytes should be performed with caution. Laser treatment of pigmented melanocytic nevi is not recommended. The guideline contains recommendations regarding the treatment of lentigines and café-au-lait spots, non-pigmented dermal nevi, Becker nevus, nevus of Ota/Hori/Ito and melasma. Further recommendations focus on the treatment of skin lesions without an increased amount of melanocytes (ephelides, postinflammatory hyperpigmentation including berloque dermatitis, seborrheic keratoses, traumatic/decorative tattoos and metallic deposits), hypopigmentation (vitiligo), benign non-pigmented neoplasms (fibrous papule of the nose, nevus sebaceus, epidermal nevus, neurofibroma, sebaceous gland hyperplasia, syringoma, xanthelasma palpebrarum), inflammatory dermatoses (acne papulopustulosa/conglobata, acne inversa, granuloma faciale, lichen sclerosus, lupus erythematosus, psoriasis vulgaris, rosacea, rhinophyma), wrinkles/dermatochalasis/striae, hypertrichosis, scars (atrophic, hypertrophic; keloids, burn/scald scars), laser-assisted skin healing, onychomycosis, precancerous lesions and malignant tumors (actinic keratoses/field cancerization, cheilitis actinica, basal cell carcinoma), vascular skin lesions (angiokeratoma, angioma, hemangioma, malformation, spider veins, granuloma telangiectaticum (pyogenic granuloma), rubeosis (erythrosis interfollicularis colli, ulerythema ophryogenes), nevus flammeus, telangiectasias and Osler's disease (hereditary hemorrhagic telangiectasia) and viral skin lesions (condylomata acuminata, mollusca contagiosa, verrucae planae juveniles/vulgares/ verrucae palmares et plantares).
Collapse
Affiliation(s)
- Uwe Paasch
- Hautaerzte Paasch, Practice Prof. Paasch, Jesewitz OT Gotha, Germany, University Hospital Leipzig, Department and Clinic for Dermatology, Venereology and Allergology, Leipzig
| | - Miriam Zidane
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Berlin
| | - Jens Malte Baron
- University Hospital Aachen, Department for Dermatology and Allergology - Skin Medicine, Aachen
| | - Thorsten Bund
- Department for Plastic, Esthetic, and Reconstructive Microsurgery, Hand Surgery at Ernst von Bergmann Hospital, Potsdam
| | | | - Michael Drosner
- Skin & Laser Schwerin, Skin & Laser Rostock, Schwerin and Rostock
| | | | - Tanja Fischer
- Skin & Laser Center Berlin-Potsdam, Berlin and Potsdam
| | - Gerd Gauglitz
- Skin and Laser Center Glockenbach Quarter, Munich, Department for Dermatology and Allergology, Ludwig-Maximilians University, Munich
| | - Peter Arne Gerber
- Dermatology at Luegplatz, Düsseldorf, Department for Dermatology, Medical Faculty, Heinrich-Heine University, Düsseldorf
| | - Sonja Grunewald
- University Hospital Leipzig, Department and Clinic for Dermatology, Venereology and Allergology, Leipzig
| | - Katharina Herberger
- University Hospital Hamburg-Eppendorf (UKE), Department for Dermatology and Venereology, Hamburg
| | - Anja Jung
- Center for Proctology, Evangelisches Elisabeth Hospital, Berlin, Deutschland
| | | | - Gerd Kautz
- Skin and Laser Hospital Dres. Gerd and Ingrid Kautz, Konz
| | - Carsten Philipp
- Center Laser Medicine, Evangelisches Elisabeth Hospital, Berlin
| | | | - Anna-Theresa Seitz
- University Hospital Leipzig, Department and Clinic for Dermatology, Venereology and Allergology, Leipzig
| | - Alexander Nast
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Berlin
| |
Collapse
|
2
|
Paasch U, Zidane M, Baron JM, Bund T, Cappius HJ, Drosner M, Feise K, Fischer T, Gauglitz G, Gerber PA, Grunewald S, Herberger K, Jung A, Karsai S, Kautz G, Philipp C, Schädel D, Seitz AT, Nast A. S2k-Leitlinie: Lasertherapie der Haut. J Dtsch Dermatol Ges 2022; 20:1248-1270. [PMID: 36162017 DOI: 10.1111/ddg.14879_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Uwe Paasch
- Hautärzte Paasch, Praxis Prof. Paasch, Jesewitz OT Gotha, Deutschland, Universitätsklinikum Leipzig, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Leipzig
| | - Miriam Zidane
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Berlin
| | - Jens Malte Baron
- Universitätsklinikum Aachen, Klinik für Dermatologie und Allergologie - Hautklinik, Aachen
| | - Thorsten Bund
- Klinik für Plastische, Ästhetische und Rekonstruktive Mikrochirurgie, Handchirurgie am Klinikum Ernst von Bergmann, Potsdam
| | | | - Michael Drosner
- Haut & Laser Schwerin, Haut & Laser Rostock, Schwerin und Rostock
| | | | - Tanja Fischer
- Haut- & Lasercentrum Berlin-Potsdam, Berlin und Potsdam
| | - Gerd Gauglitz
- Haut- und Laserzentrum im Glockenbachviertel, München, Klinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, München
| | - Peter Arne Gerber
- Dermatologie am Luegplatz, Düsseldorf, Klinik für Dermatologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf
| | - Sonja Grunewald
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Leipzig
| | - Katharina Herberger
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik für Dermatologie und Venerologie, Hamburg
| | - Anja Jung
- Zentrum Proktologie, Evangelische Elisabeth Klinik, Berlin, Deutschland
| | | | - Gerd Kautz
- Haut- und Laserklinik Dres. Gerd und Ingrid Kautz, Konz
| | | | | | - Anna-Theresa Seitz
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Leipzig
| | - Alexander Nast
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Berlin
| |
Collapse
|
3
|
Del Zingaro M, Cochetti G, Zucchi A, Paladini A, Rossi De Vermandois JA, Ciarletti S, Felici G, Maiolino G, Renzetti R, Gaudio G, Mearini E. Holmium:YAG Laser for the Treatment of Genital and urethral Warts: Multicentre Prospective Evaluation of Safety and Efficacy. J Lasers Med Sci 2021; 12:e34. [PMID: 34733757 DOI: 10.34172/jlms.2021.34] [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: 09/15/2020] [Accepted: 01/06/2021] [Indexed: 01/30/2023]
Abstract
Introduction: Genital condylomatosis is a highly contagious disease caused by the human papilloma virus (HPV). The aim of this prospective multicentre study was to evaluate the safety and efficacy of the Holmium:YAG (yttrium-aluminium-garnet) laser in the treatment of genital and intra-urethral warts; the secondary aim was to assess the patients' postoperative satisfaction and cosmetic results. Methods: From December 2016 to March 2019, patients with genital warts were prospectively enrolled in three hospitals. The inclusion criteria were male gender, age over 18 years-old and treatment-naïve. External and urethral genitalia warts were treated by the Holmium YAG laser. The follow-up analysis consisted of physical examination, flexible urethro-cystoscopy in case of meatal lesions, and administration of Dermatology Quality of Life Index (DLQI) and Patient Global Impression of Improvement (PGI-I) questionnaires at 1, 3, 6 and 12 months after surgery and subsequently yearly. Results: Sixty patients were enrolled. The single treatment was effective in 57/60 patients (95%). At a mean follow-up of 26 months, recurrences occurred in 8 patients (13.3%). No peri- or post-operative complication occurred. An improvement in pre-operative condition was highlighted with PGI-I and DLQI questionnaires. Conclusion: Our prospective multicentre study showed that holmium laser surgery seems to be a safe and effective treatment for external genital and urethral warts. Good dermatological outcomes aid to further improve patient satisfaction.
Collapse
Affiliation(s)
- Michele Del Zingaro
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Giovanni Cochetti
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | | | - Alessio Paladini
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | | | - Sara Ciarletti
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Graziano Felici
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Giuseppe Maiolino
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Roberto Renzetti
- Department of Surgeries, Urology, Presidio Ospedaliero Pescara, Pescara, Italy
| | - Gianluca Gaudio
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Ettore Mearini
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| |
Collapse
|
4
|
Iranmanesh B, Khalili M, Zartab H, Amiri R, Aflatoonian M. Laser therapy in cutaneous and genital warts: A review article. Dermatol Ther 2020; 34:e14671. [PMID: 33314577 DOI: 10.1111/dth.14671] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022]
Abstract
Traditional treatment modalities for wart require long-term treatment course and usually have high recurrence rates and unwanted side effects. In this review article, we evaluated different types of laser therapy in the treatment of warts. Published articles since 2000 up to July 2020 about laser therapy in genital and non-genital warts were searched and assessed. Fifty articles were selected for the final review, including 22 pulsed dye laser (PDL), 10 neodymium-yttrium-aluminum-garnet (Nd: YAG), 3 erbium-doped yttrium-aluminum-garnet (Er: YAG), 14 carbon dioxide (CO2 ) laser and one systematic review. Complete response rates were different in terms of laser type used (0%-100%, 9.1%-100%, 83.3%-100%, and 59.15%-100% for PDL, Nd: YAG, Er: YAG, and CO2 laser, respectively). There was no significant difference between conventional treatment modalities and laser therapy regarding efficacy and recurrence rate. Combination of lasers with keratolytic agents, immunomodulators and photodynamic therapy can be helpful especially in immunosuppressed patients, refractory, and recurrent lesions. PDL has the lowest occurrence of adverse effects relative to other types of lasers.
Collapse
Affiliation(s)
- Behzad Iranmanesh
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Khalili
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamed Zartab
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Rezvan Amiri
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
5
|
Hodeib AAE, Al-Sharkawy BG, Hegab DS, Talaat RAZ. A comparative study of intralesional injection of Candida albicans antigen, bleomycin and 5-fluorouracil for treatment of plane warts. J DERMATOL TREAT 2019; 32:663-668. [DOI: 10.1080/09546634.2019.1688236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | - Doaa Salah Hegab
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Raghda Ahmed Zaki Talaat
- Medical Microbiology and Immunology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| |
Collapse
|
6
|
Elmaadawy EH, Shams SS, Hegab DS, Zaki RA. Pulsed-dye laser versus intralesional Candida albicans. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2019. [DOI: 10.15570/actaapa.2019.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
7
|
Delmonte S, Benardon S, Cariti C, Ribero S, Ramoni S, Cusini M. Anogenital warts treatment options: a practical approach. GIORN ITAL DERMAT V 2018; 155:261-268. [PMID: 30251804 DOI: 10.23736/s0392-0488.18.06125-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anogenital warts (AGWs) are an important issue for public health centers dealing with Sexually Transmitted Infections. They are epidemiologically relevant, with significant morbidity and an established effective treatment is lacking. In this article, we examine the epidemiological, diagnostic, and therapeutic aspect of the problem in order to give an up to date picture of the situation and a practical clue for the management of AGWs.
Collapse
Affiliation(s)
- Sergio Delmonte
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy -
| | - Susanna Benardon
- Department of Internal Medicine and Medical Specialties, State University of Milan, Milan, Italy.,Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| | - Caterina Cariti
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy
| | - Simone Ribero
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy
| | - Stefano Ramoni
- Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| | - Marco Cusini
- Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| |
Collapse
|
8
|
Abstract
BACKGROUND Warts or verrucae vulgaris are common cutaneous infections with currently no definitive curative treatments available. OBJECTIVE To determine the efficacy of pulsed dye laser (PDL) in the treatment of warts. MATERIALS AND METHODS A literature search was performed using the PubMed and MEDLINE databases. A search using {(Wart[s], verruca or condylomata)} AND [(Pulsed dye laser)] was used. Forty-four articles were identified as relevant to this review. RESULTS Simple warts were very responsive to PDL, being treated successfully in over 95% of patients. Facial and anogenital warts also demonstrated excellent outcomes. Recalcitrant warts, displayed significant variability in their response, ranging between 50% and 100% across all articles. The response rates seen in peripheral warts (involving the hands and feet) were also very variable, ranging between 48% and 95%. Recurrence rates at 4 months of follow-up were documented as 0% to 15%. Complications have been described as very few and rare, the main ones being topical discomfort and erythema. CONCLUSION Pulsed dye laser is a safe and effective modality in the treatment of warts that can be applied to most body parts. Cost and availability remain a limitation to the use of PDL; however, this modality can be used when other more traditional and accessible treatments have failed.
Collapse
|
9
|
Radmanesh M, Omidian E. The pulsed dye laser is more effective and rapidly acting than intralesional meglumine antimoniate therapy for cutaneous leishmaniasis. J DERMATOL TREAT 2017; 28:422-425. [DOI: 10.1080/09546634.2016.1274364] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mohammad Radmanesh
- Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Omidian
- Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
10
|
Nonconventional Use of Flash-Lamp Pulsed-Dye Laser in Dermatology. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7981640. [PMID: 27631010 PMCID: PMC5007316 DOI: 10.1155/2016/7981640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/28/2016] [Indexed: 12/04/2022]
Abstract
Flash-lamp pulsed-dye laser (FPDL) is a nonablative technology, typically used in vascular malformation therapy due to its specificity for hemoglobin. FPDL treatments were performed in a large group of patients with persistent and/or recalcitrant different dermatological lesions with cutaneous microvessel involvement. In particular, 149 patients (73 males and 76 females) were treated. They were affected by the following dermatological disorders: angiokeratoma circumscriptum, genital and extragenital viral warts, striae rubrae, basal cell carcinoma, Kaposi's sarcoma, angiolymphoid hyperplasia, and Jessner-Kanof disease. They all underwent various laser sessions. 89 patients (59.7%) achieved excellent clearance, 32 patients (21.4%) achieved good-moderate clearance, 19 patients (12.7%) obtained slight clearance, and 9 subjects (6.1%) had low or no removal of their lesion. In all cases, FPDL was found to be a safe and effective treatment for the abovementioned dermatological lesions in which skin microvessels play a role in pathogenesis or development. Further and single-indication studies, however, are required to assess a standardized and reproducible method for applying this technology to “off-label” indications.
Collapse
|
11
|
Flash-Lamp Pulsed-Dye Laser Treatment of Keloids: Results of an Observational Study. Photomed Laser Surg 2015; 33:274-7. [DOI: 10.1089/pho.2015.3895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
12
|
Blokker RS, Lock TM, de Boorder T. Comparing thulium laser and Nd:YAG laser in the treatment of genital and urethral condylomata acuminata in male patients. Lasers Surg Med 2013; 45:582-8. [DOI: 10.1002/lsm.22181] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Rudy S. Blokker
- Urology Department; University Medical Center Utrecht; Utrecht The Netherlands
| | - Tycho M.T.W. Lock
- Urology Department; University Medical Center Utrecht; Utrecht The Netherlands
- Central Military Hospital “Dr. Mathysen,”; Utrecht The Netherlands
| | - Tjeerd de Boorder
- Urology Department; University Medical Center Utrecht; Utrecht The Netherlands
| |
Collapse
|
13
|
Viera MH, Amini S, Huo R, Konda S, Block S, Berman B. Herpes simplex virus and human papillomavirus genital infections: new and investigational therapeutic options. Int J Dermatol 2010; 49:733-49. [PMID: 20618491 DOI: 10.1111/j.1365-4632.2009.04375.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Human papillomavirus and Herpes simplex virus are the most common genital viral infections encountered in clinical practice worldwide. We reviewed the literature focusing on new and experimental treatment modalities for both conditions, based on to the evidence-based data available. The modalities evaluated include topical agents such as immune response modifiers (imiquimod, resiquimod, and interferon), antivirals (penciclovir, cidofovir, and foscarnet), sinecatechins, microbiocidals (SPL7013 gel, and PRO 2000 gel), along with experimental (oligodeoxynucleotides), immunoprophylactic, and immunotherapeutic vaccines.
Collapse
Affiliation(s)
- Martha H Viera
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
| | | | | | | | | | | |
Collapse
|
14
|
Human Papilloma Virus Type and Recurrence Rate After Surgical Clearance of Anal Condylomata Acuminata. Sex Transm Dis 2009; 36:536-40. [DOI: 10.1097/olq.0b013e3181a866a3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
15
|
|