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Martignago CCS, Bonifacio M, Ascimann LT, Vassão PG, Parisi JR, Renno AP, Garcia LA, Ribeiro DA, Renno ACM. Efficacy and safety of intense pulsed light in rosacea: A systematic review. Indian J Dermatol Venereol Leprol 2024; 90:599-605. [PMID: 39152889 DOI: 10.25259/ijdvl_1029_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/25/2023] [Indexed: 08/19/2024]
Abstract
Background Rosacea is a chronic inflammatory disease of the skin characterised by facial erythema, oedema, telangiectasias, papules, pustules and nodules. There is a paucity of effective therapeutic modalities for the management of rosacea. Intense Pulsed Light (IPL), a modality in which flash lamps installed in an optical treatment device (head or tip) with mirrors to reflect light, has in recent times gained popularity in the management of this condition. Aim This systematic review aims to evaluate the efficacy, safety and adverse effects of IPL treatment for rosacea. Methods This systematic review was conducted in accordance with the Preferred Reporting Item for Systematic Reviews and Meta-Analysis. The electronic databases searched were Medline, PubMed and Scopus databases. The Risk of bias in non-randomised studies of interventions (ROBINS-I) and risk-of-bias tools for randomised trials (RoB-2) was employed to assess the risk of bias. Results Of a total of 233 articles retrieved from Medline, Scopus and PubMed databases, 14 studies qualified for final analysis. The studies included patients with Fitzpatrick skin types I to IV, with ages ranging from 15 to 78 years. Although the included studies showed heterogeneity between the parameters used, most studies demonstrated positive effects of IPL treatment on telangiectasia and erythema in rosacea and that the adverse effects presented were transitory. Limitation The methodological quality of the included studies was poor. Conclusion Although most studies showed the efficacy of IPL in the treatment of rosacea, the poor quality of the studies was of concern.
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Affiliation(s)
| | - Mirian Bonifacio
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Laura Takahashi Ascimann
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | | | - Julia Risso Parisi
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Ana Paula Renno
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Livia Assis Garcia
- Department of Biomedical Engineering, Institute of Science and Technology of Brazil University (UB), Rua Carolina Fonseca, São Paulo, Brazil
| | - Daniel Araki Ribeiro
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Ana Claudia Muniz Renno
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
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Zhang B, Yao T, He W. Comparison Between Optimal Pulsed Technology and Meibomian Gland Massage Treatment for Contact Lens-Related Meibomian Gland Dysfunction. Photobiomodul Photomed Laser Surg 2023; 41:655-660. [PMID: 37976238 DOI: 10.1089/photob.2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Objective: The purpose of this study was to compare the effectiveness of optimal pulsed technology (OPT) and meibomian gland massage (MGM) in alleviating the signs and symptoms of contact lens-related meibomian gland dysfunction (CL-MGD). Methods: This prospective, randomized, controlled study included 90 patients (180 eyes) diagnosed with CL-MGD and were assigned to the OPT group (n = 60 eyes), MGM group (n = 60 eyes), and control group (n = 60 eyes). All participants were examined at baseline (D0), day 21 (D21), and day 42 (D42) for the ocular surface disease index (OSDI), noninvasive tear break-up time (NITBUT), noninvasive tear meniscus height (NITMH), meibomian gland score (MGS), meibomian gland score (MGYSS), best-corrected visual acuity, and intraocular pressure. Results: The OSDI scores and NITBUT improved after treatment in all the three groups. The OSDI scores in OPT and MGM groups were significantly lower compared with that in the control group at D21 and further decreased at D42. The NITBUT in OPT and MGM groups increased compared with the control group at D21 and further increased at D42, and the NITBUT in OPT group increased compared with the MGM group at D21 and D42. The MGYSS both improved after treatment in the OPT and MGM groups, The MGYSS in OPT and MGM groups decreased compared with the control group at D21 and further decreased at D42, and the MGYSS in the OPT group decreased compared with the MGM group at D21 and D42. The NITMH and MGS had no differences after treatment. Conclusions: Results imply that OPT or MGM treatment can be safely used to relieve symptoms of CL-MGD. In addition, OPT treatment was found to be more effective in improving the general stability of the tear-film in CL-MGD.
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Affiliation(s)
- Bin Zhang
- Dalian Medical University, Dalian, China
- He Eye Specialist Hospital, Shenyang, China
| | - Tao Yao
- He Eye Specialist Hospital, Shenyang, China
| | - Wei He
- Dalian Medical University, Dalian, China
- He Eye Specialist Hospital, Shenyang, China
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Arora G, Arora S. Medical Aesthetics - Current Trends and a Review of Its Applications. Indian Dermatol Online J 2023; 14:309-319. [PMID: 37266088 PMCID: PMC10231726 DOI: 10.4103/idoj.idoj_264_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 06/03/2023] Open
Abstract
Medical aesthetics is the use of a procedure or product for a therapeutic indication which is conventionally used for aesthetics. Several medical conditions are now being treated with products, procedures or equipment that are conventionally used for aesthetic indications. This has widened the scope of treatment modalities available for dermatologists to treat various indications that fall outside the purview of aesthetic dermatology. The authors present aesthetic treatment modalities and procedures which can be used for medical aesthetics, their present-day status and usefulness in field of therapeutics with a review of published literature from "Medline" (via "PubMed"), "Cochrane," the Virtual Health Library, and Google Scholar.
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology Consultant Dermatologist, Mehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences, Delhi Cantt, India
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4
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Treatment of Lentigines: A Systematic Review. Dermatol Surg 2023; 49:17-24. [DOI: 10.1097/dss.0000000000003630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 09/25/2022] [Indexed: 12/24/2022]
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Yuan J, Gao Y, Li Z, Nan M, Liu J, Jin Z, Jin C. Effective of a novel technique for sensitive skin treatment with optimal pulse technology: A clinical study. J Cosmet Dermatol 2022; 21:4345-4353. [DOI: 10.1111/jocd.14764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/18/2021] [Accepted: 12/29/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Jiachen Yuan
- Department of Medical Cosmetology Yanbian University Hospital Yanji, Jilin China
- Department of Dermatology Yanbian University Hospital Yanji, Jilin China
| | - Yang Gao
- Department of Medical Cosmetology Yanbian University Hospital Yanji, Jilin China
- Department of Dermatology Yanbian University Hospital Yanji, Jilin China
| | - Zhouna Li
- Department of Medical Cosmetology Yanbian University Hospital Yanji, Jilin China
- Department of Dermatology Yanbian University Hospital Yanji, Jilin China
| | - Meilan Nan
- Department of Medical Cosmetology Yanbian University Hospital Yanji, Jilin China
- Department of Dermatology Yanbian University Hospital Yanji, Jilin China
| | - Jian Liu
- Department of Dermatology Suzhou Mylike Cosmetic Hospital Suzhou, Jiangsu China
| | - Zhehu Jin
- Department of Medical Cosmetology Yanbian University Hospital Yanji, Jilin China
- Department of Dermatology Yanbian University Hospital Yanji, Jilin China
| | - Chenglong Jin
- Department of Medical Cosmetology Yanbian University Hospital Yanji, Jilin China
- Department of Dermatology Suzhou Mylike Cosmetic Hospital Suzhou, Jiangsu China
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Nistico SP, Silvestri M, Zingoni T, Tamburi F, Bennardo L, Cannarozzo G. Combination of Fractional CO 2 Laser and Rhodamine-Intense Pulsed Light in Facial Rejuvenation: A Randomized Controlled Trial. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:113-117. [PMID: 33449867 DOI: 10.1089/photob.2020.4876] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: This randomized controlled trial aims to verify the efficacy of a combined fractional CO2 laser and rhodamine-intense pulsed-light (r-IPL) protocol in the photoaging therapy. Background: Skin aging is related to multiple environmental and genetic factors that give rise to different manifestations. In recent years many techniques have been proposed for the rejuvenation of the skin of the face such as ablative and nonablative procedures. Combination of laser or light sources with different wavelengths represents a safe and effective treatment method. r-IPL is a new pulsed-light technique capable to generate wavelengths varying from 550 to 650 nm proposed in nonablative photorejuvenation with a good efficacy and safety profile. Methods: Twenty-two patients (skin phototypes II-III, aged 46-67 years) were randomly allocated into two groups: group A was treated only with a therapeutic standard dose of the fractional CO2 laser, whereas group B was treated with a combined therapy of r-IPL and fractional CO2 laser. All patients were treated up to three times at a 2-month interval. Efficacy of the procedures was assessed thanks to the Fitzpatrick Wrinkle Severity Scale (scores 1-9) before treatment and at a 4-month follow-up from the last treatment. Results: Patients treated with the combination of r-IPL and fractional CO2 laser showed better results in terms of wrinkle reduction according to the Fitzpatrick Wrinkle Severity score (2.82 ± 0.87 vs. 3.09 ± 1.14), with a statistically significant reduction in healing times (7.82 ± 0.75 vs. 13.82 ± 1.94 days, p ≤ 0.001) and duration of post-treatment erythema (3.55 ± 0.93 vs. 8.18 ± 1.47 days, p ≤ 0.001). Patient satisfaction was higher after combined fractional CO2 laser and r-IPL treatment. Conclusions: Our data suggest that combined use of fractional CO2 laser and r-IPL may lead to excellent results in terms of skin rejuvenation with a simple post-treatment management and an optimal tolerability.
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Affiliation(s)
| | - Martina Silvestri
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Tiziano Zingoni
- Unit of Dermatology, University of Rome, Tor Vergata, Rome, Italy
| | - Federica Tamburi
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Luigi Bennardo
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
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Husein-ElAhmed H, Steinhoff M. Laser and light-based therapies in the management of rosacea: an updated systematic review. Lasers Med Sci 2021; 36:1151-1160. [PMID: 33389310 DOI: 10.1007/s10103-020-03200-1] [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: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 01/08/2023]
Abstract
Unlike other rosacea therapies which need daily takings or applications over long periods, the edge of lasers and light-based therapies (LLBT) is the limited number of sessions to achieve improvement. The proper selection of the adequate physical device in accordance with the patients' skin features and rosacea-related signs and symptoms should be considered and the management with physical sources should be updated as new data become available. This article reviews and discusses the current use of lasers and light-based therapies in rosacea with reference to all the available literature.This systematic review demonstrates the quality of evidence to support any recommendation on LLBT in rosacea is low-to-moderate. Among all the available devices, PDL holds the most robust evidence. Treatments options should be tailored for each specific clinical scenario as it is unlike that single modality results in complete resolution. Platforms that include two or more devices and combined therapies with topical agents are suitable and they warrant further investigations.
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Affiliation(s)
- Husein Husein-ElAhmed
- Department of Dermatology and Venereology, Hospital de Baza, Granada, Spain. .,Translational Research Institute, Hamad Medical Corporation, Doha, Qatar.
| | - Martin Steinhoff
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar. .,Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar. .,College of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. .,Medical School, Qatar University, Doha, Qatar. .,Department of Dermatology, Weill Cornell Medicine, New York, NY, USA.
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Zhao L, You C, Chen H, Wang J, Cao J, Qi M, Hou S, Zheng X, Shao L, Liu Q. Retrospective Study of Factors Affecting Efficacy of Therapy with Dye Pulsed Light for Erythematotelangiectatic Rosacea. Dermatol Ther (Heidelb) 2020; 10:1273-1283. [PMID: 32865718 PMCID: PMC7649186 DOI: 10.1007/s13555-020-00440-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Dye pulsed light (DPL) was proven to be effective at treating erythematous and telangiectatic skin disorders. However, there are limited data on the efficacy of DPL treatment for erythematotelangiectatic rosacea (ETR), and researchers do not fully understand the factors that may affect the efficacy. Here, we performed a study to investigate the efficacy of DPL treatment for ETR and determine the factors affecting that efficacy. METHODS Sixty-five patients with ETR underwent three treatment sessions with DPL at 4-week intervals and were followed up at 4 weeks after the last treatment session. Skin type, sex, age, lesion site, severity of erythema and telangiectasia, VISIA percentile ranking, clinical photographs and red area images were recorded at baseline. The post-treatment erythematous and telangiectatic scores and VISIA percentile rankings were recorded, and the effects of different personal and clinical factors on the efficacy were statistically analysed. RESULTS The erythema and telangiectasia scores and VISIA percentile rankings showed significant improvement after the DPL procedures (p < 0.01). With regard to erythema, treatment efficacy was not affected by any of the investigated variables, including pre-treatment erythema scores, skin type, pre-treatment VISIA percentile ranking, sex, age and lesion site (p > 0.05). With regard to telangiectasia, the treatment efficacy was greater for mild telangiectasia than for severe telangiectasia (odds ratio = 4.14, p < 0.05). There was no significant difference in treatment efficacy between the moderate and severe categories (odds ratio = 4.00, p > 0.05). CONCLUSION DPL is not the optimal procedure for treating severe telangiectasia in patients with ETR, whereas the efficacy of the treatment for erythema was not affected by the severity of the condition.
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Affiliation(s)
- Leran Zhao
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Cong You
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Han Chen
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Jiangyi Wang
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Junya Cao
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Manli Qi
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Shuping Hou
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Xin Zheng
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Lili Shao
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Quanzhong Liu
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.
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Luo Y, Luan XL, Zhang JH, Wu LX, Zhou N. Improved telangiectasia and reduced recurrence rate of rosacea after treatment with 540 nm-wavelength intense pulsed light: A prospective randomized controlled trial with a 2-year follow-up. Exp Ther Med 2020; 19:3543-3550. [PMID: 32346416 PMCID: PMC7185073 DOI: 10.3892/etm.2020.8617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 02/18/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of the present study was to evaluate the clinical efficacy and safety of 540 nm-wavelength intense pulsed light (IPL) for the treatment of telangiectasia in late-stage rosacea. Between July 2013 and January 2016, patients with rosacea who tested positive for Demodex folliculorum were recruited. Patients received anti-mite therapy and were then randomly apportioned to receive either three 540 nm-IPL treatments at 4-week intervals (IPL group), or no treatment (control group). Telangiectasia was assessed by the same clinician at baseline and at follow-up intervals over 2 years, where ≥90% clearance of telangiectasia was considered to indicate effective treatment. The rates of effective treatment, improvement (≥30% clearance) and recurrence (original or neo-location) were compared in both groups. After 33 patients were lost during follow-up, the IPL and control groups were comprised of 107 and 120 patients for the final analysis, respectively. The rates of effective treatment and total efficacy in the IPL group (66.36 and 95.33%, respectively) were found to be significantly higher compared with those of the control group (0 and 30.83%, respectively). By contrast, the rates of recurrence were found to be lower in the IPL group (8.41%) compared with the control group (48.33%). Redness-to-blisters associated with IPL treatment (9.7% of analyzed patients) subsided within one week and hyperpigmentation (1.9%) within 3 months. To conclude, treatment with 540 nm-IPL improved facial telangiectasia in late-stage rosacea that remained after sequential anti-mite therapy and effectively reduced the recurrence of rosacea. The present study was registered into the Chinese Clinical Trial Registry under the title ‘Sequential therapy for mites folliculitis’ (Trial registration number: ChiCTR-IPR-15006451; approved May 27, 2015).
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Affiliation(s)
- Yang Luo
- Department of Dermatology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Xiu-Li Luan
- Department of Dermatology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Jian-Hong Zhang
- Department of Dermatology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Lan-Xi Wu
- Department of Dermatology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Nan Zhou
- Department of Dermatology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
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Campolmi P, Cannarozzo G, Dragoni F, Conti R, Moretti S. Efficacy of Rhodamine Light in the Treatment of Superficial Vascular Lesions of the Face. Med Princ Pract 2016; 25:477-82. [PMID: 27212149 PMCID: PMC5588436 DOI: 10.1159/000446987] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 05/22/2016] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The aim of this work was to verify the usefulness and efficacy of treating superficial vascular lesions of the face using rhodamine intense pulsed light (r-IPL). SUBJECTS AND METHODS Fifty patients suffering from telangiectasias of the face were enrolled and subsequently treated 4 times (every 20 days) with a new intensified r-IPL system optimized at the same wavelength as the dye laser (595 nm). The outcome was assessed using photographs, and clinical evaluations were made based on the percentage of fading of the erythema and telangiectasias in the lesions after treatment. RESULTS Marked clinical improvements (70-100%) were observed in 31 (62%) patients after the second session of r-IPL, while 46 (92%) showed a marked improvement after the fourth session. No patients had to resort to topical or systemic drugs. CONCLUSION r-IPL was effective in treating superficial vascular lesions, no side effects were observed and the patients readily accepted the treatment. Hence, r-IPL could be promising for the treatment of superficial vascular lesions of the face. Future study would be necessary to confirm the long-term efficacy of this technique.
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Affiliation(s)
| | | | - Federica Dragoni
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
- *Federica Dragoni, MD, Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Ospedale Piero Palagi, Viale Michelangelo 41, IT—50125 Firenze (Italy), E-Mail
| | - Rossana Conti
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Silvia Moretti
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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11
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Intense pulsed light therapy for the treatment of evaporative dry eye disease. Curr Opin Ophthalmol 2015; 26:314-8. [DOI: 10.1097/icu.0000000000000166] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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González-Rodríguez A, Lorente-Gual R. Current Indications and New Applications of Intense Pulsed Light. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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González-Rodríguez A, Lorente-Gual R. Indicaciones actuales y nuevas aplicaciones de los sistemas de luz pulsada intensa. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:350-64. [DOI: 10.1016/j.ad.2014.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/26/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022] Open
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14
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Adamič M, Pavlović MD, Troilius Rubin A, Palmetun-Ekbäck M, Boixeda P. Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology. J Eur Acad Dermatol Venereol 2015; 29:1661-78. [PMID: 25931003 DOI: 10.1111/jdv.13177] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 04/07/2015] [Indexed: 12/16/2022]
Abstract
AIM Lasers and non-coherent intense pulse light sources (IPLS) are based on the principle of selective photothermolysis and can be used for the treatment of many vascular skin lesions. A variety of lasers has been developed for the treatment of congenital and acquired vascular lesions which incorporate these concepts into their design. Although laser and light sources are very popular due to their non-invasive nature, caution should be considered by practitioners and patients to avoid permanent side-effects. The aim of these guidelines is to give evidence-based recommendations for the use of lasers and IPLS in the treatment of vascular lesions. METHODS These guidelines were produced by a Consensus Panel made up of experts in the field of vascular laser surgery under the auspices of the European Society of Laser Dermatology. Recommendations on the use of vascular lasers and IPLS were made based on the quality of evidence for efficacy, safety, tolerability, cosmetic outcome, patient satisfaction/preference and, where appropriate, on the experts' opinion. The recommendations of these guidelines are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines. RESULTS Lasers and IPLS are very useful and sometimes the only available method to treat various vascular lesions. It is of a paramount importance that the type of laser or IPLS and their specific parameters are adapted to the indication but also that the treating physician is familiar with the device to be used. The crucial issue in treating vascular lesions is to recognize the immediate end-point after laser treatment. This is the single most important factor to ensure both the efficacy of the treatment and avoidance of serious side-effects.
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Affiliation(s)
- M Adamič
- Dermatology Center Parmova, Ljubljana, Slovenia
| | - M D Pavlović
- Dermatology Center Parmova, Ljubljana, Slovenia.,Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - A Troilius Rubin
- Department of Dermatology, Centre for Laser and Vascular Anomalies, Skåne University Hospital, Malmö, Sweden
| | - M Palmetun-Ekbäck
- Department of Dermatology, University Hospital Örebro, Örebro, Sweden
| | - P Boixeda
- Laser Service, Department of Dermatology, Ramón y Cajal Hospital, University of Alcalá, Madrid, Spain
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15
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Lim HS, Lee SC, Won YH, Lee JB. The efficacy of intense pulsed light for treating erythematotelangiectatic rosacea is related to severity and age. Ann Dermatol 2014; 26:491-5. [PMID: 25143679 PMCID: PMC4135105 DOI: 10.5021/ad.2014.26.4.491] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 04/30/2014] [Accepted: 05/02/2014] [Indexed: 11/08/2022] Open
Abstract
Background Rosacea is a chronic cutaneous disease. Therapeutic modalities should be chosen based on the identified sub-types and clinical features in each patient. Vascular lasers, including intense pulsed light (IPL), are reportedly safe and effective in treating erythematotelangiectatic rosacea (ETR). Objective In this study, we assess the comparative efficacy of IPL related to several factors including clinical severity and the age of patients with ETR. Methods Patients with ETR were classified into two groups according to the National Rosacea Society Severity Guideline. Severity score and erythema index (EI) were measured using a clinical scorecard and mexameter. For additional evaluation of therapeutic efficacy, investigator and patient global assessments (IGA, PGA) were checked. Efficacy of IPL was analyzed according to severity score, EI, IGA, and PGA related to sex, age, lactic acid stinging test, and severity. Results Analyses of the efficacy of IPL according to severity score, EI, IGA, and PGA based on sex, age, lactic acid stinging test, and severity revealed significant differences with age and severity only. Conclusion This study supports the efficacy of IPL treatment for patients with ETR. IPL may be more effective in patients with more severe ETR and in younger patients with ETR.
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Affiliation(s)
- Hee Sun Lim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Wat H, Wu DC, Rao J, Goldman MP. Application of Intense Pulsed Light in the Treatment of Dermatologic Disease: A Systematic Review. Dermatol Surg 2014; 40:359-77. [DOI: 10.1111/dsu.12424] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Scevola S, Nicoletti G, Randisi F, Faga A. Refinements in brow reconstruction: synergy between plastic surgery and aesthetic medicine. Photomed Laser Surg 2013; 32:113-6. [PMID: 24160986 DOI: 10.1089/pho.2013.3600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was the introduction in clinical practice of the combined application of traditional reconstructive surgery and intense pulsed light (IPL) for the restoration of a post-traumatic eyebrow defect. CASE The authors present a case of surgical eyebrow reconstruction with an axial temporal hair-bearing scalp island flap. A persistent localized erythema and a marked difference in hair density in comparison with the contralateral one harmed the eventual surgical outcome. RESULTS A combined sequential treatment with IPL achieved both hair density and skin erythema reduction, and eventually allowed for a very satisfactory result. CONCLUSIONS Our experience demonstrated the efficacy of the integrated multidisciplinary approach involving traditional plastic reconstructive surgery and the innovative new technologies in aiming for perfection.
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Affiliation(s)
- Silvia Scevola
- 1 University of Pavia , Advanced Technologies for Regenerative Medicine and Inductive Surgery Research Centre, Pavia, Italy
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Bruscino N, Bonan P, Cannarozzo G, Moretti S, Lotti T, Campolmi P. Laser use in infantile hemangiomas, when and how. Dermatol Ther 2013; 25:314-21. [PMID: 22950558 DOI: 10.1111/j.1529-8019.2012.01466.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Infantile hemangiomas (IHs) are proliferating embrional tumors which can stem from placented tissue and are constituted by endothelial cell hyperproliferation. The management of the IHs is always challenging for all the specialists because of the heterogeneous behavior of these lesions. The factors leading to an aggressive position are essentially these: the prevention or reduction of aesthetic risks, the prevention or treatment of ulcerated hemangiomas, the prevention or impairment of functional risks and pain, and the removal of life-threatening risks. The treatment of vascular lesions is one of the mostly sought and performed cutaneous laser procedures, and in the field of IH treatments the more used laser devices certainly are pulsed dye lasers. Early laser therapy is able to reduce the possibility that the lesion will reach its full size, preventing several complications, connected to the hemangioma's growth, and providing psychological relief for pediatric patients and their parents.
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Affiliation(s)
- N Bruscino
- Department of Dermatology II, University of Florence, Florence, Italy.
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Impact of intense pulsed light irradiation on cultured primary fibroblasts and a vascular endothelial cell line. Exp Ther Med 2012; 4:669-674. [PMID: 23170124 PMCID: PMC3501436 DOI: 10.3892/etm.2012.664] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 07/17/2012] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to determine the effects of intense pulsed light (IPL) on cell proliferation and the secretion of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) in human fibroblasts and vascular endothelial cell lines, and to investigate the effects of IPL on the mRNA expression levels of type I and III procollagens in cultured human fibroblasts. Foreskin fibroblasts and a vascular endothelial cell line (ECV034) were cultured and treated with various wavelengths and doses of IPL irradiation. After culture for 1, 12, 24 and 48 h following IPL irradiation, fibroblasts and the vascular endothelial cell line were harvested for investigation of morphological changes by light microscopy, cell proliferation viability by MTT assay, and VEGF and MMP secretions by ELISA. The mRNA expression levels of type I and III procollagens in the fibroblasts were detected by RT-PCR. No marked morphological changes were observed in the cultured fibroblasts compared with the control. Cell growth and cellular viability were increased in fibroblasts 24 and 48 h after IPL irradiation. The levels of type I and III procollagen mRNA expression in fibroblasts increased in a time-dependent manner. However, the IPL management had no impact on VEGF and MMP secretion levels in fibroblasts and the ECV034 cell line at any time-point after irradiation as well as cell morphology and cellular proliferation. IPL irradiation may induce cellular proliferation and promote the expression of procollagen mRNAs directly in cultured primary fibroblasts, which may primarily contribute to photorejuvenation.
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Murray A, Moore T, Richards H, Ennis H, Griffiths C, Herrick A. Pilot study of intense pulsed light for the treatment of systemic sclerosis-related telangiectases. Br J Dermatol 2012; 167:563-9. [DOI: 10.1111/j.1365-2133.2012.11019.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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SASAYA HARUYO, KAWADA AKIRA, WADA TAMAE, HIRAO AYAKA, OISO NAOKI. Clinical effectiveness of intense pulsed light therapy for solar lentigines of the hands. Dermatol Ther 2012; 24:584-6. [DOI: 10.1111/j.1529-8019.2012.01426.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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