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Huang HJ, Chang XW, Hsieh CL, Li D, Chen YF. Compact efficient high-power continuous-wave Nd:YVO 4/KGW/LBO Raman lasers for selectable wavelengths within 559-603 nm. OPTICS EXPRESS 2024; 32:14133-14142. [PMID: 38859367 DOI: 10.1364/oe.520582] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/21/2024] [Indexed: 06/12/2024]
Abstract
Compact efficient high-power continuous-wave Nd:YVO4 Raman lasers for selectable wavelengths within 559-603 nm are achieved by using KGW crystal for intracavity stimulated Raman scattering (SRS) and lithium triborate (LBO) crystal for intracavity sum frequency generation (SFG) and second harmonic generation (SHG). The LBO crystal with the cut angle in the XY plane for the type-I phase matching is used to perform intracavity SHG or SFG. Experimental results reveal that the participated Stokes lines include the internal vibration mode at 901 cm-1, the external vibrational mode at 209 cm-1, and the combination mode of the 901 cm-1 and 209 cm-1 Raman shifts. By tuning LBO temperature for attaining the maximum output power, the output spectrum reveals the triple peaks of 588.7, 595.7, and 603.1 nm with the intensity ratio of 10:4:1. Under this circumstance, the output power can reach the highest value of 10.8 W at a pump power of 40 W. Furthermore, the output spectrum can be simply concentrated on the single peaks among 588.7 (orange), 565.7 (yellow), and 559.1 nm (lime) by tuning LBO temperature to fulfill the selection of the critical phase matching. The output powers at a pump power of 40 W can be up to 8.0, 6.1, and 9.8 W for the single-peak emission at 588.7, 565.7, and 559.1 nm, respectively. Finally, a dual-peak emission of 565.7 and 572.3 nm with total output power of 5.2 W can be generated by tuning LBO temperature to match the SFG for 572.3 nm.
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Galache TR, Sena MM, Tassinary JAF, Pavani C. Photobiomodulation for melasma treatment: Integrative review and state of the art. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12935. [PMID: 38018017 DOI: 10.1111/phpp.12935] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/06/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE Photobiomodulation therapy (PBM) is a versatile technique for treating skin diseases. Melasma, a chronic hyperpigmentation condition, has recently been associated with vascular features and dermal photoaging and poses significant management challenges. We review the recent literature on melasma etiology and the evidence supporting PBM as a therapeutic modality for melasma treatment. METHODS We conducted a comprehensive literature search in three different databases from May to August 2023, focusing on studies published in the past 10 years. The inclusion criteria comprised full-text studies investigating low-power lasers and/or light-emitting diodes (LEDs) in in vitro or in vivo models, as well as clinical trials. We excluded studies discussing alternative melasma therapies or lacking experimental data. We identified additional studies by searching the reference lists of the selected articles. RESULTS We identified nine relevant studies. Clinical studies, in agreement with in vitro experiments and animal models, suggest that PBM effectively reduces melasma-associated hyperpigmentation. Specific wavelengths (red: 630 nm; amber: 585 and 590 nm; infrared: 830 and 850 nm) at radiant exposures between 1 and 20 J/cm2 exert modulatory effects on tyrosinase activity, gene expression, and protein synthesis of melanocytic pathway components, and thus significantly reduce the melanin content. Additionally, PBM is effective in improving the dermal structure and reducing erythema and neovascularization, features recently identified as pathological components of melasma. CONCLUSION PBM emerges as a promising, contemporary, and non-invasive procedure for treating melasma. Beyond its role in inhibiting melanogenesis, PBM shows potential in reducing erythema and vascularization and improving dermal conditions. However, robust and well-designed clinical trials are needed to determine optimal light parameters and to evaluate the effects of PBM on melasma thoroughly.
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Affiliation(s)
- Thais Rodrigues Galache
- Postgraduate Program in Biophotonics Medicine, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | - Michelle Mota Sena
- Postgraduate Program in Biophotonics Medicine, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | - Christiane Pavani
- Postgraduate Program in Biophotonics Medicine, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
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Hindritiani R, Widjaya MRH, Puspitosari D, Rizqandaru T, Ruchiatan K. Partial Unilateral Lentiginosis Successfully Treated with the Combination of 511 nm and 578 nm Copper Bromide Laser in an Indonesian Woman. Clin Cosmet Investig Dermatol 2023; 16:2271-2276. [PMID: 37635736 PMCID: PMC10457460 DOI: 10.2147/ccid.s423917] [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: 06/01/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
Partial unilateral lentiginosis (PUL) is a pigmentation disorder characterized by multiple lentigines restricted to the normal skin in a unilateral and segmental pattern. Various lasers have been used for the treatment of this pigmented disorders, one of which is the copper bromide (CuBr) laser, which emits a dual-wavelength beam at 511 nm and 578 nm. A 35-year-old woman presented with multiple brown macules with a sharp demarcation from the midline of the forehead to the right cheek in a dermatomal distribution. Histopathological results showed increased melanin pigmentation in the basal layer with elongated rete ridges, supporting the diagnosis of PUL. Following photoprotection and skin priming, CuBr laser treatment was performed in two steps using 511 nm and 578 nm wavelength as the first and second steps, respectively, with the second step delivered immediately after. Clinical improvement was achieved after two sessions of treatment at a one-month interval, as shown by an increasing lightness value (L*) in spectrophotometry. No side effects, such as hyperpigmented macules, was observed. The patient also expressed satisfaction at her brighter facial skin. A sustainable favorable result persisted after six months of laser treatment. Interactions between cutaneous vasculature and melanocytes can affect the development of pigmented lesions. Melanocytes express the functional vascular endothelial growth factor receptor (VEGF) and are responsive to angiogenic factors. Ideally, these conditions should be treated with a dual-wavelength CuBr laser. The combination of 511 nm and 578 nm CuBr laser showed favorable results, supporting its potential as an effective treatment choice for PUL.
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Affiliation(s)
- Reti Hindritiani
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Muhamad Radyn Haryadi Widjaya
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Diah Puspitosari
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Trustia Rizqandaru
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Kartika Ruchiatan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
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Liu Y, Wang Y, Wang M, Shen H, Huang C, Wang X, Gao J, Tu C. Structure and spectral properties of Dy 3+ doped CaYAlO 4 single crystal. Sci Rep 2023; 13:6066. [PMID: 37055580 PMCID: PMC10101985 DOI: 10.1038/s41598-023-33366-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/12/2023] [Indexed: 04/15/2023] Open
Abstract
A 2 at.% Dy3+: CaYAlO4 single crystal was grown successfully. The electronic structures of Ca2+/Y3+ mixed sites in CaYAlO4 were investigated using first-principles based on density functional theory. The effects of Dy3+ doping on the structural parameters of host crystal were studied using XRD pattern. The optical properties including absorption spectrum, excitation spectrum, emission spectra and fluorescence decay curves were thoroughly investigated. The results show that the Dy3+: CaYAlO4 crystal could be pumped by the blue InGaN and AlGaAs or 1281 nm laser diodes. Furthermore, an intense 578 nm yellow emission was obtained directly under excitation at 453 nm, meanwhile, evident mid-infrared light emitting was observed by 808 or 1281 nm laser excitation. The fitted fluorescence lifetimes of 4F9/2 and 6H13/2 levels were about 0.316 ms and 0.038 ms, respectively. It can be concluded that this Dy3+: CaYAlO4 crystal could simultaneously act as a promising medium for both solid-state yellow and mid-infrared laser outputs.
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Affiliation(s)
- Yunyun Liu
- School of Opto-Electronic Engineering, Zaozhuang University, Zaozhuang, 277160, Shandong, China.
| | - Yan Wang
- Key Laboratory of Optoelectronic Materials Chemistry and Physics, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, Fujian, China
| | - Meng Wang
- School of Opto-Electronic Engineering, Zaozhuang University, Zaozhuang, 277160, Shandong, China
| | - Huan Shen
- Key Laboratory of Optoelectronic Materials Chemistry and Physics, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, Fujian, China
| | - Chuanxin Huang
- School of Opto-Electronic Engineering, Zaozhuang University, Zaozhuang, 277160, Shandong, China
| | - Xihu Wang
- Key Laboratory of Functional Materials and Devices for Informatics of Anhui Educational Institutions, Department of Physics, Fuyang Normal University, Fuyang, 236037, Anhui, China
| | - Ju Gao
- School of Opto-Electronic Engineering, Zaozhuang University, Zaozhuang, 277160, Shandong, China.
| | - Chaoyang Tu
- Key Laboratory of Optoelectronic Materials Chemistry and Physics, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, Fujian, China
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Chen JC, Tu YC, Ho YW, Liang HC, Chen YF. Highly efficient diode-pumped passively Q-switched Nd:YVO 4/KGW Raman lasers at yellow and orange wavelengths. OPTICS EXPRESS 2023; 31:8696-8703. [PMID: 36859979 DOI: 10.1364/oe.486533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Efficient diode-pumped passively Q-switched Nd:YVO4 yellow and orange lasers are developed with the pulse pumping scheme and the intracavity stimulated Raman scattering (SRS) and second harmonic generation (SHG). A Np-cut KGW is exploited in the SRS process to generate the yellow 579 nm laser or the orange 589 nm laser in a selectable way. The high efficiency is achieved by designing a compact resonator to include a coupled cavity for intracavity SRS and SHG and to provide a focused beam waist on the saturable absorber for reaching an excellent passive Q-switching. The output pulse energy and peak power can reach 0.08 mJ and 50 kW for the orange laser at 589 nm. On the other hand, the output pulse energy and peak power can be up to 0.10 mJ and 80 kW for the yellow laser at 579 nm.
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Liu S, Cui N, Liu S, Wang P, Dong L, Chen B, Zhang N, Zhang K, Wang Y. Nonlinear optical properties and passively Q-switched laser application of a layered molybdenum carbide at 639 nm. OPTICS LETTERS 2022; 47:1830-1833. [PMID: 35363746 DOI: 10.1364/ol.454047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
Molybdenum carbide (Mo2C) exhibits enormous potential applications in various optoelectronic and photonic fields due to its remarkably electrical and optical characteristics. Here, we fabricate a high-quality Mo2C film by the radio frequency magnetron sputtering deposition method. The nonlinear optical response and ultrafast dynamics are thoroughly studied based on open-aperture Z-scan and nondegenerate pump-probe experimental measurements. The open-aperture Z-scan experimental result exhibits a modulation depth of 8.5% and a saturation fluence of 0.28 mJ/cm2. Simultaneously, the relaxation time constant is fitted by a biexponential decay function, showing an ultrafast intraband carrier recovery time of 0.58 ps at 530 nm. Consequently, by employing the Mo2C film as a saturable absorber (SA), stable Q-switched Pr:YLF laser pulses with the shortest pulse width of 160 ns are generated at 639 nm. Our experimental results demonstrate excellent nonlinear optical properties of the layered Mo2C in the visible region and will further advance their potential applications in visible nonlinear optics.
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Humphrey S, Manson Brown S, Cross SJ, Mehta R. Defining Skin Quality: Clinical Relevance, Terminology, and Assessment. Dermatol Surg 2021; 47:974-981. [PMID: 34148998 PMCID: PMC8231670 DOI: 10.1097/dss.0000000000003079] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Flawless skin is one of the most universally desired features, and demand for improvements in skin quality is growing rapidly. Skin quality has been shown to substantially impact emotional health, quality of life, self-perception, and interactions with others. Although skin quality improvements are a common end point in studies of cosmeceuticals, they are rarely assessed in clinical studies of other aesthetic treatments and products. Descriptive terminology for skin quality parameters also varies considerably within the aesthetic field, relying on a range of redundant and occasionally contradictory descriptors. In short, skin quality has not been clearly defined. OBJECTIVE The goal of this review is to highlight the importance of skin quality to patients and physicians, explore known and unknown factors comprising skin quality, and provide clarity regarding terminology, descriptors, and evaluation tools for assessing skin quality. MATERIALS AND METHODS A review of the literature on skin quality was performed without limitation on publication date. Relevant articles are presented. RESULTS AND CONCLUSION We propose a framework of attributes contributing to skin quality rooted in 3 fundamental categories-visible, mechanical, and topographical-with the aim to provide information to help guide clinicians and inform future clinical studies.
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Affiliation(s)
- Shannon Humphrey
- Humphrey Cosmetic Dermatology, Vancouver, British Columbia, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Rahul Mehta
- Allergan Aesthetics, an AbbVie Company, Irvine, California
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Javedan K, Hydarpur F, Mohammadi Pour P, Najafi F, Mirzaeei S, Rahimi R, Gravandi MM, Farzaei MH. The formulation and efficacy of topical Dorema ammoniacum in treating Melasma: a randomized double-blind, placebo-controlled trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:743-751. [PMID: 33964194 DOI: 10.1515/jcim-2020-0191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/15/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES An acquired melanin-related hyperpigmentation that occurs in sun exposure areas is Melasma which presents as gray-brown ridges and macules with prominent margins on the skin. The aim of this assay was to assess the formulation and efficacy of topical Dorema ammoniacum among Melasma patients. METHODS This study was a 30 days double-blind, randomized clinical trial in Melasma with a placebo group. The study was carried out on 49 patients with Melasma attending Haji Daii Nursing Center in Kermanshah, Iran. Optimized topical formulation of D. ammoniacum gum extract was prepared by evaluating the characteristics of different topical formulations of this plant. Mean Melasma severity index (MMASI) instrument was applied to assess the product effectiveness and to determine the skin stains. Patients were pursued to receive the treatment throughout the 30 days trial. This scaling was accomplished before the intervention and 30 days after the use of the herbal product. To analyze the quantitative variables, t-test and Mann-Whitney test were evaluated by SPSS 21 software, and p-value <0.05 was considered as the statistically significant. RESULTS The survey was performed on 40 female subjects (81.6%) and nine male subjects (18.4%) with the mean age of 32.18 ± 8.69. According to the results, the mean MSI in the drug group was significantly lower than before treatment and decreased from 86.98 ± 69.48 to 31.03 ± 32.62 (p-value <0.05). CONCLUSIONS In compliance with findings this survey revealed a positive effect of the cream formulation of D. ammoniacum extract on Melasma. As it was represented no side effects, this formulation is appropriate for the treatment of Melasma.
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Affiliation(s)
- Kani Javedan
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Hydarpur
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pardis Mohammadi Pour
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Najafi
- Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahla Mirzaeei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roja Rahimi
- Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Ponomarev IV, Shakina LD, Topchiy SB, Klyuchareva SV, Pushkareva AE. Treatment of pyogenic granuloma with copper vapor laser radiation. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background. Pyogenic granuloma (PG) or lobular capillary hemangioma, ICD10 code: L98.0. appears as a single bright red or violet papule up to 20 mm in size, on the face, fingers, skull surface, arms, and intergluteal fold, as well as on the oral mucous membranes. Surgical removal of facial PG is not always possible due to insufficient thickness of the dermis. Treatment of PG with a pulsed dye laser (PDL) or neodymium laser (Nd:YAG) can achieve a noticeable elimination of the lesion but is reported to be accompanied by such side effects as purpura or scarring. It determines the feasibility of introducing into clinical practice the methods of laser treatment of PG using the radiation of a copper vapor laser (CVL) with a wavelength of 578 nm, which effectively absorbed by the blood.
Aim. The assessment of the clinical efficacy and safety of the CVL treating PG.
Methods. 26 adult patients with PG in various parts of the face, including the lips, limbs, and trunk, were included in this study. PG treatment was carried out in one session with CVL (Yakhroma-Med, FIAN) at an average power of 0.71.0 W, at a wavelength of 578 nm, exposure time 0.20.3 s. The diameter of the light spot is 1 mm.
Results. Immediately after the single laser treatment, the PG involved area became grey. In 710 days, the irradiated area was utterly similar to the adjacent intact skin. No postoperative bleeding or infection was noted. Side effects included mild skin atrophy. During the follow-up observation for five years, no side effects were found.
Conclusion. The high efficiency of PG elimination using CVL in the absence of pronounced side effects allows suggesting this method for introducing into dermatologists and cosmetologists' clinical practice as a highly effective and inexpensive method of treatment.
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The Vascular Component of Melasma: A Systematic Review of Laboratory, Diagnostic, and Therapeutic Evidence. Dermatol Surg 2021; 46:1642-1650. [PMID: 33252894 DOI: 10.1097/dss.0000000000002770] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Melasma is a common acquired disorder of hyperpigmentation, classically manifesting as symmetric brown patches on the face. Although the exact pathogenesis is not fully understood, vascular abnormalities have been implicated in melasma. OBJECTIVE To evaluate the laboratory and clinical evidence regarding the safety and efficacy of antivascular agents for the treatment of melasma. METHODS A systematic review of PubMed, EMBASE, and Cochrane was conducted on May 13, 2020, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Original research articles investigating the role of vascularity and/or evaluating the use of antivascular therapeutics in melasma were included. Clinical recommendations were based on the American College of Physicians guidelines. RESULTS A total of 34 original research articles as follows were identified: 4 laboratory studies, 15 diagnostic studies, and 15 therapeutic studies. CONCLUSION There is promising evidence supporting the use of tranexamic acid and laser/light therapies to treat the vascular component of melasma, and more rigorous clinical trials are needed to validate their efficacy. Clinicians may consider treatment with one or more antivascular therapeutics in patients with melasma. Further research is warranted to characterize the role of cutaneous vascularization in melasma and may provide insights for novel therapies.
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Ponomarev IV, Topchy SB, Andrusenko YN, Shakina LD. Treatment of the nevus sebaceous of Jadasson by a copper vapor laser. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/vdv1132-2020-96-4-43-48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction. Nevus sebaceous of Jadassohn (synonym: nevus of the sebaceous glands) (NSG) presents the congenital malformation of the skin with possible transformation into benign or malignant tumors during the adolescence or adulthood. Commonly appeared on the scalp or neck NSG is frequently concern with cosmetic problems making patients look for opportunities for its removal. Surgical removal of the NSG is related to an elevated risk of scarring. Using ablative lasers has proven to be effective in the removal of small NSG. However, the removal of medium and large NSG with ablative lasers was reported to be linked with a high risk of scarring and recurrence. The removal of the medium-sized NSG with a copper vapor laser (CVL) is described here for the first time.
Case report and procedure. Laser removal of NSG (linear sized of 27 mm) was performed in a 25-year-old female patient with Fitzpatrick skin type II during eight CVL treatments. Laser settings were selected as follows: the average power of 1 W at the power ratio of 3:2 radiation at a wavelength of 511 and 578 nm. Pulse duration 20 nanoseconds, reprate 16.6 kHz, exposure duration 200 ms, and the light spot's diameter on the skin 1 mm.
Results. After 8 procedures, the skin in the area of the removed NSG acquired a natural color and appearance. During 24 months of follow-up, there was no hyperpigmentation or signs of scars in the irradiated area. No relapses were observed for 24 months after the CVL removal of NSG.
Conclusion. The application of non-ablative CVL removal of NSG ensured a desired cosmetic result without side effects.
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Pomerantz H, Christman MP, Bloom BS, Lederhandler M, Feng H, Holmes J, Geronemus RG. Dynamic Optical Coherence Tomography of Cutaneous Blood Vessels in Melasma and Vessel Response to Oral Tranexamic Acid. Lasers Surg Med 2020; 53:861-864. [PMID: 33161588 DOI: 10.1002/lsm.23345] [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: 06/04/2020] [Revised: 09/13/2020] [Accepted: 10/16/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Melasma may be related to aberrant blood vessels, but there has been no report on the utility of dynamic optical coherence tomography (D-OCT) in studying vessel characteristics in melasma. We studied the characteristics of cutaneous blood vessels in melasma and the effects of oral tranexamic acid (TXA) with D-OCT. STUDY DESIGN/MATERIALS AND METHODS Six patients with moderate to severe melasma had a D-OCT scanning of the areas on the face affected by melasma and not affected by it. Three of them had scans within 3 months after starting oral TXA and at a follow-up visit. Blood flow at different depths of the skin and vessel diameter were compared between the melasma and normal skin. For those taking oral TXA, we compared the percent change of blood flow and diameter between the melasma and normal skin. RESULTS Dermal blood flow and vessel diameter were greater in the melasma skin than in the normal skin. Oral TXA reduced dermal blood flow in both the melasma and normal skin, but the reduction was more dramatic in the lesional melasma skin. CONCLUSIONS D-OCT findings that (i) dermal blood vessels in melasma are increased in size and flow and (ii) oral TXA reduced the vessel size and flow, providing evidence supporting the relationship between melasma and cutaneous blood vessels. D-OCT may be utilized in measuring response to treatments targeting melasma. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
| | | | - Bradley S Bloom
- Laser & Skin Surgery Center of New York, New York, New York.,The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Margo Lederhandler
- Laser & Skin Surgery Center of New York, New York, New York.,The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut
| | | | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York, New York.,The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
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Abstract
Pigmentation disorders are among the most common cutaneous changes and occur in up to 60% of all people. They can be genetic or acquired, functionally or cosmetically disturbing, or the expression of a medical disorder. The best treatment options for hyperpigmentation are usually lasers and intense pulsed light (IPL). However, they can also worsen some conditions and are occasionally associated with side effects. A correct diagnosis is therefore essential, taking into account the skin type, the type of pigmentation and how deep the pigmentation is located in the skin. The most common indications for which laser treatment is recommended include genetically predisposed nevi (Becker, Ota, Hora, Ito, acquired bilateral nevus of Ota-like macules [ABNOM]), pigmentation (e.g., lentigines, postinflammatory hyperpigmentation, ephelides, café au lait, nevus spilus, linear and whorled hypermelanosis [LWNH]), nevus cell nevi, exogenous pigments, tattoos and cosmetic pigments.
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Affiliation(s)
- Klaus Fritz
- Hautärzte- und Laserzentrum Landau (Pfalz), Reduitstr. 13, 76829, Landau, Deutschland. .,Medizinische und Pharmazeutische Universität Carol Davila, Bukarest, Rumänien.
| | - Carmen Salavastru
- Abteilung für pädiatrische Dermatologie, Colentina-Krankenhaus, Bukarest, Rumänien.,Medizinische und Pharmazeutische Universität Carol Davila, Bukarest, Rumänien.,Dermatologie, Colentina-Krankenhaus, Bukarest, Rumänien
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14
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Chen YF, Huang HY, Lee CC, Hsiao JQ, Tsou CH, Liang HC. High-power diode-pumped Nd:GdVO 4/KGW Raman laser at 578 nm. OPTICS LETTERS 2020; 45:5562-5565. [PMID: 33001947 DOI: 10.1364/ol.406173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/04/2020] [Indexed: 06/11/2023]
Abstract
A diode-pumped neodymium-doped gadolinium vanadate (Nd:GdVO4) laser is developed as a compact efficient yellow light at 578 nm by means of intracavity stimulated Raman scattering (SRS) in a potassium gadolinium tungstate (KGW) crystal and the second-harmonic generation in a lithium triborate crystal. The SRS process with a shift of 768cm-1 is achieved by setting the polarization of the fundamental wave along the Ng axis of the KGW crystal. The self-Raman effect arising from the Nd:GdVO4 crystal is systematically explored by employing two kinds of coating specification for the output coupler. With a specific coating on the output coupler to suppress the self-Raman effect, the maximum output power at 578 nm can reach 3.1 W at a pump power of 32 W. Moreover, two different lengths for the Nd:GdVO4 crystal are individually used to verify the influence of the self-Raman effect on the lasing efficiency.
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Ponomarev IV, Topchy SB, Pushkareva AE, Andrusenko YN, Shakina LD. Treatment of сongenital melanocytic nevus in infants and children by a dual-wavelengths copper vapor laser. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/vdv1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction.Congenital melanocytic nevus (CMN) is detected at birth or shortly after birth in 1% of infants. The localization of CMN in aesthetically significant areas causes a decline in child self-esteem and causes concern for his parents. Surgical excision of skin areas with CMN is associated with an increased risk of cosmetic side effects and is often followed by long-term stress conditions after the invasive intervention.
Aim of the study.To evaluate the efficacy of the CMN removal in infants, children and adolescents with the dual-wavelengths copper vapor laser (CVL) radiation.
Patients and Methods.Medium-sized (up to 9 cm) single CMN was treated in nine fair-skinned patients: seven girls and two boys, aged from 2 months to 16 years. The procedures were carried out at an average CVL power of 0.61.0 W, with a power ratio of 3:2 at 511 nm and 578 nm wavelengths, and an exposure time of 0.20.3 s. Light spot diameter 1 mm. The treatment was carried out during 210 sessions with an interval of 12 months between sessions.
Results.In children and adolescents, the treatment of CMN with CVL dual-wavelengths radiation made it possible to achieve significant clarification of the involved area without hypertrophic scars. The duration of the healing of the irradiated area lasted 23 weeks. Side effects were manifested with subtle skin atrophy.
Conclusion.The high efficacy of CVL removal of medium-sized CMN in infants and children using the dual-wavelengths CVL radiation without pronounced side effects allows introducing such an approach in the clinical practice of pediatric dermatologists and cosmetologists.
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16
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Mohamed EEM, Younes AKH, Hussein GM. Efficacy of 577 nm pro-yellow laser in the treatment of melasma: a prospective split-face study. J COSMET LASER THER 2020; 22:107-110. [DOI: 10.1080/14764172.2020.1744661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Zhu JW, Ni YJ, Tong XY, Guo X, Wu XP, Lu ZF. Tranexamic Acid Inhibits Angiogenesis and Melanogenesis in Vitro by Targeting VEGF Receptors. Int J Med Sci 2020; 17:903-911. [PMID: 32308543 PMCID: PMC7163366 DOI: 10.7150/ijms.44188] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/06/2020] [Indexed: 01/08/2023] Open
Abstract
Melasma is a common but complex skin condition concerning cosmetic problems. Tranexamic acid (TA) has been proved to be effective in treatment of melasma with still unclear mechanisms. Here, we show that VEGF165 enhanced the expression of VEGF receptors (VEGFRs, including VEGFR-1, VEGFR-2 and NRP-1) in human umbilical vein endothelial cells (HUVECs), which was attenuated by TA. VEGF165 also promoted tyrosine phosphorylation of VEGFR-1 and VEGFR-2 in HUVECs, which was again abolished by TA. TA further showed similar effects to neutralization of VEGFR-1 and VEGFR-2 in inhibiting cell proliferation, migration, invasion and tube formation of HUVECs induced by VEGF165, suggesting that TA could inhibit angiogenesis by targeting VEGFRs in HUVECs. In addition, VEGF165 enhanced the expression of VEGFRs and promoted tyrosine phosphorylation of VEGFR-1 and VEGFR-2 in normal human melanocytes, which were also attenuated by TA. Furthermore, TA showed similar effects to neutralization of VEGFR-1 and VEGFR-2 in inhibiting tyrosinase activity, melanin production and even melanogenic proteins induced by VEGF165, suggesting that TA could reduce melanogenesis via inhibiting activation of VEGFRs and subsequent expression of melanogenic proteins in melanocytes. Taken together, we demonstrate that TA can inhibit angiogenesis and melanogenesis in vitro at least in part by targeting VEGFRs, which may offer a new understanding of the pathogenesis of melasma as well as the molecular mechanism for TA in treatment of the disease.
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Affiliation(s)
- Jian-Wei Zhu
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Ya-Jie Ni
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Xiao-Yun Tong
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Xia Guo
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Xiao-Ping Wu
- Department of Dermatology, Zhejiang Hospital, No. 12, Lingyin Rd., Hangzhou, 310013, Zhejiang Province, China
| | - Zhong-Fa Lu
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88, Jiefang Rd., Hangzhou, 310009, Zhejiang Province, China
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18
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Klyuchareva SV, Ponomarev IV, Topchiy SB, Pushkareva AE, Andrusenko YN. Treatment of seborrheic keratosis with a copper vapour laser. VESTNIK DERMATOLOGII I VENEROLOGII 2019. [DOI: 10.25208/0042-4609-2019-95-3-25-33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Aim: to assess the efficacy and side-effect risk of the surgical treatment of seborrheic k eratosis (SK) using a copper vapour laser (CVL).Patients and methods. 3980 patients (1214 men and 2766 women aged 20 to 78 years) suffering from SK were treated using a CVL (Yakhroma-Med model, Russian producer) equipped with a laser pen and a scanning nozzle. The laser treatment was performed without anaesthesia in one to four sessions. During the treatment procedure, the following radiation parameters were applied: wavelengths ranging from 511 to 578 nm (in the ratio of 3 to 2), an average power of 0.6–1.2 W and an exposure duration ranging from 0.2 to 0.4 s. The diameter of the light spot on the skin surface was 1 mm. The follow-up observation lasted 24 months.Results. The computer simulation of tissue heating by CVL and other laser systems showed that CVL is an optimal treatment choice for seborrheic keratosis in terms of the energy deposition depth. According to our clinical data and the results of computer simulation, the CVL is established to be the safest and the most effective for seborrheic keratosis treatment.
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Affiliation(s)
- S. V. Klyuchareva
- North-Western State Medical University named after I. I. Mechnikov, Ministry of Health of the Russian Federation
| | | | - S. B. Topchiy
- Lebedev Physical Institute, Russian Academy of Sciences
| | - A. E. Pushkareva
- Saint Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University)
| | - Yu. N. Andrusenko
- Saint Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University)
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19
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Kim H, Park J, Zheng Z, Cho SB. Low-fluenced erbium:yttrium-aluminium-garnet laser treatment in combination with broadband light pretreatment for various pigmentation disorders in Asian patients. J Cosmet Dermatol 2019; 18:1657-1664. [PMID: 30825265 DOI: 10.1111/jocd.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/19/2018] [Accepted: 02/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Low-fluenced 2940-nm erbium (Er):yttrium-aluminium-garnet (YAG) resurfacing elicits ablative photothermal tissue reactions confined to the uppermost parts of the epidermis. OBJECTIVE To demonstrate the efficacy and safety of low-fluenced ablative Er:YAG laser treatment in combination with broadband light (BBL) pretreatment for various pigmentation disorders. METHODS In total, 35 Korean patients with various pigmentation disorders were pretreated with BBL, and then, low-fluenced Er:YAG laser resurfacing was performed with a beam size of 4 mm and a fluence of 1.0-1.5 J/cm2 . RESULTS An average of 1.1 ± 0.4 sessions of combined BBL and low-fluenced Er:YAG resurfacing treatment was delivered to the patients. Most post-Er:YAG scaling fell off spontaneously over 3-5 days, and most of the post-BBL crusting disappeared spontaneously over 5-7 days. At 2 months after final treatment, the mean global aesthetic improvement scale score for the clinical improvement of pigmentation lesions was estimated as 2.5 ± 0.8, and that for the improvement of overall skin tone, texture, and wrinkles was 2.8 ± 1.0. CONCLUSION Our data demonstrated that post-BBL, low-fluenced Er:YAG laser resurfacing can be used to effectively treat various pigmentation disorders in Asian patients. Further improvements in overall skin tone, texture, and wrinkles were also achieved without major side effects.
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Affiliation(s)
- Heesu Kim
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Jiho Park
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Zhenlong Zheng
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.,Department of Dermatology, Yanbian University Hospital, Yanji, China
| | - Sung Bin Cho
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.,Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea
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20
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Kwon SH, Na JI, Choi JY, Park KC. Melasma: Updates and perspectives. Exp Dermatol 2018; 28:704-708. [PMID: 30422338 DOI: 10.1111/exd.13844] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/01/2018] [Accepted: 11/05/2018] [Indexed: 11/29/2022]
Abstract
Management of melasma is highly challenging due to inconsistent treatment results and frequent relapses. However, recent studies revealed that melasma may not only be a disease of melanocytes, but also a photoaging skin disorder. Herein, we attempt to validate that melasma is indeed a photoaging disorder by presenting the histopathologic findings of melasma: solar elastosis, altered basement membrane, increased vascularization and increased mast cell count. We also provide some therapeutic implications based on these findings and a discussion on the latest updates and perspectives regarding treatment.
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Affiliation(s)
- Soon-Hyo Kwon
- College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Gyeonggi, Korea
| | - Jung-Im Na
- College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Gyeonggi, Korea
| | - Ji-Young Choi
- College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Gyeonggi, Korea
| | - Kyoung-Chan Park
- College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Gyeonggi, Korea
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21
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Hassan AM, Elfar NN, Rizk OM, Eissa NY. Pulsed dye laser versus intense pulsed light in melasma: a split-face comparative study. J DERMATOL TREAT 2018; 29:725-732. [DOI: 10.1080/09546634.2018.1441487] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Arwa M. Hassan
- Dermatology and Venereology Department, Tanta University, Tanta, Egypt
| | - Nashwa N. Elfar
- Dermatology and Venereology Department, Tanta University, Tanta, Egypt
| | - Omnia M. Rizk
- Department of Pathology, Tanta University, Tanta, Egypt
| | - Nahed Y. Eissa
- Dermatology and Venereology Department, Tanta University, Tanta, Egypt
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22
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Kong SH, Suh HS, Choi YS. Treatment of Melasma with Pulsed-Dye Laser and 1,064-nm Q-Switched Nd:YAG Laser: A Split-Face Study. Ann Dermatol 2017; 30:1-7. [PMID: 29386825 PMCID: PMC5762458 DOI: 10.5021/ad.2018.30.1.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/23/2017] [Accepted: 04/18/2017] [Indexed: 11/17/2022] Open
Abstract
Background Melasma is an acquired pigmentary disorder that is often therapeutically challenging. Recent evidence suggests that vascular abnormalities are involved in melasma pathogenesis. Pulsed-dye laser (PDL) is considered as standard therapy for vascular lesions. Objective To assess the efficacy of PDL combined with low-fluence Q-switched Nd:YAG laser (QSNY) in the treatment of melasma. Methods Seventeen melasma patients were enrolled in this study. All subjects were treated with a total of nine QSNY treatment sessions at one-week intervals. Three sessions of PDL were additionally performed immediately after QSNY treatment on the half of the face at baseline, week 4, and week 8. The melasma area and the severity index (MASI) score was calculated at the baseline, one week after the last treatment (week 9), as well as at the follow-up 8 weeks after the last treatment (week 16). Dermoscopic images at the baseline were classified as to whether the visibly widened capillaries were detected or not. Results MASI scores on the PDL+QSNY and QSNY side decreased significantly during the study period. There was no significant difference in the MASI score change between both sides in all periods. However, seven patients who had visibly widened capillaries on dermoscopy showed significant difference in both sides in terms of changes in the MASI score during treatment. Conclusion PDL combined with QSNY may be considered as a safe and effective treatment for melasma patients who show visibly widened capillaries on dermoscopy.
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Affiliation(s)
- Sook Hyun Kong
- Department of Dermatology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Ho Seok Suh
- Department of Dermatology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Yu Sung Choi
- Department of Dermatology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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23
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Chen L, Xu Z, Jiang M, Zhang C, Wang X, Xiang L. Light-emitting diode 585nm photomodulation inhibiting melanin synthesis and inducing autophagy in human melanocytes. J Dermatol Sci 2017; 89:11-18. [PMID: 29065997 DOI: 10.1016/j.jdermsci.2017.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/15/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Melasma is a common hyperpigmentation skin disease on face. Light-emitting diode (LED) photomodulation (585nm) is reported to be effective for the treatment of melasma. However, whether and how LED photomodulation would influence melanogenesis of human epidermal melanocytes (HEMs) is unknown. OBJECTIVE To evaluate the effects of LED photomodulation (585nm) on melanogenesis in HEMs. METHODS HEMs were irradiated with fluences of 0, 5, 10 and 20J/cm2 585nm LED light. After 5-day treatment, cell viability was analyzed by CCK-8 assay, and apoptosis was assessed by Annexin V APC assay. Melanin content and tyrosinase activity were measured by spectrophotometer. Melanosome stage and autophagosomes were determined under transmission electron microscope (TEM). The formation of autophagic punctate structures was observed under confocal microscope. RT-PCR and western blotting were used to assess the expression of relative mRNA and protein levels. RESULTS Yellow light LED 585nm had no effects on HEMs cell viability and apoptosis. Treatment with LED 585nm from 5J/cm2 to 20J/cm2 inhibited melanosome maturation, decreased melanin content and tyrosinase activity. Inhibition was accompanied by the decreased expression of tyrosinase (TYR), tyrosinase-related protein-1 (TRP-1) and microphthalmia-associated transcription factor (MITF) on both mRNA and protein levels. Autophagosomes were observed under TEM. Autophagic punctate structures of microtubule-associated protein light chain 3 (LC3) proteins were induced by LED 585nm light. The configuration change of LC3 from LC3-I to LC3-II, and the degradation of p62 protein were observed after LED 585nm. Furthermore, we also revealed that the anti-melanogenic effect of LED 585nm photomodulation was reversed by 3-Methyladenine (3-MA), which inhibits autophagy by blocking autophagosome formation via the inhibition of type III Phosphatidylinositol 3-kinases (PI-3K). CONCLUSIONS Our finding demonstrated that LED photomodulation with 585nm wavelength suppressed melanin content in HEMs, and the effect was caused by its dose-dependent inhibition on melanogenesis and the induction of HEMs autophagy. This may provide new insights into the efficacy of LED photomodulation in the treatment of hyperpigmentation disorders.
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Affiliation(s)
- Li Chen
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Zhongyi Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Min Jiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Xuan Wang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Leihong Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China.
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24
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Choi YJ, Nam JH, Kim JY, Min JH, Park KY, Ko EJ, Kim BJ, Kim WS. Efficacy and safety of a novel picosecond laser using combination of 1 064 and 595 nm on patients with melasma: A prospective, randomized, multicenter, split-face, 2% hydroquinone cream-controlled clinical trial. Lasers Surg Med 2017; 49:899-907. [DOI: 10.1002/lsm.22735] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2017] [Indexed: 01/29/2023]
Affiliation(s)
- Young-Jun Choi
- Department of Dermatology; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Jae-Hui Nam
- Department of Dermatology; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Jung Yup Kim
- Department of Dermatology; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Joon Hong Min
- Department of Dermatology; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Kui Young Park
- Department of Dermatology; Chung-Ang University Hospital; Chung-Ang University School of Medicine; Seoul Republic of Korea
| | - Eun Jung Ko
- Department of Dermatology; Myongji Hospital; Seonam University College of Medicine; Goyang Republic of Korea
| | - Beom Joon Kim
- Department of Dermatology; Chung-Ang University Hospital; Chung-Ang University School of Medicine; Seoul Republic of Korea
| | - Won-Serk Kim
- Department of Dermatology; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
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25
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Ogbechie-Godec OA, Elbuluk N. Melasma: an Up-to-Date Comprehensive Review. Dermatol Ther (Heidelb) 2017; 7:305-318. [PMID: 28726212 PMCID: PMC5574745 DOI: 10.1007/s13555-017-0194-1] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Indexed: 01/12/2023] Open
Abstract
Melasma is a common acquired condition of symmetric hyperpigmentation, typically occurring on the face, with higher prevalence in females and darker skin types. Multiple etiologies, including light exposure, hormonal influences, and family history, have been implicated in the pathogenesis of this disorder. Overall prevalence ranges widely at 1-50%, since values are typically calculated within a specific ethnic population within a geographic region. Histologically, melasma can display increased epidermal and/or dermal pigmentation, enlarged melanocytes, increased melanosomes, solar elastosis, dermal blood vessels, and, occasionally, perivascular lymphohistiocytic infiltrates. Various topical, oral, and procedural therapies have been successfully used to treat melasma. Traditional topical therapies including hydroquinone, tretinoin, corticosteroids, and triple combination creams; however, other synthetic and natural topical compounds have also shown varying efficacies. Promising oral therapies for melasma include tranexamic acid, Polypodium leucotomos, and glutathione. Procedures, including chemical peels, microneedling, radiofrequency, and lasers, are also often used as primary or adjunctive treatments for melasma. Notably, combination therapies within or across treatment modalities generally result in better efficacies than monotherapies. This review serves as a comprehensive update on the current understanding of the epidemiology, pathogenesis, clinical and histologic features of melasma, as well as treatments for this common, yet therapeutically challenging, condition.
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Affiliation(s)
| | - Nada Elbuluk
- Ronald O. Perelman Department of Dermatology, New York University, New York, NY, USA.
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26
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Trivedi MK, Yang FC, Cho BK. A review of laser and light therapy in melasma. Int J Womens Dermatol 2017; 3:11-20. [PMID: 28492049 PMCID: PMC5418955 DOI: 10.1016/j.ijwd.2017.01.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 12/11/2022] Open
Abstract
Melasma is a dysregulation of the homeostatic mechanisms that control skin pigmentation and excess pigment is produced. Traditional treatment approaches with topical medications and chemical peels are commonly used but due to the refractory and recurrent nature of melasma, patients often seek alternative treatment strategies such as laser and light therapy. Several types of laser and light therapy have been studied in the treatment of melasma. Intense pulsed light, low fluence Q-switched lasers, and non-ablative fractionated lasers are the most common lasers and light treatments that are currently performed. They all appear effective but there is a high level of recurrence with time and some techniques are associated with an increased risk for postinflammatory hyper- or hypopigmentation. The number and frequency of treatments varies by device type but overall, Q-switched lasers require the greatest number of treatment applications to see a benefit. Vascular-specific lasers do not appear to be effective for the treatment of melasma. Ablative fractionated lasers should be used with caution because they have a very high risk for postinflammatory hypo- and hyperpigmentation. The use of nonablative fractionated laser treatments compared with other laser and light options may result in slightly longer remission intervals. Picosecond lasers, fractional radiofrequency, and laser-assisted drug delivery are promising future approaches to treat melasma. The goal of this review is to summarize the efficacy and safety of the most commonly used laser and light therapies to treat melasma, briefly present future laser-based treatment options for patients with melasma, and provide recommendations for treatment on the basis of the reviewed information.
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Affiliation(s)
- M K Trivedi
- University of Michigan Medical School, Ann Arbor, Michigan.,Department of Dermatology, University of California San Francisco, San Francisco, California
| | - F C Yang
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - B K Cho
- Department of Dermatology, Palo Alto Medical Foundation, Sunnyvale, California
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27
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Lee SH, Kim JM, Lee SE, Jeong SK, Lee SH. Upregulation of protease-activated receptor-2 in keratinocytes by epidermal vascular endothelial growth factor in vitro and in vivo. Exp Dermatol 2017; 26:286-288. [DOI: 10.1111/exd.13183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Si-Hyung Lee
- Department of Dermatology; Yonsei University College of Medicine; Seoul Korea
- Human Barrier Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Ji Min Kim
- Bio R&D Center; Daewoong Life Science Research Institute; Yongin Korea
| | - Sang Eun Lee
- Department of Dermatology; Yonsei University College of Medicine; Seoul Korea
- Human Barrier Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Se Kyoo Jeong
- Department of Cosmetic Science; Seowon University; Cheongju Korea
| | - Seung Hun Lee
- Department of Dermatology; Yonsei University College of Medicine; Seoul Korea
- Human Barrier Research Institute; Yonsei University College of Medicine; Seoul Korea
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28
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Heterogeneous Pathology of Melasma and Its Clinical Implications. Int J Mol Sci 2016; 17:ijms17060824. [PMID: 27240341 PMCID: PMC4926358 DOI: 10.3390/ijms17060824] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/14/2016] [Accepted: 05/23/2016] [Indexed: 11/22/2022] Open
Abstract
Melasma is a commonly acquired hypermelanosis that affects sun-exposed areas of the skin, with frequent facial involvement. Its histologic manifestations are evident in the epidermis, extracellular matrix, and dermis. In addition to epidermal pigmentation, pathologic findings of melasma include extracellular matrix abnormality, especially solar elastosis. The disrupted basement membrane has been described in melasma with variable incidences. In the dermis, an increase in vascularity and an increase in the number of mast cells were observed, indicating that dermal factors have critical roles in the pathogenesis of melasma, despite the fact that melasma is characterized by epidermal hyperpigmentation. This review discusses such histologic characteristics of melasma, with consideration to their implications for melasma treatment.
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29
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Geddes ER, Stout AB, Friedman PM. Retrospective analysis of the treatment of melasma lesions exhibiting increased vascularity with the 595-nm pulsed dye laser combined with the 1927-nm fractional low-powered diode laser. Lasers Surg Med 2016; 49:20-26. [DOI: 10.1002/lsm.22518] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2016] [Indexed: 11/07/2022]
Affiliation(s)
| | - Ashlyn B. Stout
- Dermatology and Laser Surgery Center; 6400 Fannin St. Suite 2720 Houston Texas
| | - Paul M. Friedman
- Dermatology and Laser Surgery Center; 6400 Fannin St. Suite 2720 Houston Texas
- Department of Dermatology; University of Texas Houston Medical School; Houston Texas
- Department of Dermatology; Weill Cornell Medical College, Houston Methodist Hospital; Houston Texas
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30
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Long-Pulsed Dye Laser of 595 nm in Combination With Pigment-Specific Modalities for a Patient Exhibiting Increased Vascularity Within Lesions of Melasma. Dermatol Surg 2016; 42:556-9. [DOI: 10.1097/dss.0000000000000652] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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On HR, Lee SH, Lee YS, Chang HS, Park C, Roh MR. Evaluating hypertrophic thyroidectomy scar outcomes after treatment with triamcinolone injections and copper bromide laser therapy. Lasers Surg Med 2015; 47:479-84. [DOI: 10.1002/lsm.22375] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Hye Rang On
- Department of Dermatology; Gangnam Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Sang Hee Lee
- Department of Dermatology; Gangnam Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Yong Sang Lee
- Department of Surgery; Yonsei University College of Medicine; Seoul Korea
| | - Hang-Seok Chang
- Department of Surgery; Yonsei University College of Medicine; Seoul Korea
| | - CheongSoo Park
- Department of Surgery; Yonsei University College of Medicine; Seoul Korea
| | - Mi Ryung Roh
- Department of Dermatology; Gangnam Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
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Cunha PR, Pinto CAL, Mattos CB, Cabrini DP, Tolosa JL. New insight in the treatment of refractory melasma: Laser Q-switched Nd: YAG non-ablative fractionated followed by intense pulsed light. Dermatol Ther 2015; 28:296-9. [PMID: 26032175 DOI: 10.1111/dth.12250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of our study was to verify the results of the association of Q-switched Nd: YAG non-ablative fractionated with intense pulsed light, in order to treat patients with refractory melasma. The combination of these two devices seems to be the best treatment to combat hyperpigmentation produced by melasma, with low occurrence of side effects, which may be justified by the selective photothermolysis at subcellular level.
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Vachiramon V, Sirithanabadeekul P, Sahawatwong S. Low-fluence Q-switched Nd: YAG 1064-nm laser and intense pulsed light for the treatment of melasma. J Eur Acad Dermatol Venereol 2014; 29:1339-46. [DOI: 10.1111/jdv.12854] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/17/2014] [Indexed: 12/12/2022]
Affiliation(s)
- V. Vachiramon
- Ramathibodi Laser Center; Division of Dermatology; Ramathibodi Hospital; Mahidol University; Bangkok Thailand
| | - P. Sirithanabadeekul
- Ramathibodi Laser Center; Division of Dermatology; Ramathibodi Hospital; Mahidol University; Bangkok Thailand
| | - S. Sahawatwong
- Ramathibodi Laser Center; Division of Dermatology; Ramathibodi Hospital; Mahidol University; Bangkok Thailand
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Attwa E, Khater M, Assaf M, Haleem MA. Melasma treatment using an erbium:YAG laser: a clinical, immunohistochemical, and ultrastructural study. Int J Dermatol 2014; 54:235-44. [DOI: 10.1111/ijd.12477] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Enayat Attwa
- Department of Dermatology and Venereology; Faculty of Medicine; Zagazig University; Zagazig Egypt
| | - Mohamed Khater
- Department of Dermatology and Venereology; Faculty of Medicine; Zagazig University; Zagazig Egypt
| | - Magda Assaf
- Department of Pathology; Faculty of Medicine; Zagazig University; Zagazig Egypt
| | - Manal Abdel Haleem
- Department of Histology; Faculty of Medicine; Zagazig University; Zagazig Egypt
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Son IP, Park KY, Kim B, Kim MN. Pilot Study of the Efficacy of 578 nm Copper Bromide Laser Combined with Intralesional Corticosteroid Injection for Treatment of Keloids and Hypertrophic Scars. Ann Dermatol 2014; 26:156-61. [PMID: 24882968 PMCID: PMC4037666 DOI: 10.5021/ad.2014.26.2.156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 03/08/2013] [Accepted: 03/08/2013] [Indexed: 11/30/2022] Open
Abstract
Background Treatments including intralesional corticosteroid injection, pressure therapy, cryotherapy, and various laser therapies have had limited success for keloids and hypertrophic scars. Objective This trial evaluated the efficacy of a combination of 578 nm copper bromide laser and the more traditional intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to scar color. Methods Keloids or hypertrophic scars of 12 Korean patients were treated five times by the combined treatment at 4-week intervals. Clinical improvement was assessed by the physicians' global assessment (PGA) comparing pre- and post-treatment photographs, as well as 4 weeks after the last treatment. Erythema intensity was quantified using a mexameter. Results Most scars showed significant clinical improvement in PGA and decreased erythema intensity after 5 treatments. All patients showed improvements in symptoms like pruritus. Conclusion The combined treatment is effective for keloids and hypertrophic scars, especially when the telangiectatic portion of the scars is prominent. The adjunctive use of 578 nm copper bromide laser decreased the telangiectatic side effects of an intralesional corticosteroid injection by reducing the vascular components of scars.
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Affiliation(s)
- In Pyeong Son
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Beomjoon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Myeung Nam Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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Eimpunth S, Wanitphakdeedecha R, Triwongwaranat D, Varothai S, Manuskiatti W. Therapeutic outcome of melasma treatment by dual-wavelength (511 and 578 nm) laser in patients with skin phototypes III-V. Clin Exp Dermatol 2014; 39:292-7. [DOI: 10.1111/ced.12267] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S. Eimpunth
- Department of Dermatology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - R. Wanitphakdeedecha
- Department of Dermatology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - D. Triwongwaranat
- Department of Dermatology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - S. Varothai
- Department of Dermatology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - W. Manuskiatti
- Department of Dermatology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
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Lee S, Lee T, Kim H, Kim J, Eun H, Kim R. A practical comparison of Copper Bromide Laser for the treatment of vascular lesions. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:3765-8. [PMID: 24110550 DOI: 10.1109/embc.2013.6610363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The recent rapid growth in demand for aesthetic non-invasive laser treatments such as unwanted skin rejuvenation, removal of age-related vascular blemishes has led to a boom in the medical devices to treat these conditions. Among diverse laser for skin treatment, copper bromide laser is a very effective, safe, and well tolerated treatment for facial telangiectasia at various energy levels and the most important thing of the copper bromide laser device is that the stability of the energy. However there is no evidence about effective copper bromide laser's energy level for the treatment of vascular lesions. We compared energy stability and treatment performance between two energy levels in 2 W and 8 W which commonly use in laser treatment for the vascular lesions. 8 W copper bromide laser was more stable compared than 2 W copper bromide laser. Also, 8 W copper bromide laser was effectively superior to 2 W copper bromide laser in treatment of vascular legion. Consequently, 8 W copper bromide laser treatment for vascular lesion might be more suitable than 2 W copper bromide laser.
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Long-lasting effect of vascular targeted therapy of melasma. J Am Acad Dermatol 2013; 69:e141-2. [DOI: 10.1016/j.jaad.2013.02.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 02/07/2013] [Accepted: 02/21/2013] [Indexed: 11/22/2022]
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Park KY, Choi SY, Mun SK, Kim BJ, Kim MN. Combined treatment with 578-/511-nm copper bromide laser and light-emitting diodes for post-laser pigmentation: a report of two cases. Dermatol Ther 2013; 27:121-5. [PMID: 24703271 DOI: 10.1111/dth.12080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Postinflammatory hyperpigmentation (PIH) developing after cosmetic procedures such as lasers and chemical peels is always a concern, especially in darker skin types. We report two cases of laser-related PIH of the face successfully treated by combined therapy with 578-/511-nm copper bromide laser and light-emitting diodes (LED). Good cosmetic results were achieved in both patients. The side effects during and after treatment included a mild stinging and redness, but these were resolved within several days without any treatment. Combined 578-/511-nm copper bromide laser with LED provided safe and effective treatment for post-laser pigmentation in Korean patients.
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Affiliation(s)
- Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
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Abstract
Lasers are a very effective approach for treating many hyperpigmented lesions. They are the gold standard treatment for actinic lentigos and dermal hypermelanocytosis, such as Ota nevus. Becker nevus, hyperpigmented mosaicisms, and lentigines can also be successfully treated with lasers, but they could be less effective and relapses can be observed. However, lasers cannot be proposed for all types of hyperpigmentation. Thus, freckles and café-au-lait macules should not be treated as the relapses are nearly constant. Due to its complex pathophysiology, melasma has a special place in hyperpigmented dermatoses. Q-switched lasers (using standard parameters or low fluency) should not be used because of consistent relapses and the high risk of post-inflammatory hyperpigmentation. Paradoxically, targeting the vascular component of the melasma lesion with lasers could have a beneficial effect. However, these results have yet to be confirmed. In all cases, a precise diagnosis of the type of hyperpigmentation is mandatory before any laser treatment, and the limits and the potential side effects of the treatment must be clearly explained to patients.
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Affiliation(s)
- T Passeron
- Department of Dermatology, INSERM U1065, Nice CHU, France.
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Chan NPY, Lee Chan HH. Lasers for Treatment of Ethnic Skin. Dermatol Surg 2012. [DOI: 10.1002/9781118412633.ch57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Park GH, Lee JH, Choi JR, Chang SE. The degree of erythema in melasma lesion is associated with the severity of disease and the response to the low-fluence Q-switched 1064-nm Nd:YAG laser treatment. J DERMATOL TREAT 2012; 24:297-9. [DOI: 10.3109/09546634.2011.646938] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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45
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LEE EH, KANG JS, KANG DS, HAN CS, CHO SB. Combination of 1064-nm Q-switched neodymium: yttrium-aluminum-garnet laser with low fluence and 578-/511-nm copper bromide laser for nipple-areolar hyperpigmentation. J Dermatol 2012; 39:110-2. [DOI: 10.1111/j.1346-8138.2011.01272.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Affiliation(s)
- Virendra N Sehgal
- Dermato Venereology Center, Sehgal Nursing Home, Panchwati, Delhi, India.
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Affiliation(s)
- Vaneeta M Sheth
- Department of Dermatology at Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amit G Pandya
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.
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Karsai S, Fischer T, Pohl L, Schmitt L, Buhck H, Jünger M, Raulin C. Is non-ablative 1550-nm fractional photothermolysis an effective modality to treat melasma? Results from a prospective controlled single-blinded trial in 51 patients. J Eur Acad Dermatol Venereol 2011; 26:470-6. [DOI: 10.1111/j.1468-3083.2011.04100.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S Karsai
- Laser Clinic Karlsruhe, Karlsruhe, Germany.
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Y a-t-il une place pour le laser dans le traitement du mélasma ? Ann Dermatol Venereol 2011; 138:319-20. [DOI: 10.1016/j.annder.2010.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 12/30/2010] [Indexed: 11/22/2022]
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50
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Kim J, Kim H, Kim Y, Lee S, Roh M, Park C, Chang HS, Lee S. The combination of copper bromide laser, a 10 600 nm ablative carbon dioxide laser and intralesional triamcinolone for the treatment of hypertrophic thyroidectomy scars. J Eur Acad Dermatol Venereol 2011; 26:125-6. [DOI: 10.1111/j.1468-3083.2011.04025.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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