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Hou PC, del Agua N, Lwin SM, Hsu CK, McGrath JA. Innovations in the Treatment of Dystrophic Epidermolysis Bullosa (DEB): Current Landscape and Prospects. Ther Clin Risk Manag 2023; 19:455-473. [PMID: 37337559 PMCID: PMC10277004 DOI: 10.2147/tcrm.s386923] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023] Open
Abstract
Dystrophic epidermolysis bullosa (DEB) is one of the major types of EB, a rare hereditary group of trauma-induced blistering skin disorders. DEB is caused by inherited pathogenic variants in the COL7A1 gene, which encodes type VII collagen, the major component of anchoring fibrils which maintain adhesion between the outer epidermis and underlying dermis. DEB can be subclassified into dominant (DDEB) and recessive (RDEB) forms. Generally, DDEB has a milder phenotype, while RDEB patients often have more extensive blistering, chronic inflammation, skin fibrosis, and a propensity for squamous cell carcinoma development, collectively impacting on daily activities and life expectancy. At present, best practice treatments are mostly supportive, and thus there is a considerable burden of disease with unmet therapeutic need. Over the last 20 years, considerable translational research efforts have focused on either trying to cure DEB by direct correction of the COL7A1 gene pathology, or by modifying secondary inflammation to lessen phenotypic severity and improve patient symptoms such as poor wound healing, itch, and pain. In this review, we provide an overview and update on various therapeutic innovations for DEB, including gene therapy, cell-based therapy, protein therapy, and disease-modifying and symptomatic control agents. We outline the progress and challenges for each treatment modality and identify likely prospects for future clinical impact.
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Affiliation(s)
- Ping-Chen Hou
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nathalie del Agua
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - Su M Lwin
- St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - John A McGrath
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
- St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK
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Garza-Mayers AC, Su KA, Wiss K. Improved erythema and decreased blister formation in dominant dystrophic epidermolysis bullosa following treatment with pulsed dye laser. Pediatr Dermatol 2022; 39:1005-1006. [PMID: 36063122 DOI: 10.1111/pde.15126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022]
Abstract
Dominant dystrophic epidermolysis bullosa (DDEB), an inherited disorder due to type VII collagen mutations, is characterized by blisters and erosions that heal with scarring, atrophy, and milia. There is no established role for laser in the management of patients with DDEB. Pulsed dye laser (PDL) is most often used to target vascular skin lesions. We describe a patient with DDEB with marked improvement in erythema as well as fewer and less symptomatic episodes of blistering following treatment with PDL.
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Affiliation(s)
- Anna Cristina Garza-Mayers
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine A Su
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Karen Wiss
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.,Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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Caliskan E, Botsali A. Combination of Full-Field and Fractional Erbium: YAG Laser for Nonhealing Wounds. Dermatol Surg 2022; 48:114-119. [PMID: 34772834 DOI: 10.1097/dss.0000000000003292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To evaluate the outcomes of a heterogeneous group of patients with chronic ulcer receiving a combination regimen of full-field and fractional erbium-doped yttrium aluminum garnet (erbium: YAG) laser applications. METHODS Enrolled in this study were patients with chronic ulcer who had received at least 2 erbium: YAG laser sessions. Fractional applications followed the initial full-field application for debridement. The therapeutic outcomes were evaluated by serial photographs. The primary outcome measure was the proportion of patients achieving complete re-epithelialization at the first year. RESULTS Forty-three treatment regions from 23 patients between 40 and 90 years (F: M = 11:12; age: 60.3 ± 15.5 years, mean ± SD) were eligible. The ulcers' median duration was 24 months (min-max: 2-240 months). The median number of laser sessions was 5 (min-max: 2-12). Of arterial (n = 13), immunologic (n = 9), venous (n = 8), diabetic (n = 8), and mechanical ulcers (n = 5), the primary outcome measure was achieved in 69%, 77.7%, 75%, 88.8%, and 100% of the groups, respectively. CONCLUSION Full-field erbium: YAG laser applications preserve the vascular architecture and enable delicate debridement. Ongoing maintenance fractional laser sessions promote wound healing. Similar to the previous reports of erbium: YAG laser in venous and diabetic ulcers, arterial ulcers, and ulcers of immunologic origin demonstrated an objective treatment response along with different adjuvant approaches.
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Affiliation(s)
- Ercan Caliskan
- Both authors are affiliated with the Department of Dermatology, Gülhane Faculty of Medicine, University of Health Sciences, Keçiören, Turkey
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Mirza HN, Mirza FN, Khatri KA. Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients. Dermatol Ther 2020; 34:e14432. [PMID: 33084193 DOI: 10.1111/dth.14432] [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: 08/26/2020] [Revised: 09/20/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA-compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms "ablative laser" and "skin resurfacing" from March 2002 until July 2020. Studies included meta-analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self-resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.
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Affiliation(s)
- Humza N Mirza
- University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatima N Mirza
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Khalil A Khatri
- Skin & Laser Surgery Center of New England, Nashua, New Hampshire, USA
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Jiang B, Tang R, Zheng D, Yang Y, Li Y, Yang R, Liu L, Yan H. Evaluation of the Efficacy of Ultrapulsed CO 2 Laser in Chronic Wounds. Lasers Surg Med 2020; 53:443-449. [PMID: 32548904 DOI: 10.1002/lsm.23283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Chronic wound repair is a major problem in wound treatment. Recently, several studies have suggested that carbon dioxide (CO2 ) laser can be used to improve the healing of chronic wounds. The aim of the present study was to preliminarily investigate the efficacy of laser debridement in treating chronic wound through a comparison of traditional instrument/surgical debridement with the ultrapulsed CO2 laser debridement in terms of wound healing, wound infection control, and wound blood perfusion. STUDY DESIGN/MATERIALS AND METHODS Patients with chronic wound admitted to the Wound Repair Clinic at The Affiliated Hospital of Southwest Medical University (Luzhou, China) between February 2019 and May 2019 were enrolled. They were randomly divided into two groups. The patients in one group were treated with traditional sharp instrument/surgical debridement (RT group; number of wounds: 28), while the patients in the other group were treated with ultrapulsed CO2 laser debridement (LT group; number of wounds: 26). An intergroup comparison was performed based on parameters, such as wound healing, wound infection control, and changes in wound blood perfusion. RESULTS The wound healing rate and the total time to achieve healing were significantly better in the LT group versus the RT group at 7, 14, 21, and 28 days after treatment. The wound exudation scores were significantly higher in the LT group versus the RT group at 7, 14, and 28 days after treatment. The positive rate of pre-debridement bacterial culture was significantly lower in the LT group versus the RD group at 14 and 28 days after treatment. The percentage of wound perfusion/normal periwound skin perfusion was significantly higher in the LT group versus the RT group at 1, 7, and 14 days after treatment. CONCLUSION For the treatment of chronic refractory wounds, the ultrapulsed CO2 laser exhibits higher accuracy, more effectively controls wound infection, promotes an increase in wound blood perfusion, and achieves faster wound healing compared with traditional sharp instrument/surgical debridement. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Bo Jiang
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Rui Tang
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Danyu Zheng
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Yuting Yang
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Ying Li
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Ruxi Yang
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Ligang Liu
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Hong Yan
- Department of Plastic and Burn Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
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Leaker BD, Fuchs C, Tam J. When Wounds Are Good for You: The Regenerative Capacity of Fractional Resurfacing and Potential Utility in Chronic Wound Prevention. Adv Wound Care (New Rochelle) 2019; 8:679-691. [PMID: 31750016 DOI: 10.1089/wound.2019.0945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/03/2019] [Indexed: 12/24/2022] Open
Abstract
Significance: Fractional resurfacing involves producing arrays of microinjuries on the skin, by thermal or mechanical means, to trigger tissue regeneration. Originally developed for cosmetic enhancement, fractional resurfacing induces a broad array of improvements in the structural and functional qualities of the treated skin and is especially effective at returning defective skin to a more normal state. In addition to fascinating questions about the nature of this remarkable regenerative capacity, there may be potential utility in ulcer prevention by halting or even reversing the progressive decline in overall skin quality that usually precedes chronic wound development. Recent Advances: Photoaging and scarring are the two skin defects most commonly treated by fractional resurfacing, and the treatment produces profound and long-lasting improvements in skin quality, both clinically and at the cellular/histologic level. Chronic wounds usually occur in skin that is compromised by various pathologic factors, and many of the defects found in this ulcer-prone skin are similar to those that have seen improvements after fractional resurfacing. Critical Issues: The mechanisms responsible for the regenerative capacity of fractional resurfacing are mostly unknown, as is how ulcer-prone skin, which is usually afflicted by stressors external to the skin tissue itself, would respond to fractional resurfacing. Future Directions: Better understanding of the cellular and molecular mechanisms underlying the unique healing response to fractional resurfacing could reveal fundamental information about adult tissue regeneration, lead to improvements in current applications, as well as new therapies in other pathologic conditions.
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Affiliation(s)
- Ben D. Leaker
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
- The Harvard-MIT Program in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Christiane Fuchs
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Joshua Tam
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
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Krakowski AC, Ozog DM, Ginsberg D, Cheng C, Chaffins ML. Laser-Induced Neocollagenesis in Focal Dermal Hypoplasia Associated With Goltz Syndrome in a Girl. JAMA Dermatol 2017; 153:1292-1297. [PMID: 28975212 DOI: 10.1001/jamadermatol.2017.3669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Current models of Goltz syndrome cannot estimate the overall neocollagenesis and marked shift in collagen types after ablative fractional laser resurfacing (AFR) within treated areas of focal dermal hypoplasia (FDH). Objectives To clinically improve FDH by using AFR to characterize the specific ratio of collagen types associated with observed clinical changes. Design, Setting, and Participants This case report of a girl with Goltz syndrome used extensive laboratory evaluation and multiple observers blinded to the patient's clinical status. Serial samples of clinically unaffected skin constituted internal control specimens, with clinical and histologic evaluations performed as part of a multicenter investigation. The analysis tested the hypothesis that thermal microtrauma caused by AFR created a unique environment that activated latent genes, inducing neocollagenesis and allowing the patient to adaptively produce the collagen subtype that was specifically deficient at baseline. Interventions Two AFR treatments were administered within an area of FDH. Histologic comparison of the pretreatment and posttreatment skin was performed using serial internal controls. Main Outcomes and Measures Histologic changes, including Herovici collagen staining to differentiate between types I and III collagen, within a treated area of mosaically affected FDH compared with clinically unaffected skin. Results This female patient presented in the second decade of life with self-described red, itchy skin within a large plaque of FDH on her left posterior thigh and calf. After AFR, skin tightening and symptomatic relief were reported. Histologic findings demonstrated objective thickening of the dermal collagen. A marked shift in collagen predominance from type III (fetal/early wound) to type I (adult/mature) was observed. Conclusions and Relevance Although further study is needed, this report shows promising results and raises important questions about gene expression and the epigenetics of Goltz syndrome-associated mutations and the local effects of AFR. Coupled with more rigorous investigation, this novel technique may help reveal molecular workarounds permitting innovative therapies that take advantage of the subtly different collagens that exist within the skin.
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Affiliation(s)
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - Carol Cheng
- Division of Dermatology, UCLA (University of California, Los Angeles)
| | - Marsha L Chaffins
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.,Department of Pathology, Henry Ford Hospital, Detroit, Michigan
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Monami M, Mirabella C, Scatena A, Nreu B, Zannoni S, Aleffi S, Giannoni L, Mannucci E. CO 2 laser for the treatment of diabetic foot ulcers with exposed bone. A consecutive series of type 2 diabetic patients. J Endocrinol Invest 2017; 40:819-822. [PMID: 28260184 DOI: 10.1007/s40618-017-0642-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/13/2017] [Indexed: 11/30/2022]
Abstract
AIM The treatment of foot ulcers with exposed bone is challenging, because of the risk of infection and of difficulties in the development of granulation tissue. A CO2 laser beam could be used to produce discontinuities in periosteum, allowing the exposure of blood containing multipotent stem cells, capable of initiating the healing process. The local application of platelet-rich plasma (PRP) has been proposed as a therapeutic tool for accelerating healing in foot ulcers, including those in patients with diabetes. Aim of the present pilot, proof-of-concept study is the assessment of the therapeutic potential of CO2 laser treatment, either alone or combined with PRP, in the treatment of diabetic foot ulcers with exposed bone. METHODS We performed a pilot, uncontrolled 3-month observation study on a consecutive series of 9 type two diabetic patients and foot ulcers with exposed bone. A CO2-laser was used for producing nine discontinuities on periosteum for each cm2, by directing the focused laser beam on the bone until bleeding. The procedure was repeated up to 6 times, at a distance of 1 week and ulcers assessed weekly until the end of the study (3 months). In the last 5 of the 14 patients, the treatment described above was associated with PRP. RESULTS Of the nine patients treated, four healed, and one more patient developed granulation tissue covering entirely bone surface. Out of the four patients who did not heal, one underwent minor amputation. Among the five patients treated with a combination of CO2 laser and PRP, two healed within 3 months, and two more patients developed granulation tissue covering entirely bone surface; the fifth patient did not show any improvement and underwent amputation. CONCLUSIONS The present pilot experience represents a novelty in this field showing a possible use of CO2-laser in the treatment of diabetic foot ulcers.
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Affiliation(s)
- M Monami
- Diabetology, Azienda Ospedaliero Universitaria Careggi, University of Florence, SOD Diabetologia - AOU Careggi, Via delle Oblate n. 4, 50141, Florence, Italy.
| | - C Mirabella
- Immunohematology and Transfusion Medicine, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
| | - A Scatena
- Diabetology Unit, Ospedale San Donato Arezzo, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
| | - B Nreu
- Geriatric Medicine, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
| | - S Zannoni
- Diabetology, Azienda Ospedaliero Universitaria Careggi, University of Florence, SOD Diabetologia - AOU Careggi, Via delle Oblate n. 4, 50141, Florence, Italy
| | - S Aleffi
- Diabetology, Azienda Ospedaliero Universitaria Careggi, University of Florence, SOD Diabetologia - AOU Careggi, Via delle Oblate n. 4, 50141, Florence, Italy
| | - L Giannoni
- Diabetology, Azienda Ospedaliero Universitaria Careggi, University of Florence, SOD Diabetologia - AOU Careggi, Via delle Oblate n. 4, 50141, Florence, Italy
| | - E Mannucci
- Diabetology, Azienda Ospedaliero Universitaria Careggi, University of Florence, SOD Diabetologia - AOU Careggi, Via delle Oblate n. 4, 50141, Florence, Italy
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Abstract
PURPOSE OF REVIEW Epidermolysis bullosa is a hereditary skin disorder characterized by skin fragility. However, the disease can manifest in many different organ systems, therefore children born with epidermolysis bullosa may have life long, complex medical needs. In this review, we will use a system-based approach to highlight important aspects of disease management and recent advancements in each of the areas. In addition, we will overview some of the cutting edge therapeutic developments in epidermolysis bullosa. RECENT FINDINGS Recent advancements in supportive care of epidermolysis bullosa with focus on wound, pain, pruritus and nutrition status were discussed. Clinical surveillance and complication prevention are critical to improve clinical outcomes. Generalized epidermolysis bullosa is a systemic disease with increased morbidity and mortality; therefore, complex care using a multidisciplinary approach will provide the greatest benefits for patients. Current targeted treatments for epidermolysis bullosa aim at restoring the skin integrity using protein, cell, and gene therapies. SUMMARY Improvement in care of epidermolysis bullosa in recent years results from keen clinical observation, novel molecular targeting, and the embracement of translational research.
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Krakowski AC, Totri CR, Donelan MB, Shumaker PR. Scar Management in the Pediatric and Adolescent Populations. Pediatrics 2016; 137:e20142065. [PMID: 26743819 DOI: 10.1542/peds.2014-2065] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 11/24/2022] Open
Abstract
For most children and adolescents who have developed symptomatic scars, cosmetic concerns are only a portion of the motivation that drives them and their caregivers to obtain treatment. In addition to the potential for cosmetic disfigurement, scars may be associated with a number of physical comorbidities including hypertrichosis, dyshidrosis, tenderness/pain, pruritus, dysesthesias, and functional impairments such as contractures, all of which may be compounded by psychosocial factors. Although a plethora of options for treating scars exists, specific management guidelines for the pediatric and adolescent populations do not, and evidence must be extrapolated from adult studies. New modalities such as the scar team approach, autologous fat transfer, and ablative fractional laser resurfacing suggest a promising future for children who suffer symptomatically from their scars. In this state-of-the-art review, we summarize cutting-edge scar treatment strategies as they relate to the pediatric and adolescent populations.
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Affiliation(s)
- Andrew C Krakowski
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California;
| | - Christine R Totri
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Matthias B Donelan
- Department of Plastic Surgery, Shriner's Hospital for Children, Boston, Massachusetts; and
| | - Peter R Shumaker
- Department of Dermatology, Naval Medical Center, San Diego, California
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Basnett A, Nguyen TA, Cannavino C, Krakowski AC. Ablative fractional laser resurfacing with topical paromomycin as adjunctive treatment for a recalcitrant cutaneous leishmaniasis wound. Lasers Surg Med 2015; 47:788-91. [DOI: 10.1002/lsm.22426] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Andrew Basnett
- Department of Dermatology; Naval Medical Center; San Diego California
| | - Tuyet A. Nguyen
- Division of Pediatric and Adolescent Dermatology; Rady Children's Hospital; San Diego California
- University of California San Diego School of Medicine; San Diego California
| | - Christopher Cannavino
- University of California San Diego School of Medicine; San Diego California
- Division of Pediatric Infectious Disease; Rady Children's Hospital; San Diego California
| | - Andrew C. Krakowski
- Division of Pediatric and Adolescent Dermatology; Rady Children's Hospital; San Diego California
- University of California San Diego School of Medicine; San Diego California
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Krakowski AC, Diaz L, Admani S, Uebelhoer NS, Shumaker PR. Healing of chronic wounds with adjunctive ablative fractional laser resurfacing in two pediatric patients. Lasers Surg Med 2015; 48:166-9. [DOI: 10.1002/lsm.22398] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Andrew C. Krakowski
- University of California; San Diego; La Jolla California
- Rady Children's Hospital; San Diego California
| | | | - Shehla Admani
- University of California; San Diego; La Jolla California
- Rady Children's Hospital; San Diego California
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