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Rutnin S, Yongpisarn T, Sakpuwadol N, Namasondhi A, Pomsoong C, Rattananukrom T, Thadanipon K. Efficacy and safety of 1064-nm fractional picosecond laser for the treatment of postmastectomy scars in transgender men: A randomized controlled trial. Lasers Surg Med 2024; 56:337-345. [PMID: 38436118 DOI: 10.1002/lsm.23775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/30/2024] [Accepted: 02/17/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES Subcutaneous mastectomy is a crucial component of gender affirmation therapy for transgender men (TM), but the scars that result from this procedure can frequently impair their quality of life. This study aimed to assess the efficacy and safety of 1064-nm fractional picosecond laser (FxPico) treatment for hypertrophic and atrophic postmastectomy scars in TM. METHODS Twenty-two patients with a total of 35 pairs of bilateral symmetric mastectomy scars were enrolled. One of each pair of symmetric scars was randomly assigned to receive four FxPico treatments at 4-week intervals. All scars were evaluated using the modified Vancouver Scar Scale (mVSS) and three-dimensional imaging for scar roughness, melanin index, and hemoglobin index before each treatment session and at 1, 3, and 6 months following the last treatment. Additionally, participant-rated scar satisfaction (PSS) and scar improvement (Global Assessment Score, GAS), as well as adverse events were recorded. RESULTS During the 6-month follow-up period after the end of laser treatment sessions, the treated scars showed significant reductions in the mVSS compared to the untreated controls (p < 0.001), whereas the melanin index and hemoglobin index were not significantly different. Subgroup analysis of hypertrophic scars demonstrated statistically significant reductions in mVSS at 1 (p = 0.003) and 3 months (p = 0.041) after the end of laser treatments. PSS was significantly higher on the laser-treated scars than the controls (p = 0.008), and a participant-rated GAS of 2.95 ± 0.65 was found. There were no serious adverse events reported. CONCLUSIONS 1064-nm FxPico could be utilized to treat mastectomy scars among TM, particularly the hypertrophic type.
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Affiliation(s)
- Suthinee Rutnin
- Division of Dermatology, Mahidol University, Bangkok, Thailand
| | | | | | | | | | | | - Kunlawat Thadanipon
- Division of Dermatology, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Mahidol University, Bangkok, Thailand
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Laryngozele: Machbarkeit transoraler Resektion per CO2-Laser-Inversionstechnik. Laryngorhinootologie 2024; 103:245-6. [PMID: 38565104 DOI: 10.1055/a-2165-8513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
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Kommentar zu „Laryngozele: Machbarkeit transoraler Resektion per CO2-Laser-Inversionstechnik“. Laryngorhinootologie 2024; 103:246-7. [PMID: 38565105 DOI: 10.1055/a-2165-8617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
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4
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Gómez C, Alberdi E. [Translated article] Fractional Laser for Ablative Resurfacing in Onychomycosis. Actas Dermosifiliogr 2024; 115:T221-T223. [PMID: 38224733 DOI: 10.1016/j.ad.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/30/2023] [Indexed: 01/17/2024] Open
Affiliation(s)
- C Gómez
- Instituto de Química Física Blas Cabrera, CSIC, Madrid, Spain.
| | - E Alberdi
- Clínica privada Dr. Alberdi, Madrid, Spain
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Olesen UH, Pedersen KK, Togsverd-Bo K, Biskup E, Nielsen AL, Jackerott M, Clergeaud G, Andresen TL, Haedersdal M. Laser-assisted topical delivery of vismodegib reduces hedgehog gene expression in human basal cell carcinomas in vivo. Lasers Surg Med 2024; 56:239-248. [PMID: 38311811 DOI: 10.1002/lsm.23766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND Systemically delivered hedgehog inhibitors including vismodegib and sonidegib are widely used to treat basal cell carcinomas (BCCs). Ablative fractional laser (AFL)-assisted topical delivery of vismodegib has been demonstrated in preclinical studies. The aim of this explorative clinical study was to evaluate intratumoral vismodegib concentrations and effect on hedgehog pathway gene expression following AFL-assisted topical vismodegib delivery to BCCs. METHODS In an open-label clinical trial, 16 nodular BCCs (in n = 9 patients) received one application of CO2 -AFL (40 mJ/microbeam, 10% density) followed by topical vismodegib emulsion. After 3-4 days, vismodegib concentrations in tumor biopsies (n = 15) and plasma were analyzed and compared with samples from patients receiving oral treatment (n = 3). GLI1, GLI2, PTCH1, and PTCH2 expression was determined by quantitative polymerase chain reaction (n = 7) and GLI1 additionally by in situ hybridization (n = 3). RESULTS Following AFL-assisted topical administration, vismodegib was detected in 14/15 BCCs and reached a median concentration of 6.2 µmol/L, which compared to concentrations in BCC tissue from patients receiving oral vismodegib (9.5 µmol/L, n = 3, p = 0.8588). Topical vismodegib reduced intratumoral GLI1 expression by 51%, GLI2 by 55%, PTCH1 and PTCH2 each by 73% (p ≤ 0.0304) regardless of vismodegib concentrations (p ≥ 0.3164). In situ hybridization demonstrated that GLI1 expression was restricted to tumor tissue and downregulated in response to vismodegib exposure. CONCLUSION A single AFL-assisted topical application of vismodegib resulted in clinically relevant intratumoral drug concentrations and significant reductions in hedgehog pathway gene expressions.
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Affiliation(s)
- Uffe H Olesen
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | | | - Katrine Togsverd-Bo
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | - Edyta Biskup
- Department of Pathology, Copenhagen University Hospital-Herlev, Herlev, Denmark
| | - Anni Linnet Nielsen
- Department of Oncology, Copenhagen University Hospital-Herlev, Herlev, Denmark
| | | | - Gael Clergeaud
- Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Thomas L Andresen
- Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
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Gómez C, Alberdi E. Fractional Laser for Ablative Resurfacing in Onychomycosis. Actas Dermosifiliogr 2024; 115:221-223. [PMID: 37852370 DOI: 10.1016/j.ad.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- C Gómez
- Instituto de Química Física Blas Cabrera, CSIC, Madrid, España.
| | - E Alberdi
- Clínica privada Dr. Alberdi, Madrid, España
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7
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Wang Z, Chen Y, Yang X, Pan B, Xie H, Bi H. Safety and Effectiveness of Laser or Intense Pulsed Light Treatment for Early Surgical Scar: A Systematic Review and Meta-analysis. Aesthetic Plast Surg 2024; 48:228-235. [PMID: 37620564 DOI: 10.1007/s00266-023-03590-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/19/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE We aimed to investigate the safety and efficacy of laser or intense pulsed light therapy for early treatment of surgical scar. METHODS A literature search was conducted for relevant prospective, randomized controlled trials published in PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang Database, and VTTMS between January 2006 and January 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used to extract literature data. The risk of bias was assessed by RevMan. Safety was assessed based on the presence of serious adverse reactions (blisters, infections, burns above the second degree), while effectiveness was assessed using the Vancouver Score Scale. RESULTS 1512 related articles were preliminarily retrieved, including 1211 English articles and 301 Chinese articles. According to the inclusion criteria and exclusion criteria, 12 articles were selected for this analysis. In total, 475 patients were included (laser group, 238; control group, 236). All studies confirmed that the laser group was superior to the control group. In the subgroup analysis of 7 articles, the standardized mean difference was 1.99 (P = 0.0001). CONCLUSIONS This meta-analysis demonstrates that laser or intense pulsed light therapy is a safe and effective approach for early surgical scar treatment, resulting in improved scar appearance and minimal adverse reactions. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- ZheHui Wang
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - YuJie Chen
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xin Yang
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - BaiLin Pan
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - HongBin Xie
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
| | - HongSen Bi
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
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Menashe S, Heller L. Striae distensae treatment: evaluating laser efficacy and safety. Int J Dermatol 2024; 63:46-50. [PMID: 37971397 DOI: 10.1111/ijd.16914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/30/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Striae distensae (SD) are common skin lesions that are difficult to treat and affect quality of life. Laser and light are emerging non-invasive therapies that have proven successful in treating SD. Recently, hybrid laser devices offering simultaneous fractional ablative and non-ablative laser treatment have been reported to benefit various skin conditions. OBJECTIVE To evaluate the improvement of SD treated with a hybrid laser system and to analyze associations with patient characteristics. METHODS We performed a retrospective study in which 28 adults with SD were treated with a hybrid laser device. Efficacy was evaluated by the assessment of aesthetic improvement by the Global Aesthetic Improvement Scale (GAIS) of 1-10 and by patients' satisfaction using a scale of 0-10 satisfaction scale. Pain and adverse events were monitored. Statistical analysis was used to examine the potential impact of various factors on treatment outcomes. RESULTS The mean GAIS score was 7.36 ± 1.06 with a positive correlation with patient satisfaction (r = 0.685) and a weak negative correlation with patient age (r = -0.0057). Skin type and body area did not show significant associations with GAIS scores (P > 0.05 for both). No adverse events were observed. CONCLUSION This study demonstrates the potential of the hybrid laser system as a safe and effective method to achieve satisfactory aesthetic results with minimal downtime, making it a promising treatment approach for SD. Treatment outcomes were independent of patient characteristics, further supporting its widespread use.
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Affiliation(s)
- Shaked Menashe
- The Department of Adult and Pediatric Plastic, Aesthetic and Reconstructive Surgery at the Shamir Medical Center, Be'er Ya'akov, Israel
| | - Lior Heller
- The Department of Adult and Pediatric Plastic, Aesthetic and Reconstructive Surgery at the Shamir Medical Center, Be'er Ya'akov, Israel
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Winkie MJ, Sakunchotpanit G, Salazar CE, Gunasekera NS, Buzney EA, Nambudiri VE. A focused review of visible light therapies for vitiligo. Photodermatol Photoimmunol Photomed 2024; 40:e12939. [PMID: 38084061 DOI: 10.1111/phpp.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/16/2023] [Accepted: 11/28/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Vitiligo can be challenging to treat and exhibit an unpredictable clinical course. Phototherapy in the form of visible light can achieve both repigmentation and depigmentation outcomes in vitiligo, with minimal associated adverse events. This review focuses on the mechanistic understandings and clinical outcomes of visible light-based treatments for vitiligo. METHODS Articles were retrieved from PubMed starting from May 1965 until August 2023, yielding 496 unique articles. We conducted title, abstract, and full-text screening to identify articles describing the use of visible light (380-750 nm), either as part of combination therapy or as monotherapy, for repigmentation or depigmentation treatment in vitiligo. RESULTS Twenty-seven articles met inclusion criteria, offering preclinical and clinical data regarding the utilization of helium-neon laser (red light) and blue light-emitting diodes (LEDs) as methods of repigmentation therapy in vitiligo. Preclinical and clinical data on the utilization of Q-switched ruby laser (694 nm) and frequency-doubled (FD) Nd:YAG laser (532 nm) for vitiligo depigmentation therapy were also identified. CONCLUSION While limited by small studies and a lack of standardized administration of phototherapy, the evidence for visible light's effectiveness in managing vitiligo is encouraging. Red light therapy using He-Ne lasers and blue light therapy via LEDs can stimulate repigmentation in patients with vitiligo with minimal adverse events. Q-switched ruby and FD Nd:YAG lasers provide viable, visible light depigmentation options, either alone or with topical agents. With limited clinical data, larger studies are needed to validate the efficacy of visible light therapy in treating vitiligo and to better understand its long-term outcomes.
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Affiliation(s)
- Mitchell J Winkie
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Goranit Sakunchotpanit
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Carlos E Salazar
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Nicole S Gunasekera
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth A Buzney
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Li FG, Abbott JA. 'Vaginal Laser Therapy for GSM/VVA: Where We Stand Now - A Review by the EUGA Working Group on Laser'. Climacteric 2023; 26:638. [PMID: 37782251 DOI: 10.1080/13697137.2023.2259791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023]
Affiliation(s)
- F G Li
- School of Clinical Medicine (Women's Health), UNSW Sydney, Sydney, New South Wales, Australia
- Gynaecological Research and Clinical Evaluation (GRACE) Unit, Sydney, New South Wales, Australia
| | - J A Abbott
- School of Clinical Medicine (Women's Health), UNSW Sydney, Sydney, New South Wales, Australia
- Gynaecological Research and Clinical Evaluation (GRACE) Unit, Sydney, New South Wales, Australia
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Ponomarev IV, Topchiy SB, Shakina LD. Successful treatment of Xanthelasma palpebrarum with copper vapor laser radiation at 578 nm. J Cosmet Dermatol 2023; 22:3522-3523. [PMID: 37352454 DOI: 10.1111/jocd.15880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/23/2023] [Accepted: 06/11/2023] [Indexed: 06/25/2023]
Affiliation(s)
- Igor V Ponomarev
- PN Lebedev Physical Institute of the Russian Academy of Sciences, Moscow, Russia
| | - Sergey B Topchiy
- PN Lebedev Physical Institute of the Russian Academy of Sciences, Moscow, Russia
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Yılmaz FÇ, Açık M, Çağıran F. Comparison between laser and transobturator tape therapy in the treatment of stress urinary incontinence and role of overweight in treatment: a prospective observational study. Int Urogynecol J 2023; 34:2901-2908. [PMID: 37555966 DOI: 10.1007/s00192-023-05625-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/07/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) is treated with transobturator tape (TOT) sling procedures, but problems arise with artificial mesh in certain instances. Hence, non-invasive laser therapy may be useful under such circumstances. The current study was aimed at comparing the effects of these two treatments and at checking their applicability in various body mass index (BMI) groups. METHODS Seventy-nine patients, who were clinically diagnosed with SUI, were divided into two groups, those who preferred TOT and those who preferred the transvaginal fractional micro-ablative CO2 laser system. The SUI symptoms and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) scores of the patients were determined before and at the 12th month after the treatment. General linear model, Stuart-Maxwell, and Bonferroni correction for pairwise comparison analyses were performed to compare the efficacy of the treatment type. RESULTS The ICIQ-SF score decreased by 56.8% for laser therapy and 43.5% for TOT therapy (mean ± SE = 5.97 ± 0.16 and 5.09 ± 0.14 respectively). Laser therapy had a better effect on ICIQ-SF than TOT therapy (η2p: 0.176, ptime*group < 0.001). Regardless of the types of treatment, the ICIQ-SF scores of healthy-weight participants decreased more than those of overweight participants (η2p:0.050, ptime*group = 0.045). In the TOT group, healthy-weight participants were more than twice as likely to recover fully from SUI symptoms as overweight participants, 1 year after the treatment. In the laser group, the majority of healthy-weight participants (88.8%) did not report any SUI symptoms after the treatment. CONCLUSIONS The efficacy of laser therapy for urinary incontinence was confirmed. Furthermore, it was observed that being overweight may be a risk factor for the failure of laser therapy.
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Affiliation(s)
- Feray Çağıran Yılmaz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Dicle University, Diyarbakır, Turkey
| | - Murat Açık
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Firat University, Elazig, Turkey.
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Geisler AN, Eber A, Kim K, Arndt KA. Lasers for the treatment of eyebrow microblading and cosmetic tattoo pigment: a review of the literature. Lasers Med Sci 2023; 38:256. [PMID: 37932517 DOI: 10.1007/s10103-023-03921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
We aim to discuss the use of laser for the treatment of eyebrow microblading and cosmetic tattoo complications through a review of the literature. Our research question is whether quality-switched or picosecond laser is superior for the removal of eyebrow tattoos. This structured review was conducted using a PubMed search using the search terms "laser tattoo removal" AND "cosmetic tattoo" AND "eyebrow" with the article type filtered to "case reports," "clinical trial," and "randomized controlled trial" ranging from dates 1994-2023. All case reports or series evaluating the effect of laser on eyebrow cosmetic tattooing pigment were included. We summarize the results of 11 studies evaluating the use of laser for cosmetic tattoo removal, with 129 patients treated specifically for eyebrow pigment. Most studies (8/11) report Fitzpatrick skin type or race. Seven studies utilize quality-switched (QS) neodymium-doped yttrium aluminum garnet (Nd:YAG), alexandrite or ruby, three used picosecond (PS) Nd:YAG or alexandrite, and three used carbon dioxide (CO2) laser. We report laser energy, spot size, and pulse duration, as well as treatment outcomes and adverse events. Historically, methods of pigment removal included dermabrasion, cryosurgery, electrosurgery, radiofrequency, infrared light, intense pulsed light, and surgical excision; however, these methods often led to poor cosmetic outcomes including scarring and further dyspigmentation. QS laser treatments provided superior cosmetic outcomes and thus were considered the gold standard treatment option for pigment removal. However, the advent of PS lasers has challenged this given their increased selectivity, lower fluence requirements, and reduction in surrounding thermal damage. Our review demonstrates that PS Nd:YAG is quicker and more effective that QS Nd:YAG in the treatment of eyebrow tattoos. Additionally, the paradoxical darkening seen with QS lasers is less common with PS lasers. We also demonstrate that CO2 laser may be a helpful adjunct to QS or PS laser. This review focuses on Fitzpatrick skin type and race, providing a unique perspective on the use of laser treatment in skin of color, which often poses an additional treatment challenge.
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Affiliation(s)
- Amaris N Geisler
- Department of Dermatology, Emory University, 1525 Clifton Road NE, 3rd Floor, Atlanta, GA, 30322, USA.
| | | | - Karen Kim
- Skin Care Physicians, Boston, MA, USA
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Duplechain JK. Ablative Laser Therapy of Skin. Facial Plast Surg Clin North Am 2023; 31:463-473. [PMID: 37806680 DOI: 10.1016/j.fsc.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Laser skin rejuvenation was introduced in the mid-1990s. Early ablative laser devices relied on scanner technology that provided significant ablation and longer time on tissue treatments. These early treatments provided significant improvement in the appearance of the skin, but because of the longer treatment times and in some cases excessive treatment, complications such as scarring and hypopigmentation were significant. More recent advances in skin resurfacing technology have now minimized these risks providing certain key principles are observed. These parameters are reviewed in detail to improve the reader's ability to propose and execute proper skin resurfacing treatments.
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Affiliation(s)
- J Kevin Duplechain
- Division of Facial Plastic Surgery, Department of Otolaryngology, Tulane Medical School, 1103 Kaliste Saloom Road, Suite 300, Lafayette, 70508, LA, USA.
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Piulachs I, Giner-Tarrida L, España-Tost A, Arnabat-Dominguez J, Florian C. In vitro comparative study between adhesion forces obtained on zirconia ceramic micromechanically treated with femtosecond laser (1027 nm), carbon dioxide laser (10,600 nm), and aluminum-oxide particles. Lasers Med Sci 2023; 38:194. [PMID: 37626207 DOI: 10.1007/s10103-023-03859-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Conventional surface roughening treatments used for silica-based ceramics in order to improve subsequent adhesion become unreliable for zirconia ceramics. Laser conditioning can be a good alternative. The purpose of this in vitro study was to compare conventional (macro) shear bond strength (SBS) values obtained between resin composite and zirconium oxide ceramic samples grouped according to different micromechanical treatments received, and examine differences in surface roughness. One-hundred and fifty disks of sintered zirconia were randomly divided into 5 groups and roughened as follows: (1) Group NOT, no surface treatment; (2) Group APA, abraded with 50-μm aluminum-oxide (Al2O3) particles; (3) Group TBS, abraded with 30-μm aluminum-oxide particles covered with silica; (4) Group CO2, irradiated with a CO2 laser which emitted in continuous wave mode at 3 W of power; and (5) Group FEM, irradiated with a pulsed femtosecond laser, with an incident energy of 10 μJ, a frequency of 1000 Hz, and a fluence of 1.3 kJ/cm2. All surfaces were treated with a MDP-containing adhesive/silane coupling agent mixture upon which were prepared and light polymerized composite resin cylinders. Shear bond strength was measured and samples were observed by scanning electron microscopy (SEM). Statistically significant differences (p < 0.05) were found among all groups, except between CO2 and FEM, which showed the highest adhesion values (15.12 ± 2.35 MPa and 16.03 ± 2.73 MPa). SEM revealed differences in surface patterns. CO2 laser irradiation can be an alternative to sandblasting, although it could also weaken the ceramic. Suitable surface patterns on zirconia ceramics can be obtained with ultrashort pulsed radiation emitted by a pulsed femtosecond laser.
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Affiliation(s)
- Ignasi Piulachs
- Department of Prosthetic Dentistry, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
| | - Luis Giner-Tarrida
- Department of Prosthetic Dentistry, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Antoni España-Tost
- Department of Oral Surgery, Universitat de Barcelona (UB), Barcelona, Spain
| | | | - Camilo Florian
- Department of Applied Physics, Universitat de Barcelona (UB), Barcelona, Spain
- Instituto de Óptica Daza de Valdés, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
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Salvatore S, Ruffolo AF, Phillips C, Athanasiou S, Cardozo L, Serati M. Vaginal laser therapy for GSM/VVA: where we stand now - a review by the EUGA Working Group on Laser. Climacteric 2023; 26:336-352. [PMID: 37395104 DOI: 10.1080/13697137.2023.2225766] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/09/2023] [Accepted: 07/12/2023] [Indexed: 07/04/2023]
Abstract
Vulvovaginal atrophy (VVA) is a chronic progressive condition that involves the genital and lower urinary tracts, related to the decrease of serum estrogenic levels when menopause occurs. The definition of genitourinary syndrome of menopause (GSM) is a medically more accurate, all-encompassing and publicly acceptable term than VVA. Due to the chronic progressive trend of GSM, symptoms tend to reappear after the cessation of therapy, and frequently long-term treatment is required. First-line therapies include vulvar and vaginal lubricant or moisturizers, and, in the case of failure, low-dose vaginal estrogens are the preferred pharmacological therapy. Populations of patients, such as breast cancer (BC) survivors, are affected by iatrogenic GSM symptoms with concerns about the use of hormonal therapies. The non-ablative erbium:YAG laser and the fractional microablative CO2 vaginal laser are the two main lasers evaluated for GSM treatment. The aim of this comprehensive review is to report the efficacy and safety of Er:YAG and CO2 vaginal lasers for GSM treatment. Vaginal laser therapy has been demonstrated to be effective in restoring vaginal health, improving VVA symptoms and sexual function. The data suggest that both Er:YAG and CO2 vaginal lasers are safe energy-based therapeutic options for management of VVA and/or GSM symptoms in postmenopausal women and BC survivors.
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Affiliation(s)
- S Salvatore
- Obstetrics and Gynaecology Department, IRRCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - A F Ruffolo
- Obstetrics and Gynaecology Department, IRRCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - C Phillips
- Department of Obstetrics and Gynecology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - S Athanasiou
- First Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, 'Alexandra' General Hospital, Athens, Greece
| | - L Cardozo
- Department of Urogynaecology, King's College Hospital, London, UK
| | - M Serati
- Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy
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Barbero M, Villasco A, Villa M, Badellino E, Marello E, Botta G. Conjugate treatment with high concentration normobaric oxygen and hyaluronic acid for vaginal atrophy: a prospective study. Eur Rev Med Pharmacol Sci 2023; 27:2011-2017. [PMID: 36930500 DOI: 10.26355/eurrev_202303_31567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Vulvovaginal atrophy is a condition closely related to low circulating estrogen levels, with post-menopause being the main cause. However, patients of childbearing age may also present with these symptoms due to treatments that reduce estrogen production. Local estrogen therapy is the causal treatment of local symptoms, but it is not always accepted and is often abandoned by patients. In recent years, alternative therapies have been proposed: fractional CO2 laser or the conjugate treatment with normobaric oxygen and hyaluronic acid, the latter being the subject of this study. The study aimed to evaluate the effectiveness of conjugate topical treatment with normobaric oxygen and hyaluronic acid. PATIENTS AND METHODS 50 patients were evaluated and treated with 5 applications of 15 minutes each, every 15 days, with Caressflow®. All patients presented at least one of the symptoms related to vulvovaginal atrophy: dryness, burning, and dyspareunia. In all cases, vulvoscopy, colposcopy, and cervicovaginal cytology were performed. The patients were interviewed with an analogic scale (VAS) concerning the severity of symptoms before and after the treatment. Colposcopy and PAP-smear were assessed by mean of Vaginal Health Index Score (VHI) at baseline and at the end of the treatment. RESULTS All patients completed the treatment scheme and presented with a significant improvement in subjective symptoms. The colposcopy and PAP-smear performed 10 days after the end of the last treatment showed a significant improvement in the appearance and elasticity of the vaginal epithelium and the cytological picture, which showed, in the sample taken after treatment, hyaluronic acid vesicles within the cell cytoplasm. CONCLUSIONS This study corroborates the data presented in the latest published papers on the effectiveness of treatment with normobaric O2 and hyaluronic acid on vaginal atrophy. Efficacy has been confirmed both in terms of subjective symptoms reported by the patients and objective improvement at colposcopy and PAP-smear cytology.
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Affiliation(s)
- M Barbero
- Obstetrics and Gynaecology Complex Unit, Cardinal Massaia Hospital, ASL AT, Asti, Italy.
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Huang W, Cao S, Xie L, Li X, Meng Z, Yu X, Huang D, Chen R, Liang X. Efficacy and safety of super pulse CO2 laser-assisted punctoplasty with canalicular curettage in primary canaliculitis. Lasers Med Sci 2023; 38:75. [PMID: 36807698 PMCID: PMC9938812 DOI: 10.1007/s10103-023-03735-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/05/2023] [Indexed: 02/21/2023]
Abstract
The objective of this study was to evaluate the efficacy and safety of super pulse CO2 laser-assisted punctoplasty with canalicular curettage in primary canaliculitis. In this retrospective serial case study, the clinical data of 26 patients who underwent super pulse CO2 laser-assisted punctoplasty for the treatment of canaliculitis were collected from January 2020 to May 2022. The clinical presentation, intraoperative and microbiologic findings, surgical pain severity, postoperative outcome, and complications were studied. Of the 26 patients, most were females (female:male 20:6), with a mean age of 60.1 ± 16.1 years (range, 19-93). Mucopurulent discharge (96.2%), eyelid redness and swelling (53.8%), and epiphora (38.5%) were the most common presentations. During the surgery, concretions were present in 73.1% (19/26) of the patients. The surgical pain severity scores ranged from 1 to 5, according to the visual analog scale, with a mean score of 3.2 ± 0.8. This procedure resulted in complete resolution in 22 (84.6%) patients and significant improvement in 2 (7.7%) patients, and 2 (7.7%) patients required additional lacrimal surgery with a mean follow-up time of 10.9 ± 3.7 months. The surgical procedure of super pulse CO2 laser-assisted punctoplasty followed by curettage appears to be a safe, effective, minimally invasive, and well-tolerated treatment for primary canaliculitis.
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Affiliation(s)
- Weifeng Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Shujuan Cao
- Ophthalmologic Center, Affiliated Kashi Hospital of Sun Yat-sen University, First People's Hospital of Kashi Prefecture, Kashi, 844000, China
| | - Lingling Xie
- Ophthalmologic Center, Affiliated Kashi Hospital of Sun Yat-sen University, First People's Hospital of Kashi Prefecture, Kashi, 844000, China
| | - Xingyi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Ziwei Meng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Xinyue Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Danping Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Rongxin Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Xuanwei Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
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Lei Y, Tan J, Ouyang HW, Liu XJ, Yu YL. [Effects of composite laser technique combined with multipoint microinjection of triamcinolone acetonide in the treatment of hypertrophic scars in burn children]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2022; 38:810-815. [PMID: 36177584 DOI: 10.3760/cma.j.cn501225-20220519-00192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To explore the effects of pulsed dye laser (PDL) and ultra-pulsed fractional carbon dioxide laser (UFCL) combined with multipoint microinjection of triamcinolone acetonide in the treatment of red hypertrophic scar at early stage in burn children. Methods: A retrospective cohort before-after control study in the same patients was conducted. From February 2019 to December 2020, a total of 67 burn children who met the inclusion criteria (32 males and 35 females, aged 1 to 12 years) with red hyperplastic scar at early stage, were treated in Hunan Provincial People's Hospital (1st Affiliated Hospital of Hunan Normal University). All the children were treated with composite laser technique (PDL and UFCL) combined with triamcinolone acetonide (hereinafter referred to as combined treatment). After 2 months, they received the second combined treatment. Before the first combined treatment and 6 months after the last combined treatment, the scar of children was evaluated with the patient and observer scar assessment scale (POSAS) by physicians and family members. Six months after the last combined treatment, the satisfaction of the patients' family members with the efficacy was recorded and the overall satisfaction rate was calculated. Adverse reactions were recorded throughout the treatment process. Data were statistically analyzed with paired sample t test. Results: Six months after the last combined treatment, the POSAS scores of children on the thickness, blood vessels distribution, color, surface roughness, texture, scope, and overall evaluation of scar evaluated by the physicians, and the POSAS scores of children on the color, degree of pain, degree of itching, hardness, thickness, shape and size, and overall evaluation of scar evaluated by the family members were significantly lower than those before the first combined treatment (with t values of 17.32, 16.73, 15.00, 14.91, 19.62, 28.74, 29.83, 17.43, 20.52, 29.01, 28.82, 24.91, 20.30, and 42.13, respectively, P<0.01). Six months after the last combined treatment, 62 (93%), 3 (4%), and 2 (3%) children's family members were very satisfied, satisfied, and relatively satisfied with the treatment effect, respectively, and the overall satisfaction rate was 97% (65/67). Six months after the last combined treatment, no scar thickening or infection occurred in all the wounds of children. Conclusions: Composite laser technique combined with multipoint microinjection of triamcinolone acetonide in the treatment of red hypertrophic scar at early stage in burn children can improve the appearance and texture of scar, reduce scar pain and pruritus, with high satisfaction of children's family members to the treatment effect and less adverse reactions.
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Affiliation(s)
- Y Lei
- (1st Affiliated Hospital of Hunan Normal University), Changsha 410005, China
| | - J Tan
- (1st Affiliated Hospital of Hunan Normal University), Changsha 410005, China
| | - H W Ouyang
- (1st Affiliated Hospital of Hunan Normal University), Changsha 410005, China
| | - X J Liu
- (1st Affiliated Hospital of Hunan Normal University), Changsha 410005, China
| | - Y L Yu
- (1st Affiliated Hospital of Hunan Normal University), Changsha 410005, China
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Abstract
OBJECTIVES Although carbon dioxide laser vaporization is frequently used for treating vaginal intraepithelial neoplasia (VaIN), the optimal depth of epithelial destruction with laser vaporization requires elucidation. We aimed to evaluate VaIN depth and better illustrate epithelial destruction during laser vaporization. MATERIALS AND METHODS We included 246 women diagnosed with VaIN (low-grade VaIN [VaIN 1], 123 women; high-grade VaIN [VaIN 2/3], 123 women) using colposcopy-directed biopsy at our hospital from January 1, 2019, to April 30, 2020. The thickness of the noninvolved epithelium, if available, was determined. All available data, including cytology and histological information, were recorded. The t test and Pearson χ 2 test were used for statistical analysis. Statistical significance was set at p < .05. RESULTS The involved epithelial thicknesses in VaIN 2/3 and VaIN 1 were 0.41 ± 0.21 and 0.40 ± 0.19 mm, respectively, which were both greater than their noninvolved epithelial thickness values (0.17 ± 0.10 and 0.17 ± 0.08 mm, p < .01 and p < .01, respectively). In subgroup comparisons between the VaIN 2/3 and VaIN 1 groups, the involved epithelial thickness did not differ between premenopausal patients, postmenopausal women receiving estrogen, and postmenopausal women who did not receive estrogen ( p > .05). In the VaIN 2/3 group, the lesion thickness in premenopausal was greater than that in postmenopausal women receiving estrogen ( p = .016) and those who were not receiving estrogen ( p = .017). CONCLUSIONS The thickness of VaIN is generally less than 1 mm for women of all ages, except in rare cases of visible lesions with papillary hyperplasia.
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Affiliation(s)
- Can Cui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yaoxing Xiao
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - E. Lin
- Translational Oncology & Urology Research (TOUR) Team, School of Cancer and Pharmaceutical Studies, King’s College London, London, United Kingdom
| | - Lingxiao Luo
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaoyi Sun
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jianping Zeng
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Xiang Tao
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Qing Cong
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
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Chen SX, Cheng J, Watchmaker J, Dover JS, Chung HJ. Review of Lasers and Energy-Based Devices for Skin Rejuvenation and Scar Treatment With Histologic Correlations. Dermatol Surg 2022; 48:441-448. [PMID: 35165220 DOI: 10.1097/dss.0000000000003397] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lasers and energy-based devices (EBD) are popular treatments for skin rejuvenation and resurfacing. Achieving desired outcomes and avoiding complications require understanding the effects of these devices at a histologic level. Currently, no comprehensive review summarizing the histologic effects of laser and energy-based treatments exists. OBJECTIVE To describe how lasers and EBD alter skin histology and improve the overall understanding of these devices. MATERIALS AND METHODS A PubMed search was conducted for studies with histologic analysis of fractional picosecond laser, fractional radiofrequency microneedling, nonablative lasers, and ablative lasers. RESULTS Fractional picosecond lasers induce intraepidermal and/or dermal vacuoles from laser-induced optical breakdown. Fractional radiofrequency microneedling delivers thermal energy to the dermis while sparing the epidermis, making it safer for patients with darker skin phototypes. Fractional nonablative lasers induce conical zones of coagulation of the epidermis and upper dermis. Ablative lasers vaporize the stratum corneum down to the dermis. Traditional ablative lasers cause diffuse vaporization while fractional ablative lasers generate columns of tissue ablation. CONCLUSION Lasers and EBD are effective for skin resurfacing and rejuvenation and have different mechanisms with disparate targets in the skin. Safe and effective use of devices requires understanding the histologic laser-tissue interaction.
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Affiliation(s)
- Stella X Chen
- Harvard Combined Dermatology Residency Program, Boston, Massachusetts
| | - Judy Cheng
- Department of Dermatology, Northwestern Medical Group, Chicago, Illinois
| | | | - Jeffrey S Dover
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Hye Jin Chung
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Affiliation(s)
- Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York
| | - Nkemjika Ugonabo
- The Ronald O Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York, New York
- The Ronald O Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
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23
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Kent RA, Bayomi M, Magnino MZ, DeKlotz CMC. Fractional CO2 Laser Treatment of Sclerodermoid Connective Tissue Disease: A Report of 2 Patients. J Clin Rheumatol 2021; 27:S751-S752. [PMID: 33843778 DOI: 10.1097/rhu.0000000000001516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Rhett A Kent
- From the Georgetown University Hospital/Washington Hospital Center, Washington, DC
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Friedman P, Chapas A, Kilmer S, Rahman Z, Roberts W, Ross E, Waibel J, Dover J. Optimizing Outcomes With the 1550/1927 nm Dual Wavelength Non-Ablative Fractional Laser: Experienced User Recommendations. J Drugs Dermatol 2021; 20:1150-1157. [PMID: 34784135 DOI: 10.36849/jdd.6181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fractional laser treatment was introduced in 2004 as a non-invasive technique to treat sun-damaged and aging skin. Since then, numerous ablative and non-ablative photothermolysis technologies and devices have been introduced, increasing the options for clinicians and patients but also increasing the complexity regarding which system to use and the techniques to optimize outcomes. No two devices are the same and the user-manuals preset dosimetry does not address many clinical situations, which can create confusion for new and inexperienced users. METHODS An online survey addressing use of a 1550 nm /1927 nm dual wavelength, non-ablative, fractional laser was sent to eight (8) US board certified dermatologists with extensive experience in the use of the device. The survey included 39 questions, addressing experience, best practices and recommendations for use. RESULTS The survey data suggests that the device can be used to treat patients of all ages and skin types for indications including photoaging and photodamage, periorbital wrinkles, freckles, (ephelides), solar lentigines, poikiloderma, scarring due to acne or surgery. It can be used on both facial and non-facial areas, including neck, chest, hands, arms, abdomen, legs, and buttocks. Unexpected and adverse effects were rarely reported and those that did were mild and transient. CONCLUSIONS This position paper provides practical real-world guidelines resulting from a small survey of experienced users, for new and early uses of the novel 1550 nm /1927 nm dual wavelength, non-ablative, fractional laser. J Drugs Dermatol. 2021;20(11):1150-1157. doi:10.36849/JDD.6181.
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Abstract
As the resolution of 3D printing techniques improves, the possibility of individualized, 3-ossicle constructions adds a new dimension to middle ear prostheses. In order to optimize these designs, it is essential to understand how the ossicles and ligaments work together to transmit sound, and thus how ligaments should be replicated in a middle ear reconstruction. The middle ear ligaments are thought to play a significant role in maintaining the position of the ossicles and constraining axis of rotation. Paradoxically, investigations of the role of ligaments to date have shown very little impact on middle ear sound transmission. We explored the role of the two attachments in the gerbil middle ear analogous to human ligaments, the posterior incudal ligament and the anterior mallear process, severing both attachments and measuring change in hearing sensitivity. The impact of severing the attachments on the position of the ossicular chain was visualized using synchrotron microtomography imaging of the middle ear. In contrast to previous studies, a threshold change on the order of 20 dB across a wide range of frequencies was found when both ligaments were severed. Concomitantly, a shift in position of the ossicles was observed from the x-ray imaging and 3D renderings of the ossicular chain. These findings contrast with previous studies, demonstrating that these ligaments play a significant role in the transmission of sound through the middle ear. It appears that both mallear and incudal ligaments must be severed in order to impair sound transmission. The results of this study have significance for middle ear reconstructive surgery and the design of 3D-printed three-ossicle biocompatible prostheses.
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Affiliation(s)
- Eileen Y. Brister
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Speech, Language, and Hearing Sciences, Indiana University, Bloomington, Indiana, United States of America
| | - Robert H. Withnell
- Department of Speech, Language, and Hearing Sciences, Indiana University, Bloomington, Indiana, United States of America
| | - Pavel Shevchenko
- Advanced Photon Source, Argonne National Lab, Lemont, Illinois, United States of America
| | - Claus-Peter Richter
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States of America
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, United States of America
- The Hugh Knowles Center, Northwestern University, Evanston, Illinois, United States of America
- * E-mail:
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Kasraei S, Kasraei P, Valizadeh S, Azarsina M. Rehardening of Eroded Enamel with CPP-ACFP Paste and CO 2 Laser Treatment. Biomed Res Int 2021; 2021:3304553. [PMID: 34337003 PMCID: PMC8298158 DOI: 10.1155/2021/3304553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/04/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diet and lifestyle can destroy tooth structure due to the dissolution of enamel by acidic beverages. The present study evaluated the effect of CO2 laser irradiation and CPP-ACFP (casein phosphopeptide and amorphous calcium phosphate with fluoride) paste on the remineralization of enamel eroded by carbonated soft drinks. METHODS In the present in vitro study, 46 human sound premolar teeth were sectioned mesiodistally to achieve 84 samples. Fourteen samples were assigned to the positive control group (G1), and the remaining samples were immersed in 500 mL of cola drink for 2 minutes, followed by rinsing with distilled water for 10 seconds. This procedure was carried out three times to create erosive lesions. Then, the 60 eroded samples were randomly assigned to five groups of G2 to G6 in terms of the treatment as follows: negative control (G2), CO2 laser irradiation (G3), CPP-ACFP paste (G4), CO2 laser irradiation followed by CPP-ACFP paste application (G5), and CPP-ACFP paste application followed by CO2 laser irradiation (G6). The mean surface microhardness of the enamel surface was evaluated and determined at three points for each sample. Data were analyzed with one-way ANOVA and Tukey HSD tests (α = 0.05). RESULTS The highest and the lowest hardness values were recorded in the G1 (314 ± 12 kg/mm2) and G2 (213.7 ± 12 kg/mm2) groups, respectively. ANOVA revealed significant differences between the study groups (P < 0.001). Two-by-two comparisons showed significant differences between the G2 group and the other groups, indicating the efficacy of all the treatment modalities in tooth remineralization and rehardening procedures (P < 0.05). Only in group G6, the enamel microhardness was not significantly different from the G1 positive control group (P > 0.05). CONCLUSION Considering the parameters used in the present study, CO2 laser irradiation or CPP-ACFP paste application alone increased eroded enamel's surface hardness; however, their sequential application was more effective in rehardening the eroded enamel's surface to near-normal levels.
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Affiliation(s)
- Shahin Kasraei
- Department of Restorative Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sara Valizadeh
- Dental Research Center, Dentistry Research Institute, Restorative Dentistry Department, Dental School, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Azarsina
- Department of Operative Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sarmento ACA, Fernandes FS, Costa APF, Medeiros KS, Crispim JC, Gonçalves AK. Microablative fractional radiofrequency for the genitourinary syndrome of menopause: protocol of randomised controlled trial. BMJ Open 2021; 11:e046372. [PMID: 34226218 PMCID: PMC8258553 DOI: 10.1136/bmjopen-2020-046372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve. These changes have consequences: vaginal dryness, dyspareunia, discomfort, burning and irritation, vulvovaginal pruritus, dysuria and increased frequency of genitourinary infections. The therapy more suitable for vaginal symptoms in postmenopause yet is the use of a topical hormone. However, the prescription of topical oestrogens should also be avoided in women with a history of breast cancer, oestrogen-sensitive tumours and thromboembolism, emphasising the necessity of alternative treatments. Recently, physical methods, such as laser and radiofrequency (RF), in their non-ablative, ablative and microablative forms have been used in the vaginal mucosa to promote neocolagenesis and neoelastogenesis. This randomised study aims to compare the efficiency of microablative fractional RF (MAFRF) treatment with vaginal oestrogens and no treatment. METHODS AND ANALYSES This randomised, controlled clinical intervention trial with an open label design comparing the treatment of MAFRF with vaginal oestrogens and no treatment. Four important moments were considered to evaluate treatment results (T0, T1, T2 and T3). The primary outcome includes vulvovaginal atrophy (vaginal pain, burning, itching, dryness, dyspareunia and dysuria), and the secondary outcomes will be sexual function, vaginal health (epithelial integrity, vaginal elasticity, moisture, fluid volume and vaginal pH) and quality of life. ETHICS AND DISSEMINATION Due to the nature of the study, we obtained approval from the ethics committee. All participants must sign an informed consent form before randomisation. The results of this study will be published in peer-reviewed journals. The data collected will also be available in a public repository of data. TRIAL REGISTRATION NUMBER RBR-94DX93.
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Affiliation(s)
| | - Fabíola S Fernandes
- Department of Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Kleyton Santos Medeiros
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Janaina Cristina Crispim
- Department of Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana Katherine Gonçalves
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Obstetrics and Gynaecology, Federal University of Rio Grande do Norte, Natal, Brazil
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Brody HJ. Commentary on Preparation for Photodynamic Therapy, Chemexfoliation, and Ablative Laser Resurfacing: a Systematic Literature Review. Dermatol Surg 2021; 47:942-943. [PMID: 34127615 DOI: 10.1097/dss.0000000000003130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Harold J Brody
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
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Chung JH, Kim KJ, Park DJ, Ji YH, Yoon ES, Park SH. Early Treatment Effects of Nonablative Fractional Lasers (NAFL) on Hypertrophic Scars in an Animal Model. Lasers Surg Med 2021; 53:537-548. [PMID: 33053210 DOI: 10.1002/lsm.23334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Recently, there have been several attempts to apply the laser therapy to hypertrophic scars (HTS). In particular, the fractional laser is in the spotlight for its usefulness in rapid wound healing and dermal remodeling. However, most previous studies have focused on the ablative fractional laser (AFL), and there are no studies on the mechanism of the nonablative fractional laser (NAFL) effect in HTS treatment. In this study, we aimed to evaluate the changes in histology and molecular chemistry to provide scientific evidence for the early treatment of HTS with NAFL. STUDY DESIGN/MATERIALS AND METHODS A total of 40 hypertrophic burn scars were made on the abdomens of two female pigs. After epithelialization, the HTS were randomly subdivided into four groups-control, AFL, NAFL (low energy), and NAFL (high energy). Laser treatment was initiated 1 week after the crust fell and the epithelium became covered, and it was repeated for six sessions over an interval of 2 weeks. Five excisional biopsies were obtained for histologic analysis and biomarker assessment. RESULTS Histologically, dermal remodeling with thin coil-shaped collagen fibers was observed in the NAFL groups. It also showed a significant increase of matrix metalloproteinase-2 (MMP-2) and Decorin at 16 weeks in an enzyme-linked immunosorbent assay. The reverse-transcription polymerase chain reaction analysis showed a tendency that high-pulse energy of NAFL led to higher messenger RNA expression than did the low-energy group. CONCLUSION The NAFL-treated groups showed characteristic collagen re-arrangement and a significant increase in MMP-2 and Decorin. These molecular changes suggest that MMP-2 and Decorin play a significant role in dermal remodeling. Early NAFL treatment for HTS could be supported with both histological and molecular evidence. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Jae-Ho Chung
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Ki-Jae Kim
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Doug John Park
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Yi-Hwa Ji
- Medical Science Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Eul-Sik Yoon
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Seung-Ha Park
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
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Manuskiatti W, Kaewkes A, Yan C, Ng JN, Glahn JZ, Wanitphakdeedecha R. Hypertrophic Scar Outcomes in Fractional Laser Monotherapy Versus Fractional Laser-Assisted Topical Corticosteroid Delivery: A Randomized Clinical Trial. Acta Derm Venereol 2021; 101:adv00416. [PMID: 33686446 PMCID: PMC9366502 DOI: 10.2340/00015555-3781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Topical corticosteroid delivery following fractional laser treatment is an effective means of treating hypertrophic scars. However, the relative efficacy of adjuvant corticosteroid treatment vs fractional laser monotherapy alone is unclear. The aim of this study was to compare the efficacy and safety of fractional laser-assisted topical corticosteroid delivery with fractional laser monotherapy in the treatment of hypertrophic scars. In this randomized, comparative, split-scar trial of 19 subjects, a borderline significant reduction in scar thickness was observed at 3-month follow-up in the laser+steroid group compared with laser+petrolatum (p = 0.049). However, no significant long-term difference in scar flattening was observed between the 2 groups. Patient and Observer Scar Assessment Scale scores showed significant improvement in scar appearance from baseline without significant differences between treatment groups. In conclusion, fractional laser monotherapy is an effective treatment for hypertrophic scars, and the application of topical corticosteroid provides no long-term synergistic effect to fractional laser monotherapy.
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Affiliation(s)
- Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand. E-mail:
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Yang Y, Wu Y, Yu M. Letter to the Editor of JOG Regarding the "Lowering of Intraocular Pressure Effects Early After CO2 Laser-Assisted Sclerectomy Correlate to Intrascleral Lake Volumes". J Glaucoma 2021; 30:e28-e30. [PMID: 33074960 DOI: 10.1097/ijg.0000000000001717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Yangfan Yang
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Zhang Y, Cheng G. Author Response: Letter to the Editor of JOG Regarding the "Lowering of Intraocular Pressure Effects Early After CO2 Laser-Assisted Sclerectomy Correlate to Intrascleral Lake Volumes". J Glaucoma 2021; 30:e30-e31. [PMID: 33074966 DOI: 10.1097/ijg.0000000000001718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Yang Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Zang H, Xu YN. Effectiveness of CO2 laser therapy in treating acne depressed scar: A protocol of systematic review. Medicine (Baltimore) 2021; 100:e23732. [PMID: 33545938 PMCID: PMC7837843 DOI: 10.1097/md.0000000000023732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/17/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study is to assess the effectiveness of CO2 laser therapy (COLT) in treating patients with acne depressed scar (ADS). METHODS Relevant randomized controlled trials will be checked by search the electronic databases of Cochrane Library, PUBEMD, EMBASE, Web of Science, Allied and Complementary Medicine Database, VIP Database, CBM database, and China National Knowledge Infrastructure. All potential randomized controlled trials of COLT for patients with ADS will be identified by 2 independent authors by searching all sources from inception to present. Two authors will independently undertake literature selection, data collection and study quality assessment. Any divergences between 2 authors will be settled down by a third author through discussion. RevMan 5.3 software will be used for statistical analysis. RESULTS This study will assess the effectiveness of COLT for patients with ADS. CONCLUSIONS This study may provide helpful evidence to determine whether COLT is an effective intervention for patients with ADS. STUDY REGISTRATION OSF (osf.io/m9ghv).
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Affiliation(s)
- Huan Zang
- Department of Dermatology, Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang
| | - Ya-nan Xu
- Department of Dermatology, Yan’an People's Hospital, Yan’an, Shaanxi, China
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Sindou-Faurie T, Louis-Vahdat C, Oueld Es Cheikh E, Canlorbe G, Mergui JL, Uzan C, Azaïs H. Evaluation of the efficacy of fractional CO 2 laser in the treatment of vulvar and vaginal menopausal symptoms. Arch Gynecol Obstet 2020; 303:955-963. [PMID: 33179118 DOI: 10.1007/s00404-020-05868-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The objective of this study was to evaluate the efficacy of fractional CO2 laser to manage vulvar and vaginal symptoms of Genitourinary Syndrome of Menopause (GSM) in postmenopausal women. METHODS All postmenopausal women with symptoms of GSM undergoing fractional CO2 laser treatment in our centers were asked to fill out a validated quality of life questionnaire (Global Quality of Life Questionnaire), Visual Analog Scale (VAS) for symptoms, a questionnaire on overall discomfort related to pelvic floor symptoms, and the Female Sexual Function Index (FSFI) at several points: before each session (three sessions at monthly intervals) and one 3 months after treatment completion. Statistical analysis compared pre-therapy data and data at 3 months of treatment. RESULTS Forty-six women were included with a mean age of 57.3 years (± 11.1 years). A significant improvement was demonstrated in vaginal dryness (p = 6.34 10-6) and for symptoms of stress urinary incontinence (p = 0.043). Among sexually active patients, there was a significant improvement in the degree of symptom discomfort affecting their satisfaction (p = 0.007), dyspareunia (p = 0.001) and sensitivity during sexual intercourse (p = 0.001). Significantly, more women were able to achieve (p = 0.026) and maintain (p = 0.018) lubrication during intercourse. CONCLUSION CO2 laser treatment seems to improve the quality of life and sexual health of patients as well as GSM symptoms at 3 months of treatment; long-term reevaluation is necessary to demonstrate that improvement persists over time.
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Affiliation(s)
- T Sindou-Faurie
- Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 47-83 boulevard de l'hôpital, 75013, Paris, France
| | - C Louis-Vahdat
- Medicine Cabinet, 126 boulevard Saint-Germain, 75006, Paris, France
| | - E Oueld Es Cheikh
- Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 47-83 boulevard de l'hôpital, 75013, Paris, France
| | - G Canlorbe
- Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 47-83 boulevard de l'hôpital, 75013, Paris, France
| | - J L Mergui
- Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 47-83 boulevard de l'hôpital, 75013, Paris, France
| | - C Uzan
- Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 47-83 boulevard de l'hôpital, 75013, Paris, France
| | - H Azaïs
- Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 47-83 boulevard de l'hôpital, 75013, Paris, France.
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Huth L, Marquardt Y, Heise R, Fietkau K, Baron JM, Huth S. Biological Effects of Hyaluronic Acid-Based Dermal Fillers and Laser Therapy on Human Skin Models. J Drugs Dermatol 2020; 19:897-899. [PMID: 33026754 DOI: 10.36849/jdd.2020.10.36849/jdd.2020.4856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Injection of dermal fillers is one of the most frequently performed aesthetic procedures. The aim of the present study was to investigate the biological effects of different stabilized hyaluronan (HA) and poly-l-lactic acid fillers with and without subsequent additional fractional laser co-treatment on skin morphology and gene expression. Intradermal injection resulted in a significant enhancement of epidermal thickness detected by histological analysis. Combining HA fillers with ablative fractional CO2- or Er:YAG laser irradiation enhanced this effect. Gene expression profiling revealed an upregulation of modulators of tissue remodeling (eg TIMP3, SERPIN E1) and collagens (COL11A1). On the other hand, we detected a downregulation of differentiation markers (eg FLG, LOR, KRT1) and proinflammatory cytokines (eg IL-36, IL-1β). Interestingly, HA-based fillers revealed a specific upregulation pattern of chemokines such as CXCL5 andCCL20 suggesting a secondary effect of these fillers on the immune cells of the skin, especially monocytes and macrophages. Taken together, our data show enhancing effects of dermal fillers on epidermal thickness and prove the proliferating effects of these products on epidermal cells on the molecular level. Moreover, our findings reveal synergistic effects of fractional ablative laser treatment and HA dermal filler injection suggesting a combination of both treatments. J Drugs Dermatol. 2020;19(9):897-899. doi:10.36849/JDD.2020.4856.
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Tran M, Richer V. Elective Treatment of Dermatosis Papulosa Nigra: A Review of Treatment Modalities. Skin Therapy Lett 2020; 25:1-5. [PMID: 33017107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Dermatosis papulosa nigra is a benign skin lesion found most frequently on the face of patients with skin of color. Elective treatment is occasionally requested. However, in view of knowledge gaps regarding aesthetic treatments for skin of color, patients can be exposed to unnecessary risks or simply denied treatment options due to physician reservation. Cosmetic treatments should balance efficacy of lesion removal while minimizing pigmentary complications. In this review, we describe the few published treatment modalities for dermatosis papulosa nigra. Alongside established surgical techniques, laser devices including the 532-nm potassium-titanylphosphate laser, 532-nm diode laser, 585-nm pulsed dye laser, 1064-nm neodymium-doped yttrium aluminum garnet laser, 1550-nm erbium-doped fractionated laser and the 10,600-nm carbon dioxide laser have been successfully reported. The insight from this review can assist in increasing our understanding of safe and effective treatments for conditions that are common on skin of color.
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Affiliation(s)
- Mimi Tran
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
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Huth L, Marquardt Y, Heise R, Fietkau K, Baron JM, Huth S. Biological Effects of Hyaluronic Acid-Based Dermal Fillers and Laser Therapy on Human Skin Models. J Drugs Dermatol 2020. [PMID: 33026754 DOI: 10.36849/jdd.2020.4856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Injection of dermal fillers is one of the most frequently performed aesthetic procedures. The aim of the present study was to investigate the biological effects of different stabilized hyaluronan (HA) and poly-l-lactic acid fillers with and without subsequent additional fractional laser co-treatment on skin morphology and gene expression. Intradermal injection resulted in a significant enhancement of epidermal thickness detected by histological analysis. Combining HA fillers with ablative fractional CO2- or Er:YAG laser irradiation enhanced this effect. Gene expression profiling revealed an upregulation of modulators of tissue remodeling (eg TIMP3, SERPIN E1) and collagens (COL11A1). On the other hand, we detected a downregulation of differentiation markers (eg FLG, LOR, KRT1) and proinflammatory cytokines (eg IL-36, IL-1β). Interestingly, HA-based fillers revealed a specific upregulation pattern of chemokines such as CXCL5 andCCL20 suggesting a secondary effect of these fillers on the immune cells of the skin, especially monocytes and macrophages. Taken together, our data show enhancing effects of dermal fillers on epidermal thickness and prove the proliferating effects of these products on epidermal cells on the molecular level. Moreover, our findings reveal synergistic effects of fractional ablative laser treatment and HA dermal filler injection suggesting a combination of both treatments. J Drugs Dermatol. 2020;19(9):897-899. doi:10.36849/JDD.2020.4856.
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Dehghan H, Mojarad F, Serajzadeh M, Fekrazad R. The Effect of CO2 Laser Irradiation Combined with TiF4 and NaF Varnishes on Enamel Hardness: An In Vitro Study. Oral Health Prev Dent 2020; 18:543-548. [PMID: 32515426 DOI: 10.3290/j.ohpd.a44690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To assess the effects of experimental titanium tetrafluoride (TiF4) varnish and commercial sodium fluoride (NaF) varnish with CO2 laser on enamel hardness. MATERIALS AND METHODS Ninety human enamel samples were randomly assigned to one of the following groups: 1. control (no treatment) (CO); 2. NaF varnish (2.26%) (NF); 3. TiF4 varnish (2.45%) (TF); 4. CO2 laser (La); 5. NaF varnish (2.26%) with CO2 laser (NFL); 6. TiF4 varnish (2.45%) with CO2 laser (TFL). Enamel surface changes were determined by Vickers microhardness (VH) test with a load of 1000 g and a dwell time of 12 s. Each sample was indented three times. Data were analysed using one-way ANOVA and Tukey's test. RESULTS The mean surface microhardness was 245.5 VH in the CO group, 280.3 VH in group NF, 338.7 VH group TF, 277.0 VH in group La, 345.3 VH in group NFL, and 368.0 VH in group TFL. Statistical analysis showed that groups TF, NFL, and TFL had statistically significantly higher surface hardness than the control group (p < 0.05). CONCLUSION The microhardness of enamel treated with TiF4 varnish with or without laser irradiation was statistically significantly greater than that of the control group. Thus, using TiF4 to increase enamel surface microhardness can be recommended.
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Agulian LM, Mann FA, Middleton JR, Kim DY. Evaluation of various carbon dioxide laser settings on the time and number of laser beam passes required to make a full-thickness skin incision and amount of laser-induced tissue artifact. Am J Vet Res 2020; 81:514-520. [PMID: 32436796 DOI: 10.2460/ajvr.81.6.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the time and number of laser beam passes required to make full-thickness skin incisions and extent of laser-induced tissue artifacts following use of a CO2 laser at various settings. SAMPLE 24 skin specimens from six 5-month-old porcine carcasses. PROCEDURES 4 full-thickness skin specimens were harvested from the flank regions of each carcass within 30 minutes after euthanasia and randomly assigned to 4 treatment groups. Three 5-cm-long incisions were made in each specimen with a CO2 laser (beam diameter, 0.4 mm) set to deliver a continuous wave of energy alone (groups 1 and 2) or in superpulse mode (groups 3 and 4) at 10 (groups 1 and 3) or 20 (groups 2 and 4) W of power. The time and number of passes required to achieve a full-thickness incision were recorded, and extent of laser-induced tissue artifact (as determined by histologic evaluation) was compared among the 4 groups. RESULTS Mean time required to make a full-thickness skin incision for groups 2 and 4 (power, 20 W) was significantly less than that for groups 1 and 3 (power, 10 W). Mean number of passes was lowest for group 2 (continuous wave at 20 W). Extent of laser-induced tissue artifact was greatest for group 4 (superpulse mode at 20 W). CONCLUSIONS AND CLINICAL RELEVANCE Results provided preliminary information regarding use of CO2 lasers to make skin incisions in veterinary patients. In vivo studies are necessary to evaluate the effect of various CO2 laser settings on tissue healing and patient outcome.
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Losin KJ, Yukna R, Powell C, Tippets J, Font K. Evaluation of Different Dental Lasers' Ability to Congeal Pooled Blood: An In Vitro Study. INT J PERIODONT REST 2020; 40:e147-e154. [PMID: 32559038 DOI: 10.11607/prd.4773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Most dental lasers claim that they can aid in hemostasis during oral and periodontal surgery. To date, there are no studies that compare different lasers' ability to congeal pooled blood. The aim of the study was to see if there was a difference in dental lasers' ability to congeal pooled human blood in vitro. Whole blood was collected from donors, with 0.5 mL (premolar socket volume for all tests) aliquoted into microcentrifuge tubes. Different dental lasers (810-nm diode, 940-nm diode, 1,064-nm Nd:YAG, 2,790-nm Er,Cr:YSGG, 2,940-nm Er:YAG, and 10,600-nm CO2) were applied to the whole blood for 0, 15, 30, and 45 seconds. The sample tubes were centrifuged, and the supernatant color was scored to assess the degree of congealing. Additional samples of blood were tested for time needed for maximum congealing and temperature change. Analysis of supernatant colors showed that there were significant differences in the degrees of congealing for the 810-nm diode, 940-nm diode, and 2,790-nm Er,Cr:YSGG lasers when compared to the 1,064-nm Nd:YAG, 2,940-nm Er:YAG, and 10,600-nm CO2 lasers, but not within those groupings. Additionally, the 1,064-nm Nd:YAG laser increased the temperature of the blood samples more than the other lasers and had a shorter time for maximum congealing. There were differences in the dental lasers' ability to congeal pooled human blood in an in vitro model. Nd:YAG, Er:YAG, and 10,600-nm CO2 lasers were able to achieve a greater degree of congealing at an earlier time point. The Nd:YAG laser produced the most heat and was the fastest to complete coagulation.
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Ling Y, Pang W, Li X, Goswami S, Xu Z, Stroman D, Liu Y, Fei Q, Xu Y, Zhao G, Sun B, Xie J, Huang G, Zhang Y, Yan Z. Laser-Induced Graphene for Electrothermally Controlled, Mechanically Guided, 3D Assembly and Human-Soft Actuators Interaction. Adv Mater 2020; 32:e1908475. [PMID: 32173920 DOI: 10.1002/adma.201908475] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/19/2020] [Accepted: 03/02/2020] [Indexed: 05/18/2023]
Abstract
Mechanically guided, 3D assembly has attracted broad interests, owing to its compatibility with planar fabrication techniques and applicability to a diversity of geometries and length scales. Its further development requires the capability of on-demand reversible shape reconfigurations, desirable for many emerging applications (e.g., responsive metamaterials, soft robotics). Here, the design, fabrication, and modeling of soft electrothermal actuators based on laser-induced graphene (LIG) are reported and their applications in mechanically guided 3D assembly and human-soft actuators interaction are explored. Over 20 complex 3D architectures are fabricated, including reconfigurable structures that can reshape among three distinct geometries. Also, the structures capable of maintaining 3D shapes at room temperature without the need for any actuation are realized by fabricating LIG actuators at an elevated temperature. Finite element analysis can quantitatively capture key aspects that govern electrothermally controlled shape transformations, thereby providing a reliable tool for rapid design optimization. Furthermore, their applications are explored in human-soft actuators interaction, including elastic metamaterials with human gesture-controlled bandgap behaviors and soft robotic fingers which can measure electrocardiogram from humans in an on-demand fashion. Other demonstrations include artificial muscles, which can lift masses that are about 110 times of their weights and biomimetic frog tongues which can prey insects.
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Affiliation(s)
- Yun Ling
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Wenbo Pang
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Center for Flexible Electronics Technology, Tsinghua University, Beijing, 100084, China
| | - Xiaopeng Li
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Shivam Goswami
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Zheng Xu
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Center for Flexible Electronics Technology, Tsinghua University, Beijing, 100084, China
- The State Key Laboratory for Manufacturing and Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - David Stroman
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Yachao Liu
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Qihui Fei
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Yadong Xu
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Ganggang Zhao
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Bohan Sun
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Jingwei Xie
- Department of Surgery-Transplant and Mary and Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68130, USA
| | - Guoliang Huang
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Yihui Zhang
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Center for Flexible Electronics Technology, Tsinghua University, Beijing, 100084, China
| | - Zheng Yan
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, 65211, USA
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, 65211, USA
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Kobielarz M, Tomanik M, Mroczkowska K, Szustakiewicz K, Oryszczak M, Mazur A, Antończak A, Filipiak J. Laser-modified PLGA for implants: in vitro degradation and mechanical properties. Acta Bioeng Biomech 2020; 22:179-197. [PMID: 32756551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Irradiations by CO2 laser poly(lactic-co-glycolic acid) surface lead to alterations of physicochemical properties of a copolymer. Effects of PLGA irradiations are results of photochemical and photothermal processes leading to polymer degradation. The scale of the degradation depends on the inducted surface modification. Hence the main goal of presented studies was to define the influence of CO2 laser irradiation with different process parameters, inducing three cases of surface modification, on mechanical properties and topography of PLGA during degradation in the aqueous environment. METHODS Hydrolytic degradation were performed in distilled (demineralized) water. Mechanical properties were conducted in accordance with the PN-EN ISO 527-3:1998 standard. pH of incubating solution, specimens' topography, mass and geometrical dimensions were controlled during process. RESULTS During the hydrolytic degradation, gradual changes in failure mode were observed from ductile failure characteristic for untreated PLGA to brittle failure of incubated PLGA regardless of the case of triggered modification. Tensile strength decreased with degradation time regardless of the case of surface modification with insignificant fluctuation in means Young's moduli. pH for each case decreased and topography od specimens become smoother with incubation time. CONCLUSIONS PLGA surface modification by CO2 laser below the ablation threshold (P1) and at the ablation threshold (P2) leaded to surface functionalization, however, irradiation above the ablation threshold (P3) caused marked degradation of PLGA and accelerated specimens disintegration during incubation in the aquatic environment.
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Affiliation(s)
- Magdalena Kobielarz
- Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Magdalena Tomanik
- Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Katarzyna Mroczkowska
- Laser and Fiber Electronics Group, Faculty of Electronics, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Konrad Szustakiewicz
- Polymer Engineering and Technology Division, Faculty of Chemistry, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Magdalena Oryszczak
- Scientific Circle of Biomechanics, Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Wrocław, Poland
| | - Anna Mazur
- Scientific Circle of Biomechanics, Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Wrocław, Poland
| | - Arkadiusz Antończak
- Laser and Fiber Electronics Group, Faculty of Electronics, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Jarosław Filipiak
- Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
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Eleryan MG, Awosika O, Akhiyat S, Qureshi A, Rengifo-Pardo M, Curiel R, Rider LG, Ehrlich A. Treatment of calcinosis associated with adult and juvenile dermatomyositis using topical sodium thiosulfate via fractionated CO2 laser treatment. Clin Exp Rheumatol 2019; 37:1092-1093. [PMID: 31796160 PMCID: PMC7108296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 06/11/2018] [Indexed: 06/10/2023]
Affiliation(s)
- Misty G Eleryan
- The George Washington University School of Medicine and Health Sciences, and Department of Dermatology, George Washington Medical Faculty Associates, Washington DC, USA
| | - Olabola Awosika
- Department of Dermatology, George Washington Medical Faculty Associates, Washington DC, USA
| | - Sophia Akhiyat
- The George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Azam Qureshi
- Department of Dermatology, George Washington Medical Faculty Associates, Washington DC, USA
| | - Monica Rengifo-Pardo
- The George Washington University School of Medicine and Health Sciences, and Department of Dermatology, George Washington Medical Faculty Associates, Washington DC, USA
| | - Rodolfo Curiel
- The George Washington University School of Medicine and Health Sciences, and Department of Dermatology, George Washington Medical Faculty Associates, Washington DC, USA
| | - Lisa G Rider
- Department of Dermatology and Division of Rheumatology, Department of Medicine, George Washington Medical Faculty Associates, Washington DC, USA
| | - Alison Ehrlich
- The George Washington University School of Medicine and Health Sciences, Washington DC, USA.
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Tenore G, Palaia G, Mohsen A, Ambrogiano S, Gioia CRTD, Dominiak M, Romeo U. Could the super-pulsed CO2 laser be used for oral excisional biopsies? ADV CLIN EXP MED 2019; 28:1513-1517. [PMID: 31596556 DOI: 10.17219/acem/104525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The main purpose of a biopsy is microscopic examination and diagnosis. Keeping the margins of specimens safe and readable is always fundamental to detecting marginal infiltrations or malignant transformation. Numerous options and tools have been introduced for biopsy procedures. Lasers are one of these options that provide many enhancements to clinical and surgical biopsy procedures in comparison to scalpels. OBJECTIVES The aim of the present study is to quantify the thermal artefacts in histological specimens obtained using a CO2 laser from different oral mucosal lesions and to evaluate if the resulting thermal effect hinders the histological examination. This aim is accomplished through quantitatively and qualitatively assessing the thermal effect in both the epithelium and connective tissue. MATERIAL AND METHODS A super-pulsed CO2 laser (10,600 nm) was used to obtain 10 excision biopsy samples. The parameters were a power of 4.2 W in focused mode and a frequency of 80 Hz in super-pulse mode. The histological analysis was performed with an optical microscope. Computerized imaging software was utilized to quantitatively evaluate the thermal effect in both the epithelium and connective tissue expressed in microns. RESULTS The thermal effect of the CO2 laser was limited to the surgical resection margins in all the specimens and did not hinder the histological analysis. Thermal artefacts were observed in 3 specimens. The range of thermal effects in the epithelial tissue was between 184 μm and 2,292 μm, while in the connective tissue it was between 133 μm and 2,958 μm. CONCLUSIONS The resulting thermal effects of using a CO2 laser did not hamper the histological evaluation. Utilizing a laser in biopsy procedures should be tailored. Not only should laser parameters and safety margins be taken into consideration but also the working time, clinical accessibility, and the nature and water content of the tissue.
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Affiliation(s)
- Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Gaspare Palaia
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Ahmed Mohsen
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Simone Ambrogiano
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | | | | | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
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Del Mundo DAA, Morimoto K, Masuda K, Iwaki S, Furukawa T, Teshima M, Shinomiya H, Miyawaki D, Otsuki N, Sasaki R, Nibu KI. Oncologic and functional outcomes of transoral CO2 laser cordectomy for early glottic cancer. Auris Nasus Larynx 2019; 47:276-281. [PMID: 31522907 DOI: 10.1016/j.anl.2019.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 08/03/2019] [Accepted: 08/13/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To investigate the oncological and functional outcomes of the patients treated with transoral CO2 laser cordectomy for early glottic cancer. PATIENTS AND METHODS Fifty-five consecutive patients who underwent CO2 laser cordectomy for early glottic cancer were retrospectively reviewed. RESULTS Overall survival, larynx preservation, and relapse free local control rates were 96%, 100%, and 91%, respectively. Five patients with local recurrences were salvaged with re-cordectomy and/or radiotherapy. In type I cordectomy, VHI-10 consistently improved during postoperative course and VHI-10 at postoperative 12months was significantly better than preoperative value (2.3 vs. 9.4, p=0.02). Perceptual grading, MPT, MFR and AC/DC also improved and were better than preoperative values. In type III cordectomy, shimmer at 12months after cordectomy was significantly better than preoperative value (14.7 vs. 9.3, p=0.007). CONCLUSIONS These results further support the rationale of CO2 cordectomy as initial and salvage surgery for early glottic cancer.
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Affiliation(s)
- Daryl Anne A Del Mundo
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Otorhinolaryngology, University of the Philippines Manila & Philippine General Hospital, Manila, Philippines
| | - Koichi Morimoto
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | | | - Shinobu Iwaki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Miyawaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Pliszkiewicz M, Brzuchalski MA, Pliszkiewicz M, Siekierski BP. [CO2 laser ablation of cervical endometrioid lesions - treatment efficacy evaluation]. Pol Merkur Lekarski 2019; 47:60-64. [PMID: 31473753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
UNLABELLED Endometriosis affects 10-15% of the female population of childbearing potential. Endometrioid lesions of the cervical surface are a rare manifestation of the disease. There are various complaints related to this particular form of endometriosis, making the diagnosis challenging. Treatment also raises problems, as widely available and used therapeutic methods often prove to be ineffective. AIM The aim of the study was to evaluate the efficacy of CO2 laser beam ablation in a group of patients with cervical endometriosis lesions. MATERIALS AND METHODS This paper presents a summary of cervical endometriosis treatment efficacy in a group of 15 patients who have undergone CO2 laser ablation between May 2016 and April 2019. The majority of patients have already been treated for cervical endometriosis, using cryotherapy, electrocoagulation, curettage and loop electrosurgical excision procedure (LEEP). All patients, following preliminary colposcopy verification and exclusion of malignancies, have undergone CO2 laser ablation of endometrioid cervical lesions. A visual evaluation of the cervix was performed before treatment, directly after the procedure, as well as 4-6 weeks after the procedure, and subsequently every 6-8 months. RESULTS This paper presents a summary of cervical endometriosis treatment efficacy in a group of 15 patients who have undergone CO2 laser ablation between May 2016 and April 2019. The majority of patients have already been treated for cervical endometriosis, using cryotherapy, electrocoagulation, curettage and loop electrosurgical excision procedure (LEEP). All patients, following preliminary colposcopy verification and exclusion of malignancies, have undergone CO2 laser ablation of endometrioid cervical lesions. A visual evaluation of the cervix was performed before treatment, directly after the procedure, as well as 4-6 weeks after the procedure, and subsequently every 6-8 months. CONCLUSIONS Cervical endometriosis is a rare manifestation of the diseases, with variable symptoms. It can become a diagnostic challenge, as endometrioid lesions may be confused with cervical malignancies, as well as a therapeutic one, as many of the methods employed prove unsuccessful. Laser ablation of endometrioid cervical lesions seen to be a minimally invasive, safe and effective treatment method that can be offered in an outpatient setting.
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Affiliation(s)
| | | | | | - B Paweł Siekierski
- Medicover Hospital, Department of Obstetric and Gynecology, Warsaw, Poland
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Hsiao YC, Ting K, Su YL, Chang CJ. Continuous cooling system in conjunction with laser surgery for ear reshaping. Lasers Med Sci 2019; 35:387-393. [PMID: 31257557 DOI: 10.1007/s10103-019-02831-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
When the cartilage on the prominent ears is reshaped, the arising stress returns the tissue to its initial configuration. Laser irradiation of areas of maximal stress leads to stress relaxation and results in a stable configuration. Sixty auricles were harvested from 30 New Zealand white rabbits and cut into a rectangle measuring 50 mm by 25 mm with an average thickness of approximately 1.3 mm. Bilateral skin was included for ex vivo studies. Continuous cryogen spray cooling (CSC) with laser energy was delivered to the exposed cartilage for reshaping. In clinical applications, from January 2006 to December 2016, a total of 50 patients with 100 bat ears who underwent CO2 laser reshaping (otoplasty) were assessed. A continuous cooling system (4 °C) in conjunction with a CO2 laser was applied to make a retroauricular-approached incision and reshape the ear cartilage. The well cartilage bending correlated with the different parameters demonstrated in the continuous CSC protected group. All 100 (100%) of the subjects experienced early complications (≤ 1 month) related to laser exposure with swelling, while 5 (5%) experienced ecchymosis, 2 (2%) minimal hematoma, 2 (2%) scarring, 1 (1%) minor infection, 1 (1%) under correction, 1 (1%) overcorrection, and 1 (1%) relapse. These problems were corrected and/or had resolved after 3 months. All patients achieved good to excellent results in our final outcome assessment (> 6 months). Laser reshaping has a potential use in certain surgical procedures involving the cartilage. The appropriate conditions for laser ear reshaping clearly depend on the laser wavelength used, energy controlling, and tissue optical properties.
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Affiliation(s)
- Yen-Chang Hsiao
- Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, 10507, Republic of China
| | - Kuen Ting
- Department of Chemical and Materials Engineering, Lunghwa University of Science and Technology, Taoyuan, 333, Republic of China
| | - Yun-Liang Su
- Department of Applied Mathematics, National Chung Hsing University, Taichung, 402, Republic of China
| | - Cheng-Jen Chang
- Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, 10507, Republic of China.
- Department of Plastic Surgery, Taipei Medical University Hospital, No.252, Wu Hsing Street, Taipei City, 110, Taiwan, Republic of China.
- Graduate Institute of Biomedical Optomechatronics, College of Biomedical Engineering, Taipei Medical University, Taipei, Republic of China.
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Republic of China.
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Haley CT, Tyring SK. A 22-Year-Old Man With Painful Vesicles on His Flank. JAMA 2019; 321:1213-1214. [PMID: 30830143 DOI: 10.1001/jama.2019.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Stephen K Tyring
- Center for Clinical Studies, Webster, Texas
- Department of Dermatology, University of Texas Health Science Center at Houston
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Hanna R, Amaroli A, Signore A, Benedicenti S. Utilization of Carbon Dioxide Laser Therapy in the Management of Denture-Induced Hyperplasia and Vestibuloplasty in a Medically Compromised Patient: A Case Report. INT J PROSTHODONT 2019; 32:211-213. [PMID: 30856650 DOI: 10.11607/ijp.6046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This case history reports the treatment of a Caucasian woman in her mid-70s who was medically compromised and on anticoagulant medication. She presented with three lesions: the first was located in the mandibular buccal mucosa, extending into the regions of the mandibular left and right second premolars, the second in the maxillary right region, and the third in the junction between the hard and soft palates. Carbon dioxide laser therapy was chosen as a treatment modality and was utilized at a lower power setting of 1.62 W in a gated mode (50% on, 50% off) for excision of these lesions and for increasing the depth of the mandibular buccal vestibule. The average power was 0.81 W, and the spot area was 0.8 mm. In terms of pain, infection, and bleeding, minimal to no postoperative complications were reported, and better healing was observed within 2 weeks. Carbon dioxide laser therapy at a lower power setting is a minimally invasive tool that proved in the present case to have greater benefits in the management of oral soft tissue lesions in a medically compromised patient.
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50
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Sutter E, Giacomelli-Hiestand B, Rücker M, Valdec S. [CO2 laser application in stomatology]. Swiss Dent J 2019; 129:214-215. [PMID: 30932397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The CO2 laser has found great acceptance in the stomatologic field of dentistry. This article gives an overview of the most important bene fits. The absorption of the laser light produces photothermal effects such as coagulation, vaporization and photoablation. The main indications in stomatology are pain alleviation and prevention of recurences in aphthae and cold sores (minor aphthae, herpes simplex), ablation of benign and irritant tissue excess (stimulus fibroma), lip and tongue band correction and soft tissue hemostasis. One great advantage is the minimal bleeding in the surgical field, which allows for optimal visibility. In addition, the CO2 laser offers high patient comfort since no primary wound closure with sutures are required. However, in suspect of malignancy a sharp excision with a scalpel is still preferred due to possible compromisation of the histopathologic evaluation.
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Affiliation(s)
- Eveline Sutter
- Klinik für Mund-, Kiefer- und Gesichtschirurgie – Klinik für Oralchirurgie, Universität Zürich, Universitätsspital Zürich
| | - Barbara Giacomelli-Hiestand
- Klinik für Mund-, Kiefer- und Gesichtschirurgie – Klinik für Oralchirurgie, Universität Zürich, Universitätsspital Zürich
| | - Martin Rücker
- Klinik für Mund-, Kiefer- und Gesichtschirurgie – Klinik für Oralchirurgie, Universität Zürich, Universitätsspital Zürich
| | - Silvio Valdec
- Klinik für Mund-, Kiefer- und Gesichtschirurgie – Klinik für Oralchirurgie, Universität Zürich, Universitätsspital Zürich
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