Samer A Dhaher; Ali M Yosif
Abstract
Background: Acne vulgaris is a common chronic inflammation ofpilosebaceous units with a multifactorial pathogenesis. Traditionaltreatment may have limited success with potential side effects.The long-pulsed neodymium-doped yttrium garnet (Nd:YAG)laser may be a desirable alternative.Methods: A prospective ...
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Background: Acne vulgaris is a common chronic inflammation ofpilosebaceous units with a multifactorial pathogenesis. Traditionaltreatment may have limited success with potential side effects.The long-pulsed neodymium-doped yttrium garnet (Nd:YAG)laser may be a desirable alternative.Methods: A prospective clinical trial was conducted on 61 acnepatients at the Department of Dermatology, Basrah TeachingHospital, from April 2019 to April 2020. Three treatments withlong-pulsed Nd:YAG were performed across two-weeks intervals(fluence 50 J/cm2, spot size 5 mm, pulse duration 15 ms, andfrequency 1.5 Hz). Patients were assessed at baseline and 2, 4,6, and 12 weeks later by counting the acne lesions and scoringthe response according to the percentage of lesions’ reduction.Results: Sixty-one patients completed the study (49 femalesand 12 males); the mean age was 18.7 ± 1.67 years. A significantreduction of acne lesions at the end of therapy was observedcompared to the baseline. The mean number of total lesions wasreduced from 84.2 ± 25.8 to 16 ± 23.3 (P < 0.05). Overall, 49 (80.3%)patients achieved an excellent response, 3 (4.9%) good, 1 (1.6%)moderate, and 8 patients (13.1%) showed a poor response. Thetreatment was well tolerated with insignificant adverse effects.Conclusion: Long-pulsed Nd:YAG laser is an effective and safemodality for treating acne vulgaris and may be considered analternative option for cases of recurrence after conventionaltreatment. However, more sessions are needed for severe cases.
Elham Behrangi; Azadeh Goodarzi; Amir Heydarian; Mohammadreza Ghasemi; Zahra Azizian; Parvaneh Hassani; Behrad Dalvand; Nima Hajiha
Abstract
Background: Among different treatments for periorbital hyperpigmentation (POH), both semi-invasive protocols of fractional CO2 laser and platelet-rich plasma (PRP) are favored among clinicians and rarely cause complications; however, the level of patients’ satisfaction seems to differ across these ...
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Background: Among different treatments for periorbital hyperpigmentation (POH), both semi-invasive protocols of fractional CO2 laser and platelet-rich plasma (PRP) are favored among clinicians and rarely cause complications; however, the level of patients’ satisfaction seems to differ across these methods.Methods: This randomized clinical trial was conducted on 100 patients (98 women; 2 men) between 28 to 62 years of age who complained of POH and referred to the Dermatology Clinic of Rasool Akram Medical Complex located in Tehran in 2017. The patients were randomly assigned to two groups receiving fractional CO2 laser (group C) and adding PRP treatments plus laser therapy (group CP). The outcome of both treatment protocols was followed 3 and 6 months after the last treatment by standard photography.Results: The time for swelling after treatment in the C and CP groups was 4.58 ± 0.61 days and 2.94 ± 0.68 days, respectively, which was significantly shorter in group CP (P < 0.001). The mean time for erythema disappearance was also shorter in group CP (5.20 ± 0.76 days vs. 3.40 ± 0.76 days, P < 0.001). Regarding the trend of the change in the ΔE parameter, it fell significantly in both groups within the follow-up period (P < 0.001); however, the mean ΔE was significantly higher in the CP group when compared with the control group (P < 0.001). There were no significant or resistant side effects in either treatment group.Conclusion: Although both therapies are effective and safe, the concurrent use of CO2 laser and PRP can more effectively reduce the severity of POH with a shorter duration of post-treatment swelling and erythema. Hence, this combination is a superior modality for the treatment of POH as compared to laser therapy alone.
Samaneh Mozafarpoor; Ali Asilian; Mohammad Amin Jafari; Azadeh Goodarzi
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is an autosomal recessive disorder that affects type VII collagen, one of the main components of the basement membrane. Patients present with non-healing chronic wounds in the body, extremities, and mucosal areas. There are many suggestive medical and ...
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Recessive dystrophic epidermolysis bullosa (RDEB) is an autosomal recessive disorder that affects type VII collagen, one of the main components of the basement membrane. Patients present with non-healing chronic wounds in the body, extremities, and mucosal areas. There are many suggestive medical and surgical treatments, but most are ineffective. In this case, we discuss a new laserassisted surgical protocol for these types of patients. A 54-year-old male patient was suffering from RDEB with large, excruciating, non-healing wounds on his extremities dating ten months, with no reasonable improvement, despite receiving intensive wound care. After ruling out other diagnoses (particularly malignancies), treatment was performed with a fractional Er:YAG laser for a single session. After four weeks of follow-up, the patient showed significant improvement, with no considerable complications reported. Fractional ablative Er:YAG laser could be an effective treatment option in RDEB patients. Clinical trials are required with long-term follow-ups for this novel treatment approach.
Samaneh Mozafarpoor; Ali Asilian; Azadeh Goodarzi; Zahra Ebrahimi; Fatemeh Mokhtari; Zeynab Rastgar Moqaddam
Abstract
Lymphangioma is an unusual congenital malformation of the lymphatic system that affects the skin and subcutaneous tissue. A surgical procedure is among the options for lymphangioma treatment, although it can lead to significant complications. The Nd:YAG Laser appears to be one of the safest therapeutic ...
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Lymphangioma is an unusual congenital malformation of the lymphatic system that affects the skin and subcutaneous tissue. A surgical procedure is among the options for lymphangioma treatment, although it can lead to significant complications. The Nd:YAG Laser appears to be one of the safest therapeutic options rarely proposed to treat oral cavity lesions. This paper comprehensively reviewed the studies published from 2010 to date on the treatment of cutaneous and mucosal lymphangioma with different types of lasers. In the current report, an 18-yearold female presented with a lymphangiomatous lesion on the tongue diagnosed through a pathologic study. The patient initiallyunderwent three sessions of pulsed-dye laser (PDL) therapy that evoked an insignificant response. Therefore, the approach was changed to long-pulsed Nd:YAG laser therapy, and a dramatic response was observed within three sessions of the treatment.
Azadeh Goodarzi
Abstract
There are many patients with inflammatory acne vulgaris who are not compliant or eligible to consume acne medications, such as oral antibiotics or isotretinoin. PubMed and Medline databases were searched for all related articles. All finding were summarized and chronologically presented ...
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There are many patients with inflammatory acne vulgaris who are not compliant or eligible to consume acne medications, such as oral antibiotics or isotretinoin. PubMed and Medline databases were searched for all related articles. All finding were summarized and chronologically presented in the tables. Nonmedical device-based therapies largely improve the treatment of active inflammatory acne vulgaris, especially in patients who are not compliant or eligible to consume acne medications, do not respond to these drugs over a specified period of time, or do not sustain in the remission phase.
Mehran Golnaz; Fotooei Mahrokh; Goodarzi Azadeh; Forghani Siamak Farokh; Rohaninasab Masoomeh; Ghassemi Mohammadreza; Sadeghi Somayeh; Behrangi Elham
Abstract
Background: Microneedling is recently used to treat skin scars mostly atrophic scars; however, there are limited data about its effectiveness on hypertrophic burn scars. Carbon dioxide (CO2) laser is an effective method for the treatment of burn scars. Here, we aim to compare the efficacy of microneedling ...
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Background: Microneedling is recently used to treat skin scars mostly atrophic scars; however, there are limited data about its effectiveness on hypertrophic burn scars. Carbon dioxide (CO2) laser is an effective method for the treatment of burn scars. Here, we aim to compare the efficacy of microneedling to CO2 laser in the treatment of hypertrophic burn scars in a randomized clinical trial. Methods: Patients with second and third-degree burn scars (n=60) were randomized to receive 3 sessions of microneedling (n=30) or CO2 laser (n=30), 4-6 weeks apart. The outcomes, including physical characteristics of the scar scored by Vancouver Scar Scale (VSS) and patients’ satisfaction with the treatment measured by Visual Analogue Scale (VAS), were investigated at baseline, at the end of the treatment period, and at the 3-month follow-up. Results: The VSS score at the follow-up visit showed a significant reduction from 6.63±1.95 to 3.8±2.3 in the microneedling group and from 7.1+2.3 to 5.6±1.7 in the CO2 laser group; while, the reduced VSS score was significantly higher in the microneedling group (P<0.05), especially in reducing the thickness (P=0.001) and pliability (P=0.001) scores. The patients’ subjective assessments for acne improvement were significantly more satisfactory in the microneedling group (P=0.025).
Conclusion: Microneedling seems to be an effective method to improve hypertrophic burn scars. It also causes better scores in the physical characteristics of scar and the patients’ satisfaction compared to the CO2 laser at the 3-month follow-up.
Farideh Jowkar; Najmeh Radgoodarz; Nasrin Saki; Alireza Heiran
Volume 19, Issue 1 , 2016, , Pages 11-15
Abstract
Background: Laser treatment is a rapid, non-invasive procedure for long-term hair removal. Lasers operate based on the principle of selective photothermolysis and target melanin in the hair follicle. We intend to determine the level of hirsute patient satisfaction with the alexandrite laser hair removal ...
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Background: Laser treatment is a rapid, non-invasive procedure for long-term hair removal. Lasers operate based on the principle of selective photothermolysis and target melanin in the hair follicle. We intend to determine the level of hirsute patient satisfaction with the alexandrite laser hair removal procedure.Methods: In this cross-sectional study 82 hirsute patients with unwanted hair on their faces were enrolled. The patients received treatment with a 755 nm alexandrite laser (GentleLASE, Candela Corporation, USA). We documented their level of satisfaction with this laser in terms of hair removal. Laser therapy, electrolysis, and depilation were compared.Results: Patients ≥30 years old expressed greater satisfaction compared to those <30 years of age (P=0.03). Patients with medically related hirsutism had the same satisfaction as the idiopathic hirsute group (P=0.81). Patients rated laser hair removal as 4.12 compared to depilation and 3.96 compared to electrolysis. From total patients, 60.97% would recommend laser treatment to other hirsute patients. There were 79.3% of patients who expressed satisfaction with alexandrite laser hair removal.Conclusions: Most patients expressed satisfaction with the alexandrite laser hair removal procedure. Age played a significant role in patient satisfaction.
Fariba Ghalamkarpour; Reza Robati; Ghadeh Ghasir; Mohammad Saeedi; Nahid Mohtasham
Volume 14, Issue 1 , 2011, , Pages 12-15
Abstract
Background: Treatment of vitiligo remains an attractive topic and several therapies with varying degrees of success have been used. The aim of this study was to find out whether the combination of topical calcipotriol and excimer laser increases the efficacy of therapy compared to excimer laser alone. ...
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Background: Treatment of vitiligo remains an attractive topic and several therapies with varying degrees of success have been used. The aim of this study was to find out whether the combination of topical calcipotriol and excimer laser increases the efficacy of therapy compared to excimer laser alone. Methods: Twenty eight patients in two groups were treated with 308nm excimer laser alone (14 patients) and the combination of excimer laser–calcipotriol (14 patients). After 16 sessions, response rate, side-effects and compliance were assessed. Results: Repigmentation rate more than 50% was significantly higher in the laser- calcipotriol group. No differences were seen in complication rate between the two groups. Conclusion: Combination of calcipotriol and 308nm excimer laser might enhance the response rate without increasing treatment complications.
Zohreh Tehranchinia; Hoda Rahimi; Mansour Moradloo
Volume 13, Issue 3 , 2010, , Pages 82-86
Abstract
Background: Benign pigmented lesions, including freckles, are common and various treatment modalities including lasers and peeling have been evaluated for their effectiveness in their treatment.Objective: To compare the clinical effects of focal peeling with Trichloroacetic Acid (TCA) and Nd:YAG (532 ...
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Background: Benign pigmented lesions, including freckles, are common and various treatment modalities including lasers and peeling have been evaluated for their effectiveness in their treatment.Objective: To compare the clinical effects of focal peeling with Trichloroacetic Acid (TCA) and Nd:YAG (532 nm) laser on freckles.Methods: Twenty patients with freckles were treated with focal peeling with TCA 25% on their left-sided lesions and Nd:YAG (532 nm, Fluence 9.5 J/cm2, spot size 1.5 mm) on their right-sided lesions. Photographs were taken prior to treatment and at follow-up visits and were evaluated by three dermatologists and the results were analyzed.Results: Eighteen out of the 20 patients (90%) with freckles manifested more than 50% improvement in laser treated areas whereas clinical improvement in focal peeling treated areas was observed in 15 out of 20 (75%). The mean improvement rate for laser and focal peeling was 66.50±12% and 58.3±15%, respectively. No significant difference was observed in the treatment results between these modalities.Conclusion: Focal peeling with TCA 25% could be as effective as frequency-doubled Nd:YAG (532 nm) laser in the treatment of freckles.
Davoudi Seyyed Masoud; Behnia Fereydoun; Gorouhi Farzam; Saeed Keshavarz; Mansour Nassiri Kashani; Alireza Firooz
Volume 9, Issue 4 , 2006, , Pages 319-323
Abstract
Background and aim: Laser is one of the most recent techniques which has widespread use in the treatment of many skin diseases. This technique has been successfully used to remove unwanted hairs in hirsutism. The aim of this study was to evaluate and compare the efficacy and safety of long-pulsed 755 ...
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Background and aim: Laser is one of the most recent techniques which has widespread use in the treatment of many skin diseases. This technique has been successfully used to remove unwanted hairs in hirsutism. The aim of this study was to evaluate and compare the efficacy and safety of long-pulsed 755 nm alexandrite and long-pulsed 1064 nm Nd: YAG lasers individually and in combination for permanent hair removal. Materials and Methods: This single-blind randomized clinical trial was conducted on 25 patients. They were treated by alexandrite or Nd: YAG or combination of them in 4 sessions with 8 weeks intervals. The treatment was applied on their medial and lateral sides of both legs. All the parameters of the systems were set on the company defaults. Subjects were evaluated 1 and 8 months after completion of the treatment. Hair count was measured by Visiomed device and digital camera photographs every session. To calculate mean hair reduction, the difference between hair count before and after treatment was divided by hair count before treatment. Pain severity, measured by Visual Analogue Scale (VAS), and side effects (bullae, scar and pigmentation changes) were recorded every session. The data were analyzed with ANOVA, post hoc Tukey and chi square tests. Results: Fifteen patients completed the study and 10 patients were excluded due to appearance of bullae in 2 patients and refuse to continue in 8 patients. The mean hair reduction measured by Visiomed 8 months after last treatment was: 61.96 ±21.09, 60.03±23.40 and 68.05±21.23 percent for alexandrite, Nd: YAG and combination therapy, respectively. When digital camera photos were used for measurement of hair reduction these values were 85.99±11.62, 73.60±16.57 and 79.61±18.08 percent, respectively. The differences between the systems were not significant (ANOVA, P>0.05). In paired comparison of the systems, no significant differences were observed either (Tukey test). The incidence of adverse effects (hyperpigmentation) and pain severity were significantly greater in area received combination therapy (P=0.001).Conclusion: Both alexandrite and Nd:YAG laser systems were effective in hair removal. In contrast, combination therapy did not have more efficacy and also caused more side effects.
Toosi Parviz; Dadras Mohammad Shahidi; Sadiqha Afshin; Farshi Hamideh Moravej
Volume 9, Issue 4 , 2006, , Pages 324-330
Abstract
Background and aim: It is possible to use light sources suxh as lasers to destruct melanosomes and treat pigmented skin lesions. One of the most commonly used laser systems is Q switched ruby laser with a wave-length of 694 nm. This study was performed to evaluate the efficacy of the Q switched ruby ...
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Background and aim: It is possible to use light sources suxh as lasers to destruct melanosomes and treat pigmented skin lesions. One of the most commonly used laser systems is Q switched ruby laser with a wave-length of 694 nm. This study was performed to evaluate the efficacy of the Q switched ruby laser in the treatment of pigmented skin lesions including lentigines (simplex or solar) and café-au-lait macules.Materials and Methods: After physical examination for ruling out the possibility of malignancy by two dermatologists, patients were treated with Q switched ruby laser. Response to treatment was categorized in four groups of equal interval according to the 0-100% lesion lightening.Results: Ninetyy patients including 81 patients with solar lentigo and 9 cases of lentigo simplex were recruited into this study. Mean±standard deviation (SD) of the number of treatment sessions for solar lentigo and lentigo simplex cases were 1.0 ± 0.5 and 3.6 ± 1.3 , respectively. Although the mean of sessions was increased in darker skin types, there was no statistically significant difference between different skin types (p=0.335). In addition, there was no significant relation between mean treatment sessions and location of the lesions (p=0.685). Cure rate was 100% in all lentigo cases and after a mean ±SD of 8.7±2.3 months follow up there was no recurrence. Also, there was neither pigmentary change nor folliculitis during treatment. In 7 cases with café-au-lait macules, the mean±SD score of improvement was 2.4 ± 0.8, which was achieved after 3.1±0.4 treatment sessions. In 6 cases whom were followed up for 10.2 ± 3.1 months, despite primary disappearance, recurrence of café-au-lait macules was observed. Conclusion: It seems Q switched ruby laser is an appropriate method for treatment of lentiginous lesions in caucasians with Fitzpatrick's skin types II to IV.
M Bayat; M.Gh Gol Mohammadi; FS Rezaei
Volume 8, Issue 6 , 2006, , Pages 475-481
Abstract
Background and aim: Low-power lasers relief pain in some musculoskeletal disorders and accelerate wound healing process. However, there are few reports on effects of low-power lasers on mast cells. In this study the effects of low-power gallium aluminium arsenide laser (Ga.Al.As.laser) radiation on number ...
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Background and aim: Low-power lasers relief pain in some musculoskeletal disorders and accelerate wound healing process. However, there are few reports on effects of low-power lasers on mast cells. In this study the effects of low-power gallium aluminium arsenide laser (Ga.Al.As.laser) radiation on number and degranulation of mast cells of open skin wound bed of rats were studied using quantitative histological methods.Materials and Methods: Forty-six male rats were randomly divided into experimental and control groups. Each group divided into 3 subgroups based on duration of study: 4 , 7 and 15 days. Under general anesthesia and sterile conditions one circular full thickness skin wound was made on the doesum of neck of each rat. The wounding day was considered as the day zero. From the day one, experimental rats received Ga. Al. Ar. laser radiation at a energy density of 1.2 J/cm2. After doing daily treatments, on days 4, 7 and 15, rats were killed by ether and samples were obtained from wound bed and normal adjacent skin from each rat. Samples were fixed in formalin saline and were prepared for routine histological study. Sections were stained by 0.1% watery solution of toluidine blue and total number of mast cells and their grades (one, two and three) were counted. In grade one, mast cell is intact, in grade two some granules have been extruded from the cell and in the mast cells of grade 3, degranultion is more extensive and widespread. Data were analysed by Student t test.Results: On the day 4, total number and grade one mast cells were significantly higher in the control group (P<0.01). On days 7 and 15, total number of mast cells and their grades were higher in the experimental group. The grade 2 mast cells on day 7 and grade 1 mast cells on day 15 of experimental group was significantly higher than control group (P<0.05).Conclusion: Low-power gallium aluminium arsenide laser irradiation on open skin wound of rats reduced significantly total number of mast cells and intact ones at inflammatory phase, and 90 significantly increased active mast cells at proliferation, and intact ones at remodeling phases of the wound healing process.
M Mir Shams Shahshahani; AH Ehsani; RM Robati
Volume 8, suppl , 2005, , Pages 42-14
Abstract
Pulsed dye laser (PDL) is an effective treatment for port- wine stain and can cause some short- term and long- term side- effects. Pyogenic granoluma is one of its late- onset adverse effects. Herein, we present two cases of pyogenic granoluma following treatment of port- wine stain with PDL.
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Pulsed dye laser (PDL) is an effective treatment for port- wine stain and can cause some short- term and long- term side- effects. Pyogenic granoluma is one of its late- onset adverse effects. Herein, we present two cases of pyogenic granoluma following treatment of port- wine stain with PDL.
K Balighi; K Kiani Far; F Farnaghi; SZ Ghodsi; P Mehrian
Volume 8, suppl , 2005, , Pages 53-59
Abstract
Nowadays, Erbium: YAG laser resurfacing of periorbital skin has become a very popular method of wrinkle reduction. Seven patients with Fitzpatrick skin phototypes of II to V were treated with a 2940 nm Erbium: YAG laser system for resurfacing of periorbital wrinkles. Photographic evalution performed ...
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Nowadays, Erbium: YAG laser resurfacing of periorbital skin has become a very popular method of wrinkle reduction. Seven patients with Fitzpatrick skin phototypes of II to V were treated with a 2940 nm Erbium: YAG laser system for resurfacing of periorbital wrinkles. Photographic evalution performed before and after treatment. Patients were visited at 1,2,3,5,7,14,30 and 60 days after laser resurfacing. The results were graded into five categories: no improvement (grade 0), mild (grade 1: up to 25% ), moderate (grade 2: 25-50%), good (grade 3: 50-75%) or excellent (grade 4: 75-100%). Two independent investigators and also the patients themselves evaluated the improvement grades by comparing the photographs. Peri- orbital skin re- epithelization after treatment took a mean duration of 3.7 days. Duration of erythema varied from two to seven weeks with a mean duration of 16.2 days. Eight weeks after the end of the treatment the mean improvement grade was 2.35 (moderate to good) by investigators judgment and 2.14 (moderate to good) by the patients themselves. No pigmentary complications were evident after 8 weeks. No scars or ectropion were observed.
N Farsi; M Mandegar Fard
Volume 8, Issue 4 , 2005, , Pages 307-310
Abstract
Lymphangioma circumscriptum is a congenital lymphatic malformation that results in gradual dilatation of lymphatic vessels and development of lymphatic cisterns. The treatment of choice is radical surgery. Other treatment methods including cryotherapy, sclerosing agent injections, radiation therapy and ...
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Lymphangioma circumscriptum is a congenital lymphatic malformation that results in gradual dilatation of lymphatic vessels and development of lymphatic cisterns. The treatment of choice is radical surgery. Other treatment methods including cryotherapy, sclerosing agent injections, radiation therapy and CO2 laser were suggested. We report successful treatment of a 14-year-old boy affected with lymphangioma with CO2 laser.
P Toosi; F Malekzad; A Sedigha
Volume 8, Issue 1 , 2004, , Pages 7-14
Abstract
Background: The theory of selective photo-thermolysis led to the development of a variety of different laser systems which range from the shorter spectrum of 694nm ruby laser to the middle with the 755nm alexandrite and 810nm diode lasers to the long end with the 1064nm (Nd:YAG) laser. Objective: A systematic ...
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Background: The theory of selective photo-thermolysis led to the development of a variety of different laser systems which range from the shorter spectrum of 694nm ruby laser to the middle with the 755nm alexandrite and 810nm diode lasers to the long end with the 1064nm (Nd:YAG) laser. Objective: A systematic review on the clinical trials with use of various laser sources for hair removal. Methods: All clinical trials related to hair removal lasers in 1998-2003 were selected. After elimination of heterogenicity sources in data, results were synthesized on the basis of laser type and were compared using ANOVA and t tests, P
A Majdabadi
Volume 5, Issue 4 , 2002, , Pages 32-38
Abstract
Nowadays laser is extensively used in various industrial, communicative, medical, and other fields. Using laser in medicine has enabled physicians to perform the most accurate and finest operations within few minutes. Non-observance of safety points during laser performance could be seriously harmful ...
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Nowadays laser is extensively used in various industrial, communicative, medical, and other fields. Using laser in medicine has enabled physicians to perform the most accurate and finest operations within few minutes. Non-observance of safety points during laser performance could be seriously harmful for the medical staff and the patient. Therefore, in order to prevent the possible damage of this electromagnetic energy, some international standard points are advised. In this paper, a brief review of laser itself, the vulnerable parts during laser operation, maximum allowable radiation and etc are presented. We hope to help the physicians in offering medical services as safe as possible.
