Results: 6

1.Dermatol Surg. 2010 Apr;36(4):461-9. Epub 2010 Feb 19.

Consensus recommendations on the use of an erbium-doped 1,550nm fractionated laser and its applications in dermatologic laser surgery.
Sherling M, Friedman PM, Adrian R, Burns AJ, Conn H, Fitzpatrick R, Gregory R, Kilmer S, Lask G, Narurkar V, Katz TM, Avram M.

Source
Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA.

Abstract
BACKGROUND:
Nonablative fractional photothermolysis has revolutionized the way we treat a number of common skin conditions with laser technology.

OBJECTIVE:
A comprehensive guide is needed for clinicians using this technology to treat specific skin conditions in various skin types.

MATERIALS AND METHODS:

Recommendations were made from a recent round table discussion among experienced physicians and a review of recent literature findings.

RESULTS:
Optimal laser parameters are dependent on patient skin type and condition. We recommended guidelines for the successful treatment of several common skin conditions on and off the face using nonablative fractional photothermolysis. Specific conditions were dyschromia, rhytides, acne scars, surgical scars, melasma, and striae distensae.

CONCLUSIONS:
We developed reproducible guidelines to most effectively treat a variety of skin types and conditions using nonablative fractional photothermolysis. Future large, multicenter trials are indicated for further optimization of treatment parameters. 2.G Ital Dermatol Venereol. 2009 Jun;144(3):229-41.

Current role of resurfacing lasers.

Hantash BM, Gladstone HB.

Source
Elixir Institute of Regenerative Medicine, San Jose, CA, USA.

Abstract
Resurfacing lasers have been the treatment of choice for diminishing rhytids and tightening skin. The carbon dioxide and erbium lasers have been the gold and silver standards. Despite their effectiveness, these resurfacing lasers have a very high risk profile including scarring, hyperpigmentation and hypopigmentation. Because of these side effects, various practitioners have tried alternative settings for these lasers as well as alternative wavelengths, particularly in the infrared spectrum. These devices have had less downtime, but their effectiveness has been limited to fine wrinkles. As with selective photothemolysis, a major advance in the field has been fractionated resurfacing which incorporates grids of microthermal zones that spares islands of skin. This concept permits less tissue damage and quicker tissue regeneration. Initially, fractionated resurfacing was limited to the nonablative mid-infrared spectrum. These resurfacing lasers is appropriate for those patients with acne scars, uneven skin tone, mild to moderate photodamage, and is somewhat effective for melasma. Importantly, because there is less overall tissue damage and stimulation of melanocytes, these lasers can be used in darker skin types. Downtime is 2-4 days of erythema and scaling. Yet, these nonablative fractionated devices required 5-6 treatments to achieve a moderate effect. Logically, the fractionated resurfacing has now been applied to the CO2 and the Erbium:Yag lasers. These devices can treat deeper wrinkles and tighten skin. Downtime appears to be 57 days. The long term effectiveness and the question of whether these fractionated devices will approach the efficacy of the standard resurfacing lasers is still in question. Ultimately either integrated devices which may use fractionated resurfacing, radiofrequency and a sensitizer, or combining different lasers in a single treatment may prove to be the most effective in reducing rhtyides, smoothing the skin topography and tightening the skin envelope. 3.Pediatr Dermatol. 2008 Jul-Aug;25(4):434-8.

Infantile acne: a retrospective study of 16 cases.

Hello M, Prey S, Laut-Labrze C, Khammari A, Dreno B, Stalder JF, Barbarot S.

Source
Department of Dermatology, Nantes University Hospital, Nantes, France.

Abstract

Infantile acne is a rare and poorly understood disorder. The objective of this study was to improve our knowledge about the epidemiology and clinical course of infantile acne, and evaluate approaches to treatment. This twocenter retrospective study covered the period between 1985 and 2007. Inclusion criteria were: (i) age less than 24 months when lesions appeared; (ii) presence of both inflammatory and noninflammatory lesions; (iii) persistence of lesions for at least 2 months. The data were drawn from clinical and photographic records, followed by administration of a telephone questionnaire to parents. It was proposed that each case be reviewed on the basis of the child's appearance and score on an acne scar clinical grading scale. Sixteen children were included. Nine had a family history of severe adolescent acne. The average duration of disease was 22 months. Two patients had been effectively treated with oral isotretinoin. More than half of the patients exhibited scars. We re-examined five children (average acne scar clinical grading scale score = 12/540). On the basis of the frequency of scarring, and the severity and average duration of lesions, the use of oral retinoids in severe infantile acne warrants evaluation. 4.Dermatol Nurs. 2007 Apr;19(2):137-43; quiz144.

Primary cicatricial alopecia: clinical features and management.

Ross EK.

Source
Dermatology and Laser Center, NW, Bellingham, WA, USA.

Abstract
The primary cicatricial alopecias are an uncommon, complex group of disorders that result in permanent destruction of the hair follicle, usually involving scalp hair alone. Prompt diagnosis and treatment are needed to help thwart continued hair loss and the distress that often accompanies this hair loss. Nurses can facilitate the diagnostic and treatment process and, through educational and emotionally supportive measures, have a meaningful, positive impact on the patient's well being. 5.J Eur Acad Dermatol Venereol. 2006 May;20 Suppl 1:2-6.

Dispelling the myth: appropriate use of poly-L-lactic acid and clinical considerations.
Lowe NJ.

Source
Cranley Clinic, London, UK, and UCLA School of Medicine, Los Angeles, CA, USA. cranleyuk@aol.com

Abstract
OBJECTIVES:
Injectable poly-L-lactic acid (PLLA; Sculptra) is widely used throughout Europe and the USA to restore volume in depressed areas of the face by stimulating neocollagenesis. Injectable PLLA was previously marketed as NewFill, which was often injected incorrectly and at too high a concentration, resulting in some physicians losing confidence in this product. Today, Sculptra is still regarded with a degree of scepticism by some physicians, due to direct or indirect experience with New-Fill. Sculptra, both in formulation and use, is vastly superior to New-Fill and clinical experience with this product dispels the myths associated with the earlier types of injectable PLLA.

RESULTS:
PLLA is a very safe, biodegradable compound that has been used in a wide range of medical devices for the last 30 years. In injectable form a good safety profile has been proven; however, when the device is overconcentrated, localized overstimulation of the fibroblasts can result in the formation of small lumps (subcutaneous papules), which are non-pathological but nevertheless palpable by the patient. Physicians must also be trained in the injection of this device, as incorrect injection technique can cause device-related adverse events.

CONCLUSION:
New product guidelines have ensured that problems with PLLA concentration have been countered, and tried and tested injection techniques have been shown to ameliorate device-related adverse events, both of which are dispelling the myths associated with modern injectable PLLA. 6.Hautarzt. 2005 Nov;56(11):1040-7.

[Systemic acne therapy].

[Article in German] Thielitz A, Gollnick H.

Source
Klinik fr Dermatologie und Venerologie, Otto-von-Guericke-Universitt Magdeburg.

Abstract
The development of scarring in inflammatory acne may induce permanent disfigurement and considerable psychosocial impact on the lives of affected individuals. The early use of systemic acne therapy can help to prevent these unfortunate consequences. Antiinflammatory antibiotics such as tetracyclines are required in

moderate to severe papulopustular acne. The recommended treatment duration is 3 months; combination with topical retinoids and benzoyl peroxide increases the speed and efficacy of lesion reduction and helps to prevent bacterial resistance. Oral isotretinoin is the treatment of choice in severe acne resistant to adequate conventional therapy. Hormonal treatment represents an alternative regimen for women with acne and is the first choice in lateonset acne and in those with clinical signs of hyperandrogenism.