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Biomedical subjects

Bärbel Greve

Publications and source records attributed to Bärbel Greve.

9 recordsLinked to original sources
PubMed2006

[Excimer laser treatment of vitiligo -- critical retrospective assessment of own results and literature overview].

BACKGROUND: In numerous studies the 308-nm excimer laser has been described as an effective therapy method for localized vitiligo. Our experience and critical evaluation of the relevant literature lead to a less enthusiastic endorsement. PATIENTS AND METHODS: A total of 9 patients with localized vitiligo were evaluated in our retrospective study. The sessions took place 2-3 times per week; the energy dose was increased depending on the occurring side effects. The rate of repigmentation was evaluated in 5 grades: grade 0 = 0 %, grade 1 = 1-25 %, grade 2 = 26-50 %, grade 3 = 51-75 %,grade 4 = 76-100 %. Subjective patient satisfaction was rated "satisfied"/"not satisfied". RESULTS: In face and neck areas we used a cumulative energy dose of 16.6 J/cm(2) and achieved repigmentation grade 4 in 33.3 %, grade 2 in 33.3 %, grade 1 in 11.1 % and no improvement in 22.2 % of the cases. On hands and knees we used a medium cumulative energy dose of 20.8 J/cm(2) and did not observe any tendency towards repigmentation. Four of the patients were satisfied, while 5 were not. Side effects (erythema, blisters, crusting and perilesional hyperpig-mentation) were transient in all cases. Within a medium observation period of 19.1 months, one patient had a relapse. CONCLUSIONS: The excimer laser should be regarded as a treatment alternative in cases of localized vitiligo of the face. The treatment at other sites is clearly limited because of only partial repigmentation, considerable expense of time and money as well as the potentially higher risk of tumorigenesis.

Adult↗
PubMed2005

[Excimer laser therapy of alopecia areata--side-by-side evaluation of a representative area].

We report for the first time on hair regrowth in alopecia areata of the scalp achieved with the 308-nm xenon-chloride excimer laser in a prospective side-by-side trial. The alopecia areata had shown progression over a period of three years, and various treatments had not been effective. Out of a number of affected areas, one representative lesion was chosen; one half of it was treated, the other half remained untreated. After 27 sessions (200 - 4000 mJ/cm2, cumulative dose 52.6 J/cm2) over 3 months, only the treated area showed hair growth; which suggests that this was most probably not a spontaneous remission.

Adult↗
PubMed2004

Treatment of alopecia areata with the 308-nm xenon chloride excimer laser: case report of two successful treatments with the excimer laser.

BACKGROUND AND OBJECTIVES: Alopecia areata is a common disease of unknown etiology; it causes significant cosmetic and psycho-social distress for most of the people it affects. We report on an innovative form of treatment in two patients with typical alopecia areata on the capillitium. STUDY DESIGN/PATIENTS AND METHODS: We successfully treated two patients whose alopecia areata had worsened progressively for 3 and 14 weeks. The treatment involved the use of a 308 nm xenon chloride excimer laser (dosage 300-2,300 mJ/cm(2) per session). RESULTS: After 11 and 12 sessions within a 9-week and 11-week period, the entire affected focus showed homogenous and thick regrowth. No relapse was observed during the follow-up period of 5 and 18 months. CONCLUSIONS: The use of the excimer laser is an effective, elegant, and safe means of treatment and has good tolerability. Analogous to topical treatment of alopecia areata, the immunosuppressive mechanism of the excimer laser can be interpreted as an induction of T-cell apoptosis. This new means of treatment has yet to be discussed in medical literature. Further studies with greater numbers are needed to assess its potential more precisely and evaluate the excimer laser in treating alopecia areata.

Adult↗
PubMed2003

IPL technology: a review.

BACKGROUND AND OBJECTIVES: Intense pulsed light (IPL) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad wavelength spectrum of 515-1,200 nm. These properties allow for great variability in selecting individual treatment parameters and adapting to different types of skin types and indications. The purpose of this article was to critically review international medical publications of the many indication in which IPL technology can be used, including our own evaluations and experiences. STUDY DESIGN/MATERIALS AND METHODS: The range of therapeutic uses for high-intensity flashlamps was reviewed, ranging from benign cavernous hemangiomas, benign venous malformations, essential telangiectasias, leg telangiectasias, poikiloderma of Civatte, and port-wine stains to pigmented lesions, cosmetically undesired hypertrichosis, and facial rhydids. The relative benefits and risks were discussed in detail and compared with other laser systems. RESULTS: Because of the wide spectrum of potential combinations of wavelengths, pulse durations, pulse frequency, and fluences, a great deal of experience is required when using IPL technology. Proper patient selection and critical diagnostics serve to keep the adverse effects of the treatment to a minimum. CONCLUSIONS: The distinctive technical conditions involved combine to make IPL technology an alternative and auxiliary treatment option to existing laser systems and conventional therapies.

Facial Dermatoses↗
PubMed2003

Facial rhytides--subsurfacing or resurfacing? A review.

UNLABELLED: STUDY DESIGN/BACKGROUND AND OBJECTIVES: Currently, ablative laser therapy (with CO2/Er:YAG lasers) is considered an effective and promising method of skin rejuvenation. The induction of collagen synthesis was observed after treatments with the CO2 laser and with the long-pulsed Er:Yag laser. In past years, the undesirable side effects and risks of these methods have led to intensified research efforts in the fields of non-ablative facial rejuvenation as well as subsurfacing by means of non-ablative laser systems and intense pulsed light systems. The objective is to achieve selective, heat-induced denaturalization of dermal collagen that leads to subsequent reactive synthesis of neocollagen but does not damage the epidermis. This article reviews the use of different types of lasers and intense pulsed light sources for the non-ablative treatment of facial rhytides. RESULTS: The results of numerous clinical and histological investigations have recently indicated that these new technologies are successful. Some studies demonstrated remarkable effects with non-ablative systems; others, however, showed only limited cosmetic improvement or none at all. CONCLUSIONS: After critical review and assessment of current literature on the treatment of rhytides, we have found that non-ablative methods do not appear to be a comparable alternative to ablative skin resurfacing in terms of their efficacy and side effects.

Face↗
PubMed2002

Scar sarcoidosis--treatment with the Q-switched ruby laser.

BACKGROUND AND OBJECTIVE: Scar sarcoidosis is a circumscribed form of cutaneous sarcoidosis, which is often very difficult to treat. To date, therapeutic approaches have yielded little success and often been accompanied by adverse effects, some of which are severe. Laser treatment is one alternative, which has proven to be effective in a dramatically increasing number of cases over the past years. STUDY DESIGN/MATERIALS AND METHODS: We report about a 50-year-old female patient who presented with histologically confirmed scar sarcoidosis on the right elbow and both knees; the sarcoidosis had spontaneously developed on three sites which had traumatic tattoos from abrasions. Because of the reddish-brown livid discolorations, we treated the granulomas with the pulsed dye laser for three sessions, although without success. Treatment with the Q-switched ruby laser was commenced to remove the traumatic tattoos. RESULTS: Not only had the areas lightened fully after four sessions, the sarcoidosis foci had resolved completely, and the patient has been recurrence-free for over 3 years. CONCLUSION: The Q-switched ruby laser appears to be a rapid and effective means of treating scar sarcoidosis with traumatic tattoos without incurring adverse effects. The definitive mode of action is still not fully known, however.

Cicatrix↗
PubMed2002

Lichenoid dermatitis--treatment with pulsed dye laser: a case study.

BACKGROUND AND OBJECTIVES: Both the diagnosis and the treatment of lichenoid dermatosis are often difficult and can be time-consuming. There are now more and more publications about the use of laser systems--especially the flashlamp-pumped pulsed dye laser--in the treatment of inflammatory dermatoses, although the laser's exact mechanism of action in these cases is not yet clear. STUDY DESIGN/PATIENTS AND METHODS: We report on a female patient with lichenoid dermatitis that was presumably drug-induced (roxatidine, H(2) receptor antagonists). After a 10-month treatment with local corticosteroids, without significant clearance the drug was discontinued and the pulsed dye laser was used (wavelength 585 nm, pulse duration 450 microseconds). RESULTS: Six laser treatments resulted in complete clearance of the lesions. No recurrence occurred during the follow-up period of 54 months. Scars were not observed. A post-operative biopsy showed no evidence of lichenoid dermatitis. CONCLUSIONS: The pulsed dye laser seems to accelerate the clearance of presumably drug induced corticosteroid-resistant lichenoid dermatoses. No permanent pigmental changes or scarring were observed.

Aged↗
PubMedDate not supplied

Current therapeutic strategies for hyperhidrosis: a review.

Overproduction of sweat by the exocrine sweat glands is called hyperhidrosis. It is differentiated into two forms - a localised (e.g. axillary, palmar and plantar hyperhidrosis) and a generalised form that affects the entire skin. Patients with increased sweat production often suffer from enormous psychosocial stress because they are restricted in both their private and professional lives. If the hyperhidrosis is not caused by a primary disease (e.g. hyperthyroidism or phaeochromocytoma) that can be treated, with elimination of the sweating problem, then only symptomatic treatment is possible. For axillary hyperhidrosis, local application of aluminium chloride seems to be the method of choice; an alternative is botulinum toxin whose efficacy for 3 to 9 months is an advantage. Surgical options should not be considered until conservative methods have failed. Curettage with a scraper and liposuction are reliable and safe treatments for axillary hyperhidrosis. The method of choice in treating palmoplantar hyperhidrosis is tap water iontophoresis. Adding anticholinergic substances to the water produces a more rapid therapeutic success that also lasts longer. Botulinum toxin can be an effective and promising alternative. Surgical treatment, i.e. sympathectomy, does bring about a long-term resolution of the problem, but should only be considered in well-justified cases because of the highly invasive character of the procedure. The use of systemic anticholinergic medication for patients with localised or generalised tendency to sweat can be tried, but is often limited because of the profile of adverse effects. It can be stated that in spite of the interesting and promising new alternatives, especially using botulinum toxin, the tried-and-true procedures such as tap water iontophoresis and aluminium chloride salts still have a firm place in the treatment of hyperhidrosis.

Administration, Topical↗