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Christian Raulin

Publications and source records attributed to Christian Raulin.

16 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

Evaluation of different temperatures in cold air cooling with pulsed-dye laser treatment of facial telangiectasia.

BACKGROUND AND OBJECTIVES: Cold air cooling is widely used in dermatological laser therapy. We investigated the influence of cold air cooling at different skin temperatures on therapeutic outcome and side effects of pulsed dye laser treatment of facial telangiectasia. STUDY DESIGN/MATERIALS AND METHODS: From September 2002 to February 2003, 17 patients with previously untreated facial telangiectasia underwent a single treatment session with flash-lamp pulsed dye laser (3.5 J/cm(2), 585 nm, 0.45 milliseconds pulse length, 10 mm beam diameter, Cynosure V). The treatment area was divided into three sub-areas: no cooling, cold air cooling to 20 degrees C and to 17 degrees C skin temperature. The skin temperature was monitored by a prototype infrared sensor system which controlled the temperature of the cold air stream (Cryo5). In a prospective study, we collected data on purpura, pain, clearance, and patient satisfaction on numerical analog scales (NAS) from 0 (meaning "no") to 3 (meaning "high"). RESULTS: Without cooling, purpura (2.53), pain (2.41), and clearance (2.35) were rated medium to high. Cooling to 20 degrees C reduced purpura (1.12) and pain (1.06), whereas the clearance (2.12) was only slightly affected. Cooling to 17 degrees C reduced purpura (0.88) and pain (0.76) even more, the clearance (2.06) was lowered marginally. Most patients preferred cooling to 20 degrees C skin temperature. CONCLUSION: In dermatological laser therapy of facial telangiectasia, the use of cold air cooling can significantly reduce side effects and increase patient satisfaction while only slightly affecting clearance. Cooling to 20 degrees C skin temperature proved to be a well-balanced middle course. For the practical use of cold air cooling, we thus recommend cooling to a level which the patient can tolerate without problems and to try to increase the energy densities.

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

Single-pass carbon dioxide laser skin resurfacing combined with cold-air cooling: efficacy and patient satisfaction of a prospective side-by-side study.

BACKGROUND: Ablative skin resurfacing with carbon dioxide (CO(2)) and erbium:YAG lasers is still considered the gold standard for treating rhytides, photodamage, and acne scars. However, the prolonged downtime and undesired concomitant effects that are involved have sent dermatologists looking for less invasive nonablative laser techniques to rejuvenate skin. OBJECTIVE: To combine cold-air cooling with single-pass CO(2) laser skin resurfacing to generate as much benefit as possible while minimizing the spectrum of adverse effects. STUDY DESIGN: The efficacy of single-pass CO(2) laser skin resurfacing on perioral and periorbital wrinkles was examined prospectively during a 6-month follow-up period. In a side-by-side comparison, the influence of simultaneous cold-air cooling on concomitant effects, pain tolerance, therapeutic success, and patient satisfaction was also studied. Eight patients with perioral and/or periorbital wrinkles underwent the procedure. During laser treatment, only the right half of each face was cooled using a cold-air system. RESULTS: Six months after treatment, a mild improvement of the wrinkles was observed in all cases. The use of cold-air cooling did not have any impact on the long-term results, although in a direct comparison between sides, it was observed that cooling reduced the recovery period from 3.9 +/- 1.5 (mean +/- SD) days to 3.5 +/- 1.4 days (P = .09) and helped postoperative erythema fade more quickly, from an average of 21.3 +/- 17.9 days to 11.7 +/- 3.9 days (P = .17). The reduction of pain was significant, which led to a much higher level of patient acceptance: on a numerical analog scale of 1 to 10, the rate decreased from an average of 6.8 +/- 1.8 (mean +/- SD) to 3.6 +/- 1.7 (P = .006). CONCLUSIONS: Given the clear decline in demand for invasive laser technologies, single-pass CO(2) laser skin resurfacing in conjunction with cold-air cooling is a worthwhile alternative both to conventional resurfacing and to conventional subsurfacing. The use of cold-air cooling not only minimizes intraoperative and postoperative adverse effects, it also contributes strongly to patient satisfaction.

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↗
PubMed2004

Prospective study of port wine stain treatment with dye laser: comparison of two wavelengths (585 nm vs. 595 nm) and two pulse durations (0.5 milliseconds vs. 20 milliseconds).

BACKGROUND AND OBJECTIVES: The conventional pulsed-dye laser (wavelength 585 nm, pulse duration 0.5 milliseconds) is seen as the standard treatment for port wine stains (PWS). Using the pulsed-dye laser at wavelengths of 590, 595, and 600 nm and at varying pulse durations of 1.5-40 milliseconds is one of the newest developments in the field, the therapeutic value of which has been examined in only a few studies. Treatment of PWS with short- and long-pulse dye lasers. Comparison of two wavelengths (585 nm vs. 595 nm) and two pulse durations (0.5 milliseconds vs. 20 milliseconds). STUDY DESIGN/MATERIALS AND METHODS: Fifteen patients with untreated PWS were included in a randomized prospective study with three different laser settings. Patients underwent one treatment session. The following treatment parameters were chosen at a uniform spot size of 7 mm: (1) 585 nm/0.5 milliseconds/5.5 J/cm(2), (2) 595 nm/0.5 milliseconds/5.5 J/cm(2), and (3) 595 nm/20 milliseconds/13 J/cm(2). The clearance as well as side effects was evaluated. All treatments were performed with cold air-cooling. Follow-up took place immediately, 2 days and 4 weeks after the treatment. The PWS was assigned a clearance score (CS) from 1 to 4 (1 = poor to 4 = excellent). RESULTS: Descriptively, 585 nm/0.5 milliseconds generated the best average CS of 2.7, followed by 595 nm/20 milliseconds (2.5) and 595 nm/0.5 milliseconds (1.6)); statistically, there is no difference between the CS of 585 nm/0.5 milliseconds and 595 nm/20 milliseconds. The best lightening rates overall were achieved in purple PWS (CS = 3.5) versus red (CS = 2.5) and pink (CS = 2.0). Purple PWS responded best to 585 nm/0.5 milliseconds; red and pink PWS yielded similar results with 585 nm/0.5 milliseconds and 595 nm/20 milliseconds. The setting, 595 nm/0.5 milliseconds was clearly not as effective as the other laser settings. Purpura, pain, and crusting were most commonly reported after treatments with 585 nm/0.5 milliseconds (93%/93%/33%), closely followed by treatments at 595 nm/20 milliseconds (86%/93%/20%). The settings 595 nm/0.5 milliseconds yielded the lowest rate of adverse effects (67%/60%/0%). Hypopigmentation only occurred in one case (585 nm/0.5 milliseconds), and there were no reports of hyperpigmentation or scarring. CONCLUSIONS: With respect to treating PWS, the conventional pulsed-dye laser set to 585 nm/0.5 milliseconds yields a significantly greater clearance rate than it does at a setting of 595 nm (with the same pulse duration, fluence, and spot size), although the former also entails the highest spectrum of adverse effects. In this study, purple PWS treated at these parameters showed the best results. In dealing with pink PWS, the results were similar to those of the conventional pulsed-dye laser when the pulse duration was increased to 20 milliseconds and fluence was increased. As a rule, the clearance rate corresponded to the extent of the postoperative purpura.

Adolescent↗
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

The combined continuous-wave/pulsed carbon dioxide laser for treatment of pyogenic granuloma.

BACKGROUND: Pyogenic granuloma is a frequently diagnosed, benign vascular lesion. OBJECTIVES: To present the use of the combined continuous-wave/pulsed carbon dioxide (CO2) laser as an innovative therapeutic method, to compare it with established methods, and to assess its results. DESIGN: Prospective observational study between March 1998 and July 2000, comprising 1 treatment session with 6-week and 6-month follow-up examinations and evaluations. SETTING: Private or institutional practices as well as ambulatory or hospitalized care. PATIENTS: One hundred patients with pyogenic granuloma selected from a population-based sample. INTERVENTIONS: Treatment with CO2 laser. The laser was first used in continuous mode (power, 15 W) and then in pulsed mode (pulse length, 0.6-0.9 milliseconds; energy fluence, 500 mJ/pulse). MAIN OUTCOME MEASURE: Complete resolution of treated granuloma pyogenicum. RESULTS: Pyogenic granuloma was removed completely in 1 treatment session in 98 patients without recurrence. In 88 cases there were no visible scars; in 10 cases slight textural changes of the skin were observed. Hypertrophic scars or keloids did not occur. Sixty-three patients were very satisfied with the result of the treatment, 37 were satisfied (ie, 100% patient satisfaction), and none indicated that they were not satisfied. No permanent hypopigmentation, hyperpigmentation, or erythema was observed. CONCLUSIONS: The combined continuous-wave/pulsed CO2 laser is our treatment of choice for pyogenic granuloma because this kind of laser is widely available, produces excellent results with few adverse effects, is easy to use, yields low recurrence rates, and is well tolerated by most patients.

Adolescent↗
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↗
PubMed2002

Professional errors caused by lasers and intense pulsed light technology in dermatology and aesthetic medicine: preventive strategies and case studies.

BACKGROUND: The use of lasers and intense pulsed light (IPL) technology has become established practice in dermatology and aesthetic medicine. The increase in popularity and widespread use of such equipment has been accompanied by a sharp increase in the number of case reports about professional errors. OBJECTIVE: We present 14 case studies of professional errors. METHODS: Selected representative case reports are used to illustrate and discuss typical professional errors and serve as the basis for creating preventive strategies. RESULTS: Recommendations have been developed for the following areas: physician training, patient information, documentation, diagnosis, indication, test treatment, and performing treatment. CONCLUSION: The use of lasers and IPL technology in dermatology and aesthetic medicine requires practitioners not only to have high levels of training and experience, but also to exercise professional judgment. In spite of all of the precautions taken, the risk of complications and side effects can be reduced but not completely eliminated.

Facial Dermatoses↗
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↗