Biomedical subjects

M C Grossman

Publications and source records attributed to M C Grossman.

12 recordsLinked to original sources

PubMed2000

Prospective study of hair reduction by diode laser (800 nm) with long-term follow-up.

BACKGROUND: Multiple laser systems are available for the purpose of hair removal. OBJECTIVE: The purpose of this study was to determine the safety and long-term efficacy of the 800 nm, pulsed diode laser at reducing hair count. METHODS: Fifty volunteers, primarily Fitzpatrick skin types II and III, with dark brown or black hair, were treated with a diode laser (800 nm, 10-40 J/cm2, 5-30 msec, 9 mm 9 mm, 5 degrees C chilled handpiece). Each subject had eight treatment sites at varying fluences and pulse durations, as well as a varying number of treatments and pulses. Hair counts were obtained at each site at baseline, 1, 3, 6, 9, and an average of 20 months after treatment. RESULTS: After one treatment, hair regrowths ranged from 22 to 31% at the 1-month follow-up visit, then remained stable between 65 and 75% from the 3-month to the averaged 20-month follow-up. After two treatments there were relatively longer growth delays, with hair regrowths plateauing beginning at 6 months after treatment and ranging from 47 to 66% for the remainder of the follow-up evaluations. Side effects were limited to pigmentary changes, transient in subjects with skin types II and III. CONCLUSIONS: This 800 nm diode laser with a chilled sapphire tip and variable pulse duration is safe and effective for long-term hair reduction in individuals with skin types II and III.

Dose-Response Relationship, Radiation↗

PubMed1999

Effects of topical vitamin K and retinol on laser-induced purpura on nonlesional skin.

BACKGROUND: Pulsed dye laser treatments usually result in purpura. Any topical application that eliminates or shortens the duration of purpura would be extremely useful. OBJECTIVE: The purpose of this prospective study was to determine the safety and efficacy of topical vitamin K cream in shortening the duration of laser-induced purpura. METHODS: Twenty adult subjects were enrolled. Each subject had five 1.5 cm sites treated with a pulsed dye laser at 585 nm, 450 nsec, 7 mm spot size at each subject's respective threshold fluence. Each subject had a control site where no topical application was used and four other sites where a different formulation was applied to each for 2 weeks before and for 2 weeks after laser irradiation. Five vitamin K formulations with or without retinol were studied: 3% vitamin K in acrylates copolymer cream, 5% vitamin K in acrylates copolymer cream, 1% vitamin K and 0.3% retinol in acrylates copolymer cream, 1% vitamin K and 0.15% retinol in acrylates copolymer cream, 1% free vitamin K cream. Purpuric discoloration at each site was rated on days 0, 1, 3, 7, 10, and 14 after laser treatment on a quartile scale. Each site was assigned 100% discoloration on day 0 after laser irradiation. RESULTS: Laser-induced purpuric discoloration resolved faster with 1% vitamin K and 0.3% retinol in acrylates copolymer cream than with no topical application. The difference is statistically significant from day 3 onward. CONCLUSION: A combination of 1% vitamin K and 0.3% retinol in acrylates copolymer cream hastened the resolution of laser-induced purpura.

Administration, Topical↗

PubMed1998

Permanent hair removal by normal-mode ruby laser.

OBJECTIVE: To assess the permanence of hair removal by normal-mode ruby laser treatment. METHODS: Hair removal was measured for 2 years after a single treatment with normal-mode ruby laser pulses (694 nm, 270 microseconds, 6-mm beam diameter). OBSERVATIONS: Six test areas on the thighs or backs of 13 volunteers were exposed to normal-mode ruby laser pulses at fluences of 30 to 60 J/cm2 delivered to both shaved and wax-epilated skin. In addition, there was a shaved and wax-epilated control site. Terminal hairs were manually counted before and after laser exposure. Transient alopecia occurred in all 13 participants after laser exposure, consistent with induction of telogen. Two years after laser exposure, 4 participants still had obvious, significant hair loss at all laser-treated sites compared with the unexposed shaved and wax-epilated control sites. In all 4 participants, there was no significant change in hair counts 6 months, 1 year, and 2 years after laser exposure. Laser-induced alopecia correlated histologically with miniaturized, velluslike hair follicles. No scarring and no permanent pigmentary changes were observed. CONCLUSIONS: Permanent, nonscarring alopecia can be induced by a single treatment with high-fluence ruby laser pulses. Miniaturization of the terminal hair follicles seems to account for this response.

Alopecia↗

PubMed1998

Scar resurfacing with high-energy, short-pulsed and flashscanning carbon dioxide lasers.

BACKGROUND: Scars have a significant effect on a person's physical and social being. Many treatment modalities for scar improvement such as surgical scar revision, electrosurgical planing, chemical peeling, filler substance implantation, and dermabrasion have been developed. Recently, the resurfacing carbon dioxide (CO2) laser systems have proven to be a useful and safe treatment in the treatment of facial rhytides and acne scarring. OBJECTIVE: The purpose of this study was to evaluate the resurfacing CO2 lasers in the treatment of various surgical, traumatic, acne, and varicella scars. METHODS: Thirty subjects, aging between 14 and 84 years, with surgical, traumatic, acne, or varicella scars were evaluated. Two types of resurfacing laser systems were utilized in this study, a high-energy, short-pulsed CO2 laser and a continuous wave CO2 laser with an optico-mechanical computer flash-scanner. Post-surgical scars were treated with laser resurfacing between 4 and 6 weeks after scar formation. Traumatic, acne, and varicella scars were treated after scar maturation (range, 1-10 years). Scar improvement was evaluated by photographic analysis of before and after images by four independent health care workers using a quartile scale of improvement (< 25%, 25-49%, 50-74%, > 75%) as well as optical profilometry using silicone surface impressions in 12 scars. RESULTS: Twenty of 24 surgical scars had greater than 75% improvement, and 24 of 24 had greater than 50% improvement by photographic analysis. All six traumatic, acne and varicella scars had greater than 50% improvement. Optical profilometry and surface topography maps reveal a significant flattening of related and depressed scars. CONCLUSION: The high-energy, short-pulsed CO2 laser and the continuous wave CO2 laser with flash-scanning attachment are safe and effective as a treatment modality for scar revision. In general, elevated scars improve more dramatically than depressed scars.

Adolescent↗

PubMed1997

Long-term results after CO2 laser skin resurfacing: a comparison of scanned and pulsed systems.

BACKGROUND: New laser technology permits the use of high-energy pulsed and continuous-wave carbon dioxide (CO2) lasers with flashscanners to treat rhytides. OBJECTIVE: We compared the efficacy and side effects of the two leading CO2 lasers used in skin resurfacing. METHODS: A total of 28 patients with facial rhytides were treated with either the UltraPulse or SilkTouch laser systems; in five additional patients, contralateral cosmetic units were treated with one system or the other in a direct comparison of the lasers. RESULTS: We compared photographs taken before and after treatment, and a lessening of facial wrinkling was noted in all subjects. In some subjects improvement was confirmed by optical profilometry methods. Biopsy specimens in representative patients showed that immediate thermal damage was limited to 180 microns. Long-term postoperative specimens showed changes in the papillary dermis consistent with new collagen deposition and reduction of pretreatment solar elastosis. Posttreatment facial erythema was noted in half the patients for up to 2 months; transient hyperpigmentation was observed in one third of the treated areas. CONCLUSION: Although the SilkTouch system produced more immediate thermal damage, there were no significant differences in efficacy or adverse effects between the lasers. Our results suggest that both laser systems, used with appropriate settings, are capable of safely smoothing the skin surface.

Adult↗

PubMed1997

What is new in cutaneous laser research.

Laser surgery is a dynamic, growing field in dermatology. Recent advances in cutaneous laser applications include the treatment of scars, wrinkles, warts, and stretch marks. Current investigation focuses on permanent hair removal and leg vein treatment as well as improvement of current treatment of vascular and pigmented lesions. This article provides an overview of laser applications and focuses on novel research.

Dermatology↗

PubMed1997

The short- and long-term side effects of carbon dioxide laser resurfacing.

BACKGROUND: Carbon dioxide (CO2) laser resurfacing has become a very popular method of rhytide and scar removal in the recent past. Preliminary studies have been published describing the method, histology, and clinical results of CO2 laser resurfacing. However, none of these studies has dealt with long-term follow-up results. OBJECTIVE: To review all side effects resulting from CO2 laser resurfacing with regard to both short- and long-term effects. METHOD: Retrospective analysis of 104 patients who have undergone CO2 laser resurfacing for either facial rhytides and/or scarring with follow-up periods of 4-23 months (average, 8.2 months). RESULTS: The incidence of side effects are generally very low for CO2 laser resurfacing, including scarring, postinflammatory hyperpigmentation, and infection. However, there is a significant and previously unreported risk of hypopigmentation in an area of the population who often seek improvement in the appearance. CONCLUSIONS: CO2 laser resurfacing of facial rhytides and acne scars can be a very safe procedure by an experienced laser operator. However, careful patient selection, thorough patient instruction, and proper aesthetic analysis of treatment sites must be followed to insure the most favorable outcomes with CO2 laser resurfacing.

Adult↗

PubMed1996

Damage to hair follicles by normal-mode ruby laser pulses.

BACKGROUND: Although many temporary treatments exist for hirsutism and hypertrichosis, a practical and permanent hair removal treatment is needed. OBJECTIVE: Our purpose was to study the use of normal-mode ruby laser pulses (694 nm, 270 microseconds, 6 mm beam diameter) for hair follicle destruction by selective photothermolysis. METHODS: Histologically assessed damage in ex vivo black-haired dog skin after the use of different laser fluences was used to design a human study; 13 volunteers with brown or black hair were exposed to normal-mode ruby laser pulses at fluences of 30 to 60 J/cm2, delivered to both shaved and wax-epilated skin sites. An optical delivery device designed to maximize light delivery to the reticular dermis was used. Hair regrowth was assessed at 1, 3, and 6 months after exposure by counting terminal hairs. RESULTS: Fluence-dependent selective thermal injury to follicles was observed histologically. There was a significant delay in hair growth in all subjects at all laser-treated sites compared with the unexposed shaven and epilated control sites. At 6 months, there was significant hair loss only in the areas shaved before treatment at the highest fluence. At 6 months, four subjects had less than 50% regrowth, two of whom showed no change between 3 and 6 months. Transient pigmentary changes were observed; there was no scarring. CONCLUSION: Selective photothermolysis of hair follicles with the normal-mode ruby laser produces a growth delay consistent with induction of prolonged telogen with apparently permanent hair removal in some cases.

Animals↗

PubMed1996

Acquired eyelash trichomegaly and alopecia areata in a human immunodeficiency virus-infected patient.

We describe a human immunodeficiency virus (HIV) seropositive man with acquired eyelash trichomegaly and alopecia areata. This combination of clinical manifestations is intriguing since the new onset of elongated eyelashes in patients with acquired immunodeficiency syndrome has usually been associated with severe immunosuppression and alopecia areata has a presumed autoimmune etiology that requires T cell activation. The occurrence of these dichotomous conditions illustrates the potential selective pathogenesis of progressive HIV infection.

Adult↗

PubMed1995

Treatment of cafe au lait macules with lasers. A clinicopathologic correlation.

BACKGROUND: Cafe au lait macules (CALMs) respond variably to treatment with different lasers. This study was done to determine whether the type of laser and the individual histologic features of the CALMs could predict clinical response to treatment. Nine CALMs were treated with both the frequency-doubled Q-switched neodymium: YAG laser (wavelength, 532 nm; beam diameter, 2.0 mm) and the Q-switched ruby laser (wavelength, 694 nm; beam diameter, 5.0 mm). Both lasers were used at a fluence of 6.0 J/cm2. Biopsy specimens of the CALMs were obtained before and after treatment. Clinical follow-up was done at 1-, 3-, and 6-month intervals. OBSERVATIONS: Both lasers yielded variable responses to treatment. Two histologic subtypes of CALMs were identified, but these different subtypes did not predict clinical outcome after laser treatment. CONCLUSIONS: Cafe au lait macules respond variably to treatment with both the Q-switched ruby laser and the frequency-doubled Q-switched neodymium:YAG laser. Further research might address the effect of using multiple treatments. In view of these results, clinicians using lasers to treat CALMs should inform their patients of the potential for recurrence or darkening of CALMs.

Adult↗

PubMed1993

Chronic hyperkeratotic herpes zoster and human immunodeficiency virus infection.

A patient with human immunodeficiency virus infection had hyperkeratotic papules in the T 11 and T 12 dermatomes in which she previously had papulovesicular herpes zoster. Findings of a biopsy specimen and viral culture of these papules subsequently revealed varicella-zoster that eventually responded to prolonged high-dose acyclovir therapy and debridement. A review of reported cases of hyperkeratotic varicella-zoster infections is presented, in addition to our recommendations for the treatment of varicella-zoster infection in patients who have acquired immunodeficiency syndrome.

AIDS-Related Opportunistic Infections↗

PubMed1992

The Tzanck smear: can dermatologists accurately interpret it?

BACKGROUND: The Tzanck preparation is a standard technique for the rapid diagnosis of herpes simplex and varicella-zoster virus infections. OBJECTIVE: This study was designed to determine the ability of practicing dermatologists to interpret Tzanck preparations accurately. METHODS: Dermatologists at different levels of training interpreted a series of Tzanck preparations under test conditions. RESULTS: Second- and third-year residents had a pooled average for correct responses of 91%; dermatologists in practice less than 10 years, 84%; dermatologists in practice more than 10 years, 67%. CONCLUSION: Dermatologists are able to use the Tzanck preparation effectively for diagnosing herpetic infections. Second- and third-year residents who are most likely to be diagnosing blistering eruptions in immunosuppressed or otherwise critically ill patients are especially accurate interpreters.

Clinical Competence↗