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P Boixeda

Publications and source records attributed to P Boixeda.

15 recordsLinked to original sources
PubMed2006

[Laser treatment of port wine stain].

Laser treatment of vascular skin lesions is rapidly improving. Port wine stain (PWS) is one of the first lesions successfully treated with laser. The pulsed dye laser (PDL) has been developed on the concept of selective photothermolysis and has revolutionized PWS treatment. Even though the response is variable, substantial blanching can be obtained after several sessions. Greater selectivity and better response have been achieved by modifying PDL parameters such as longer pulse width, longer wavelength, or higher energy fluencies with cooling skin devices. It is known that thick, deep or raised lesions present poor response to conventional treatments. The aim of this study is to review the different lasers and other light sources which are developing for the treatment of PWS and other vascular lesions.

Humans↗
PubMed1997

Progressive ascending telangiectasia treated with the 585 nm flashlamp-pumped pulsed dye laser.

BACKGROUND AND OBJECTIVE: Progressive ascending telangiectasia (PAT) is a distinct entity with telangiectatic superficial vessels on lower extremities as its main clinical feature. A relationship with occult infections and response to antibiotic and antifungal drugs have been described, although not all cases can be successfully managed with these therapies. Our objective was to treat a woman with PAT that had failed to respond to systemic antibiotic and antifungal drugs. STUDY DESIGN/PATIENTS AND METHODS: A 44-year-old woman with PAT was treated with the flashlamp-pumped pulsed dye laser at 585 nm, with fluences varying from 7 to 7.25 J/cm2. RESULTS: A successful outcome was obtained with this treatment approach, with no relevant adverse effects except for mild pigmentary changes. CONCLUSIONS: Although ectatic vessels on lower extremities are often resistant to dye laser therapy, superficial thin capillaries like those featuring PAT can be eliminated with the pulsed dye laser at 585 nm. Transient pigmentary changes occur on treated areas but they are expected to disappear in 6 to 12 months after treatment. Laser treatment should be considered in PAT despite the extension and location of the lesions.

Adult↗
PubMed1997

Complications of 585-nm pulsed dye laser therapy.

BACKGROUND: Port-wine stains (PWS) are a congenital, progressive ectasia of the superficial cutaneous vascular plexus that occur in 0.3%-0.5% of children at birth. They should be considered a disease with physical and psychologic complications. Treatment with the flashlamp pulsed dye laser (FPOL) has proven to be effective. Because treatment results in selective vascular injury, the risk of complications is minimal. The purpose of this study was to determine the cutaneous side-effects and complications and their frequency in patients with PWS treated with the FPDL. Eighty-nine patients who had been treated with the FPDL for PWS were included in this study. METHODS: Patients were treated at 3-month intervals using slightly overlapping pulses with fluences of 6.0-9.0 J/cm2. Treating physicians were responsible for evaluating the patients. All patients were reviewed and side-effects and complications were recorded. RESULTS: Pigmentary changes were the most frequently observed complications. Hyper- and hypopigmentation appeared in 16.8% and 2.4% of patients, respectively. Cutaneous depressions occurred in 2.2% of patients. One patient developed a hypertrophic scar, and another patient presented with transient cutaneous pustulosis. All these changes usually resolved spontaneously and completely in a few months. CONCLUSIONS: Most of the side-effects and complications produced by the FPDL are usually transitory, and it is essentially a very secure technique.

Adolescent↗
PubMed1997

Evaluation of agreement among dermatologists in the assessment of the color of port wine stains and their clearance after treatment with the flashlamp-pumped dye laser.

BACKGROUND: Color classification and its subjective clearance evaluation in response to treatment are essential in the management of patients with port wine stains (PWS). But color perception by physicians is not an objective measurement so that it can change among observers. Agreement among physicians is essential for the reliability of the color classification and the clinical assessment of the response to laser treatment. OBJECTIVE: The purpose of our study was to determine the reliability of the clinical color classification of port wine stains and of their color change or clearance in response to laser treatment. The study was not designed to evaluate the outcome of laser treatment in PWS or the factors that could predict the final response. METHODS: We used the kappa index to evaluate the proportion of agreement in color and clearance perception among dermatologists. Six dermatologists classified the initial color of PWS in 80 patients. Three of them also assessed the amount of clearance achieved after treatment with the flashlamp-pumped dye laser. These three dermatologists were usually dedicated to treat patients with PWS, while the other three were not. RESULTS: The kappa index showed a substantial agreement in both cases. No difference in the initial color perception was observed between the group of dermatologists specialized in PWS and the other three dermatologists. CONCLUSION: These results favor the reliability of the clinical method in the assessment of PWS before and after laser treatment. So, although subjective, color perception by physicians can be used in the study of laser treatment outcome in PWS and its related factors, and the results of different authors can be compared.

Color↗
PubMed1994

CO2, argon, and pulsed dye laser treatment of angiofibromas.

BACKGROUND: Tuberous sclerosis is a complex disorder of hamartoma formation in many organs, particularly the skin, brain, eye, kidney, and heart. The characteristic skin lesions are angiofibromas (AF), the shagreen patch, periungual fibromas, and "ash-leaf" white macules. Treatment for AF has previously included electrocoagulation, electrodesiccation and curettage, dermabrasion, excision, cryosurgery, and oral 13-cis retinoic acid. Both argon and CO2 lasers have been used in isolated cases to treat AF. OBJECTIVE: The purpose of this work is the study of the application of three different lasers in the treatment of facial AF. METHODS: Ten patients with facial AF were treated with CO2, argon, and pulsed dye lasers. Patients' AF were graded with regard to the size and color of the lesions. A 2-3-cm2 test was assayed on the face of all patients with each laser before performing a complete treatment and in order to choose the best laser. RESULTS: Results were considered excellent in seven patients and good in three patients, with decrease of erythema and flattening of the AF. Minimal scarring was noted in two patients. Transient erythema was observed in patients treated with the CO2 laser. All patients or their parents considered the treatment cosmetically satisfactory. CONCLUSION: We found the CO2 laser to be a better therapeutic tool than the argon laser to treat AF, especially in those patients with multiple and protuberant AF. The argon laser would be more useful in those patients with very red AF and light complexion, and the pulsed dye laser in those with very red and flat AF.

Adolescent↗
PubMed1989

[Reiter's syndrome exacerbated by indomethacin].

A 26-year-old man, with a personal history of drug abuse and positive serology for HIV, had Reiter's syndrome for six years. He experienced progressive worsening of his cutaneous lesions after initiation of indomethacin therapy. The skin lesions were almost completely resolved after the discontinuance of the drug and its reintroduction resulted in a similar deterioration. To our knowledge, indomethacin has not been reported to aggravate Reiter's syndrome. This case study documents anti-inflammatory drugs as possible causal factors for triggering Reiter's syndrome. Possible implicated mechanisms are also discussed.

Adult↗
PubMedDate not supplied

Iontophoresis for anesthesia during pulsed dye laser treatment of port-wine stains.

Port-wine stains (PWS) are benign, congenital vascular malformations found in approximately 0.3% of newborns. PWS may be effectively treated with the flashlamp pulsed dye laser (FPDL) at 585 nm. However, laser therapy of vascular lesions often produces pain. We performed a prospective double-blind, placebo-controlled evaluation of the iontophoresis of lidocaine 5% with epinephrine 1:50,000 and mepivacaine 2% with epinephrine 1:50,000. Thirty-six patients with facial PWS were included in the study; 13 of them were treated with lidocaine 5% with epinephrine, another 13 were treated with mepivacaine 2% with epinephrine, and the other 13 were treated with preservative-free 0.9% NaCl. The pain was graded by the patient on a visual analog scale from 0 to 10, comparing the iontophoretically treated area with an adjacent area treated without anesthesia. Pain evaluation by patients demonstrated a significant decrease in the pain of pulsed dye laser impulses using the iontophoresis of lidocaine 5% with epinephrine. No change in the efficacy of pulsed dye laser treatment of PWS or important side effects were observed in our patients. Iontophoresis of lidocaine 5% with epinephrine is a safe and effective method of local anesthesia for pulsed dye laser and it is more effective than the iontophoresis of mepivacaine 2% with epinephrine.

Adolescent↗