Vascular mechanisms in laser hair removal.
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Hair Follicle↗
Biomedical subjects
R M Adrian
Publications and source records attributed to R M Adrian.
800 nanometer diode laser hair removal in African American patients: a clinical and histologic study.
BACKGROUND: Although numerous lasers are available for laser assisted hair removal, their use in individuals with a dark skin type presents many challenges due to competition from epidermal melanin. OBJECTIVE: Our aim was to evaluate two 800 nm diode lasers (Lightsheer) with 30 msec and 100 msec pulse durations in the treatment of African American patients with skin types V and VI. Histologic studies, efficacy and side effects were examined in an effort to optimize laser hair removal procedures in this patient population. METHODS: Facial, neck and axillary areas were treated using 800 nm diode lasers at 30 and 100 msec pulse durations with fluences between 15 J/cm2 and 40 J/cm2. RESULTS: Both lasers could be used safely in skin type V and VI African American patients. Longer pulse durations enabled the delivery of higher fluences with minor and acceptable postoperative complication profiles. CONCLUSION: The Lightsheer diode laser (Coherent Medical, Santa Clara, CA, USA) operating at 30 msec and 100 msec can be safely used in hair removal procedures in African American patients.
Black or African American↗
Laser tattoo removal.
The availability of Q-switched ruby Nd:YAG and alexandrite lasers has revolutionized the treatment of tattoos. These modalities offer significant advantages over all previously available treatments and are currently the standard of care for the cosmetic removal of unwanted tattoos.
History, 20th Century↗
Laser therapy of spider leg veins: clinical evaluation of a new long pulsed alexandrite laser.
BACKGROUND: The response of spider leg veins to laser or intense pulsed light therapy has generally been characterized by varying degrees of success and frequently inconsistent clinical response rates. OBJECTIVE: The purpose of this study was to examine the effectiveness of the 755 nm long pulsed infrared alexandrite (LPA) laser for the treatment of leg telangiectasias. METHODS: This study was constructed in four phases. Phase I examined 28 patients with variable sized telangiectasias using 5 treatment parameters (15 J/cm2 x 1 pulse, 20 J/cm2 x 1 pulse, 20 J/cm2 x 2 pulses, 20 J/cm2 x 3 pulses, or 30 J/cm2 x 1 pulse). Each patient received 3 treatments at 4 week intervals with the LPA. Patient diaries were obtained to examine the effects of the treatments. Subjective grading was performed at each follow-up visit by the investigators. Blinded objective grading was performed at the conclusion of the study by trained observers. Phase II examined the effects of these treatment parameters on varying vessel diameters. Vessels were grouped into small (<0.4 mm), intermediate (0.4-1.0 mm), and large (1.0-3.0 mm) subsets. Phase III examined the effects of a combination of LPA treatment followed by 23.4% hypertonic saline sclerotherapy. Subjective and blinded objective grading was used to determine improvement after a single treatment with the LPA at 20 J/cm2, single pulsed with a pulse duration of 5 or 10 msec followed by treatment with 23.4% hypertonic saline injected 3, 7, 14, or 28 days after laser therapy. Phase IV involved biopsies after LPA treatment alone at time intervals of immediately posttreatment and 5 and 21 days posttreatment. RESULTS: These evaluations revealed that the optimal treatment parameters for LPA therapy alone appeared to be 20 J/cm2, double pulsed at a repetition rate of one Hz. After 3 treatments at 4 week intervals, subjective grading indicated a 63% reduction in leg telangiectasias. Medium diameter vessels responded best with small vessel diameters responding poorly, if at all. The addition of 23.4% hypertonic saline sclerotherapy performed 3 to 7 days after laser therapy (LPA at 20 J/cm2, single pulsed with a pulse duration of 5 msec) produced 87% reduction in leg telangiectasias. Biopsies after LPA treatment revealed vessel wall endothelial cell necrosis at 5 days with fibrosis occurring at 3 weeks. The optimal clinical "window" for sclerotherapy seems to coincide with the period of endothelial cell necrosis. CONCLUSION: LPA therapy is most effective for leg telangiectasias 0.4-3.0 mm in diameter. This LPA technique is significantly improved with the addition of sclerotherapy.
Adult↗
Pulsed carbon dioxide and long pulse 10-ms erbium-YAG laser resurfacing: a comparative clinical and histologic study.
BACKGROUND: The recent introduction of pulsed erbium-YAG laser technology has been accompanied by relatively few clinical studies with widely varying claims regarding postoperative healing, clinical side-effects and efficacy. We evaluated a new long (10 ms) pulsed erbium-YAG laser in order to determine safety and clinical efficacy in comparison with a pulsed carbon dioxide laser. OBJECTIVE: Our objective was to comparatively evaluate a pulsed CO2 and long-pulsed erbium-YAG laser with regard to clinical side-effects, postoperative healing and efficacy in the reduction of rhytids. METHODS: Bilateral periocular or perioral sites were treated using a pulsed CO2 (UltraPulse) laser on one side and long-pulsed erbium-YAG laser (CO3) on the opposite side. Histologic specimens were also studied in order to compare tissue effects of both lasers. RESULTS: Results showed equivalent postoperative healing and lack of complications. In addition, the long-pulsed erbium-YAG laser showed significant efficacy in the treatment of mild and moderate rhytids. CONCLUSION: The long-pulsed (10 ms) erbium-YAG laser appears to be of significant benefit in the treatment of facial rhytids. Tissue studies show a greater degree of thermal damage in the dermis when compared to traditional 350 microseconds erbium-YAG lasers which may underlie the beneficial effects of this laser in the treatment of aging skin.
Adult↗
Pulsed carbon dioxide and erbium-YAG laser resurfacing: a comparative clinical and histologic study.
BACKGROUND: The recent introduction of pulsed erbium-YAG (Er:YAG) laser technology has been accompanied by relatively few clinical studies with widely varying claims regarding post-operative healing, clinical side effects and efficacy. OBJECTIVE: The aim was to evaluate comparatively pulsed CO2 and Er:YAG lasers with regard to clinical side effects, post-operative healing and efficacy when equivalent depths of histologic damage were produced. METHODS: Bilateral periocular or perioral sites were treated using a pulsed CO2 laser on one side and a pulsed Er:YAG laser on the opposite side. Attempts were made to produce equivalent depths of coagulation (CO2) and ablation (erbium). RESULTS: Results showed almost equivalent post-operative healing. However, the pulsed CO2 laser proved more effective in the treatment of moderate and deep rhytids. CONCLUSION: When equivalent depths of coagulation and ablation are compared, the healing time is similar. CO2 proved to be more efficacious in the treatment of perioral and periocular rhytids.
Adult↗
Treatment of leg telangiectasias using a long-pulse frequency-doubled neodymium:YAG laser at 532 nm.
BACKGROUND: At the present time a large variety of vascular lesion lasers are available for the treatment of both congenital and acquired disorders of blood vessels. Although most vascular lesions lasers are variably effective in the treatment of facial telangiectasias, port-wine stains, hemangiomas, and other vascular anomalies, their use in the treatment of leg veins has been disappointing. Histologic, anatomic, and other variables have been associated with a poor response of leg veins to currently available vascular lesion lasers. OBJECTIVE: This study examines the use of a new long pulse frequency-doubled Neodymium (Nd):YAG laser emitting radiation at 532 nm for the treatment of leg veins. METHODS: Fifty patients with leg telangiectasias of varying diameters were treated using a variable pulse width frequency doubled Nd:YAG laser. This laser delivers energy through a novel water-cooled chill tip, which appears to limit epidermal damage during laser treatment. RESULTS: Sixty-two treatment sites were evaluated in 50 patients. Seventy-three percent of patients had greater than 50% improvement after one treatment. Eight-three percent were graded with clearances of better than 50% after two treatments, with 63% showing greater than 75% improvement. CONCLUSION: The VersaPulse variable pulse width laser appears to be an effective modality for the treatment of leg telangiectasias. The relative lack of patient discomfort combined with a high degree of patient satisfaction may indicate a fairly high level of patient acceptance of this new form of therapy for the treatment of leg telangiectasias.
Humans↗
Long pulse 532-nm laser treatment of facial telangiectasia.
BACKGROUND: Facial telangiectasias are a frequently observed cosmetic concern: Current therapeutic modalities have certain side effects and limitations. We treated a group of patients with facial telangiectasias with a new variable pulse width frequency-doubled neodymium: YAG laser at 532 nm. OBJECTIVE: This study evaluated the clinical response and side effects during the treatment of facial telangiectasias in 40 patients. METHODS: Forty patients with facial telangiectasias were treated with the VersaPulse laser. Fluences of between 9.5 and 12.0 J/cm2 at 3 or 4-mm spot size were used. A sapphire water-cooled chill tip was used to cool the cutaneous surface during treatment. RESULTS: Ninety percent of patients experienced between 75% and 100% clearance of their facial telangiectasias after single treatment. No significant side effects or complications were noted. CONCLUSION: The VersaPulse variable pulse width neodymium: YAG laser appears to be an effective treatment modality for facial telangiectasia.
Face↗
The erbium:YAG laser: facts and fiction.
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Dermatologic Surgical Procedures↗
Familial Kaposi's sarcoma.
Familial cases of Kaposi's sarcoma are exceedingly rare. We identified an 85-year-old man with Kaposi's sarcoma. Multiple lesions were present on the feet. Previously, the man's 84-year-old sister presented with similar lesions on the lower extremity. Both siblings were lifelong residents of the United States and were of English/German descent. Neither had risk factors for infection with human immunodeficiency virus (HIV). On histologic examination, lesions in both patients demonstrated vascular slits, hemorrhage, and dense aggregates of spindle cells within the dermis.
Aged↗
Therapeutic dermabrasion.
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Dermabrasion↗
Multiple keratoacanthomas possibly induced by psoralens and ultraviolet A photochemotherapy.
We report two patients who developed multiple keratoacanthomas while receiving photochemotherapy (PUVA). Both patients had received excessive doses of PUVA, which resulted in severe phototoxicity. The role of PUVA in the production of these lesions is discussed.
Adult↗
Diffuse melanosis secondary to metastatic malignant melanoma. Light and electron microscopic findings.
Tumor-free hyperpigmented skin from a patient with diffuse melanosis secondary to metastatic melanoma was examined by light and electron microscopy. Our findings indicate that the pathogenesis of this diffuse slate blue color is primarily to pigment deposition within perivascular dermal macrophages. We did not find intact melanosomes or individual tumor cell metastases in clinically normal skin, as has been previously reported.
Adult↗
Photochemotherapy in psoriasis and other skin diseases.
Oral psoralen-ultraviolet A (PUVA) therapy is one of the most effective treatment methods available for psoriasis. The combination of psoralen and ultraviolet A radiation inhibits DNA synthesis. Its usefulness in treating other skin conditions such as mycosis fungoides and vitiligo is being explored. While PUVA seems relatively safe, long-term risks associated with this therapy are unclear. Special training and careful dosimetry are important.
Humans↗
Outpatient phototherapy for psoriasis.
Using a new protocol with varied exposure increments, we found that, in 18 of 20 patients with psoriasis vulgaris who were given ultraviolet (UV)-B phototherapy three times a week, the disease completely cleared. One patient's condition substantially improved, and one patient's condition failed to respond. Ten to 38 treatments were required during a three- to 13-week period. The only topical treatment agent used was white petrolatum. The results are compared with a schedule using five treatments a week and fixed UV-B--exposure increments. Infrequent (three times weekly) treatments, avoidance of hospitalization and crude coal tar treatment, and fewer episodes of UV-radiation burn may offer advantages for selected patients. Long-term effects and maintenance requirements for this treatment regimen are not known.
Administration, Topical↗
Perifolliculitis capitis: successful control with alternate-day corticosteroids.
A case of perifolliculitis capitis is reported in which the patient was initially treated with high-dose intravnous antibiotics and topical antibacterial agents without success. Systemic corticosteroids were instituted, with rapid subsidence of disease activity. One year later, the patient remains on 5 mg of prednisone on alternate days, and is free of disease activity. In view of other more aggressive treatments reported in the literature for this disease, high-dosage prednisone with rapid change to alternate-day dosage is a reasonable initial course of action.
Adrenal Cortex Hormones↗
Analysis of epidermal fibrous proteins in inflammatory linear verrucous epidermal nevus.
A baby had inflammatory linear verrucous epidermal nevus (ILVEN). Scale from the lesion was analyzed by sodium lauryl sulfate polyacrylamide gel electrophoresis. It showed a pattern different from psoriatic scale. This procedure was useful in distinguishing the lesion (or ILVEN) from psoriasis, the diagnosis that had been made earlier.
Diagnosis, Differential↗
Mucocutaneous reactions to antineoplastic agents.
Mucocutaneous reaction patterns in patients receiving cancer therapy are not only variable, but in many instances identical patterns are produced by different pathologic mechanisms. For example, patients with leukemia or lymphoma may present with nodular skin lesions that may represent malignant infiltration, septic emboli, vasculitis, or a drug eruption. The most banal skin eruption may signal an impending or ongoing catastrophe. If one is able to make some clinical evaluation regarding the likelihood of a drug being responsible for the mucocutaneous eruption, it may help avoid further clinical or laboratory investigation and patient discomfort. Unfortunately, only a few antineoplastic agents have "characteristic" skin manifestations. If, however, these are kept in mind they may be helpful in the diffential diagnosis of mucocutaneous eruptions occurring in patients treated with cancer chemotherapeutic agents.
Alkylating Agents↗