Presidential Greeting - American Society for Laser Medicine and ...

#66
NON-ABLATIVE FRACTIONAL RESURFACING
WITH THE 1,927 NM THULIUM LASER IS AN
EFFECTIVE, WELL-TOLERATED TREATMENT
FOR ACTINIC CHEILITIS
Robert Anolik, Paul M. Friedman, Elliot T. Weiss,
Anne Chapas, Lori Brightman, Elizabeth K. Hale,
Julie K. Karen, Leonard Bernstein,
Roy G. Geronemus, Leonard H. Goldberg,
Abdul K. El Tal
Laser and Skin Surgery Center of New York, New York, NY;
DermSurgery Associates; MD Anderson Cancer Center Houston,
TX
Background: Actinic cheilitis is an ultraviolet radiation-induced
transformation of the vermillion portion of the lower lip. The
finding raises medical and cosmetic concerns, as it is both
premalignant and disfiguring. Despite some having apparently
focal involvement, the entire vermillion should be considered
during treatment, as actinic cheilitis tends to be a multifocal and
diffuse process. Absent from existing treatment options are welltolerated
procedures with little side effect or downtime. Recent
evidence finds nonablative fractional resurfacing using the
thullium 1,927 nm laser as effective and well tolerated for the
treatment of actinic keratosis. The objective of this study is to
assess its efficacy and tolerability for actinic cheilitis.
Study: This is a multicenter, retrospective chart review of
patients presenting with actinic cheilitis to a private laser and
skin surgery center. Upon chart review in reverse chronological
order, the first fifteen patients found to have been treated with the
nonablative fractional 1,927 nm laser for actinic cheilitis were
selected for analysis. All patients were pretreated with topical
anesthetic creams and given oral antiviral prophylaxis. Efficacy
was rated using a quartile improvement scale (0–25%, 25–50%,
50–75%, and 75–100%) by three blinded, non-treating staff
dermatologists using pre- and post-treatment standardized
photographs. Charts were also reviewed for any adverse effects.
Results: Actinic cheilitis showed marked improvement after laser
therapy. All patients showed either 50–75% or 75–100%
improvement after just one or two treatments. No adverse effects
were observed, and the only side effects were mild erythema and
edema of 1–4 days duration.
Conclusion: The non-ablative fractional thullium 1,927 nm laser
a well tolerated and effective global treatment strategy for
patients with actinic cheilitis. The treatment is achieved without
any downtime or significant adverse effects.
#67
American Society for Laser Medicine and Surgery Abstracts 21
MULTIPLE TREATMENT, NON-INVASIVE
CRYOLYPOLYSIS FOR BODY CONTOURING IN
CHINESE PATIENTS
Samantha Y. Shek, Nicola P.Y. Chan,
Henry H.L. Chan
The University of Hong Kong, Hong Kong, China
Background: Non-invasive cryolipolysis has been demonstrated
to be effective in body contouring. The objective of the study is to
determine the efficacy of multiple treatments with a cryolipolysis
device for body contouring in Chinese patients.
Study: This is a retrospective study where 12 patients, age 35–
60, with discreet bulges were treated with two treatments of
cryolipolysis at their own cost. On average, the two treatments
were 2 months apart. The cryolipolysis system was used and the
treatment parameters were CIF 41.6 ( 73 mW/cm 2 ) for
60 minutes per site at the desired anatomical region. The areas
treated included the abdomen and love handles. At baseline visit,
their weight was measured and caliper measurement was used at
the maximum area of fat when standing. Standard photographs
were taken with Canfield Visia CR system 1 . They were followedup
2 months after, when the physician will perform assessment
then a second treatment. Subjects were followed-up again 2
months post-second treatment.
Results: During the study, the weight of the subjects remained
relatively constant. For both the abdomen and love handles, there
was a statistically significant improvement after one treatment
(P < 0.001, P ¼ 0.003) with a further improvement after a second
treatment (P ¼ 0.02, P ¼ 0.084). However, the decrease in
measurement with the caliper was of lesser extend with the
second treatment compared to the first. Control sites had no
significant difference post-treatment.
Conclusion: Multiple treatment with a cryolipolysis device for
body contouring in Chinese patients demonstrated a cumulative
effect.
#68
TREATMENT OF THE DERMIS AND HYPODERMIS
JUNCTION WITH WATER AND FAT SELECTIVE
LASER WAVELENGTHS USING OPTICAL
COMPRESSION PINS
Brian Zelickson, Susan Walgrave,
Irmina Wallander, James Childs, David Tabatadze,
Mikhail Smirnov, Gregory Altshuler
Zel Skin and Laser Specialists, Edina, MN; Marshfield Clinic,
Marshfield, WI; Palomar Medical Technologies, Inc., Burlington,
MA
Background: Indications benefiting from deep reticular and
hypo-dermis remodeling include cellulite, deep wrinkles and
scars. 1,540 and 1,208 nm laser micro-beams (mb) are co-aligned
with optical pins to provide skin compression that minimizes
epidermal injury while treating deeper skin layers. The fractional
devices are characterized ex vivo and clinically.
Study: The 1,540 nm device delivers up to 70 mJ/mb in an array of
49 pyramid-shaped pins (the XD TM optic, Palomar Medical
Technologies, Inc., Burlington, MA). The 1,208 nm prototype
consisted of a five-pin array delivering 4 W/mb in 5–20 seconds
pulse widths. Porcine skin was treated ex vivo. Abdominal skin of
two subjects was treated and biopsied prior to abdominoplasty.
Coagulation profiles were assessed with cell viability staining
(NBTC) of sections. Effects of compression were assessed clinically
by measuring the size of pigmented spots on volar forearms or
back 2 days post-treatment with the 1,540 device and by
measuring skin transmission through the fingers’ webs with a
1,450 nm test device. Medial or lateral thighs of two subjects were
treated with the 1,208 device under local anesthesia and
evaluated to 3 weeks post.
Results: In vivo skin transmission of 1,450 nm light increased
and the diameters of the 1,540 spots decreased with compression
time. The 1,540 device provided deeper coagulation to 1.5 mm
depths and less epidermal injury than without compression. The
depths of the 1,208 device reached below 3 mm into the
hypodermis with papillary dermis preservation. Clinically
palpable indurations persisted to 3 weeks post-treatment and
resolved with no adverse side effects.
Conclusion: The fractional 1,208 and 1,540 nm devices
effectively de-couple depth of treatment from epidermal coverage