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

Results: At the 3-month follow-up visit, there was 25–50%
increased clearance on the half of the tattoo that received
combination compared to single wavelength treatment in 10/11
tattoos which had already completed treatment and 3-month
follow-up visits. Less than 25% increased clearance on the side
treated with the combination of wavelengths versus the single
wavelength treatment was observed in one tattoo. After the 3month
follow-up, no subject elected to pursue additional
treatments under the study protocol due to the increased
clearance observed on the side treated with the combination of
wavelengths. Combination treatment did not increase the
incidence of adverse effects. Additional safety and efficacy data
will be reported for this ongoing clinical trial.
Conclusion: The application of a second pass of QS 755 nm laser
treatment to multicolored tattoos after a first pass treatment
using either the QS 532 or 1,064 nm lasers to the absorbing
pigments significantly increased tattoo pigment clearance without
increasing adverse effects.
#78
American Society for Laser Medicine and Surgery Abstracts 25
#79
REDISTRIBUTION OF INK FOLLOWING LASER
TATTOO REMOVAL
Arisa Ortiz, Mathew Avram
University of California, Irvine, CA; Massachusetts General
Hospital, Boston, MA
Background: Q-switched lasers are known to be effective for
selectively targeting and removing unwanted tattoos with
minimal damage to the skin. Exogenous pigment is the
chromophore for Q-switched lasers, which have a shorter pulse
duration compared to the thermal relaxation time of the tattoo
pigment particles. By delivering high-energy, nanosecond pulses,
the laser targets the pigment-containing cells and fragments the
tattoo pigment into smaller particles which are re-phagocytized
and cleared by lymphatics.
Study: Three patients with Fitzpatrick skin type II–III received
several treatments with a Q-switched 694 nm ruby laser
(Spectrum RD-1200, Palomar, Burlington, MA) for unwanted
tattoos on the abdomen, arm, and ankle. All patients were
anesthetized with approximately 12–15 cc of 1% lidocaine with
1:100,000 epinephrine using a 30 gauge needle. It was noted that
the anesthesia for these patients was delivered via numerous
puncture wounds into the tattoo and surrounding skin. Patients
were then treated with a 6.5 mm spot and an irradiation of
4–8 J/cm 2 .
Results: At follow-up visits, all three patients had good
improvement of their tattoos. An unexpected finding was
clinically evident discoloration in the surrounding normal skin
consistent with the original color of the tattoo.
Conclusion: We theorize that repeated injury to the skin from
the needle puncture created tunnels which allowed ink particles
to disperse into the surrounding tissue after Q-switched laser
treatment. Another contributing factor may have been excess
amounts of lidocaine, which assisted in the migration of the ink
particles through the tunnels. These cases demonstrate a possible
complication when using multiple injections of anesthesia prior to
laser tattoo removal. One might avoid this complication by using
small amounts of lidocaine and minimizing the number of needle
punctures into the skin prior to laser tattoo removal or by using a
topical anesthetic. This finding may also indicate a potential
avenue for new treatment strategies for improved efficacy of laser
tattoo removal.
A MULTI-CENTER EVALUATION OF THE
MIRADRY SYSTEM TO TREAT SUBJECTS WITH
AXILLARY HYPERHIDROSIS
Mark Lupin, H. Chih-Ho Hong,
Kathryn F. O’Shaughnessy
University of British Columbia, Victoria, Canada;
University of British Columbia, Vancouver, Canada;
Miramar Labs, Sunnyvale, CA
Background: A third generation microwave-based device has
been developed to treat axillary hyperhidrosis by selectively
heating the interface between the skin and underlying fat where
the sweat glands reside.
Study: Thirty-one (31) adult subjects were enrolled in this
multi-center, single-group study. All subjects had primary
axillary hyperhidrosis evidenced by Hyperhidrosis Disease
Severity Scale (HDSS) ratings of 3 or 4 and a gravimetric sweat
assessment of at least 50 mg in each axilla (in 5 minutes). Subjects
were excluded if they had surgery for axillary hyperhidrosis or
botulinum toxin injections in the axillae in the last 12 months.
All subjects had between one and three treatment sessions over a
6-month period to fully treat both axillae. Local anesthetic was
used for pain management. Follow-up visits between and after
treatments measured effectiveness by collecting HDSS scores
and gravimetric assessments at approximately 30-day intervals.
Subject safety was assessed at each visit. Subjects will be
followed for 12 months after all treatment sessions are complete.
Results: The mean age of enrolled subjects was 33 (range 18–65);
74% were female; mean BMI was 24.8. Efficacy measurements for
the 21 subjects that had a visit 30 days after their second
treatment session show 100% with HDSS scores of 1 or 2 and
gravimetric assessments show 86% have had at least a 50%
reduction in axillary sweat compared to baseline (while the
median reduction was 90%). Regarding safety, all subjects
experienced transient effects in the treatment area such as
swelling, discomfort or numbness. As of the time of this report, the
most common adverse event (n ¼ 8 subjects) has been the
presence of discrete, localized numbness in the arm that appears
to be resolving.
Conclusion: The device tested provides an efficacious treatment
for axillary hyperhidrosis. Further follow-up for safety and
efficacy duration is planned.
#80
A PILOT STUDY OF LASER ASSISTED DELIVERY
OF ALLOGENEIC MESENCHYMAL STEM CELLS
Jill Waibel, Evangelos Badiavas, Stephen Davis
Miami Dermatology and Laser Institute; Miller School of
Medicine, University of Miami, Cutaneous Surgery Wound
Healing Research Laboratory, Miami, FL
Background: Mesenchymal stem cells (MSCs) are multipotent
cells that can differentiate into a variety of cell types. Optimal
delivery of stem cells that enable their viability is a current
challenge to MSC research. Fractional laser technology has
revolutionized laser therapy. The fractional ablative tunnels can
be utilized for laser assisted delivery systems of a variety of drugs,
topicals and other living tissue. This is the first pilot study to test
the hypothesis that ablative fractional laser could deliver
mesenchymal stem cells to skin using a porcine full thickness
wound model.