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

#115
OPTIMUM CHOICE OF IRRADIATION
WAVELENGTH FOR SKIN COLOR
DETERMINATION USING SKIN REFLECTANCE
MEASUREMENTS
Caerwyn Ash, Stuart Jones, Godfrey Town,
Marc Clement, Peter Bjerring, Michael Kiernan
Swansea University; CyDen, Ltd; University of Wales,
Global Academy, Swansea, United Kingdom; Molholm Hospital,
Vejle, Denmark
Background: The need for objective, non-invasive methods to
measure melanin concentration in vivo in human skin,
independent of the competing chromophore, haemoglobin is much
needed in the field of skin colour determination. The classification
of skin types is based on human skin reaction to ultraviolet
exposure and used to help predict skin response in laser/IPL
treatments. There is an ever increasing need to quantify skin
colour for beauty treatments, and home use IPL/laser systems are
increasingly practiced by non-medically trained personnel who
may lack the requisite skills necessary to predict accurately, safe
treatment parameters. To evaluate the optimum wavelength
choice to categorize skin tones into one of the six Fitzpatrick
groups to optimise safety in light-based skin treatments.
Study: A calibrated prototype device consisting of an optical head
with four wavelengths (460, 522, 594, 617 nm), broadband
detector, microprocessor and an LCD display was used alongside a
commercial RGB colorimeter on the inner arm of nine subjects,
which typically has little UV exposure and minimal hair. To
establish the effect of haemoglobin on skin colour two addition
tests show the effect of oxy and deoxyhaemoglobin using induced
reduced haemoglobin and controlled erythema, were made on two
subjects.
Results: Four hundred and sixty nanometer has a clear linear
relationship with skin colour when comparing against other
wavelengths in standard, under reduced haemoglobin, and
erythema conditions for a range of skin colours. At this
wavelength absorption of melanin dominates other chromophores
when comparing skin colour. Five hundred and twenty-two, 694,
and 617 nm wavelengths showed variation practically on light
skin tone subjects.
Conclusion: Through accurate detection of skin melanin, a novel
device using 460 nm may significantly decrease the risk of side
effects by overtreatment and extend treatment to wider patient
populations with light based dermatological procedures.
#116
American Society for Laser Medicine and Surgery Abstracts 37
CONCOMITANT USE OF LASER AND
ISOTRETINOIN, HOW SAFE?
Ahmed Alissa
National Center for Vitiligo and Psoriasis, Riyadh, Saudi Arabia
Background: Isotretinoin-induced keloid formation has
occasionally been reported in patients who had undergone
dermabrasion or laser treatment. According to a safe
dermatologist practice, laser should be used during or within 6–8
months after Isotretinoin; however, few recent reports suggest
using isotretinoin and laser hair removal is a safe practice. It is
well known in laser hair removal that there is no real significant
epidermal damage.
Study: This paper present 100 patients who underwent to laser
hair removal, erbium laser, vascular laser, Q-switched
alexandrite and Q-switched 532 nm double frequency, Q-switched
1,064 Nd-YAG, and non-ablative fractional laser. All of them have
received isotretinoin therapy, during their laser treatment
sessions.
Results: We have up to 7 years follow-up (for some patients) none
of our patients develop hypertrophic scar or keloid. Also all the
previous reported cases in the literature will be reviewed and
summarized.
#117
A PROSPECTIVE PILOT STUDY OF THE
ALEXANDRITE LASER ON BASAL CELL
CARCINOMAS
Daniel I. Wasserman, Zeina Tannous,
Gary D. Monheit
Total Skin & Beauty Dermatology Center, Birmingham, AL;
Harvard Medical School, Boston, MA
Background: Basal cell carcinomas (BCC) are the most common
form of human cancer. Treatments include Mohs micrographic
surgery, excision, electrodessication and curettage, cryosurgery,
topical immunomodulators, photodynamic therapy, and
radiotherapy. The pulsed-dye laser (PDL) (595 nm) has
demonstrated considerable efficacy for superficial BCCs, however,
is limited by an approximate penetration of 2 mm. Based on the
3 mm penetration and a small peak of hemoglobin absorption in
the near infrared range, we investigated whether superficial and
nodular basal cell carcinomas can be successfully treated using a
755 nm alexandrite laser. The goal of this pilot study is to
determine whether superficial and nodular BCCs can be
successfully treated using the alexandrite laser.
Study: Thirteen tumors, in nine subjects, less than 2 cm located
on the trunk or extremities were enrolled in this study. Each
tumor was treated with the 755 nm alexandrite laser either once
(N ¼ 10) or four times (N ¼ 3) at 4-week intervals. Four weeks
following the final treatment, all tumors were excised and
reviewed histologically. Additionally, pain, purpura, edema, and
blistering following treatments were measured during the study.
Photos were taken throughout the study.
Results: All 3 tumors treated in the 4-treatment arm completely
resolved, while 4 out of 10 tumors in the single treatment arm
completely resolved. All patients experienced significant purpura
and edema with some experiencing mild blistering. Scarring was
found in only one patient, while hypopigmentation was frequently
present on follow-up visits.
Conclusion: The 755 nm long-pulsed alexandrite laser appears to
produce considerable efficacy when tumors are treated four times.
Meanwhile, single treatments of tumors produced complete
clearance in less than half of the tumors suggesting that the longpulsed
alexandrite may be a suitable non-surgical option for the
treatment of BCCs. Additional studies are needed in order to
determine ideal treatment settings and number of treatments
required for reliable rates of complete clearance.
#118
PROPOSING CONCEPT OF SELECTIVE
PHOTOTHERMOCOAGULATION AND VARIOUS
DERMATOLOGIC INDICATIONS BY USING
1,444 NM ND:YAG LASER
Kyung Goo Lee, Sang Geun Lee, Sang Min Yi,
Jae Hwan Kim, Jae Eun Choi, Il-Hwan Kim
Korea University Hospital, An-San Si, Korea