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

38 American Society for Laser Medicine and Surgery Abstracts
Background: Dermatologic laser treatment is based on selective
photothermolysis (SP) which specifically targets chromophore of
each disease. The concept of SP became possible after the pulsed
irradiation of laser was technically available. However, SP theory
has certain limitations that treatment efficacy significantly
decreases when lesion’s chromophore is not clear or the leisons’s
size is too big.
Study: 1,444 nm Nd:YAG laser (Acculculpt TM , Lutronic, Korea) is
relatively specific for fat and water and primarily indicated for
liposuction, lipo-plasty and facial lifting. Authors experienced
that this laser has great effect on coagulation of target ‘‘structure’’
such as blood vessel and water rich organelles. And also this
infrared laser has greater lateral heat diffusion capacity than
conventional CO2 and Erbium YAG laser which enables to stack
more heat energy to dermal portion of skin. As this laser is pulsed
laser, to control amount of energy stacking is also easily possible.
These findings led us to propose a new concept named ‘‘selective
photothermal-coagulation (SPTC),’’ which supplements the
limitations of SP theory mentioned above.
Results: Using this new concept, authors applied this 1,444 nm
Nd:YAG laser for treatment of various diseases such as
angiokeratoma, venous malformation, pyogenic granuloma,
mucocele, neurofibroma and xanthelasma. Certain and
satisfactory treatment results were observed at above cases
without recurrence for over at least 6 months.
Conclusion: This SPTC, using 1,444 nm Nd:YAG laser have few
advantages. First, unlike CO 2 laser, bleeding is simultaneously
coagulated while laser irradiation which make physician able to
precisely visualize procedure field. Second, as this beam
irradiation can be done by external handpiece, it is much simpler
than surgical procedure and easily repeatable even if the lesions
recur. Herein, authors propose a new concept of SPTC using
1,444 nm Nd:YAG laser, and report our experiment of various
possible indications using SPTC theory.
#119
ERBIUM LASER DERMABRASION FOR TREATING
VITILIGO: A COMBINATION APPROACH
Thierry Passeron, Wedd Bayoumi, Florence Le Duff,
Laura Sillard, Jean-Philippe Lacour,
Jean-Paul Ortonne
University Hospital of Nice, Nice, France
Background: No treatment gives fully satisfactory results for
treating vitiligo, especially on difficult areas such as bony
prominences and extremities. The objective of the study was to
evaluate in vitiligo patients, the interest of a laser dermabrasion
in addition to the association of topical steroids and UVB in
difficult to treat areas.
Study: Monocentric prospective randomized trial with intraindividual
comparison. Inclusion criteria: non-segmental vitiligo
with at least two symmetrical lesions of more than 4 cm 2 , located
on bony prominences and/or extremities. Intervention: Day 0:
Erbium laser dermabrasion on one side (randomly assigned).
After 48 h, hydrocortisone 17-butyrate cream was applied daily 3
weeks/4 for 12 weeks, on both sides and associated with
narrowband UVB 2 sessions/weeks for 12 weeks. A blinded
evaluation was done by two independent physicians on
standardized pictures. The criterion of success was a
repigmentation of at least 50% at 1 month after the end of the
treatment.
Results: Eighteen patients were included; two drop off for
personal reasons. A significant higher repigmentation was noted
in laser dermabrasion side as compared to UVB and topical
steroids alone (P < 10 4 ). Almost 50% of lesions achieved at least
50% of repigmentation in difficult to treat areas while only 4.2%
did with topical steroids and UVB alone. No repigmentation
> 50% was achieved in the extremities of the fingers. A high rate
of side effects was noted with delayed healing, pain, and two
hypertrophic scars. The tolerance and satisfaction of the patients
were 4.2 and 4/10 in laser side and 8.4 and 3/10 in UVB and
steroids alone group, respectively.
Conclusion: The laser dermabrasion improves the
repigmentation rate in vitiligo patients. Despite the high rate of
repigmentation in such difficult areas the global satisfaction was
moderate to low. The actual side effects strongly limit its use in
current practice. However, studying the mechanism of action of
the laser dermabrasion for inducing pigmentation should provide
interesting clues for treating vitiligo.
#120
STUDY ABOUT EFFICACY AND SAFETY IN LASER
ASSISTED SWEAT GLAND REDUCTION FOR
AXILLARY HYPERHIDROSIS (LASR-H)
Afschin Fatemi
S-thetic Clinic, Duesseldorf, Germany
Background: Axillary Hyperhidrosis is still a challenge, when it
comes to the treatment options. Btx is efficient, but most patients
wish for a permanent solution and are therefore ready to undergo
surgery, it was efficient.
Study: Three hundred seventy-five patients were treated by
Laser Assisted Sweat Gland Reduction for Hyperhidrosis (LASR-
H) in tumescent local anesthesia, using a special technique.
Histologies of the aspirate and the tissue some months after the
treatment were taken. In a retrospective, quantitative study,
patients were screened up to 18 months retrospectively about
success by this treatment. In a prospective, qualitative study, a
group of 20 patients had weight measurements before, 6 months
and 1 year after surgery.
Results: Out of 375 patients, less than 10% still had some
residual sweating after the first surgery. After a touch up
procedure, this number went down to 1%. The studies also
showed, that in 90% of the patients the reduction of axillary sweat
was > 85% and it stayed like this 18 months after the surgery.
Complications were temporary in most cases, there was visible
necrosis in two patients.
Conclusion: Laser Assisted Sweat Gland Reduction LASR-H
using a certain technique is efficient and reliable and safe.
#121
TREATMENT OF SEVERE OR REFRACTORY ACNE
WITH NON-ABLATIVE 1,450 NM DIODE LASER
Thierry Passeron, Rosalind Hughes,
Katerina Tsilika, Jean-Paul Ortonne,
Jean-Philippe Lacour
University Hospital of Nice, Nice, France
Background: Several laser treatments have been reported for
acne but most of them studied only mild or moderate acne
patients. The objective of the study was to evaluate the long-term
efficacy and the tolerance of the non-ablative 1,450 nm diode laser
alone or combined with pulse dye laser (PDL) in treating severe or
refractory acne.
Study: Prospective randomized trial. Inclusion criteria: patients
with severe acne or moderate acne who resisted to topical