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B ibliography 1. Shade H, Marchionini A. Der sauremantel der haut. Klin Wochenschr 1928; 7:12-14. 2. Fluhr JW, Behne MJ, Brown BE, et al. Stratum corneum acidification in neonatal skin: secretory phospholipase A2 and the sodium/hydrogen antiporter-1 acidify neonatal rat stratum corneum. J Invest Dermatol 2004; 122:320-9. 3. Krien PM, Kermici M. Evidence for the existence of a self-regulated enzymatic process within the human stratum corneum -an unexpected role for urocanic acid. J Invest Dermatol 2000; 115:414-20. 4. Thueson DO, Chan EK, Oechsli LM, et al. The roles of pH and concentration in lactic acid-induced stimulation of epidermal turnover. Dermatol Surg 1998; 24:641-5. Evaluation of cutaneous pH after chemical peel and its correction with anphoteric solutions 5. Gunathilake R, Schurer NY, Shoo BA, et al. pH-regulated mechanisms account for pigment-type differences in epidermal barrier function. J Invest Dermatol 2009; 129:1719-29. 7. Choi EH, Man MQ, Xu P, et al. Stratum corneum acidification is impaired in moderately aged human and murine skin. J Invest Dermatol 2007; 127:2847-56. 6. Kim E, Kim S, Nam GW, et al. The alkaline pH-adapted skin barrier is disrupted severely by SLS-induced irritation. Int J Cosmet Sci 2009; 31:263-9. 8. Mathieu L, Cavallini M, Corsi MM. Efficacy of diphoterine HCl decontamination in rats: a comparative study. Toxicology Letters 2002; 135:166-67. Journal of Plastic Dermatology 2010; 6, 2 147
Elisabetta Perosino Elisabetta Perosino 1 Eleonora Tati 2 1 Medico Chirurgo Dermatologo Roma, Italy 2 Medico Chirurgo, Roma, Italy Case report: treatment of keloid with Intense Pulsed Light Summary I ntroduction Hypertrophic scars and keloids are common problems especially in young women and dark skin types (Fitzpatrick VI) like in individuals of African, Hispanic, and Asian descent 1 . Hypertrophic scars and keloids occur as a result of excessive healing reactions to damage to the deep skin tissues after traumatic or surgical wounds that have a prolonged phase of inflammation and fibroplasias. This healing reaction leads to excessive fibroblast proliferation and collagen synthesis that result in benign fibrous outgrowths for both keloids and hypertrophic scars. Both have a similar clinical appearance; however, the growth reaction remains within the margins of the scar in hypertrophic scars, while in keloids the reaction has the ability to extend the boundaries of the initial scar and is likely to recur after treatment 2 . The exact pathogenesis of keloids and hypertrophic scar formation still remains unknown which makes treatment even more complicated 3 ; however, an imbalance of matrix degradation and collagen biosynthesis, resulting in excess accumulation of collagen in the wound, has been postulated to be the primary biochemical feature of these skin lesions 4-6 . Case report: treatment of keloid with Intense Pulsed Light Keloids are scars, unique to humans that grow beyond the boundaries of a cutaneous injury, inflammation, burn or surgical incision. However spontaneous keloids sometimes develop without a preceding trauma, most commonly over the sternum. A wide range of therapies is available for keloids but the reported efficacy has been variable. These options include intralesional steroid injections, pressure dressing, silicone gel sheeting, topical retinoids, excisional surgery, radiotherapy and cryosurgery. Lasers are now being used to improve keloids. In this article we present a case of a young woman with keloid of the sternum region treated with Intense Pulsed Laser. KEY WORDS: Keloid, Intense Pulsed Laser Many persons seek medical attention for the treatment of scars, not only for aesthetic reasons (an unsightly scar can be very distressing, especially to young females) but also for functional reasons; scar contracture over a joint can severely restrict movement of the affected area. Pain and pruritus are typical symptoms associated with a proliferative scar. A wide range of therapies is also available for keloids, but the reported efficacy has been variable. These options include intralesional steroid injections, pressure dressing, silicone gel sheeting, topical retinoids, excisional surgery, radiotherapy, and cryosurgery 7-10 . Lasers are now being used to improve hypertrophic scars and keloids 11 . Since their introduction for hypertrophic scars and keloids by Apfelberg et al. 12 and Castro et al. 13 in the mid-1980s, more and more lasers with different wavelengths have been studied. Q-switched lasers (e.g. Nd: YAG, alexandrite, ruby) can be used to treat hyperpigmented scars and to remove artificial pigment from a scar (e.g. tarmac or gun powder particles embedded in a scar after traffic or explosives accident, respectively). Journal of Plastic Dermatology 2010; 6, 2 149
Page 1 and 2: Periodico quadrimestrale - Spedizio
Page 3 and 4: Journal of Plastic Dermatology Edit
Page 5 and 6: 122 S. Bottini, S. Ferrucci, M. Bra
Page 7 and 8: 124 S. Bottini, S. Ferrucci, M. Bra
Page 9 and 10: Gianluca Campiglio External laser l
Page 11 and 12: Figure 4. The photomology module pr
Page 13 and 14: C onclusions The preliminary data o
Page 15 and 16: 136 M. Tutino, A. Bodian, R. Oddeni
Page 23: 146 M. Cavallini, V. Puggioni, R. G
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Page 29 and 30: Michela Quaglini Michela Quaglini S
Page 31 and 32: Valutazione clinica e strumentale d
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Page 46 and 47: 15. Manuskiatti W, Triwongwaranat D
Page 48 and 49: 178 V. Bevelacqua, G. Schipani, M.
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