Lasers in Surgery and Medicine最新文献

{"title":"Comparison of the Efficacy of Low-Energy Delicate Pulsed Light and Q-Switched 1064 nm Nd:YAG Laser in the Treatment of Post-Acne Erythema: A Prospective Randomized Split-Face Study.","authors":"Hongshan Liu, Luyue Zhang, Ziyun Gao, Jingchen Liang, Yuxin Ma, Youbao Li, Jing Liu, Weihui Zeng","doi":"10.1002/lsm.70064","DOIUrl":"https://doi.org/10.1002/lsm.70064","url":null,"abstract":"<p><strong>Objectives: </strong>Post-acne erythema (PAE), a common consequence of acne, is characterized by capillary dilation and erythema, which significantly impact facial aesthetics and quality of life. This study aims to evaluate and compare the efficacy and safety of intense pulsed light (DPL) and 1064 nm Q-switched Nd:YAG laser in treating PAE.</p><p><strong>Methods: </strong>This prospective, randomized, self-controlled, evaluator-blinded clinical trial compared DPL and 1064 nm Q-switched Nd:YAG laser treatments on one side of the face, with biweekly sessions for 6 weeks. Patients were assessed during the treatment period using the VISIA 6.0 system, CEA scale, GAIS, and skin physiological parameters. Photographs were taken before and after each session, and adverse reactions and pain were recorded. Data analysis was performed using SPSS software, with p-values < 0.05 considered significant.</p><p><strong>Results: </strong>A total of 26 patients were enrolled, all completing follow-up. Both treatments significantly reduced PAE lesions (p < 0.001) compared with baseline, with the DPL group showing more significant improvement from Week 8. After six treatments, both groups showed significant reductions in erythema index and red zone area (p < 0.001), with no significant differences between the groups (p > 0.05). The DPL group had significantly lower CEA scores at week 8 (p < 0.043), but no significant difference was found at Week 12. Both treatments improved wrinkles (p < 0.001), with the Nd:YAG group showing better skin elasticity recovery (p = 0.044). GAIS scores indicated significant improvement in both treatments. Patient satisfaction was 92.31%, with the DPL group slightly higher. No pigmentation or depigmentation was observed, ensuring good safety.</p><p><strong>Conclusions: </strong>Both DPL and low-dose Q-switched 1064 nm Nd:YAG laser effectively treat PAE. DPL yields better early results, while Q-switched Nd:YAG laser improves skin retraction more effectively. Both are safe, well-tolerated options for PAE therapy.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Shaping and Skin Appearance Improvement in the Abdomen and Flanks by Radiofrequency Technology.","authors":"Alejandra Fernández Santos, Alejandra Iglesias Fernández, Lorena Suárez Fernández, Leticia Huergo Zapico, Susana Valero Freitag","doi":"10.1002/lsm.70059","DOIUrl":"https://doi.org/10.1002/lsm.70059","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the safety and effectiveness of the Symmed radiofrequency (RF)-based device (Termosalud Inc., Gijón, Spain) in body contouring and skin appearance improvement treatments for abdomen/flanks.</p><p><strong>Material and methods: </strong>Eight sessions of Symmed RF were performed in 15 volunteers' abdomen/flanks. Sessions were conducted every 72/96 h. To evaluate the efficacy and safety of the device, photographs, body contours, and ultrasound scans of dermal echogenicity, and adipose tissue thickness were taken at baseline and after the treatments. Additionally, a blind evaluation of the photographic results was conducted. Data regarding the satisfaction level of the participants was also obtained through a customized survey.</p><p><strong>Results: </strong>At the follow-up visit, significant reductions of 2% in body circumference and 9% in fat thickness were detected in the abdomen/flanks. These effects were accompanied by a significant 12% increase in dermal echogenicity, related to skin collagen content and organization. Furthermore, the blind evaluation of the photographic results revealed an overall visual improvement. A high satisfaction level was reported by the participants and no severe adverse events were detected.</p><p><strong>Conclusion: </strong>Symmed treatment is a noninvasive procedure treating skin laxity and reducing abdomen/flanks circumferences safely and effectively.</p><p><strong>Clinical trial registration: </strong>This clinical trial is not registered in a publicly accessible database, and no clinical trial registration number is available. At the time of the investigation, the intended use for fat reduction through radiofrequency was not classified as a medical application under European legislation (COUNCIL DIRECTIVE 93/42/EEC). In accordance with Spanish and European regulations, only clinical trials evaluating medical devices are required to be registered.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal Laser Therapy as a Potential Treatment Option for Postmenopausal Women With Recurrent Cystitis: Initial Experience From a Single Institution.","authors":"Hirokazu Abe, Fumihiko Urabe, Minoru Nakazono, Ayaka Kawaharada, Takahiro Kimura","doi":"10.1002/lsm.70061","DOIUrl":"10.1002/lsm.70061","url":null,"abstract":"<p><strong>Background: </strong>Recurrent cystitis is a prevalent condition, especially among postmenopausal women, significantly impairing their quality of life. Antibiotic therapy has historically been the primary treatment; however, concerns over antimicrobial resistance have highlighted the need for alternative therapies. Vaginal laser therapy, a noninvasive approach, has shown promise in improving vaginal health and may help prevent recurrent cystitis. This study assessed the efficacy of vaginal laser therapy in reducing cystitis episodes and improving the vaginal environment among postmenopausal women with recurrent cystitis.</p><p><strong>Methods: </strong>This retrospective study involved 51 postmenopausal women who received vaginal laser therapy between January 2023 and July 2024. Eligible patients underwent a pretreatment phase with estriol ovules, followed by vaginal laser therapy. The Vaginal Health Index (VHI), vaginal pH, and cystoscopic findings were evaluated before and after treatment and are presented as median (interquartile range). The cystitis-free interval (CFI) was calculated to assess the duration between treatment and recurrence.</p><p><strong>Results: </strong>The median number of cystitis episodes significantly decreased from 4 (3-6) in the 6 months before treatment to 0 (0-1) in the 6 months after treatment (p < 0.001 unless stated otherwise). The median CFI was 9.2 months. The VHI score significantly improved from 10 (9-13) to 18 (15-21), and vaginal pH significantly decreased from 8.0 to 5.5. Cystoscopic assessments indicated significant improvements in the atrophy of vaginal and periurethral tissues. Only grade 1 adverse events (7.8%) were observed, including vaginal pain and dyspareunia.</p><p><strong>Conclusions: </strong>Vaginal laser therapy significantly reduced cystitis episodes and improved vaginal tissue health in postmenopausal women with recurrent cystitis. These findings suggest that this therapy may represent a promising alternative in selected patients. Further studies with larger sample sizes and prospective designs are required to confirm these results and investigate the long-term benefits of vaginal laser therapy in managing recurrent cystitis.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Cutaneous Collagenous Vasculopathy With Pulsed Dye Laser.","authors":"Hannah L Hanania, Isabella Camacho-Hubbard, Zeena Y Nawas","doi":"10.1002/lsm.70048","DOIUrl":"10.1002/lsm.70048","url":null,"abstract":"<p><strong>Objectives: </strong>Cutaneous collagenous vasculopathy (CCV) is a rare, idiopathic microangiopathy marked by widespread telangiectasias and histologic vessel wall thickening. Due to its rarity and clinical overlap with other vascular conditions, CCV poses diagnostic and therapeutic challenges. This report highlights the successful use of pulsed dye laser (PDL) therapy in treating a case of extensive CCV.</p><p><strong>Methods: </strong>A 40-year-old woman with a decade-long history of progressive telangiectasias involving the extremities, trunk, and forearms underwent treatment with a 595-nm PDL. Six treatment sessions were conducted over 14 months.</p><p><strong>Results: </strong>The patient experienced significant improvement in erythema, telangiectasias, and associated discomfort, with sustained clinical response and substantial cosmetic benefit observed across all treated areas.</p><p><strong>Conclusion: </strong>PDL is a safe and effective treatment for CCV, offering both symptomatic relief and cosmetic improvement. This case adds to limited existing literature supporting its use and highlights the importance of individualized laser parameters for optimal outcomes.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":"571-574"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoporfin-Mediated Photodynamic Therapy-Caused Skin Barrier Damage and Triggered Dermatitis in Port-Wine Stains.","authors":"Kai Chen, Yan-Yan Hu, Shan-Shan Qian, Jin-Zhao Wu, Li-Juan Cao, Lin-Lin Wang, Meng Li, Yu-Xin Xia, Qian Jiang, Hong-Ying Chen, Liu-Qing Chen, Dong-Sheng Li","doi":"10.1002/lsm.70036","DOIUrl":"10.1002/lsm.70036","url":null,"abstract":"<p><strong>Background: </strong>Hemoporfin-mediated photodynamic therapy (PDT) is a high efficacy treatment alternative for port-wine stains (PWS) patients, and PDT also induced eczematous dermatitis in treated areas. However, the effect of PDT treatment on the prevalence and risk of dermatitis in patients with PWS have not been reported.</p><p><strong>Purpose: </strong>To assess the association between PDT and dermatitis incidence and to investigate the mechanism of PDT-triggered dermatitis in PWS patients.</p><p><strong>Patients and methods: </strong>A total of 512 PWS patients who received hemoporfin-mediated PDT treatment between June 2020 and September 2022 at the dermatology department of Wuhan No.1 Hospital were recruited in this study. Clinical images were used to calculate the percentage of dermatitis in treated areas. The arithmetic mean roughness (Ra), the average depth of roughness (Rz) and the mean square roughness (Rq) were used to assess the change of surface roughness. Transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total lipid content (TLC) were used to analyze the skin barrier function.</p><p><strong>Results: </strong>After treatment, we found that 27.15% (139/512) of PWS patients developed dermatitis on the treated areas, and the percentage of dermatitis was closely related to the treatment times and age of the patient. Moreover, these treated areas also exhibited markedly increased skin roughness (Ra, Rz, Rq; p < 0.05) and impaired barrier function, evidenced by significantly elevated TEWL and TLC (p < 0.05) and reduced SCH (p < 0.05).</p><p><strong>Conclusion: </strong>PDT caused skin barrier dysfunction in PWS patients, which may lead to increased permeability of the epidermis and contribute to the dermatitis development.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":"575-580"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical Coherence Tomography Enables the Depth-Resolved Measurement of Cilia Beat Frequency in Ex Vivo Human Fallopian Tubes.","authors":"Dilara J Long, Tian Xia, Photini F Rice, Deirdre M Scully, Makayla Johnson, Ryan Mistifer, Andrea Aguirre, John M Heusinkveld, Irina V Larina, Jennifer K Barton","doi":"10.1002/lsm.70049","DOIUrl":"10.1002/lsm.70049","url":null,"abstract":"<p><strong>Objectives: </strong>The movement of cilia in the fallopian tubes (FTs) facilitates important processes involved in fertility, and abnormalities in cilia function are linked with diseases including endometriosis and pelvic inflammatory disease. For the first time, we demonstrate the use of optical coherence tomography (OCT) to create depth-resolved mapping of motile cilia locations and quantify cilia beat frequency (CBF) in human FT samples ex vivo.</p><p><strong>Methods: </strong>Segments of the FT ampulla were acquired from five patients following salpingectomy under an IRB approved protocol. The samples were longitudinally opened to expose the luminal surface for imaging. A sequence of at least 500 OCT images were acquired at 5-10 locations on each sample. To define the location of the motile cilia in the images, pixel-wise Fast Fourier Transform (FFT) analysis of intensity fluctuations with a sliding temporal window was performed on each image sequence. The frequencies corresponding to the physiological range of CBF (2-10 Hz) were selected for mapping, while the part of the FFT spectrum at higher frequencies (> 23 Hz) was used to define the noise threshold. The frequency with the highest FFT amplitude for each supra-threshold pixel was considered the CBF for this pixel and used to create a color-coded CBF map. The CBF map was overlaid with the OCT intensity image sequences to reveal cilia locations. Frequency histograms from the sliding window were examined to assess temporal consistency of the mapping and evaluate movement artifacts.</p><p><strong>Results: </strong>OCT image sequences clearly showed the structure of FT plicae. The ciliated epithelium was obvious as a \"shimmering\" (rapidly changing intensity) layer atop plicae. Colored pixels on CBF maps visually aligned to these shimmering regions. Frequency histograms revealed that the image sequence peak CBF could be robustly determined, even in the presence of outliers attributable to table vibrations or bulk sample movement.</p><p><strong>Conclusions: </strong>OCT can provide depth-resolved maps of CBF in human ex vivo FT tissue. Potentially, this technique can aid in understanding cilia dynamics in the normal human FT over the menstrual cycle and across age, as well as in diseases that affect the FTs. Future work will be directed toward in vivo implementation including miniaturization and robust motion compensation.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":"598-607"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninsulated Microneedle Radiofrequency for Skin Rejuvenation: A Histological, Transcriptomic and Clinical Study.","authors":"Jiayi Feng, Lvping Huang, Jun Qi, Shize Ma, Ling Zhang","doi":"10.1002/lsm.70041","DOIUrl":"10.1002/lsm.70041","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of microneedle radiofrequency (MRF) for antiaging skin treatment has already been demonstrated. This study aims to, for the first time, comprehensively interpret the short and long-term effects of MRF by combining histology, high-throughput molecular analysis, and clinical evaluation.</p><p><strong>Methods: </strong>At 1, 3, and 6 months after MRF in different parameters, the skin samples were taken for HE staining, Masson staining, and Victoria blue staining to observe the overall histological changes. Real-time PCR and WB were used to evaluate the quantitative changes of collagen I and III, MMP-2 and TGF-β1 at the different time periods. After transcriptome sequencing, bioinformatics analysis was performed to identify important biological processes related to skin after MRF treatment. At the same time, patients who had undergone facial MRF treatment in our department between 2020 and 2023 were collected for clinical review within half a year after treatment. Patient satisfaction score and Global Aesthetic Improvement Scale (GAIS) were collected.</p><p><strong>Results: </strong>The histological sections showed that collagen and elastic fibers regenerated and the density increased after MRF. The mRNA and protein levels of collagen in each treatment group also showed an upward trend after treatment, especially in Group A. However, there was no significant difference among the treatment groups and compared with the blank control group. Transcriptome analysis showed that the differentially expressed genes were significantly enriched in collagen regeneration-related pathways at 1 month after treatment, then gradually decreased at 6 months. The clinical data showed that after MRF treatment, patients mainly rated the effect of skin rejuvenation as \"3 - satisfied.\" The GAIS score showed that the long-term effect after MRF was better than the short-term effect (p = 0.040).</p><p><strong>Conclusions: </strong>MRF can stimulate collagen rearrangement and rejuvenation in facial rejuvenation. The long-term rejuvenation effect of MRF can last at least 6 months and is better than the short-term effect.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":"608-617"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmission Laser Speckle Contrast Imaging Combined With Optical Clearing Using Magnetic Resonance Contrast Agents.","authors":"Polina A Timoshina, Yury I Surkov, Andrei E Lugovtsov, Alexander V Priezzhev, Valery V Tuchin","doi":"10.1002/lsm.70051","DOIUrl":"10.1002/lsm.70051","url":null,"abstract":"<p><strong>Objectives: </strong>Advances in improving existing noninvasive optical diagnostic methods and creating new criteria for assessing the effects of diabetes on tissues and the vascular system are highly demanded. One of the promising, noninvasive and contactless methods for visualizing the vascular system is laser speckle contrast imaging. This study studies the possibility of using magnetic resonance contrast agents in laser speckle contrast imaging and optical coherence tomography, for the first time, on rat ears, under conditions of alloxan-induced type 1 diabetes. By combining diagnostic techniques, the study investigated the ability to differentiate between healthy rat tissue and diabetic rat tissue based on dynamic and structural changes caused by local application of magnetic resonance agents.</p><p><strong>Methods: </strong>This study explores the possibility of using magnetic resonance contrast agents for laser speckle-contrast imaging and optical coherence tomography of rat ears under conditions where alloxan-induced type 1 diabetes mellitus is developing was studied for the first time.</p><p><strong>Results: </strong>Kinetics of scattering coefficient (µ_s) for healthy and diabetic rats during optical clearing were evaluated. The most significant reduction is seen with the Gadovist solution, showing decreases of 18.6% and 16.1% for healthy and diabetic rats, respectively. Magnevist induced a smaller reduction in the µ_s, with decreases of 12.6% and 6.8%, respectively. Data on the flow rate in the vessels of the ears of laboratory rats obtained in the diabetic group demonstrate reduced indicators, relative to the healthy group of animals.</p><p><strong>Conclusions: </strong>These results confirm the effectiveness of magnetic resonance contrast agents as optical clearing agents for both optical coherence tomography and laser speckle contrast imaging. For the first time, the nature of the change in the contrast of the static part with a change in scattering was studied. This is an additional application for studying the efficiency of optical clearing, and contributes to the multimodal application of speckle imaging methods.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":"625-636"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Approaches for Seborrheic Keratosis Treatment: Curettage Versus 532-nm Lithium Borate Laser Versus Cryotherapy: A Prospective Interventional Study.","authors":"Vanessa Timmermann, Sven Krengel, Petra Mrowka, Ozan Haase","doi":"10.1002/lsm.70042","DOIUrl":"10.1002/lsm.70042","url":null,"abstract":"<p><strong>Background: </strong>Seborrheic keratosis (SK) is the most prevalent benign skin tumor associated with aging, posing esthetic concerns and potential discomfort. The rising demand for cosmetic interventions prompts the exploration of effective removal methods. This study compares three treatment modalities: curettage, 532 nm laser, and propane-butane cryotherapy.</p><p><strong>Methods: </strong>A prospective interventional clinical study was conducted with 30 subjects, treating 123 SK using curettage, 532 nm laser, and propane-butane cryotherapy. Randomized allocation and evaluations at 0, 4, 8, and 12 weeks were employed. Objective measures included clearance rates (assessed by a dermatologist) and blinded cosmetic ratings by 125 observers. Subjective outcomes encompassed patient-reported pain (VAS), side effects, satisfaction, and preferences.</p><p><strong>Results: </strong>Curettage achieved the highest clearance rate (87.5% vs. laser: 55%, cryotherapy: 50%; p < 0.01). However, patients perceived complete healing most frequently with laser (90% vs. curettage: 87%, cryotherapy: 53%). Despite lower efficacy, 67% favored laser for future treatments, valuing minimal bleeding and no dressings. Observers rated curettage's cosmetic outcomes superior (50% vs. laser: 22.5%). Laser caused the fewest side effects (mean 0.93/lesion) but highest pain (VAS: 4.62 vs. cryotherapy: 3.85). Cryotherapy showed efficacy comparable to laser (50% vs. 55%) but more adverse events.</p><p><strong>Conclusion: </strong>Curettage remains optimal for thick, hyperkeratotic SKs, enabling histopathological confirmation. The 532 nm laser, preferred subjectively for convenience, may suit small, non-hyperkeratotic lesions but warrants further validation. Propane-butane cryotherapy offers a cost-effective alternative. The discordance between patient preferences (prioritizing convenience) and clinical efficacy underscores the need for personalized treatment strategies balancing outcomes, tolerability, and cosmetic expectations.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":"581-589"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimized Distance Holders Improve Precision in Fractional Laser Treatment.","authors":"Aditi Maheshwari, Nelson Manstein, John Warner-Levy, Alexander Warner-Levy, Connor M Alfonso, Abigail E Doyle, Michael Wang-Evers","doi":"10.1002/lsm.70050","DOIUrl":"10.1002/lsm.70050","url":null,"abstract":"<p><strong>Background: </strong>Fractional Photothermolysis (FP) relies on precise laser focus to create microscopic treatment zones (MTZs). Focal plane deviations, caused by handpiece pressure and movement, shift the treated tissue out of focus, increasing spot size and reducing lesion depth, compromising treatment efficacy. This study investigates an optimized spacer to mitigate load-induced deviations and improve clinical outcomes.</p><p><strong>Methods: </strong>A difference frequency generation (DFG) laser system (IPG Medical) with 3050/3200 nm wavelength treated ex vivo human abdominoplasty skin, mounted on a load-adjustable platform (0-1000 g, ±0.1 g). Tissue was treated at 5 mJ/pulse with a nominal spot size of 40 µm using spacers ranging from 2 × 2 mm² to 8 × 8 mm² and an optimized 2 × 2 mm² grid spacer. Optical coherence tomography measured skin bulging and focal plane deviations, while histological analysis validated lesion depth and diameter. Knife-edge technique projections were used to assess theoretical beam behavior.</p><p><strong>Results: </strong>Applied load caused skin bulging, resulting in a linear increase in lesion diameter and a linear decrease in depth. Smaller spacers (2 × 2 mm²) reduced focal deviations and maintained MTZ precision within the Rayleigh range. 2 × 2 mm² grid spacers further reduced bulging by redistributing the load and ensuring more uniform MTZ formation.</p><p><strong>Conclusion: </strong>Load-induced focal shifts significantly impact FP efficiency, particularly on nonuniform skin surfaces. An optimized spacer enhanced precision by minimizing bulging, allowing treatments to remain within one Rayleigh length. These findings highlight the clinical importance of spacer selection in achieving consistent FP outcomes, particularly for small-spot laser applications. Clinicians should integrate smaller or grid-patterned spacers to enhance procedural accuracy.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":"618-624"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}