Lasers in Surgery and Medicine最新文献

{"title":"Picosecond 532 nm Laser: An Optimal Device for the Reduction of Acquired Agminated Nevi","authors":"Briana R. Halle,&nbsp;Nicole M. Golbari,&nbsp;Janellen Smith,&nbsp;Christopher Zachary","doi":"10.1002/lsm.23851","DOIUrl":"10.1002/lsm.23851","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Agminated nevi are rare, grouped lesions, which are confined to one anatomic area. Herein, we report a case of successful cosmetic treatment of bilateral, acquired agminated nevi with a picosecond 532 nm Nd:YAG laser device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Literature search was completed on acquired agminated nevi. A healthy 21-year-old woman presented with numerous, grouped 1-mm brown-to-dark brown macules in the axillae bilaterally. Biopsies revealed lentiginous junctional nevi with mild atypia, leading to the diagnosis of agminated nevi. She was referred for laser treatment to improve cosmetic appearance. Two different laser devices were utilized initially, a picosecond 532 nm Nd:YAG laser on the left axilla and a millisecond domain 532 nm laser on the right. Greater improvement was noted with the picosecond 532 nm device. Three additional treatments were completed with the picosecond laser with significant improvement in pigmentation of melanocytic nevi.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Various pigmented and melanocytic lesions have been noted to occur in an agminated pattern although their pathway of development remains unknown. While various devices have demonstrated efficacy for pigmented lesions, treatment of agminated nevi specifically is less reported or established. Our patient's presentation is novel because of the axillary location and bilateral distribution of multiple acquired agminated nevi, neither of which have been previously reported in the literature. We also report successful treatment utilizing a picosecond 532 nm laser. While laser can help improve the cosmetic appearance of pigmented lesions, most lasers do not remove all melanocytes, highlighting the need for close monitoring, as atypia and melanoma have been reported to develop in acquired agminated nevi.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Thus, we present a case of acquired agminated nevi in a novel bilateral distribution in a healthy female successfully treated with a picosecond 532 nm laser.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 1","pages":"37-40"},"PeriodicalIF":2.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349301","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":"Efficacy of Alexandrite Laser in the Treatment of Pigmented Actinic Keratoses: A Pivotal Study","authors":"Stefano Bighetti,&nbsp;Cristina Zane,&nbsp;Nicola Zerbinati,&nbsp;Mariachiara Arisi,&nbsp;Simone Caravello,&nbsp;Vincenzo Maione,&nbsp;Piergiacomo Calzavara-Pinton,&nbsp;Luca Bettolini","doi":"10.1002/lsm.23849","DOIUrl":"10.1002/lsm.23849","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Pigmented actinic keratoses (PAKs), a pigmented variant of actinic keratosis, present diagnostic challenges due to their resemblance to both benign and malignant lesions. Conventional therapies have inconsistent outcomes and may cause undesirable side effects. This study investigates the efficacy of the Alexandrite laser, a pulsed laser with selective melanin absorption, for PAK treatment. Through dermoscopic analysis pretreatment, it aims to identify predictive patterns for better treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients with PAKs were enrolled in a multicenter study, receiving standardized Alexandrite laser therapy. Detailed dermoscopic evaluations were conducted pretreatment. The Physician's Global Assessment (PGA) and Target Lesion Pigmentation (TLP) scales measured treatment efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 50 patients with 60 PAKs. Following treatment, there was a statistically significant reduction in TLP scores, particularly in lesions with pigmented pseudo-networks and gray-brownish dots, which were linked to improved outcomes. No adverse effects were reported, suggesting the safety and tolerability of the laser treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Alexandrite laser emerges as a promising modality for the management of PAK pigmentation, with specific dermoscopic patterns being indicative of a favorable response. This study reinforces the critical importance of dermoscopic expertise in the selection and optimization of treatment for PAKs. Future research should focus on comparative studies with different lasers or combination therapies to develop a more comprehensive treatment framework for PAKs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"776-782"},"PeriodicalIF":2.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23849","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349298","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":"In Silico Evaluation of Nanosecond Laser Treatment of Pigmented Lesions Based on Skin Optical Properties Using a Model of Melanosome Disruption Threshold Fluence","authors":"Yu Shimojo,&nbsp;Takahiro Nishimura,&nbsp;Daisuke Tsuruta,&nbsp;Toshiyuki Ozawa,&nbsp;Taro Kono","doi":"10.1002/lsm.23848","DOIUrl":"10.1002/lsm.23848","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the efficacy and safety of nanosecond laser treatment of pigmented lesions in silico using a model of melanosome disruption threshold fluence (MDTF) based on skin optical properties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Particle size analysis and scanning electron microscopy were performed to determine the threshold fluence for melanosome disruption using a nanosecond laser. By inputting the obtained threshold fluence into the MDTF model and considering the variability in skin optical properties, irradiation parameters were calculated and compared with the results from clinical studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The threshold fluences for 532 and 755 nm nanosecond laser irradiation were determined to be 3.0 and 15.0 J/cm², respectively. In silico analysis showed that the incident fluence for moderately pigmented skin should be 1.2 times that for lightly pigmented skin, whereas it should be 50% lower than that for lightly pigmented skin to achieve the same level of energy deposition. Clinically applied fluences for moderately pigmented skin are at the low end of the calculated range of values, suggesting that the clinical fluence is chosen to minimize energy deposition in normal tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results showed that the MDTF model can be used to evaluate nanosecond laser treatments and provide clinical guidance on fluence settings based on laser–tissue interactions in moderately pigmented skin. The in silico method can, therefore, provide a robust and quantitative retrospective evaluation of the treatment effects that accounts for variation in irradiation parameters among patients by combining the MDTF model with the in vivo optical properties of individual skin types.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 1","pages":"130-140"},"PeriodicalIF":2.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349299","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":"In Vivo Imaging Techniques for the Human Scalp: A Systematic Review of the Literature","authors":"Bobak Hedayati,&nbsp;Luke Horton,&nbsp;Brittany Urso,&nbsp;Chloe Ekelem,&nbsp;Arash Babadjouni,&nbsp;Ajay N. Sharma,&nbsp;Natasha Atanaskova Mesinkovska","doi":"10.1002/lsm.23835","DOIUrl":"10.1002/lsm.23835","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Scalp inflammation and alopecia are distressing conditions for which patients regularly present to dermatology. Although some diagnoses can be made clinically, others require biopsy, which carries the risk of pain, infection, bleeding, and scarring. This review examines the existing literature regarding noninvasive in vivo imaging techniques and their evidence and utility in evaluating scalp pathology, with a focus on the diagnostics of hair conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines without timeframe restrictions. The PubMed and Clarivate (Web of Science) databases were searched using the terms (“imaging” OR “in-vivo imaging” OR “non-invasive imaging” OR “non-invasive in vivo imaging” “imaging,” “in-vivo imaging) AND (“human scalp disorders” OR “scalp” OR “hair loss” OR “alopecia”). Peer-reviewed randomized control trials (RCTs), prospective studies, retrospective studies, and case series or reports discussing in vivo imaging of the scalp published before 2022 were selected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two studies were included and discussed; modalities included laser devices (<i>n</i> = 27), ultrasound (US) (<i>n</i> = 13), infrared thermography (<i>n</i> = 1), skin capacitance imaging (SCI), and ultraviolet light–enhanced visualization (ULEV) (<i>n</i> = 1). The most common laser devices used were reflectance confocal microscopy (RCM), multiphoton microscopy (MPM), and optical coherence tomography (OCT). US techniques included high-frequency US (HFUS) and US biomicroscopy (UBM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Quality imaging of the scalp in the setting of alopecic, neoplastic, and inflammatory diseases is highly sought after. Many of these noninvasive imaging techniques show promise, each with individual advantages and disadvantages in imaging-specific conditions. Ultimately, noninvasive imaging techniques may be used to optimize patient management and minimize morbidity associated with scalp biopsies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"741-754"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349300","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":"Timing of Laser Intervention on Facial Scars: A 3D Imaging and Scar Scale Analysis in a Retrospective Study","authors":"Shuai Qiang,&nbsp;Xing Fan,&nbsp;Yue Yin,&nbsp;Ping Xue,&nbsp;Wen-Jie Dou,&nbsp;Tong Li,&nbsp;Qing Yang","doi":"10.1002/lsm.23846","DOIUrl":"10.1002/lsm.23846","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Scars resulting from injuries or surgical procedures often present both physical and aesthetic challenges. Recent studies have indicated promising results in improving postoperative scar outcomes through the combined use of specific laser technologies. Nevertheless, there remains a crucial need for further exploration to ascertain the optimal timing for initiating such treatments.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this retrospective investigation, a cohort of 47 adult patients who did not require hospitalization was analyzed. These patients were divided into two distinct groups: Group A, which received intervention beginning 2 weeks after their respective operations, and Group B, which commenced intervention 4 weeks postoperation. Each group underwent a comprehensive treatment protocol consisting of five laser sessions. Initially, patients underwent three sessions of V-beam pulsed-dye laser (PDL) therapy followed by two sessions of ablative fractional CO&lt;sub&gt;2&lt;/sub&gt; laser (AFL) therapy. Evaluation of outcomes was conducted using advanced imaging techniques such as Antera 3D imaging, in conjunction with established scar assessment tools including the Vancouver Scar Scale (VSS) and the University of North Carolina “4P” Scar Scale (UNC4P).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;All patients successfully completed the full course of five treatment sessions, with no dropouts and no reported adverse events. Baseline cosmetic assessments of scars were equivalent across both groups. In Group A, the mean VSS scores decreased from 7.04 before treatment to 5.29 at 3 months posttreatment and further to 4.33 at 6 months posttreatment. Meanwhile, in Group B, scores decreased from 7.52 to 6.83 at 3 months and 6.17 at 6 months. There were no statistically significant differences in baseline VSS scores between the two groups (&lt;i&gt;p&lt;/i&gt; = 0.34). At both the 3- and 6-month follow-up points, mean VSS scores were significantly lower in Group A compared to Group B (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Similar trends were observed in UNC4P scores. Statistically significant differences were noted across all time points (baseline, 3 months, and 6 months posttreatment) for both VSS and UNC4P scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Subset analysis revealed greater improvements in texture and depression volume at 3 months posttreatment, while improvements in depression area, depth, elevation variation, and area were more pronounced at the 6-month mark.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Early intervention using the combined 595-nm pulse dye laser and CO&lt;sub&gt;2&lt;/sub&gt; ablative fractional laser (AFL) 2- and 4-week","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"770-775"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290324","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":"Use of Optical Coherence Tomography to Assess Properties of Cutaneous Defects Following Radiofrequency Microneedling and Laser Treatment","authors":"Kira Seiger,&nbsp;William Driscoll,&nbsp;Feben Messele,&nbsp;Nicole M. Golbari,&nbsp;Xiying Fan,&nbsp;Jon Holmes,&nbsp;Christopher B. Zachary","doi":"10.1002/lsm.23840","DOIUrl":"10.1002/lsm.23840","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterize the properties of cutaneous defects created by energy-based devices using optical coherence tomography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Radiofrequency (RF) microneedling and non-ablative fractional laser (NAFL) treatment were performed in vivo with various parameters. Following treatment, optical coherence tomography (OCT) was used to image and measure cutaneous defects at multiple time points over a 24 h period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Channel-like cutaneous defects were visible with OCT following bipolar RF microneedling and NAFL treatment. Using a double pulse technique with RF microneedling yielded a greater number of defects visible with OCT, as well as defects that were deeper and more durable over time. Following treatment with 1927 nm thulium fiber laser, the average diameter of the defects was greater when the energy level was 20 mJ as compared to 10 mJ (0.33 mm vs. 0.27 mm, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cutaneous defects were observed following both RF microneedling and NAFL treatment. Properties of the cutaneous defects varied based on device, treatment setting, and technique, which may be useful in guiding further study of device-assisted drug delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"762-769"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23840","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290325","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":"Defining the Treatment Window: Early Versus Late Pulsed Dye Laser Therapy for Posttraumatic and Surgical Scars in Asian Patients","authors":"Han-Yuan Chang,&nbsp;Bing-Qi Wu,&nbsp;Chang-Cheng Chang,&nbsp;Yu-Tsung Chen,&nbsp;Yen-Jen Wang","doi":"10.1002/lsm.23844","DOIUrl":"10.1002/lsm.23844","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This retrospective study evaluates the effectiveness of pulsed dye laser (PDL) treatment in early versus late treatment groups for traumatic or postoperative scars. The study aims to determine the threshold between early and late treatment. Additionally, it investigates factors that may influence wound healing outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The medical records of 147 patients who underwent PDL treatment at our institution between January 2018 and December 2022 were retrospectively reviewed. Inclusion criteria were patients receiving PDL treatment for traumatic or postoperative scars. Out of these patients, we selected those who were willing to receive telephone interviews or re-visit at a scheduled time. Eventually, 52 participants were included in our study. A standardized questionnaire was administered to all participants during telephone interviews, encompassing inquiries regarding their medical history, treatment experiences, and the patient component of the Patient and Observer Scar Assessment Scale. Among the enrolled patients, 38 were contacted and interviewed via telephone, while the remaining 14 patients attended follow-up visits where photographs of their current skin condition were captured. The pretreatment and latest follow-up photographs obtained from the clinical database were independently scored in a blinded manner by two dermatologist reviewers using both the Vancouver Scar Scale and the Manchester Scar Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 52 patients, 43 (82.7%) were successfully treated with good response. The correlation coefficients between week-to-treatment initiation and posttreatment MSS and VSS among patients with good response were 0.50 (<i>p</i> &lt; 0.001) and 0.46 (<i>p</i> = 0.002), respectively. Given these findings, we established a treatment initiation threshold of 10 weeks, distinguishing patients into early and late treatment groups. The early treatment group showed borderline significantly lower posttreatment MSS and VSS scores than the late treatment group (MSS: 7.5 ± 2.1 vs. 9.3 ± 2.5, <i>p</i> = 0.011; VSS: 2.8 ± 2.0 vs. 4.5 ± 2.3, <i>p</i> = 0.011). Furthermore, both MSS and VSS of posttreatment showed significantly greater improvement in the early treatment group (4.4 ± 1.6 vs. 3.2 ± 1.9; <i>p</i> = 0.03 and 3.8 ± 1.8 vs. 2.8 ± 1.4; <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early intervention using a PDL within 10 weeks post-injury achieved better outcomes in treating traumatic and postoperative scars based on both clinical and patient opinions.</p>\u0000 </section>\u0000 ","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 1","pages":"71-79"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290319","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":"The 2910-nm Fiber Laser Is Safe and Effective for Improving Acne Scarring","authors":"Eric Bernstein,&nbsp;Ali Alajmi,&nbsp;Jennifer Wang,&nbsp;Edward Hochman,&nbsp;Brian Biesman,&nbsp;James F. Sanzo","doi":"10.1002/lsm.23845","DOIUrl":"10.1002/lsm.23845","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acne scarring results from the inflammation associated with acne papules, which alters dermal collagen, typically producing depressed scars. Lasers have been used to remodel skin improving the texture and appearance of acne scars. Herein, we investigate a new 2910 nm, erbium-doped, fluoride glass, fiber laser for improving acne scars. This novel laser delivers up to 5000 Hz low-energy pulses, providing a unique treatment modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fourteen subjects with rolling and/or boxcar acne scars were enrolled in this study. Thirteen subjects completed the final visit and received three treatments with the 2910 nm fiber laser at 6–8-week intervals. Eight subjects were Fitzpatrick type II and five were Fitzpatrick type III. Digital images were taken pre- and 1- and 3-months posttreatment and evaluated by two blinded reviewers in a randomized fashion for improvement. Subjects and the treating physician completed a Global Aesthetic Improvement Scale (GAIS) before treatment and at each visit to subjectively evaluate treatment effect. Histological analysis was performed on ex vivo lower eyelid skin samples. Side effects were evaluated by the treating physician and included erythema, edema, and pinpoint bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Evaluation of blinded digital images revealed a mean improvement of 47.3% ± 14.2% (mean ± SEM) 3 months following the final treatment. GAIS scores demonstrated improvement as evaluated by both the subjects and the treating physician. Side effects averaged trace-to-mild erythema, edema, and pinpoint bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows that the 2910 nm, erbium-doped, fluoride glass, fiber laser is safe and effective for improving the appearance of acne scars.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"755-761"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23845","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290323","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":"Physician Level Assessment of Hirsute Women and of Their Eligibility for Laser Treatment With Deep Learning","authors":"Kenneth Thomsen,&nbsp;Raluca Jalaboi,&nbsp;Ole Winther,&nbsp;Hans Bredsted Lomholt,&nbsp;Henrik F. Lorentzen,&nbsp;Trine Høgsberg,&nbsp;Henrik Egekvist,&nbsp;Lene Hedelund,&nbsp;Sofie Jørgensen,&nbsp;Sanne Frost,&nbsp;Trine Bertelsen,&nbsp;Lars Iversen","doi":"10.1002/lsm.23843","DOIUrl":"10.1002/lsm.23843","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Hirsutism is a widespread condition affecting 5%–15% of females. Laser treatment of hirsutism has the best long-term effect. Patients with nonpigmented or nonterminal hairs are not eligible for laser treatment, and the current patient journey needed to establish eligibility for laser hair removal is problematic in many health-care systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we compared the ability to assess eligibility for laser hair removal of health-care professionals and convolutional neural network (CNN)-based models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CNN ensemble model, synthesized from the outputs of five individual CNN models, reached an eligibility assessment accuracy of 0.52 (95% CI: 0.42–0.60) and a <i>κ</i> of 0.20 (95% CI: 0.13–0.27), taking a consensus expert label as reference. For comparison, board-certified dermatologists achieved a mean accuracy of 0.48 (95% CI: 0.44–0.52) and a mean <i>κ</i> of 0.26 (95% CI: 0.22–0.31). Intra-rater analysis of board-certified dermatologists yielded <i>κ</i> in the 0.32 (95% CI: 0.24–0.40) and 0.65 (95% CI: 0.56–0.74) range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current assessment of eligibility for laser hair removal is challenging. Developing a laser hair removal eligibility assessment tool based on deep learning that performs on a par with trained dermatologists is feasible. Such a model may potentially reduce workload, increase quality and effectiveness, and facilitate equal health-care access. However, to achieve true clinical generalizability, prospective randomized clinical intervention studies are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 1","pages":"80-87"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290322","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":"In Vivo Histological Study Evaluating Non-Ablative Fractional 1940-nm Laser","authors":"Konika Patel Schallen,&nbsp;Madelyn Seder,&nbsp;Michael Jorgenson,&nbsp;Kevin Schomacker,&nbsp;Jag Bhawan","doi":"10.1002/lsm.23842","DOIUrl":"10.1002/lsm.23842","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Non-ablative fractional lasers (NAFL) have increased in demand compared to ablative laser treatments as they provide lesser down time, fewer side-effects, and are safer to use. Non-ablative fractional treatment with lasers ranging from 1320 to 1927-nm have been shown to be safe and effective for skin resurfacing procedures. The objective of this study is to investigate healing of the 1940-nm NAFL-induced microthermal treatment zones (MTZs) in human skin from a histologic perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three subjects received 1940-nm NAFL treatment to test areas on the abdomen at various timepoints during the study. The minimum 5 mJ/MTZ and maximum 20 mJ/MTZ energy settings were used at 20% coverage. Biopsies were taken coinciding with immediately posttreatment, 1, 3, 7 days, and 6 weeks posttreatment. Blinded analysis of hematoxylin and eosin stained slides was performed to measure the width and depth of the MTZs and evaluate the inflammatory and healing response of the skin over time (immediately to 6 weeks posttreatment). Safety was evaluated by assessing local skin responses and adverse events immediately after treatment and at all study visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histological analysis of tissue following NAFL 1940-nm treatments showed mild early inflammatory response (presence of lymphotic infiltrate) in some test areas and zones of necrosis and coagulation having widths and depths (immediately–3 days posttreatment) that scaled with the 1940-nm pulse energy. Signs of healing such as presence of dermal mucin, evidence of fibrosis, and absence of necrosis were observed long-term (7 days to 6 weeks posttreatment). Evidence of the MTZ persisted beyond the 6-week study and was predicted to last for 100 days. All local clinical skin responses healed within 6 weeks and were limited to mild, transient erythema and edema which resolved in less than 12–24 h following treatment. No serious adverse events occurred during the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NAFL 1940-nm treatments are safe for inducing small fractional coagulation and necrosis zones in abdominal skin. NAFL 1940-nm laser creates fractional columns of injury with sufficient depth and coverage that suggest effective skin resurfacing, like other non-ablative fractional lasers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 1","pages":"54-62"},"PeriodicalIF":2.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290320","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}