Lasers in Medical Science最新文献

{"title":"Novel application of diode engraving laser for preparing corneal allogenic intrastromal ring segments: a comparative study with femtosecond laser and manual trephine.","authors":"Omar M Alabbasi, Hani Basher ALBalawi","doi":"10.1007/s10103-025-04689-0","DOIUrl":"https://doi.org/10.1007/s10103-025-04689-0","url":null,"abstract":"<p><p>Corneal allogenic intrastromal ring segments (CAIRS) provide a biocompatible option for the treatment of keratoconus and ectatic disorders, however surgical outcomes rely heavily on pre-operative planning and precise donor tissue preparation. Femtosecond (FS) lasers ensure micron-level accuracy but are costly and often inaccessible, whereas manual trephines are more affordable but limited to fixed geometries and variable thickness. This study evaluated a low-cost automated handheld portable diode engraving laser as a novel alternative for CAIRS preparation. In an ex vivo feasibility study, human donor corneal buttons unsuitable for optical transplantation customized into CAIRS segments using a consumer-grade blue diode engraver (LaserPecker L2, 5 W, 450 nm). Dimensional accuracy, thickness variation with controlled dehydration, stromal interface quality on anterior-segment OCT, and collateral thermal effects were evaluated. As a proof of concept, A diode-engraved laser cut segment was implanted in a keratoconus patient following femtosecond-assisted tunnel creation, and the postoperative visual and tomographic outcomes were documented. Twenty semicircular segments were created without failure. The Mean inner diameter was 6.48 ± 0.05 mm, the outer diameter was 8.01 ± 0.06 mm, and width measured 0.76 ± 0.05 mm (coefficient of variation < 5%). Three engraving passes consistently achieved full stromal penetration (~ 450 μm). Dimensional reproducibility was comparable published FS laser data, while device cost (~ USD 1,200) was over ten-fold lower. Manual trephination proved less precise and lacked customization capability. Preliminary histological analysis confirmed that thermal effects were confined to a narrow coagulation rim with no evidence of deeper stromal alteration. In vivo, a 39-year-old patient improved from UCVA 20/150 to 20/40 and BCVA 20/80 to 20/25, with Kmax reduced from 57.5 D to 44.0 D at one month, and no compications were observed. A consumer-grade diode engraving laser can reliably produce customized CAIRS segments with high precision, minimal collateral damage, and substantially lower cost than FS platforms. This proof-of-concept clinical case demonstrates its potential as an accessible, customizable, and affordable alternative for CAIRS preparation in resource-limited settings.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"438"},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric parameters and clinical outcomes of photobiomodulation in diabetic neuropathy: a concise review.","authors":"Vanessa de Souza, Marlon da Palma Cruz, Caroline Chaves Bittencourt, Ana Paula Ligeiro de Oliveira, José Antônio Silva Júnior, Stella Regina Zamuner, Nivaldo Antonio Parizotto, Richard Eloin Liebano, Rodrigo Álvaro Brandão Lopes Martins, Rodrigo Labat Marcos","doi":"10.1007/s10103-025-04701-7","DOIUrl":"https://doi.org/10.1007/s10103-025-04701-7","url":null,"abstract":"<p><p>Diabetes mellitus (DM) is a multifactorial metabolic disorder characterized by chronic hyperglycemia, insulin resistance, and systemic inflammation. Diabetic neuropathy (DN) is a prevalent and debilitating complication of type 2 diabetes mellitus (T2D), associated with sensory impairment, persistent pain, and increased risk of lower limb amputations. Photobiomodulation (PBM) has been investigated as an adjunctive treatment due to its effects on cellular repair mechanisms, pain modulation, and wound healing.This review aims to synthesize evidence from clinical and preclinical studies published between 2015 and 2025, focusing on dosimetric parameters used in PBM for DN and their association with clinical outcomes.The search was conducted in the LILACS, SciELO, EMBASE, MEDLINE, PubMed e Cochrane Library, covering publications from 2015 to 2025. A total of 23 studies met the inclusion criteria. This review provides comprehensive evidence supporting PBM as a promising, safe and effective adjunctive therapy for diabetic neuropathy. The most consistent therapeutic effects were observed with wavelengths ((630-670 nm/808-904 nm), fluences of 3-10 J/cm², output power between 45 and 100 mW, and treatment protocols comprising at least 12 sessions. Despite the favorable therapeutic outcomes, the absence of standardized dosimetry among the studies remains a major challenge. Therefore, further research is needed to define optimized and reproducible therapeutic protocols.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"436"},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of 570/590 Nm yellow light combined with red light and infrared LED in treating facial skin photoaging: A Single-Center, randomized Controlled, exploratory study.","authors":"Shiyun Yi, Jie Ding, Xihao Li, Xing Guo, Hongxuan Wu, Xianwei Cao, Duyang Wang, Zhibin Zhang","doi":"10.1007/s10103-025-04659-6","DOIUrl":"https://doi.org/10.1007/s10103-025-04659-6","url":null,"abstract":"<p><p>This study compared the efficacy of 570 nm and 590 nm yellow light, combined with red light and infrared LED phototherapy, in treating facial skin photoaging. Thirty patients with skin photoaging were enrolled between December 2024 and January 2025 and randomly assigned to two groups: the 570 nm combined LED group (hereafter referred to as the 570 group) and the 590 nm combined LED group (hereafter referred to as the 590 group), with 15 patients in each. The 570 group received treatment using 570 nm yellow light, 620 nm red light, and 850 nm infrared light (power density: 7.1 mW/cm²; total energy: 6.39 J/cm²), while the 590 group was treated with 590 nm yellow light alongside the same red and infrared wavelengths and identical parameters. Treatments were administered three times weekly for 8 weeks. GSP scores and VISIA skin imaging analyzer assessments (pores, wrinkles, texture, brown spots) were recorded pre- and post-treatment. Twenty-eight subjects (93.3%) completed the study. After 8 weeks, the 570 group showed significant reductions in GSP scores, wrinkle scores, and brown spot scores compared to baseline (P < 0.05). The 590 group also demonstrated reductions in GSP and wrinkle scores (P < 0.05). The difference in wrinkle scores between the two groups post-treatment was statistically significant (P < 0.05). Both 570 nm and 590 nm yellow light, combined with red light and infrared LED therapy, effectively reduce pores, wrinkles, texture, and brown spots, improving skin photoaging. The 570 nm yellow composite LED treatment showed more significant effects on both facial wrinkles and brown spots.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"435"},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations in teeth bleaching: harnessing antimicrobial photodynamic therapy for enhanced outcomes.","authors":"Yijun Li, Yuwang Tu, Lixuan Wu, Suli Xiao, Guanwen Sun","doi":"10.1007/s10103-025-04698-z","DOIUrl":"https://doi.org/10.1007/s10103-025-04698-z","url":null,"abstract":"<p><p>The objective of this study was to provide the first review on the emerging role of antimicrobial photodynamic therapy (aPDT) as an adjunct or alternative to conventional tooth bleaching methods. A detailed literature review of the current knowledge on aPDT bleaching was performed using PubMed and Google Scholar from 2018 to 2024. aPDT targets pigmented substances with precision while minimizing non-specific side effects. Studies have demonstrated that aPDT achieves comparable or superior whitening results to traditional methods, with reduced enamel damage and dentinal hypersensitivity. Antimicrobial action of aPDT further mitigates gingival irritation and secondary infections. aPDT represents a promising innovation in tooth bleaching, offering the dual benefits of aesthetic improvement and biological safety.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"439"},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Nd: YAG laser on the treatment of intraradicular dentin prior obturation with calcium silicate-based sealer.","authors":"Gustavo de Castro-Vasconcelos, Guilherme Alves Dos Santos, Helena Assis, Washington Dos Santos, Dione Reis, Patrícia Moreira de Freitas, Jardel Mazzi-Chaves, Manoel Sousa-Neto, Fabiane Lopes-Olhê","doi":"10.1007/s10103-025-04608-3","DOIUrl":"https://doi.org/10.1007/s10103-025-04608-3","url":null,"abstract":"<p><p>To evaluate the effect of Nd:YAG laser irradiation on intraradicular dentin prior to obturation with calcium silicate-based and epoxy resin-based sealers, focusing on push-out bond strength, failure pattern using a stereomicroscope, adhesive interface quality via confocal laser scanning microscopy (CLSM), chemical composition using Raman spectroscopy, and dentin surface morphological alterations through scanning electron microscopy (SEM). Forty-six teeth were sectioned to standardize root length (16 mm) and prepared using a reciprocating R50 instrument. Specimens were randomly divided into control (no treatment) and Nd: YAG laser (1,064 nm) groups, with laser irradiation performed at 1.5 W, 25 Hz, for 20 s using a 400 μm fiber in a helical motion (1.5 mm/s). Twenty specimens per group were obturated using the single-cone technique with R50 gutta-percha and further subdivided by sealer: AH Plus (n = 10) and Bio-C Sealer (n = 10), with and without laser treatment. Three non-obturated specimens per group underwent Raman spectroscopy and SEM analysis of intracanal dentin. After 30 days at 37 °C, obturated samples were sectioned into slices (nine per specimen). The first two slices per third underwent push-out bond strength testing and failure analysis, while the third was examined via CLSM for adhesive interface quality. Bond strength was analyzed using three-way ANOVA, chemical composition by two-way ANOVA, failure patterns by chi-square, and interface adaptation by Kruskal-Wallis with post-hoc tests (p < 0.05). In laser groups, Bio-C Sealer showed higher bond strength in the cervical third (p = 0.011), whereas AH Plus maintained superior values in the middle and apical thirds (p < 0.001). The laser group obturated with Bio-C Sealer demonstrated adhesive interface adaptation comparable to the control group obturated with AH Plus (p = 1.000) and superior to the control group obturated with Bio-C Sealer (p = 0.037). Laser groups exhibited more mixed failures, while control groups showed a higher prevalence of adhesive failures (p = 0.045). Laser irradiation resulted in lower organic content intensity in the cervical third (p = 0.002) and an increased inorganic/organic ratio (p < 0.001). Additionally, it induced fusion and obliteration of dentinal tubules in the cervical third, whereas alternating areas of fused dentin and exposed tubules were observed in the middle and apical thirds. The Nd:YAG laser treatment of intraradicular dentin prior obturation positively influenced the obturation process when associated with Bio-C Sealer, particularly in the cervical third. Therefore, Nd:YAG laser may be a promising approach to enhance bond strength and improve the adhesive interface quality of obturations performed with calcium silicate-based sealers.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"433"},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractional non ablative 675 nm diode laser versus low fluence high frequency Q- switched 1064 nm nd: YAG laser in the treatment of melasma: a comparative split face trial.","authors":"Hadeer M Bassiony, Zakaria M Obaid, Shady M Ibrahim, Hany O Aboelwafa, Mohamed L Elsaie","doi":"10.1007/s10103-025-04679-2","DOIUrl":"10.1007/s10103-025-04679-2","url":null,"abstract":"<p><p>Melasma is a chronic, relapsing pigmentary disorder that poses a significant therapeutic challenge, particularly in individuals with darker skin types. Laser therapies have shown promise in targeting both epidermal and dermal melanin deposits. The study aimed to compare the efficacy and safety of fractional non-ablative 675 nm diode laser and Q-switched 1064 nm Nd:YAG laser in the treatment of facial melasma using a split-face design. Thirty female patients with bilateral facial melasma were enrolled in a prospective, split-face trial. Each received five treatment sessions at two-week intervals: the right side with 675 nm diode laser and the left with 1064 nm Q-switched Nd:YAG laser. Clinical efficacy was assessed using the Melasma Area and Severity Index (MASI), dermoscopic scoring, and post-therapy lightening grade at baseline and 12 weeks post-treatment. Both modalities resulted in significant reductions in MASI and dermoscopic scores (p < 0.05). The 675 nm laser showed superior improvement, with a greater proportion of patients achieving excellent lightening. Adverse events were mild and transient. Fractional non-ablative 675 nm diode laser is more effective and equally safe compared to Q-switched 1064 nm Nd:YAG laser in treating facial melasma, offering a promising modality for patients with recalcitrant hyperpigmentation.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"434"},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photobiomodulation with IR and RED light acutely applied to lipedema patients: preliminary study with 3 cases.","authors":"Nivaldo Antonio Parizotto, Curro Millan, Fabio Kamamoto, Vitor Gornati, Lyvia Almeida Nascimento Salem, Marília Soler, Ana Laura Andrade, Ciro Dantas Soares, Patrícia Froes Meyer","doi":"10.1007/s10103-025-04693-4","DOIUrl":"https://doi.org/10.1007/s10103-025-04693-4","url":null,"abstract":"<p><p>Lipedema is a clinical entity that deserves special attention, as it predominantly affects women during specific hormonal phases such as menarche, pregnancy and menopause. Among the available treatments, surgery is considered the most invasive and is usually indicated for severe cases. As an alternative, conservative therapies may be recommended, including photobiomodulation therapy (PBMT), which still requires scientific substantiation to validate its effectiveness. We conducted a clinical study involving three patients who underwent dermolipectomy for previously indicated medical reasons. Prior to surgery, PBMT was applied using red and infrared LED irradiation on one side of the body, with the contralateral side serving as a non-irradiated control. PBMT was administered 3-4 h before the surgical procedure. The excised skin samples from both treated and control sites were subjected to histopathological analysis. Qualitative assessments (H&E staining) and adipocyte histomorphometry were performed, alongside immunohistochemistry using the following markers: caspase-3 (apoptosis), CD68 (macrophages), COX-2 and Cytochome P4501A1 (CYP1A1). Results demonstrate positive effects, including a reduced adipocyte size in irradiated sites modulation of inflammatory process and increasing COX-2 and macrophage activity in this early post-treatment phase, enhanced adipocyte apoptosis, and upregulation of aromatase (CYP1A1). These membrane-associated hemoproteins are known to catalyze mono-oxygenation of both endogenous and exogenous substrates such as hormones, fatty acids. This is the first study to investigate the effects of PBMT in lipedema patients. Despite is preliminary nature, the findings suggest that PBMT exerts beneficial biological effects on lipedema tissue when applied under the tested parameters.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"437"},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsurgical lower eyelid rejuvenation using a novel 1064-nm Nd:YAG laser with a 650- microsecond pulse duration.","authors":"Yun Seok Yang, Ji Hyun Ha, Byong Han Song, Da-Hyun Kang, Hye-Jin Ahn","doi":"10.1007/s10103-025-04682-7","DOIUrl":"10.1007/s10103-025-04682-7","url":null,"abstract":"<p><p>The lower eyelid region is prone to age-related concerns, including wrinkles and dark circles, resulting from structural changes, such as collagen depletion, fat prolapse, and reduced elasticity. Traditional treatments, such as surgery, fillers, and conventional lasers have limitations including risks, downtime, and variable efficacy. This study evaluated the safety and efficacy of a novel 1064-nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser with a 650 µs pulse duration for noninvasive lower eyelid rejuvenation targeting wrinkles and dark circles. Sixteen participants underwent five weekly treatment sessions, with evaluations at baseline, during treatment, and 1 month post-treatment. The outcomes included quantitative assessments of wrinkles and pigmentation using a facial skin analyzer and participant satisfaction scores. As a result, no significant side effects occurred apart from transient erythema, and participant satisfaction was high. Statistically significant improvements were observed in wrinkle level (baseline: 4.15 ± 1.09; post-treatment: 3.32 ± 1.13, p < 0.001) and dark circle scores (baseline: 69.63 ± 14.09; post-treatment: 77.00 ± 13.59, p < 0.001). The novel 1064 nm Nd: YAG laser with a 650 µs pulse duration offered a painless, downtime-free alternative to traditional treatments and demonstrated significant efficacy in lower eyelid rejuvenation.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"432"},"PeriodicalIF":2.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of antibacterial efficacy of laser-assisted and passive ultrasonic irrigation methods in disinfection of post space and effects on bond strength of glass fiber posts to radicular dentin.","authors":"Tülin Doğan Çankaya, Zeliha Uğur Aydın, Ülkü Tuğba Kalyoncuoğlu, Demet Erdönmez","doi":"10.1007/s10103-025-04694-3","DOIUrl":"https://doi.org/10.1007/s10103-025-04694-3","url":null,"abstract":"<p><p>The aim of this study was to evaluate the antibacterial efficacy of various irrigation activation methods and their effects on the push-out bond strength (PBS) of glass fiber posts (GFP) to radicular dentin in teeth with post spaces infected with E. faecalis. Sixty human mandibular premolar teeth were decoronized. All root canals were shaped using a similar protocol and sterilized in an autoclave. Sterilization was confirmed in 10 randomly selected samples. 50 root canals were obturated. Post spaces were prepared in all samples, and root canals were contaminated with E. faecalis and incubated for 4 weeks. Bacterial growth was confirmed in 10 randomly selected samples. Samples were randomly divided into four groups according to irrigation activation methods (n = 10): Standard needle irrigation (SNI), passive ultrasonic irrigation (PUI), photon-induced photoacoustic streaming (PIPS), and shock wave-enhanced emission photoacoustic streaming (SWEEPS). CFU levels were recorded before and after disinfection by taking samples from the root canals with paper points. GFPs were cemented with self-adhesive resin cement. 2 mm thick sections were taken from the apical, middle, and coronal parts of GFPs, and a push-out test was performed with a universal testing machine. Failure modes were examined under a stereomicroscope (40×). Data were analyzed statistically. None of the irrigation methods tested achieved complete bacterial elimination. However, PIPS and SWEEPS achieved significantly greater bacterial reduction than SNI (ΔCFU [S1-S2], mean: PIPS 0.097; SWEEPS 0.090; SNI 0.045; P < .05). No significant differences were observed in PBS among groups (P > .05); values were generally higher coronally than apically (e.g., SNI 79.1 ± 50.1 vs. 34.1 ± 26.7 MPa), regardless of irrigation method. Adhesive fractures were dominant in all sections in SWEEPS, cohesive fractures were dominant in SNI, and mixed fractures were dominant in PUI. PIPS and SWEEPS are more effective than SNI in reducing bacterial load in the post space; however, this superiority is not reflected in bond strength. Irrigation activation method may affect the dentin surface and fracture type but does not make a decisive difference on PBS.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"429"},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of procedural modalities in the treatment of lichen planopilaris, frontal fibrosing alopecia, and discoid lupus erythematosus.","authors":"Ali Ezzatollahi Tanha, Yekta Ghane, Alireza Jafarzadeh, Azadeh Goodarzi","doi":"10.1007/s10103-025-04704-4","DOIUrl":"https://doi.org/10.1007/s10103-025-04704-4","url":null,"abstract":"<p><p>Lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), and discoid lupus erythematosus (DLE) are lymphocytic cicatricial alopecias causing irreversible follicular loss. Procedural therapies have been proposed to control inflammation, remodel scarred tissue, and, occasionally, promote hair regrowth. We performed a PRISMA-guided systematic review of PubMed/Medline, Ovid Embase, and Scopus through July 28, 2025, selecting original studies of procedural interventions for LPP, FFA, and DLE. We assessed methodological quality using NIH and Murad et al. tools. Thirty-eight studies comprising 411 patients were included, reporting lasers/light therapies, platelet-derived products, adipose/exosome injections, low-level light therapy (LLLT), intralesional corticosteroids (ILCS), carboxytherapy, microneedling, and hair transplantation. Outcomes reported were both subjective (patient-reported symptom change, global physician assessment) and objective (LPPAI/FFASS activity scores, terminal hair counts, hair shaft diameter, and photographic density). Platelet products most consistently reduced activity scores and improved symptoms; several reports also documented increases in terminal hair counts or shaft diameter. LLLT led to improved patient-reported outcomes and modest, measurable gains in hair counts/thickness in small series. ILCS reliably achieved disease stabilization and reductions in activity scores but yielded inconsistent objective regrowth. Hair transplantation resulted in good early cosmetic density in quiescent patients, with several studies documenting quantitative density at 6-24 months but progressive graft loss by 3-5 years. Adipose and exosome injections showed promising case-level increases in density/thickness, although the results remained preliminary. Adverse events were generally mild and procedure-specific. In hair transplantation, long-term graft durability remains a major concern. Procedural modalities may serve as useful treatments for symptom control and limited regrowth in selected patients with scarring alopecia. These modalities are best considered adjuncts to medical therapy pending standardized, controlled trials.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"431"},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}