Efficacy and safety of 1064‐nm Q‐switched Nd:YAG laser with low fluence for keloids and hypertrophic scars

Background Several treatment modalities using laser devices have been used for the treatment of keloids and hypertrophic scars with various therapeutic outcomes. Objective The purpose of this study was to describe the efficacy and safety of 1064‐nm Q‐switched (QS) Nd:YAG laser with low fluence on keloids and hypertrophic scars. Methods Keloids and hypertrophic scars located at 21 anatomic sites in 12 Korean patients (10 men and 2 women; mean age 23.8 years, range 21–33) were treated using 1064‐nm QS Nd:YAG laser with low fluence at 1–2 week intervals. Treatment settings were 1.8–2.2 J/cm², 7‐mm spot size and 5–6 passes with appropriate overlapping. Results Follow‐up data collected 3 months after the final treatment revealed decreases in the mean score for the following lesion characteristics: pigmentation from 1.8 to 1.2; vascularity from 1.4 to 1.0; pliability from 3.0 to 2.0 and height from 2.3 to 1.8. The modified Vancouver General Hospital Burn Scar Assessment score decreased from 8.6 to 5.9 (P < 0.0001). Observed side‐effects were a mild prickling sensation during treatment, and mild post‐treatment erythema, both of which resolved within few hours. Conclusion Our results demonstrate that QS Nd:YAG laser with low fluence may be used for the treatment of keloids and hypertrophic scars.     

长脉宽1064nm Nd:YAG激光治疗甲真菌病

目的:评价长脉宽1064nm Nd:YAG激光治疗甲真菌病的疗效。方法:60例甲真菌病患者给予长脉宽1064nm Nd:YAG激光治疗,每周1次。结果:治疗结束后6个月有效率为60%。完成4次(23例)和8次治疗(32例)患者的有效率分别为34.8%和78.1%(P0.01)。结论:Nd:YAG1064nm激光治疗甲真菌病有效,疗效与治疗次数相关。     

Diagnostic value of multiple café‐au‐lait macules for neurofibromatosis 1 in Chinese children

Neurofibromatosis 1 (NF1) is a common autosomal dominant condition caused by mutations in the NF1 gene. The appearance of multiple café‐au‐lait macules is an early sign of the condition, which often alert physicians to follow up and further examine the patient for the possibility of NF1. In order to determine the predictive value of multiple café‐au‐lait macules at early age for NF1 in Chinese patients, we recruited 19 children who shared the common sign of multiple café‐au‐lait macules from a general pediatric clinic in Shanghai. All the patients were clinically evaluated following the National Institutes of Health criteria for NF1 and molecular tested for sequence variants and copy number changes. Nine children met the clinical diagnostic criteria of NF1, and molecular tests confirmed all nine patients with pathogenic variants including two genomic deletions, two novel frame‐shift variants, four novel nonsense and a splicing variants. In addition, four children who did not meet the diagnostic criteria were also found to carry pathogenic NF1 variants. Overall, 68.4% (13/19) of children with café‐au‐lait macules and various other clinical presentations were molecularly confirmed with NF1. This study demonstrated that the majority of Chinese children with multiple café‐au‐lait macules who came to seek for medical attention had NF1. Molecular testing is necessary to be used as an adjunct and sometimes as the main tool for confirming and diagnosing children of NF1 at early age.     

Treatment of procedure-related postinflammatory hyperpigmentation using 1064-nm Q-switched Nd:YAG laser with low fluence in Asian patients: report of five cases

Postinflammatory hyperpigmentation (PIH) developing after cosmetic procedures, such as chemical peeling and laser therapies, are always a concern, especially in Asians. Some cases of PIH tend to be spontaneously regressed; however, certain forms of PIH need to be treated with several therapeutic attempts, including bleaching creams, several kinds of Q-switched lasers, and erbium-doped fractional photothermolysis system, with various treatment outcomes. A 1064-nm Q-switched Nd:YAG laser with low-fluence therapy is easily applicable, and the therapeutic trial in our case was revealed to have minimal downtime without post-therapy bleeding or crust formation; the post-therapy erythema spontaneously resolved within a few hours. The 1064-nm Q-switched Nd:YAG laser with low-fluence treatment should be considered in the treatment of PIH caused by procedures like laser surgery and chemical peeling in Asian patients.     

Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias

BACKGROUND: Facial and leg telangiectasias are a frequent cosmetic concern for both females and males with various skin types and ages. To date the different treatments for these problems, in particular leg telangiectasias, have frequently failed or led to negative side-effects. OBJECTIVE: This study examines the clinical effects and safety of applications with a 1064-nm Nd:YAG laser system (SmartEpil II, DEKA M.e.l.a., Florence, Italy) to treat vessels on the face and legs. MATERIALS AND METHODS: Twenty-five subjects with facial telangiectasias underwent one treatment at 100 J/cm2, 10 ms and 2 Hz repetition rate. Thirty-two subjects with leg telangiectasias, measuring 0.1-3 mm in diameter, were treated at 125-200 J/cm2, 10-30 ms and 2 Hz repetition rate. Subjects in this group underwent one to five treatment sessions at 8 week intervals. RESULTS: All subjects showed visible improvement, with 95-100% clearing of the face telangiectasias after only one treatment, and 50-100% clearing of the lower extremity vessels after three to five treatments. Transitory hypopigmentation was seen in two cases subjected to leg vessel treatment. CONCLUSIONS: Treatment of facial and leg telangectasias using a true long pulse 1064 nm Nd:YAG laser is an effective and safe method. The relative lack of discomfort combined with a high degree of individual satisfaction should play a part in the fairly high level of acceptance of this new form of therapy for the treatment of leg and face telangiectasias.     

Effects of Q-switched and long-pulsed 1064 nm Nd:YAG laser on enlarged facial pores

'Enlarged facial pore' is a subjective term, which is not clearly defined but often complained by many. A diverse range of treatments are used though evidence of efficacy remains largely anecdotal. We report a series of nine patients who underwent a split face trial with Q-switched 1064 nm Nd:YAG and long-pulsed 1064 nm Nd:YAG laser to treat enlarged facial pores.     

Q开关1064 nm Nd:YAG激光治疗黄褐斑所致点状色素减退:2年随访研究

目的:了解大光斑低能量模式Q开关1064 nm激光治疗黄褐斑后所致点状色素减退恢复情况。方法:对大光斑低能量模式Q开关1064 nm Nd:YAG激光治疗5次以上的180例黄褐斑患者随访2年。结果:15例出现点状色素减退(8.33%),2年后1例痊愈,2例有改善,13例无变化。结论:大光斑低能量Q开关1064 nm激光治疗黄褐斑所致的点状色素减退斑可持续2年以上。     

Efficacy of combination therapy with efinaconazole 10% solution and 1064 nm Nd:YAG laser for treatment of toenail onychomycosis

Background: Onychomycosis is a common but difficult to treat nail disorder. Treatment strategies thus far have included oral and topical antifungals, surgical treatment and recently lasers have emerged as a therapeutic modality.

Objective: The objective of this study was to assess whether efinaconazole together with laser would result in greater clinical and mycologic cure and lower rate of relapse compared to efinaconazole alone.

Methods: Thirty subjects were randomized to either self-apply efinaconazole 10% once daily for 48 weeks, or follow the same treatment plan but also receive six treatments with a 1064 nm Nd: YAG laser every 4 weeks. The primary endpoint was to assess the proportion of subjects who achieved complete cure at week 52.

Results: The combination therapy group showed significantly quicker mycological cure at the 48- and 52-week follow-up.

Conclusion: Both efinaconazole and combination with laser were efficacious treatment, but the combination therapy leads to quicker resolution with fewer rate of relapse.     

大光斑低能量1064nm Q开关Nd:YAG激光在皮肤科的拓展应用

大光斑低能量1064 nm Q开关Nd:YAG激光具有红外波长、短脉宽、大光斑、低能量等特点。近年研究发现该激光除治疗色素性疾病,还可引起皮肤一系列非热损伤的生物学事件,即光生物调节作用。本文就大光斑低能量1064 nmQ开关Nd:YAG激光在皮肤科的拓展应用进行综述,为该激光更灵活地用于治疗多种色素性疾病、皮肤老化、皮肤屏障功能受损、痤疮、病理性瘢痕及其他皮肤疾病提供依据。     

Treatment of facial reticular veins with dynamically cooled, variable spot-sized 1064 nm Nd:YAG laser

Background Facial reticular veins are often seen on the temple and periorbital areas in patients with genetic predisposition or after facial cosmetic surgery. Aim The purpose of this study was to evaluate the efficacy and safety of dynamically cooled, variable spot sized 1064 nm Nd:YAG laser in the treatment of facial reticular veins. Patients/methods This is a retrospective study. Twenty patients with facial reticular veins who underwent treatment with dynamically cooled, variable spot sized 1064 nm Nd:YAG laser were evaluated. Patients were followed up 1 month to 2 years after the procedure. Results Objective and subjective improvement scores after one or two treatments of dynamically cooled, variable spot sized 1064 nm Nd:YAG laser were nearly 100% when appropriate parameters were used. Conclusion Dynamically cooled, variable spot sized 1064 nm Nd:YAG laser is a safe and effective treatment for facial reticular veins. Most patients responded to one treatment and experienced no significant side effects other than tolerable pain associated with the procedure.     

长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗甲真菌病疗效的Meta分析

目的:通过Meta分析方法评价长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗甲真菌病的疗效.方法:搜集PubMed、Web of Science、Sinomed、FMRS、知网、中国生物医学文献数据库、维普和万方数据库自建库至2021年3月1日收纳的长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗...     

Dermoscopy as a useful tool for evaluating melasma and assessing the response to 1064‐nm Q‐switched Nd:YAG laser

Melasma is a hard‐to‐manage disorder with considerable relapsing behavior. Dermoscopy emerged to help in comprehensive evaluation of pigmentary disorders and melasma. The aim of the study was to evaluate the potential role of dermoscopy in assessing melasma and monitoring the efficacy of 1064‐nm low‐fluence Q‐switched neodymium:yttrium‐aluminum‐garnet (QS Nd:YAG) laser. A total of 31 patients with facial melasma were included. A total of five laser sessions were performed with 2‐week intervals. Patients were evaluated at baseline and 2 weeks after the last session (at the 10th week) by using digital photography, modified melasma area and severity index (mMASI), and colorimetry, as well as dermoscopic score for pigment and vascular elements. Adverse effects were reported. Postlaser sessions, mMASI scores as well as the colorimetric melanin and erythema indices had showed significant improvement. The “dermoscopic score of pigmentary and vascular elements” displayed significant change and confirmed the improvement. Side effects were tolerable. mMASI, colorimetry, and dermoscopy had ascertained the efficacy of low‐fluence 1064‐nm QS Nd:YAG laser in melasma; however, dermoscopy is superior to other assessments as it can help in the diagnosis of melasma besides the follow‐up assessment and can precisely detect the detailed changes in response to treatment.     

长脉宽1064nmNd:YAG激光治疗婴儿血管瘤疗效评价

目的：评价长脉宽1064nmNd:YAG激光治疗婴儿血管瘤的临床疗效及不良反应。方法：回顾性分析61例经长脉宽1064nmNd:YAG激光治疗的婴儿血管瘤,治疗参数：3mm光斑,脉宽30-40ms,能量密度180-220J/cm2,DCD30/20/30ms,间隔时间为4周,治疗次数1-7次不等,所有患儿均为浅表血管瘤的隆起性皮损。 结果：57例患儿皮损改善76%～100%,4例改善51%～75%。不良反应包括： 水疱20例 （32.79%）,1天～10天修复;浅表瘢痕9例（14.75%）;色素减退5例（8.20%）;色素沉着4例（6.56%）;毛发稀少或缺失3例（4.92%）。随访3个月时色素改变及瘢痕均有不同程度的改善,但毛发改变无明显改善。结论：长脉宽1064nmNd:YAG激光治疗婴儿血管瘤有效,但不良反应率较高。     

Q开关Nd:YAG激光治疗双侧太田痣3例

报告3例双侧太田痣。患者均为女性,1例为早发型,2例为迟发型。皮损特点是蓝褐色斑疹,主要累及巩膜及受三叉神经支配的面部皮肤,无自觉不适。其中1例患者父亲及妹妹均患此病。予Q开关Nd:YAG激光(波长1064nm)治疗,疗效满意。     

长脉冲1064 nm钕:钇-铝石榴子石激光治疗蜘蛛痣临床观察

目的:探讨长脉冲1 064 nm钕:钇-铝石榴子石(Nd:YAG)激光治疗蜘蛛痣的临床疗效.方法:以长脉冲Nd:YAG激光治疗86例蜘蛛痣患者,每2个月治疗1次.结果:经1～4次治疗后有效率为94.19%,治愈率为79.07%.2例患者在治疗中出现轻度凹陷性瘢痕.结论:长脉冲Nd:YAG激光治疗蜘蛛痣安全,临床效果较好.