Angiokeratoma of Fordyce response to long pulsed Nd:YAG laser treatment

Angiokeratoma of Fordyce can be easily diagnosed by their typical erythra and cured by varied therapeutic methods including surgery, electrocoagulation, cryotherapy, or various laser systems. Which are the optimal therapeutic methods? There are no consentaneous opinions in the reported articles. We present our characteristic treatment with the application of long pulsed neodymium–dopedyttrium–aluminum–garne (lpNd:YAG) laser in the treatment of angiokeratoma of Fordyce. A 1064 nm lpNd:YAG laser (spot size: 5 mm/7 mm, energy:90–130 J/cm², and pulse duration: 10–20 ms.) was used to treat the patient's lesions. The desirable clinical endpoint of the treatment was lesions shrunk and turned pallor immediately after the irradiation. The treatment interval was at least 8 weeks. Of the 11 patients, 9 of them were cured and 2 of them were improved. The mean treatment sessions were 2.2 times. None of them had a scar formation and any other side effects. All of them were satisfied with the treatment results. We conclude that angiokeratoma of Fordyce responded well to lpNd:YAG laser treatment. It provided a simple, rapid, and no bleeding treatment in treating Angiokeratoma of Fordyce.     

Visualizing nuclei in skin cryosections: viable options to 4'6-diamidino-2-phenylindol for confocal laser microscopy

Background: Visualization of nuclei in skin (cryo‐) sections is essential for both, rapid overview and reliable orientation within skin samples. Therefore, nuclear staining is a very common counterstain for immunohistochemical studies of human skin as this nuclear staining precisely depicts the cellular distribution within the epidermis. Moreover, it clearly shows the epidermal–dermal border as well as the transition zone between the living and the cornified layers of the epidermis. For standard epifluorescence microscopy, 4′6‐diamidino‐2‐phenylindol (DAPI) is commonly used. For confocal laser scanning microscopy (CLSM), however, DAPI is often not suitable because its excitation maximum is in the ultraviolet (UV) range (Ex_max 359 nm) when bound to DNA, and UV lasers and the corresponding optics are not part of CLSM standard configuration. Methods: In order to find an adequate DAPI substitute that is excitable with standard visible light lasers, the following nuclear stains were tested: LOLO^?‐1 iodide (Ex_max 565 nm), TOTO^®‐3 iodide (Ex_max 642 nm), LO‐PRO^?‐1 iodide (Ex_max 567 nm), SYTO^® 84 (Ex_max 567 nm), SYTO^® 85 (Ex_max 567 nm), SYTOX^® Green (Ex_max 488 nm) and SYTOX^® Orange (Ex_max 547 nm), Propidium iodide (Ex_max 535 nm). Besides optimal concentration and incubation time, following criteria were also evaluated: photobleaching, background, e.g. cytoplasmic staining of RNA, and sensitivity to different fixation conditions (unfixed, IEM fixation, PLP fixation and PFA fixation). Results: According to these criteria Sytox^® Green showed the best overall staining score and can be used for variously fixed skin samples and shows a distinct and stable green nuclear fluorescence.     

ED2000®: 585 nm collagen remodelling pulsed dye laser

The wavelength of 585nm corresponds to an absorption peak of haemoglobin. The heating effect in these skin layers triggers the release of various growth factors that stimulate collagen remodelling and tightening. We report our experience with a 585nm collagen remodelling, double flashlamp excited pumped dye laser was used (ED2000^®, Deka MELA, Calenzano, Italy), spot size 5?mm, energy density (fluence J/cm²) from 2 to 4?J/cm², emission modality (repetition rate) at 0.5?Hz, with a short pulse duration of 250?μsec. The efficiency of 585?nm collagen remodelling pulsed dye laser is controversial in only one session. It is probably reasonable to inform patients that 3–4 treatment sessions are necessary, and that 10% of the patient have no response to nonablative photorejuvenation.

Because of its low fluence and is shorter pulse duration, the 585?nm collagen remodelling pulsed dye laser has limited efficacy for the treatment of port wine stains. However, it may offer patients with erythematous, raised or hypertrophic acne scars or striae distensae a permanent cosmetic solution. This laser is safe and effective in the treatment of surgical scars starting as soon as possible, on the day of suture removal if possible. We found that 96.3% of molluscum contagiosum healed after the first treatment, the other 3.7% after the second.     

Comparison of quality of facial scars after single low‐level laser therapy and combined low‐level with high‐level (PDL 595 nm) laser therapy

The main goal of our study was to compare the quality of resulting facials scar 12 weeks after single and combined laser therapy. Forty‐one children from age 1.5 to 5 years with facial scars after injury participated in the study. Thirty‐one underwent laser therapy, 14 were treated using single low‐level laser therapy (670 nm, fluence 3–5 J/cm^?2), and 17 underwent combined high‐level laser therapy with non‐ablative pulsed dye laser (PDL; 595 nm, spot size 7 mm, delay 0.45 ms or 1.5 ms, fluence 9–11 J/cm^?2, cryogen spray/delay 20/30 ms) and low‐level laser therapy. The control group consisted of 10 untreated children. Before treatment and at week 4, 8, and, 12 the scars were evaluated using the POSAS questionnaire. A statistically significant improvement in scars (between ratings before treatment and 4 weeks after therapy, before treatment and 8 weeks after therapy and before treatment and 12 weeks after therapy) was observed in all parameters in both treatment groups (p < 0.0001). For the HLLT+LLLT group the most significant enhancement in the quality of scars was found for all items and at all evaluations, except pigmentation and pliability. There was no improvement observed in quality of facial scars in the control group.     

The pulsed‐dye laser as an adjuvant treatment modality in acne vulgaris: a randomized controlled single‐blinded trial

Background Acne vulgaris is the most common skin disease and can pose a substantial therapeutic challenge. Recently, several phototherapeutic modalities, most notably pulsed‐dye laser (PDL) treatment, have been introduced, but the published results – albeit promising – are controversial. Objectives To assess the efficacy of an adjuvant PDL treatment when combined with a proven topical treatment [fixed‐combination clindamycin 1%–benzoyl peroxide 5% hydrating gel (C/BPO)]. Methods Eighty patients (38 males and 42 females, mean ± SD age 19·7 ± 5·9 years) were randomized in a 1 : 2 ratio to receive C/BPO alone or in combination with PDL treatment (wavelength 585 nm, energy fluence 3 J cm⁻², pulse duration 0·35 ms, spot size 7 mm). Patients were evaluated at baseline and at 2 and 4 weeks after initial treatment. The primary end points were the Investigator’s Static Global Assessment (ISGA) score and lesion count; the secondary end point was the Dermatology Life Quality Index (DLQI). Results Both groups showed a significant improvement during observation [ISGA 27·1% (C/BPO) and 24·6% (C/BPO + laser), total lesion count 9·2% and 9·0%, inflammatory lesion count 36·3% and 36·9%, DLQI 54·5% and 42·5%], but there was no significant or otherwise appreciable difference between treatment modalities as far as the extent of improvement was concerned. Patients with more severe findings at baseline had a greater benefit from either therapy regimen. Conclusions Our findings do not support the concept of a substantial benefit of PDL treatment in acne vulgaris.     

Laser treatment of onychomycosis: an in vitro pilot study

Background: Laser treatment of onychomycosis is the object of considerable interest. Laser therapy could be a safe and cost‐effective treatment modality without the disadvantages of drugs. Some studies have described the inhibitory effects of lasers on the growth of fungal colonies. We therefore examined the effects of various laser wavelengths, which have previously shown inhibitory potential, on the fungal isolate Trichophyton rubrum. Patients and Methods: Isolates of fungal colonies were placed clockwise on culture plates. Each culture plate was irradiated on one half with one of the following treatment regimens: 1064 nm‐Q‐switched Nd:YAG laser at 4 J/cm² and 8 J/cm²; 532 nm‐Q‐switched Nd:YAG laser at 8 J/cm²; 1064 nm‐long‐pulsed Nd:YAG laser at 45 J/cm² or 100 J/cm². The other half remained untreated. Standardized photographs were taken and areas of treated and untreated colonies were compared for growth inhibition. Results: There was no inhibition of fungal growth in any of the treated plates. Differences in size between treated and untreated colonies were not significant (p > 0.10). Conclusions: In this in vitro study Nd:YAG laser treatment of Trichophyton rubrum colonies failed to inhibit fungal growth. Nevertheless there might be an effectiveness in vivo which has to be clarified by clinical studies.     

Skin tightening induced by fractional CO(2) laser treatment: Quantified assessment of variations in mechanical properties of the skin

Background Certain authors have reported the efficacy of fractional resurfacing laser treatment in patients with photodamaged skin resulting in skin tightening of treated area. Objective To assess skin tightening after CO₂ fractional resurfacing laser treatment by measuring variations in mechanical properties in treated areas. Dermal elasticity was measured using suction applied with an in vivo skin elasticity meter (Cutometer^®). Methods A prospective observational study was undertaken from January 2007 to August 2009. Laser treatment was performed with the SmartXide Dot^® (Deka^®, Firenze, Italy) CO₂ fractional resurfacing device. Patients were offered quantified analysis using the Cutometer^® before and after treatment. Results Seventeen patients (61 areas treated) were included in the study. Median delay between before and after cutometric evaluations was 80 days. We found significant improvement in elastic (R2 +5.9%), viscoelastic (R8 ?9.4%), fatigue (R3 and R9 ?16.2% and ?19.7%, respectively), and thickness (R0 ?14.9%) parameters. These results are consistent with significant tightening and also elastic tissue improvement. Conclusions It was possible to quantify skin tightening because of CO₂ fractional laser treatment using a noninvasive technique.     

Indocyanine green-augmented diode laser treatment of port-wine stains: clinical and histological evidence for a new treatment option from a randomized controlled trial

Background Complete clearance of port‐wine stains (PWS) is difficult to achieve, mainly because of the resistance of small blood vessels to laser irradiation. Indocyanine green (ICG)‐augmented diode laser treatment (ICG+DL) may overcome this problem. Objectives To evaluate the feasibility of ICG+DL therapy of PWS and to compare the safety and efficacy of ICG+DL with the standard treatment, flashlamp‐pumped pulsed dye laser (FPDL). Methods In a prospective randomized controlled clinical study, 31 patients with PWS were treated with FPDL (λ_em = 585 nm, 6 J cm^?2, 0·45 ms pulse duration) and ICG+DL (λ_em = 810 nm, 20–50 J cm^?2, 10–25 ms pulse duration, ICG‐concentration: 2 mg kg^?1 body weight) in a split‐face modus in one single treatment setting that included histological examination (haematoxylin and eosin, CD34). Two blinded investigators and the patients assessed clearance rate, cosmetic appearance and side‐effects up to 3 months after treatment. Results ICG+DL therapy induced photocoagulation of medium and large blood vessels (> 20 μm diameter) but not of small blood vessels. According to the investigators’ assessment, clearance rates and cosmetic appearance were better after ICG+DL therapy than after FPDL treatment (P = 0·114, P = 0·291, respectively), although not up to a statistically significant level, whereas patients considered these parameters superior (P = 0·003, P = 0·006, respectively). On a 10‐point scale indicating pain during treatment, patients rated ICG+DL to be more painful (5·81 ± 2·12) than FPDL treatment (1·61 ± 1·84). Conclusion ICG+DL represents a new and promising treatment modality for PWS, but laser parameters and ICG concentration need to be further optimized.     

Intralesional therapy of metastatic spreading melanoma with beta‐interferon

A 74‐year‐old female patient developed multiple local metastases after excision of a nodular melanoma of the left cheek. There was no regression after treatment with dacarbazine (DTIC^®) and radiotherapy. After treatment with intralesional interferon‐β, the metastases regressed completely. The dosage was 5 million IU interferon‐β (Fiblaferon^®) three times weekly with courses of two and four weeks, separated by a month. Except for local swelling and inflammation, no side effects occurred. Five years after completing therapy, the patient is still tumor‐free.     

Evaluation of tissue thermal effects from 1064/1320-nm laser-assisted lipolysis and its clinical implications

Liposuction is a standard for removing fat. Recently developed, laser lipolysis can be used to simultaneously remove unwanted fat and tighten skin. Laser lipolysis is accomplished with single or multiple sequential wavelengths. Development of an optimal method requires detailed understanding of tissue heating for the wavelengths employed. This study systematically evaluates tissue heating for superficial and deep laser lipolysis using three approaches, and correlates temperature rise with histology changes, defining appropriate system parameters. Two individuals scheduled for abdominoplasty had laser testing on healthy abdominal skin scheduled for excision. Each treatment was applied to 3×3 cm squares with various laser parameters. Treatment was conducted in the fatty layer for lipolysis and subdermally for skin tightening. Individual squares were treated with SmartLipo (Cynosure, Inc. Westford, MA, USA) using 1064 nm, 1320 nm, or MultiPlex (1064 nm/1320 nm) with laser doses of 8.3 to 333 J/cm². Exposures were applied at 3–5 mm or ～20 mm depth below the skin surface. Skin temperatures at the surface and at depths of 5 mm to 37 mm were recorded immediately post-treatment for each exposure. Treated tissue was excised and evaluated for thermal injury using H&E and transmission polarization microscopy. Histology was correlated to tissue temperature to determine appropriate treatment limits. Superficial treatment with surface temperatures exceeding 47°C (50°C and 55°C at 5 mm depth) typically caused epidermal and dermal injury, with blistering above 58°C. Below this threshold, focal collagen change and dermal inflammatory response were found in many samples without epidermal injury. These acute thermal effects may link to skin tightening during the healing process. Deep treatments, at up to 133 J/cm², exhibited minimal temperature rise and induced thermal effects in vessels and ligaments. Higher laser doses were associated with a significant temperature increase. In conclusion, superficial subdermal heating (within approximately 5 mm of the surface) during laser lipolysis should limit skin surface temperature to 42°C. The laser dose per surface temperature rise in treatments are 4.5 J/cm²/°C for 1320 nm, 6 J/cm²/°C for MultiPlex and 7.5 J/cm²/°C for 1064 nm. Clinical studies should be performed to validate these results.     

Treatment of halo nevus with a 308‐nm excimer laser: A pilot study

Background: The treatment of halo nevus is controversial and ranges from observation requiring no therapy to excision biopsy. Objective: To assess the efficacy of excimer laser for the treatment of halo nevus. Methods: Four patients with halo nevus on the face were treated by excimer laser three times a week until they achieved 75% pigmentation or a maximum of 36 treatment sessions. They were assessed visually by comparing photographs taken before and at the end of treatment. Results: Two patients re‐pigmented completely and two showed 80% pigmentation. The number of sessions ranged from seven to 35. The study is limited by the small number of patients. Conclusion: Treatment with the 308‐nm excimer laser may be an effective treatment of halo nevi located on the face.     

Histological characterization of age‐related skin changes following the use of picosecond laser: Low vs high energy

Fractional lasers have become widespread in dermatology owing to their efficacy and safety. Comparative analysis of histological features after laser rejuvenation using a 1064‐nm fractionated handpiece picosecond laser with different energy fluence levels (1.1 or 2.1 J/cm²). An open‐label, study of 28 women aged 36 to 60 years with signs of age‐related photodamage and skin changes of the face and neck was conducted using a fractional picosecond 1064 nm laser in low vs high fluence. The clinical assessment at 3 weeks showed more pronounced effect on facial skin rejuvenation with the higher fluence of 2.1 J/cm² compared to 1.1 J/cm². The effect and safety of laser rejuvenation using a picosecond laser has been shown with more pronounced histological effects at higher fluences.     

Penetration enhancement of two topical 5‐aminolaevulinic acid formulations for photodynamic therapy by erbium:YAG laser ablation of the stratum corneum: continuous versus fractional ablation

Please cite this paper as: Penetration enhancement of two topical 5‐aminolaevulinic acid formulations for photodynamic therapy by erbium:YAG laser ablation of the stratum corneum: continuous versus fractional ablation. Experimental Dermatology 2010; 19 : 806–812. Abstract: 5‐Aminolaevulinic acid (ALA) is used in photodynamic therapy (PDT). Response rates of PDT vary widely, which may be because of the limited uptake of topically applied photosensitisers. We investigated skin penetration and fluorescence induction of protoporphyrin IX (PpIX) after applying either 20% ALA cream or 20% aminolaevulinic acid solution on laser‐stripped stratum corneum (SC) in an ex vivo full‐thickness porcine skin model. Both formulations are used in clinical practice. To enhance the skin penetration of ALA, we used two different 2940‐nm erbium:yttrium–aluminium–garnet (Er:YAG) laser systems to partially ablate the SC: continuous and fractional ablation. Different fluences were applied ranging from 0.5 to 1.5 J/cm² (continuous ablation) and from 4 to 24 J/cm² (fractional ablation). Fluorescence microscopy was used for detecting PpIX‐induced fluorescence. Compared to skin without laser pretreatment, mean fluorescence intensity (MFI) of PpIX was enhanced 13.8‐fold after continuous ablation with 1.0 J/cm² and 7.3‐fold after fractional ablation with 4 J/cm²; each laser procedure was followed by 4‐h incubation with lipophilic ALA cream. Optimal parameters for continuous ablation without damage to the epidermis were 1 J/cm² for both formulations, fractional ablation was best with 4 J/cm². Histological evaluations of laser‐treated skin showed necrosis and apoptosis, depending on light dose. In laser‐stripped skin, PpIX fluorescence was detected earlier and reached deeper epidermal layers than in untreated skin. Continuous laser ablation induced higher PpIX fluorescence levels than fractional ablation. This method offers a promising new tool for enhancing ALA penetration in PDT without damaging the underlying tissue.     

Ultrastructural Observation of Platelets from Patients with Progressive Systemic Sclerosis (PSS)

We observed the ultrastructure of platelets from patients with PSS (7 cases; 48.2 ± 12.3 y-old; M:F= 1:6) and healthy controls (HC) (5 cases; 44.8 ± 8.0 y-old; M:F=1:4) by using transmission (TEM) and freeze-fracture electron microscopy (FEM). The open canalicular system (OCS) connected with the plasma membrane (PM) formed pinhole-like invaginations (50 nm in diameter) in the cleaved face (P-face) of the plasma membrane seen from the outside of the platelets and sharply elevated structures in the cleaved face (E-face) of PM seen from the inside of the platelts by FEM. The density of OCS on the surface of the platelets from PSS patients was 3 ± 1/μm², which was higher than that from HC (1 ± 0.5/μm²) (p<0.02). Dome-shaped structures, which clearly differ from OCS and were 80–150 nm in diameter without intramembranous particles, were seen in the P-face, and the complementary depressed structures were seen in the E-face. These structures were thought to be vesicles fused onto the PM of the platelets. The total volume of platelets (7.62 ± 0.11 μm³), total volume of granules (0.79 ± 0.01 μm³) and vacuoles including OCS (0.78 ± 0.05 μm³), and the total surface area of platelets (17.25 ± 1.30 μm²) from four PSS patients calculated by the morphometrical method were similar to those from four HC (7.32 ± 0.25 μm³, 0.76 ± 0.03 μm³, 0.80 ± 0.05 μm³, 18.75 ± 0.35 μm², respectively); there were no statistical significances between the data from PSS patients and HC. The total volumes of vacuoles in platelets from both PSS patients and HC significantly decreased after a 2 min-vibration stress of the hands (p<0.02) and the total volume of granules in platelets from PSS patients decreased significantly after the same stress (p<0.002), although that from HC showed no similar significant change. However, there were no statistically significant differences in total volume or total surface of platelets from PSS patients and HC after the stress. These data may suggest that depletion of granules occurred due to activation of platelets from PSS patients following a secretion of their proteins, because their plasma protein levels were elevated after the stress (Jpn J Dermatol, 98; 1205, 1988). Higher density of OCS on the surface of the platelets from PSS patients may play an important role in secretion of their proteins, although the detailed mechanism of secretion of specific proteins derived from platelet granules is still unknown. These ultrastructural abnormalities of platelets may correlate with some involvement of a platelet disorder and with a possible role for the activation of platelets from PSS patients.     

Reduction of subcutaneous fat and improvement in cellulite appearance by dual‐wavelength,low‐level laser energy combined with vacuum and massage

Background: This study compares the efficacy and safety of low‐level, dual‐wavelength laser energy and massage with massage alone for the reduction of subcutaneous fat in the thighs of normal women. The device was an early prototype of the FDA‐cleared SmoothShapes^TM system (Elemé Medical, Merrimack, NH, USA). Methods: The thighs of each individual (n = 102) were randomized to either laser light (dual wavelength of 650±20?nm and 915±10?nm) and massage or to massage alone (control). Individuals who completed the study (n = 74) received a mean of 14.3 treatments over 4–6 weeks. Magnetic resonance imaging (MRI) scans quantified fat pad dimensions before and after the final treatment. Results: Fat thickness decreased for the leg treated with laser‐massage by 1.19 cm² (mean) and increased by 3.82 cm² (mean) for the control leg over time. The difference was statistically significant (p<0.001). Among those who completed the study, 82.26% responded to treatment. Individuals reported looser‐fitting clothing and satisfaction with the procedure and results. Adverse effects were limited to occasional increases in urinary frequency. Conclusion: Low‐level, dual‐beam laser energy with massage appears to be safe and more efficacious than massage alone for reducing subcutaneous fat in the thighs of normal women.     

Effective treatment and improvement of quality of life in patients with scalp psoriasis by topical use of calcipotriol/betamethasone (Xamiol®‐gel): results

Background: Quality of life of patients with scalp psoriasis is greatly impaired due to itch and scaling. To control the disease long‐term therapy is necessary and treatment success is greatly dependent on compliance. Patients and Methods: In a prospective, non‐interventional trial in German dermatological practices 721 patients with scalp psoriasis received Xamiol^® gel (calcipotriol 50 μg/g, betamethasone 0,5 mg/g) topically for 4 weeks. Severity was assessed by physician's global assessment (PGA) and quality of life by using a scalp‐specific questionnaire at the beginning of the study and after 4 weeks of treatment. Results: The mean disease severity of scalp psoriasis (PGA) improved from 4.26 to 2.49 (–41.8 %, p < 0.0001) during 4 weeks of treatment and quality of life improved from 10.57 to 3.22 (–69.5 %, p < 0.0001). Among patients with pre‐treatment 89.5 % of patients and 87.9 % of dermatologists judged treatment response to Xamiol^® gel as better/much better compared to previous therapy. Tolerability of Xamiol^® gel was rated good/very good by 98 % of dermatologists and patients, respectively. The use of Xamiol^® gel was found easy/very easy by 90.4 % of the patients. Conclusions: Due to the major improvement of quality of life and quick onset of improvement together with the high acceptance by the patients Xamiol^® gel may be regarded as the topical treatment of choice for scalp psoriasis.     

The effect of a 1550 nm fractional erbium–glass laser in female pattern hair loss

Background Female pattern hair loss (FPHL) is the most common cause of hair loss in women, and its prevalence increases with advancing age. Affected women may experience psychological distress and social withdrawal. A variety of laser and light sources have been tried for treatment of hair loss, and some success has been reported. Objective The purpose of this study was to determine the efficacy and safety of a 1550 nm fractional erbium–glass laser in treatment of female pattern hair loss. Patients and methods Twenty eight ethnic South Korean patients with varying degrees of FPHL were enrolled in the study. Patients received ten treatments with a 1550 nm fractional Er:Glass Laser (Mosaic, Lutronic Co., Ltd, Seoul, South Korea) at 2‐weeks intervals using the same parameters (5–10 mm tip, 6 mJ pulse energy, 800 spot/cm² density, static mode). Phototrichogram and global photographs were taken at baseline and at the end of laser treatment, and analysed for changes in hair density and hair shaft diameter. Global photographs underwent blinded review by three independent dermatologists using a 7‐point scale. Patients also answered questionnaires assessing hair growth throughout the study. All adverse effects were reported during the study. Results Twenty seven patients completed a 5‐month schedule of laser treatment. One patient was excluded during treatment due to occurrence of alopecia areata. At the initial visit, mean hair density was 100 ± 14/cm², and mean hair thickness was 58 ± 12 μm. After 5 months of laser treatment, hair density showed a marked increase to 157 ± 28/cm² (P < 0.001), and hair thickness also increased to 75 ± 13 μm (P < 0.001). Global photographs showed improvement in 24 (87.5%) of the 27 patients. Two patients (7.4%) reported mild pruritus after laser treatment; however, these resolved within 2 h. Conclusion A 1550 nm fractional erbium–glass laser irradiation may be an effective and safe treatment option for women with female pattern hair loss.     

The objective evaluation of the severity of psoriatic scales with desquamation collecting tapes and image analysis

Background: Assessment of psoriatic scales is important to determine the severity of psoriasis. However, there are very limited numbers of objective, quantitative and observer‐independent tools for measuring the severity of psoriasis. Objective: To determine whether the bioengineering parameters of the psoriatic scale can be used to assess the severity of psoriasis instead of the psoriatic severity index of scales (PSIs) score. Methods: Thirty‐four patients with psoriasis were included. A representative lesion from each patient was selected and bioengineering parameters were measured using the Corneofix^®. Simultaneously, the severity of the scales was assessed by the PSIs score using clinical photographs of the lesions. In addition, skin color and elasticity parameters were also measured using the Colorimeter^®, the Mexameter^® and the Cutometer^®. Results: Statistical differences in the scale parameters were observed between the PSIs 2 and 3 scores. Among the scale parameters, the percent area and area in μm² were negatively correlated with the PSIs score. In addition, the Colorimeter^®a, b parameters and the Cutometer^® R9 parameters were significantly correlated with the PSIs score. Conclusions: The results of this study showed that the severity of psoriatic scales could be measured objectively using the Corneofix^®.     

Response of spider leg veins to pulsed diode laser (810 nm): a clinical,histological and remission spectroscopy study

BACKGROUND: Spider leg veins are common. Their treatment with laser or intensed light therapy shows generally variable success rates and often adverse side effects such as hyper‐ or hypopigmentation. This study was performed to investigate whether pulsed diode laser (810?nm) treatment is effective and safe.

METHODS: Thirty‐five female patients with spider leg veins were included in this prospective trial. They were treated twice with a pulsed diode laser (810?nm; spot size 12?mm, frequency 2–4?Hz, pulse width 60?msec, fluence 80–100?Jcm^?2). Laser therapy was performed on day 0 and day 14. Clinical assessments were carried out before and immediately after the first laser therapy, after 2 weeks, 8 weeks, and one year. Skin biopsies were taken before and immediately after the first laser treatment, and after 10 weeks. Contact‐free remittance spectroscopy was performed before laser treatment, immediately after the first treatment, after 2 weeks and 8 weeks.

RESULTS: After the first treatment 15 patients showed a complete disappearance (CR) of spider leg veins; in the remaining 20 patients a remarkable improvement (RI) was noted (n=35). After six months of follow‐up CR was seen in 6 patients, RI in 6, a stable situation in 9, and scar formation in 1 patient (n=21). The effect was almost completely stable during one year of follow‐up. The examination of histological specimens before and after laser treatment showed no cellular inflammatory reaction. The mean vascular area was significantly reduced after the first (p<0.05) and after the second (p<0.05) laser treatment. Spectral analysis showed a marked decrease of peaks for oxygenized haemoglobin immediately after laser treatment and during the follow‐up. Safety profile was excellent without purpuric reaction or pigmentary changes. Mild scarring was observed in two patients at the end of follow‐up.

CONCLUSIONS: Pulsed diode laser therapy (810?nm) is an effective and safe treatment option for spider leg veins. The effects can be seen immediately. Objective monitoring by non‐invasive remission spectroscopy and histology of biopsy specimens demonstrates selectivity of the laser action.     

Efficacy of 577‐nm Pro‐Yellow laser in port wine stain treatment

A port‐wine stain (PWS) is a congenital capillary malformation that is seen in 0.3–0.5% of newborns. Although many types of lasers have been used to treat PWSs, few studies have investigated the efficacy of 577‐nm Pro‐Yellow lasers. The aim of this study was to establish the efficacy of Pro‐Yellow lasers in PWS treatment. In total, 26 patients, comprising 15 females (57.7%) and 11 males (42.3%) with a mean age of 24.7 ± 11.8 (range 1–50) years were included in the study. All were treated with a 577‐nm Pro‐Yellow laser at 4‐week intervals, 3–10 times. The sessions initially used scan mode and a fluence dose of 24 J/cm² per session, on average. The mean dose was increased by 4 J/cm each session and the maximum dose administered was 44 J/cm². A mean regression of 68.8 ± 13.9% in the size of the lesions over 5.23 ± 2.7 sessions was observed. There was no statistically significant difference between the female and male patients when they were compared in terms of the number of treatment sessions (p = .789) and treatment success (p = .39). These case series demonstrate that the Pro‐Yellow laser is a safe and well‐tolerated treatment for PWSs. However, deep‐seated lesions required more treatment sessions and it was observed that clinically the lesions did not completely disappear.