Treatment of dermatosis papulosa nigra with a 1064 nm Nd:YAG laser: Report of two cases

Dermatosis papulosa nigra (DPN) is a chronic skin condition characterized by verrucous hyperpigmented papules on the face, neck and upper trunk in African American patients. The lesions are more common in females and in older patients. Although the lesions are benign, treatment is often sought for cosmetic reasons. We report two cases of patients with facial DPN who achieved an excellent cosmetic result following a single treatment with a long‐pulsed 1064?nm Nd:YAG laser. We suggest this modality for consideration in treating patients with DPN.     

High‐frequency ultrasound evaluation of cellulite treated with the 1064 nm Nd:YAG laser

Objectives: To investigate non‐invasive laser treatment for cellulite using the 1064?nm Nd:YAG laser and to correlate clinical results with high‐frequency skin ultrasound images. Methods: Twelve individuals of normal weight were treated on either the left or right posterior side of the thigh with the following parameters: fluence 30?J/cm, 18?mm spot size and dynamic cooling device pulse duration of 30?ms. Three treatments were performed at intervals of 3–4 weeks, and followed‐up 1 and 3 months after the last session. Photographs and ultrasound imaging were assessed before each session. Results: The 1064?nm Nd:YAG laser resulted in a tightening of the skin and an improvement in cellulite. No side effects were reported. High‐resolution ultrasound imaging showed a significant improvement in dermis density and a reduction of dermis thickness. The method is described in detail in Appendix 1. Conclusion: Infra‐red lasers may constitute a safe and effective treatment for cellulite and high‐frequency ultrasound imaging provides a quantitative and objective measurement of the treatment efficacy.     

Exogenous ochronosis – successful outcome after treatment with Q-switched Nd:YAG laser

Abstract

Background: Exogenous ochronosis (EO), a disfiguring cutaneous complication of topical hydroquinone use, is difficult to treat. There are few reports of successful outcomes following treatment with different modalities. Objective: We assessed the results of treatment of EO with the Q-switched Nd:YAG laser. Material and methods: Patients with histologically-confirmed EO were treated with the Q-switched Nd:YAG laser. Results and conclusion: Q-switched Nd:YAG laser treatment appears to be effective in reducing the dyschromia of EO.     

Comparison of treatment with an Alexandrite picosecond laser and Nd:YAG nanosecond laser for removing blue–black Chinese eyeliner tattoos

Objective: To retrospectively evaluate the efficacy of an Alexandrite picosecond laser versus Nd:YAG nanosecond laser for removing blue–black eyeliner tattoos which have existed more than 10 years.

Methods: A total of 40 patients were treated with an Alexandrite picosecond laser in our department from August 2015 to July 2017, with a fluence of 1.96–6.37J/cm², spot size of 2.0–3.6 mm, and pulse width of 750 ps. Another 32 patients were treated with an Nd:YAG nanosecond laser, with a fluence of 2.80–7.00 J/cm², spot size of 3 mm, and pulse width of 5–20 ns. All analysed patients completed at least one treatment and follow-up.

Results: The median number of treatment for all the patients was 1 (range, 1–4). After a single session, no difference was found between the two lasers for the eyeliner removal (p > 0.05). For the people who achieved an excellent response of tattoo clearance, there was still no difference between the two groups (p > 0.05). Transient side effects were observed in two groups, but neither group had significant adverse reactions.

Conclusions: To treat blue–black Chinese eyeliner tattoos over 10 years, Alexandrite picosecond laser does not provide better clearance than the Nd:YAG nanosecond laser.     

In support of the delayed response of naevus of Ota to a Nd‐YAG laser patch test

Unilateral naevoid telangiectatic syndrome (UNTS) was first described in 1899 and is characterized by the dermatomal distribution of telangiectasia. It is broadly divided into congenital and acquired forms based upon the time of presentation. To date no effective treatment has been reported for this condition. In view of the vascular component of this eruption, it was felt that the pulsed dye laser (PDL), 585 nm, may have a role to play in the selective photothermolysis of these lesions. The treatment of five patients with acquired UNTS using the PDL is described. Based upon the findings it is concluded that the PDL is an effective treatment for UNTS; however, the clinical response is short lived with a 100% recurrence noted in all cases. Possible explanations for this condition are also briefly discussed.     

Treatment of recalcitrant plantar warts with long-pulsed Nd:YAG laser versus cantharidin–podophylline resin–salicylic acid

Background: Treatment for recalcitrant plantar warts remains a continuing challenge as the options for treatment have differing levels of success. long-pulsed Nd:YAG laser is considered a good treatment modality in resistant plantar warts. On the other hand, high cure rates have been reported with a topical proprietary formulation consisting of 1% cantharidin, 5% podophyllotoxin, 30% salicylic acid. Aim: To compare the efficacy of 1% cantharidin, 20% podophylline resin and 30% salicylic acid (CPS) versus long-pulsed Nd:YAG laser in the treatment of recalcitrant plantar warts. Methods: This study included 30 patients with single or multiple recalcitrant plantar warts; patients were assigned to two groups: the first group included 15 patients with 71 recalcitrant plantar warts who were treated by long-pulsed Nd:YAG laser (group I) and the second group included 15 patients with 78 recalcitrant plantar warts who received CPS (group II). The diagnosis of plantar warts was made by clinical examination. Results: Fourteen patients (93%) were completely cleared of their warts with topical CPS, while 11 patients (73%) showed complete clearance with long-pulsed Nd:YAG laser with statistically significant difference between the two groups. Conclusion: Topical CPS is safe and efficacious and represents a promising therapeutic modality than long-pulsed Nd:YAG laser in the treatment of recalcitrant plantar warts.     

Non‐ablative scar revision using a long pulsed frequency doubled Nd:YAG laser

OBJECTIVE: Unsightly scars often are the only reminder of a previous surgical or traumatic wound. Surgical or ablative scar revision is sought by patients, sometimes unnecessarily. When the aesthetic drawback is mainly a result of hypervascularity or hyperpigmentation, these problems can be specifically targeted with a wavelength that is well absorbed by the two above mentioned chromophores. Some degree of epidermal tightening can also be achieved, which is sometimes useful in slightly atrophic scars.

The average improvement after 2–3 sessions was 81% (75%–100%) clearance, as judged by an independent observer who reviewed pre‐ and post‐treatment photographs. No undesired effects were reported. All our patients were satisfied and required no further treatment.

METHODS: Selective photothermolysis by means of a long pulsed frequency doubled Nd:YAG laser (DioLite^? 532, IRIDEX Corporation, Mountain View, CA, USA) was used to eliminate the unsightly vascular and pigmented components of 23 mature scars (scars older than 2 years) in 22 consecutive patients. Energy densities of 17–22?j/cm2 were used with a 500?micron spot, or 65–90?j/cm2 with a 200?micron spot.

RESULTS: overall scar clearance averaged 81% after 2.4 treatments. Facial scars showed the best clearance averaging 94% after 2 treatments. Inframammary scars were the most difficult to clear averaging 46%. Postoperative undesired effects were immediate erythema and swelling that subsided within 2–10?hours and microcrusting on 19/22 (88%) patients that resolved within one week. No other temporary or permanent undesired effects such purpura, hypo‐ or hyperpigmentation were noticed, even in patients with darker skin types.     

Fractional 532-nm Q-switched Nd:YAG laser: One of the safest novel treatment modality to treat café-au-lait macules

Café-au-lait macules (CALMs) are benign epidermal basilar hyperpigmentations that can be found in an isolated form or in association with neurocutaneous syndromes. Frequency-doubled Q-switched neodymium-doped yttrium aluminum garnet laser (532-nm QSNYL) does not penetrate deeply into the skin and is therefore suitable for epidermal pigmented lesion. Fractional photothermolysis (FP) targets only very small areas of the skin, without injuring adjacent areas of healthy, normal skin. Herein, we report a case of CALMs successfully treated with fractional 532-nm QSNYL. By applying FP to 532-nm QSNYL, we could treat CALMs safely with less downtime as compared to conventional laser treatments and expect more energy delivery for each microscopic hole, thereby allowing higher response rate.     

Nd:YAG laser combined with IPL treatment improves clinical results in non‐ablative photorejuvenation

BACKGROUND: Intense pulsed light (IPL) sources have been reported in non‐ablative photorejuvenation, but the excellent histological findings do not always coincide with the clinical results and patient satisfaction index (SI).

METHODS: Ten female patients (two forehead, four periocular and four perioral), ages ranging from 28 to 46 years, skin types II–IV, wrinkle types I–III, participated in the study. The IPL system was applied with the yellow (570?nm) cut‐off filter, 30?J/cm², single pulse, followed by the Nd:YAG at 120?J/cm², double pulse (7?ms per shot with 20?ms between pulses) on the wrinkled areas only. Three sessions were given at monthly intervals, and an assessment was made 1 and 6 months after the third session. Biopsies were taken from four consenting patients as a cross‐section before the first treatment and then 1 and 6 months after the third session. For clinical control and contrast of tissue results, a group of 10 patients (two forehead, four periocular and four perioral; ages ranging from 27 to 47 years, skin types II–IV, wrinkle types I–III) was treated only with IPL, using the same parameters and sessions. Histologies were taken from four consenting patients.

RESULTS: The histology showed thickening of the epidermis with good dermal collagen organization in both groups. However, the combined treatment showed more dramatic changes in histological tissue condition, and ectatic blood vessels were seen in the deeper dermis. The patient SI values, related to the results, were lower when IPL was used alone. All patients completed the study. In the combined treatment group, overall SIs of 8 (80%) and 8 (80%) were obtained at the control points of 1 and 6 months, respectively, after session 3, compared with SIs of 6 (60%) and 4 (40%) scored by patients in the IPL group at the same points. Discomfort and side effects were minimal in both groups.

CONCLUSIONS: The addition of the Nd:YAG laser to the IPL regimen in non‐ablative skin rejuvenation gave very good histological results, which were echoed by stronger patient satisfaction than in the control group treated only with IPL. Visible improvement in the skin condition of both groups was achieved, but was better in the combined treatment group.     

Treatment of a café-au-lait macule with the erbium:YAG laser

The erbium:YAG laser is a relatively new instrument for skin rejuvenation. We present a case of a "Q-switched laser-resistant" café-au-lait macule that was successfully treated with the erbium:YAG laser.     

Successful treatment of Becker’s Nevus with long-pulsed 1064-nm Nd:YAG and 755-nm alexandrite laser and review of the literature

Background: Becker’s Nevus is an aesthetically troublesome condition secondary to hyperpigmentation and hypertrichosis. Although several lasers have been employed with varying degrees of success, the exact devices and treatment parameters have yet to be elucidated. Objective: To assess the combination Nd:YAG and alexandrite laser as a safe and efficacious treatment for Becker’s Nevus. Methods: In a 20-year-old Fitzpatrick Skin Type IV male, a Becker’s Nevus was treated with six sessions of long-pulsed 1064 nm Nd:YAG laser at six-week intervals followed by five sessions of long-pulsed 755 nm alexandrite laser at three-month intervals. Results: This patient experienced a significant reduction in both hyperpigmentation and hypertrichosis after these treatment sessions. No serious adverse events were reported. Conclusion: This case supports the use of combination long-pulsed 1064 nm laser and 755 nm laser as a safe and efficacious treatment for Becker’s Nevus.     

Q开关Nd:YAG激光治疗太田痣体会

Q开关Nd:YAG激光治疗太田痣已在临床广泛开展,我科自1997年12月以来开展该疗法,现就治疗体会总结如下。1临床资料     

倍频Nd:YAG激光治疗鲜红斑痣48例

鲜红斑痣多发生在面部,影响容貌。自1999年4月以来,我科引进美国COHERENT公司生产的VERSAPUISE“C”激光治疗仪,选择其特定的VPW532nm波长治疗鲜红斑痣,取得良好的疗效,现报告如下。     

Nd:YAG激光治疗面部毛细血管扩张症

毛细血管扩张症若发生于面部 ,影响美观 ,给患者造成一定程度的心理障碍。以往的治疗包括 :冷冻、铜蒸汽激光、同位素等。这些方法往往造成不可逆转的皮肤结构改变、瘢痕、色素变化等后遗症。我科自 1998年 4月引进长脉宽倍频 532固体激光治疗此疾病 ,取得满意疗效 ,现报道如下     

Nd:YAG激光治疗臭汗症临床观察

为比较应用Nd:YAG激光治疗臭汗症的疗效,应用3种激光参数治疗臭汗症比较。53例患者分为A、B、C3组,A组:输出功率50W～60W之间,每行距离1.5cm,光纤插入皮下组织深度0.5cm;B组输出功率60W～70W之间,每行距离1cm,光纤插入皮下组织0.6cm;C组输出功率>70W,每行距离0.6cm,光纤插入皮下组织0.7cm～0.8cm。结果:C组疗效>B组>A组。     

Nd:YAG激光仪治疗太田痣298例

目的：探讨多波长激光仪治疗太田痣的疗效。方法：我院应用多波长激光仪对298例太田痣患者进行皮损区的多次照射治疗。治疗间期3月～6月，对患者治疗次数、年龄、皮损面积、部位、颜色以及不良反应等进行了分组观察研究。结果：年龄小，皮损颜色浅者，随治疗次数增加疗效越显著，298例患者经过1次～7次左右的治疗，痊愈166例，显效76例，有效26例，无效30例。总显效率81．20％，总有效率89．92％。166例痊愈患者平均治疗次数为5．74次，其中小于6岁儿童为4．25次。一般治疗5次左右可以治愈，无遗留瘢痕。结论：多波长激光仪治疗太田痣安全有效。     

Nd:YAG激光治疗腋臭48例的体会

１９９３年１０月～１９９６年３月我们采用Ｎｄ：ＹＡＧ激光插入法治疗腋臭４８例，现报告如下。临床资料４８例均为我科门诊患者，男８例，女４０例，年龄１３～４２岁。治疗方法术前常规备皮消毒后，用２％盐酸利多卡因５ｍｌ加生理盐水１０ｍｌ皮下浸润麻醉。手持Ｎｄ...     

Nd:YAG激光治疗文眉所致的异物反应

5例女患者分别于文眉6～12个月后局部发生异物反应．自觉局部疾痒，脱屑。有2例曾用电离子治疗无效，另3例曾局部外用皮质类固醇或封闭治疗均无效，就诊时患接触性皮炎6个月至2年不等，检查见眉弓处有红斑或浸润性斑块，上覆干燥性鳞屑或浆液性痂皮。治疗方法：5例患者使用Nd:YAG四波段激光仪治疗，选择波长1064nm、脉冲能量密度6．0－8．OJ／。’、脉冲宽度5－IOl。。、光斑直径2On。m万例经I次治疗后自觉病痒明显减轻，浸润渐消退，鳞屑减少。3－4个月后恢复至文眉前状态，炎症消退，文眉痕迹均清除。另2例经过1次治疗后症状明显减轻…