Use of the Q-switched alexandrite laser (755 nm, 100 nsec) for eyebrow tattoo removal.

BACKGROUND AND OBJECTIVE: Permanent tattooing for cosmetic reasons has increased in recent years; as a consequence, there has been an increase of requests for pigment removal due to complications or undesired results. The Q-switched alexandrite laser has been found useful in removing black exogenous pigment, which is the most popular color in eyebrow enhancement. We report the case of a patient with black-pigment eyebrow cosmetic tattoo after treatment with the Q-switched alexandrite laser. STUDY DESIGN/MATERIALS AND METHODS: Treatment conditions included 755-nm wavelength, 100 +/- 10-nsec pulse width, and 3-mm spot size. Fluence threshold was determined, and a spot test was made at the first visit. Single impact technique with 10% overlapping was applied to the whole tattoo. Five treatments were performed with a mean fluence of 7 J/cm(2). RESULTS: Complete pigment removal was achieved after five sessions. Superficial bleeding and vesicle formation was observed. CONCLUSIONS: Eyebrow tattooing can be treated efficiently with the use of the Q-switched alexandrite laser when black pigment has been used for cosmetic reasons.     

Necrobiosis lipoidica diabeticorum treated with the pulsed dye laser

BACKGROUND AND OBJECTIVE : Different treatment modalities have been advocated for necrobiosis lipoidica diabeticorum but clinical response is unpredictable. The purpose of this study was to evaluate the usefulness of pulsed dye laser (Candela SPTLÁ, Irvine, MA, USA) in the treatment of an area of necrobiosis lipoidica of 4 cm in diameter on the anterior aspect of the leg in a non-diabetic patient. MATERIALS AND METHODS : A spot test was made at 6.0, 6.5 and 7.0 J/cm 2 energy fluences and the best energy fluence was selected after a 2-month postoperative evaluation. The patient received three treatment sessions with a fluence of 6.5 J/cm 2 , 585-nm wavelength, 5-mm spot size, and 450 µs pulse duration at 8-week intervals. The patient was given routine skin care advice with emollient cream and sunscreen (SPF 15) until the following session. RESULTS : Overall cosmetic improvement was achieved, with a decrease of erythema and telangiectasis, and stabilization in terms of progression (size) in the left half of the lesion, with no modification of atrophy or pigmentary changes. The right upper quadrant of the lesion showed an erythematous peripheral halo with minimal reduction in the erythema and telangiectasia, and discrete size increase. CONCLUSION : Pulsed dye laser may be a useful treatment for improving the telangiectasia and erythematous component of necrobiosis lipoidica.     

Intense Pulsed Light for Hairy Grafts and Flaps

BACKGROUND: Intense pulsed light (IPL) is an effective and safe method of hair removal. OBJECTIVE: To evaluate the clinical response of hairy grafts and flaps of different anatomic areas to an IPL source. METHODS: Four patients (three men, one woman; 17-72 years old) with hairy skin grafts (n = 2) or flaps (n = 2) were included. Donor skin areas included the forehead (n = 1), supraclavicular (n = 1), abdomen (n = 1), and groin (n = 1). Excisional surgery was performed because of basal cell carcinoma (BCC) of the nasal wall (n = 1), squamous cell carcinoma (SCC) of the forehead (n = 1), congenital nevus of the malar region (n = 1), and breast carcinoma (n = 1). The treatment was IPL with the following parameters: wavelength 695-755 nm, pulse width 3.8-4.5 msec, delay 20-30 msec, spot size 10 mm x 45 mm, fluence 38-42 J/cm2, and an interval of 4 weeks. A total of one to six treatment sessions were administered. RESULTS: A progressive decrease in terminal hair and delayed hair growth rate (more than 8 months) were observed in all the patients. Improvement of skin coarseness, pigmentation, and erythema was also observed in the graft and its periphery in one patient. Persistent erythema (more than 48 hours) was the only side effect, observed in one patient. CONCLUSION: IPL is an effective method to depilate hairy grafts and flaps.     

Second intention healing after Mohs micrographic surgery

BACKGROUND: Although second intention healing has been used for many years in Mohs micrographic surgery, it has lost popularity. This is due to the long process and functional alteration of important anatomical units if certain wound healing factors are not carefully taken into consideration. OBJECTIVE: To review indications, contraindications, complications, advantages, disadvantages, as well as basic concepts of the wound healing process, wound care and antibiotic prophylaxis in the management of open wounds after Mohs surgery. METHODS: A short but comprehensive review of studies published in the literature dealing with second intention healing as a reconstruction alternative option in certain situations. CONCLUSIONS: Second intention healing is a simple and cost-effective method for reconstruction after Mohs micrographic surgery in well-defined cases. It allows adequate tumoral control with good to excellent functional and cosmetic results.     

Treatment of Widespread Segmental Nevus Spilus by Q-Switched Alexandrite Laser (755 nm, 100 nsec)

BACKGROUND: Widespread unilateral nevus spilus causes important cosmetic and psychological disturbances, and only a few therapeutic options can guarantee good functional and cosmetic results. OBJECTIVE: To evaluate the clinical response of a patient with widespread segmental nevus spilus to Q-switched (QS) alexandrite laser. METHODS: The treatment was QS alexandrite laser (755 nm, 100 nsec) with a mean fluence of 7.28 +/- 0.37 J/cm2 using a single-impact technique at 10 +/- 8.47-week intervals. RESULTS: Fifty percent clearance of the facial portion of the lesion was observed after 16 treatment sessions with QS alexandrite laser. CONCLUSION: QS alexandrite laser is suitable for removal of widespread segmental nevus spilus.     

Long-Lasting Hypopigmentation Induced by Long-Pulsed Alexandrite Laser Photo-Epilation

BACKGROUND: Long-lasting hypopigmentation induced by laser hair removal systems has been reported. OBJECTIVE. : To evaluate clinical aspects of a female Caucasian that developed long-lasting hypopigmentation in the arms and forearms after photodepilation with a long-pulsed alexandrite laser. METHOD: A 29-year-old Caucasian female (phototype III) with localized hypertrichosis in the upper limbs was submitted to long-pulsed alexandrite laser-assisted hair removal. One treatment session was done with these laser parameters: a pulse width of 2 ms, a spot of 7 mm, and fluence energy of 18 J/cm2. RESULTS: The patient developed long-lasting hypopigmentation (more than 6 months) in the arms and forearms after a single treatment session of photodepilation. CONCLUSION: Long-pulsed alexandrite laser may induce reversible melanocyte suppression and long-lasting hypopigmentation.     

0．1％他克莫司治疗浆细胞性龟头炎

背景：浆细胞性龟头炎或Zoon龟头炎（BZ）是成年男性的一种常见疾病，皮肤损害多位于龟头，也可累及包皮，其病因尚不明确。目的：报道采用0．1％他克莫司软膏治疗两例BZ患者的经验，并与其他局部疗法对比。患者和方法：两例未曾行包皮环切术的高加索成年男性均患BZ，局部外用0．1％他克莫司软膏，2次／d。结果：分别随访1年和10个月，发现两例患者的皮肤损害均显著改善。结论：局部外用0．1％他克莫司软膏治疗BZ安全有效。     

Becker's naevus: a comparative study between erbium: YAG and Q-switched neodymium:YAG; clinical and histopathological findings

BACKGROUND: Becker's naevus (BN) may represent a distressing cosmetic handicap and a challenging issue regarding treatment. OBJECTIVES: To compare clinical and histopathological findings of patients with BN treated with two different lasers: an erbium:yttrium-aluminium-garnet (Er:YAG) system vs. a neodymium:YAG (Nd:YAG) laser. PATIENTS AND METHODS: In this prospective and comparative study we present the clinical and histopathological evolution during a 2-year follow-up of 22 patients with BN treated with only one pass of the Er:YAG laser (n = 11) or three treatment sessions with the Q-switched Nd:YAG system (n = 11). RESULTS: Clinical evaluation 2 years after treatment with the Er:YAG laser showed complete clearance (100%) in 54% of the patients (n = 6) and clearance of > 50% in 100% of the subjects. In relation to Nd:YAG laser treatments our results echo those of other authors. Numerous sessions are necessary to get an acceptable clinical clearance rate. Only one patient showed marked clearance (51-99%) after three treatment sessions. Moderate (26-50%) and mild (1-25%) clearance was observed in 45.5% (n = 5) and 27.3% (n = 3) of the patients. CONCLUSIONS: Both Er:YAG and Nd:YAG are safe tools to treat BN. However, in terms of pigment removal, one pass with Er:YAG is a superior technique to three treatment sessions with the Nd:YAG.