المؤلفون: Baugh, Erica G, Anagu, Olive, Kelly, Kristen M

المصدر: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], vol 48, iss 2

مصطلحات موضوعية: Cicatrix, Humans, Hypopigmentation, Burns, Retinoids, Treatment Outcome, Laser Therapy, Lasers, Gas, Clinical Sciences, Dermatology & Venereal Diseases

جغرافية الموضوع: 201 - 206

الوصف: BackgroundDespite history of multiple treatment modalities, repigmentation of hypopigmented scars remains a difficult clinical problem.ObjectiveThe purpose of this review is to evaluate the literature on laser and combination laser plus adjunct topical therapy for hypopigmented burn and traumatic scars.Materials and methodsA search on PubMed and on Oxford Academic was conducted with additional relevant literature obtained from reference lists.ResultsTreatment regimens that address hypopigmentation within scars were reviewed. A combination of nonablative fractional or ablative fractional laser treatment with topical prostaglandin analogue with or without topical retinoid were found to result in superior repigmentation.ConclusionReliable improvement of hypopigmentation in scars after laser treatment is challenging. Laser can achieve success in some cases. Ultraviolet laser can achieve modest repigmentation; however, results are short-lived and require continued re-treatment. Modest improvement in pigmentation is seen with nonablative fractional laser or ablative fractional laser alone and enhanced repigmentation is demonstrated when combining fractional laser resurfacing with topical application of synthetic prostaglandin analogues and other known modulators of melanogenesis.

وصف الملف: application/pdf

العلاقة: qt01j6581d; https://escholarship.org/uc/item/01j6581dTest; https://escholarship.org/content/qt01j6581d/qt01j6581d.pdfTest

الإتاحة: https://doi.org/10.1097/dss.0000000000003330Test
https://escholarship.org/uc/item/01j6581dTest
https://escholarship.org/content/qt01j6581d/qt01j6581d.pdfTest

المؤلفون: Mehrabi, Joseph N, Kelly, Kristen M, Holmes, Jon D, Zachary, Christopher B

المصدر: Lasers in Surgery and Medicine, vol 53, iss 6

مصطلحات موضوعية: Medical Biotechnology, Biomedical and Clinical Sciences, Cancer, Biomedical Imaging, Clinical Research, Heating, Humans, Laser Therapy, Lasers, Solid-State, Low-Level Light Therapy, Skin, Tomography, Optical Coherence, long-pulse 1064nm laser, Nd:YAG, optical coherence tomography, thermal monitoring, Clinical Sciences, Dermatology & Venereal Diseases, Dentistry

جغرافية الموضوع: 806 - 814

الوصف: BACKGROUND ANDOBJECTIVE: Long-term benefits can be predicted by the incorporation of more intelligent systems in lasers and other devices. Such systems can produce more reliable zones of thermal injury when used in association with non-invasive monitoring and precise laser energy delivery. The more classical endpoint of tumor destruction with radiofrequency or long-pulsed (LP) 1064 nm laser is the non-specific appearance of tissue graying and tissue contraction.Herein we discuss combining non-invasive LP 1064 nm Nd:YAG treatment with the assistance of optical coherence tomography (OCT) and the forward-looking infrared (FLIR) thermal camera while testing literature-based formulaefor thermal destruction.Study design/materials and methodsThe skin on the forearm and back of two consenting volunteers was marked and anesthetized with lidocaine with epinephrine. The parameters of a scanner-equipped LP 1064 nm Nd:YAG laser were adjusted to achieve an epidermal/superficial dermal heating of between 50°C and 60°C over a specified time course. Experimental single treatments examined various adjusted parameters including, fluence, pulse overlap, pulse duration, scan size, and pulse rate. A FLIR camera was used to record skin temperature. Outcome measures included skin temperature, post-treatment appearance, and OCT assessment of skin and vascular damage. The clinical response of each treatment was followed daily for 4 weeks.ResultsOptimal protocols initially raised the skin temperature to between 55°C and 60°C, which was carefully maintained using subsequent laser passes over a 60-second time course. Immediately post laser, clinical responses included erythema, edema, and blistering. Immediate OCT revealed increased vascularity with intact, dilated blood vessels. Prolonged exposure above 60°C resulted in sub-epidermal blistering and an absence of blood flow in the treatment area with prolonged healing.ConclusionThe LP 1064 nm laser can be used to achieve heat-related tissue injury, though the narrow parameters necessary for ...

وصف الملف: application/pdf

العلاقة: qt2fj2p2bv; https://escholarship.org/uc/item/2fj2p2bvTest

الإتاحة: https://escholarship.org/uc/item/2fj2p2bvTest

المؤلفون: Fransen, Frederike, Spuls, Phyllis, Alam, Murad, Badawi, Ashraf, Boixeda, Pablo, Haedersdal, Merete, Hamzavi, Iltefat, Hedelund, Lene, Kelly, Kristen M, Kono, Tara, Laubach, Hans Joachim, Manuskiatti, Woraphong, Marini, Leonardo, Nouri, Keyvan, Paasch, Uwe, Passeron, Thierry, Prinsen, Cecilia AC, Verner, Ines, Wolkerstorfer, Albert

المصدر: BMJ Open, vol 10, iss 6

مصطلحات موضوعية: Consensus, Delphi Technique, Dermatology, Humans, Laser Therapy, Outcome Assessment, Health Care, Registries, Research Design, Stakeholder Participation, surgical dermatology, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences

الوصف: IntroductionWhile laser technology has expanded the armamentarium of treatment for various skin diseases during the past years, heterogeneity in study outcomes hampers comparability and appropriate evidence synthesis. Part of these issues can be addressed by developing a generic outcome set. Using the Delphi method, this study aims to seek consensus between key stakeholders on relevant generic outcomes (what to measure) for implementation in the international registry on Laser trEAtments in Dermatology (LEAD). The registry is focused on collecting research data on various laser treatments for skin disorders.Methods and analysisBy reviewing the literature and involvement of key stakeholder groups and adult patients in need or after laser surgery and health professionals, a preliminary list of outcomes will be generated and categorised into domains. Using these outcomes, an international three-round Delphi study will be performed to rate the importance of outcomes in the selection of a generic outcome set. Participants are allowed to provide new outcomes to the preliminary list for revisions during the first Delphi round. Finally, results will be discussed during a consensus meeting to agree on generic outcomes to be used in the LEAD registry.Ethics and disseminationAn ethics approval was not applicable (W19_290 # 18.336). The study is registered with the Cochrane Skin Core OUtcome Set INitiative) and the Core Outcome Measures in Effectiveness Trials initiative. Procedures will be conducted according to the Declaration of Helsinki. The findings will be disseminated through peer-reviewed publications and conference presentations.

وصف الملف: application/pdf

العلاقة: qt8j8562kw; https://escholarship.org/uc/item/8j8562kwTest

الإتاحة: https://escholarship.org/uc/item/8j8562kwTest

المؤلفون: Mehrabi, Joseph N, Kelly, Kristen M

المصدر: Journal of Drugs in Dermatology, vol 19, iss 11

مصطلحات موضوعية: Physical Injury - Accidents and Adverse Effects, Skin, Abdominal Wall, Aged, Biological Dressings, Chronic Disease, Cicatrix, Female, Humans, Laser Therapy, Lasers, Gas, Solid-State, Skin Ulcer, Treatment Outcome, Wound Healing

الوقت: 1112 - 1115

الوصف: Ablative fractional resurfacing (AFR) can be utilized to improve scar appearance, texture, pain and associated contractures. Non-healing ulcers can also develop in areas of scarring and, in some cases, AFR can be utilized to heal these chronic wounds. We present a case of scarring with non-healing ulceration refractory to wound care, debridement and hydrotherapy successfully healed in four sessions with AFR using a 2940 nm Er:YAG laser. We review the literature on AFR for wound healing including potential mechanisms. AFR can be considered for non-healing ulcers in areas of scarring, once malignancy and infection are ruled out, and has the potential to provide relief for these suffering patients.J Drugs Dermatol. 2020;19(11): doi:10.36849/JDD.2020.5444.

وصف الملف: application/pdf

العلاقة: qt8cp5h6kf; https://escholarship.org/uc/item/8cp5h6kfTest

الإتاحة: https://escholarship.org/uc/item/8cp5h6kfTest

المؤلفون: Valdebran, Manuel, Martin, Brent, Kelly, Kristen M

المصدر: Seminars in Cutaneous Medicine and Surgery, vol 36, iss 4

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Cancer, Angiofibroma, Facial Dermatoses, Granuloma, Pyogenic, Hemangioma, Capillary, Humans, Intense Pulsed Light Therapy, Laser Therapy, Low-Level Light Therapy, Lymphatic Abnormalities, Photochemotherapy, Port-Wine Stain, Rosacea, Skin Neoplasms, Vascular Malformations, Dermatology & Venereal Diseases

جغرافية الموضوع: 207 - 212

الوصف: Notable milestones in the treatment of vascular lesions have been achieved over the past century. Many cutaneous vascular lesions can be successfully treated with lightbased devices. In this review, we will discuss the treatment of port-wine birthmarks, lymphatic malformations, infantile hemangiomas, rosacea, venous lakes, pyogenic granulomas, cherry angiomas, and angiofibromas using lasers, total reflection amplification of spontaneous emission of radiation, intense pulsed light, and photodynamic therapy. In addition, for several of these diagnoses, we will review medical therapies that can be combined with light-based devices to provide enhanced results.

وصف الملف: application/pdf

العلاقة: qt13n782kf; https://escholarship.org/uc/item/13n782kfTest

الإتاحة: https://escholarship.org/uc/item/13n782kfTest

المؤلفون: Soleymani, Teo, Abrouk, Michael, Kelly, Kristen M

المصدر: Dermatologic Surgery, vol 43, iss 5

مصطلحات موضوعية: Cancer, Development of treatments and therapeutic interventions, 5.1 Pharmaceuticals, Skin, Carcinoma, Basal Cell, Squamous Cell, Humans, Laser Therapy, Skin Neoplasms, Clinical Sciences, Dermatology & Venereal Diseases

جغرافية الموضوع: 615 - 624

الوصف: BackgroundSkin cancer remains the most prevalent type of cancer in the United States, and its burden on the health care system remains substantial. Standard treatments such as cryosurgery, electrodessication and curettage, topical and photodynamic therapies, and surgical excision including Mohs micrographic surgery are not without inherent morbidity, including risk of bleeding, infection, and scar.ObjectiveLasers may be an alternative for treatment of nonmelanoma skin cancer, and this paper reviews this therapeutic option.MethodsA comprehensive search in the Cochrane Library, MEDLINE, and PUBMED databases was performed to identify relevant literature investigating the role of laser therapy in the treatment of nonmelanoma skin cancer.ResultsNew literature regarding laser treatment of nonmelanoma skin cancer is emerging, demonstrating promising clinical outcomes. The greatest efficacy has been seen with vascular-selective and ablative lasers in the treatment of basal cell carcinomas. Some success has been reported for laser treatment of squamous cell carcinoma, but data are less convincing. In summary, laser therapy offers an alternative treatment option for nonmelanoma skin cancer; however, its clinical efficacy is variable and, at this time, remains less than currently accepted standards of care.ConclusionFurther studies are needed to optimize parameters, determine maximum efficacy, and provide long-term follow-up.

وصف الملف: application/pdf

العلاقة: qt9sw5z1p8; https://escholarship.org/uc/item/9sw5z1p8Test

الإتاحة: https://escholarship.org/uc/item/9sw5z1p8Test

المؤلفون: Fransen, Frederike, Spuls, Phyllis, Alam, Murad, Badawi, Ashraf, Boixeda, Pablo, Haedersdal, Merete, Hamzavi, Iltefat, Hedelund, Lene, Kelly, Kristen M, Kono, Tara, Laubach, Hans Joachim, Manuskiatti, Woraphong, Marini, Leonardo, Nouri, Keyvan, Paasch, Uwe, Passeron, Thierry, Prinsen, Cecilia AC, Verner, Ines, Wolkerstorfer, Albert

المصدر: BMJ Open, vol 10, iss 6

مصطلحات موضوعية: Consensus, Delphi Technique, Dermatology, Humans, Laser Therapy, Outcome Assessment, Health Care, Registries, Research Design, Stakeholder Participation, surgical dermatology, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences, hisphilso, edu

الوصف: IntroductionWhile laser technology has expanded the armamentarium of treatment for various skin diseases during the past years, heterogeneity in study outcomes hampers comparability and appropriate evidence synthesis. Part of these issues can be addressed by developing a generic outcome set. Using the Delphi method, this study aims to seek consensus between key stakeholders on relevant generic outcomes (what to measure) for implementation in the international registry on Laser trEAtments in Dermatology (LEAD). The registry is focused on collecting research data on various laser treatments for skin disorders.Methods and analysisBy reviewing the literature and involvement of key stakeholder groups and adult patients in need or after laser surgery and health professionals, a preliminary list of outcomes will be generated and categorised into domains. Using these outcomes, an international three-round Delphi study will be performed to rate the importance of outcomes in the selection of a generic outcome set. Participants are allowed to provide new outcomes to the preliminary list for revisions during the first Delphi round. Finally, results will be discussed during a consensus meeting to agree on generic outcomes to be used in the LEAD registry.Ethics and disseminationAn ethics approval was not applicable (W19_290 # 18.336). The study is registered with the Cochrane Skin Core OUtcome Set INitiative) and the Core Outcome Measures in Effectiveness Trials initiative. Procedures will be conducted according to the Declaration of Helsinki. The findings will be disseminated through peer-reviewed publications and conference presentations.

العلاقة: https://escholarship.org/uc/item/8j8562kwTest

الإتاحة: https://escholarship.org/uc/item/8j8562kwTest

المؤلفون: Saager, Rolf B, Hassan, Khaled M, Kondru, Clement, Durkin, Anthony J, Kelly, Kristen M

المصدر: Lasers in Surgery and Medicine, vol 45, iss 1

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Dentistry, Argyria, Female, Humans, Laser Therapy, Lasers, Solid-State, Middle Aged, Spectroscopy, Near-Infrared, Nd:YAG, quantitative spectroscopy, NIR spectroscopy, tissue optics, Dermatology & Venereal Diseases

جغرافية الموضوع: 15 - 21

الوصف: Background and objectiveGeneralized argyria is a blue-gray hyperpigmentation of the skin resulting from ingestion or application of silver compounds, such as silver colloid. Case reports have noted improvement after Q-Switched Neodymium-Yttrium Aluminum Garnet laser (1,064 nm QS Nd:YAG) laser treatment to small surface areas. No reports have objectively monitored laser treatment of generalized argyria over large areas of skin, nor have long-term outcomes been evaluated.Study design/materials and methodsAn incremental treatment plan was developed for a subject suffering from argyria. A quantitative near infrared spectroscopic measurement technique was employed to non-invasively analyze tissue-pigment characteristics pre- and post-laser treatment. Post-treatment measurements were collected at weeks 1, 2, 3, and 4, and again at 1 year.ResultsImmediate apparent removal of pigment was observed with 1 Q-switched 1,064 nm Nd:YAG laser treatment (3-6 mm spot; 0.8-2 J/cm(2) ) per area. Entire face, neck, upper chest, and arms were treated over multiple sessions. Treatments were very painful and general anesthesia was utilized in order to treat large areas. Near-infrared spectroscopy was used to characterize and quantify the concentration of silver particles in the dermis based on the absorption features of the silver particles as well as the optical scattering effects they impart. We were able to estimate that there was, on average, 0.042 mg/ml concentration of silver prior to treatment and that these levels went below the minimum detectable limit of the instrument post-treatment. There was no recurrence of discoloration over the 1-year study period.ConclusionQS 1,064 nm laser treatment of argyria is a viable method to restore normal skin pigmentation with no evidence of recurrence over study period. Quantitative spectroscopic measurements: (1) confirmed dyspigmentation was due to silver, (2) validated our clinical assessment of no recurrence up to 1-year post-treatment, and (3) indicated no collateral tissue damage with ...

وصف الملف: application/pdf

العلاقة: qt8sf0x4q8; https://escholarship.org/uc/item/8sf0x4q8Test

الإتاحة: https://escholarship.org/uc/item/8sf0x4q8Test

المؤلفون: Patel, Amit M, Chou, Elizabeth L, Findeiss, Laura, Kelly, Kristen M

المصدر: Seminars in Cutaneous Medicine and Surgery, vol 31, iss 2

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Cancer, Angiofibroma, Angiogenesis Inhibitors, Arteriovenous Malformations, Hemangioma, Hemangiosarcoma, Humans, Laser Therapy, Low-Level Light Therapy, Photochemotherapy, Port-Wine Stain, Sarcoma, Kaposi, Sclerotherapy, Skin Diseases, Vascular, Skin Neoplasms, vascular malformations, infantile hemangiomas, Kaposi sarcoma, angiosarcomas, angiofibromas, photodynamic therapy, Dermatology & Venereal Diseases

جغرافية الموضوع: 98 - 104

الوصف: Dermatologists encounter a wide range of cutaneous vascular lesions, including infantile hemangiomas, port-wine stain birthmarks, arteriovenous malformations, venous malformations, Kaposi sarcomas, angiosarcomas, and angiofibromas. Current treatment modalities to reduce these lesions include topical and/or intralesional steroids, laser therapy, surgical resection, and endovascular therapy. However, each method has limitations owing to recurrence, comorbidities, toxicity, or lesion location. Photodynamic therapy, antiangiogenic therapy, and evolving methods of sclerotherapy are promising areas of development that may mitigate limitations of current treatments and offer exciting options for patients and their physicians.

وصف الملف: application/pdf

العلاقة: qt8qt7q2q3; https://escholarship.org/uc/item/8qt7q2q3Test

الإتاحة: https://escholarship.org/uc/item/8qt7q2q3Test

المؤلفون: Aguilar, Guillermo, Choi, Bernard, Broekgaarden, Mans, Yang, Owen, Yang, Bruce, Ghasri, Pedram, Chen, Jennifer K, Bezemer, Rick, Nelson, J Stuart, van Drooge, Anne Margreet, Wolkerstorfer, Albert, Kelly, Kristen M, Heger, Michal

المصدر: Annals of biomedical engineering, vol 40, iss 2

مصطلحات موضوعية: Animals, Hemodynamics, Humans, Laser Therapy, Light Coagulation, Phototherapy, Port-Wine Stain: surgery, therapy, Skin Physiological Phenomena

جغرافية الموضوع: 486 - 4506

الوصف: During the last three decades, several laser systems, ancillary technologies, and treatment modalities have been developed for the treatment of port wine stains (PWSs). However, approximately half of the PWS patient population responds suboptimally to laser treatment. Consequently, novel treatment modalities and therapeutic techniques/strategies are required to improve PWS treatment efficacy. This overview therefore focuses on three distinct experimental approaches for the optimization of PWS laser treatment. The approaches are addressed from the perspective of mechanical engineering (the use of local hypobaric pressure to induce vasodilation in the laser-irradiated dermal microcirculation), optical engineering (laser-speckle imaging of post-treatment flow in laser-treated PWS skin), and biochemical engineering (light- and heat-activatable liposomal drug delivery systems to enhance the extent of post-irradiation vascular occlusion).

وصف الملف: application/pdf

العلاقة: qt9gs8z9wx; https://escholarship.org/uc/item/9gs8z9wxTest

الإتاحة: https://escholarship.org/uc/item/9gs8z9wxTest