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Safe Treatment Modality (safe + treatment_modality)
Selected AbstractsFractional Photothermolysis for Photoaging of HandsDERMATOLOGIC SURGERY, Issue 1 2008MING H. JIH MD BACKGROUND Laser treatment for photoaging of the hands should ideally address pigmentary alteration as well as associated skin roughness and wrinkling. Fractional resurfacing has been previously shown to effectively treat facial rhytids and dyschromia. OBJECTIVE We examined the effect of fractional resurfacing for photoaging of the hands. METHODS AND MATERIALS Ten patients (skin phototypes II to IV) with hand photodamage were randomized to receive five treatments with a 1,550-nm diode-pumped erbium fiber laser (Fraxel SR, Reliant Technologies) laser on either the right or left hand. Treatments were performed at settings of 8 to 9 mJ/microscopic treatment zone and density of 2,500 microscopic treatment zones/cm2. Subjective assessments by the patients and investigator were performed for skin roughness, wrinkling, and pigmentation using a 5-point scale. Skin biopsies were taken at baseline and at 1 and 3 months. RESULTS Patient subjective assessment and physician clinical assessment at 1 and 3 months revealed a mean 51% to 75% improvement in skin pigmentation and 25% to 50% improvement in skin roughness and wrinkling. Biopsies of the skin showed increased density of dermal collagen. Patients experienced transient erythema and edema and none had scarring or other adverse effects. LIMITATIONS This was a small study. CONCLUSION Fractional resurfacing appears to be an effective and safe treatment modality for correcting both the pigmentary and the textural aspects of photoaging of the hand. [source] UVB phototherapy and skin cancer risk: a review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2005Ernest Lee MD Background, UVB phototherapy is a common treatment modality for psoriasis and other skin diseases. Although UVB has been in use for many decades, many clinicians are hesitant to use this type of phototherapy because of concern over increasing the skin cancer risk. Over the past 20 years, numerous studies have been published examining this issue, but a consensus or analysis of the skin cancer risk is required for the dermatologist to make an educated risk,benefit analysis. Objective, To assess the risk of skin cancer associated with UVB phototherapy. Methods, All prospective or retrospective studies were identified in MEDLINE from 1966 to June 2002. Bibliographies were searched to identify any additional studies examining this issue. All studies that attempted to quantify or qualify any additional skin cancer risk from UVB phototherapy were included. Study selection was performed by two independent reviewers. Results, Eleven studies (10 of which concerned psoriasis patients), involving approximately 3400 participants, were included. Of note, three of the studies involved the same cohort: members of the 16-center US Psoralen plus UVA (PUVA) Follow-up Study. Other than the most recent Finnish study, all studies eventually showed no increased skin cancer risk with UVB phototherapy. One of the PUVA cohort studies examined genital skin cancers, and found an increased rate of genital tumors associated with UVB phototherapy, although this study has not been duplicated. Conclusion, The evidence suggests that UVB phototherapy remains a very safe treatment modality. [source] Evidence-based review of hair removal using lasers and light sourcesJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2006M Haedersdal Abstract Background, Unwanted hair growth remains a therapeutic challenge and there is a considerable need for an effective and safe treatment modality. Objective, From an evidence-based view to summarize efficacy and adverse effects from hair removal with ruby, alexandrite, diode, and Nd:YAG lasers and intense pulsed light (IPL). Methods, Original publications of controlled clinical trials were identified in Medline and the Cochrane Library. Results, A total of 9 randomized controlled (RCTs) and 21 controlled trials (CTs) were identified. The best available evidence was found for the alexandrite (three RCTs, eight CTs) and diode (three RCTs, four CTs) lasers, followed by the ruby (two RCTs, six CTs) and Nd:YAG (two RCTs, four CTs) lasers, whereas limited evidence was available for IPL sources (one RCT, one CT). Based on the present best available evidence we conclude that (i) epilation with lasers and light sources induces a partial short-term hair reduction up to 6 months postoperatively, (ii) efficacy is improved when repeated treatments are given, (iii) efficacy is superior to conventional treatments (shaving, wax epilation, electrolysis), (iv) evidence exists for a partial long-term hair removal efficacy beyond 6 months postoperatively after repetitive treatments with alexandrite and diode lasers and probably after treatment with ruby and Nd:YAG lasers, whereas evidence is lacking for long-term hair removal after IPL treatment, (v) today there is no evidence for a complete and persistent hair removal efficacy, (vi) the occurrence of postoperative side-effects is reported low for all the laser systems. Conclusion, The evidence from controlled clinical trials favours the use of lasers and light sources for removal of unwanted hair. We recommend that patients are pre-operatively informed of the expected treatment outcome. [source] Low-dose broad-band UVA in morphea using a new method for evaluationPHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 2 2000M. El-Mofty Until recently, various therapies for localized scleroderma have been used with limited success. Recently, phototherapy, with or without psoralen, was proposed as a successful treatment modality. The aim of this study was to evaluate the effect of broad-band low-dose ultraviolet A (UVA) phototherapy in patients with localized scleroderma, using a new method for evaluation. Twelve patients complaining of morphea were exposed to UVA irradiation at a dose of 20 J/cm2 3 times per week for 20 sessions. Selected covered plaques served as internal controls. The efficacy of therapy was judged clinically by sequential inspection and palpation. In biopsy specimens from exposed and covered plaques stained with hematoxylin and eosin (H & E) and Masson trichrome stains, the concentration of collagen per dermal surface area was measured with the use of a computerized image analyzer. All patients reported remarkable softening of skin lesions, confirmed by sequential palpatory assessment. A significant reduction in the mean concentration of collagen per surface area was detected in the plaques exposed to UVA (the P value being 0.007, P<0.01), whereas in the covered plaques the difference was not statistically significant (the P value being 0.10, P>0.05). The conclusion is that low-dose broad-band UVA phototherapy is a very effective and safe treatment modality for localized scleroderma. [source] | ||||||||||