Background: The 1450-nm diode laser has been known to thermally alter sebaceous glands and has been found to be effective for the treatment of inflammatory facial acne. Objective:Our aim was to evaluate the dose respo...Background: The 1450-nm diode laser has been known to thermally alter sebaceous glands and has been found to be effective for the treatment of inflammatory facial acne. Objective:Our aim was to evaluate the dose response of a 1450-nmdiode laser for treatment of facial acne, sebum production, and acne scarring utilizing two laser fluences and to determine long-term remission after laser treatment. Methods: Twenty patients (Fitzpatrick skin phototypes II-VI) received 3 treatments using the 1450 nm diode laser (3- 4 week intervals).Split face comparisons were performed by randomizing patients to one of two fluences (14 or 16 J/cm2) on the right or left side of the face. Clinical photographs, lesion counts,and sebum measurements were obtained at baseline and after each treatment. Investigators’ and patients’ subjective evaluations of response to treatment were assessed. Results:Percentage reductions in mean acne lesion counts from baseline were 42.9% (14 J/cm2) and 33.9% (16 J/cm2) after one treatment and 75.1% (14 J/cm2) and 70.6% (16 J/cm2) after 3 treatments. There was persistent reduction of 76.1% (14 J/cm2) and 70.5% (16 J/cm2) at the 12-month follow up(P < .01). Both objective and subjective improvements in acne scarring and sebum production were noted. Treatment-related pain was well tolerated, and adverse effects were limited to transient erythema and edema at treatment sites. Limitations:This was a small study and comparison was limitedto two laser fluences. Conclusion: The 1450-nm diode laser reduced inflammatory facial acne lesions even in Fitzpatrickskin phototypes IV-VI with minimal side effects. Significant improvement in acne lesion counts were noted after the first treatment and was maintained 12 months after the third treatment,indicating significant long-term clinical remission after laser treatment.展开更多
Background: Diffuse epidermal and periadnexal squamous cell carcinoma in situ (DEPS) is a condition in which large areas of skin are affected by atypical keratinocytes that grow beneath the epidermis and encase adnexa...Background: Diffuse epidermal and periadnexal squamous cell carcinoma in situ (DEPS) is a condition in which large areas of skin are affected by atypical keratinocytes that grow beneath the epidermis and encase adnexal epithelia. Normal differentiation of the overlying epidermis and adnexal epithelium is seen. Objective: Our aim was to describe the clinical features of DEPS. Methods: We undertook a retrospective case series of 13 patients with DEPS. Results: All 13 patients were fairskinned men older than 50 years with a history of significant sun exposure. The lesions were present on the scalp, face, and neck. Histologic examination showed a growth of atypical keratinocytes in the lower epidermis with encasement of adnexal structures by atypical neoplastic keratinocytes. In the 52 cumulative patient-years of follow-up, we treated 80 invasive squamous cell and 48 basal cell carcinomas in these patients. Despite improvement of DEPS with aggres sive topical and destructive therapy,multifocal recurrencewould typically develo p within a few months. Conclusion: DEPS is characterized by diffuse involvement of chronically sun-exposed skin with atypical keratinocytes that grow along the inferior portion of the basal layer of the epidermis and around adnexal structu res. The treatment of DEPS is challenging because of its widespread nature and d eeper periadnexal involvement. DEPS is also associated with the development of i nvasive squamous cell and basal cell carcinomas.展开更多
文摘Background: The 1450-nm diode laser has been known to thermally alter sebaceous glands and has been found to be effective for the treatment of inflammatory facial acne. Objective:Our aim was to evaluate the dose response of a 1450-nmdiode laser for treatment of facial acne, sebum production, and acne scarring utilizing two laser fluences and to determine long-term remission after laser treatment. Methods: Twenty patients (Fitzpatrick skin phototypes II-VI) received 3 treatments using the 1450 nm diode laser (3- 4 week intervals).Split face comparisons were performed by randomizing patients to one of two fluences (14 or 16 J/cm2) on the right or left side of the face. Clinical photographs, lesion counts,and sebum measurements were obtained at baseline and after each treatment. Investigators’ and patients’ subjective evaluations of response to treatment were assessed. Results:Percentage reductions in mean acne lesion counts from baseline were 42.9% (14 J/cm2) and 33.9% (16 J/cm2) after one treatment and 75.1% (14 J/cm2) and 70.6% (16 J/cm2) after 3 treatments. There was persistent reduction of 76.1% (14 J/cm2) and 70.5% (16 J/cm2) at the 12-month follow up(P < .01). Both objective and subjective improvements in acne scarring and sebum production were noted. Treatment-related pain was well tolerated, and adverse effects were limited to transient erythema and edema at treatment sites. Limitations:This was a small study and comparison was limitedto two laser fluences. Conclusion: The 1450-nm diode laser reduced inflammatory facial acne lesions even in Fitzpatrickskin phototypes IV-VI with minimal side effects. Significant improvement in acne lesion counts were noted after the first treatment and was maintained 12 months after the third treatment,indicating significant long-term clinical remission after laser treatment.
文摘Background: Diffuse epidermal and periadnexal squamous cell carcinoma in situ (DEPS) is a condition in which large areas of skin are affected by atypical keratinocytes that grow beneath the epidermis and encase adnexal epithelia. Normal differentiation of the overlying epidermis and adnexal epithelium is seen. Objective: Our aim was to describe the clinical features of DEPS. Methods: We undertook a retrospective case series of 13 patients with DEPS. Results: All 13 patients were fairskinned men older than 50 years with a history of significant sun exposure. The lesions were present on the scalp, face, and neck. Histologic examination showed a growth of atypical keratinocytes in the lower epidermis with encasement of adnexal structures by atypical neoplastic keratinocytes. In the 52 cumulative patient-years of follow-up, we treated 80 invasive squamous cell and 48 basal cell carcinomas in these patients. Despite improvement of DEPS with aggres sive topical and destructive therapy,multifocal recurrencewould typically develo p within a few months. Conclusion: DEPS is characterized by diffuse involvement of chronically sun-exposed skin with atypical keratinocytes that grow along the inferior portion of the basal layer of the epidermis and around adnexal structu res. The treatment of DEPS is challenging because of its widespread nature and d eeper periadnexal involvement. DEPS is also associated with the development of i nvasive squamous cell and basal cell carcinomas.
