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
The pathogenesis of acne has been linked to multiple factors such as increased sebum production, inflammation, follicular hyperkeratinization, and the action of Propionibacterium acnes within the follicle. In an attem...The pathogenesis of acne has been linked to multiple factors such as increased sebum production, inflammation, follicular hyperkeratinization, and the action of Propionibacterium acnes within the follicle. In an attempt to understand the specific genes involved in inflammatory acne, we performed gene expression profiling in acne patients. Skin biopsies were obtained from an inflammatory papule and from normal skin in six patients with acne. Biopsies were also taken from normal skin of six subjects without acne. Gene array expression profiling was conducted using Affymetrix HG-U133A 2.0 arrays comparing lesional to nonlesional skin in acne patients and comparing nonlesional skin from acne patients to skin from normal subjects. Within the acne patients, 211 genes are upregulated in lesional skin compared to nonlesional skin. A significant proportion of these genes are involved in pathways that regulate inflammation and extracellular matrix remodeling, and they include matrix metalloproteinases 1 and 3, IL- 8, human β defensin 4, and granzyme B. These data indicate a prominent role of matrix metalloproteinases, inflammatory cytokines, and antimicrobial peptides in acne lesions. These studies are the first describing the comprehensive changes in gene expression in inflammatory acne lesions and are valuable in identifying potential therapeutic targets in inflammatory acne.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The pathogenesis of acne has been linked to multiple factors such as increased sebum production, inflammation, follicular hyperkeratinization, and the action of Propionibacterium acnes within the follicle. In an attempt to understand the specific genes involved in inflammatory acne, we performed gene expression profiling in acne patients. Skin biopsies were obtained from an inflammatory papule and from normal skin in six patients with acne. Biopsies were also taken from normal skin of six subjects without acne. Gene array expression profiling was conducted using Affymetrix HG-U133A 2.0 arrays comparing lesional to nonlesional skin in acne patients and comparing nonlesional skin from acne patients to skin from normal subjects. Within the acne patients, 211 genes are upregulated in lesional skin compared to nonlesional skin. A significant proportion of these genes are involved in pathways that regulate inflammation and extracellular matrix remodeling, and they include matrix metalloproteinases 1 and 3, IL- 8, human β defensin 4, and granzyme B. These data indicate a prominent role of matrix metalloproteinases, inflammatory cytokines, and antimicrobial peptides in acne lesions. These studies are the first describing the comprehensive changes in gene expression in inflammatory acne lesions and are valuable in identifying potential therapeutic targets in inflammatory acne.
