mag 23 2012

New therapeutic options for onychomycosis.

Expert Opin Pharmacother. 2012 Jun;13(8):1131-42. Epub 2012 Apr 25.

Gupta AK, Simpson FC.

Source

Division of Dermatology, Department of Medicine, University of Toronto, Toronto , Ontario , Canada +1 519 657 4222 ext. 277 ; +1 519 657 4233 ; agupta@execulink.com.

Abstract

Introduction: Onychomycosis is a fungal infection of the nail apparatus that affects 10 – 30% of the global population. Current therapeutic options for onychomycosis have a low to moderate efficacy and result in a 20 – 25% rate of relapse and reinfection. New therapeutic options are needed to broaden the spectrum of treatment options and improve the efficacy of treatment. Areas covered: This review discusses the emerging pharmacotherapeutics; including topical reformulations of terbinafine, new azole molecules for systemic and topical administration, topical benzoxaboroles and topical polymer barriers. The paper also discusses device-based options, which may be designed to activate a drug or to improve drug delivery, such as photodynamic therapy and iontophoresis; laser device systems have also begun to receive regulatory approval for onychomycosis. Expert opinion: Device-based therapeutic options for onychomycosis are expanding more rapidly than pharmacotherapy. Systemic azoles are the only class of pharmacotherapy that has shown a comparable efficacy to systemic terbinafine; however terbinafine remains the gold standard. The most notable new topical drugs are tavaborole, efinaconazole and luliconazole, which belong to the benzoxaborole and azole classes of drugs. Photodynamic therapy, iontophoresis and laser therapy have shown positive initial results, but randomized controlled trials are necessary to determine the long-term success of these devices.

PMID:

 

22533461

 

[PubMed - in process]
Pubblicato su PubMed a http://www.ncbi.nlm.nih.gov/pubmed/22533461
mag 12 2012

Treatment of traumatic scars using fat grafts mixed with platelet-rich plasma, and resurfacing of skin with the 1540 nm nonablative laser.

Clin Exp Dermatol. 2012 Jan;37(1):55-61. doi: 10.1111/j.1365-2230.2011.04199.x.

Cervelli V, Nicoli F, Spallone D, Verardi S, Sorge R, Nicoli M, Balzani A.

Source

Department of Plastic and Reconstructive Surgery, Policlinico Casilino, University Tor Vergata, Rome, Italy.

Abstract

BACKGROUND:

Many treatments have been proposed for cosmetic or functional improvement of scars. It is known that fat grafts and lasertreatment can have beneficial effects on remodelling of scar tissue, and platelet-rich plasma (PRP) can be effective during the wound-healing process. Leggi l’articolo completo →

mag 9 2012

Treatment of actinic keratoses and photodamage with non-contact fractional 1540-nm laser quasi-ablation: an ex vivo and clinical evaluation.

Lasers Med Sci. 2012 Apr 27. [Epub ahead of print]

Lapidoth M, Adatto M, Halachmi S.

Source

Laser Unit, Department of Dermatology, Rabin Medical Center, Golda Campus, 7 Keren Kayemet St, Petach Tikva, Israel, alapidot@netvision.net.il.

Abstract

The main use of non-ablative fractional photothermolysis today is for the improvement of wrinkles and scars. The purpose of this work was to evaluate the effect of a “classic” non-ablative fractional 1540nm on facial photodamaged skin and actinic keratoses. Seventeen Leggi l’articolo completo →

mag 4 2012

Comparison of the effectiveness of nonablative fractional laser versus ablative fractional laser in thyroidectomy scar prevention: A pilot study.

J Cosmet Laser Ther. 2012 Apr;14(2):89-93.

Kim HS, Lee JH, Park YM, Lee JY.

Source

Department of Dermatology, Seoul St. Mary’s Hospital, The Catholic University of Korea , Seoul , Korea.

Abstract

Abstract A scar is a mark that remains after the healing of a wound or other morbid processes. In the past, treatment was mainly focused on severe scarring, such as the hypertrophic and burn scars. However, scars from relatively minor wounds can also be stressful. The site of an open thyroidectomy is the anterior neck, a prominently exposed part of the body, where postoperative scarring can cause patients distress. The cosmetic outcome of the scar after thyroidectomy is of particular importance to women, who constitute the majority of patients with thyroid disease. Active prevention is more likely to yield better cosmetic results and would require fewer treatment sessions and less expense than scar revision procedures. Many interventions have been proposed, but there is yet no universal consensus on optimal treatment. Recently, focus has been made on ‘laser scar prevention’, where various types of lasers have been used to improve the appearance of scars. The purpose of this study was to improve the appearance of scars, by laser intervention of the wound healing process. In this pilot study, we comparatively examined the effect of non-ablative 1550-nm fractional Er: glass laser and ablative 2940-nm fractional Er: YAG laser on fresh surgical scars of patients with Fitzpatrick skin type III-IV.

PMID:22409153

 [PubMed - in process]Pubblicato su PubMed a http://www.ncbi.nlm.nih.gov/pubmed/22409153

apr 27 2012

Ablation efficiency and relative thermal confinement measurements using wavelengths 1,064, 1,320, and 1,444 nm for laser-assisted lipolysis.

Lasers Med Sci. 2012 Apr 26. [Epub ahead of print]

Youn JI, Holcomb JD.

Source

Department of Biomedical Engineering, College of Medical Science, Catholic University of Daegu, Gyeongbuk, South Korea.

Abstract

Laser-assisted lipolysis is routinely used for contouring the body and the neck while modifications of the technique have recently been advocated for facial contouring. In this study, wavelength-dependence measurements of laser lipolysis effect were performed using different lasers at 1,064, 1,320, and 1,444 nm wavelengths that are currently used clinically. Fresh porcine skin with fatty tissue was used for the experiments with radiant exposure of 5-8 W with the same parameters (beam diameter = 600 μm, peak power = 200 mJ, and pulse rate = 40 Hz) for 1,064, 1,320 and 1,444 nm laserwavelengths. After laser irradiation, ablation crater depth and width and tissue mass loss were measured using spectral optical coherence tomography and a micro-analytical balance, respectively. In addition, thermal temporal monitoring was performed with a thermal imaging camera placed over ex vivo porcine fat tissue; temperature changes were recorded for each wavelength. This study demonstrated greatest ablation crater depth and width and mass removal in fatty tissue at the 1,444 nm wavelength followed by, in order, 1,320 and 1,064 nm. In the evaluation of heat distribution at different wavelengths, reduced heat diffusion was observed at 1,444 nm. The ablation efficiency was found to be dependent upon wavelength, and the 1,444 nm wavelength was found to provide both the highest efficiency for fatty tissue ablation and the greatest thermal confinement.

PMID:22534741

 [PubMed - as supplied by publisher]Pubblicato su PubMed a http://www.ncbi.nlm.nih.gov/pubmed/22534741

apr 21 2012

Nonablative fractional resurfacing in combination with topical tretinoin cream as a field treatment modality for multiple actinic keratosis: a pilot study and a review of other field treatment modalities.

J Dermatolog Treat. 2012 Apr 19. [Epub ahead of print]

Prens SP, Vries KD, Neumann MH, Prens EP.

Source

Department of Dermatology, Erasmus MC, Universtity Medical Center Rotterdam , The Netherlands.

Abstract

Abstract Background: Actinic keratosis (AK) are premalignant lesions occurring mainly in sun-damaged skin. Current topical treatment options for AK and photo damaged skin such as liquid nitrogen and electro surgery are not suitable for field treatment. Otherwise, therapies suitable for field treatment bring along considerable patient discomfort. Nonablative fractional resurfacing has emerged as a logical treatment option especially for field treatment of AK. Objectives: – To evaluate the clinical efficacy of fractional laser therapy for clearing AK and improving skin quality. – To compare patient friendliness of the “fractional” therapy with those reported for other field treatment modalities. Materials & Methods: Ten patients with Fitzpatrick I to III type skin with multiple actinic keratoses and extensive sun-damaged skin, received 5 to 10 sessions with a 4-week interval using a 1550 nm Erbium-Glass Fractionated laser (Sellas, Korea). Four weeks and 24 weeks after the last treatment the clinical results were evaluated by an independent physician. Results: The mean degree of improvement, in terms of reduction in the number of AK and improvement ofskin texture, was 54% on a 4 point PGA scale, and persisted for approximately 6 months. The biggest advantage of fractional laser treatment, besides the eradication of AK and a clear rejuvenation effect, is the absence of “down time”. Conclusion: Fractional nonablative resurfacing induces significant reduction in the number of AK and improves the skin quality. Also all patients preferred fractional laser therapy above other AK treatment modalities.

PMID:22515664

 

[PubMed - as supplied by publisher]
Pubblicato su PubMed a http://www.ncbi.nlm.nih.gov/pubmed/22515664
apr 12 2012

Photocoagulation of dermal blood vessels with multiple laser pulses in an in vivo microvascular model.

Lasers Surg Med. 2012 Feb;44(2):144-51. doi: 10.1002/lsm.22000. Epub 2012 Jan 24.

Jia W, Tran N, Sun V, Marinček M, Majaron B, Choi B, Nelson JS.

Source

Beckman Laser Institute and Medical Clinic, Department of Surgery, University of California, Irvine, California 92617-3010, USA. wjia@uci.edu

Abstract

BACKGROUND/OBJECTIVES:

Current laser therapy of port wine stain (PWS) birthmarks with a single laser pulse (SLP) does not produce complete lesion removal in the majority of patients. To improve PWS therapeutic efficacy, we evaluated the performance of an approach based on multiplelaser pulses (MLP) to enhance blood vessel photocoagulation.

STUDY DESIGN:

The hamster dorsal window chamber model was used. Radiant exposure (RE), pulse repetition rate (f(r)), total number of pulses (n(p)), and length of vessel irradiated were varied. Blood vessels in the window were irradiated with either SLP with RE of 4-7 J/cm(2) or MLP with RE per pulse of 1.4-5.0 J/cm(2), f(r) of 0.5-26.0 Hz, and n(p) of 2-5. The laser wavelength was 532 nm and pulse duration was 1 ms. Either a 2 mm vessel segment or entire vessel branch was irradiated. Digital photographs and laser speckle images of the window were recorded before and at specific time points after laser irradiation to monitor laser-induced blood vessel structural and functional changes, respectively.

RESULTS:

We found that: (1) for a SLP approach, the RE required to induce blood vessel photocoagulation was 7 J/cm(2) as compared to only 2 J/cm(2) per pulse for the MLP approach; (2) for MLP, two pulses at a repetition rate of 5 Hz and a RE of 3 J/cm(2) can induce photocoagulation of more than 80% of irradiated blood vessel; and (3) irradiation of a longer segment of blood vessel resulted in lower reperfusion rate.

CONCLUSIONS:

The MLP approach can induce blood vessel photocoagulation at much lower RE per pulse as compared to SLP. The 5 Hz f(r) and the need for two pulses are achievable with modern laser technology, which makes the MLP approach practical in the clinical management of PWS birthmarks.

Copyright © 2012 Wiley Periodicals, Inc.

PMID:

 22275290

[PubMed - in process]Pubblicato su PubMed a http://www.ncbi.nlm.nih.gov/pubmed/22275290

ago 14 2011

K-Laser Professional TFL

Nella medicina moderna l’utilizzo del laser per la dermatologia si è rivelato altamente efficace, garantendo tempi di trattamento e guarigione estremamente ridotti. La radiazione laser viene oggi impiegata con successo per il ringiovanimento dei tessuti cutanei e per il trattamento degli inestetismi della pelle.
K-Laser Professional TFL consente di fare una terapia efficace, mirata, rapida e ottimamente tollerabile dal paziente: UNA TERAPIA INDOLORE. Grazie all’azione frazionata (Laser termofrazionato), il fascio Laser colpisce dei settori circoscritti producendo impercettibili lesioni nel derma (dei microspot del diametro fino a 99micron), lasciando perfettamente intatte le sezioni non interessate. In questo modo vengono prodotte centinaia di microcoaugulazioni quasi invisibili, da qui si riattiva il nuovo derma : le microlesioni eseguite sono separate tra loro da tessuto perfettamente intatto che innesca un intenso processo di rigenerazione tissutale, producendo così nuovo collagene e nuova elastina.
 K-Laser Professional TFL non si limita dunque a stimolare, bensì attiva direttamente la produzione di nuovo tessuto, più tonico e più luminoso, con una ragguardevole riduzione di rughe e segni di invecchiamento.

Tutto ciò è ottenuto in piena sicurezza e senza sofferenza da parte del paziente in quanto K-Laser Professional TFL non asporta alcuna sezione di pelle. Questa è la grande innovazione del nostro trattamento e la garanzia degli eccellenti risultati.

UN VISO GIOVANE, UNA PELLE LISCIA E LUMINOSA, TESA E SENZA SEGNI DEL TEMPO

Con K-Laser Professional TFL, possono essere trattate le problematiche più tipiche della pelle quali : rughe del volto, cicatrici atrofiche e ipertrofiche, acne in stato infiammatorio, esiti di acne, smagliature, lassità e invecchiamento cutaneo.