44,211 research outputs found
Risk factors for recurrence after successful treatment of warts: the role of smoking habits
No full textBACKGROUND:
Several therapies have been proposed for cutaneous warts without results concerning factors affecting recurrences.
OBJECTIVE:
To determine the importance of individual characteristics and different therapy modalities in the occurrence of relapses.
METHODS:
Observational prospective cohort study including 199 patients affected by multiple plantar warts treated as follows: 49 with keratolytics, 50 with CO2 laser, 50 with pulsed dye laser (PDL) and 50 with cryotherapy. Personal data were evaluated through a questionnaire, and treatment information was collected. A Cox regression analysis was performed to identify independent factors for relapse occurrence.
RESULTS:
Of patients, 57.8% showed a persistent clearance of warts after treatment with a higher recurrence-free interval when treated with PDL. Accordingly, the risk of recurrence was increased with CO2 laser [hazard ratio (HR) 2.92, 95% confidence interval (CI) 1.49-5.74] and keratolytic treatment (HR 3.23, 95% CI 1.60-6.54), as compared to PDL. Furthermore, the multivariate analysis highlighted a higher risk of recurrence in patients between 26 and 35 years (HR 1.88, 95% CI 1.03-3.45), older than 35 (HR 2.23, 95% CI 1.23-4.07) and smokers (HR 4.90, 95% CI 3.09-7.78).
CONCLUSIONS:
Pulsed dye laser is characterized by the lowest rate of recurrence. Furthermore, our study highlights that the risk of warts relapse is 5-fold higher in smokers compared to non-smokers, revealing the importance of the effects of smoking on inflammation and immune response
Picosecond laser treatment of atrophic and hypertrophic surgical scars: In vivo monitoring of results by means of 3D imaging and reflectance confocal microscopy
No full textPurpose A growing interest in the treatment of scars with picosecond laser (PSL) is evident, although the basis for scar improvement is poorly understood. The aim is to provide new insights into the role of PSL in scar improvement through noninvasive in vivo skin imaging. Methods A total of 16 patients with 20 surgical scars were treated with three sessions of PSL. Efficacy was estimated through blinded evaluations performed by external dermatologists, Vancouver Scar Scale (VSS), Global Assessment Improvement Scale (GAIS), patient satisfaction, 3D imaging, and reflectance confocal microscopy (RCM) assessments at T0 (before treatment) and at T1 (6 months post-treatment). Safety was estimated through adverse events evaluation. Results In vivo findings revealed the modulation of pigmentation, vascularization, improved texture (P = .0001; 3D imaging), and variations of collagen remodeling (at RCM) in both atrophic and hypertrophic scars. A reduced epidermal thickness (at RCM) was observed in hypertrophic scars (P < .01) after treatment. Conclusions Our results confirm that PSL is an effective and safe technique for the treatment of atrophic and hypertrophic scars. In detail, we describe herein 3D and RCM features enabling the visualization of variations occurring in the skin after PSL treatment
Ultrapulsed CO2 Resurfacing of Photodamaged Facial Skin in Vegan and Omnivore Patients: A Multicentric Study
No full textBackground and Objectives: Skin photoaging is related to extrinsic environmental exposures, mainly represented by ultraviolet radiation. One of the treatment options is laser resurfacing. As nutritional status is involved in cutaneous photodamage, we evaluated whether dietary patterns can also influence the response to facial resurfacing. Our prospective multicentric study involves three dermatologic centers specialized in laser therapy in northern Italy. The study aims to compare the outcome of a CO2 ablative laser therapy between omnivore and vegan patients. Study Design/Materials and Methods: Fifty-three omnivore and fifty-three vegan women undergoing ultrapulsed CO2 resurfacing for photodamaged facial skin were enrolled in this study. Clinical improvement was evaluated 3 and 6 months after the treatment using the modified Dover score. Results: After laser treatment, vegans showed slower complete re-epithelialization (P < 0.001*) and disappearance of the erythema (P < 0.001*). After 3 and 6 months, vegans showed worse outcomes in terms of fine lines (P < 0.001* and P < 0.001*, respectively) and tactile roughness (P = 0.003* and P = 0.002*, respectively) compared with omnivores, while they did not differ in mottled pigmentation. Conclusions: The present study suggests that diet influences the clinical outcome of fractioned CO2 laser treatment. Lasers Surg. Med. © 2021 Wiley Periodicals LLC
Picosecond Laser treatment of Striae Distensae: In vivo Evaluation of Results by 3D Analysis, Reflectance Confocal Microscopy, and Patient′s Satisfaction
No full textBackground and Objectives: The efficacy of picosecond laser (PSL) in the treatment of striae distensae (SD) has been recently reported; otherwise, the base for this improvement has not been clarified yet. The aim of this study is to treat long-lasting SD with PLS and to describe their in vivo morphological variations after treatment using three-dimensional (3D) imaging and reflectance confocal microscopy (RCM). Study Design/Materials and Methods: A total of 27 patients asking for treatment for SD were treated with four monthly sessions of PLS. Clinical improvement was estimated through a blinded evaluation performed by two independent dermatologists, Global Assessment Improvement Scale (GAIS), patients′ satisfaction, 3D imaging, and RCM assessments at baseline and 6 months after the last laser session. Results: Although a clinical improvement of SD was observed in 81.4% of patients according to physicians′ GAIS, only 66.6% of patients reported subjective improvement and satisfaction after treatment (P = 0.04). 3D imaging revealed a significant improvement in terms of skin texture (P < 0.001) and mean SD depth (P < 0.001). Otherwise, RCM highlighted collagen remodeling and the appearance of new dermal papillae in all the treated SD compared with baseline. Conclusions: The present study confirms that PLS represents a safe treatment option for SD; herein, we report morphological documentation of skin variations after PLS treatment. Lasers Surg. Med. © 2021 Wiley Periodicals LLC
Porokeratosis: immunosuppression and exposure to sunlight
No full textFour cases of disseminated superficial actinic porokeratosis are described, all in patients who had been given immunosuppressive treatment, which might have been a contributing factor in the development of the condition. The possible relationship of immunosuppressive actinic porokeratosis to viral infection is also discussed
Treatment of striae distensae with non-ablative fractional laser: clinical and in vivo microscopic documentation of treatment efficacy
No full textThe efficacy of NAFL in the treatment of striae distensae (SD) has been demonstrated. Nevertheless, the base for this improvement has not been clarified yet. The aim of this study is to describe in vivo variations occurring in the skin after the treatment, using reflectance confocal microscopy (RCM). Ten patients asking for the treatment of SD were enrolled. Clinical and RCM images were acquired before the treatment, immediately after 1 and 6Â months after the first treatment. One thousand five hundred forty-nanometer laser treatments were performed every 4Â weeks for 6 sessions. Efficacy was estimated through the evaluation of pre- and post-treatment clinical pictures by two expert and independent physicians and with GAIS. Improvement of SD was observed in 80% of patients. Temporary erythema and edema were reported. RCM revealed the dissolution of collagen bundles and the appearance of new papillae, as compared to baseline. NAFL represents an effective and safe treatment modality for SD. We report herein in vivo variations occurring in SD after NAFL treatment
Telangiectasia of the face: risk factors for reappearance in patients treated with dye laser
No full textBackground: Lasers can be successfully used in the treatment of facial telangiectasias. Nevertheless, reappearance of telangiectasias after successful laser treatment is a significant problem. Risk factors involved in the reappearance have not been previously investigated. Objective: To evaluate whether personal, clinical and behavioural factors can influence the recurrence or new appearance of telangiectasias after treatment. Methods: Four hundred and fifteen women and 69 men obtaining complete clearance after laser treatment were included in the study and the role of different risk factors in the reappearance of telangiectasias was analysed. Immunocompromised patients were excluded. A statistical analysis was then performed. Results: Twenty four percent of women and 14.5% of men enrolled showed a persistent clearance after treatment. In women in whom telangiectasias reappeared, logistic regression highlighted the importance of tanning addiction, aesthetic medicine and surgery procedures as risk factors, while therapy for menopause was found to be a protective factor. Hypertension was found to be a risk factor in men. Conclusions: The efficacy of laser for treatment of telangiectasias of the face has been previously proven. Nevertheless, this is the first study presenting an analysis of risk factors involved in the new appearance of telangiectasias after the clearance induced by therapy
Antibiotic prophylaxis of wound infections in skin surgery
No full textA controlled prospective study of 2165 outpatients undergoing skin surgery was performed to evaluate the utility and the effects of several antibiotic schedules for prophylaxis of wound infections. The patients were divided into four groups. Twenty-three of the 541 group A patients, given no antibiotics, had wound infections. Eight of the 542 group B patients, given systemic antibiotics from immediately after surgery until the third day, had wound infections. Four of the 540 group C patients, treated only with local sterile antibiotic powder sprinkled into the wound during surgery, had wound infections develop, and only one infection occurred in the 542 group D patients given systemic antibiotics from 2 days before surgery until the second day after surgery. This last schedule was the best for prophylaxis of wound infections in contamination-prone regions. Local antibiotic administration is a simple method for prevention of infections in routine skin surgery
Fractional 1064 nm picosecond laser and skin photoaging: in vivo evaluation of treatment effects with reflectance confocal microscopy
No full textFew studies showed the role of picosecond laser (PLS) in the treatment of skin photoaging signs. However, no studies have explored the microscopic effects of PSL in photoaging. The aim of this study is to preliminarily identify clinical variations induced by a 1,064 nm Nd:YAG PSL on the décolleté area, then to apply the treatment protocol to treat facial photoaging and estimate the clinical and microscopic outcomes. A total of 10 consecutive patients with cutaneous photoaging were enrolled. Patients were treated 3 times at monthly intervals with the fractionated 1,064 nm Nd:YAG PSL. In a preliminary phase, PSL treatment was performed on the décolleté to establish its efficacy and safety. Then, the same treatment protocol was applied to all the face and clinical and reflectance confocal microscopy (RCM) were analyzed, comparing baseline (T0) pictures and 4 months after the treatment (T1) ones. On the face, a reduction of dyschromia and wrinkles was observed at T1. Furthermore, the underlying RCM variations were revealed at different skin levels. Our results show the clinical and microscopic effectiveness and safety of the 1,064-nm Nd:YAG PSL in the treatment of skin photoaging signs
Application of photodynamic therapy combined with pre-illumination microneedling in the treatment of actinic keratosis in organ transplant recipients
No full textN
- …
