Successful Treatment of Atrophic Scars from Cutaneous Leishmaniasis Using a Fractional Laser

2010 ◽  
Vol 14 (6) ◽  
pp. 303-306 ◽  
Author(s):  
Khalid M. AlGhamdi
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Successful Treatment ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Fractional Laser ◽  
Atrophic Scar ◽  
Atrophic Scars ◽  
Skin Conditions ◽  
Excellent Improvement

Background: Cutaneous leishmaniasis can lead to unsightly atrophic scars, which have limited treatment options. There is a scarcity of literature on its treatment modalities. Fractional lasers have been successfully used in treating a variety of skin conditions with minimal downtime and side effects. Methods: We report a successful treatment of a 25-year-old female patient with an atrophic scar from cutaneous leishmaniasis on the nose with a fractional laser (Fraxel Re:store SR 1500). Ten treatment sessions were performed at a pulse energy of 45 to 70 mJ. The treatment response was assessed by comparing pre- and posttreatment clinical photographs. Results: After three sessions, the patient observed 40% improvement. More than 90% improvement was noticed after the tenth session. No significant adverse effects were noted. The improvement was persistent at the 3-month follow-up. Conclusion: The excellent improvement in this patient should encourage further studies to achieve more efficacy and optimize the treatment parameters.

Aanpak en behandelingsopties voor congenitale melanocytaire naevi

2021 ◽  
Author(s):  
A. VANNESTE ◽  
M. GARMYN ◽  
M.-A. MORREN
Keyword(s):  
Treatment Options ◽  
Neurological Complications ◽  
Treatment Modalities ◽  
Melanocytic Nevi ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
Long Term Prognosis ◽  
Congenital Melanocytic Nevi

Management and treatment options in congenital melanocytic nevi Congenital melanocytic nevi (CMN) are benign collections of nevus cells in the skin. They are present at birth or arise during the first weeks of life. Depending on the size, they appear in 1 in 100 to 500.000 live births. CMN are associated with a variety of benign conditions such as benign proliferations, certain facial characteristics or subtle endocrine dysfunctions as well as malign developments such as melanoma and neurological complications. The risk for these complications strongly depends on the clinical phenotype. Magnetic resonance imaging (MRI) has a strong value in estimating the risk of these complications. A normal MRI of the central nervous system results in a lower risk of developing melanoma and neurological complications because of the thorough follow-up and early capture. Although there are various treatment modalities, a shift to more conservative treatment is seen. Little is known about the long term prognosis after treatment of CMN. This article tries to give a recommendation for treatment and follow-up of CMN based on the current literature.

The Successful Treatment of Elephantiasis Nostras Verrucosa With Ablative Carbon Dioxide Laser

2018 ◽  
Vol 22 (6) ◽  
pp. 611-613 ◽  
Author(s):  
Caitlin G. Robinson ◽  
Kory R. Lee ◽  
Valencia D. Thomas
Keyword(s):  
Carbon Dioxide ◽  
Study Design ◽  
Successful Treatment ◽  
Carbon Dioxide Laser ◽  
Skin Condition ◽  
Treatment Modalities ◽  
Medical Benefit

Background and Objective: Elephantiasis nostras verrucosa (ENV) is a disfiguring skin condition that is difficult to treat. Existing treatment modalities serve to improve cosmesis or treat symptoms. Herein, we report a case of ENV with lymphocutaneous fistula successfully treated with ablative carbon dioxide laser. Study Design/Patients and Methods: A 57-year-old woman with biopsy-proven ENV with lymphocutaneous fistula was treated with ablative carbon dioxide laser to the symptomatic area of her right thigh in 3 treatment sessions over 6 months. Results: The patient had resolution of lymphocutaneous drainage as well as 90% improvement in the appearance of ENV lesions at the 1-month follow-up visit. Conclusion: Ablative carbon dioxide laser may provide cosmetic, symptomatic, and medical benefit for patients with localized ENV.

scholarly journals Primary Intracranial Malignant Melanomas: Retrospective Analysis of Management in a Single Chinese Institution and literature Review

2021 ◽  
Author(s):  
Lifeng Chen ◽  
Yang Yang ◽  
Dongmei Li ◽  
Bo Bu ◽  
xiaodong ma
Keyword(s):  
Overall Survival ◽  
Preoperative Diagnosis ◽  
Treatment Options ◽  
Survival Rates ◽  
Radical Resection ◽  
Treatment Modalities ◽  
Subtotal Resection ◽  
Mri Features ◽  
Diagnosis Rate

Abstract Background: Primary intracranial malignant melanoma (PIMM) is a rare malignant tumor. The authors retrospectively reviewed and discussed the clinical features, treatment modalities, and clinical outcomes of patients with histologically proven PIMM. Methods: The data of 15 patients with PIMM in our hospital within 14 years (from January 2005 to January 2019) were collected. The clinical and imaging presentations, pathology, surgical strategies, adjuvant treatment and the prognosis were analyzed in this study.Results: Eleven men and 4 women with mean age 37.9 years (19-61 years) were observed over an average follow-up period of 22.6 months (range, 6–36 months). CT showed iso or high density in 12 cases (80%). MRI sacns indicated that 14 tumors were mainly hyperintensity on T1 weighted images, hypointensity on T2 weighted images, and had no or mild enhancement. The treatment modalities included total resection followed by conventional radiotherapy (RT) (n=12), and subtotal resection followed by stereotactic radiosurgery (SRS) (n=3). Fifteen cases had recurrence or metastasis at the average 14.7 months (6-23 months): local recurrence (8 cases), distant metastasis (5 cases), both of them (2 cases). Fourteen cases (93.3%) died and the mean overall survival was 22 months (6-36 months). The median survival period was 23 months. The overall survival rates at 1, 2 and 3 years were 80%, 47%, and 13%, respectively. Radical resection with RT was associated with longer overall survival (log-rank, p<0.05). Conclusions: PIMM is an extremely rare tumor with poor prognosis, which is difficult to get correct preoperative diagnosis. Improvement of the recognition of MRI features of melanoma can increase the preoperative diagnosis rate, and radical resection with RT may provide longer overall survival rate. Targeted and immunotherapy therapies may provide promise as treatment options for PIMM.

scholarly journals Percutaneous collagen induction (microneedling) for the management of non-atrophic scars: literature review

2019 ◽  
Vol 5 ◽  
pp. 205951311988030
Author(s):  
Christos Iosifidis ◽  
Ioannis Goutos
Keyword(s):  
Literature Review ◽  
English Literature ◽  
Fat Graft ◽  
Level Of Evidence ◽  
Puncture Wound ◽  
Atrophic Scar ◽  
Scar Management ◽  
Atrophic Scars ◽  
Underlying Mechanisms

Introduction: Percutaneous collagen induction (PCI) or needling techniques are increasingly popular in the reconstructive and aesthetic arena. The underlying mechanisms of action rest on producing a pattern of non-ablative and non-confluent puncture wound pattern to the dermis with a resulting regenerative effect to the skin. Methods: A detailed English literature review was conducted using PubMed Medline, Embase and Web of Science; the manuscripts were appraised and classified according to level of evidence as well risk of bias. Results are presented in descending order of evidence for non-atrophic scars. Discussion: On the basis of level 1 evidence currently available, the combination of needling and silicone gel can improve the short-term pliability, height and vascularity of hypertrophic and keloid scars. According to level 2 evidence, needling alongside spray keratinocytes can produce a statistically significant improvement to patient/observer scar ratings and improve pigmentation in hypopigmented burn scars at 12-month follow-up. Results from mixed cohort studies also point towards needling having a beneficial effect on fat graft retention. Level 3 data suggest that needling can render significant resurfacing effects to both mature and actively hypertrophic burn scars at 12-month follow-up based on objective scar scales; furthermore, favourable histological changes are seen, including better collagen alignment in the dermis and increased epidermal thickness. Conclusion: Needling techniques are promising adjuncts to non-atrophic scar management. Further research with long-term follow-up and comparative design protocols incorporating other resurfacing modalities is warranted before the exact value of needling is delineated in scar management protocols.

Diode Laser and Fractional Laser Innovations

2019 ◽  
Vol 35 (03) ◽  
pp. 248-255 ◽  
Author(s):  
Kaete A. Archer ◽  
Paul Carniol
Keyword(s):  
Carbon Dioxide Laser ◽  
Treatment Options ◽  
Vascular Lesions ◽  
Fractional Laser ◽  
Striae Distensae ◽  
Facial Aging ◽  
Acne Scars ◽  
Selective Photothermolysis ◽  
Skin Conditions ◽  
New Generation

AbstractLaser technology continues to increase in popularity and expand treatment options for patients with common but challenging skin conditions including facial telangiectasias, facial aging, striae distensae, and acne scars. Facial telangiectasias have been estimated to occur in tens of millions of people worldwide. The 585-nm laser was the first to follow the principle of selective photothermolysis for the treatment of cutaneous vascular lesions, but it caused significant postoperative purpura. Newer diode lasers target superficial and deep telangiectasias without the side effects of the 585-nm laser. Ablative resurfacing was introduced in the 1990s with the carbon dioxide laser to address facial rhytids and photoaging. While effective, the risks and downtime were significant. The newest fractionated nonablative lasers are demonstrating impressive results, with decreased risks and downtime. This new generation of lasers is being used extensively and in unique combinations for facial aging, striae, and acne scars.

scholarly journals Effectiveness of miltefosine in cutaneous leishmaniasis caused by Leishmania tropica in Pakistan after antimonial treatment failure or contraindications to first line therapy—A retrospective analysis

2021 ◽  
Vol 15 (1) ◽  
pp. e0008988
Author(s):  
Suzette Kämink ◽  
Boota Masih ◽  
Noor Ali ◽  
Aman Ullah ◽  
Syed Juma Khan ◽  
...  
Keyword(s):  
Adverse Events ◽  
Treatment Failure ◽  
Cutaneous Leishmaniasis ◽  
Treatment Options ◽  
Previous Treatment ◽  
Standard Of Care ◽  
Initial Response ◽  
Cure Rate ◽  
Stomach Pain

Background Cutaneous leishmaniasis (CL) is a neglected tropical skin disease, caused by Leishmania protozoa. In Pakistan, where CL caused by L. tropica is highly endemic, therapy with pentavalent antimonials is the standard of care, but has significant toxicity when used in systemic therapy, while are no evidence-based safer alternative treatment options for L. tropica. The efficacy of oral miltefosine has not been studied in CL caused by L. tropica. We evaluated effectiveness and tolerability of miltefosine in patients with previous treatment failure or with contraindications to systemic antimonial treatment. Methods A retrospective review was conducted of a cohort of CL patients who were treated with a 28-day course of miltefosine between December 2017 and August 2019, in urban Quetta, Pakistan, an area endemic for L. tropica. Descriptive analyses were performed, and effectiveness was assessed by initial response after treatment, and final cure at routine follow up visits, six weeks to three months post-treatment. Tolerability was assessed by routinely reported adverse events. Results Of the 76 CL patients in the cohort, 42 (55%) had contraindications to systemic antimonial treatment, and 34 (45%) had failure or relapse after antimonial treatment. Twelve patients defaulted during treatment and 12 patients were lost to follow up. In the remaining 52 patients, final cure rate was 77% (40/52). In those with contraindications to systemic antimonial treatment the final cure rate was 83% (24/29) and in the failure and relapse group 70% (16/23). Twenty-eight patients (40.0%) reported 39 mild to moderate adverse events with the main complaints being nausea (41.0%), general malaise (25.6%), and stomach pain (12.8%). Conclusion Results indicate that miltefosine is an effective second line treatment in CL in areas endemic for L. tropica. Prospective studies with systematic follow up are needed to obtain definitive evidence of effectiveness and tolerability, including identification of risk factors for miltefosine treatment failure.

scholarly journals Interdisciplinary Clinical Management of High Grade Arteriovenous Malformations and Ruptured Flow-Related Aneurysms in the Posterior Fossa

2010 ◽  
Vol 16 (4) ◽  
pp. 400-408 ◽  
Author(s):  
A. Mpotsaris ◽  
C. Loehr ◽  
A. Harati ◽  
F. Lohmann ◽  
M. Puchner ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Acute Phase ◽  
Arteriovenous Malformations ◽  
De Novo ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Interdisciplinary Treatment ◽  
Treatment Modalities ◽  
Risk Of Rupture

Posterior fossa arteriovenous malformations are rare entities and treatment modalities technically challenging. In recent years new therapeutic options have emerged through microsurgical and endovascular means. Based on a series of six cases we describe combined interdisciplinary treatment strategies and report the outcome in a midterm follow-up interval of 12 months. Clinical case data were collected during acute phase and follow-up including standardized angiographic control intervals during follow-up and assessment of the outcome. Treatment options included endovascular techniques as well as microsurgical techniques. All reported cases had SAH based on ruptured flow-related aneurysms in posterior fossa AVM; three out of six had multiple aneurysms. In one case we observed a de novo formation of two flow-associated distal aneurysms in an interval of ten years. Two patients were treated only endovascularly, one patient only surgically and three patients with combined methods. Five out of six patients had a good outcome (GOS 4 or 5). One died in the acute phase. Infratentorial AVMs are rare but characterized by a high risk of rupture and SAH, especially in conjunction with flow related aneurysms, which are predictors of poor outcome. The anatomic conditions of the posterior fossa may lead quickly to life-threatening complications due to mass effects. The present study indicates that treatment strategies in the acute phase should focus on flow-related aneurysms, followed by an elective AVM embolization and ectomy whenever possible. An experienced interdisciplinary team and the combination of techniques contribute to a reduction of complications and to a better outcome.

Canadian Hand Dermatitis Management Guidelines

2010 ◽  
Vol 14 (6) ◽  
pp. 267-284 ◽  
Author(s):  
Charles Lynde ◽  
Lyn Guenther ◽  
Thomas L. Diepgen ◽  
Denis Sasseville ◽  
Yves Poulin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Options ◽  
Significant Loss ◽  
Treatment Modalities ◽  
Management Guidelines ◽  
Hand Dermatitis ◽  
Randomized Controlled Clinical Trials ◽  
Common Skin ◽  
Skin Conditions

Background: Hand dermatitis (HD) is one of the most common skin conditions; however, it is not a homogeneous disease entity. The severity of HD may range from very mild cases to severe chronic forms, which may result in prolonged disability and, occasionally, refractory HD. Chronic hand dermatitis (CHD) is associated with a high health- economic burden and significant loss of quality of life. Objective: Although numerous treatment options are available, the management of CHD is often difficult and unsatisfactory. There is a paucity of well-designed, randomized, controlled clinical trials in support of the efficacy of established treatment modalities. Conclusion: These guidelines cover the epidemiology, burden, quality of life, etiology, diagnosis, classification, and prevention of HD and provide guidance on management using an approach that is as evidence based as possible.

scholarly journals Microdermabrasion for treatment of acne scars in South Indian patients: a clinical study

2016 ◽  
Vol 2 (4) ◽  
pp. 109 ◽  
Author(s):  
Anupama Y. G. ◽  
Afthab Jameela Wahab
Keyword(s):  
Clinical Study ◽  
Side Effects ◽  
Treatment Options ◽  
Common Disorder ◽  
Indian Patients ◽  
Acne Scars ◽  
South Indian ◽  
Atrophic Scars ◽  
Severe Grade

<p class="abstract"><strong>Background:</strong> Acne is a common disorder with a more prevalence among adolescents and seldom has it caused atrophic scars. Several treatment options are available for atrophic acne scars treatment.<strong> </strong>The objective of the study was to assess the efficiency and safety of microdermabrasion for acne scars in South Indian patients<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Forty patients (24 males and 16 females) with acne scars were enrolled in the study. Microdermabrasion was done to all patients and repeated at every two weeks intervals for a total of four sittings. Patients were followed up on tenth week. The response to the treatment was assessed by objective and subjective methods.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients completed the study and follow up period.  There were 8 patients with mild, 28 patients with moderate and 4 patients with severe grade of acne scars. At the end of the study, 9 patients (22%) with mild to moderate acne scars showed good response. 30% of patients were satisfied with the treatment with varying degrees. Side effects were transient and mild<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Microdermabrasion is a safe, easy to perform, well tolerated procedure for treatment of mild to moderate acne scars<span lang="EN-IN">.</span></p>

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