The 730 nm picosecond titanium sapphire laser for treatment of café-au-lait macules in all skin types

IF 2.2 3区 医学 Q2 DERMATOLOGY Lasers in Surgery and Medicine Pub Date : 2024-02-27 DOI:10.1002/lsm.23769
Joan K. Fernandez MD, Emily L. Guo MD, Heather Richmond MD, Paul M. Friedman MD
{"title":"The 730 nm picosecond titanium sapphire laser for treatment of café-au-lait macules in all skin types","authors":"Joan K. Fernandez MD,&nbsp;Emily L. Guo MD,&nbsp;Heather Richmond MD,&nbsp;Paul M. Friedman MD","doi":"10.1002/lsm.23769","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>Café-au-lait macules (CALM) are benign birthmarks presenting as uniformly pigmented, well demarcated, brown patches that can be distressing to patients, especially when located in cosmetically sensitive areas. As with all pigmentary lesions in skin of color patients, CALMs have been particularly challenging to treat. Here we present the first case series characterizing treatment parameters and clinical outcomes utilizing the 730-nm picosecond titanium sapphire laser for the treatment of CALMs. This device provides an additional safe and effective treatment option for these challenging cases.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We performed a retrospective review of patients treated at a single institution between April 2021 and December 2023. Clinical photographs were graded by 3 outside board-certified dermatologists using a 5-point visual analog scale.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Fourteen patients (age range: 10 months–66 years, mean age: 27.4 years, Fitzpatrick skin types II–VI) were treated for CALM on the face (11) or body (3). On average, patients received 4.3 treatments, with treatment intervals ranging from 4 to 40 weeks. Treatment remains ongoing with the 730-nm picosecond laser for eight patients. Overall, patients were rated to have a mean improvement of 26%–50%. Two patients (FST III and VI) achieved 100% clearance after 4-5 treatment sessions. Our study included four patients whose CALM were of the smooth bordered “coast of California” subtype, three of whom had a mean improvement rating of only 1%–25%. The fourth patient had near complete resolution. Follow up for these patients has ranged from 6 weeks to 1.5 years. Of the patients treated, one patient experienced transient post-inflammatory hyperpigmentation and another transient post-inflammatory hypopigmentation, while a third patient experienced mild persistent guttate hypopigmentation. Three patients experienced partial recurrence indicating that maintenance treatments may be needed in some patients.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The 730-nm picosecond titanium sapphire laser is a safe and efficacious treatment option, in the right morphologic setting, to improve the cosmetic appearance of CALMs in a wide range of ages and skin types. To our knowledge, this is the first reported treatment of CALMs with picosecond lasers in FST V and VI patients. Our study also supports prior studies which have found that CALM with smooth-bordered “coast of California” morphology have a poor response to laser therapy as compared to those with jagged or ill-defined bordered “coast of Maine” morphology.</p>\n </section>\n </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 3","pages":"257-262"},"PeriodicalIF":2.2000,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23769","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lasers in Surgery and Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/lsm.23769","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives

Café-au-lait macules (CALM) are benign birthmarks presenting as uniformly pigmented, well demarcated, brown patches that can be distressing to patients, especially when located in cosmetically sensitive areas. As with all pigmentary lesions in skin of color patients, CALMs have been particularly challenging to treat. Here we present the first case series characterizing treatment parameters and clinical outcomes utilizing the 730-nm picosecond titanium sapphire laser for the treatment of CALMs. This device provides an additional safe and effective treatment option for these challenging cases.

Methods

We performed a retrospective review of patients treated at a single institution between April 2021 and December 2023. Clinical photographs were graded by 3 outside board-certified dermatologists using a 5-point visual analog scale.

Results

Fourteen patients (age range: 10 months–66 years, mean age: 27.4 years, Fitzpatrick skin types II–VI) were treated for CALM on the face (11) or body (3). On average, patients received 4.3 treatments, with treatment intervals ranging from 4 to 40 weeks. Treatment remains ongoing with the 730-nm picosecond laser for eight patients. Overall, patients were rated to have a mean improvement of 26%–50%. Two patients (FST III and VI) achieved 100% clearance after 4-5 treatment sessions. Our study included four patients whose CALM were of the smooth bordered “coast of California” subtype, three of whom had a mean improvement rating of only 1%–25%. The fourth patient had near complete resolution. Follow up for these patients has ranged from 6 weeks to 1.5 years. Of the patients treated, one patient experienced transient post-inflammatory hyperpigmentation and another transient post-inflammatory hypopigmentation, while a third patient experienced mild persistent guttate hypopigmentation. Three patients experienced partial recurrence indicating that maintenance treatments may be needed in some patients.

Conclusion

The 730-nm picosecond titanium sapphire laser is a safe and efficacious treatment option, in the right morphologic setting, to improve the cosmetic appearance of CALMs in a wide range of ages and skin types. To our knowledge, this is the first reported treatment of CALMs with picosecond lasers in FST V and VI patients. Our study also supports prior studies which have found that CALM with smooth-bordered “coast of California” morphology have a poor response to laser therapy as compared to those with jagged or ill-defined bordered “coast of Maine” morphology.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
730 nm 皮秒钛蓝宝石激光器用于治疗各种肤质的咖啡色黄斑。
目的:咖啡斑(CALM)是一种良性胎记,表现为色素均匀、界限清楚的棕色斑块,会给患者带来痛苦,尤其是位于美容敏感区域时。与有色人种皮肤上的所有色素性病变一样,CALMs 的治疗尤其具有挑战性。在此,我们介绍了首例利用 730 纳米皮秒钛蓝宝石激光治疗 CALMs 的系列病例,描述了治疗参数和临床效果。该设备为这些具有挑战性的病例提供了另一种安全有效的治疗方案:我们对 2021 年 4 月至 2023 年 12 月期间在一家医疗机构接受治疗的患者进行了回顾性研究。临床照片由 3 位外部委员会认证的皮肤科医生使用 5 点视觉模拟评分法进行评分:结果:14 名患者(年龄范围:10 个月-66 岁,平均年龄:10 个月-66 岁10个月-66岁,平均年龄:27.4岁,菲茨帕特里克皮肤类型II-VI)接受了面部(11例)或身体(3例)的CALM治疗。患者平均接受了 4.3 次治疗,治疗间隔从 4 周到 40 周不等。有 8 名患者仍在接受 730 纳米皮秒激光治疗。总体而言,患者的平均病情改善率为 26%-50%。两名患者(FST III 和 VI)在接受了 4-5 次治疗后,病情得到了 100% 的清除。我们的研究包括四名 CALM 属于边界光滑的 "加利福尼亚海岸 "亚型的患者,其中三人的平均改善率仅为 1%-25%。第四位患者的病情几乎完全缓解。这些患者的随访时间从 6 周到 1.5 年不等。在接受治疗的患者中,一名患者出现了一过性的炎症后色素沉着,另一名患者出现了一过性的炎症后色素减退,而第三名患者则出现了轻度的持续性色素减退。三名患者出现了部分复发,这表明一些患者可能需要进行维持治疗:结论:730nm 皮秒钛蓝宝石激光器是一种安全有效的治疗方法,在适当的形态环境下,可改善不同年龄和皮肤类型的 CALMs 的美容外观。据我们所知,这是首次报道用皮秒激光治疗 FST V 和 VI 患者的 CALMs。我们的研究还支持之前的研究,这些研究发现,与锯齿状或边界不清晰的 "缅因州海岸 "形态相比,边界光滑的 "加利福尼亚海岸 "CALM 对激光治疗的反应较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
5.40
自引率
12.50%
发文量
119
审稿时长
1 months
期刊介绍: Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.
期刊最新文献
Cutaneous Immune Responses to Ablative Fractional Laser, Heat- and Cold-Based Dermatological Procedures. Multiphoton Microscopy Assessment of Healing From Tendon Laceration and Microthermal Coagula in a Rat Model. Differentiation of Tumors of the Upper Respiratory Tract Using Optical Metabolic Imaging. Evaluation of Papain-Urea for Enzymatic Debridement of Coagulation Zones Following Ablative Fractional Laser Treatment. The 595-nm Wavelength Pulsed Dye Laser for Pediatric Port-Wine Birthmarks and Infantile Hemangiomas: A Systematic Review.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1