Photobiomodulation, photomedicine, and laser surgery最新文献

Background: Phototherapy is a well-established treatment for various chronic inflammatory dermatoses, yet data on its safety and efficacy in geriatric populations remain limited. Older adults face unique clinical challenges due to age-related physiological changes, comorbidities, and polypharmacy, which may impact treatment responses and tolerance. Objective: This study aimed to evaluate the safety, efficacy, and clinical outcomes of phototherapy in elderly patients treated over a 10-year period at a tertiary dermatology center. Materials and Methods: A retrospective analysis was conducted on patients aged ≥65 years who received ≥8 sessions of phototherapy between 2013 and 2023. Narrowband UVB (NB-UVB), systemic psoralen plus ultraviolet A (PUVA), and localized PUVA therapies were administered using standardized protocols. Diagnosis-specific clinical criteria were used to assess treatment response. Data on adverse events, recurrence, and the need for additional sessions were recorded. Results: The study included 149 patients (mean age 70.2 ± 5.0 years; 44.3% female, 55.7% male) with 19 distinct dermatologic diagnoses. The most common indications were psoriasis (24.8%), generalized pruritus (18.1%), mycosis fungoides (11.4%), and lichen planus (6.7%). NB-UVB was used in 85.2% patients, while 10.1% received local PUVA and 4.7% underwent systemic PUVA. Overall, 83.2% of patients demonstrated clinical improvement. The highest treatment durations and cumulative doses were observed in mycosis fungoides (mean 9.3 months, 88.7 J/cm²) and lichen planus (9.5 months, 59.6 J/cm²). Adverse events occurred in 12.8%, predominantly mild erythema and pruritus. Recurrence was noted at 18.1%, and 16.1% required additional sessions. Despite 40.9% of patients using photosensitizing medications, no severe phototoxic reactions were observed. Conclusions: Phototherapy is a safe, effective, and well-tolerated treatment option for elderly patients with a variety of dermatologic conditions. The high clinical response rates, even in complex and refractory cases, support its continued use in this population. With its favorable safety profile and non-systemic nature, phototherapy remains a particularly suitable modality in the context of multimorbidity and polypharmacy. Further large-scale, multicenter prospective studies are warranted to establish standardized protocols tailored for geriatric populations.

Background and Objectives: This study reports an adaptive experience of pigmented scar treatment management with different characteristics. It is complicated to define a single solution for all the patients. For this reason, we report a multi-modal approach combining CO₂ laser, Q-switched lasers (QSL), and dye laser to adapt to every different patient clinical situation. Materials and Methods: Thirty patients were enrolled to treat pigmented scars. Twenty patients presented scars with exogenous pigment (such as traumatic tattoos) and 10 with endogenous pigment (hyperpigmentation cases). A combination of CO₂ laser, QSL, and dye laser was used. The number of treatment sessions performed for each laser, or their combination was as follow: For keloid scars from tattoo: 1-4 combined treatment sessions with QS and dye lasers; 3-4 combined treatment sessions with dye and CO₂ laser;1-4 treatment sessions with QS followed by dye laser; for asphalt traumatic tattoo: 2-3 treatment sessions with QS; for surgical hypertrophic scars: 2-3 combined treatment sessions of QS and CO₂ laser; for burn scars (due to asphalt contact) and hyperpigmentation: one treatment session with QS followed by CO₂ laser. Six months after the final treatment, the patient's scar improvement was evaluated compared with baseline (T0) using a five-point Global Aesthetic Improvement Scale (GAIS). Results: Regardless of the type of lesion and treatment, the whole population of the study showed satisfactory clinical results. The GAIS mean value was 3.3 ± 0.6. Specifically, 47% of the patients reported good results while 43% had excellent ones. No serious side effects were observed. Conclusions: Our results suggest that a combination of CO₂, dye, and Nd:YAG lasers is a feasible strategy for treating scars, reducing the pigmentary, fibrotic, and vascular components.

Background: The major challenge in cosmetics is the ability of functional ingredients to penetrate the skin barrier. For this reason, "skin boosters" have been developed, indicating a change from the traditional application of hyaluronic acid (HA) fillers, which had been confined to increasing the volume of the skin, to a more diversified use designed to relieve dermal complications. Methods: Thirty subjects (aged between 31 and 83 years and Fitzpatrick skin types II-IV) with skin irregularities as mild wrinkles or pigmented lesions were enrolled. Patients were treated on the one side with laser and a medical repairing ointment, and on the other side with laser and postlaser exosomes booster solution. Different laser procedures were used (Q-switched laser, CO₂ laser, 675 nm nonablative laser). To analyze the effect on postprocedure laser management, patients were monitored before treatment, immediately after, 1 h after, 3 days after, and 30 days after with the imaging system. Results: All the patients treated did not show any significant side effects apart from the redness. The side of the face treated with laser and medical repairing ointment showed a more intense redness than the side treated with laser and postlaser booster solution, both immediately after and 1 h after the treatment. Conclusions: These data confirm that the use of the postprocedure laser booster solution helps in posttreatment management by reducing redness statistically significantly, thus allowing patients to return to everyday life in a shorter time.

Background: There is strong evidence supporting the effectiveness of photobiomodulation therapy (PBMT) in improving neuronal damage and enhancing neuropsychological activities. However, there is limited research on the effects of this method on cognitive function and mood disorders. This project aimed to evaluate the potential benefits of PBMT in improving cognitive status and mood disorders in patients with dementia. Methods: In this randomized, double-blinded, controlled trial, 30 patients with mild-to-moderate dementia participated. The patients were divided into two groups: the first group (n = 15) received standard treatment along with PBMT, whereas the second group (n = 15) received standard treatment along with the use of an off-device on the head. Cognitive function, anxiety, and depression levels were assessed before, immediately after treatment, and 1 month later. Results: The comparison of cognitive functional score at baseline, after completing the therapeutic regimen, as well as one later showed no difference between the two groups (Table 1). Similarly, the two groups had similar mean scores for depression and anxiety at baseline and after treatment interventions. [Table: see text] Conclusion: The treatment likely has no significant impact on improving cognitive status or mood disorders in patients with mild-to-moderate dementia.

Background: Green light photobiomodulation (GPBM, 500-565 nm) promotes tissue healing, reduces inflammation, and alleviates pain, with emerging potential in bone repair. This review evaluates GPBM's therapeutic effects on bone-related cells (proliferation, differentiation, migration), inflammation, vascularization, and neuronal responses. Methods: We assessed the influence of different GPBM parameters, possible underlying molecular mechanisms, and prospects for in vivo applications based on available studies. Results: GPBM acts through mitochondria, opsins, and transient receptor potential vanilloid (TRPV) channels. The most effective irradiation method uses low irradiance (5.3-100 mW/cm²) with a single exposure of ∼5 J/cm². Excessively low irradiance is ineffective, while excessively high irradiance may cause inhibitory effects. GPBM enhances bone-related cell functions, suppresses inflammation, and promotes vascular and neuronal responses. Conclusions: GPBM shows promise for bone repair, but further research is needed to optimize parameters, clarify molecular mechanisms, and standardize clinical trial protocols to ensure reliable in vivo outcomes.

This split-mouth randomized study evaluated the effect of in-office tooth whitening with violet Light-Emitting Diode (LED) on gingival inflammation, assessed by gingival crevicular fluid (GCF) interleukin-6 (IL-6) level, histomorphology, and immunohistochemical analysis of Tumor Necrosis Factor (TNF-α) and Cluster of Differentiation 8 (CD8) expression, with and without gingival barrier protection. Thirteen volunteers requiring gingivoplasty were included. The whitening procedure was performed with parameters of 400 nm, 134J/cm², and 20 cycles of 30 sec with 60 sec of standby. Gingival surgery was performed 48 h post-whitening for histomorphology analysis, while GCF IL-6 levels were quantified using an Enzyme-Linked Immunosorbent Assay (ELISA). We also attempted immunohistochemical analysis of TNF-α and CD8 expression; however, the small gingival specimens, which were primarily epithelial tissue, limited the reliability of the results. No statistically significant differences were observed between sides for histomorphology or GCF IL-6. These findings suggest that LED whitening without a gingival barrier may not induce gingival inflammation. However, further studies with larger and gender-balanced samples, extended time points, and additional cytokine markers are needed to confirm these results.

Background: Photobiomodulation therapy has been widely used in various branches of regenerative medicine because it has the advantages of noninvasive, drug-free, and safe form of light therapy. However, the complexity of the parameters of low-level laser (LLL) hinders its wider clinical application. Materials and Methods: Mouse fibroblasts (L929) were cultured in vitro using an 810-nm diode laser with low-level mode (E1C 0.1 W, continuous; E1R 0.1 W, intermittent; E2C 0.5 W, continuous; E2R 0.5 W, intermittent). Cell migration ability was detected by in vitro scratch test. Cell proliferation ability was detected by cell counting kit-8 (CCK-8) assay. Reactive oxygen species (ROS) fluorescence intensity was detected by an inverted fluorescence microscope. Production of ROS was detected by flow cytometry. Results: Scratch results show that E1C and E2R significantly increased the cell migration rate compared with the E0 group (p < 0.001). E1R also enhanced cell migration (p < 0.01). CCK-8 results show that the increase in the optical density of E1R, E1C, and E2R was higher than that of E0 (p < 0.001). The E2C group did not facilitate cell proliferation. The results of ROS fluorescence analysis and flow cytometry analysis showed that the ROS produced by L929 cells irradiated with different modes of LLL were different. The ROS production of E2C cells was the highest, followed by E2R, E1C, and E1R, and the E0 group was the lowest, with a significant difference (p < 0.01). Conclusions: An 810-nm diode laser of 0.1 W with continuous pulse mode and 2 cm away from the wound can maintain the appropriate level of ROS, as well as effectively promote cell proliferation and migration.

Objective: Prolonged soft tissue anesthesia (STA) after dental treatments in children poses a risk of soft tissue injury (STI). This study aimed to systematically review the role of photobiomodulation therapy (PBMT) in reducing the duration of STA and incidence of STI after dental procedures. Methods: This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration code: CRD42024622981). Results: Five eligible studies were included, involving 32-60 participants between 4 and 10 years, utilizing a diode laser with various wavelengths (635, 660, 808, and 810 nm), energy densities (6-11.5 J/cm²), irradiation times (12-30 sec), and irradiation points (6-12). The results demonstrated a significant reduction in duration of STA in all studies (p < 0.05); however, the reduction in the incidence of STI remained inconclusive. Conclusions: PBMT may serve as a painless and acceptable method to reduce the duration of STA in pediatric dentistry; however, its positive role in preventing STI remains inconclusive in patients with normal intellectual abilities supervised by alert caregivers.

Background: Keloids and hypertrophic scars appear more frequently in people with darker skin tones, such as those of African, Asian, or Hispanic descent. The combination of CO₂ laser, pulsed dye laser (PDL), and triamcinolone was successful in treating a keloid. Aim: The purpose of this research was to assess the clinical efficacy of a multi-modal treatment protocol comprising a 595 nm PDL, fractional ablative CO₂ laser, 1540 nm nonablative laser, and intralesional corticosteroid injections for keloid management in Indian patients. Methods: A total of 30 patients with keloids were treated with a combination of two different lasers (595 nm pulsed/10,600 nm and 1540 nm fractional laser) and intralesional steroids injections. Clinical images were collected before treatment and at 9 months after the last treatment, and adverse effects were monitored throughout the study. Patients were assessed with the Detroit Keloid Scale before treatment and at follow-up. Results: After completing treatments, almost all patients showed improvement; in particular, a decrease in redness was noted, and the keloids appeared flatter. This improvement was also recorded through the Detroit Keloid Scale, where a significant 6-point decrease on the scale was recorded between baseline and follow-up (p < 0.01). Conclusions: This combined therapy is a good option for people with darker skin tones since it has been proven as an effective tool for managing keloid, especially for enhancing texture and decreasing redness with a lower risk of postinflammatory hyperpigmentation.

Background: Low-level laser therapy has gained increasing attention in the field of dentistry as a promising modality due to its photobiomodulatory effects that facilitate tissue regeneration. Accumulating evidence suggests that neodymium-doped yttrium aluminum garnet (Nd:YAG) and erbium-doped yttrium aluminum garnet (Er:YAG) lasers, when applied at low-energy settings, can enhance cellular proliferation and promote mineralization in osteoblasts and mesenchymal stem cells. Objectives: This study aimed to investigate the photobiomodulation effects of low-level Nd:YAG and Er:YAG laser irradiation on rat odontoblast-like cells, with a particular focus on cellular proliferation, differentiation, and mineralization in vitro. Methods: Rat odontoblast-like cells (MDPC-23) were subjected to Nd:YAG and Er:YAG laser irradiation at a frequency of 10 Hz, with energy settings of 60, 80, 100, and 120 mJ for exposure durations of 0, 2, 5, 10, and 15 sec, respectively. The effects of low-level laser irradiation on cellular proliferation, differentiation, and mineralization were systematically evaluated. In addition, intracellular reactive oxygen species (ROS) levels were quantified, and an NF-κB inhibitor was employed to investigate its involvement in the regulation of cell proliferation and differentiation. Statistical analysis was conducted using one-way analysis of variance followed by post hoc Tukey's HSD tests. Results: Both Nd:YAG and Er:YAG laser irradiation at the energy of 80 mJ for 10 or 15 sec enhanced cell proliferation, differentiation, and mineralization in MDPC-23 cells. An elevation in cellular ROS levels was observed after laser irradiation, and the laser irradiation in the presence of the NF-κB inhibitor resulted in decreased cell proliferation and ALPase activity. Conclusions: Low-level Nd:YAG and Er:YAG laser irradiation enhanced the proliferation, differentiation, and mineralization of odontoblast-like cells in vitro. These effects appear to be mediated by the activation of the NF-κB signaling pathway through ROS, thereby promoting cellular proliferation followed by differentiation and mineralization.