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Auricular keloids pose significant aesthetic and functional challenges, and traditional treatments often fall short in addressing these issues. Our study presents an innovative combined approach of ablative CO2 and dye laser therapy for improved keloid management. This treatment protocol was applied to 15 patients with auricular keloids after an initial multispectral analysis to assess keloid composition. The laser sequence was tailored per patient based on this analysis. Evaluations using the Vancouver Scar Scale and Patient and Observer Scar Assessment Scale were carried out at baseline and at 3-week intervals post-treatment. The results showed a significant reduction in these scores at the final follow-up (p < 0.05), suggesting improvements in keloid color, texture, and pliability, with minimal adverse events. Additionally, no recurrence of keloids was observed. Our findings indicate that this novel methodology of multispectral analysis followed by tailored laser therapy may offer a safe and effective solution for auricular keloids, promising enhanced keloid treatment and prevention of recurrence. However, further investigations, including randomized controlled trials, are needed to confirm and optimize this treatment protocol.

Several studies confirmed the role of Pulsed Dye Laser (PDL) in successfully treating keloids. To our knowledge, this is the first study conducted entirely in children (<14 years old). Case notes and photographic records of 16 pediatric patients with keloids treated with PDL at our centre between 2012 and 2019 were reviewed. The red tone of the lesion before the first treatment, number of sessions, clinical improvement, and the evaluation of the satisfaction of patients have been reported. An excellent clearance has been achieved in 7 out of 16 (43.8%) cases, a good-moderate clearance in 7 patients (43.8%), and a slight clearance in 2 patients (12.4%). No patients detected absent or low results. A total of 13 out of 16 patients (81.2%) were satisfied. Lesions of higher red-tone grades were able to take advantage of multiple treatment sessions. PDL is an effective treatment of keloids in the pediatric population, characterized by a good safety profile and high satisfaction. We observed good results treating the active remodeling lesions with a higher red tone. These data have to be confirmed with further studies in a larger set of pediatric patients.

No particular regimen is considered standard therapy for widespread metastatic melanoma, although surgery is the primary choice for regional nodal metastases. Systemic interleukin-2 (IL-2) is an effective immunotherapy for melanoma, but standard doses are associated with severe toxicity. We report a patient who was treated with intralesional low-dose IL-2 and V-beam pulsed dye laser for the treatment of scalp melanoma metastases. This treatment resulted in rapid regression of metastatic tumors with limited adverse effects.

Previous clinical studies have shown that pulsed dye laser (PDL) and intense pulsed light (IPL) are effective for treating erythematotelangiectatic rosacea(ETR). This article aims to compare the efficacy and safety of PDL and IPL at three different wavelength bands (broad-band, single-narrow-band, and dual-narrow-band) in treating ETR. Sixty subjects with ETR were randomly categorized into four groups and received one of the following laser treatments: PDL (595 nm), IPL with Delicate Pulse Light (DPL, 500–600 nm), IPL with M22 590 (590–1200 nm), or IPL with M22 vascular filter (530–650 nm and 900–1200 nm). Four treatment sessions were administered at 4-week intervals, with one follow-up session 4 weeks after the final treatment. The efficacy of the four lasers was evaluated by comparing the clinical symptom score, total effective rate, VISIA red area absolute score, and RosaQoL score before and after treatment. The safety was evaluated by comparing adverse reactions such as pain, purpura, erythematous edema, and blister. All 60 subjects completed the study. Within-group effects showed that the clinical symptom score, VISIA red area absolute score, and RosaQoL score of all four groups were significantly reduced compared to before treatment (p < 0.001). Between-group effects showed no statistically significant difference among the four laser groups. Safety analysis showed that all four lasers were safe, but the incidence of blister was higher in the M22 vascular group. Nonpurpurogenic PDL, DPL, M22 590, and M22 vascular were equally effective in treating ETR and were well-tolerated. ClinicalTrial.gov Identifier: NCT05360251.

Background Top surgery masculinizes the chest appearance for transgender men (TM); however, some individuals may experience hypertrophic scars (HTS) or keloids following the surgery. Objectives This study aimed to evaluate the efficacy of combined 595‐nm pulsed dye laser (PDL) and intralesional triamcinolone acetonide injection (IL TAC) compared to IL TAC monotherapy for treating HTS and keloids. Methods Twenty‐five TM with 35 pairs of bilateral symmetric postmastectomy HTS or keloids were randomly allocated to receive the combined PDL and IL TAC on the scar(s) on one side of the chest and IL TAC monotherapy on the contralateral scar(s) in four monthly treatment sessions. Clinical improvement was evaluated using the Vancouver Scar Scale (VSS). Melanin index, hemoglobin index, and scar roughness were determined before each treatment session and at 1, 3, and 6 months after the last treatment. Participant‐rated satisfaction and adverse events were documented. Results After two treatment sessions, scars treated with combined PDL and IL TAC demonstrated significantly greater improvements in the VSS (p = 0.012) and melanin index (p = 0.004) compared to those treated with IL TAC alone. The superior outcomes of the combined therapy persisted for 3 and 6 months after the end of treatment sessions for the VSS (p = 0.001) and melanin index (p = 0.048), respectively. Participants reported higher satisfaction for combined PDL and IL TAC than IL TAC monotherapy (p = 0.005). No serious or permanent adverse event was reported. Conclusion The addition of 595‐nm PDL to IL TAC may provide more favorable outcomes for treating postmastectomy HTS and keloids among TM.

The tendency to use less-invasive laser-based methods with far more obvious effectiveness has been taken into consideration today for improvement of burning scars. The present study thus aimed to assess the efficacy of two laser-based techniques including pulsed dye laser (PDL) and ablative fractional CO2 laser (AFCL) and its combination on improving different aspects of burning scars regardless of the types of scar as hypertrophic or keloid scars. This randomized single-blinded clinical trial was performed on patients suffering hypertrophic or keloid burning scars. The patients were randomly assigned into three groups scheduling for treatment with PDL alone, AFCL alone, or its combination. All patients were visited before and 40 days after the last treatment session, and their scars were assessed. In all groups, significant improvement was revealed in the Vancouver scar scale (VSS) score, the color of scar, vascular bed in the scar, the and height of scar and its pliability; however, the improvement in each item was more highlighted in the group receiving a combination therapy with PDL and AFCL techniques. In this regard, the highest improvement was found in vascular bed and pliability in the combination therapy group as compared to other groups. Although the superiority of the combined group was not statistically significant, due to the high percentage of improvement in total VSS and most of its indicators, it can be clinically significant. The efficacy of the treatment protocols was different considering subgroups of mature and immature scars (less than 1 year), so that more improvement in pliability of scar, vascularity, and color of scar was found in the group scheduling for PDL + AFCL as compared to those who were treated with PDL alone in immature scar group but not in mature scar group. Combined treatment can be much more effective in improving the appearance and pathological characteristics of scars than each individual treatment. This effectiveness can be seen mainly in immature scars.

Background Comedone extraction provides greater satisfaction for acne treatment than conventional treatment alone; however, post‐comedone extraction erythema (PCEE) remains a concern for patients. Objectives To evaluate the efficacy of pulsed‐dye laser (PDL) in PCEE and comedone reduction. Methods Mild‐to‐moderate acne patients were randomly allocated in split‐face fashion. Three comedones were extracted on each facial side. On the PDL‐treated side, 595‐nm PDL was delivered to the entire side with an additional shot on three comedone‐extracted sites. Erythema index (EI) and total acne lesion counts (TALC) were evaluated at baseline, week 2 and 4. The comprehensive acne severity scale (CASS) was assessed by three blinded independent pediatric dermatologists. Participant satisfaction surveys were completed at the end of the study. Results Thirty‐five participants (age 12.9–24.2 years) showed no differences in the EI and TALC at baseline on both sides. At weeks 2 and 4, the EI on the PDL‐treated side was significantly lower (p < 0.001) with a greater EI reduction (p < 0.001) when compared to the control side regardless of gender and menstruation. There was significantly lower TALC on the PDL‐treated side at week 2 (p < 0.001) and week 4 (p = 0.02). No complications were noted with high participant satisfaction reported (median 8; IQR 7–9). PDL remained significantly associated with EI improvements after controlling for gender, menstruation cycle, and examination stress. Conclusion PDL can be an adjunctive intervention for the treatment of PCEE and comedone reduction due to its effectiveness and high participant satisfaction.

Background Acne vulgaris is a common inflammatory disease associated with various sequelae after skin lesion remission. Acne erythema has been considered simple erythema or a vascular lesion; however, because the understanding of this disease has improved, acne erythema is currently considered an early scar with erythematous components. Aims This study evaluated the efficacy of using both a 595‐nm pulsed dye laser (PDL) and 1565‐nm nonablative fractional laser (NAFL) for the treatment of erythematous scars caused by acne. Methods Ninety patients with acne scars were equally randomized to two groups. Group A (n = 45) received treatment with the NAFL. Group B (n = 45) received treatment with the PDL and NAFL. Each patient underwent one treatment session and 4 weeks of follow‐up. Results Qualitative (χ2 = 12.415; p < 0.05) and quantitative (t = 2.675; p < 0.05) scores of Groups A and B were determined using a global scarring grading system and exhibited statistically significant differences. The quantitative score of Group A was higher than that of Group B (6.67 ± 3.46 vs. 4.98 ± 2.44). The erythema areas of the groups differed significantly after treatment, with Group B exhibiting more notable score improvements (5.00 [3.10, 7.10] vs. 2.80 [1.65, 4.60]; Z = 3.072; p < 0.05). The erythema regression rate of Group B (88.9%) was significantly higher than that of Group A (66.7%) (χ2 = 20.295; p < 0.001). Adverse events, including redness and swelling (86.6%), scabbing (78.8%), and purpura (36.6%), occurred within 7 days for 86.6% of patients. Conclusions The combined use of the PDL and NAFL is safe and effective for erythematous acne scars.

Background Pulsed‐dye lasers (PDL) are one of the standard therapies for rosacea, but alternatives are needed. Aims To compare the efficacy and safety of the variable‐sequenced, large‐spot 532 nm KTP laser to the 595 nm PDL in treating rosacea. Materials and Methods A prospective, controlled, evaluator‐blinded study. Patients were treated with either a KTP or PDL with 1–3 sessions at intervals of 6–8 weeks. A follow‐up visit was scheduled on Week 6 post‐treatment. Clinical outcome was assessed by computer‐assisted analysis and by patients and two blinded dermatologists. Pain intensity during treatment and adverse events were documented. Results Forty‐five patients (mean age 51 years) were allocated in a 2:1 ratio to either the KTP or PDL. Erythema in both treatment arms decreased significantly (p < 0.01). Clinical evaluation revealed high improvement. Mean pain intensity was significantly lower with the KTP (2.5/10) than with the PDL (4.1/10). Both lasers showed a good safety profile. Relevant purpura was only seen in the PDL group. Conclusions Both the variable‐sequenced, large‐spot KTP and the PDL demonstrated comparable efficacy in treatment of rosacea. Regarding safety, the KTP exhibited fewer post‐treatment reactions. The KTP might serve as a potential alternative to PDL in the treatment of rosacea.

A 6-month interval between systemic isotretinoin (ISO) and the initiation of energy-based interventions has been recommended, due to concerns about keloid formation and delayed wound healing. While this postponement goes against the current trend of early intervention for acne scarring. This systematic review evaluates the efficacy, safety, and patient satisfaction of combinations of ISO with energy-based devices (EBD). PubMed, Embase, Web of Science, Cochrane Library, and Cochrane Central Register of Controlled Trials were comprehensively searched up to April 2023 according to PRISMA guidelines. Two independent reviewers screened the titles and abstracts to select articles. The quality of the literature was assessed for each study design. A total of 16 studies addressing the efficacy and safety of energy-based modalities combined with ISO were identified, including six randomized controlled trials (RCTs), two case series, seven cohort studies, and one case report. ISO combinations with intense pulsed light (IPL), fractional ablative CO laser, pulsed dye laser (PDL), non-ablative fractional laser (NAFL) and fractional microneedle radiofrequency (FMRF) have been tested for improving acne severity, acne scarring and erythema. The current evidence does not justify delaying the use of EBDs for patients who have recently undergone or are currently receiving ISO treatment. Evidence-based treatments such as PDL, NAFL, and FMRF etc. are suggested relatively safe and effective in treating acne and acne scarring.