Lasers in dermatology. A review.
The use of lasers in dermatology has become widespread over the past decade. This article reviews the types of lasers in current use and the skin problems that could benefit from their use.
Humans↗
Biomedical subjects
C H Dicken
Publications and source records attributed to C H Dicken.
A clinical and histopathologic study of granulomatous rosacea.
A retrospective clinical and histopathologic study of 53 patients with granulomatous rosacea was undertaken. The patients had a broad clinical spectrum of lesions that ranged from primarily erythema to papulonodular lesions. Extrafacial lesions occurred in 15% of patients. Histologic examination showed mixed lymphohistiocytic inflammation (primarily lymphocytic inflammation in 40% of patients and primarily histiocytic with a few giant cells in 34%), epithelioid granulomas in 11% of patients, and epithelioid granulomas with caseation necrosis in 11%. Most patients had a good response to oral antibiotic therapy. Granulomatous rosacea is not a distinct disease but can be regarded and treated as a subtype of rosacea.
Aged↗
Generalized lichen spinulosus in an HIV-positive man.
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Adult↗
Periorbital edema: an important physical finding in dermatomyositis.
Periorbital edema is frequently present in dermatomyositis and can be seen in the absence of other skin lesions. Sometimes, as in the two cases reported here, it can be the dominant physical sign.
Aged↗
Argon laser treatment of the red nose.
Ten patients with red nose due to telangiectasias were treated with the argon laser. Seven had telangiectasias due to rosacea, two had had rhinoplasty, and one had experienced trauma. All of the patients had a good clinical result.
Aged↗
Treatment of psoriasis with etretin: a preliminary report.
Eight patients with psoriasis (seven with plaque-type and one with palmoplantar pustular psoriasis) were treated with the synthetic retinoid etretin, the active metabolite of etretinate. An initial 8-week double-blind phase of the study with dosages of 0, 25, or 50 mg/day was followed by an open phase in which variable dosages of 25, 50, or 75 mg/day were used to achieve an optimal clinical response. All patients completed a minimum of 6 months of therapy. A good or an excellent response (at least 50% clearing) after 8 months of treatment was noted in six of the eight patients. One patient had a poor response (less than 50% clearing), and one patient continued to have worsening of psoriatic involvement during treatment. The best response occurred in those patients with the most extensive initial plaque involvement or palmoplantar pustulosis. The clinical side effects were similar to those reported with use of etretinate and seemed to be related to the dose. The laboratory abnormalities--primarily mild intermittent elevations of liver enzymes and elevations in serum lipids--were similar to those described in previous reports about etretinate. Both etretin and etretinate are potent teratogens. Because of its shorter half-life, etretin will likely be preferred, especially in female patients of childbearing potential.
Acitretin↗
Isotretinoin treatment of pityriasis rubra pilaris.
Five patients with pityriasis rubra pilaris were treated with isotretinoin from September 1982 through 1985. Isotretinoin at an average dose of 1.16 mg/kg/day for 16 to 24 weeks caused complete or almost complete clearing in four of the five patients.
Adolescent↗
Treatment of the red nose with the argon laser.
Nasal telangiectasias, a common condition, can be caused by chronic exposure to ultraviolet light, rosacea, topically applied corticosteroids, or rhinoplasty. Use of the argon laser for 15 to 45 minutes in a continuous mode over the entire involved area can produce considerable lightening of the nasal redness and improvement in the cosmetic appearance, as illustrated in the two cases described in this report.
Follow-Up Studies↗
Bowel-associated dermatosis-arthritis syndrome: bowel bypass syndrome without bowel bypass.
The bowel bypass syndrome is a well-recognized complication in patients who have had jejunoileal bypass for morbid obesity. It consists of an influenza-like illness with increased temperature, chills, polyarthralgia, myalgia, and inflammatory papules and pustules that are 2 to 4 mm in diameter and that usually appear on the extremities and the upper part of the trunk. A patient is reported who had an identical bowel-associated dermatosis-arthritis syndrome but who had not undergone a jejunoileal bypass operation. Seven previously reported similar cases are reviewed.
Adult↗
Elastolysis of the earlobes.
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Adolescent↗
Argon laser treatment of port-wine stains.
Port-wine stains, especially of the face, are frequently a severely disfiguring lesion. Previous treatment modalities have not produced satisfactory results. The argon laser can be of benefit: in more than 70% of patients who undergo this treatment, the lesion becomes lighter. Three cases are presented to illustrate the range of clinical results.
Adult↗
Neutrophilic dermatoses and myeloproliferative disease: report of two cases.
The term "neutrophilic dermatosis" has been suggested for a spectrum of skin lesions that have been noted in some patients with myeloproliferative diseases. These cutaneous conditions vary from plaques typical of Sweet's syndrome to bullous and pyodermatous lesions. We describe two patients with neutrophilic dermatoses and myeloproliferative disorders. Distinctive features included concurrent bullous pyodermatous lesions and characteristic lesions of Sweet's syndrome in one patient and overwhelming sterile pulmonary infiltration in the other patient. These disorders may be difficult to distinguish from acute infectious processes, and they may have systemic components, including pneumonitis. Possible therapeutic alternatives to systemic corticosteroid therapy are suggested.
Aged↗
Malignant pyoderma.
Malignant pyoderma is a destructive, ulcerating skin disease that occurs chiefly in young adults. Only eight cases of this rare disease have been reported. The head and neck have been involved in all cases, and a predilection for the periauricular region has been noted in several of the cases. Although the disease is progressive and chronic, responses to high-dose systemic corticosteroids have been noted, but usually a flare is associated with a reduction in dose. An additional case is described in which therapy with isotretinoin and sulfapyridine led to complete remission.
Adolescent↗
Pemphigus erythematosus, primary biliary cirrhosis, and D-penicillamine: report of a case.
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Adult↗
Hereditary acrolabial telangiectasia. A report of familial blue lips, nails, and nipples.
We describe a mother and two daughters who had the following clinical manifestations: bluish discoloration of the vermillion ridge of the lips, nipple areolae, and nail beds; discrete telangiectasia of the chest, elbows, and dorsa of the hands; varicosities of the lower part of the legs; and (in the two daughters) migraine headaches. Routine histologic examination of tissue from the lips and elbows disclosed extensive, dilated, horizontal subpapillary telangiectases. Enzyme histochemical stains demonstrated activity of adenosine triphosphatase and leucine aminopeptidase around these dilated vessels. Alkaline phosphatase activity was strikingly absent from the dilated subpapillary vessels. By electron microscopy, these vessels were demonstrated to be postcapillary venules. We propose an autosomal dominant mode of inheritance.
Adult↗
Inflammatory macular atrophy: immunofluorescent and ultrastructural findings.
In a patient with primary inflammatory macular atrophy, immunofluorescence studies disclosed both C'3 and IgM in a granular and fibrillar pattern in the dermis between the coagen fibers and at the basement membrane zone. Localization of C'3 to autofluorescent elastic fibers was demonstrated. Ultrastructural examination showed the presence of activated macrophages enveloping fragmented elastic fibers. Immunologic mechanisms may play a participatory role in some forms of macular atrophy.
Adult↗