Biomedical subjects
Publications and source records attributed to C Raulin.
Indications for dermatological laser therapy have been enlarged during the last few years. In this article the physics and biophysics of laser therapy and the common laser systems in dermatology are described. Modern pulsed laser systems are combined with little side effects. Nevertheless, successfully used alternative methods should not be neglected.
The Q-switched ruby laser (694 nm, 25-40 nsec) is an effective and safe therapeutic device for the treatment of tattoos and well-defined, benign, pigmented epidermal and dermal lesions. Because of its selective mode of action, dermal pigments of natural and artificial origin are destroyed photothermically and removed without scar. This method is exceptionally suited for the elimination of lay and professional tattoos, traumatic tattoos, and permanent makeup. Other frequent indications include benign pigmented lesions such as lentigines, freckles, café-au-lait spots, seborrheic keratosis, and Becker nevi. As a dermal pigmented lesion, the nevus of Ota is perfectly treatable. However, chloasma can no longer be considered an indication for ruby laser treatment due to unsatisfactory results. Melanocytic nevi and congenital nevi should be treated only in clinical studies. The effectiveness of the long-term epilation of dark hair with this laser device has to be verified in future investigations. Particularly attractive is the nonproblematic and straightforward removal of pigmented lesions in precarious anatomic regions like the lips, eyelids, and genitals (e.g., benign melanosis of the lips or of the penis, seborrheic keratosis of the lid angle).
BACKGROUND AND OBJECTIVE: The pulsed dye laser is effective and safe in the treatment of port-wine stains. It is the laser of choice for port-wine stains and initial superficial hemangiomas in children. For the treatment of darker port-wine stains in adults that have not responded to pulsed dye laser treatment, excellent results can be achieved using the PhotoDerm VL, a new technology based upon the emission of wide band, noncoherent intense pulsed light. STUDY DESIGN/PATIENT AND METHODS: Our report presents a patient with a facial port-wine stain that hardly responded to previous pulsed dye laser therapy. After the first ineffective treatment trial, the patient refused further dye laser applications. An intense pulsed light source (Photoderm VL) was applied instead. RESULTS: The lesion responded well after the first treatment session and was completely resolved after four treatments with the PhotoDerm VL. CONCLUSIONS: The new intense pulsed light source Photoderm VL seems to be a promising treatment alternative for the therapy of otherwise nonresponding port-wine stains due to its special technical features.
BACKGROUND AND OBJECTIVE: Sebaceous gland hyperplasia may be treated by cryotherapy, cauterization, topical chemicals, or excision. The major disadvantage of these therapeutic strategies is a considerable risk of postoperative scarring or dyspigmentation. The pulsed dye laser may be an effective and safe alternative treatment option. STUDY DESIGN AND METHODS: Our report presents two patients with sebaceous gland hyperplasia who were treated with the pulsed dye-laser (585 nm, 6.5-8 J/cm2, 300-450/microsecond). RESULTS: After 2-3 treatment sessions, the lesions were completely gone. To data, no side effects have been observed. CONCLUSIONS: Based upon our experiences, we recommend the pulsed dye laser as a safe, fast, and minimal straining treatment alternative for hyperplasia of sebaceous glands.
13 patients with pyogenic granuloma were treated with a CO2 laser using the continuous wave laser in all cases and using additionally the ultrapulsed laser in 7 patients. The pyogenic granuloma was removed in all patients in one session. Side effects included transient erythema in 8 patients and scars in 2 cases. There was no hypo- or hyperpigmentation. The use of the CO2 laser is a fast and bloodless way to treat pyogenic granuloma with slight side effects and is an elegant alternative to standard approaches.
The pulsed dye laser (wavelength 585 nm, pulse duration 0.3-0.45 ms) is very effective in the treatment of port-wine stains, beginning hemangiomas, telangiectasias, spider nevi, xanthelasma and red hypertrophic scarring. It is the laser of choice in the therapy of young patients with port-wine stains. The pulsed dye laser is limited by its relatively superficial penetration into the skin with a maximum of 1.5 mm.
By varying the light spectrum, impulse length, impulse sequences and fluences, the PhotoDerm VL allows a large choice of individual treatment parameters. Superficial as well as deeper localized vascular malformations (essential telangiectases, port-wine stains, Poikiloderma of Civatte, hemangiomatous malformations) and cosmetically bothering hypertrichosis can be treated successfully with this high intensity polychromatic pulsed light source.
BACKGROUND: For many years, the treatment of facial wrinkles has been performed exclusively by dermabrasion, chemical peeling, or surgical face lifting. However, the recently introduced carbon dioxide lasers which emit ultrashort coherent light beams enable the cosmetic surgeon to ablate superficial epidemic layers with absent or very limited side effects. The purpose of this paper is to compare laser skin resurfacing with classical face lifting and discuss the potentials and limitations of each method. METHODS AND PATIENTS: Three patients suffering from facial wrinkles on photoaged skin were treated with the ultrapulsed CO2 laser (UltraPulse 5000 C; wavelength 10,600 nm, pulse duration 0.6 to 0.9 ms, maximum pulse energy 500 mJ). This laser guarantees vaporization of very thin superficial skin layers without scarring and with minimizing lateral thermal injury due to extreme short pulse duration. A special handpiece (CPG) permits an exact approach and a bloodless ablation of relatively large areas of facial skin. The fourth patient underwent a surgical face lift due to the depth of wrinkles. RESULTS: Excellent cosmetic results were achieved in all three patients with superficial wrinkles who were treated by laser skin resurfacing. When treating deeper wrinkles, e.g., glabella or nasolabial fold, the surgical face lift is the preferred method. CONCLUSION: Ultrapulsed CO2 laser treatment expands the therapeutic options for superficial facial wrinkles, especially for perioral, periorbital, forehead, and cheeks wrinkles. It proves to be a safe and effective method with very limited if any side effects. Nevertheless, deeper wrinkles are still a domain of the classical face lift. The combination of both methods may improve the overall outcome in the future.
Hypertrichosis is an often stigmatizing cosmetic problem not only for women but also for male-to-female transsexual patients. The hitherto described therapeutic measures include chemical epilation, razoring, camouflage, electrolysis and thermolysis, and waxing. All of these measures are transient, more or less painful, and may lead to severe side effects (e.g., inflammatory responses and scarring). We report the successful treatment of the perioral and mandibular area of two transsexual patients (male to female), who we treated with a recently introduced intense, pulsed light source--the PhotoDerm VL. Two days after the nearly painless treatment, hair could be epilated easily with forceps. Biopsies of the treated area show an atrophy of the follicles, which can be contributed either to direct thermal injury or to an indirect photothermolytical effect. Six months after the last treatment, there is no local recurrence and no side effects.
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BACKGROUND: The flashlamp-pumped pulsed dye laser (585 and 577 nm) has proven to be a very effective and safe treatment option in the therapy of essential telangiectasias (ETE). Nevertheless, the postoperative intracutaneous hematomata, which most patients see as cosmetically disfiguring, always has been a matter of concern. OBJECTIVE: To test the efficacy and safety of a new, large spot size, intense pulsed light source, the PhotoDerm VL, which omits noncoherent light adjustable within the 515-1200-nm range, in the treatment of ETE. METHODS: Fourteen patients were treated with the PhotoDerm VL. They suffered from ETE of the face, postoperative teleangiectasis of the nose, ETE of both legs, and poikiloderma of Civatte. RESULTS: All treated lesions could be abrogated with excellent results by this new device. There were no unpleasant side effects of the treatment. Additionally, due to the large spot size (2.8 cm2), a larger area could be treated within one session. No anesthesia was required. CONCLUSION: The PhotoDerm VL is an innovative, highly effective, and comparably safe therapeutic alternative to the laser in the treatment of ETE. The rate of cosmetically relevant side effects is considerably smaller, the patient compliance is excellent, and the method can be applied easily in an outpatient setting.
UNLABELLED: BACKGROUND OF OBJECTIVE: Treatment of xanthelasma palpebrarum may prove difficult due to its delicate location at the periorbita and its sometimes extensive dimension. During recent years, carbon dioxide and argon lasers have been used with good results. However, local anesthesia is always required, and there is a concrete risk of scarring and pigmentation changes after the treatment. STUDY DESIGN/PATIENTS AND METHODS: In this case report, we describe for the first time the treatment of xanthelasmas with the pulsed dye laser. RESULTS: This technique can be carried out without anesthesia and shows excellent cosmetic results. CONCLUSION: We see the pulsed dye laser as a good alternative to the hitherto used other two laser types in the treatment of xanthelasma palpebrarum.
The Q-switched ruby laser (wave-length 694 nm, pulse duration 25 ns or 40 ns) causes selective damage to natural or artificial pigment. This laser has produced very good results in the treatment of amateur, professional and traumatic tattoos and of a number of benign pigmented lesions. We report on two patients with lentigines treated effectively with a Q-switched ruby laser.
The introduction of the UltraPulse Co2 laser has made it possible to remove wrinkles without scarring, especially in the perioral and periorbital area. Often only a single treatment session is required. The very short impulse duration of the laser is less than the thermal relaxation time of the skin, so that thermal damage and scanning of adjacent skin is almost non-existent. We report on a patient with perioral wrinkles who was treated by UltraPulse CO2 laser in a single sitting with a cosmetically excellent result. Another patient with acne scarring, and a third patient with wrinkles and acne scarring were also treated successfully in a single session.
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The Q-switched ruby laser (wave length 694 nm; pulse durations 25 ns or 40 ns) cause selective damage to natural and artificial skin pigments. Treatable lesions include benign pigmented growths (benign, lentigo, ephelides, caféau-lait spots and Becker's nevi), as well as amateur and professional tattoos. The Q-switched ruby laser is also very effective in the treatment of traumatic tattoos. We report our experiences with two patients whose traumatic tattoos resolved completely without any scarring after ruby laser therapy. Our findings show that Q-switched ruby laser treatment may represent the therapy of choice for these tattoos.
BACKGROUND: Two new types of lasers, the pulsed dye laser and the Q-switched ruby laser, have shown good to excellent results in the treatment of vascular malformations and benign pigmented lesions of the skin. A new and very effective alternative to pulsed dye laser is the recently introduced Photoderm VL. This device is based on the use of a wide-band non-coherent intense pulsed light source which emits a continuous spectrum in the range of 515 nm to 1200 nm. PATIENTS AND METHODS: More than a 1000 patients with a variety of lesions of the skin were treated by these new laser systems and the Photoderm VL. The Q-switched ruby laser (wavelength 694 nm, pulse duration 25 ns) is suitable for the treatment of benign lentigines, café-au-lait macules, seborrhoic ceratosis, tattoos, and traumatic tattoos. The pulsed dye laser (585 nm, 0,3-0,45 ms) treats nevi flammei, capillary hemangiomas, telangiectasias, xanthelasma, hypertrophic scarring, and adenoma sebaceum. In addition we present the facilities of the new Photoderm VL (515 nm-1200 nm, 0,5-20 ms) for the treatment of nevi flammei, benign hemangiomatous malformations, telangiectasias, erythrosis interfollicularis colli, hypertrophic scarring, and hypertrichosis. RESULTS AND CONCLUSIONS: the Q-switched ruby laser, the pulsed dye laser, and the Photoderm VL show excellent results in the treatment of lesions of the skin, which otherwise would have been difficult to treat of untreatable. The efficiency of the laser types presented is based on the theory of selective photothermolysis. Scarring is almost never seen and hypo- or hyperpigmentation is in most cases transient.