Treatment Options for Congenital Birthmarks Explored in Study

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Combination surgical excision/laser treatment shows better clinical outcomes and patient satisfaction, according to a study published recently in Lasers in Surgery and Medicine, the official journal of the American Society for Laser Medicine and Surgery Inc (ASLMS).

Congenital melanocytic nevi (CMN) are nevi (birthmarks) that present at birth or arise within the first few weeks of life. For small to medium sized CMN, the current treatment of choice is staged surgical excision. Ablative lasers or pigment-specific lasers have also been recommended for lesions difficult for surgical removal or to avoid surgery.

In this study, researchers led by Jung Min Lim, MD, retrospectively analyzed the results of several treatment options for CMN to determine the optimal treatment method, according to a media release from ASLMS.

A total of 119 cases with small to medium sized CMN were retrospectively reviewed. Treatment options were categorized into four groups: (i) Excision only; (ii) Excision followed by scar laser; (iii) Excision followed by pigment specific laser; and (iv) Laser only.

For the treatment of small to medium sized CMN, treatment strategies including surgical methods are cosmetically superior to laser-only treatment. Also, the combination of surgical excision with scar laser has the potential for better clinical outcomes and patient satisfaction, per the release..

“This large-scale retrospective review about treatment options for small to medium congenital melanocytic nevi may give reassurance to clinicians seeking the best option for their patient, as large-scale assessments have never been made in this field,” says Lim, from the Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.

“It strongly supports the efficacy of surgical excision, which showed better cosmetic outcomes, while suggesting the need for improvement in laser-based treatment strategies. This review also promises the potential of combining scar lasers with surgical excision, which showed superior outcomes along with increased patient satisfaction.

“As various tools for treatment are constantly being developed, the comparison of different treatment strategies in a large scale will benefit the clinician in their daily practice,” Lim concludes, in the release.

[Source: American Society for Laser Medicine and Surgery Inc]

Ablative Fractional Skin Resurfacing Demonstrates Improved Scar Results

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A study assesses the efficacy of fractional CO2-laser treatment to improve the cosmetic outcome of skin grafts.

The study, led by Elisabeth Datz, MD, was published in Lasers in Surgery and Medicine, the official journal of the American Society for Laser Medicine and Surgery Inc (ASLMS).

In the study, two independent investigators evaluated adaptation of treated and non-treated sides of skin grafts to the surrounding skin on an 11-point scale. Pigmentation, resizing, and roughness of skin grafts were also objectively measured as well as patient satisfaction with the cosmetic result. Two treatments with the fractional CO2-laser had significantly improved adaptation to the surrounding skin in comparison to untreated controls 8 weeks, 6, and 12 months after the two treatments, according to a media release from ASLMS.

“No evidence-based clinical data on improving the appearance of skin grafts by fractional CO2- laser resurfacing have been available so far,” Datz says. “This is the first clinical trial that has shown that adaptation of the skin graft to the surrounding skin can be significantly improved with ablative fractional skin resurfacing.”

“Patient satisfaction with the appearance of the skin graft is also significantly higher after graft resurfacing. Thus, fractional skin resurfacing can be recommended for patients wishing to improve the appearance of their skin graft,” she adds.

[Source: American Society for Laser Medicine and Surgery Inc (ASLMS)]

Multicolor Tattoo Removal in Fewer Treatments

The first ever production picosecond‐domain laser with a 785 nm wavelength was recently developed to improve the rate of clearance of green, blue, and purple tattoo inks – often the colors most resistant to laser removal.

A clinical trial published in Lasers in Surgery and Medicine (LSM), the official journal of the American Society for Laser Medicine and Surgery Inc (ASLMS), investigated the safety and efficacy of the new 785 nm Ti-Sapphire laser for treating blue, green and purple tattoo inks as an addition to a picosecond-domain 1,064 nm and 532 nm laser platform. This first study of a new, 785 nm, picosecond-domain, laser-pumped-laser demonstrates safe and effective removal of multicolor tattoos.

The study, conducted by Eric F. Bernstein, MD, Jayant Bhawalkar, PhD, and Kevin T. Schomacker, PhD, titled “A Novel Titanium Sapphire Picosecond-domain Laser Safely and Effectively Removes Purple, Blue and Green Tattoo Inks,” was selected as Editor’s Choice in the September 2018 issue of LSM.

“The laser-pumped-laser concept enables delivery of multiple discrete wavelengths from a single laser platform. A commercial 785 nm Ti-Sapphire laser has been a long time coming,” Bernstein says. “Having a picosecond-domain version for treating blue, green and purple tattoos is a big advantage.”

[Source: American Society for Laser Medicine & Surgery Inc]