Faculty Bibliography

BACKGROUND: Despite the widespread and quite successful use of various lasers and light sources to treat facial erythema, the literature contains little, if any, objective and quantitative improvement. In addition, very few studies specifically address rosacea-associated erythema. OBJECTIVE: To assess quantitatively the degree of improvement in patients with rosacea after intense pulsed light treatment. The three main parameters that were objectively measured were blood flow, telangiectasia, and erythema. METHODS: Four patients with rosacea-associated erythema and telangiectasia were treated five times at 3-week intervals with the Photoderm VL (Lumenis, Needham, MA). The 515-nm filter, a single pulse duration of 3 ms, and various fluences were used. Blood flow was measured by the scanning laser Doppler. Close-up photography ensured reproducibility and enabled quantification of telangiectasia and erythema by subsequent computer image analysis. Measurements were taken at baseline and at 1 month after the last treatment. RESULTS: The scanning laser Doppler demonstrated a 30% decrease in blood flow (P<0.05). A 29% decrease in actual area of the cheek occupied by telangiectasia was noted (P<0.05). A 21% decrease in the intensity of erythema was noted (P<0.05). CONCLUSION: As demonstrated by truly objective and quantitative means, intense pulsed light is effective for reducing rosacea-associated blood flow, telangiectasia, and erythema

In the authors' experience, surgical repair of pitted scars, performed in conjunction with CO(2) laser resurfacing, produces no linear scars visible to the naked eye on the skin surface. Here, they describe their single-stage technique, suture-assisted resurfacing, in which, one-by-one, each ice-pick scar is incised with a triple bevel NoKor 18-gauge needle. (Aesthetic Surg J 2002;22:284-288.)

BACKGROUND: Molluscum contagiosum is usually a self-limited benign viral disease in children and young adults. In patients with acquired immunodeficiency syndrome (AIDS), however, the infection is often widespread, disfiguring, and recalcitrant to conventional therapy. OBJECTIVE: A treatment modality for widespread, recurrent molluscum contagiosum is necessary that is effective, safe, and simple. METHODS: Widespread molluscum contagiosum recalcitrant to conventional therapy in a patient with AIDS was treated with the 585-nm pulsed dye laser. RESULTS: There was a significant reduction in the number of molluscum contagiosum lesions following a single treatment with the pulsed dye laser. Treated-areas remained disease-free after 4 months. No complications were associated with the procedure. CONCLUSION: Pulsed dye laser treatment may offer another therapeutic modality that is effective and safe in the treatment of widespread and recurrent molluscum contagiosum

Twelve patients with multiple basal cell carcinomas resulting from varying causes were treated with high-dose oral isotretinoin (mean daily dosage: 3.1 mg/kg/day) for a mean of 8 months. Of the 270 tumors monitored in these patients, only 8% underwent complete clinical and histologic regression. All patients developed moderate to severe acute toxicities, leading five patients to withdraw from the study. Retinoid skeletal toxicity was identified in two patients who were examined after long-term therapy. Lower doses of isotretinoin (0.25 to 1.5 mg/kg/day) were ineffective for chemotherapy but demonstrated a chemopreventive effect in a subset of three patients who received these lower doses for 3 to 8 years. Two of these three patients have been observed after discontinuation of therapy. In one patient with a history of arsenic exposure, only one new tumor has appeared in a 27-month posttreatment observation period; in the other patient with the nevoid basal cell carcinoma syndrome, 29 new tumors have appeared within a 13-month period. This suggests that the need for long-term maintenance therapy with isotretinoin for chemoprevention of basal cell carcinoma may depend on the underlying cause of the skin cancers