Faculty Bibliography

BACKGROUND: Traumatic tattoos result from accidental or unintentional deposition of exogenous pigment within injured skin. Pigments may consist of heavy metals, vegetable matter, or commercial dyes. OBJECTIVE: The clinical and histologic description of a traumatic tattoo resulting from a surgical procedure using undyed, braided, synthetic, absorbable suture material and its removal with the Q-switched ruby laser (694 nm, 28 nsec). METHODS: The pigmented linear lesion was biopsied and processed using standard histological methods. Subsequently, the area was treated on two occasions with the Q-switched ruby laser. RESULTS: The pigmented lesion was completely removed with the Q-switched laser treatments. CONCLUSION: We report on the occurrence of a traumatic tattoo resulting from synthetic suture material and complete removal with the Q-switched ruby laser

Cutaneous laser resurfacing is already proving to be a highly effective tool for improving photodamaged or scarred skin. The clinical and histological effects of the new high-energy, pulsed carbon dioxide (CO2) systems compare favorably with other treatments such as dermabrasion and chemical peels. The tissue-tightening effect noted after laser treatment may account for the claims of superior clinical improvement and needs further investigation

BACKGROUND. New 'char-free' carbon dioxide lasers are capable of precise tissue vaporization with minimal residual thermal damage. These lasers operate either by producing high energy, rapid pulses or by scanning a highly focused continuous mode beam. OBJECTIVE. To determine the depth of ablation and the depth of residual thermal injury produced with one to three passes of the pulsed and scanned systems. METHODS. The distal ends of preauricular donor skin from 12 patients requiring full-thickness skin grafts following Mohs micrographic surgery were treated with zero to three passes of each of the lasers, and fixed for histopathological analysis. RESULTS. The three lasers tested produced vaporization of thin (20-50 microns) layers of tissue and narrow (20-150 microns) zones of thermal injury following one, two, or three passes on intact skin. CONCLUSION. The pulsed and scanned technologies are capable of producing 'char-free' tissue ablation with minimal residual thermal damage

BACKGROUND: The Q-switched ruby laser has been used successfully to treat a variety of benign pigmented lesions. In this study, congenital nevi (diameter, < or = 5 cm) in 18 prepubertal children were treated with the Q-switched ruby laser. OBSERVATIONS: Photographic evaluation revealed an average of 57% clearance of pigmentation in all treated nevi by the fourth treatment session and an average maximum clearance of 76% after approximately eight sessions. Greater than 90% clearance of pigment was attained in five patients. Partial repigmentation was seen in all patients who were followed up after discontinuation of therapy. Findings from histopathologic studies, obtained from one patient, revealed reduction of nevus cells in papillary dermis and upper reticular dermis that correlated with clinical lightening. There was no such reduction in the lower reticular dermis. side effects were limited to transient erythema and hypopigmentation. CONCLUSIONS: The Q-switched ruby laser effectively lightens and may clear pigmentation and eliminate superficial nevus cells from small and medium congenital nevi safely without scarring. However, these results are not permanent. The Q-switched ruby laser may be a viable alternative for providing cosmetic improvement for unresectable lesions, but it should not be considered definitive treatment. Additional studies are needed to address the long-term results of this therapy

OBJECTIVE: To determine the safety and efficacy of the flashlamp-pumped pulsed dye laser for the treatment of uncomplicated and recalcitrant warts. DESIGN: Observational study. PATIENTS: A total of 142 patients with 703 recalcitrant and 25 previously untreated warts consecutively referred to two tertiary care laser centers from July 1993 through January 1994. INTERVENTION: Photocoagulation with the flashlamp-pumped pulsed dye laser. MAIN OUTCOME MEASURES: Complete resolution of treated warts after a follow-up ranging from 3 to 9 months. RESULTS: The overall response rates were 99% for body, limb, and anogenital warts; 95% for hand warts; 84% for plantar warts; and 83% for periungual warts. Side effects were limited and infrequent. CONCLUSION: Pulsed dye laser therapy is a highly effective and safe method used to selectively destroy warts without damaging the surrounding skin