Faculty Bibliography

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

BACKGROUND. Recent advances in carbon dioxide (CO2) laser technology have resulted in the development of lasers that can precisely remove thin layers of skin with minimal thermal damage to the surrounding tissue. These lasers rely on rapid pulsing or scanning of the laser beam. The effects of these lasers are predictable and reproducible, making them ideal for skin resurfacing. Clinical results have been promising, however, to date, no published series exist. OBJECTIVE. To evaluate the effectiveness and side effect profile of laser resurfacing utilizing a CO2 laser with a scanning device, and make recommendations for patient selection and treatment protocol. METHODS. Patients with perioral, periorbital, and glabellar rhytides were treated with a CO2 laser with a scanning device. Utilizing chart review and photographic evaluation, patients treated between November 1994 and April 1995 were retrospectively evaluated for effectiveness of therapy, healing time, and complication rates. RESULTS. A total of 47 patients were evaluated. Photographic evaluation or chart review revealed good to excellent cosmetic results in all anatomic areas studied. All patients experienced posttreatment erythema lasting 1-6 months. Other minor complications were limited to contact dermatitis to topical preparations, transient postinflammatory hyperpigmentation, and milia formation. One patient experienced a primary herpes simplex virus infection during reepithelialization and required intravenous therapy. Minor focal atrophy was seen in one patient. No hypertrophic scarring or permanent pigmentation changes were seen. CONCLUSIONS. A CO2 laser system with a scanning beam can effectively and safely improve or remove glabellar, perioral, and periorbital rhytides

BACKGROUND. Approximately 50-75% lightening of port-wine stains is achieved within two to three treatments with pulsed dye laser therapy, but the incidence of complete clearing is variable. OBJECTIVE. This study was designed to: 1) assess the ability of continued repetitive pulsed dye laser treatments to further lighten persistent port-wine stains; 2) evaluate the factors contributing to the resistance of port-wine stains to laser therapy; and 3) determine the relative risk of adverse effects following repetitive treatments to the same area. METHODS. A retrospective photographic analysis was performed of 69 patients that failed to achieve greater than 75% lesional lightening within nine treatment sessions. The percentage improvement was assessed by comparing the degree of lightening at the last treatment to that of the midway point of treatment. RESULTS. Significant improvement in port-wine stain lightening, from the midway to last treatment, was seen in patients who had 10-25 repetitive treatments. CONCLUSION. Repetitive treatments with the pulsed dye laser can lead to improvement in the overall lightening of persistent port-wine stains without an increased risk of adverse effects