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Jeffrey S. Dover - One of the best experts on this subject based on the ideXlab platform.
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clinical effect of a single Pulsed Dye Laser treatment of fresh surgical scars randomized controlled trial
Dermatologic Surgery, 2006Co-Authors: Murad Alam, Jeffrey S. Dover, S Van Laborde, Michael S Kaminer, Kenneth A ArndtAbstract:BACKGROUND Pulsed Dye Laser has been used to decrease erythema and telangiectasia associated with scars, including surgical scars. There is limited evidence indicating improved surgical scar appearance if Pulsed Dye Laser treatments are commenced immediately at the time of suture removal. OBJECTIVE To determine whether a single one-pass Pulsed Dye Laser treatment at the time of suture removal can improve the appearance of surgical scars. METHODS Randomized controlled trial enrolling 20 patients (complete data for 17 patients) at two geographic sites, with blinded ratings of pre- and post-treatment photographs obtained at various time points. Included patients underwent elliptical excision for atypical nevi of the trunk and/or extremities, with at least one resulting scar of at least 5 cm in length or two scars of at least 2.5 cm in length. For each patient, each scar or half-scar (if a larger scar was used) was randomized to treatment or control groups. Treatment scars received a single one-pass treatment with a 595 nm Pulsed Dye Laser (Vbeam, Candela Corporation, Wayland, MA, USA) at the time of suture removal (ie, 2 weeks after excision) at the following parameters: 7 J/cm2 fluence, 7 mm spot size, 1.5-millisecond pulse duration, and 30-millisecond spray, 20-millisecond delay of dynamic cooling. The treatment area included 1 cm on either side of the scar, and the round Laser spots were overlapped 10%. Control scars were not treated with Laser. RESULTS Immediate purpura was induced from the Laser treatment. Six weeks after Laser treatment, no significant difference was found in the clinical appearance of surgical scars treated with a single Pulsed Dye Laser treatment on suture removal day versus those surgical scars not treated with Laser. Parameters on which no significant difference was found included visibility of incision, erythema, hyperpigmentation, hypopigmentation, induration, and atrophy. Both sets of scars improved over time. CONCLUSIONS A single Pulsed Dye Laser treatment at the time of suture removal does not appear to have a beneficial effect on clinical scar appearance. The point of minimal benefit for such Laser treatments may lie somewhere between one and three treatments.
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Understanding Pulsed-Dye-Laser Treatment of Rosacea
NEJM Journal Watch, 2004Co-Authors: Jeffrey S. Dover, FrccpAbstract:The Pulsed Dye Laser (PDL) effectively reduces the redness, telangiectasia, and, occasionally, the flushing of rosacea. Patients with rosacea commonly
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Pulsed-Dye Laser Heals Ulcerated Hemangiomas
NEJM Journal Watch, 2003Co-Authors: George J. Hruza, Jeffrey S. Dover, FrcpcAbstract:The Pulsed-Dye Laser (PDL) is used to treat the superficial component of hemangiomas. However, its effectiveness for ulcerated lesions is
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Adverse Effects of Pulsed Dye Laser for Port-Wine Stains
NEJM Journal Watch, 1997Co-Authors: Jeffrey S. DoverAbstract:Because of its high rate of clearing and low incidence of adverse effects, the Pulsed Dye Laser has become the treatment of choice for port-wine
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Long-Pulsed Dye Laser for Treatment of Leg Telangiectasia
NEJM Journal Watch, 1997Co-Authors: Jeffrey S. DoverAbstract:The 585-nm 450-μsec Pulsed Dye Laser is an effective treatment for port-wine stains and other facial vascular abnormalities, but abnormalities of the
R G Geronemus - One of the best experts on this subject based on the ideXlab platform.
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Treatment of spider veins with the 595 nm Pulsed-Dye Laser
Journal of The American Academy of Dermatology, 1998Co-Authors: Eric F. Bernstein, R G Geronemus, J Lowery, D B Brown, G Lask, James C. HsiaAbstract:Abstract Background: Previous attempts to treat spider veins with the conventional 585 nm Pulsed-Dye Laser with a 0.5-ms pulse duration have been relatively ineffective. Recently, a new Pulsed-Dye Laser that is tunable from 585 to 600 nm with a pulse duration 3 times longer than previously available Lasers has preliminarily been shown to be effective for treatment of spider veins. Objective: Our purpose was to evaluate the effectiveness of multiple treatments with the tunable long-pulse Dye Laser in treatment of spider veins of the lower extremity. Methods: Ten female volunteers were treated in two separate areas containing blue or red linear spider veins less than 1.5 mm in diameter. Treatments were administered with the Pulsed-Dye Laser with a 1.5-ms pulse duration and 595-nm light at fluences of 15 and 20 J/cm 2 , and each subject received a total of 3 treatments at each site, administered at 6-week intervals. Photographs were taken before and 6 weeks after the last treatment. Results: Computer-based image analysis showed clearing of more than three fourths of veins after 3 treatments with 15 or 20 J/cm 2 . Side effects were minimal and the treatments were well tolerated. Conclusion: The 595 nm, 1.5 ms pulse duration, Pulsed-Dye Laser is safe and effective for treating blue or red spider veins of the lower extremities less than 1.5 mm in diameter in nontanned patients with Fitzpatrick skin types I and II. Multiple treatments improve on the results obtained after a single treatment. (J Am Acad Dermatol 1998;39:746-50.)
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Pulsed Dye Laser treatment of warts
Archives of Family Medicine, 1995Co-Authors: Arielle N B Kauvar, David H Mcdaniel, R G GeronemusAbstract: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.
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Pulsed Dye Laser Treatment of Vascular Lesions in Children
The Journal of Dermatologic Surgery and Oncology, 1993Co-Authors: R G GeronemusAbstract:background. The flashlamp-pumped Pulsed Dye Laser (577, 585 nm) with 300 to 450 μsecond pulsewidths has been demonstrated to effectively and safely treat portwine stains, telangiectases, and superficial hemangiomas in children. objective. The objective of this manuscript is to review the indications of the Pulsed Dye Laser in the treatment of vascular lesions in children. conclusion. Pulsed Dye Laser treatment of port-wine stains can remove or lighten the lesions with multiple treatment sessions. Spider telangiectases respond with complete resolution, usually within one to two treatment sessions. Superficial hemangiomas respond quite easily and effectively with the Pulsed Dye Laser, while a more variable response is noted in deeper hemangiomas, early proliferative lesions, and ulcerated hemangiomas. This procedure is safe with a low incidence of scarring and pigmentary alteration.
Eric F. Bernstein - One of the best experts on this subject based on the ideXlab platform.
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Laser treatment of dyschromia with a novel 607 nm Pulsed-Dye Laser.
Journal of Drugs in Dermatology, 2011Co-Authors: Eric F. Bernstein, Jay Bhawalkar, Joan Clifford, James White, James C. HsiaAbstract:BACKGROUND: Due to the hemoglobin-selective wavelength of the 595 nm Pulsed-Dye Laser, it is a device of choice for treating cutaneous vascular lesions. However, it is less effective and removing dyschromia, which along with hypervascularity is a cardinal sign of cutaneous photodamage. A novel 607 nm Dye Laser was developed as a first step in creating a dual-wavelength Pulsed-Dye Laser. STUDY DESIGN/MATERIALS AND METHODS: Twenty-five subjects with dyschromia on the chest due to chronic photodamage were enrolled into an open-label study to explore the safety and efficacy of a 607 nm Pulsed-Dye Laser, with 22 completing the study. Two treatments were administered to the chest, one month apart, with fluences ranging from 3-6 J/cm,2 using a 10 mm diameter spot and pulse duration of 1.5 msec. Cross-polarized digital photographs were taken before and two months following the final treatment and rated for improvement by physicians in a blinded fashion. RESULTS: Improvement was rated on a five-point scale with no subjects rated as poor(less than 25%) clearance, three subjects (13.6%) demonstrating fair (26-50%) improvement, seven subjects (31.8%) rated as good (51-75%) improvement, 12 (54.5%) were rated as excellent (76-95%) improvement, while none were rated as outstanding improvement (greater than 95%). CONCLUSION: This is the first study of the 607 nm Pulsed-Dye Laser which showed it to be safe and effective for treating dyschromia of the chest due to chronic photodamage, and may in the future expand the ability of the Pulsed-Dye Laser to treat photodamaged skin.
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High-energy 595 nm Pulsed Dye Laser improves refractory port-wine stains.
Dermatologic Surgery, 2008Co-Authors: Eric F. BernsteinAbstract:BACKGROUND Port-wine stains respond quite well to 585 nm Pulsed Dye Laser treatment, but often clearance is not complete. We investigated a prototype, a high-energy 595 nm Pulsed Dye Laser capable of delivering up to 9.5 J/cm2 using a 10 mm circular spot, with a 1.5 ms pulse duration. OBJECTIVE This study was undertaken to determine if the high-energy, 595 nm, variable-pulse duration Pulsed Dye Laser could improve port-wine stains that had become refractory to conventional treatment. METHODS Twenty patients were entered into the study and treated with the high-energy, 595 nm, variable-pulse duration Pulsed Dye Laser using fluences ranging from 7.5 to 9.5 J/cm2, a 1.5 ms pulse duration, and a 10 mm spot size. RESULTS Average improvement was rated as 40% prior to the initiation of the study after an average of 8.8 treatments at an average energy of 7.9 J/cm2 with the 585 nm Pulsed Dye Laser and 76% following an average of 3.1 treatments with the high-energy 595 nm Pulsed Dye Laser using an average fluence of 7.9 J/cm2. Dermal spectrometer erythema measurements improved from 2.2-fold that of normal skin to 1.5-fold that of unaffected skin. CONCLUSIONS The high-energy 595 nm Pulsed Dye Laser improves port-wine stains that have become refractory to the conventional 585 nm Pulsed Dye Laser.
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rosacea treatment using the new generation high energy 595 nm long pulse duration Pulsed Dye Laser
Lasers in Surgery and Medicine, 2008Co-Authors: Eric F. Bernstein, Albert KligmanAbstract:Background and Objectives Rosacea results from sun-induced hyper-vascularity of exposed facial skin, often accompanied by acneiform papules and pustules. The Pulsed-Dye Laser has an unparalleled safety record and emits an ideal wavelength for treating the abnormal vessels that occur in rosacea patients. In this study we investigate the ability of the long pulse-duration Pulsed-Dye Laser to improve rosacea. Study Design/Materials and Methods Twenty subjects with rosacea were treated with the high-energy, long pulse-duration Pulsed-Dye Laser. An elliptical spot and long pulse-duration was used to spot-treat linear telangiectasias, while a circular spot and short pulse-duration was used to treat the entire face. Improvement was determined by blinded evaluation of photographs and by the treating physician's subjective evaluation, before and 8 weeks following the final treatment. Results The average rosacea score as estimated by the treating physician decreased from 2.7±1.1 to 1.4+ 0.7 (mean+SD) on a 0–6 scale with 0 representing no rosacea and 6 representing the most severe rosacea (P<0.001 level). The average rosacea score as rated by blinded physician observers scoring digital photos was 2.3±1.3 before treatment and 1.4±0.9 8 weeks following treatment, using a 0 (mild) to 6 (severe) scale. Conclusions The high-energy, long pulse-duration Pulsed-Dye Laser improves rosacea with a very favorable safety profile, and less purpura than resulted from earlier generation Pulsed-Dye Lasers. Lesers Surg. Med. 40:233–239, 2008. © 2008 Wiley-Liss, Inc.
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Pulsed Dye Laser therapy for sun damaged skin
Lasers in Surgery and Medicine, 1999Co-Authors: Brian D Zelickson, Eric F. Bernstein, Suzanne L Kilmer, Vera Chotzen, Jayson Dock, David A Mehregan, Charlotte ColesAbstract:Objective The objective of this study was to evaluate the effectiveness of the Pulsed Dye Laser (585 nm, 450 ms) in the treatment of sun induced wrinkles. Design Patients had one Pulsed Dye Laser (585 nm) treatment. The treated areas were assessed by the following methods: grading of skin wrinkles at 6 weeks, 12 weeks, and 6–14 months after treatment by blinded observers and by light and electron microscopy. Setting An ambulatory care center at Abbott Northwestern Hospital (ANH) and the Laser & Skin Surgery Center of Northern California (LSSCNC). Patients Twenty patients were treated, half with mild to moderate and half with moderate to severe sun induced skin wrinkles. Results At last follow up 90% (9/10) of the mild to moderate wrinkles and 40% (4/10) of the treated patients with moderate to severe wrinkles had clinically observable improvement in their sun induced skin wrinkles. Histologic examinations of the treated areas showed a superficial dermal band of well organized elastin and collagen fibers replacing pre-treatment elastic tissue. Increased cellularity and mucin deposition was consistent with dermal collagen remodeling. Lasers Surg. Med. 25:229–236, 1999. © 1999 Wiley-Liss, Inc.
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Treatment of spider veins with the 595 nm Pulsed-Dye Laser
Journal of The American Academy of Dermatology, 1998Co-Authors: Eric F. Bernstein, R G Geronemus, J Lowery, D B Brown, G Lask, James C. HsiaAbstract:Abstract Background: Previous attempts to treat spider veins with the conventional 585 nm Pulsed-Dye Laser with a 0.5-ms pulse duration have been relatively ineffective. Recently, a new Pulsed-Dye Laser that is tunable from 585 to 600 nm with a pulse duration 3 times longer than previously available Lasers has preliminarily been shown to be effective for treatment of spider veins. Objective: Our purpose was to evaluate the effectiveness of multiple treatments with the tunable long-pulse Dye Laser in treatment of spider veins of the lower extremity. Methods: Ten female volunteers were treated in two separate areas containing blue or red linear spider veins less than 1.5 mm in diameter. Treatments were administered with the Pulsed-Dye Laser with a 1.5-ms pulse duration and 595-nm light at fluences of 15 and 20 J/cm 2 , and each subject received a total of 3 treatments at each site, administered at 6-week intervals. Photographs were taken before and 6 weeks after the last treatment. Results: Computer-based image analysis showed clearing of more than three fourths of veins after 3 treatments with 15 or 20 J/cm 2 . Side effects were minimal and the treatments were well tolerated. Conclusion: The 595 nm, 1.5 ms pulse duration, Pulsed-Dye Laser is safe and effective for treating blue or red spider veins of the lower extremities less than 1.5 mm in diameter in nontanned patients with Fitzpatrick skin types I and II. Multiple treatments improve on the results obtained after a single treatment. (J Am Acad Dermatol 1998;39:746-50.)
Arielle N B Kauvar - One of the best experts on this subject based on the ideXlab platform.
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Pulsed Dye Laser treatment of warts
Archives of Family Medicine, 1995Co-Authors: Arielle N B Kauvar, David H Mcdaniel, R G GeronemusAbstract: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.
Christian Raulin - One of the best experts on this subject based on the ideXlab platform.
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Treating REM syndrome with the Pulsed Dye Laser.
Lasers in Surgery and Medicine, 2020Co-Authors: Baerbel Greve, Christian RaulinAbstract:Background and Objective REM syndrome (reticular erythematous mucinosis) is a benign but bothersome skin disease that common occurs in middle age and among women. Local and systemic treatment measures are often associated with a high rate of side effects and relapses are common. We evaluated the Pulsed Dye Laser as an alternative method because of its good efficacy in vascular skin diseases. Study Design/Materials and Methods We treated two female patients with REM syndrome using the Pulsed Dye Laser. Results In both patients the erythematous skin changes were almost completely removed after five and three Laser sessions, respectively. Other than transient hypopigmentation, no side effects occurred. In one case there is still no evidence of recurrence 6 years after a trial treatment was conducted. In the same patient, clinical success was histologically confirmed. Conclusions This is the first report on the successful treatment of REM syndrome of two female patients with the Pulsed Dye Laser. Lasers Surg. Med. 29:248–251, 2001. © 2001 Wiley-Liss, Inc.
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Reticulohistiocytoma. Treatment with Pulsed-Dye Laser
Hautarzt, 2004Co-Authors: Warncke Sh, Bärbel Greve, Christian RaulinAbstract:Reticulohistiocytoma is a rare non-Langerhans-cell histiocytosis. On exposed skin areas it is a cosmetic problem and can cause mechanical irritation due to its prominent nature. We successfully treated a histologically confirmed reticulohistiocytoma on the back of a 60 year old woman with a Pulsed Dye-Laser (wavelength 585 nm, pulse 0.45 msec). The lesion regressed significantly after the first treatment (spot size: 7 mm, fluence 7.8 J/cm(2)). After another Laser treatment, the lesion completely disappeared. At 28 month follow-up, no recurrence was seen. Permanent side effects were not observed. In our case report the use of the pumped Pulsed Dye-Laser has proven to be an elegant and low risk treatment option for reticulohistiocytoma. The mechanism of action remains unknown.
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Lichenoid dermatitis-treatment with Pulsed Dye Laser: A case study
Lasers in Surgery and Medicine, 2002Co-Authors: Bärbel Greve, Wolfgang Hartschuh, Christian RaulinAbstract:Background and Objectives Both the diagnosis and the treatment of lichenoid dermatosis are often difficult and can be time-consuming. There are now more and more publications about the use of Laser systems—especially the flashlamp-pumped Pulsed Dye Laser—in the treatment of inflammatory dermatoses, although the Laser's exact mechanism of action in these cases is not yet clear. Study Design/Patients and Methods We report on a female patient with lichenoid dermatitis that was presumably drug-induced (roxatidine, H2 receptor antagonists). After a 10-month treatment with local corticosteroids, without significant clearance the drug was discontinued and the Pulsed Dye Laser was used (wavelength 585 nm, pulse duration 450 microseconds). Results Six Laser treatments resulted in complete clearance of the lesions. No recurrence occurred during the follow-up period of 54 months. Scars were not observed. A post-operative biopsy showed no evidence of lichenoid dermatitis. Conclusions The Pulsed Dye Laser seems to accelerate the clearance of presumably drug induced corticosteroid-resistant lichenoid dermatoses. No permanent pigmental changes or scarring were observed. Lasers Surg. Med. 31:23–26, 2002. © 2002 Wiley-Liss, Inc.
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Cutaneous lupus erythematosus-treatment with Pulsed Dye Laser
British Journal of Dermatology, 1999Co-Authors: Christian Raulin, C. Schmidt, S. HellwigAbstract:Because of its vascular selectivity, the flashlamp-pumped Pulsed Dye Laser (585 nm) is efficacious in the treatment of vascular lesions and is successfully used for the treatment of port-wine stains and haemangiomas in children. Based on the encouraging results with these cutaneous vascular disorders, the cutaneous lesions of patients with lupus erythematosus (LE) have now also been treated with the Pulsed Dye Laser. Cutaneous lesions in lupus erythematosus are often difficult to treat with readily available local therapeutic methods. We report here on a group of 12 patients whose LE lesions were treated with the Pulsed Dye Laser. In 10 patients, the LE was limited to the skin, while two patients had systemic LE (SLE). Even in the two patients with SLE, a significant improvement of skin lesions was achieved. After a mean number of 51 Laser sessions, a median clearance rate of 70% was attained for nine patients. In one case, the Laser treatment failed to clear the lesions. Two patients did not show any visible improvement of the lesions, but pain and itching were significantly reduced. There were few side-effects. No prolonged Laser-induced scarring occurred and in only two patients was hyperpigmentation seen, which had resolved completely after 4 and 5 months, respectively. During a median follow-up of 7 months (range: 3-32 months), only one patient (after a complete clearance of the skin lesions) had a small relapse. In summary, the Pulsed Dye Laser is an effective therapy for the treatment of superficial skin lesions in LE.
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treatment of sebaceous gland hyperplasia with the Pulsed Dye Laser
Lasers in Surgery and Medicine, 1997Co-Authors: Matthias P Schonermark, C. Schmidt, Christian RaulinAbstract: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/μsec). Results After 2–3 treatment sessions, the lesions were completely gone. To date, 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. Lasers Surg. Med. 21:313–316, 1997. © 1997 Wiley-Liss, Inc.
