The Experts below are selected from a list of 11637 Experts worldwide ranked by ideXlab platform
Keyvan Nouri - One of the best experts on this subject based on the ideXlab platform.
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Comparing the efficacy and safety of Q-switched and picosecond Lasers in the treatment of nevus of Ota: a systematic review and meta-analysis
Lasers in Medical Science, 2020Co-Authors: Natalie M. Williams, Pooja Gurnani, Jun Long, John Reynolds, Takahiro Suzuki, Ghadah I. Alhetheli, Keyvan NouriAbstract:Nevus of Ota is cosmetically burdensome and often prompts patients to seek treatment. Lasers are commonly used in removing these lesions; however, no systemic analysis has been conducted to support a gold standard laser. To conduct a meta-analysis of the efficacy and safety of Q-switched Nd:YAG Lasers (QSNL), Q-switched Ruby Lasers (QSRL), Q-switched alexandrite Lasers (QSAL), and picosecond alexandrite Lasers (PSAL) in removing nevus of Ota. Inclusion criteria were nevus of Ota patients treated with QSNL, QSRL, QSAL, or PSAL and documentation of percent clearance and the rate of at least one adverse event. Articles in English, Chinese, or Japanese were included. The prespecified outcome measures were efficacy (percent clearance) and safety (rates of hyperpigmentation, hypopigmentation, scarring, and recurrence). The review included 57 studies and 13,417 patients. The pooled success rate was 64% for QSNL (95% CI 52–76%), 54% for QSRL (95% CI 39–69%), 58% for QSAL (95% CI 44–72%), and 100% for PSAL (95% CI 98–102%). The pooled adverse event rate was 5% for QSNL (95% CI 4–6%), 14% for QSRL (95% CI 9–19%), 9% for QSAL (95% CI 6–12%), and 44% (95% CI 31–57%) for PSAL. QSNL has the most evidence for effectively and safely treating nevus of Ota. PSAL potentially has a superior efficacy; however, further studies are needed to elucidate its side effect profile when treating nevus of Ota.
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Laser and Light Treatments for Hair Reduction in Fitzpatrick Skin Types IV–VI: A Comprehensive Review of the Literature
American Journal of Clinical Dermatology, 2018Co-Authors: Rachel A. Fayne, Marina Perper, Ariel E. Eber, Adam S. Aldahan, Keyvan NouriAbstract:Unwanted facial and body hair presents as a common finding in many patients, such as females with hirsutism. With advances in laser and light technology, a clinically significant reduction in hair can be achieved in patients with light skin. However, in patients with darker skin, Fitzpatrick skin types (FST) IV–VI, the higher melanin content of the skin interferes with the proposed mechanism of laser-induced selective photothermolysis, which is to target the melanin in the hair follicle to cause permanent destruction of hair bulge stem cells. Many prospective and retrospective studies have been conducted with laser and light hair-removal devices, but most exclude patients with darkly pigmented skin, considering them a high-risk group for unwanted side effects, including pigmentation changes, blisters, and crust formation. We reviewed the published literature to obtain studies that focused on hair reduction for darker skin types. The existing literature for this patient population identifies longer wavelengths as a key element of the treatment protocol and indicates neodymium-doped yttrium aluminum garnet (Nd:YAG), diode, alexandrite, and Ruby Lasers as well as certain intense pulsed light sources for safe hair reduction with minimal side effects in patients with FST IV–VI, so long as energy settings and wavelengths are appropriate. Based on the findings in this review, safe and effective hair reduction for patients with FST IV–VI is achievable under proper treatment protocols and energy settings.
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Laser treatment of congenital melanocytic nevi: a review of the literature
Lasers in Medical Science, 2016Co-Authors: Fleta N. Bray, Vidhi Shah, Keyvan NouriAbstract:Congenital melanocytic nevi (CMN) are nevi that are present from birth and occur in approximately 1 % of newborns. CMN may be cosmetically disfiguring and are at risk for malignant transformation. For these two reasons, CMN are frequently treated. A variety of treatment modalities have been utilized with variable efficacy, including excision, dermabrasion, curettage, chemical peels, radiation therapy, cryotherapy, electrosurgery, and Lasers. The current treatment of choice for CMN is surgical excision. However, some CMN occur in cosmetically sensitive areas, where a surgical scar is less acceptable, or in inoperable locations. For these reasons, there has been increasing interest in the potential for laser treatment of CMN. The Lasers that have been studied to date for the treatment of CMN include pigment-specific Lasers, including Ruby (694 nm), alexandrite (755 nm), and Nd:yttrium aluminum garnet (YAG) (1064 nm), as well as ablative laser treatment with CO_2 laser (10,600 nm) and Er:YAG (2940 nm). To date, Ruby Lasers have been studied most extensively in the treatment of CMN. Ruby laser has been shown to improve the cosmetic appearance of some CMN and may be cautiously considered for lesions located in cosmetically sensitive areas that are less amenable to surgical excision. For very large CMN, Ruby laser has been tried as an alternative to extensive surgical and grafting procedures. Dual treatment with Q-switched Ruby laser and normal mode Ruby laser may provide the best outcomes; however, multiple treatment sessions should be anticipated. The practicality and expense of multiple treatments should be discussed with the patient prior to initiating treatment. Importantly, because of the persistence of dermal nevus cells, lifelong follow-up is required for all laser-treated CMN, even those with excellent cosmetic effect.
Eric F. Bernstein - One of the best experts on this subject based on the ideXlab platform.
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Laser Tattoo Removal
Seminars in plastics surgery, 2007Co-Authors: Eric F. BernsteinAbstract:Tattooing has been a part of human culture since the earliest beginnings of modern civilization. What has changed over the millennia are the myriad of colors with which we can now express our thoughts, feelings, and desires through body art. What has not changed is human nature, and our propensity to change our minds about what it is we think, feel, and wish to express on the canvas of our skin. Our fickle nature results in the desire to change what has been placed as a permanent reminder of a friend, spouse, or as a work of art. The technology used to remove tattoos began with destructive methods of removal, which wreaked havoc not only on the tattoo but more prominently on the skin containing that tattoo. The discovery of selective photothermolysis, the ability to selectively remove target structures without disrupting the surrounding skin, made it at least possible to remove tattoos without destroying the surrounding skin and leaving a scar. Theory predicted that pulse durations in the nanosecond domain would be optimal for tattoo removal, and the Q-switched neodymium:yttrium-aluminum-garnet, alexandrite, and Ruby Lasers operate in this range and are the key tools for modern tattoo removal. Too often, the wrong devices operating in the millisecond range, such as intense pulsed light sources, or Lasers that are nonselective, such as the carbon dioxide laser, are used to treat tattoos, resulting in significant scarring without complete removal of the tattoo. Although the Q-switched Lasers are capable of removing tattoos without harming the skin, removal often takes numerous treatments and still can be incomplete, especially when attempting to remove multicolored tattoos. Developments leading to removable tattoo inks, feedback systems to detect the absorbance characteristics of tattoo inks, dermal clearing agents, and perhaps even shorter pulse-duration Lasers should result in improvements in tattoo removal in the near future.
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Laser treatment of tattoos.
Clinics in Dermatology, 2006Co-Authors: Eric F. BernsteinAbstract:Tattooing has been around since the early beginnings of modern civilization. Modern tattoo artists use a myriad of colors to produce striking designs, resulting in permanent works of body art; however, we humans have been changing our minds since the beginning of time. Our fickle nature results in the desire to change what has been placed as a permanent reminder of a friend, spouse, or work of art. Removing tattoos began with abrasive and destructive measures to destroy the tattoo, and unfortunately, the skin it was contained in. The discovery of selective photothermolysis, the ability to selectively remove target structures without disrupting the surrounding skin, made it at least possible to remove tattoos without destroying the surrounding skin leaving a scar. Theory predicted that pulse durations in the nanosecond domain would be optimal for tattoo removal, and the Q-switched neodymium:yttrium-aluminum-garnet, alexandrite, and Ruby Lasers fulfilled this need. Too often, older Lasers or intense pulsed light sources are used to treat tattoos, often with significant scarring. Since the advent of the Q-switched Lasers more than a decade ago, improvement in tattoo-removal Lasers has been incremental. Developments leading to new tattoo inks, feedback systems to detect the absorbance characteristics of tattoo inks, dermal clearing agents, and perhaps even shorter pulse-duration Lasers should result in improved results for the future.
Christian Raulin - One of the best experts on this subject based on the ideXlab platform.
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Laser Treatment of Tattoos and Other Dyschromia
Laser and IPL Technology in Dermatology and Aesthetic Medicine, 2010Co-Authors: Syrus Karsai, Christian RaulinAbstract:Q-switched Lasers (alexandrite, Nd:YAG and Ruby Lasers) can successfully remove tattoos with few adverse effects. Removing professional tattoos usually entails 20–25 treatment sessions at intervals of 4–6 weeks. Residual pigment may remain, especially when multi-coloured tattoos are involved. Amateur tattoos and traumatic tattoos are usually easier to treat (5–10 sessions). Drug-induced hyperpigmentation is fairly common and tends to respond well to treatment with Q-switched laser (the exception here is chrysiasis). Frequent adverse effects are changes in pigmentation (particularly hypopigmentation), shifts in tattoo colour and changes in skin texture; the latter two are usually temporary. Scarring is possible but rare when treatment is performed correctly.
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Tattoo removal--state of the art.
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2007Co-Authors: Gudrun Pfirrmann, Susanne Roos, Stefan Hammes, Syrus Karsai, Christian RaulinAbstract:Tattooing has been around since the early beginnings of modern civilization. The discovery of selective photothermolysis at last has made it possible to remove tattoos without leaving a scar. Q-switched neodymium: yttrium-aluminum-garnet, alexandrite, and Ruby Lasers with pulse durations in the nanosecond domain fulfill this need. Argon or cw-CO(2) Lasers as well as intense pulsed light sources should not be used since they often produce significant scarring. This article provides an overview of current laser systems. Developments leading to new tattoo inks, feedback systems to detect the absorbance characteristics of tattoo inks, dermal clearing agents, and perhaps even Lasers with shorter pulse-durations might improve the results in the future.
Joop M Grevelink - One of the best experts on this subject based on the ideXlab platform.
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comparison of the q switched alexandrite nd yag and Ruby Lasers in treating blue black tattoos
Dermatologic Surgery, 1999Co-Authors: Mia L Leuenberger, Maria W Mulas, Tissa R Hata, Mitchel P. Goldman, Richard E. Fitzpatrick, Joop M GrevelinkAbstract:Background. A new generation of highly selective short-pulsed Lasers has emerged in recent years for the treatment of tattoos. Several studies (including reports by the present investigators) have proven the efficacy of each of the three commercially available, FDA approved devices; namely, the Q-switched alexandrite, Q-switched Nd:YAG and Q-switched Ruby Lasers. Considerable differences among the three have been reported in relation to the rate of clearing of the tattoo ink particles, tissue effects, beam profile, wound healing, and side effects. Objective. This study was primarily conducted to examine and compare the clinical response of patients with blue-black tattoos simultaneously treated with three different Q-switched Lasers (alexandrite, Nd:YAG, Ruby) with a focus on the percentage of tattoo lightening/clearance and the occurrence or non-occurrence of pigmentary change as a side effect. Methods. A total of forty-two blue-black tattoos seen at two laser centers (Massachusetts General Hospital Dermatology Laser Center and Laser and Skin Surgery Center of La Jolla) were simultaneously treated with three types of Q-switched Lasers: a Candela Q-switched alexandrite laser (755nm 50-100 nanoseconds, 3.0mm spot size, 6-8 J/cm2); a Continuum Biomedical Q-switched Nd:YAG laser (1064nm, 10-20 nanoseconds, 3.0mm spot size, 5-10 J/cm2); and a Spectrum Q-switched Ruby laser (694nm, 25-40 nanoseconds, 5.0mm spot size, 4-10 J/cm2). Paired t-tests and McNemar tests were used to compare the treatment outcome and pigmentation side effects between sites per tattoo, with each site representative of one of the three Lasers. The statistical significance level was set at p < .05. Results. Overall, the Q-switched Ruby laser had a significant difference in tattoo lightening versus the Q-switched Nd:YAG and Q-switched alexandrite Lasers. An increase in the number of treatments paralleled a statistically significant increase in tattoo clearance for all three Q-switched Lasers. Conclusion. The Q-switched Ruby laser had the highest clearance rate in blue-black tattoos and the highest incidence of longlasting hypopigmentation. The Nd:YAG had no incidence of hypopigmentation.
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modulation of α4β1 and α5β1 integrin expression heterogeneous effects of q switched Ruby nd yag and alexandrite Lasers on melanoma cells in vitro
Lasers in Surgery and Medicine, 1996Co-Authors: Robert L Van Leeuwen, Sybren K Dekker, Randolph H Byers, Bert Jan Vermeer, Joop M GrevelinkAbstract:BACKGROUND AND OBJECTIVE Integrins of the beta 1 family are cellular adhesion molecules that play an important role in cell attachment and migration by interacting with extracellular matrix molecules. Agents such as hormones, cytokines, and ultraviolet radiation have all been shown to have an integrin modulating potential. The present study indicates that radiation of Q-switched Lasers is also able to induce transient changes in integrin expression levels on human melanoma cells in vitro. STUDY DESIGN/MATERIALS AND METHODS Radiation from Q-switched Ruby (694 nm), Alexandrite (755 nm), and Nd:YAG laser (1,064 nm) with fluences comparable to those that are generally used in treating dermatologic lesions were used to irradiate a subconfluent layer of human melanoma cells. After fixed time intervals, the cells were harvested either to analyse the integrin expression by flow cytometry or to investigate changes in cell attachment, spreading, and migration. RESULTS It was established that all three types of laser were able to cause a significant downregulation of both the alpha 4 and the common beta 1 integrin subunit. The Alexandrite and Ruby Lasers also induced a decrease in alpha 5 expression; however, the cells treated with the Nd:YAG laser showed a marked upregulation of the alpha 5 subunit. The expression of the other beta 1 integrin subunits was shown to be unaltered after laser treatment. Downregulation of the alpha 4 upregulation of the alpha 5 integrin subunit expression resulted in, respectively, decreased and increased attachment and spreading on fibronectin, the extracellular matrix ligand for both the alpha 4 beta 1 and alpha 5 beta 1 integrins. Marked upregulation of the alpha 5 subunit also resulted in a higher migration rate. CONCLUSION Taken together, these results show that nonlethal doses of Q-switched laser radiation are able to induce changes in cellular behavior in vitro by modulating the integrin expression pattern.
Fumio Kaneko - One of the best experts on this subject based on the ideXlab platform.
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treatment of ota s nevus using two different types of Ruby Lasers
European Journal of Dermatology, 2000Co-Authors: T Tateshita, I Ono, H Gunji, N Sanbe, N Watanabe, M Satou, Fumio KanekoAbstract:Conventional methods, including cryotherapy abrasion, have been employed in the treatment of pigmented skin lesions such as Ota's nevus and other pigmented nevi. However, these methods require a great deal of skill and are of limited clinical effectiveness. In addition, scars often develop on the treated lesions [1, 2]. In recent years, a number of reports have confirmed the clinical effectiveness of the Q-switched Ruby laser [3-7], [...]
