Objectives To evaluate the efficacy of nonablative fractional 1,540 nm laser to treat the atrophic scars caused by the cutaneous leishmaniasis (CL). Methods This clinical trial with a pre‐ and a posttreatment measurement was conducted on patients with atrophic CL scars. The lesions were treated with nonablative fractional 1,540 nm laser. We evaluated the patients initially and then monthly, before each treatment session. The final follow‐up was done 6 months after the end of study for all patients. Patient assessment was performed by two physicians using the modified Manchester Scar Scale (MSS) as well as the interpretation of captured digital photographs. Moreover, the patients performed a self‐assessment by filling in a researcher‐made questionnaire. The data were statistically analyzed by SPSS software. P < 0.05 was considered statistically significant. Results Thirty patients with 37 skin lesions participated in the study. The pairwise comparison demonstrated a statistically significant difference between the modified MSS parameters (P < 0.05); however, no significant difference was observed between the modified MSS of the third and fourth (P = 0.82) as well as fourth and fifth (P = 0.636) sessions. The lesions improvement was significant based on the physician's evaluation (P < 0.001). Furthermore, patients’ level of satisfaction was significantly increased in all six follow‐ups (P < 0.001). No persistent complication was found. Conclusions Nonablative fractional 1,540 nm laser is an effective and safe therapeutic choice for atrophic CL, even in darker skins. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

DEAR EDITOR, Leishmaniasis encompasses a group of chronic infections caused by over 20 species of the Leishmania genus. It is transmitted by sandflies between animal and human hosts and accounts for a complicated health problem in endemic areas, often of developing countries. 1 The elderly population has specific health characteristics: alterations in the immune system, 2 hormonal changes, 3 altered attention to illness and treatment, irregular and multiple drug consumption, comorbidities and different disease presentations. 4,5 M€ uller et al. 2 have shown that in older rats the severity of leishmaniasis lesions and the number of parasites were less than in younger rats. Davies et al. 6 have reviewed the epidemiology of leishmaniasis in five countries in South America; they reported a lower number of lesions in older people. However, Guessous-Idrissi et al. 7 indicated more severe and larger lesions in older patients in an epidemiological study in north Morocco. A shortage of studies about leishmaniasis in the elderly population and their contradictory results encouraged us to conduct a descriptive prospective study between April 2010 and March 2011 on confirmed cases of cutaneous leishmaniasis in Mashhad, Iran, to evaluate the clinical features of cutaneous leishmaniasis in two age groups: a younger group (age ≤ 20 years) and an older group (age ≥ 60 years). Demographic data, the past medical history of the patients, and the site, number, size and duration of the lesions were recorded. The clinical manifestation and the pattern of lesions were categorized as stated in Table 1. The area of lesions was calculated as a circle, the diameter of which was the mean of the largest and smallest diameter of each lesion.We studied 598 cases of cutaneous leishmaniasis (284 male and 314 female) aged under 20 years (age range 0Á2-20 years, mean AE SD = 9Á7 AE 5Á9 years) and 152 cases (55 male and 97 female) over 60 years old (age range 60-96 years, mean AE SD = 66Á7 AE 8Á4 years). The head and neck was the most common site of involvement in younger patients (67Á1% of lesions), while in the older patients the upper extremities encompassed the most lesions (63Á8% of lesions). In the lower extremities and trunk there were no significant differences between the two age groups.The average number of lesions and the mean size of lesions were larger in the over-60s group (2Á38 AE 2Á21 vs.1Á83 AE 1Á5 lesions, P = 0Á002; and 947Á85 AE 126Á8 vs.

No abstract