Ablative fractional laser resurfacing with topical paromomycin as adjunctive treatment for a recalcitrant cutaneous leishmaniasis wound

Basnett, Andrew; Nguyen, Thao Thi Thu; Cannavino, Christopher; Krakowski, Andrew C.

doi:10.1002/lsm.22426

Cited by 12 publications

(11 citation statements)

References 15 publications

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“…In addition, the channels that the ablative fractional CO 2 laser creates allow for deeper penetration and greater bioavailability of topically applied medications . The use of laser‐assisted drug delivery for leishmaniasis was published in one case report treating a recalcitrant leishmania lesion with fractional ablative CO 2 laser followed by topical paromomycin with good clinical and aesthetic outcomes …”

Section: Discussionmentioning

confidence: 99%

“…Several studies have described the successful use of a fractional ablative laser in assisted topical drug delivery, achieving results similar to those of intralesional injections . The use of laser‐assisted drug delivery for leishmaniasis was reported on in a case report of the treatment of a recalcitrant leishmania lesion using a fractional ablative carbon dioxide (CO 2 ) laser followed by topical paromomycin with good clinical and aesthetic outcome, but the use of lasers as an alternative for intralesional injection of pentavalent antimony for CL has not been previously described.…”

Section: Introductionmentioning

confidence: 99%

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Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application: A treatment option for pediatric cutaneous leishmaniasis

Hilerowicz

Koren

Mashiah

et al. 2018

Pediatric Dermatology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application: A treatment option for pediatric cutaneous leishmaniasis

Hilerowicz

Koren

Mashiah

et al. 2018

Pediatric Dermatology

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“…Adverse events were reported in six patients from two case reports. Basnett et al 30 reported the use of ablative fractional laser resurfacing for a 16-year-old female with several nonhealing lesions of cutaneous leishmaniasis on the bilateral and upper extremities. After two treatments, the patient's wounds healed completely without evidence of infection and with minimal scarring.…”

Section: Case Reportsmentioning

confidence: 99%

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

Mirza

Khatri

2020

Dermatologic Therapy

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It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.

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“…Fractional ablative CO 2 laser is an effective treatment for cutaneous atrophic scars resulting from CL (14). Furthermore, the use of laser-assisted drug delivery for leishmaniasis was published in one case report treating recalcitrant active Leishmania lesion with fractional ablative CO 2 laser followed by topical paromomycin with good clinical and aesthetic outcome (15).…”

Section: Fractional Ablative Co 2 Laser Followed By Topical Applicatimentioning

confidence: 99%

Fractional Ablative CO2 Laser Followed by Topical Application of Sodium Stibogluconate for Treatment of Active Cutaneous Leishmaniasis: A Randomized Controlled Trial

Artzi¹,

Sprecher²,

Mehrabi³

et al. 2018

Acta Derm Venerol

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SIGNIFICANCE Cutaneous leishmaniasis is a parasitic infection that affects millions of people every year (1). Although common treatments vary in safety and efficacy, none of them addresses the disfiguring atrophic hypo-or hyper-pigmented post-inflammatory scars. The current study shows that fractional carbon dioxide (CO 2) laser treatment, followed by topical application of sodium stibogluconate, is an effective, safe treatment, which is less painful and results in better final cosmesis compared with the current gold standard, intralesional injections of sodium stibogluconate. Conventional treatment of cutaneous leishmaniasis often leaves permanent scars with frequent psychosocial sequelae. The aim of this study was to compare the efficacy, safety, associated pain and final cosmetic outcome of fractional carbon dioxide (CO 2) laser followed by topical application of sodium stibogluconate vs. sodium stibogluconate injections for the treatment of cutaneous leishmaniasis. A total of 181 lesions (20 patients) were randomly assigned to receive intralesional injections of sodium stibogluconate (control group) or fractional CO 2 laser treatment followed by topical application of sodium stibogluconate (study group). The visual analogue scale (VAS) score of the control group was much higher than that of the study group (6.85 vs. 3.5, respectively, p < 0.001). Both the patients and 2 blinded dermatologists found the final cosmetic outcome to be superior for laser-treated lesions (p = 0.001 vs. p =0.008 for controls). Fractional CO 2 laser treatment followed by topical application of sodium stibogluconate is less painful and leads to a better final cosmetic outcome compared with intralesional injections of sodium stibogluconate.

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Ablative fractional laser resurfacing with topical paromomycin as adjunctive treatment for a recalcitrant cutaneous leishmaniasis wound

Abstract: AFR with laser-assisted delivery of topical paromomycin represents a novel treatment option for resistant, non-healing CL wounds. The technique may prove additionally useful for concurrent mitigation of scarring related to CL.

Cited by 12 publications

References 15 publications

Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application: A treatment option for pediatric cutaneous leishmaniasis

Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application: A treatment option for pediatric cutaneous leishmaniasis

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

Fractional Ablative CO2 Laser Followed by Topical Application of Sodium Stibogluconate for Treatment of Active Cutaneous Leishmaniasis: A Randomized Controlled Trial

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