Hypertrophic Scar Following Excisional Surgery and Full-Thickness Skin Grafting Due to Rhinophyma Treated with 1064 nm Q-Switched Neodymium:Yttrium Aluminum Garnet Laser

Abstract

Rhinophyma is characterized by progressive enlargement of the nasal skin, which is considered to be an advanced stage of phymatous rosacea. Esthetic disfigurement makes surgical treatment necessary for this condition. Hypertrophic scars are the consequence of alterations in the skin’s healing process following surgical interventions. Laser may be the treatment of choice in hypertrophic scars. We reported a case of hypertrophic scars following excisional surgery and full-thickness skin grafting due to rhinophyma in an 18-year-old male who was consulted from the Department of Plastic Surgery and Reconstruction. The 1064 nanometer (nm) Q-switched Neodymium: Yttrium Aluminum Garnet (QS Nd:YAG) with 4 mm spot size, 1.5 J/cm2 and 1 Hz was applied to the hypertrophic scars for three sessions within one month interval. Clinical improvement was observed as indicated by the patient’s Vancouver scar scale score and spectrophotometry result, and no side effects were found. Nd:YAG laser is a non-ablative device that targets hemoglobin, water, and melanin. Any thermal effects on dermal tissue containing blood vessels could result in reduced blood flow through the capillaries in the dermal papillae. QS Nd:YAG-induced selective photothermolysis was responsible for collagen breakdown and reduced collagen production in hypertrophic scars. The 1064 nm QS Nd:YAG laser gave good results in this case although more treatment sessions may be recommended and a longer follow-up is necessary in order to assess the stability of the result.

Preparation of Compound Salvia miltiorrhiza–Blumea balsamifera Nanoemulsion Gel and Its Effect on Hypertrophic Scars in the Rabbit Ear Model

“…85,86 There are few limitations of our present study: (1) The investigation into the impact of CSB-NEG on proteins such as TGF-β 1 , Smad2, and CD34 relied solely on immunohistochemical analyses, lacking molecular experimentation such as Western blotting and PCR to corroborate our findings. (2) The cellular experiments exclusively focused on assessing CSB-NEG's effects on the proliferative qualities of hypertrophic scar fibroblasts (HSFbs), neglecting aspects such as migration and apoptosis. (3) Although the main chemical components of the CSB extract have been identified, future investigations are needed to study the material basis for this formula against hypertrophic scar.…”

“…Hypertrophic scar (HS) is a fibrotic skin disease caused by abnormal local tissue repair after skin burns, trauma, and surgery. , The clinical manifestations of HS are red, prominent surrounding normal skin tissue, firm texture, often accompanied by itching, local numbness, and paresthesia, which seriously affect the quality of life and the physical and mental health of patients. , In addition, HS has still been a troublesome clinical problem, whose mechanisms are still obscure and whose complexity and multimodal nature also present significant challenges to physicians.…”