Laser therapy in superficial morphea lesions – indications, limitations and therapeutic alternatives

Tatu, Alin Laurențiu; Radaschin, Diana Sabina; Constantin, Vlad Denis; Paunica, Stana; Ardeleanu, Valeriu

doi:10.22543/7674.71.p4651

Cited by 8 publications

(13 citation statements)

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“…Infection modalities confirmed by clinical trials are through droplets, aerosols, direct and indirect contact (6,7). To prevent in-hospital contamination of medical personnel, the new protocol guidelines recommend avoiding all medical-surgical procedures with the potential to generate aerosols in suspected infected individuals or whose COVID-19 status has not yet been evaluated, including endoscopy and laparoscopy, and performing them with appropriate protective equipment, only when the benefit to the patient outweighs the risk (8)(9)(10)(11)(12)(13)(14)(15)(16). This has a significant impact on the management of acute abdomen, a clinical entity of special severity, whose Acute surgical abdomen during the COVID-19 pandemic: Clinical and therapeutic challenges investigation and surgical approach does not allow a time delay until obtaining the result of RT-PCR testing for SARS-Cov-2.…”

Section: Introductionmentioning

confidence: 99%

Acute surgical abdomen during the COVID‑19 pandemic: Clinical and therapeutic challenges

et al. 2021

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The present study investigated the effects of the COVID-19 pandemic on the clinical presentation and therapeutic management of acute surgical abdomen. A retrospective study of emergency hospitalizations with a diagnosis of acute surgical abdomen between April and July 2020 vs. a similar period in 2019 was performed. The observation sheets and the operating protocols were analyzed. Between April and July 2020, 50 cases of acute surgical abdomen were hospitalized and treated, compared to 43 cases in the same period last year. The main types of pathology in both groups included: Occlusions (60%, respectively 44.2% in 2019) and peritonitis (32%, respectively 41.8% in 2019). There was an increased rate of patients with colorectal cancers neglected therapeutically or uninvestigated, who presented during the pandemic period with emergencies for complications such as occlusion or tumor perforation (32 vs. 6.97%, P=0.0039). One case, with gastric perforation, was COVID-positive, with no pulmonary symptoms at admission. The number of postoperative infectious complications was lower during the pandemic (2 vs. 13.95%, P=0.0461). As the COVID-19 pandemic appears to be still far from ending, we should learn to adapt our surgical protocols to the new evidence.Oncological patients are a vulnerable group, who were neglected in the first months of the pandemic. SARS-Cov-2 infection may be a cause of abdominal pain and should be taken into account in different diagnoses of acute abdomen in surgical wards. Correct wearing of adequate personal protective equipment (PPE) and respecting strict rules of asepsis and antisepsis are required for preventing in-hospital transmission of infection.

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Section: Introductionmentioning

confidence: 99%

Acute surgical abdomen during the COVID‑19 pandemic: Clinical and therapeutic challenges

et al. 2021

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“…The efficacy of excimer lasers in morphea mainly results from their anti-inflammatory action, since the 308 nm wavelength used in the excimer laser is the most efficient wavelength for inducing DNA breakage in lymphocytes [ 34 ]. Thus, although sparse clinical data, the excimer laser treatment seems to represent a valuable management option for active lesions refractory to previous therapies or as an adjunct to conventional treatment, potentiating the therapeutic effect.…”

Section: Resultsmentioning

confidence: 99%

“…Thus, although sparse clinical data, the excimer laser treatment seems to represent a valuable management option for active lesions refractory to previous therapies or as an adjunct to conventional treatment, potentiating the therapeutic effect. In fact, Tatu et al in their recent review, recommended 308 nm excimer laser therapy as an effective and safe treatment of superficial inflammatory LoS lesions, i.e., erythematous plaques or oedematous patches, especially when the topical corticosteroids or UVA-therapy do not give clinical improvement [ 34 ]. Basically, if therapy with UVB or narrow-band UVB is recommended, the excimer laser represents a valuable therapeutic alternative [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…In fact, Tatu et al in their recent review, recommended 308 nm excimer laser therapy as an effective and safe treatment of superficial inflammatory LoS lesions, i.e., erythematous plaques or oedematous patches, especially when the topical corticosteroids or UVA-therapy do not give clinical improvement [ 34 ]. Basically, if therapy with UVB or narrow-band UVB is recommended, the excimer laser represents a valuable therapeutic alternative [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

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Laser Therapy for the Treatment of Morphea: A Systematic Review of Literature

Szczepanik-Kułak

Michalska-Jakubus

Krasowska

2021

JCM

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Morphea, also known as localized scleroderma (LoS), comprises a set of autoimmune sclerotic skin diseases. It is characterized by inflammation and limited thickening and induration of the skin; however, in some cases, deeper tissues might also be involved. Although morphea is not considered a life-threatening disease, the apparent cosmetic disfigurement, functional or psychosocial impairment affects multiple fields of patients’ quality of life. Therapy for LoS is often unsatisfactory with numerous treatments that have only limited effectiveness or considerable side effects. Due to the advances in the application of lasers and their possible beneficial effects, the aim of this study is to review the reported usage of laser in morphea. We present a systematic review of available literature, performed with MEDLINE, Cinahl, Central, Scopus, Web of Science, and Google Scholar databases. We identified a total of twenty relevant studies (MEDLINE n = 10, Cinahl n = 1, Central n = 0, Scopus n = 2, Web of Science n = 5, Google Scholar n = 2) using laser therapy for LoS. Eight studies were focused on the use of PDL, six on fractional lasers (CO2 and Er:YAG), four on excimer, and two on either alexandrite or Nd:YAG.

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“…The presence of rosacea may contraindicate or limit the indications for some dermato-cosmetic treatments such as chemical peels or hyaluronic acid treatments [51][52][53]. It may also limit the use of other types of lasers for various dermatological conditions that induce local vasodilation; in these cases, the order of treatment must be analyzed [54][55].…”

Section: Discussionmentioning

confidence: 99%

The use of NDYAG laser combined with pulsed light in the treatment of rosacea

Ardeleanu¹,

Moroianu²,

Constantin³

et al. 2020

JMMS

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Rosacea is a chronic inflammatory skin disease with a complex pathogenesis that mainly affects the central part of the face, with a global incidence of 5.46%. The present study was performed on a group of 68 patients with rosacea 1 and 2 subtypes, patients between 34-63 years old. The treatments were performed using a Cutera Xeo laser, using 2 types of probes: NdYag 1064nm for telangiectasias and LimeLight 520-1100nm for diffuse facial erythema, papules, and pustules, having an 10x30mm window. For patients with diffuse facial erythema, etc., the optimal number of sessions was between 3 and 6 with or without anesthetic cream, using energies between 14-19J / cm. The average recovery time was 5 days. Registered effects included bruises, pustules, burning sensation, transient stinging, and hypopigmentation. For patients with telangiectasia, the optimal number of sessions was two, performed at an average interval of once per month/ monthly.

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Laser therapy in superficial morphea lesions – indications, limitations and therapeutic alternatives

Cited by 8 publications

References 0 publications

Acute surgical abdomen during the COVID‑19 pandemic: Clinical and therapeutic challenges

Acute surgical abdomen during the COVID‑19 pandemic: Clinical and therapeutic challenges

Laser Therapy for the Treatment of Morphea: A Systematic Review of Literature

The use of NDYAG laser combined with pulsed light in the treatment of rosacea

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