Novel treatment of calcifications from dermatomyositis with picosecond and carbon dioxide laser

Abrouk, Michael; Nousari, Yasmine; Waibel, Jill

doi:10.1016/j.jdcr.2020.06.022

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…Some patients were prescribed with nonsteroidal anti-inflammatory drugs or paracetamol after the procedure. Postoperative management included an ointment or cream of healing and soothing properties [ 55 ], often combined with antimicrobials such as chlorhexidine [ 50 ], mupirocin [ 13 , 52 ], fusidic acid [ 35 , 44 ], and povidone-iodine [ 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…No recurrences were observed within the follow-up, in contrast to conventional surgery, when the soft tissue injury from procedure may induce the formation of new lesions [ 2 , 12 , 14 , 17 ]. Spontaneous extrusion of the chalky exudate (expelling the softened calcium deposits) after laser therapy and ESWL is considered as a good sign of the healing process [ 5 , 55 ]. In comparison to curettage, laser treatment helps to achieve a good haemostasis by closing capillaries, which ensures a clear operating field [ 13 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

“…In patients treated with CO 2 , Er:YAG, and diode lasers only one session was required [13,23,35,35,44,[49][50][51][52][53][54]. One patient who underwent therapy with a picosecond laser followed by a CO 2 laser required three sessions [55]. Among the CO 2 lasers, the ultrapulse variant was most commonly reported.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Some patients were prescribed with nonsteroidal anti-inflammatory drugs or paracetamol after the procedure. Postoperative management included an ointment or cream of Table 2 Summary of local, non-systemic, and minimally invasive treatment options for calcinosis cutis Er:YAG erbium-doped yttrium aluminium garnet, ESWL extracorporeal shockwave lithotripsy, N/A not applicable, N/R not reported, STS sodium thiosulfate a Missing data were managed by available case analysis and mean imputation was used when a mean was known for a variable of interest but exact values were not reported for individual cases from a single study b Olesen et al [17] also reported injection pain, however, without an exact number of cases experiencing it c A group of patients was too small d Bottomley et al [13] healing and soothing properties [55], often combined with antimicrobials such as chlorhexidine [50], mupirocin [13,52], fusidic acid [35,44], and povidone-iodine [53].…”

Section: Perioperative Managementmentioning

confidence: 99%

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Local, non-systemic, and minimally invasive therapies for calcinosis cutis: a systematic review

2021

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Calcinosis cutis is a deposition of calcium in the skin and subcutaneous tissue, often accompanied by pain, reduced mobility, and chronic infections. Limited evidence is available about the feasibility and efficacy of therapies alternative to systemic treatment and surgical excision, both of which often lead to unsatisfactory results or complications. We conducted a systematic review to evaluate the efficacy and safety of topical and intralesional sodium thiosulfate, extracorporeal shock-wave lithotripsy (ESWL), and laser for calcinosis cutis. PubMed, Embase, and Web of Science were searched. Reports of calciphylaxis and treatment combined with systemic medications were excluded. A total of 40 studies including 136 patients were analysed. Partial or complete remission after monotherapy was observed in 64% to 81% of cases. Self-applied topical sodium thiosulfate required patient’s adherence (mean treatment duration, 4.9 months; range 2–24). Laser therapy enabled complete remission of microcalcifications after a single procedure (57%; 12/21). ESWL and intralesional sodium thiosulfate injections decreased calcinosis-associated pain (median reduction in VAS score, 3; range 0–9 and 1; range 0–5, respectively). The most common adverse event was scarring and hyperkeratosis, observed after CO2 laser (56%; 10/18). Intralesional sodium thiosulfate injections caused transient pain in over 11% of patients. Recurrences within the follow-up were rare (2%; 3/136). This study provides an overview of minimally invasive and local therapies that in selected cases might transcend conventional treatment. The limitation of this study is the poor level of evidence, which emerges mainly from non-randomized studies at high risk of bias.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Treatment Modalitiesmentioning

confidence: 99%

Section: Perioperative Managementmentioning

confidence: 99%

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Local, non-systemic, and minimally invasive therapies for calcinosis cutis: a systematic review

2021

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“…In contrast to reports on laser therapy as a valuable additive to the treatment of lupus erythematosus, only 6 case reports exist on laser therapy in dermatomyositis. [6][7][8][9][10][11] Most of these reports consider the effect of the carbon dioxide laser and picosecond laser in the treatment of calcinosis cutis. The PDL, argon laser, and intense pulse light system have been reported in the treatment of telangiectasias, chronic facial erythema, poikiloderma, and Gottron papules in dermatomyositis.…”

Section: Discussionmentioning

confidence: 99%