Rhinophyma Treatment by Copper Vapor Laser With the Computerized Scanner

Abstract

Introduction: Rhinophyma is recognized as a common and severe skin disease manifested as progressive thickening of the nasal skin due to hypertrophy of the soft tissue. The most severe complication of rhinophyma is telangiectasis. So far the pathogenetic approach for the treatment of rhinophyma should be based on the removal of the dysplastic vessels to provide the appropriate revascularization of the involved skin area. Case Report: This study presented the experience of the treatment of rhinophyma with the copper vapor laser (CVL) designed with the computerized scanner device. A 52-year-old elderly Caucasian male patient with typical clinical signs of rhinophyma was successfully managed during three sessions of CVL treatment. CVL emits light with a wavelength of 578 nm, exposure time of 0.2 seconds. The settings used for the CVL in scanner mode were set at 1.2 W. The scanner device has a hexagonal frame with a maximum width of 12 mm with the distance of 1 mm between centers of laser spots. The CVL treatment resulted in a restoration of the natural appearance of the nose without side effect during 18 months after treatment. Conclusion: The described clinical case demonstrates excellent results of the management of rhinophyma by means of the scanned CVL. CVL treatment was associated with the removal both of dysplastic superficial skin vessels, the solution of the inflammation, decline of the sebum production and the disappearance of the nasal hypertrophy.

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“…In some cases, when patients have other comorbidities like cardiac failure, impaired hemostasis, or allergies to anesthesia drugs, the possibilities to treat rhinophyma are some light treatments and laser (CO 2 , Argon, Nd: YAG) 8 . Laser therapies are successful methods since eradicating telangiectasias leads to decreased blood supply to the hypertrophic tissue and subsequent tissue reduction, they can carefully cut and vaporize skin while obliterating sebaceous glands and expression of sebum 1,9 . Laser treatment and dermabrasion have the advantages of precise hemostasis and contouring of an aesthetic nasal shape 7,10,11 .…”

Rosacea treatments: Current standards and additional options

“…Successful phyma correction has been reported with microdebrider contouring (3000 rpm) after excision (300 rpm) with a straight microdebrider handpiece (Medtronic Straightshot M4 Microdebrider) 123,124 . Fractional CO 2 laser, ablative CO 2 laser + 595 nm dye laser, and copper vapor laser have also been described with good results 125–128 …”

Epidermal nevus in blaschkoid distribution treated with dual-wavelength copper vapor laser

“…In the laser management of the epidermal blaschkoid nevus, the target chromophores include melanin in acanthotic cells, lipids in sebocytes as well as oxyhemoglobin and hemoglobin in erythrocytes of the microvascular bed of the papillary dermis. 6 The high simultaneous absorption of dual-wavelength copper vapor laser radiation at 511 nm and 578 nm by all the target nevus sebaceous chromophores provided the sound removal of nevus sebaceous due to the appropriate heating of melanin in acanthotic cells, sufficient sebum discharge and photodestruction of the involved dilated microvascular bed. 7 Copper vapor laser at 578 nm, mostly absorbed by oxyhemoglobin and deoxyhemoglobin, provides appropriate photocoagulation followed by the remodeling of the vascular bed, likely preventing both relapses and malignant change in facial blaschkoid nevus.…”

“…Copper vapor laser neither passes into the deep dermis nor overheats dermal stem cells, essential for the appropriate skin healing after the laser exposure. 6 Copper vapor laser can be useful in the treatment of facial epidermal nevi distributed along Blaschko's line without inflammatory signs.…”