Using reflectance confocal microscopy to observe in vivo melanolysis after treatment with the picosecond alexandrite laser and Q‐switched Nd:YAG laser in melasma

Jo, Da Jung; Kang, In-Hye; Baek, Joon Sang; Gwak, Min Jae; Lee, Sang Jun; Shin, Min Kyung

doi:10.1002/lsm.23025

Cited by 16 publications

(28 citation statements)

References 23 publications

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“…The proinflammatory effect of a biopsy may interfere with the interpretation of UVR-induced photoinflammation and limit the capacity of reversal. Reflectance confocal microscopy (RCM) is a valid tool for the noninvasive diagnosis and monitoring of superficial skin cancers and pigment disorders [20][21][22]. However, en face images require substantial learning and practice for interpretation.…”

Section: Discussionmentioning

confidence: 99%

Photoaging and Sequential Function Reversal with Cellular-Resolution Optical Coherence Tomography in a Nude Mice Model

Wang

Chang

et al. 2022

IJMS

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Although nude mice are an ideal photoaging research model, skin biopsies result in inflammation and are rarely performed at baseline. Meanwhile, studies on antiphotoaging antioxidants or rejuvenation techniques often neglect the spontaneous reversal capacity. Full-field optical coherence tomography (FFOCT) can acquire cellular details noninvasively. This study aimed to establish a photoaging and sequential function reversal nude mice model assisted by an in vivo cellular resolution FFOCT system. We investigated whether a picosecond alexandrite laser (PAL) with a diffractive lens array (DLA) accelerated the reversal. In the sequential noninvasive assessment using FFOCT, a spectrophotometer, and DermaLab Combo®, the photodamage percentage recovery plot demonstrated the spontaneous recovery capacity of the affected skin by UVB-induced transepidermal water loss and UVA-induced epidermis thickening. A PAL with DLA not only accelerated skin barrier regeneration with epidermal polarity, but also increased dermal neocollagenesis, whereas the nonlasered group still had >60% collagen intensity loss and 40% erythema from photodamage. Our study demonstrated that FFOCT images accurately resemble the living tissue. The photoaging and sequential function reversal model provides a reference to assess the spontaneous recovery capacity of nude mice from photodamage. This model can be utilized to evaluate the sequential noninvasive photodamage and reversal effects after other interventions.

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Section: Discussionmentioning

confidence: 99%

Photoaging and Sequential Function Reversal with Cellular-Resolution Optical Coherence Tomography in a Nude Mice Model

Wang

Chang

et al. 2022

IJMS

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“…This conclusion was inconsistent with a split-face study in which 755-nm PICO was more effective than QSND for melasma in Asians (33). Another study further proved that a significantly greater decrease in melanin-induced reflectance in the spinous layer and the basal layer was observed after 755 nm of PICO treatment compared with the QSND treatment for melasma (34). More RCTs with PICO for melasma should be included in the future.…”

Section: Discussionmentioning

confidence: 92%

Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials

Liu

et al. 2021

Front. Med.

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Background: Melasma is an acquired pigmentation disorder with challenges in treatment because of its refractory nature and high risk of recurrence.Objectives: This study aimed to compare the efficacy and side effects of 14 common therapies for melasma using a systematic review and network meta-analysis (NMA).Methods: The PubMed, Embase, and Cochrane Library databases were searched till December 2020 using the melasma area and severity index as a therapeutic index. A total of 59 randomized controlled trials (RCTs) met the inclusion criteria and were selected.Results: The ranking of relative efficacy compared with placebo in descending order was Q-switched Nd:Yag 1,064-nm laser (QSND), intense pulsed light, ablative fractional laser (AFL), triple combined cream (TCC), topical vitamin C, oral tranexamic acid (oTA), peeling, azelaic acid, microneedles (MNs), topical tranexamic acid (tTA), tretinoin, picosecond laser, hydroquinone (HQ), and non-AFL. Moreover, QSND was more effective than HQ and tTA against melasma. The ranking of percentage (%) of side effects in ascending order for each of 14 therapies with more than 80 participants was tretinoin (10.1%), oTA (17.6%), HQ (18.2%), AFL (20.0%), QSND (21.5%), TCC (25.7%), tTA (36.75%), peeling (38.0%), and MN (52.3%). Taking both efficacy and safety into consideration, TCC was found to be the most favorable selection among the topical drugs for melasma. QSND and AFL were still the best ways to treat melasma among photoelectric devices. oTA as system administration was a promising way recommended for melasma. Among 31 studies, 87% (27/31) studies showed that the efficacy of combination therapies is superior to that of single therapy. The quality of evidence in this study was generally high because of nearly 50% of split-face RCTs.Conclusions: Based on the published studies, this NMA indicated that QSND, AFL, TCC, and oTA would be the preferred ways to treat melasma for dermatologists. However, more attention should be paid to the efficacy and safety simultaneously during the clinical application. Most of the results were in line with those of the previous studies, but a large number of RCTs should be included for validation or update.Systematic Review Registration: identifier: CRD42021239203.

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“…There are other tools to study the amount and distribution of melanin in the face. Reflectance confocal microscopy (RCM) is a non‐invasive tool for analysis of the skin at almost histologic resolution to a depth of 200−300 μm including epidermis and upper dermis 13 . Since melanin is the main source of reflectance, melanin is easily visualized as bright structures in RCM images uses an 830 nm laser beam 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Reflectance confocal microscopy (RCM) is a non‐invasive tool for analysis of the skin at almost histologic resolution to a depth of 200−300 μm including epidermis and upper dermis. 13 Since melanin is the main source of reflectance, melanin is easily visualized as bright structures in RCM images uses an 830 nm laser beam. 14 RCM is inefficient in obtaining a full picture of melanin distribution as it focuses on a small part of the skin and repeated procedures may be required for enough data to represent the whole face.…”

Section: Discussionmentioning

confidence: 99%

Proposal of facial pigmentary unit and facial hyperpigmentation type for Fitzpatrick skin types II‐IV

Lee²,

Ko³

et al. 2022

Skin Research and Technology

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Background Studies on facial hyperpigmentation across different facial units are limiting. We aimed to analyze melanin pigmentation images to observe facial pigmentary demarcation lines (FPDLs) and suggest facial hyperpigmentation types for normal individuals. Materials and methods 3D facial melanin pigmentation images of 173 volunteers were obtained and analyzed for the presence of FPDLs. Pigmentation severity was assessed for each of the thirteen facial pigment units. The images were then grouped according to a pattern of hyperpigmentation to suggest three facial hyperpigmentation types—dark spot, photoaging and post‐inflammatory hyperpigmentation. Results Four groups of FPDLs including a novel group I were observed. Nasal, frontal, auricular were the darkest pigmented facial pigment unit, and the anterior neck was the least pigmented. The dark spot type was the most common facial hyperpigmentation type. The photoaging type and the PIH type showed age‐dependent distribution, as the photoaging type was more common among the subjects over 40s, and the PIH type was more common in younger subjects. Conclusion Facial hyperpigmentation among healthy individuals with Fitzpatrick skin types II‐IV is often accompanied by FPDLs and categorized into three types. Each type is modeled after the pattern of pigmentation associated with certain dermatological disorders. The practical implications of facial hyperpigmentation types can be resourceful in various fields including prevention and treatment of pigmentary disorders.

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Using reflectance confocal microscopy to observe in vivo melanolysis after treatment with the picosecond alexandrite laser and Q‐switched Nd:YAG laser in melasma

Cited by 16 publications

References 23 publications

Photoaging and Sequential Function Reversal with Cellular-Resolution Optical Coherence Tomography in a Nude Mice Model

Photoaging and Sequential Function Reversal with Cellular-Resolution Optical Coherence Tomography in a Nude Mice Model

Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials

Proposal of facial pigmentary unit and facial hyperpigmentation type for Fitzpatrick skin types II‐IV

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