Objectives: The aim of this presentation is to assess the function of dermoscopy in diagnosis and monitoring of lesions treated with laser procedures.

Introduction: Dermoscopy is useful tool for diagnosis of skin cancers and pigmented lesions. It enhance accurate diagnosis of malignancy of pigmented lesions, and help laser surgeon to choose parameters and monitor response for each laser procedure.

Materials / method: We present dermoscopic findings of pigmented and vascular lesions before and after laser irradiation. A litterature review is discussed.

Results: Laser surgeon needs dermoscopy before treating any pigmented flat lesion of the face to differentiate accurately between pigmented lentigo maligna and pigmented actinic keratosis. The color of melanin perceived on dermoscopy may help to predict the anatomic location of this chromophore when treating pigmented lesions with Q switched lasers. Dermoscopy can help differential diagnosis of facial melanoses like mélasma, Riehl melanosis and lichen planus pigmentosus. Recent reports have commented on the use of dermoscopy in guiding laser therapy for a variety of dermatologic conditions.

Conclusion: Dermoscopy can help to assess efficacy and to adjust laser settings when treating vascular lesions like erythema, telangiectasias, and port-wine stains. This non invasive imaging tool can be helpful for long term follow up of skin cancers treated with non surgical procedures.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: Treatment of pigmented dermatoses with Q-Switched laser by choosing the appropriate wavelength depending on the location of the pigment in the epidermis or dermis

Introduction: Benign pigmented lesions are a very heterogeneous common cosmetic dermatosis. The lasers have provided a major advance in the treatment.

Materials / method: The principle is based on our understanding of selective photothermolysis by Anderson and Parrish. This principle focuses on the lasers’ specificity to a wavelength that targets a dedicated chromophore, in this case melanosomes.

Results: To obtain a selective action, the laser pulse duration must be at least ten times less than the target's thermal relaxation time (TRT). The size of a melanosome is approximately 1 μm and its TRT varies from 1 to 10 μs. The laser pulse duration should therefore be less than 100 ns, and using a Q-Switched laser, whose emission duration generally varies between 10 and 100 ns, or pico laser, we are confining the damage inside the target. The choice of wavelength depends on pigment location in the dermis or epidermis.

Conclusion: The interest of these pigmentary lasers in the treatment of several dermatoses, the choice of optimal parameters and the treatment modalities will be presented through clinical cases.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: Treatment modalities for benign pigmented lesions range from cryotherapy to laser and energy-based technologies. These treatments have been shown to be effective, yet may lead to dyschromia or significant downtime. We report a novel Cooling System that provides localized and controlled freezing to benign pigmented lesions.

Introduction: Existing therapeutic modalities for treatment of benign pigmented lesions suffer certain limitations, including risks of post-inflammatory hyperpigmentation especially in susceptible ethnic populations and darker Fitzpatrick skin types. Prior experience with cutaneous cryotherapy has demonstrated the cold sensitivity of melanocytes. A novel device has been developed to deliver precise, controlled, localized cooling to effect a reduction in pigmentation without collateral damage to the epidermis. A GLP animal study was performed to evaluate the dosimetry and role of controlled skin cooling

Materials / method: Preclinical testing was performed in a porcine model. Two female Sinclair Yucatan pigs were treated on the flanks using the Dermal Cooling System. Different contact cooling applicators were used to deliver a range of temperatures and exposure times. Pigmentation changes were assessed by photographic review scoring, and biopsy samples were taken immediately following treatment and monthly thereafter for histopathology. Subsequently, clinical utilization of the Dermal Cooling System was initiated to assess the safety and effectiveness of the device and to evaluate treatment parameter ranges.

Results: In the GLP porcine study, specific exposure conditions were determined that consistently and safely elicited a reduction in pigmentation based on the photographic review. There was an absence of any notable side effects in the animals. Histologic evaluation revealed that localized epidermal cooling was associated with decreases in histomorphometric and histomorphologic pigmentation parameters without adverse tissue reactions. Clinical experience with the device is ongoing. Subjects with lentigines, seborrheic keratosis, melasma, or other hyperpigmentation conditions have been treated

Conclusion: Preclinical and clinical testing have demonstrated the ability to selectively and safely reduce pigmentation using controlled, localized cooling of the epidermis. The Dermal Cooling System provides an alternative to energy-delivery devices for treatment of benign pigmented lesions, offering minimal procedural discomfort and downtime, low risk of post-inflammatory hyperpigmentation, and the ability to treat all skin types.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
Yes
Please specify entities (individual, company, society): R2 Dermatology

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability