Objectives: This lecture has three objectives.
1. Discuss treatments for hyperhidrosis with clinical trials to support the different theoretical backgrounds.
2. Evaluate different procedures for second and third degree burns.
3. Assess different therapies for skin lesions, especially diabetic neuropathic wounds which is one of the most difficult to treat, with high levels of reoccurrence and a substantial increase with aging.

Introduction: Diabetic wounds results in expensive hospitalizations, often resulting in an amputated lower limb. We explored a variety of methods such as RF, low-level laser, monochromatic near-infrared treatment, TENS, acupuncture and pulsed electromagnetic fields that demonstrated inconclusive, limited or temporary wound repair with minor or short-term improvements. We also explored low energy technologies that seemed to offer long lasing results with no re-occurrence.

Materials / method: Research conducted by ultra-low energy technologies also reports a fast improvement in hyperhidrosis, burns and wound repair. Medical research reports a reduction of inflammation as a result of anti-oxidant electron donation transforming free radicals into stable molecules. We report the results of clinical studies on burns and hyperhidrosis and a randomized double blind one-year-long longitudinal clinical study on skin lesions. Hyperhidrosis patients experience fast relief from their symptomatology with no side effects. Burns patients reported significant improvement and no scarring.

Results: The statistically significant results on wound repair and pain analgesia and improvement in neuropathic symptomatology were not age contingent. This contradicted past research postulating that age-accumulated inflammation and endothelial dysfunction can further exacerbate diabetic neuropathy. Importantly, a method offering age-independent, cost-effective, long-term neuropathic wound healing and increased mobility, fast relief from hyperhidrosis and substantial skin healing after severe burns have major implications in reducing hospitalization time and overall expenses.

Conclusion: In hyperhidrosis, getting rid of the sweat glands that eliminate the symptom exposes the patients to possible health deterioration due to the inability to perspire during the course of physical illness. Other safe modalities that consider the patient’s health must be considered. Evaluation of different methodologies for diabetic lesions healing should consider the degree of relief & symptom reoccurrence. Trauma-based technologies may not be indicated for lesions or burns due to a possible exacerbation of inflammation that may delay or complicate healing.

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Objectives: We aim to demonstrate the contributing effects of long pulse laser Nd:YAG 1064 nm, long pulse laser Alexandrite 755 nm and radio frequency fractional when used in parallel with systemic or topical therapies to treat acne vulgaris and acne scar. The result assessment is based on fundamental criteria such as decreasing inflammation, comedon acne and acne-scar-related complications and finally total treatment duration.

Introduction: Acne vulgaris is a common pilosebaceous unit disease causing significant psychological and financial burden for patients. Current conventional oral and topical therapies for acne are often tedious and depressing. Recently, laser and energy-based devices emerge as alternative interventions to deal with acne and acne scar problems and the preliminary results appear promising. However, there is a scarcity of literature regarding the combination of these two types of lasers and RF fractional with conventional therapies in acne and acne scar treatment and this is the reason of our study.

Materials / method: Long pulse laser Nd:YAG 1064 nm, long pulse laser Alexandrite 755 nm and radio frequency fractional are used in parallel with oral and topical therapies to treat acne and acne scar. The modality of combination is indicated by the degree of severity of skin lesions.

Results: Twenty cases with diagnosis of acne vulgaris were treated by a combination of long pulse laser Nd:YAG 1064 nm, long pulse laser Alexandrite 755 nm, radio frequency fractional and conventional therapies (oral and topical remedies) at Dr Thanh Dermatology and Aesthetic Clinic. The preliminary outcome was satisfactory in terms of treatment duration, side effect and recurrence rate.

Conclusion: Combined treatment including long pulse laser Nd:YAG 1064 nm, long pulse laser Alexandrite 755 nm, and radio frequency fractional and conventional therapies for acne vulgaris is relatively safe and satisfactory in both cosmetic and financial aspects. Further clinical trials with larger population and longer follow-up are necessary to make stronger conclusion about this novel therapy.

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Objectives: To understand: (1) How EBDs can target Post inflammatory Erythema ( PIE) (2) Which EDBs work best for PIE (3) Potential benefit of Pulse Dye Laser (PDL) in PIE treatment.

Introduction: Post inflammatory erythema (PIE) is a relative new term to describe the phenomenon of pink to red discoloration after an inflammatory acne lesion. Facial PIE improves slowly even with topical medicine or cosmeceuticals, in some cases, it maybe never completely cleared. Oftentimes, patients have any combination of PIH, PIE, and acne scars. Recognizing these distinctions is essential as each has a unique therapeutic approach. Though there are many therapeutic strategies for Acne, Acne scar, PIH that are described in the literature, fewer studies focus on acne – induced PIE.

Materials / method: EBDs have been used for the treatment of Post Inflammatory Erythema and have shown their effective performance, no down time, fewer side effects.

Results: The clinical cases which have been done in Buon Ma Thuot University Hospital with EDBs for PIE will be presented in this presentation. The mechanism of action for how EBDs work in PIE, which EDBs work best for PIE will be reviewed as well.

Conclusion: Using EBDs in treatment of Acne – Induced PIE is safe and effective. However, further randomized clinical trials are needed in this field.

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Objectives: This report highlights the possibility of a non-surgical, scarless treatment on Basal Cell Carcinoma using a combination of Laser and topical medication.

Introduction: Basal cell carcinoma (BCC) is one of the most frequent skin cancers found in humans. Each year, millions of people are diagnosed with BCC. Greatest risk factor to basal cell carcinoma is chronic sun exposure and the abundance of sun in tropical areas are especially risky. Despite its low metastatic capability, basal cell carcinoma is known to be locally invasive and destructive. However, surgical options may not yield the best cosmetic outcome particularly in aesthetically important areas of the face as a wide margin excision may yield unwanted scars and alter important facial features.

Materials / method: 72 year old Asian male with two large Basal Cell Carcinoma on bilateral cheeks. Patient has a history multiple comorbidities including chronic renal failure and insisted on a non-surgical approach. We chose a combined approach using a 595-nm Pulsed-Dye Laser and topical Imiquimod 5%.

Five Pulsed-Dye Laser treatments were done on a monthly interval. At home, patient was instructed to apply topical Imiquimod 5% five times a week.

Results: All cancer lesions were cleared after five Pulsed-Dye Laser sessions and five-times weekly topical imiquimod.

Conclusion: The combination of 595-nm Pulsed-Dyle Laser and topical imiquimod 5% results in an excellent cleareance of BCC without scarring or major pigmentary alterations.

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