Quantitative Analysis of Skin Erythema Due to Laser Hair Removal: A Diffusion Optical Spectroscopy Analysis

 Introduction: Laser hair removal needs an accurate understanding of tissue structure and chromophores content in order to optimize the selection of laser irradiation parameters. None of the optimized laser therapy might lead to side effects in skin tissue such as severe erythema, burn, scar etc. Therefore, guidance by a noninvasive real-time diagnostic method like optical spectroscopy technique is beneficial. The purpose of this survey is to analysis the skin hemoglobin spectrum quantitatively before and after hair removal laser irradiation to minimize the side effects of the procedure.Methods: To carry out a spectroscopy study, a halogen-tungsten light source was used in the wavelength region of 400-700 nm on an ocean optic device. The measurements were made on the facial area under identical conditions. Total 19 volunteers for laser hair removal by gentle laser Candela, ranging 14- 49 years old, were included in the study. A total of 18 spectra were taken from each person, 9 spectra before hair removal as a reference and 9 subsequent spectra. Colorimetry was done for all acquired before and after spectrums using Origin software (version 8.6). Then, the erythema index derived for each spectrum. Statistical analysis of correlation and normalization in colorimetry data were done using data analysis by SPSS (version 16).Results: Spectra analysis, before and after optical reflectance spectrums in laser hair removal procedure, revealed the subpeak derivation, and concentration on special visible wavelength 510-610 nm. We studied the changes of skin chromophores absorption. The derived erythema index [E] and colorimetry parameters a*, b*, l* were compared and correlated statistically. There was a statistically considerable direct linear correlation between a* and E while inverse linear correlation was observed for l* and E and no correlation for b* and E.Conclusion: Diffuse reflectance spectroscopy showed its potency as an accurate, noninvasive real-time as complementary method for laser treatment to detect erythema as a complication of the method, in order to optimize the parameters based on the tissue characteristics in various candidates

Quantitative Autofluorescence Imaging of A375 Human Melanoma Cell Samples: A Pilot Study

Introduction: Skin cancer is one of the most common types of malignancy worldwide. Human skin naturally contains several endogenous fluorophores, as potential sources that can emit inherent fluorescence, called intrinsic autofluorescence (AF). The melanin endogenous fluorophore in the basal cell layer of the epidermis seems to have a strong autofluorescence signal among other ones in the skin. This pilot study aimed to investigate the feasibility of the detection of autofluorescence signals in the A375 human melanoma cell line in the cell culture stage using the FluoVision optical imaging system.Methods: The human skin melanoma cell line (A375) donated as a gift from Switzerland (University Hospital Basel) was cultured. For the imaging of the A375 human melanoma cell sample in this pilot study, the FluoVision optical imaging device (Tajhiz Afarinan Noori Parseh Co) was applied. The proposed clustering image processing code was developed based on the K-mean segmentation method, using MATLAB software (version 16).Results: The quantification of color pixels in the color bar along with the intensity score of the autofluorescence signal ranged between 0 and 70 was written in the image processing code execution and a threshold higher than 40%, proportional to the ratio of autofluorescent cells. The percentage of the signal of A375 autofluorescent melanoma cells in the 3 studied cell samples was calculated as 3.11%±0.6.Conclusion: This imaging method has the advantage of no need for fluorophore labels over the existing fluorescence imaging methods, and it can be regarded as one of the important choices of label-free imaging for this A375 melanoma cell line containing the intrinsic endogenous fluorophore in cell studies. DOI: 10.34172/jlms.2021.0

Treatment of oral lichen planus with photodynamic therapy mediated methylene blue : A case report

Oral lichen planus (OLP) is a common chronic disease of uncertain origin. Many patients with OLP are refractory to all available therapies. The photodynamic therapy (PDT) was used as a possible alternative method in the treatment of lichen planus. Two patients with five oral lichen planus lesions were treated using topical PDT mediated by methylene blue (MB-PDT). The patients were followed up on sessions 3, 7, 15 days and 1 to 9 months after PDT. Clinical improvement was achieved in four lesions. Two lesions showed complete remission, and another two lesions had about 50% clinically improvement 3-9 months after a single session of PDT. No response detected in one lesion. MB-PDT blue seems to be an effective alternative treatment for control of OLP. In our opinion, this preliminary result warrant further studies in order to show the efficacy of MB-PDT in control of OLP for a longer period of time

The Immediate Pain-Relieving Effects of Non-Thermal CO2 Laser Therapy on Genital Ulcers of Behcet’s Disease: A Case Report

Behçet’s disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. Oral and genital aphthous ulcers are considered as the hallmarks of BD. The genital ulcers of BD may be extremely painful and often refractory to multiple treatments. In addition, they exert a negative impact on the patient’s quality of life. Some investigations have demonstrated the significant and immediate pain-relieving effects of NTCLT (non-thermal CO2 laser therapy) on some oral lesions with no visible adverse effects. In this paper, we report a case of BD whose painful genital ulcers were irradiated with NTCLT and the patient’s pain caused by the ulcers relieved immediately and significantly with no visible complications

Low Level Laser Therapy in Management of Chemotherapy-Induced Oral Mucositis: Prophylaxis or Treatment?

INTRODUCTION: Chemotherapy-induced oral mucositis (COM) is a common, debilitating complication of cancer therapy. The aims of this study were to evaluate the effect of low level laser therapy (LLLT) on prevention of COM in patients with hematologic malignancies.METHODS: Fifty-five patients hospitalized to undergo chemotherapy in Imam Hospital were included into the study. These patients were divided into two groups. The oral cavity of the patients were illuminated by continues laser beam using a GaAlAs laser device with wavelength of 630 nm, power output 30 mW, and dose of 5 J/cm2 for six days (LLLT group). The patients in the second group underwent placebo irradiation (power output equal to zero) with the similar protocol. The severity of the COM was clinically evaluated based on WHO grading scale. The patientys’quality of life was assessed before and after the intervention according to EORTC QLQ-C30 questionnaire.RESULTS: The incidence of COM in LLLT group (31%) was less than the placebo group (41%). Mean duration of COM healing was 4.8 and 12 days in LLLT and placebo groups, respectively (p=0.03). Xereostomia was significantly less severe in LLLT group in comparison with the placebo group (p=0.007).CONCLUSION: Our findings showed that LLLT significantly reduced the incidence of oral mucositis of WHO grade 3 and 4 as the most debilitating form of oral mucositis,in which oral alimentation is impossible. Also, LLLT could reduce duration of oral mucositis, decreased the risk of secondary infection, and accelerated return to normal nutrition.

Relieving Pain in Oral Lesions of Pemphigus Vulgaris Using the Non-ablative, Non-thermal, CO2 Laser Therapy (NTCLT): Preliminary Results of a Novel Approach

Introduction: Pemphigus vulgaris (PV) is a chronic, serious autoimmune mucocutaneous bullous disease. Oral lesions in PV may be extremely painful. This pain may adversely affect the patients’ oral intake and quality of life. This before-after clinical trial was designed to assess the pain relieving effects of single session of non-ablative, non-thermal CO2 laser therapy (NTCLT) in oral lesions of PV.Methods: Fifty painful oral lesions of fourteen patients with PV were illuminated by CO2 laser (power: 1 W, scanning the lesions with rapid circular motion of the handpiece) passing through a thick layer of transparent gel with high water content. The pain severity of the oral lesions was reported by the patients up to the fourth postoperative day. They were also asked to continue their existing systemic treatment during the course of this study as a precondition for the participation.Results: The severity of contact and non-stimulate (non-contact) pain declined immediately and significantly after NTCLT (P < 0.001). The pain relieving effect was sustained during the four successive days of follow-up. The procedure was pain free and no kind of analgesics was required. Following NTCLT, there were no visible thermal complications such as destruction, ablation or irritation of the oral lesions.Conclusion: The results of the trial proposed that single session of NTCLT could immediately and significantly relieve pain in oral lesions of PV, without any visible thermal complications

Subcutaneous Injection of Allogeneic Adipose-Derived Mesenchymal Stromal Cells in Psoriasis Plaques: Clinical Trial Phase I

Objective: Mesenchymal stromal cells (MSCs) play immunomodulatory role in various autoimmune diseases. Previouspre-clinical and clinical studies have shown that MSCs could be a therapeutic modality for psoriasis. However, themechanisms of treatment and its possible side effects are under investigation. In this study, the safety and probableefficacy of injecting allogeneic adipose-derived mesenchymal stromal cells (ADSCs) in psoriatic patients were evaluated.Materials and Methods: In this phase I clinical study with six months of follow-up, total number of 1×106 or 3×106cells/cm2 of ADSCs were injected into the subcutaneous tissue of each plaque as a single dose in three males and twofemales (3M/2F) with a mean age of 32.8 ± 8.18. The primary outcome was safety. Changes in clinical and histologicalindexes, the number of B and T lymphocytes in local and peripheral blood, and serum levels of inflammatory cytokineswere assessed. Paired t test was used to compare variables at two time points (baseline and six months after injection)and repeated measures ANOVA test was utilized for variables at three time points in follow-up visits.Results: No major adverse effects such as burning, pain, itching, or any systemic side effects were observed followingADSCs injection, and the lesions showed slight to considerable improvement after injection. The mRNA expressionlevels of pro-inflammatory factors were reduced in the dermis of the patients after injection. The increased expressionlevel of Foxp3 transcription factor in the patient blood samples suggested modulation of inflammation after ADMSCsadministration. Six months after the intervention, no major side effects were reported, but skin thickness, erythema, andscaling of the plaques, as well as the PASI score, were decreased in majority of patients.Conclusion: Our study suggested that ADSC injection could be considered as a safe and effective therapeuticapproach for psoriatic plaques (registration number: IRCT20080728001031N24)

Detection of Melanoma Skin Cancer by Elastic Scattering Spectra: A Proposed Classification Method

Introduction: There is a strong need for developing clinical technologies and instruments for prompt tissue assessment in a variety of oncological applications as smart methods. Elastic scattering spectroscopy (ESS) is a real-time, noninvasive, point-measurement, optical diagnostic technique for malignancy detection through changes at cellular and subcellular levels, especially important in early diagnosis of invasive skin cancer, melanoma. In fact, this preliminary study was conducted to provide a classification method for analyzing the ESS spectra. Elastic scattering spectra related to the normal skin and melanoma lesions, which were already confirmed pathologically, were provided as input from an ESS database. Materials and Methods: A program was developed in MATLAB based on singular value decomposition and K-means algorithm for classification. Results: Accuracy and sensitivity of the proposed classifying method for normal and melanoma spectra were 87.5% and 80%, respectively. Conclusion: This method can be helpful for classification of melanoma and normal spectra. However, a large body of data and modifications are required to achieve better sensitivity for clinical applications

Clinical effect of Non-Thermal CO2 Laser Therapy (NTCLT) on Pain Relief of Oral Aphthous Ulcers of Behçet’s Disease: Pain Relieving Effects of NTCLT on Oral BD Ulcers

Introduction: Behçet’s disease (BD) is a debilitating and chronic vasculitis that can affect multiple organs. Recurrent oral aphthosis is the most common clinical feature of BD. The remarkable pain associated with painful oral ulcers can exert a major impact on the patients’ quality of life. Non-thermal CO2 laser therapy (NTCLT) as a novel photobiomodulative approach has recently been used for significant and immediate pain reduction of some types of painful oral lesions such as recurrent aphthous stomatitis, pemphigus Vulgaris, and so on. In this procedure by some considerations, the conventional CO2 laser is used as a non-surgical, non-thermal, photobiomodulative laser without any visible thermal adverse effects. In this article, we report ourexperiences about the analgesic effects of NTCLT on painful oral aphthous ulcers of BD.Case Presentation: We report four cases of BD, whose painful oral aphthous ulcers were irradiated with NTCLT. Immediately after NTCLT, the pain of the lesions was significantly relieved with no visible complications.Conclusion: The results of this study suggest that NTCLT could be proposed as a hopeful procedure for significant and instant pain relief of oral aphthous ulcers of BD without any visible thermal adverse effects. DOI:10.34172/jlms.2021.72

Non-thermal CO2 Laser Therapy (NTCLT): A Novel Photobiomodulative Approach for Immediate Pain Relief of Patchy Oral Mucositis Due to Chemotherapy of Solid Tumors: NTCLT/ pain relief of COM

Introduction: Chemotherapy-induced oral mucositis (COM) is a prominent complication of chemotherapy (CT). Non-thermal CO2 laser therapy (NTCLT) has been demonstrated as an innovative and safe photobiomodulative approach in some kinds of painful oral lesions. The purpose of this study was to evaluate the palliative effects of one session of NTCLT on COM lesions.Methods: Patients with painful COM (WHO grade:≥2) were included in this before-after clinical trial based on the eligibility criteria. The oral lesions were irradiated with a CO2 laser (power: 1 W, scanning the lesions with the rapid circular motion of the defocused handpiece) through a thick layer (3-4 mm) of a transparent gel containing a high water content. The severity of pain in the lesions was self-assessed using a 0-to-10 visual analog scale (VAS) for 7 consecutive days. The evaluating physician visited the patients on the 3rd and 7th days in search of any kind of complications.Results: Seventeen adult patients with 35 patches of OM due to chemotherapy of solid tumors completed the trial. Immediately after NTCLT, the mean for non-contact VAS pain scores of the lesions significantly declined from 4.91±2.356 to 0.29±0.622 (P<0.001) and the mean for contact VAS pain scores from 7.77±1.57 to 1.31±1.18 (P<0.001). The mean VAS pain scores of the lesions showed statistically significant differences between the follow-up periods compared to the baseline (P<0.001). The process was completely pain-free and required no anesthesia. After NTCLT, no kind of thermal adverse effects such as irritation, destruction, aggravation, and even erythema were observed.Conclusion: Based on the results of this before-after clinical trial, NTCLT has the potential to be considered a non-invasive and safe palliative option for the pain management of patchy OM due to chemotherapy of solid tumor