Refractory Port Wine Stains (PWS): Long Pulsed Alexandrite Laser as an Option

INTRODUCTION: Port wine stains (PWS) are congenital vascular malformations. Pulsed dye laser (PDL) is the treatment of choice till now, although many lesions do not respond completely. One of possible options is long pulsed alexandrite laser. Some literatures confirmed its efficacy. The aim of the present study is to determine the efficacy of this laser as an option in treating refractory PWS in Iranian patients.METHODS: Patients with refractory PWS lesions that did not respond to at least six PDL sessions were included if they had no history of Isotretinoin consumption in past year, history of keloid or hypertrophic scar formation, active infection in laser site and if they were not pregnant. All patients signed an informed consent. Alexandrite laser with fluencies from 36-40J/Cm2, 12 mm spot size, 3 ms pulse duration and dynamic cooling device tuned to 50/50 ms was used in three successive sessions to treat lesions. All patients photographed before each session and after 8 weeks from the last sessions. Then, pictures were rated by two blinded dermatologist rater to determine degree of response based of visual analog scaling from score 1(below 25% response) to score 4 (more than 75% response).RESULTS: A total of 20 patients comprised of 12 males and 8 females with mean age of 23 years were included. 35% (7 patients) had score of 1, 35% (7 patients) had score of 2, 25% (5 patients) had score of 3 while one patient (5%) reached score 4. No serious side effect was observed. There was no significant relationship with age, gender and size of lesions and response rate.CONCLUSION: It seems that considering a conservative approach, long pulsed alexandrite laser may be an effective option in treating refractory PWS lesions. Although future studies with higher sample size using higher fluences are required to confirm these results

Comparison of seropositivity of human T lymphotropic virus type 1 in mycosis fungoides patients and normal volunteers: A case-control study and review of literature

Background: There have been controversial reports about the possible association between mycosis fungoides (MF), its leukemic variant Sιzary syndrome (SS) and human T lymphotropic virus type 1 (HTLV-1) in different geographical regions. Aims: The purpose of this study was to explore any association between MF and presence of HTLV-1 infection in Iran. Methods: In a case-control setting, 150 clinically and histopathologically proven MF patients had been admitted to the tertiary referral skin center during a 10-year period and another 150 normal volunteers had been compared with each other for the presence of HTLV-1 infection. Enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies against HTLV-1, and positive results were confirmed with western blotting. Results: Only three MF patients had HTLV-1 infection, whereas two cases of normal subjects had the infection ( P > 0.05). The only three seropositive MF patients were male and from North-Eastern Iran . Conclusion: This study showed that MF does not correlate with HTLV-1 infection in Iran

Effect of Different Pulse Durations on the Efficacy of Long-Pulsed Alexandrite-Assisted Hair Removal; A Split-Face Comparison Study: Pulse Duration and Hair Removal Efficacy

Introduction: Laser-assisted hair removal is widely used by a large number of patients complaining of unwanted hair. However, little is known about the effect of varying the pulse duration on clinical results and side effects. This study aimed to investigate the effectiveness of hair removal using an alexandrite laser with different pulse durations.Methods: Fifty female patients with facial hirsutism were subjected to a hair removal procedure with an alexandrite laser, using 3 and 10 milliseconds pulse durations on each side of the face every 5 weeks for three sessions. Photographs were taken and hair counts were checked before the treatment and one month postoperatively.Results: one month after the laser treatment, the clearance rate was 56% with both 3 and 10 milliseconds pulse durations. There was not any significant difference in clinical efficacy or the side effect profile.Conclusion: Using a 755 nm alexandrite laser for hair removal is an effective and safe method for delaying hair regrowth and this delay is not markedly different by increasing the pulse duration from3 to 10 milliseconds. DOI: 10.34172/jlms.2021.2

Folliculotropic mycosis fungoides: clinical and histologic features in five patients

Background: Alopecia can be a manifestation of mycosis fungoides (MF); however, the prevalence is unknown. Aims: We sought to describe the clinicopathologic presentation of alopecia in patients with diagnosis of MF. Methods: A retrospective analysis of patients with biopsy-proven MF, who were evaluated at our cancer center from 2002 to 2012, was performed to identify patients with alopecia. Results: Five patients with alopecia were identified from reviewing of 157 patients with MF. The male:female ratio was 3:2, and the mean age of patients was 42.8 years. Two of these patients showed patchy hair loss on scalp which was clinically identical to alopecia areata. In remaining three patients, hair loss was seen in areas of MF lesions, and epidermal changes consisted of patch- and plaque-type lesions of MF, tumors, and follicular lesions (follicular MF) were also present. In two of these patients, lymphadenopathy without any visceral involvement was detected. Conclusions: Alopecia was observed in 5 (3.18%) patients with MF, which makes it a rare finding, which included alopecia areata-like patchy loss in 2 and alopecia within MF lesions in 3

EFFICACY AND SAFETY OF LONG-PULSE PULSED DYE LASER DELIVERED WITH COMPRESSION VERSUS CRYOTHERAPY FOR TREATMENT OF SOLAR LENTIGINES

Background: Although cryotherapy is still the first-line therapy for solar lentigines, because of the side effects such as post-inflammatory hyperpigmentation (PIH), especially in patients with darker skin types, pigment-specific lasers should be considered as a therapy for initial treatment. Aim: The aim of this study is to evaluate the efficacy and safety of cryotherapy compared with 595-nm pulsed dye laser (PDL) with cutaneous compression in the treatment of solar lentigines. Materials and Methods: Twenty-two patients (skin type II−IV) with facial or hand lentigines participated in this study. Lesions of one side of the face or each hand were randomly assigned and treated with either cryotherapy or PDL. Treatments were performed with radiant exposures of 10 J/cm 2 , 7-mm spot size and 1.5 ms pulse duration with no epidermal cooling. Photographs were taken before treatment and 1-month later. The response rate and side effects were compared. Results: PDL was more likely to produce substantial lightening of the solar lentigines than cryotherapy, especially in skin type III and IV (n = 8, n = 9; P 0.05). PIH was seen only in cryotherapy group. PDL group had only minimal erythema. No purpura was observed. Conclusion: PDL with compression is superior to cryotherapy in the treatment of solar lentigines in darker skin types