Biopsy Techniques

Abstract This chapter will review the various types of biopsies utilized in dermatologic surgery, and the indications for the different approaches. In addition, the appropriate instruments and instructions for proper technique will be discussed

Laser‐Assisted Hair Removal

This chapter contains sections titled: Introduction Biology of hair follicles Basic concepts of laser‐assisted hair removal Preoperative management Description of techniques Radiofrequency combinations Other removal methods for non‐pigmented hair Postoperative management Complications Conclusion

Comparative effectiveness among available treatments in difficult-to-treat port-wine stains (PWS): a Network Meta-Analysis of observational evidence

Background Although pulsed dye laser (PDL) is the treatment of choice for port-wine stains (PWS), clinical resistance to PDL has been observed in 20–30% of cases. Several alternative treatment modalities have been introduced; however, there is still a lack of definite recommendations regarding the optimal treatment for difficult-to-treat PWS. Objective We aimed to systematically review and analyze the comparative effectiveness among treatments for problematic PWS. Methods & Materials We systematically searched for comparative studies assessing treatments for patients with difficult-to-treat PWS through relevant biomedical databases until August 2022. A Network Meta-Analysis (NMA) was conducted to estimate the odds ratio (OR) for all pairwise comparisons. The primary outcome is the improvement of lesions of more than 25%. Results Of the 2498 studies identified, six treatments from five studies were available for NMA. Compared with 585 nm short-pulsed dye laser (SPDL), intense pulsed light (IPL) was the most effective in clearing lesions (OR 11.81, 95% CI 2.15 to 64.89, very low confidence rating), followed by 585 nm long-pulsed dye laser (LPDL) (OR 9.95, 95% CI 1.75 to 56.62, very low confidence rating). The 1064 nm NdYAG, 532 nm NdYAG, and LPDL >585 nm exhibited potential superiority over SPDL 585 nm, although statistical significance was not observed. Conclusions IPL and 585 nm LPDL are likely to be more effective than 585 nm SPDL for treating difficult-to-treat PWS. Well-designed clinical trials are warranted to confirm our findings

Anesthesia for Laser Surgery

A number of laser procedures such as laser resurfacing or tattoo removal are associated with some discomfort. Anesthesias provide a reversible loss of sensation and alleviate most of the discomfort. The techniques most commonly used are topical anesthesia and regional anesthesia with or without systemic analgesics and/or anxiolytics

Laser‐assisted Hair Removal

Current options for hair removal include shaving, epilation, depilatories, electrolysis, and, more efficiently, lasers. Lasers are fast, safe, and effective when used appropriately. Selective photothermolysis is the key concept in laser hair removal. By varying specific parameters such as wavelength, pulse duration, and fluence, certain specific chromophores may be targeted while protecting other tissues. Melanin is the main endogenous chromophore in hair follicles. In permanent hair reduction, heat from the laser must spread from the hair shaft to the bulb and the bulge of the hair. Adverse effects reported after laser‐assisted hair removal including erythema, perifollicular edema, crusting, vesiculation, hypopigmentation, and hyperpigmentation

Photoepilation: a growing trend in laser-assisted cosmetic dermatology

Excess hair is an age-old condition plaguing both men and women alike, of all races. Conditions such as hirsutism or hypertrichosis, procedures that involve grafted donor sites, transsexual transformations from male to female, and genetics are all responsible for excess or unwanted hair. Previous options for people seeking to remove or lessen the presence of hair have either been painful or resulted in short-term hair removal. With the recent advent of laser technology, hair removal has been added to the many capabilities of the new generation nonablative lasers and light systems. Lasers are not yet a permanent solution for hair removal, but they are able to provide a safe, fast, and effective method of hair reduction

Treatment of Poikiloderma by Pigment and Vascular Lasers

Poikiloderma of Civatte (PC) is a condition of the middle aged fair-skinned women and men. It is characterized by a triad of superficial skin atrophy, telangiectasia, and reticulate pattern of pigmentary alterations (both hyperpigmentation and hypopigmentation). Discoloration is usually profound at the lateral aspects of the cheeks, the lower anterior and lateral aspects of the neck, and V shape of the upper chest. The submental area, shaded by the shin, is spared (Fig. 7.1).1–14 Lesions are usually asymptomatic, although patients occasionally report itching, mild burning, and flushing