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Zhang J, Zhou S, Xia Z, Peng Z, Luo W, Cheng X, Yang R. Effectiveness of artesunate combined with fractional CO2 laser in a hypertrophic scar model with underlying mechanism. Burns 2022; 48:662-671. [PMID: 34103199 DOI: 10.1016/j.burns.2021.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/08/2021] [Accepted: 05/25/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Both artesunate and fractional CO2 laser have been proved effective in the treatment of hypertrophic scars, yet little data are available for the efficacy of artesunate combined with fractional CO2 laser. In order to assess the pre-clinical significance and the underlying mechanism of this combined treatment profile, we attempted to observe the effectiveness of this therapy in rabbit models through determining the expression of BMP-7 and Fas. MATERIALS AND METHODS Twenty-Four New Zealand white rabbits with established hypertrophic scar samples were randomly divided into control group and three treatment groups. Artesunate (20 μl/cm2) was injected into the rat's scar of artesunate and combination groups, while fractional CO2 laser (Combo mode, deep energy:10 mJ, super energy: 50 mJ) was applied to rats in fractional CO2 laser and combination groups at week 4 after model establishment. All rabbits underwent a total of 3 sessions of treatment once every 2 weeks. Histological and immunohistochemistry study, Western blot assay, cell viability, ELISA and RT-QPCR were performed at week 10 to observe the aspects of hypertrophic scar sample changes and expression of BMP-7 and Fas in the scar tissues. RESULTS Compared with control group, hypertrophic scars and the collagen fibers were significantly inhibited after treatment, and higher inhibition was seen in the samples in combination group compared to that in artesunate and fractional CO2 laser groups (P < 0.01). Meanwhile, BMP-7 and Fas expressions were both notably increased in all treatment groups, and upregulation of the two proteins was dominant in combination group (P < 0.01). CONCLUSIONS Artesunate combined with fractional CO2 laser is effective in hypertrophic scarring in this rabbit model. Our findings can serve as a potential alternative strategy to treatment of hypertrophic scar in clinical practice.
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Affiliation(s)
- Jinxia Zhang
- Seventh Medical Center of PLA General Hospital, Beijing, 100700 China
| | - Shuanglin Zhou
- Seventh Medical Center of PLA General Hospital, Beijing, 100700 China
| | - Zhikuan Xia
- Seventh Medical Center of PLA General Hospital, Beijing, 100700 China
| | - Zhuoying Peng
- Seventh Medical Center of PLA General Hospital, Beijing, 100700 China
| | - Wanting Luo
- Seventh Medical Center of PLA General Hospital, Beijing, 100700 China
| | - Xiaoxian Cheng
- Seventh Medical Center of PLA General Hospital, Beijing, 100700 China
| | - Rongya Yang
- Seventh Medical Center of PLA General Hospital, Beijing, 100700 China.
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Wang B, Yao Y, Huang X, Zhang L, Peng D, Zhang G. The combination of photodynamic therapy and ultrapulse carbon dioxide laser for facial angiofibromas in tuberous sclerosis complex: A case report. Photodiagnosis Photodyn Ther 2022; 37:102725. [PMID: 35041984 DOI: 10.1016/j.pdpdt.2022.102725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/02/2022] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Abstract
Facial angiofibromas are one of the dermatological hallmarks of tuberous sclerosis complex. Facial angiofibromas often lead to disfigurement and cosmetic concerns, which has a serious negative effect on the quality of life of the patients. There are no guidelines or consensus on the management of facial angiofibromas up to now. We report a patient with extensive facial angiofibromas treated with the combination of photodynamic therapy and ultrapulse carbon dioxide laser, achieving satisfying results. We suggest this might be a promising therapeutic option for facial angiofibromas in tuberous sclerosis complex.
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Affiliation(s)
- Bin Wang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yue Yao
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xin Huang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liyun Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dandan Peng
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guoqiang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
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Cortell Fuster C, Martínez Gómez MA, Cercós Lleti AC, Climente Martí M. Topical rapamycin in the treatment of facial angiofibromas in tuberous sclerosis: a systematic review based on evidence. J DERMATOL TREAT 2021; 33:1804-1810. [PMID: 33821748 DOI: 10.1080/09546634.2021.1905768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION facial angiofibromas of tuberous sclerosis are the most prevalent cutaneous manifestation, affecting 80% of patients, which cause facial lesions with negative psychosocial consequences. Newly, topical rapamycin has been established as an effective and safe therapy for this skin condition. PURPOSE to analyze the available scientific evidence about the effectiveness and safety of topical sirolimus in the treatment of facial angiofibromas in tuberous sclerosis. METHODS a literature search was conducted in PubMed and Cochrane. Effectiveness and safety were analyzed along with the main characteristics of each formulation in all included studies. RESULTS thirty studies were included involving a total of 508 patients, developed in the last 20 years. Four randomized clinical trial, 17 case series and 9 single case reports were founded. Multiple topical rapamycin concentrations (0.003-1%) and formulations (gel, ointment, solution) were found in literature. Rapamycin demonstrated its effectiveness in all studies included, except for 5 patients in a 1 b study. Rapamycin was shown to be safe for the treatment of FA. CONCLUSIONS Topical sirolimus can be considered an effective and safety option for the treatment of facial angiofibromas in tuberous sclerosis. However, further long-term studies need to establish an evidence-based therapeutic protocol.KEY MESSAGEUpdated review to date in topical rapamycin for facial angiofibromas, allowing support in therapeutic decisions.
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Lu KB, Parus A, Siegel A, Glenn C, Plank DM. Large nipple areolar complex angiofibroma treated with combined surgical debulking and carbon dioxide laser therapy - a case report. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2020; 7:34-37. [PMID: 32128351 PMCID: PMC7034039 DOI: 10.1080/23320885.2020.1724513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/28/2020] [Indexed: 11/23/2022]
Abstract
Here, we describe single case review of a 14-year-old female who presented with an angiofibroma on the right nipple areolar complex, which was treated successfully with debulking and CO2 laser. After 8 months of follow up, there has still been no recurrence of disease.
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Affiliation(s)
- Karen B Lu
- Plastic Surgery, University of Texas Medical Branch at Galveston (University of Texas Libraries), Galveston, TX, USA
| | - Anamaria Parus
- Plastic Surgery, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Ashley Siegel
- Plastic Surgery, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Candace Glenn
- Mid Florida Dermatology and Plastic Surgery, Orlando, FL, USA
| | - David M Plank
- Plastic Surgery, University of Central Florida College of Medicine, Orlando, FL, USA
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Negosanti F, Tengattini V, Gurioli C, Neri I. Facial angiofibromas treated by rapamycin 0.05% ointment and a combined laser therapy. J Cosmet Dermatol 2018; 17:762-765. [DOI: 10.1111/jocd.12725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 03/07/2018] [Accepted: 05/30/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Vera Tengattini
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
| | - Carlotta Gurioli
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
| | - Iria Neri
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
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Mercuri S, Brianti P, Cestone E, Dattola A, Nisticò SP. Effective Use of Nonablative Fractional Laser on Multiple Whip Scars. Photomed Laser Surg 2018; 36:337-339. [DOI: 10.1089/pho.2017.4370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Santo Mercuri
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Pina Brianti
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Enza Cestone
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Annunziata Dattola
- Department of Dermatology, University of Rome “Tor Vergata,” Rome, Italy
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Mercuri SR, Brianti P, Dattola A, Bennardo L, Silvestri M, Schipani G, Nisticò SP. CO 2 laser and photodynamic therapy: Study of efficacy in periocular BCC. Dermatol Ther 2018; 31:e12616. [PMID: 29766626 DOI: 10.1111/dth.12616] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/10/2018] [Indexed: 01/08/2023]
Abstract
Basal cell carcinoma (BCC), the most common type of skin cancer in the world, usually arises in sun-exposed areas of the skin. The therapeutic approach to periocular BCC has changed in the last few years. Currently the treatment, considering the delicate localization of the disease, must not only ensure complete recovery from the neoplastic disease, but must also satisfy functional and aesthetic criteria. In this study we tried to evaluate the efficacy of CO2 laser and photodynamic therapy in periocular BCC.
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Affiliation(s)
| | - Pina Brianti
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Annunziata Dattola
- Department of Dermatology, University of Rome "Tor Vergata", Rome, Italy
| | - Luigi Bennardo
- Department of Dermatology, Magna Graecia University, Catanzaro, Italy
| | - Martina Silvestri
- Department of Dermatology, Magna Graecia University, Catanzaro, Italy
| | - Giusy Schipani
- Department of Dermatology, Magna Graecia University, Catanzaro, Italy
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Grohmann M, Benedikt S, Forbes A, Justich I. Ablation of facial adenoma sebaceum using the Versajet™ Hydrosurgery System. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-017-1347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Crall C, Valle M, Kapur K, Dies KA, Liang MG, Sahin M, Huang JT. Effect of Angiofibromas on Quality of Life and Access to Care in Tuberous Sclerosis Patients and Their Caregivers. Pediatr Dermatol 2016; 33:518-25. [PMID: 27436143 DOI: 10.1111/pde.12933] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Facial angiofibromas (AF) have the potential to cause disfigurement in children with tuberous sclerosis complex (TSC). Facial disfigurement can impact the quality of life (QoL) of individuals and their families, leading to negative psychosocial outcomes. QoL has not been studied in TSC patients with AF. METHODS We conducted a cross-sectional survey study to investigate QoL of TSC patients with AF and their caregivers and to explore the current state of access to treatment for AF. TSC patients and caregivers in TSC clinic at Boston Children's Hospital and through the Tuberous Sclerosis Alliance were recruited to complete QoL surveys including the CADIS, CDLQI, and Skindex-teen questionnaires, and a survey on access to treatment of AF. RESULTS Fifty-eight patients with TSC and 161 caregivers participated in the study. Caregivers of patients with AF had significantly poorer QoL scores compared to caregivers of those without AF, as measured by a modified CADIS questionnaire (mean 31.7 vs. 11.7, p = 0.004). Among patients with AF, those who received treatment had significantly better QoL scores compared with those without treatment, as measured by the CDLQI (mean 3.8 vs. 9.5, p = 0.001). Forty-one and two-tenths percent of subjects reported never receiving treatment for AF. Forty-seven and three-tenths percent of subjects were prescribed topical rapamycin, 47.7% of whom experienced difficulty with insurance coverage. CONCLUSIONS Presence and lack of treatment of AF significantly impacts QoL in TSC patients and their caregivers. Access to care for AF is limited by multiple factors and should be addressed by clinicians working with this patient population.
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Affiliation(s)
- Cary Crall
- Harvard Medical School, Boston, Massachusetts
| | - Molly Valle
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Kush Kapur
- Harvard Medical School, Boston, Massachusetts.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Kira A Dies
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | | | - Mustafa Sahin
- Harvard Medical School, Boston, Massachusetts.,Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
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Ali FR, Mallipeddi R, Craythorne EE, Sheth N, Al-Niaimi F. Our experience of carbon dioxide laser ablation of angiofibromas: Case series and literature review. J COSMET LASER THER 2016; 18:372-375. [DOI: 10.1080/14764172.2016.1197403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Valdeolivas-Casillas N, Polo-Rodríguez I, Piteiro-Bermejo AB, Vélez MD, Guirado-Koch C. [Facial papules: A warning sign]. Semergen 2014; 41:e78-80. [PMID: 25456086 DOI: 10.1016/j.semerg.2014.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 09/17/2014] [Accepted: 09/21/2014] [Indexed: 11/30/2022]
Affiliation(s)
- N Valdeolivas-Casillas
- Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
| | - I Polo-Rodríguez
- Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - A B Piteiro-Bermejo
- Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - M D Vélez
- Servicio de Anatomía Patológica, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - C Guirado-Koch
- Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
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