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Mezzana P. “Two wavelengths endovaginal laser system”: Clinical evaluation of a new device for mild SUI and vaginal atrophy treatment. Dermatol Ther 2020; 33:e14445. [DOI: 10.1111/dth.14445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Paolo Mezzana
- European Society of Aesthetic Gynecology Delle Medical Center Roma Italy
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Heidari Beigvand H, Razzaghi M, Rostami-Nejad M, Rezaei-Tavirani M, Safari S, Rezaei-Tavirani M, Mansouri V, Heidari MH. Assessment of Laser Effects on Skin Rejuvenation. J Lasers Med Sci 2020; 11:212-219. [PMID: 32273965 DOI: 10.34172/jlms.2020.35] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Laser skin resurfacing has changed the approach of facial skin rejuvenation over the past decade. This article evaluates the laser effects on skin rejuvenation by the assessment of laser characteristics and histological and molecular changes, accompanied by the expression of proteins during and after laser-assisted rejuvenation of skin. It is important to note that different layers of skin with different cells are normally exposed to the sun's UV radiation which is the most likely factor in aging and damaging healthy skin. To identify the expression of proteins, using validated databases and reviewing existing data could reveal altered proteins which could be analyzed and mapped to investigate their expression and their different effects on cell biological responses. In this regard, proteomics data can be used for better investigation of the changes in the proteomic profile of the treated skin. Different assessments have revealed the survival and activation of fibroblasts and new keratinocytes with an increase of collagen and elastin fibers in the dermis and the reduction of matrix metalloproteinases (MMPs) and heat shock proteins (HSPs) as a result of different low-power laser therapies of skin. There are a wide range of biological effects associated with laser application in skin rejuvenation; therefore, more safety considerations should be regarded in the application of lasers in skin rejuvenation.
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Affiliation(s)
- Hazhir Heidari Beigvand
- Firoozabadi Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Razzaghi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rostami-Nejad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Rezaei-Tavirani
- Firoozabadi Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Safari
- Proteomics Research Center, Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Rezaei-Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Mansouri
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Heidari
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Borges J, Araújo L, Cuzzi T, Martinez L, Gonzales Y, Manela-Azulay M. Fractional Laser Resurfacing Treats Photoaging by Promoting Neocollegenesis and Cutaneous Edema. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2020; 13:22-27. [PMID: 32082467 PMCID: PMC7028380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND: Laser resurfacing is a common treatment for photoaging. This treatment creates skin incisions that initiate the wound healing cascade, including reorganization of the collagen matrix, in a dermal remodeling process that can last up to 12 months. OBJECTIVE: We compared the effects of nonablative and ablative Erbium fractional laser resurfacing on dermal content and arrangement of Collagen Types I and III, and on fibroblast activation. METHODS: Ten female patients (50-63 years) with Fitzpatrick Skin Types I-IV and clinical signs of photoaging underwent two types of Erbium fractional laser resurfacing (nonablative, 1540nm; ablative, 2940nm) on opposite sides of the face. Skin biopsies were obtained pretreatment and three months post-treatment. Morphometric analysis was performed using Picrosirius staining for overall collagen, and immunohistochemistry for Collagen Types I and III. Finally, hematoxylin and eosin staining was used to identify fibroblast activation. RESULTS: Both laser treatments induced reorganization of Collagen Types I and III and demonstrated signs of fibroblast activation. However, morphometric analysis of Picrosirius staining revealed that, after both treatments, there was a lower density of collagen fibers, which is characteristic of edema. CONCLUSION: At three months after laser resurfacing, skin lifting in photoaged skin likely resulted from new collagen deposition but also from edema.
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Affiliation(s)
- Juliano Borges
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Luciana Araújo
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Luis Martinez
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Yliana Gonzales
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
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Kim SH, Lee SJ, Lee JW, Jeong HS, Suh IS. Clinical trial to evaluate the efficacy of botulinum toxin type A injection for reducing scars in patients with forehead laceration: A double-blinded, randomized controlled study. Medicine (Baltimore) 2019; 98:e16952. [PMID: 31441893 PMCID: PMC6716761 DOI: 10.1097/md.0000000000016952] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Botulinum toxin type A (BoNTA) is known to prevent fibroblast proliferation and expression of transforming growth factor beta 1 (TGF-β1). It also induces temporary muscle paralysis and decreases tension vectors. Fibroblasts induce scar contracture and hypertrophy by producing collagen fibers in wound healing processes. The aim of this study is to identify the effect of BoNTA on the scar formation. METHODS Forty-five patients with forehead laceration were enrolled in this study and randomized into 2 groups with or without injection of BoNTA. When the patients presented to the clinic to remove the stitches, BoNTA was injected to the BoNTA group with 24 patients and saline was injected to the control group with 21 patients. The BoNTA was injected on dermal layer with 5 IU/cm. After that, follow-up was done in 1, 3, and 6 months. The scars were analyzed with the patient and observer scar assessment scale, Stony Brook scar evaluation scales (SBSESs), and visual analog scale (VAS) and analyzed with independent T-test, along with clinical photographs, cutometer, and biopsies. RESULTS In all scar scales, the scores changed into favorable direction in both groups and the changes were larger in BoNTA group compared with the control group. On SBSES and VAS, better improvements on BoNTA group showed statistical significance. Skin biopsy showed less collagen deposition on dermal layer in BoNTA group. CONCLUSION Improvement of aesthetic, functional, and emotional aspect of the scar formation in the groups treated with BoNTA was illustrated. The application of BoNTA may be expanded to prevent hypertrophic scar after trauma, burns, or operations.
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Abstract
Smooth, wrinkle-free skin is associated with supposed attractiveness, youthfulness, and health, while rhytids have a negative impact on one's perceived appearance, image, and self-esteem. Noninvasive esthetic procedures such as laser or light therapy have been used to achieve and attain a more youthful appearance. Currently, there is a wide range of lasers and devices available for the regeneration and healing of skin. Lasers and light sources for skin rejuvenation involve the removal of aged skin tissue via thermal heat from high-powered lasers, stimulating the surrounding tissues to recover through natural wound-healing processes. In contrast, photobiomodulation, which makes use of low energy lasers or light emitting diodes, uses no heat and has shown positive effects in the reduction of wrinkles and improving skin laxity.
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Serra M, Bohnert K, Sadick N. A randomized, single-blind, study evaluating a 755-nm picosecond pulsed Alexandrite laser vs. a non-ablative 1927-nm fractionated thulium laser for the treatment of facial photopigmentation and aging. J COSMET LASER THER 2018; 20:335-340. [PMID: 30019970 DOI: 10.1080/14764172.2018.1493513] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Laser toning is one of the most popular strategies to treat facial photopigmentation and aging. Several laser modalities, including fractional non-ablative, Q-switched (QS) lasers and new generation picosecond lasers have been used for this indication. However, there is paucity of head to head comparisons of older generation of lasers with new ones. Objective: To compare a 755 nm picosecond pulsed alexandrite laser with a non-ablative 1927 nm fractionated thulium laser for the treatment of facial photopigmentation and aging through a randomized, single-blind study. Materials and methods: 20 subjects (skin types I-IV) were randomized to receive either four 755-nm picosecond alexandrite laser treatments, spaced 3 weeks apart, or two dual wavelength thulium fiber fractionated 1550/1927 nm laser treatments, spaced 6 weeks apart. Follow-up assessment visits occurred 4 and 12 weeks after the last study treatment. Results: At the 4- and 12-week follow-up, both groups showed significant improvement of photoaging, pigmentation, skin quality according to the investigator and subjects assessments. When comparing the two groups, subjects in 755 nm group had statistically significant greater improvement in investigator assessments of photoaging/skin quality and subject satisfaction than those in the 1927 nm group. Conclusion: Both the non-ablative 1927 and 755 nm picosecond laser can improve facial photopigmentation, but the latter can yield superior results with less pain and side effects according to patient and investigator assessments.
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Affiliation(s)
- Monica Serra
- a Director of Research at Sadick Dermatology , New York , NY , USA
| | - Krista Bohnert
- a Director of Research at Sadick Dermatology , New York , NY , USA
| | - Neil Sadick
- b Sadick Dermatology , Clinical Professor of Dermatology at Weill Cornell Medical College , New York , NY , USA
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El-Hoshy K, Abdel-Halim MRE, Dorgham D, El-Din Sayed SS, El-Kalioby M. Efficacy of Fractional Carbon Dioxide Laser in the Treatment of Mature Burn Scars: A Clinical, Histopathological, and Histochemical Study. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2017; 10:36-43. [PMID: 29399265 PMCID: PMC5774902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE: The purpose of this study was to evaluate the efficacy of fractional carbon dioxide laser use in the treatment of mature burn scars. DESIGN: This was an uncontrolled, open-label clinical trial. SETTING: The setting for this study was Dermatology Department at Cairo University in Cairo, Egypt. PARTICIPANTS: Twenty patients with mature burn scars were included in the study. MEASUREMENTS: Three fractional carbon dioxide laser sessions were given, 4 to 8 weeks apart. Primary outcome was measured using two scar scales, the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale. Secondary outcomes included evaluation of collagen and elastic fibers using routine hematoxylin and eosin, Masson's trichrome, and orcein stains. Outcomes were measured two months after the last laser session. RESULTS: Both Vancouver Scar Scale and Patient and Observer Scar Assessment Scale showed significant reduction following treatment (p<0.001). Scar relief and pliability improved most followed by vascularity. Pigmentation improved the least. Percent improvement in Patient and Observer Scar Assessment Scale patients' overall assessment was 44.44 percent. The pattern and arrangement of collagen and elastic fibers showed significant improvement (p<0.001, p=0.001, respectively), together with significant improvement in their amounts (p=0.020, p<0.001, respectively). No significant correlation existed between clinical and histopathological/histochemical scores. Side effects and complications were mild and tolerable. CONCLUSION: Fractional carbon dioxide laser use is an effective and safe method for treating burn scars with a significant change in the opinion of the patients about their scar appearance.
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Affiliation(s)
- Khaled El-Hoshy
- Dr. El-Hoshy is Professor of Dermatology
- Dr. Abdel-Halim is Diplomate of Dermatopathology and Professor of Dermatology
- Dr. Dorgham is Lecturer of Dermatology
- Dr. El-Din Sayed is Professor of Histology
- Ms. El-Kalioby is Assistant Lecturer of Dermatology with Cairo University in Cairo, Egypt
| | - Mona R E Abdel-Halim
- Dr. El-Hoshy is Professor of Dermatology
- Dr. Abdel-Halim is Diplomate of Dermatopathology and Professor of Dermatology
- Dr. Dorgham is Lecturer of Dermatology
- Dr. El-Din Sayed is Professor of Histology
- Ms. El-Kalioby is Assistant Lecturer of Dermatology with Cairo University in Cairo, Egypt
| | - Dina Dorgham
- Dr. El-Hoshy is Professor of Dermatology
- Dr. Abdel-Halim is Diplomate of Dermatopathology and Professor of Dermatology
- Dr. Dorgham is Lecturer of Dermatology
- Dr. El-Din Sayed is Professor of Histology
- Ms. El-Kalioby is Assistant Lecturer of Dermatology with Cairo University in Cairo, Egypt
| | - Safinaz Salah El-Din Sayed
- Dr. El-Hoshy is Professor of Dermatology
- Dr. Abdel-Halim is Diplomate of Dermatopathology and Professor of Dermatology
- Dr. Dorgham is Lecturer of Dermatology
- Dr. El-Din Sayed is Professor of Histology
- Ms. El-Kalioby is Assistant Lecturer of Dermatology with Cairo University in Cairo, Egypt
| | - Mona El-Kalioby
- Dr. El-Hoshy is Professor of Dermatology
- Dr. Abdel-Halim is Diplomate of Dermatopathology and Professor of Dermatology
- Dr. Dorgham is Lecturer of Dermatology
- Dr. El-Din Sayed is Professor of Histology
- Ms. El-Kalioby is Assistant Lecturer of Dermatology with Cairo University in Cairo, Egypt
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Comparison of the Effectiveness of Ablative and Non-Ablative Fractional Laser Treatments for Early Stage Thyroidectomy Scars. Arch Plast Surg 2016; 43:575-581. [PMID: 27896191 PMCID: PMC5122549 DOI: 10.5999/aps.2016.43.6.575] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 09/08/2016] [Accepted: 10/12/2016] [Indexed: 11/26/2022] Open
Abstract
Background Open thyroidectomy is conventionally performed at the anterior side of neck, which is a body part with a comparatively great degree of open exposure; due to this, postoperative scarring may cause distress in patients. We aimed to compare the effects of ablative and nonablative fractional laser treatments on thyroidectomy scars. We examined medical records in a retrospective manner and analyzed scars based on their digital images by using the modified Manchester Scar Scale (mMSS). Methods Between February 2012 and May 2013, 55 patients with thyroidectomy scars were treated with ablative (34 patients) or nonablative (21 patients) fractional laser. Each patient underwent 4 laser treatment sessions in 3–4 week intervals, 1–2 months postoperatively. Scar improvement was assessed using patient images and the mMSS scale. Results The mean decrease in scar score was 3.91 and 3.47 in the ablative and nonablative groups, respectively; the reduction between 2 groups did not exhibit any significant difference (P=0.16). We used the scale once again to individually evaluate scar attributes. The nonablative group accounted for a considerably higher color score value (P=0.03); the ablative group accounted for a considerably higher contour score value (P<0.01). Patient satisfaction was high and no complications occurred. Conclusions Both types of fractional laser treatments can be used successfully for thyroidectomy scar treatment with minimal complications; however, results indicate that higher effectiveness may be obtained from the use of ablative and nonablative lasers for hypertrophic scars and early erythematous scars, respectively. Therefore, the appropriate laser for scar treatment should be selected according to its specific characteristics.
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Lueangarun S, Panchaprateep R. White Fibrous Papulosis of the Neck Treated With Fractionated 1550-nm Erbium Glass Laser: A Case Report. J Lasers Med Sci 2016; 7:256-258. [PMID: 28491262 DOI: 10.15171/jlms.2016.45] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Despite its clinical features of multiple, confluent, small, whitish, smooth, and clear-demarcate papules on the neck and back, the pathogenesis of white fibrous papulosis of the neck (WFPN) is still unknown. The lesions increase progressively and do not regress over time. However, no effective treatment has yet been identified. Case Report: We reported the successful results of a female patient receiving efficacious treatment for her extensive lesions of WFPN with nonablative fractional photothermolysis laser (Fractionated 1550-Erbium Glass laser). Conclusion: This photothermolysis laser could then be suggestive as the therapeutic option for WFPN.
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Affiliation(s)
- Suparuj Lueangarun
- Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Ratchathorn Panchaprateep
- Division of Dermatology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Mezzana P, Valeriani M, Valeriani R. Combined fractional resurfacing (10600 nm/1540 nm): Tridimensional imaging evaluation of a new device for skin rejuvenation. J COSMET LASER THER 2016; 18:397-402. [DOI: 10.1080/14764172.2016.1202417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Borges J, Manela-Azulay M, Cuzzi T. Photoaging and the clinical utility of fractional laser. Clin Cosmet Investig Dermatol 2016; 9:107-14. [PMID: 27217790 PMCID: PMC4861605 DOI: 10.2147/ccid.s77996] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The description of atomic structure by Niels Bohr set the basis for the emergence of quantum physics. Based on these fundamentals, Einstein published in 1917 a paper on the amplification of energy by Stimulated Emission of Radiation as part of his quantum theories. In 1955, Townes and Gordon turned Einstein’s theories into practice, creating a coherent and amplified microwave device using ammonia gas in an optical medium. But it was at the beginning of the 1980s, that Anderson and Parrish published an article about the selective photothermolysis model which revolutionized clinical practice. The use of laser in photoaging began with CO2 (10,600 nm). In 1989, it was first used for resurfacing of a face with prominent photoaging. Ablative lasers have therefore had great popularity in the 1980s and 1990s, but prolonged postoperative time and significant risk of side effects have lowered the acceptance by patients. In 2004, the description of the fractionated radiation for the treatment of photoaging, by Mainstein, represented a great event. The stimulation of collagen occurred through fractional laser beams, which would reach the selected area while saving islands of sound skin. These islands accelerated the process of cicatrization of the treated tissue and shortened the postprocedure time. Furthermore, the fractionated radiation presented a smaller range of side effects, increasing the safety of the procedure. As mentioned earlier, as fractional lasers incise on the skin, they leave islands of healthy skin that accelerate recovery, while generating necrosis columns. Such necrosis columns remove damaged extracellular matrix material, allowing resettlement of fibroblasts. Such resettled fibroblasts, under the influence of a new tensile strength, restart to produce structures for extracellular matrix, such as collagen, elastin, and proteoglycans, in a more physiological way. Fractional lasers are considered by many dermatologists as the best choice in laser therapy for the treatment of photoaging.
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Affiliation(s)
- Juliano Borges
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil; Serviço de Anatomia Patológica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil; Serviço de Anatomia Patológica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil; Serviço de Anatomia Patológica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Panchaprateep R, Tusgate S, Munavalli GS, Noppakun N. Fractional 1,550nm Ytterbium/Erbium fiber laser in the treatment of lichen amyloidosis: Clinical and histological study. Lasers Surg Med 2015; 47:222-30. [DOI: 10.1002/lsm.22338] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2014] [Indexed: 11/12/2022]
Affiliation(s)
- Ratchathorn Panchaprateep
- Department of Medicine; Division of Dermatology; King Chulalongkorn Memorial Hospital; Bangkok Thailand
| | - Sai Tusgate
- Department of Medicine; Division of Dermatology; King Chulalongkorn Memorial Hospital; Bangkok Thailand
| | - Girish S. Munavalli
- Division of Dermatology; Laser and Vein Specialists of Carolinas; Charlotte North Carolina
| | - Nopadon Noppakun
- Department of Medicine; Division of Dermatology; King Chulalongkorn Memorial Hospital; Bangkok Thailand
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