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Eijkenboom QL, Daxenberger F, Guertler A, Steckmeier S, French LE, Sattler EC. Line-field confocal optical coherence tomography (LC-OCT) for the in vivo examination of nails: Analysis of typical features for the differentiation of nail disorders. J Eur Acad Dermatol Venereol 2024; 38:e413-e416. [PMID: 38059388 DOI: 10.1111/jdv.19641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/13/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Q L Eijkenboom
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - F Daxenberger
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A Guertler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - S Steckmeier
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - L E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - E C Sattler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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Eijkenboom QL, Daxenberger F, Gust C, Hartmann D, Guertler A, Steckmeier S, Deussing M, French LE, Welzel J, Schuh S, Sattler EC. Line-field confocal optical coherence tomography, a novel non-invasive tool for the diagnosis of onychomycosis. J Dtsch Dermatol Ges 2024; 22:367-375. [PMID: 38279541 DOI: 10.1111/ddg.15310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND AND OBJECTIVES Onychomycosis is common and important to distinguish from other nail diseases. Rapid and accurate diagnosis is necessary for optimal patient treatment and outcome. Non-invasive diagnostic tools have increasing potential for nail diseases including onychomycosis. This study evaluated line-field confocal optical coherence tomography (LC-OCT) as a rapid non-invasive tool for diagnosing onychomycosis as compared to confocal laser scanning microscopy (CLSM), optical coherence tomography (OCT), and conventional methods. PATIENTS AND METHODS In this prospective study 86 patients with clinically suspected onychomycosis and 14 controls were examined using LC-OCT, OCT, and CLSM. KOH-preparation, fungal culture, PCR, and histopathology were used as comparative conventional methods. RESULTS LC-OCT had the highest sensitivity and negative predictive value of all methods used, closely followed by PCR and OCT. Specificity and positive predictive value of LC-OCT were as high as with CLSM, while OCT scored much lower. The gold standard technique, fungal culture, showed the lowest sensitivity and negative predictive value. Only PCR and culture allowed species differentiation. CONCLUSIONS LC-OCT enables quick and non-invasive detection of onychomycosis, with advantages over CLSM and OCT, and similar diagnostic accuracy to PCR but lacking species differentiation. For accurate nail examination, LC-OCT requires well-trained and experienced operators.
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Affiliation(s)
| | - Fabia Daxenberger
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Charlotte Gust
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Daniela Hartmann
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Anne Guertler
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Stephanie Steckmeier
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Maximilian Deussing
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, USA
| | - Julia Welzel
- Department of Dermatology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology, University Hospital Augsburg, Augsburg, Germany
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Eijkenboom QL, Daxenberger F, Gust C, Hartmann D, Guertler A, Steckmeier S, Deussing M, French LE, Welzel J, Schuh S, Sattler EC. Konfokale Line-Field optische Kohärenztomographie, ein innovatives nichtinvasives Instrument zur Diagnose der Onychomykose: Line-field confocal optical coherence tomography, a novel non-invasive tool for the diagnosis of onychomycosis. J Dtsch Dermatol Ges 2024; 22:367-376. [PMID: 38450988 DOI: 10.1111/ddg.15310_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 03/08/2024]
Abstract
ZusammenfassungHintergrund und ZieleOnychomykose ist weit verbreitet und sollte von anderen Nagelerkrankungen unterschieden werden. Eine rasche und genaue Diagnostik ist für die optimale Behandlung des Patienten und ein bestmögliches Ergebnis erforderlich. Nichtinvasive Techniken haben ein wachsendes Potenzial bei der Diagnose von Nagelerkrankungen, einschließlich Onychomykose. In dieser Studie wurde die konfokale Line‐Field optische Kohärenztomographie (LC‐OCT) als schnelle nichtinvasive Methode zur Diagnose von Onychomykose im Vergleich zur konfokalen Laserscanmikroskopie (KLM), optischen Kohärenztomographie (OCT) und konventionellen Methoden bewertet.Patienten und MethodikIn dieser prospektiven Studie wurden 86 Patienten mit klinischem Verdacht auf Onychomykose und 14 Kontrollen mittels LC‐OCT, OCT und KLM untersucht. KOH‐Präparation, Pilzkultur, PCR und Histopathologie wurden als vergleichende konventionelle Methoden eingesetzt.ErgebnisseLC‐OCT hatte die höchste Sensitivität und den höchsten negativen Vorhersagewert aller verwendeten Methoden, dicht gefolgt von PCR und OCT. Die Spezifität und der positive Vorhersagewert der LC‐OCT waren genauso hoch wie bei der KLM, während OCT deutlich schlechter abschnitt. Das Goldstandardverfahren Pilzkultur zeigte die geringste Sensitivität und den niedrigsten negativen Vorhersagewert. Nur PCR und Kultur ermöglichten eine Differenzierung der Pilzspezies.SchlussfolgerungenLC‐OCT ermöglicht eine schnelle und nichtinvasive Diagnostik von Onychomykose, mit Vorteilen gegenüber KLM und OCT und ähnlicher diagnostischer Genauigkeit wie die PCR, aber ohne Differenzierung der Pilzarten. Für eine genaue Nageluntersuchung erfordert die LC‐OCT gut geschulte und erfahrene Anwender.
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Affiliation(s)
| | - Fabia Daxenberger
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Charlotte Gust
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Daniela Hartmann
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Anne Guertler
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Stephanie Steckmeier
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Maximilian Deussing
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Lars Einar French
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, USA
| | - Julia Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Sandra Schuh
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Elke Christina Sattler
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
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Guertler A, Schwaiger H, Poetschke J, Steckmeier S, Gauglitz G. Objective evaluation of an occlusive overnight intensive patch containing onion extract and allantoin for hypertrophic scars. J Cosmet Dermatol 2020; 19:2415-2420. [PMID: 32573095 DOI: 10.1111/jocd.13561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/17/2020] [Accepted: 06/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients suffering from hypertrophic scars often describe esthetic, functional, and psychological impairments. While current guidelines for the treatment of pathologic scarring recommend the use of onion extract containing gels and sheets, hard evidence for its efficacy remains scarce due to inconsistent data. Onion extract and allantoin containing occlusive overnight intensive patches (OIP) were introduced as a recent option for noninvasive scar management. However, objective data demonstrating their efficacy are missing. AIMS This study is the first to objectively evaluate the benefit and safety of an OIP for hypertrophic scars using a three-dimensional imaging device and a standardized scar scale. METHODS Twelve patients with untreated, three to twelve months old hypertrophic scars received an OIP for 3 months. The assessment was performed using PRIMOS®pico , a three-dimensional imaging device and POSAS, a standardized scar questionnaire at baseline, one and 3 months after the last treatment. RESULTS Objective evaluation at three months follow-up (FU) showed a significant decrease in scar height of 28.8% (baseline mean: 2.08 ± 0.68 mm, three months FU mean: 1.48 ± 0.52 mm) and a reduction in scar volume of 31.9% (baseline mean: 454.33 ± 265.53 mm3, 3 months FU mean: 309.58 ± 224.28 mm3). Pain and pruritus subsided under treatment. There were no negative side effects. CONCLUSION Overnight intensive patches is a convenient, painless, safe, affordable and effective prevention and treatment option for hypertrophic scars. Treatment should be performed at least for 3 months for visible effects.
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Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Hannah Schwaiger
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Julian Poetschke
- Department of Plastic and Hand Surgery, Klinikum St. Georg GmbH, Leipzig, Germany
| | | | - Gerd Gauglitz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
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Guertler A, Reinholz M, Steckmeier S, Gauglitz GG. Evaluation of a non-ablative, fractional 1565 nm laser for the improvement of striae distensae albae. J Eur Acad Dermatol Venereol 2018; 33:220-226. [PMID: 30169914 DOI: 10.1111/jdv.15228] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 08/14/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Striae distensae (SD) represent therapeutically challenging forms of dermal atrophic scarring. In addition to topical ointments, medical needling and various energy-based devices, non-ablative fractional lasers have been suggested for their improvement. However, objective evaluations of their efficacy are widely missing. In this study, we aimed to assess the clinical improvement of SD albae after three treatments with a non-ablative fractional 1565 nm Er: glass laser by employing three-dimensional analysis and several questionnaires. METHODS A total of 16 Caucasians suffering from SD albae were included in this prospective study. Every patient received three treatments - one every 4 weeks - using a non-ablative, fractional 1565 nm laser (two passes: 300 μbeams/cm2 , 40 mJ inside the SD; 150 μbeams/cm2 , 50 mJ inside the SD and within the surrounding area). Questionnaires (DLQI, POSAS), digital photography and three-dimensional analysis employing PRIMOS® software and VECTRA® camera system were taken at baseline, 1 and 6 months after the last treatment. RESULTS Evaluation of objective measurements at 6-month follow-up (FU) showed a significant reduction in depth of atrophic lesions by 31.7% and less skin irregularities with Smax at baseline of 621.2 μm decreasing to 411.6 μm (P < 0.01, respectively). Improvement in objective measurements was supported by significant changes in patients' rating of skin appearance. POSAS patient total score declined from 33.5 points to 17.5 points throughout the study (P < 0.001). From baseline to 6-month FU, patients' life quality improved by 68.0% (DLQI score). Procedures showed no lasting negative side-effects and little to no down time. CONCLUSION The use of a fractional non-ablative 1565 nm laser represents a safe approach for the treatment of SD albae. Clinically observed improvements were supported by significant data from objective measurements. The results achieved at 1-month FU represented at 6-month FU, showing stable clinical improvements.
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Affiliation(s)
- A Guertler
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - M Reinholz
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - S Steckmeier
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - G G Gauglitz
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig-Maximilian-University, Munich, Germany
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Gauglitz G, Steckmeier S, Pötschke J, Schwaiger H. Cohesive Polydensified Matrix ® hyaluronic acid volumizer injected for cheek augmentation has additional positive effect on nasolabial folds. Clin Cosmet Investig Dermatol 2017; 10:507-513. [PMID: 29276401 PMCID: PMC5733916 DOI: 10.2147/ccid.s141906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose Cohesive Polydensified Matrix® hyaluronic acid (CPM-HA) volumizer has been used successfully for several years to reverse biometric volume loss during facial aging. This observational study explored the additive effect on nasolabial folds when CPM-HA volumizer is injected into the neighboring cheek area. Patients and methods In this open-label, prospective, postmarketing noninterventional study, 18 adult patients seeking esthetic enhancement of the lateral cheek hollows and cheekbone area were injected with CPM-HA volumizer integrated with lidocaine (CPM-HA-VL) in the upper or lower cheek area. Safety and performance of CPM-HA-VL up to 12 months after injection with follow-up visits at week 4 and month 3, 6, and 12 were assessed. The primary endpoint was improvement of cheek fullness on the validated Merz Aesthetics Scales. Additionally, changes in nasolabial folds were quantified using a phaseshift rapid in vivo measurement of skin optical three-dimensional (3D) in vivo measurement device. Results Patients (94.4% female, median age 52 years, age range 39–69 years) were injected with a mean volume of 2.5±1.1 mL CPM-HA-VL per side. Immediately after injection, mean severity for upper and lower cheek fullness assessed on the validated MAS improved from 2.5±0.6 and 2.8±0.5, respectively, to 1.0±0.0, and remained unchanged through month 12. Improvement in relation to baseline was attested on the Global Aesthetics Improvement Scale for all assessments. Compared with baseline, the following assessments offered a statistical significance in the reduction of wrinkle depth of nasolabial folds (maximum depth reduction by 30.4% at 3 months) according to optical 3D in vivo measurements. Pain during injection was minimal and abated within 30 minutes. Treatment was well tolerated and led to great patient satisfaction. Conclusion CPM-HA-VL injected into the upper and lower cheeks led to long-lasting satisfactory cosmetic results in cheek augmentation as well as in reducing depth of nasolabial folds adjacent to the injection site.
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Affiliation(s)
- Gerd Gauglitz
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - Stephanie Steckmeier
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - Julian Pötschke
- Department of Plastic and Hand Surgery, Klinikum St Georg gGmbH, Leipzig, Germany
| | - Hannah Schwaiger
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
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Guertler A, Reinholz M, Poetschke J, Steckmeier S, Schwaiger H, Gauglitz GG. Objective evaluation of the efficacy of a non-ablative fractional 1565 nm laser for the treatment of deliberate self-harm scars. Lasers Med Sci 2017; 33:241-250. [PMID: 29080008 DOI: 10.1007/s10103-017-2348-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
Scars resulting from deliberate self-harm (DSH) represent therapeutically challenging forms of scarring due to their highly variable patterns, with no official therapeutic guidelines available. In this pilot study, we aimed to evaluate the effectiveness and safety of a non-ablative fractional Er:glass 1565 nm laser, as a potential new, minimal-invasive approach for the improvement of DSH scars. Sixteen Caucasians suffering from mature DSH scars were included in this clinical study. Patients received a total of three treatments using a non-ablative fractional 1565 nm Er:glass laser every 4 weeks, employing two passes (300 μbeams/cm2, 40 mJ, onto the scar; 150 μbeams/cm2, 50 mJ, overall area). Measurements included questionnaires (DLQI, POSAS), digital photography, and objective three-dimensional analysis using PRIMOS and VECTRA software at baseline, 1 and 6 months after treatment. PRIMOS objective measurements showed highly significant changes in scar surface with a reduction of atrophic lesions by 27.5% at 6 months follow-up (FU), a decrease in scar height by 42.7% at 6 months FU, resulting in an overall diminished skin irregularity dropping from 678.3 μm at baseline to 441.6 μm throughout the course of the study (p = <0.001 respectively). Improvements in objective measurements were supported by clinical evaluation of scar parameters and showed a strong correlation with enhanced life quality of treated patients. Procedures were well-tolerated, with no lasting negative side effects and little to no downtime. The use of a fractional non-ablative 1565 nm Er:glass laser represents a promising and safe approach for the therapy of DSH scars. Although these scars will never fully resolve, their appearance can be significantly improved to a cosmetically and socially more acceptable appearance.
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Affiliation(s)
- Anne Guertler
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany.
| | - Markus Reinholz
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Julian Poetschke
- Department for Plastic and Handsurgery, Regional Burn Center, Klinikum St. Georg, 04129, Leipzig, Germany
| | - Stephanie Steckmeier
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Hannah Schwaiger
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Gerd G Gauglitz
- Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
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Steckmeier S, Gauglitz G, Poetschke J. Fraktionierte CO2-Laserbehandlung der Haut. Akt Dermatol 2017. [DOI: 10.1055/s-0043-112537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungZur Verbesserung der Hautstruktur und zur allgemeinen Glättung bzw. Straffung der Haut (vor allem der Gesichtshaut) kommen heutzutage zunehmend fraktionierte Laserverfahren zum Einsatz. Durch das Prinzip der fraktionierten Photothermolyse ist im Vergleich zu den klassisch ablativen Verfahren eine effektive Neokollagenese bei minimalen Ausfallzeiten und guter Verträglichkeit für die Patienten zu erreichen. Der besonders bei den fraktionierten CO2-Lasern ausgeprägte „Shrinking“-Effekt führt zu einer signifikanten Stimulation des Kollagenumbaus und einer Straffung der Haut. Bis heute zählt er zu den am besten untersuchten und effektivsten Behandlungsverfahren im Anti-Aging-Bereich und in der Therapie von atrophen und hypertrophen (Brand-)Narben.
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Affiliation(s)
- S. Steckmeier
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | - G. Gauglitz
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | - J. Poetschke
- Plastische und Handchirurgie mit Schwerbrandverletzungszentrum, Klinikum St. Georg, Leipzig
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Poetschke J, Dornseifer U, Clementoni MT, Reinholz M, Schwaiger H, Steckmeier S, Ruzicka T, Gauglitz GG. Ultrapulsed fractional ablative carbon dioxide laser treatment of hypertrophic burn scars: evaluation of an in-patient controlled, standardized treatment approach. Lasers Med Sci 2017; 32:1031-1040. [DOI: 10.1007/s10103-017-2204-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
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Poetschke J, Schwaiger H, Steckmeier S, Ruzicka T, Gauglitz GG. [Anti-wrinkle creams with hyaluronic acid: how effective are they?]. MMW Fortschr Med 2016; 158 Suppl 4:1-6. [PMID: 27221554 DOI: 10.1007/s15006-016-8302-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/20/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anti-wrinkle creams containing hyaluronic-acid are often advertised as an efficacious option for the treatment of wrinkles and have even been presented as an option equal to some medical procedures in this regard. Evidence from conclusive and systematic research supporting those claims, however, is widely lacking. OBJECTIVES During this trial we examined whether the daily use of anti-wrinkle creams containing hyaluronic-acid has an influence on the depth of wrinkles as well as skin tightness and elasticity. METHODS We split up 20 patients into four groups, each of which were assigned an anti-wrinkle cream containing hyaluronic acid for daily use. Four different creams within different price ranges were chosen (Balea, Nivea, Lancôme, Chanel). Before and after the 3 month trial, wrinkle depth was assessed using the PRIMOS(pico) (GFMesstechnik, Teltow, Germany) and skin-tightness and elasticity were evaluated using the Cutometer MP580 (Courage+Khazaka, Cologne, Germany). Additionally, after the trial, questionnaire data on patient satisfaction with their individual product was collected. RESULTS The depth of perioral and orbital wrinkles decreased significantly in all groups, with depth reduction ranging between 10% and 20%. Skin-tightness increased significantly in all groups, rising by 13 to 30%. Minimal significant changes in skin-elasticity could only be shown in individual groups. CONCLUSIONS The regular use of hyaluronic-acid containing anti-wrinkle creams for over 3 months showed clear and positive effects on wrinkle-depth and skin-tightness. Due to the design of the study, however, no clear indication on the efficacy of hyaluronic acid could be shown.
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Affiliation(s)
- Julian Poetschke
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Hannah Schwaiger
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Stephanie Steckmeier
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Thomas Ruzicka
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Gerd G Gauglitz
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland.
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Steckmeier S, Pavicic T, Korting H. Striae distensae: Vom vertieften Verständnis der Pathogenese zu rationaler Therapie und Prophylaxe. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1185323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Pavicic T, Steckmeier S, Kerscher M, Korting H. Evidenzbasierte Kosmetika: Konzept und Anwendung bei den Zielstellungen Cellulite, Striae distensae und Acne vulgaris. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-965753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Blagova R, Burgmeier C, Steckmeier S, Steckmeier B, Barbaryka G, Beck TJ, Hecht V, Schmedt CG, Sroka R. Ex-vivo investigations on endoluminal laser therapy of varicosis – An optimization process. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.mla.2007.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schmedt CG, Sroka R, Steckmeier S, Meissner OA, Babaryka G, Hunger K, Ruppert V, Sadeghi-Azandaryani M, Steckmeier BM. Investigation on Radiofrequency and Laser (980nm) Effects after Endoluminal Treatment of Saphenous Vein Insufficiency in an Ex-vivo Model. Eur J Vasc Endovasc Surg 2006; 32:318-25. [PMID: 16781172 DOI: 10.1016/j.ejvs.2006.04.013] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2005] [Accepted: 04/09/2006] [Indexed: 11/29/2022]
Abstract
OBJECTIVES An ex-vivo model for the experimental evaluation of endoluminal thermal procedures for occlusion of saphenous veins was developed. Radiofrequency obliteration (RFO) and endovenous laser therapy (ELT) were compared using this model. DESIGN Experimental ex-vivo treatment study. MATERIALS AND METHODS The model consists of the subcutaneous foot veins from freshly slaughtered cows which were reperfused in situ with heparinised bovine blood. The veins were treated with either radiofrequency (RFO n=5) or with endoluminal 980 nm laser light (ELT n=5) using a continuous pull-back for RFO and a stepwise illumination and pull-back protocol for ELT. Immediately after treatment perivenous tissue and veins were examined macroscopically. In a second study the same treatment parameters were used in four further vein segments with RFO (n=2) and ELT (n=2). These vein segments were examined microscopically in HE-stained histological sections. RESULTS Induration of the vessel wall and contraction of the vessel lumen were observed after RFO. Laser treatment produced carbonised lesions of the vein wall. After 12-24 laser exposures these lesions often became transmural, causing complete perforation of the vessel wall. Histological evaluation after radiofrequency treatment demonstrated homogenous circular thermal tissue alteration with disintegration of intima and media structures. Histological evaluation after endovenous laser treatment showed large variations of thermal tissue effects. Tissue effects ranged from major tissue ablation and vessel wall disruption to minor effects located between laser exposures and on the opposite vessel wall. CONCLUSIONS Our model is suitable for systematic scientific evaluation of endovenous thermal occlusion procedures. Our first results and theoretical considerations indicate that endovenous laser treatment should be modified in order to ensure controlled homogenous circular thermal damage, avoiding vessel wall perforation and damage to perivascular structures.
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Affiliation(s)
- C-G Schmedt
- Clinic for Surgery, Department for Vascular Surgery and Phlebology, Ludwig-Maximilians-University Munich, Nussbaumstrasse, Munich, Germany.
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Sroka R, Schmedt CG, Steckmeier S, Meissner OA, Beyer W, Babaryka G, Steckmeier B. Ex-vivo investigation of endoluminal vein treatment by means of radiofrequency and laser irradiation. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.mla.2005.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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