Mycosis Fungoides in Puerto Rico: A 15-year Follow-up Retrospective Study

OBJECTIVE

To describe the patient population with mycosis fungoides (MF) in Puerto Rico in terms of demographics, disease course, and management.

METHODS

We performed a retrospective chart review of patients with MF who were being followed at the University of Puerto Rico dermatology clinics from 1999 through 2016. Collected data included demographics, age at diagnosis, stage at diagnosis, follow-up time, treatment, and stage at the time of the study.

RESULTS

A total of 53 patients were diagnosed with MF from 1999 through 2016, with a mean follow-up period of 89 months. Of those, 45% were male. At the time of diagnosis, 40% were at stage 1A, 53% were at stage 1B, and 7% were at stages 2 to 4. During data collection, 74% of the patients remained stable, 18% improved clinically, and 8% progressed in disease stage. The treatment modalities used included phototherapy, topical steroids, topical and systemic retinoids, methotrexate, topical and systemic chemotherapy, and interferon.

CONCLUSION

Our study reflects the chronic and indolent course of MF, which has an overall good prognosis if diagnosed at an early stage, as has been demonstrated in the recent literature. The information contained within this manuscript should contribute to the understanding and characterization of MF in patients in Puerto Rico.

Low-level laser therapy as a treatment for androgenetic alopecia

BACKGROUND AND OBJECTIVES

Androgenetic alopecia (AGA) affects 50% of males by age 50 and 50% of females by age 80. Recently, the use of low-level laser therapy (LLLT) has been proposed as a treatment for hair loss and to stimulate hair regrowth in AGA. This paper aims to review the existing research studies to determine whether LLLT is an effective therapy for AGA based on objective measurements and patient satisfaction.

STUDY DESIGN

A systematic literature review was done to identify articles on Medline, Google Scholar, and Embase that were published between January 1960 and November 2015. All search hits were screened by two reviewers and examined for relevant abstracts and titles. Articles were divided based on study design and assessed for risk of bias.

RESULTS

Eleven studies were evaluated, which investigated a total of 680 patients, consisting of 444 males and 236 females. Nine out of 11 studies assessing hair count/hair density found statistically significant improvements in both males and females following LLLT treatment. Additionally, hair thickness and tensile strength significantly improved in two out of four studies. Patient satisfaction was investigated in five studies, and was overall positive, though not as profound as the objective outcomes.

CONCLUSION

The majority of studies covered in this review found an overall improvement in hair regrowth, thickness, and patient satisfaction following LLLT therapy. Although we should be cautious when interpreting these findings, LLLT therapy seems to be a promising monotherapy for AGA and may serve as an effective alternative for individuals unwilling to use medical therapy or undergo surgical options. Lasers Surg. Med. 49:27-39, 2017. © 2016 Wiley Periodicals, Inc.

Non-invasive subcutaneous fat reduction: a review

The risks, financial costs and lengthy downtime associated with surgical procedures for fat reduction have led to the development of a number of non-invasive techniques. Non-invasive body contouring now represents the fastest growing area of aesthetic medicine. There are currently four leading non-invasive techniques for reducing localized subcutaneous adipose tissue: low-level laser therapy (LLLT), cryolipolysis, radio frequency (RF) and high-intensity focused ultrasound (HIFU). To review and compare leading techniques and clinical outcomes of non-invasive subcutaneous fat reduction. The terms 'non-invasive', 'low-level laser', 'cryolipolysis', 'ultrasound' and 'radio frequency' were combined with 'lipolysis', 'fat reduction' or 'body contour' during separate searches in the PubMed database. We identified 31 studies (27 prospective clinical studies and four retrospective chart reviews) with a total of 2937 patients that had been treated with LLLT (n = 1114), cryolipolysis (n = 706), HIFU (n = 843) or RF (n = 116) or other techniques (n = 158) for fat reduction or body contouring. A majority of these patients experienced significant and satisfying results without any serious adverse effects. The studies investigating these devices have all varied in treatment regimen, body locations, follow-up times or outcome operationalization. Each technique differs in offered advantages and severity of adverse effects. However, multiple non-invasive devices are safe and effective for circumferential reduction in local fat tissue by 2 cm or more across the abdomen, hips and thighs. Results are consistent and reproducible for each device and none are associated with any serious or permanent adverse effects.

Lasers for nevi: a review

A nevus is described as a benign, often pigmented, skin growth that can be congenital or acquired. Different types of nevi are located at different depths within the skin. Traditional treatments for nevi include topical treatments, dermabrasion, and excision, which are generally ineffective, invasive, and often result in scars and dyspigmentation. Lately, laser therapy has been used as an alternative. Based on the theory of selective photothermolysis, melanin can be specifically targeted, minimizing adverse effects and increasing effectiveness of laser treatments. Several types of lasers and lights have been studied for this purpose without a concise agreement as to which is the best. In general, quality-switched lasers are preferred for the treatment of pigmented lesions. However, there is controversy about this therapy because certain nevi may have malignant potential. This article serves as a comprehensive review of available laser treatments for nevi and discusses the appropriate measures that should be taken before and after laser therapy. Based on the reviewed literature, laser treatment has generally been proven to be a safe and effective therapy for nevi with minimal side effects.

Pulsed dye laser therapy for molluscum contagiosum: a systematic review

BACKGROUND

Molluscum contagiosum (MC) is a benign contagious viral skin infection that typically resolves without treatment within months. For cases where treatment is recommended or requested, a number of options are available. Over the last 2 decades, a number of case reports and case series have described cases of MC lesions that were successfully treated with pulsed dye laser (PDL); however, a review of these studies has not been reported in the dermatologic literature.

OBJECTIVES

To review the use of PDL for the treatment of MC.

MATERIALS AND METHODS

A search of the National Library of Medicine's PubMed Database and the SCOPUS Database was performed to find articles that detailed the treatment of MC with PDL.

RESULTS

Eight articles met criteria for inclusion in this review. These articles represented 161 patients with over 4200 MC lesions that were treated with PDL. Each article was reviewed and summarized in a table.

LIMITATIONS

The main limitation of this review is the small number of published studies, which reflects the importance of this review of the dermatology literature.

CONCLUSIONS

PDL offers a novel and effective treatment for MC. However, the articles reviewed herein suggest PDL is a safe, effective, quick and well-tolerated treatment for clearing MC lesions that does not cause scarring or permanent pigment change.

Emerging treatments in alopecia

INTRODUCTION

Alopecia is a common concern encountered in the medical practice. Treatment approach varies according to the type and severity of alopecia. However, available treatment options have limited efficacy and several adverse effects. Presently, there are different treatment options being studied to overcome these limitations. Additionally, cellular pathways involved in the pathophysiology of alopecia are further being clarified to potentially target pathogenic molecules.

AREAS COVERED

We searched the literature for recently published articles discussing new treatment options as well as mechanisms involved in alopecia. We discuss the use of stem cells, growth factors, cellular pathways and robotic hair transplant, among other emerging therapies used for alopecia.

EXPERT OPINION

Future looks very promising and new effective treatments such as janus kinase inhibitors could possibly be available for alopecia areata. The stem-cell technology is advancing and companies involved in hair follicle neogenesis are starting clinical trials on patients with androgenetic alopecia.