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Fractional CO2 laser plus topical antifungal versus fractional CO2 laser versus topical antifungal in the treatment of onychomycosis
摘要： Introduction: Onychomycosis is an important medical disorder affecting both patients’ health and quality of life. Objective: This study was done to compare the efficacy of CO2 laser in combination with topical tioconazole versus CO2 laser only versus topical tioconazole alone in onychomycosis. Patients and methods: A total of 120 patients with onychomycosis were randomly assigned to 3 groups. Group A patients were treated with fractional CO2 laser followed by topical tioconazole 28% for 5 sessions with 3 weeks interval. Group B patients were treated with only fractional CO2 laser for 5 sessions with 3 weeks interval. Group C patients were treated with only topical tioconazole 28% for 16 weeks. The clinical effect, KOH examination, and culture for the affected nails in the 3 groups were analyzed. Results: One month after last session, regarding clinical response, 55% showed complete clinical improvement in group A versus 30% in group B versus 25% in group C with significant difference in between. There was a significant difference between the three studied groups as regard KOH test and culture after treatment. Conclusion: Fractional CO2 laser combined with topical antifungal is a safe and effective treatment for onychomycosis.
关键词： Onychomycosis,Fractional CO2 Laser,Tioconazole
更新于2025-09-12 10:27:22
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High- Versus Low-Density Fractional Laser in the Treatment of Hypertrophic Postburn Scars
摘要： BACKGROUND Fractional CO2 laser has been shown effective in improving pigmentation, pruritus, and tightness of hypertrophic burn scars. However, there is no consensus on the optimal treatment parameters. OBJECTIVE To compare effectiveness of different densities of fractional CO2 laser in the treatment of mature hypertrophic burn scars. MATERIALS AND METHODS The study included 25 patients, each with 3 or more mature hypertrophic burn scars. Scars were randomly assigned to treatment with low-, medium-, and high-density fractional CO2 laser. Each scar received 3 sessions of laser at 1-month interval. The degree of improvement was assessed clinically using Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) scores, and histologically through evaluation of collagen (Masson’s Trichrome stain) before and 1 month after end of therapy. RESULTS High-density parameters showed significant higher improvement in VSS and POSAS assessment scores (p-value < .001). Pliability and relief are the most improved parameters. Histopathological evaluation revealed a significant drop in the mean area percent of collagen in the 3 used parameters, with highest improvement with high-density laser treatment (p-value < .001). CONCLUSION High-density fractional CO2 laser treatment provides more improvement in burn scars both clinically and histopathologically.
关键词： hypertrophic burn scars,collagen,Fractional CO2 laser,Patient and Observer Scar Assessment Scale,Vancouver Scar Scale
更新于2025-09-12 10:27:22
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Photodynamic therapy following fractional CO <sub/>2</sub> laser for treatment of primary vulvar Paget’s disease: does it really work?
摘要： Introduction: Extra-mammary Paget’s disease is a rare form of intraepithelial adenocarcinoma with a variable pattern of invasion. Vulvar Paget’s disease represents 1% of all vulvar cancers. Standard treatment is surgical excision, however, the recurrence rate is high and surgery leads to anatomical, functional and sexual morbidity. Some studies suggest the efficacy of photodynamic therapy following CO2 Laser irradiation as treatment for this disease. Methods: In the present study, ten patients with vulvar Paget’s disease underwent fractional carbon dioxide (CO2) laser abrasion, followed by 3 h of occlusive application of aminolaevulinic acid (ALA) and then 100 J/cm2 irradiation with a 630-nm lamp. This combination treatment regime was repeated every 2 weeks for a total of 5 times. Results: At the end of the 12-month follow-up period, only two patients maintained a complete remission of the disease and recurrence was observed in all patients who had originally shown a partial remission. Conclusions: According to our experience, Photodynamic Therapy-ALA following fractional CO2 Laser does not seem to be an effective treatment for vulvar EMPD in the long term.
关键词： photodynamic therapy,fractional CO2 laser,Paget disease
更新于2025-09-12 10:27:22
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Fractional CO2 laser versus promestriene and lubricant in genitourinary syndrome of menopause
摘要： Objective: The aim of this study was to compare the effects of fractional CO2 laser therapy, promestriene, and vaginal lubricants on genitourinary syndrome treatment and sexual function in postmenopausal women. Methods: We performed a randomized clinical trial including 72 postmenopausal women over the age of 50 years. The women were randomized into three intervention groups to receive one of the following treatments: three sessions of intravaginal fractional CO2 laser therapy; 10 mg of intravaginal promestriene cream 3 times a week; and vaginal lubricant application alone. Vaginal maturation, Vaginal Health Index (VHI) score, and Female Sexual Function Index (FSFI) were evaluated at baseline and after 14 weeks of therapy. Results: We observed an improvement in the vaginal elasticity, volume, moisture, and pH in the CO2 laser and promestriene groups. The VHI score at 14 weeks was higher in the CO2 laser group (mean score 18.68) than in the promestriene (15.11) and lubricant (10.44) groups (P < 0.001). Regarding vaginal maturation, basal cells were reduced and superficial cells were increased after treatment. This improvement was more significant in the CO2 laser group (P <0.001). The FSFI score only showed improvement in the desire and lubrication domains in the CO2 laser group. There were no differences in total FSFI score among the three treatment groups. There were no adverse effects associated with any of the treatments. Conclusions: The use of fractional CO2 laser therapy to treat genitourinary syndrome resulted in better short-term effects than those of promestriene or lubricant with respect to improving the vaginal health in postmenopausal women.
关键词： Genitourinary syndrome,Vulvovaginal atrophy,Dyspareunia,Promestriene,CO2 laser,Female sexual function,Postmenopausal
更新于2025-09-12 10:27:22
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Treatment of Benign Adnexal Tumors in Birt–Hogg–Dubé Syndrome With Surgical Debulking in Combination With Fractional and Fully Ablative Carbon Dioxide Laser Resurfacing
摘要： Birt–Hogg–Dub′e syndrome (BHDS) is a rare autosomal dominant condition caused by germline mutations in the FLCN gene, which is associated with both cutaneous and extracutaneous manifestations. Cutaneous lesions include fibrofolliculomas and trichodiscomas, which are benign adnexal tumors presenting as smooth dome-shaped papules on the face, neck, and trunk. Extracutaneous manifestations include pulmonary cysts, spontaneous pneumothorax, and various renal tumors. Although benign, the cutaneous lesions may have profound psychological effects on patients given their propensity for the face. We present a case of a man with BHDS who was successfully treated with surgical debulking combined with fractional and fully ablative carbon dioxide (CO2) laser resurfacing.
关键词： fibrofolliculomas,CO2 laser resurfacing,surgical debulking,Birt–Hogg–Dub′e syndrome,BHDS,trichodiscomas
更新于2025-09-12 10:27:22
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Laser treatment for onychomycosis
摘要： Background: Laser systems are a common treatment choice for onychomycosis. They exert their effects on inhibiting the growth of the fungus by selective photothermolysis but efficacy is dependent on the specific type of apparatus used. To systematically review the available published literature on the curative effects and safety of laser treatment for onychomycosis. Methods: Databases including PubMed, web of science, China National Knowledge Internet (CNKI), WanFang Database and VIP were searched systematically to identify relevant articles published up to July 2018. Potentially relevant articles were sourced, assessed against eligibility criteria by 2 researchers independently and data were extracted from included studies. A meta-analysis was performed using R software. Results: Thirty-five articles involving 1723 patients and 4278 infected nails were included. Meta-analysis of data extracted from these studies revealed that: the overall mycological cure rate was 63.0% (95%CI 0.53-0.73); the mycological cure rate associated with the 1064-nm Nd: YAG laser was 63.0% (95%CI 0.51-0.74); and that of CO2 lasers was 74.0% (95%CI 0.37-0.98). The published data indicate that laser treatment is relatively safe, but can cause tolerable pain and occasionally lead to bleeding after treatment. Conclusion: Laser treatment of onychomycosis is effective and safe. The cumulative cure rate of laser treatment was significantly higher for CO2 lasers than other types of laser. Laser practitioners should be made aware of potential adverse effects such as pain and bleeding.
关键词： onychomycosis,CO2 laser,single rate,systematic review,laser,Nd-YAG laser
更新于2025-09-11 14:15:04
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Combination of continuous wave CO <sub/>2</sub> laser and topical application of trichloroacetic acid 50% vs CO <sub/>2</sub> laser alone the treatment of cutaneous leishmaniasis (A case series of 6 patients)
摘要： Background: Cutaneous leishmaniasis (CL) is an endemic disease of Iran and despite self‐healing nature of this disease and many suggested treatments, scar is usually inevitable results of the affection with this cutaneous infection. CO2 laser in CL has a specific thermolysis effect on infected tissues and application of trichloroacetic acid (TCA) 50% solution for treatment of leishmaniasis scars showed promising results. Aim: To evaluate CO2 laser plus TCA 50% versus CO2 laser alone for treatment of CL. Patients/Methods: In the current report, we present 6 cases of noduloulcerative CL that were treated successfully by the combination of the continuous wave CO2 laser plus topical application of TCA 50%. Results: Five patients improved after 3 weeks of starting treatment, and 1 patient needed to repeat treatment. The scars were flat and good. Conclusions: The CO2 laser plus topical TCA 50% may be more effective in treatment of the cutaneous leishmaniasis and results in shorter healing time.
关键词： treatment,trichloroacetic acid,leishmaniasis,laser,CO2 laser
更新于2025-09-11 14:15:04
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Ablative fractional resurfacing with laser‐facilitated steroid delivery for burn scar management: Does the depth of laser penetration matter?
摘要： Background and Objective: To investigate whether the depth of ablative fractional CO2 laser (CO2‐AFL) penetration of pathological burn scars influences clinical outcomes. Study Design/Materials and Methods: All patients presenting to the Concord Repatriation General Hospital (CRGH) Scar Clinic received ultrasound measurement at the thickest point of their burn scars. Subsequently, the effect of various CO2‐AFL settings (energy which correlates to penetration depths) on different outcome parameters was analysed. Patients were divided into five groups depending on minimal scar penetration depth. Results: Seventy‐eight patients (158 scars) had complete data allowing for analysis. Median scar thickness was 3,400 μm and median laser scar penetration depth was 900 μm. Scar penetration categories were as follows: 0–25% (n = 40), 25–50% (n = 67), 50–75% (n = 31), 75–100% (n = 8), >100% (n = 3) of scar thickness. The median reduction in maximum scar thickness was 800 μm following one treatment (P < 0.001). However, this effect depended on scar penetration depth, whereby scars that were penetrated ≥75% showed no significant improvement in scar thickness and those penetrated >100% indicated a tendency to become worse. Other assessed outcome parameters included: the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale, a neuropathic pain score (DN4 Pain Questionnaire), and a pruritus score (modified D4 Pruritus Score). All these factors showed significant improvement in the categories up to 75% scar penetration depth. Conclusions: CO2‐AFL scar penetration depth significantly influences subjective and objective pathologic burn scar modulation. The penetration depth of 51–75% achieves the greatest reduction in scar thickness.
关键词： ablative fractional CO2 laser,scar assessment scores,burn scars,scar thickness,depth of laser penetration
更新于2025-09-11 14:15:04
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Office‐based CO <sub/>2</sub> laser surgery for benign and premalignant laryngeal lesions
摘要： Objective: Patients with laryngeal pathology are often treated with CO2 laser surgery, usually in the operating room under general anesthesia. Although of?ce-based laser surgery using several other laser types has been investigated, prospective studies on of?ce-based CO2 laser surgery are scarce. Our goal was to investigate the feasibility of of?ce-based CO2 laser surgery for benign and premalignant laryngeal pathology by analyzing completion rate, safety, effect on voice quality, and success rate (i.e., no residual or recurrent disease). Methods: A prospective cohort study was performed of 30 consecutive procedures. Inclusion started in June 2016 and was completed in August 2018. Adult patients with clinically benign or premalignant laryngeal lesions who could not undergo transoral laser microsurgery in the operating room under general anesthesia were included. Reasons were either contraindications for general anesthesia, previously failed therapeutic laryngoscopy under general anesthesia, and preference of a procedure under topical anesthesia by the patient. The mean follow-up was 9 months. Results: Thirty procedures were performed in 27 patients (24 males) with an average age of 62 years. Twenty-nine (97%) procedures were fully completed without complications. The mean preoperative Voice Handicap Index (VHI) score (VHI 44) signi?cantly decreased 2 months (VHI 28, P = 0.032) and 6 months (VHI 14, P < 0.001) after the procedure. Almost two-thirds of patients showed no residual or recurrent disease at their follow-up visits. Conclusion: Of?ce-based CO2 laser surgery is a feasible and safe procedure that results in signi?cant voice-quality improvement. Almost two-thirds of patients did not require further treatment.
关键词： Laser surgery,of?ce-based,topical anesthesia,larynx,CO2 laser
更新于2025-09-11 14:15:04
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CO2 laser-induced micro-plume treatment of silicon: technique and application
摘要： A method for treating the surface of crystalline silicon (α-Si) covered with a fused silica (SiO2) plate by a laser-induced plume arising from the absorption of CO2 laser radiation in glass is presented. The mechanism of micro-plume formation and the effect of this micro-plume on α-Si sample are considered. The α-Si processing regimes were determined that relate the depth of the formed relief to the radiation power density, the temperature of the micro-plume formed during SiO2 irradiation was measured and reached 3000 K. The diffraction phase gratings were designed, manufactured on silicon, and tested, they successfully split 10.6 μm laser beam at 0 and ± 1 diffraction orders. The method belongs to the group of direct writing methods and is easily adapted to different types of diffraction elements on the surface of Si and other materials transparent to 10 μm irradiation.
关键词： Diffraction phase grating,Fused silica,Laser-induced treatment,CO2 laser,Silicon
更新于2025-09-11 14:15:04