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Treatment of a refractory allergic reaction to a red tattoo with the combination of picosecond neodymium-doped yttrium aluminum garnet laser, fractional carbon dioxide laser, and corticosteroid intralesional injections: a case report

Hannah LEE ; Jiwon LEE ; Sang Ju LEE ; Han Kyoung CHO

Medical Lasers.2024;13(4):224-227. doi:10.25289/ML.24.031

Allergic reactions to tattoo pigments, particularly red ink, are a known complication of tattooing. This paper reports the case of a 21-year-old female with a refractory allergic reaction to red tattoo ink on her shoulder, presenting with swelling, itching, and erythema. She was treated with a picosecond neodymium-doped yttrium aluminum garnet laser combined with a fractional carbon dioxide (CO 2 ) laser and corticosteroid intralesional injections. Significant improvement was observed after four treatment sessions, and complete resolution of the tattoo and symptoms was achieved after ten sessions. This case highlights the potential of combining picosecond and fractional CO 2 lasers with corticosteroid therapy in managing refractory tattoo allergies, suggesting further studies to assess the broader efficacy of this treatment approach.

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Successful treatment of depressed facial scars using single monopolar microneedle radiofrequency: case reports

Kyongmin PARK ; Kihoon KIM ; Sangtae AHN

Medical Lasers.2024;13(4):228-230. doi:10.25289/ML.24.021

The increasing demand for scar treatments has led to various innovative methods. This paper presents two cases involving the treatment of distinct scar types using a single monopolar microneedle radiofrequency (SMNR) device. The first case involved a 52-year-old male with 2-cm linear depressed facial scar of unknown etiology. The patient underwent two sessions of SMNR spaced two weeks apart and showed scar improvement after four weeks. The second case involved a 35-year-old male presenting with a combination of icepick and boxcar acne scars on both cheeks. He received seven SMNR treatments every two weeks and showed scar improvement after 12 weeks. In both cases, scar improvement was achieved through subcisions of fibrous septa combined with dermal remodeling using microneedle radiofrequency. This case report shows that SMNR is an effective and safe modality for treating various types of scars, including acne scars, with minimal downtime and no significant adverse effects

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Novel small spot-high fluence 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet (Q-Nd:YAG) laser toning approach using quadruple pulsing clears epidermal pigmented lesions safely and effectively: case reports

Jewan Kaiser HWANG

Medical Lasers.2024;13(4):219-223. doi:10.25289/ML.24.029

A new 1,064 nm Q-Nd:YAG system developed by the author offers a quadruple-pulse (Q4) mode as a 1,064 nm laser toning method for epidermal pigmented lesions (EPLs) traditionally treated using the 532 nm wavelength. EPLs in seven Korean subjects were treated with the Q-Nd:YAG in Q4 mode with a zoom handpiece using a 2 mm spot, 26-40 J/cm 2 fluence at 10 Hz. The endpoint was a grayish color change or frosting. Two-four sessions were given, two-three weeks apart, with a follow-up of three-four weeks after the final session. A Global Aesthetic Improvement Scale (GAIS) and patient satisfaction were scored, and the pain was assessed on a visual analogue scale. The target lesions cleared well in all subjects with high GAIS scores and patient satisfaction. No adverse events were noted; the downtime was short, and the pain was reasonable. The author’s Q4 toning approach proved safe and effective for EPLs.

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Scar resurfacing treatment with a Q-switched laser using a novel fractional multi-depth focusing handpiece: case reports

Ivan Pérez HADED ; Daniela SABBAGH

Medical Lasers.2024;13(4):214-218. doi:10.25289/ML.24.028

Scar management remains a challenging aspect of dermatology, necessitating effective but minimally invasive treatment modalities. The emergence of the Q-Nd:YAG laser with a MDF handpiece offers a promising solution, combining fractional laser therapy with precise MDF. The present case reports present the initial clinical experiences with this technology in scar resurfacing. This paper describes seven cases involving traumatic and acne scars, treated with the MDF handpiece at 1,064 nm in four sessions spaced one month apart. The treatment yielded significant improvements with minimal adverse effects and high patient satisfaction. The ability of clinicians to tailor the treatment parameters with a Q-Nd:YAG laser, MDF handpiece provided precise control over scar resurfacing, offering a favorable therapeutic option for scar management. This paper highlights the potential of the Q-Nd:YAG laser, MDF handpiece in enhancing the appearance of skin affected by traumatic injuries, underscoring its role as an innovative tool in scar revision therapy.

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Effect of micro-vibration treatment in a blepharitis rat model

Sungyoung PARK ; Hoon KIM ; Kyong-Jin CHO

Medical Lasers.2024;13(4):203-212. doi:10.25289/ML.24.034

Background: Blepharitis, a chronic inflammatory condition of the eyelid margin, can cause significant discomfort and impair the quality of life. While traditional treatments like eyelid hygiene and medications are often insufficient, non-invasive therapies such as micro-vibration devices are gaining popularity despite minimal empirical validation. This study evaluated the efficacy and safety of a commercially available microvibration device in a rat model of blepharitis. Methods: Blepharitis was induced in rats using complete Freund’s adjuvant injections. The treatment groups included micro-vibration (180 Hz), micro-vibration with thermal enhancement, and pharmacological interventions with cyclosporine or hyaluronic acid. Ocular signs, including tear break-up time (TBUT), fluorescein staining, eyelid swelling, and telangiectasia, were assessed weekly. Immunohistochemical analysis quantified inflammatory cytokines (interleukin [IL]-1β, IL-6, and tumor necrosis factor-α) in ocular tissues. Results: The micro-vibration therapy significantly improved TBUT, reduced eyelid swelling, and lowered inflammatory cytokine levels. Combining thermal therapy with micro-vibration yielded enhanced antiinflammatory effects, though uncontrolled heating caused tissue damage. Pharmacological treatments were effective but less comprehensive compared to micro-vibration therapies. Conclusion Micro-vibration therapy at 180 Hz demonstrated substantial efficacy in alleviating symptoms of blepharitis and reducing inflammation. However, the uncontrolled thermal function of the device posed safety concerns, emphasizing the need for stringent regulation and parameter control in commercially available devices. This study highlights the potential of micro-vibration therapy as a non-invasive treatment for blepharitis while underscoring the importance of device safety.

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Optimizing experimental conditions of femtosecond laser-induced breakdown spectroscopy for differentiating melanoma from the normal dermis in Republic of Korea:an experimental study

Janghee CHOI

Medical Lasers.2024;13(4):195-202. doi:10.25289/ML.24.030

Background: Femtosecond laser-induced breakdown spectroscopy (fs-LIBS) is a powerful tool for biomedical diagnostics because it provides real-time, in situ elemental analysis with high spatial resolution. This study used fs-LIBS to distinguish melanoma from normal dermis tissue. Methods: A crater size of approximately 20 μm and an enhanced signal-to-background ratio of critical emission lines were achieved by optimizing the key experimental parameters, such as laser energy, gate delay, and spectral normalization. Results: Principal component analysis and support vector machine algorithms were applied to the normalized spectra, resulting in 96.4% classification accuracy. Conclusion fs-LIBS, under the appropriate experimental conditions and data processing, provides precise tissue analysis and has significant potential for advancing bio-imaging and early cancer detection.

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Photobiomodulation as a novel therapeutic approach in the management of atopic diseases

Kelly WOO ; Andrew PADALHIN

Medical Lasers.2024;13(4):185-194. doi:10.25289/ML.24.036

Hypersensitivities such as asthma, eczema, and allergic rhinitis, are chronic conditions marked by inflammation and immune system dysfunction. These conditions pose significant health challenges, often leading to an impaired quality of life. Although traditional therapies focus primarily on symptom management, they frequently come with substantial side effects. Photobiomodulation (PBM), a non-invasive treatment involving low-level light therapy, has emerged as a promising alternative. PBM offers a multifaceted approach to addressing the underlying mechanisms of atopic diseases by targeting the key immune pathways, including cytokine production, mast cell stabilization, and T cell modulation. Numerous experimental studies have revealed the therapeutic potential of PBM in various atopic disease models. These findings suggest that PBM may offer a safe and effective adjunct or alternative therapy for individuals suffering from these conditions.Nevertheless, further clinical research is essential to optimize the treatment parameters and fully unlock the therapeutic benefits of PBM. A deeper understanding of PBM’s molecular mechanisms will elucidate its precise mode of action. This can pave the way for the development of targeted therapies that maximize efficacy while minimizing the potential side effects. Ultimately, PBM may revolutionize the management of atopic diseases, offering a more holistic and patient-centered approach to treatment.

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Photobiomodulation as a multimodal therapy to enhance wound healing and skin regeneration

Ken WOO

Medical Lasers.2024;13(4):173-184. doi:10.25289/ML.24.033

Photobiomodulation (PBM) is a novel approach in regenerative medicine that utilizes red and near-infrared light to enhance wound healing and skin regeneration by regulating crucial cellular processes. This noninvasive therapy stimulates mitochondrial activity, balances reactive oxygen species, and regulates gene expression to increase fibroblast proliferation, angiogenesis, keratinocyte migration, and collagen remodeling. PBM’s applications range from faster recovery of patients with burns and diabetic ulcers to improved cosmetic outcomes through skin rejuvenation and reduced scarring. Unlike traditional treatments, PBM addresses the multifaceted challenges of wound healing, such as prolonged inflammation and suboptimal tissue repair, by simultaneously targeting multiple pathways. Despite its transformative potential, challenges remain, such as standardizing treatment protocols and refining mechanistic understanding. With the advancement of light delivery technologies and multimodal applications, PBM is poised to become a cornerstone therapy for enhancing tissue repair across diverse clinical settings. This review provides current insights into the mechanisms, therapeutic applications, and future directions of PBM, highlighting its integral role in advancing wound care and skin regeneration.

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Ectopic Mongolian spot

Kwangho YOO

Medical Lasers.2024;13(4):167-172. doi:10.25289/ML.24.027

The Mongolian spot is a congenital, blue-gray color with a variety of shapes and sizes, mostly located in the lumbosacral area, commonly observed in Asian and African infants but rare in Caucasians. A diagnosis is based on the clinical morphology. A histopathological examination of the lesions is required when in doubt. Mongolian spots are often present at birth, usually disappear during childhood, and are generally unnoticeable after one to four years. On the other hand, these spots persist for a long time in approximately 3%-4% of Asian populations. Darker pigmented spots located in the extrasacral area are called ectopic Mongolian spots (previously known as aberrant Mongolian spots). These are more likely to persist than the typical sacral Mongolian spots. They have a benign course, but patients with ectopic Mongolian spots in exposed areas may experience psychological distress owing to their cosmetic appearance. Herein, ectopic Mongolian spots are described in terms of their epidemiology, pathogenesis, clinical features, pathological features, and treatment.

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Optimizing tattoo removal using the picosecond laser with topical perfluorodecalin and subsequent fractional CO2 laser:a case report

Jiwon LEE ; Hannah LEE ; Sang Ju LEE ; Han Kyoung CHO

Medical Lasers.2024;13(2):104-107. doi:10.25289/ML.24.012

Picosecond lasers are considered the most effective treatment for tattoo removal, with the R0 method using perfluorodecalin to rapidly remove opaque cavitation bubbles after each pass, allowing multiple sequential passes during each treatment session. Previous research indicated that combining picosecond lasers with fractional lasers yielded superior results and reduced posttreatment blistering. This paper presents the case of a 25-year-old female seeking tattoo removal from her chest. Initially, the patient underwent treatment using the R0 method with a picosecond laser set to 532 nm (0.8-1.3 J/cm 2 ) and 1,064 nm (2.0-3.0 J/cm 2 ). Each session included four passes with the picosecond laser and a single pass with the fractional CO 2 laser. The lesion was cleared after only four treatment sessions. This case highlights the safety, efficiency, and effectiveness of combining the R0 method with subsequent fractional laser treatment for tattoo removal.

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