Pulsed dye laser in treatment of steroid-induced atrophy

Summary Background One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our knowledge, laser therapy for steroid‐induced atrophic scars has not been investigated to date. Objective The aim of thi...

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Published inJournal of cosmetic dermatology Vol. 14; no. 4; pp. E15 - E20
Main Authors Mansouri, Parvin, Ranjbar, Maryam, Abolhasani, Ehsan, Chalangari, Reza, Martits-Chalangari, Katalin, Hejazi, Somayeh
Format Journal Article
LanguageEnglish
Published England Blackwell Publishing Ltd 01.12.2015
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ISSN1473-2130
1473-2165
DOI10.1111/jocd.12158

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Abstract Summary Background One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our knowledge, laser therapy for steroid‐induced atrophic scars has not been investigated to date. Objective The aim of this study was to evaluate the efficacy and safety of pulsed dye laser in the treatment of steroid‐induced atrophic scars. Methods In this pilot study, 15 patients with at least one atrophic patch were treated with the 585‐nm pulsed dye laser at 4‐week interval sessions until achieving complete improvement or until patient were lost to follow‐up. Clinical outcome was assessed via standard photographic method before each treatment session and after the final visit. An independent dermatologist evaluated the photographs. Result All of the patients (13 females and two males) with 25–59 years of age experienced some degree of improvement, except one patient who withdrew from the treatment after three sessions. The treatment was well tolerated. Conclusion The results of our study indicated that pulsed dye laser therapy could be employed as a new method in the treatment of steroid‐induced atrophic scars. Pulsed dye laser might affect the lesions through inducing collagen deposition and production of more superficial dermal elastin as well as less unidirectional collagen in clusters.
AbstractList Summary Background One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our knowledge, laser therapy for steroid‐induced atrophic scars has not been investigated to date. Objective The aim of this study was to evaluate the efficacy and safety of pulsed dye laser in the treatment of steroid‐induced atrophic scars. Methods In this pilot study, 15 patients with at least one atrophic patch were treated with the 585‐nm pulsed dye laser at 4‐week interval sessions until achieving complete improvement or until patient were lost to follow‐up. Clinical outcome was assessed via standard photographic method before each treatment session and after the final visit. An independent dermatologist evaluated the photographs. Result All of the patients (13 females and two males) with 25–59 years of age experienced some degree of improvement, except one patient who withdrew from the treatment after three sessions. The treatment was well tolerated. Conclusion The results of our study indicated that pulsed dye laser therapy could be employed as a new method in the treatment of steroid‐induced atrophic scars. Pulsed dye laser might affect the lesions through inducing collagen deposition and production of more superficial dermal elastin as well as less unidirectional collagen in clusters.
One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of our knowledge, laser therapy for steroid-induced atrophic scars has not been investigated to date. The aim of this study was to evaluate the efficacy and safety of pulsed dye laser in the treatment of steroid-induced atrophic scars. In this pilot study, 15 patients with at least one atrophic patch were treated with the 585-nm pulsed dye laser at 4-week interval sessions until achieving complete improvement or until patient were lost to follow-up. Clinical outcome was assessed via standard photographic method before each treatment session and after the final visit. An independent dermatologist evaluated the photographs. All of the patients (13 females and two males) with 25-59 years of age experienced some degree of improvement, except one patient who withdrew from the treatment after three sessions. The treatment was well tolerated. The results of our study indicated that pulsed dye laser therapy could be employed as a new method in the treatment of steroid-induced atrophic scars. Pulsed dye laser might affect the lesions through inducing collagen deposition and production of more superficial dermal elastin as well as less unidirectional collagen in clusters.
Author Ranjbar, Maryam
Martits-Chalangari, Katalin
Hejazi, Somayeh
Mansouri, Parvin
Abolhasani, Ehsan
Chalangari, Reza
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10.1016/j.clindermatol.2007.05.006
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Issue 4
Keywords lasers
atrophy
pulsed dye
steroid
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References DeHoratius DM, Dover JS. Nonablative tissue remodeling and photorejuvenation. Clin Dermatol 2007; 25: 474-9.
Sommer S, Sheehan-Dare RA. Atrophie blanche-like scarring after pulsed dye laser treatment. J Am Acad Dermatol 1999; 41: 100-2.
Canturk F, Canturk T, Aydin F et al. Cutaneous linear atrophy following intralesional corticosteroid injection in the treatment of tendonitis. Cutis 2004; 73: 197-8.
Parrett BM, Donelan MB. Pulsed dye laser in burn scars: current concepts and future directions. Burns 2010; 36: 443-9.
Hengge UR, Ruzicka T, Schwartz RA et al. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol 2006; 54: 1-15; quiz 16-8.
Chua SH, Ang P, Khoo LS et al. Nonablative 1450-nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective clinical study. Dermatol Surg 2004; 30: 1287-91.
Katz TM, Glaich AS, Goldberg LH et al. 595-nm long pulsed dye laser and 1450-nm diode laser in combination with intralesional triamcinolone/5-fluorouracil for hypertrophic scarring following a phenol peel. J Am Acad Dermatol 2010; 62: 1045-9.
Lee DH, Choi YS, Min SU et al. Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd:YAG laser for the treatment of acne scars: a randomized split-face clinical study. J Am Acad Dermatol 2009; 60: 801-7.
Nuutinen P, Autio P, Hurskainen T et al. Glucocorticoid action on skin collagen: overview on clinical significance and consequences. J Eur Acad Dermatol Venereol 2001; 15: 361-2.
Jih MH, Friedman PM, Kimyai-Asadi A et al. Successful treatment of a chronic atrophic dog-bite scar with the 1450-nm diode laser. Dermatol Surg 2004; 30: 1161-3.
Seaton ED, Mouser PE, Charakida A et al. Investigation of the mechanism of action of nonablative pulsed-dye laser therapy in photorejuvenation and inflammatory acne vulgaris. Br J Dermatol 2006; 155: 748-55.
Seaton ED, Charakida A, Mouser PE et al. Pulsed-dye laser treatment for inflammatory acne vulgaris: randomised controlled trial. Lancet 2003; 362: 1347-52.
Epstein NN, Epstein WL, Epstein JH. Atrophic striae in patients with inguinal intertrigo: Pathogenesis. Arch Dermatol. 1963; 87: 450-7.
Schoepe S, Schacke H, May E et al. Glucocorticoid therapy-induced skin atrophy. Exp Dermatol 2006; 15: 406-20.
Shiffman MA. Letter: Treatment of local, persistent cutaneous atrophy after corticosteroid injection with normal saline infiltration. Dermatol Surg 2010; 36: 436.
Allison KP, Kiernan MN, Waters RA et al. Pulsed dye laser treatment of burn scars. Alleviation or irritation? Burns 2003; 29: 207-13.
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References_xml – reference: Schoepe S, Schacke H, May E et al. Glucocorticoid therapy-induced skin atrophy. Exp Dermatol 2006; 15: 406-20.
– reference: Katz TM, Glaich AS, Goldberg LH et al. 595-nm long pulsed dye laser and 1450-nm diode laser in combination with intralesional triamcinolone/5-fluorouracil for hypertrophic scarring following a phenol peel. J Am Acad Dermatol 2010; 62: 1045-9.
– reference: Seaton ED, Mouser PE, Charakida A et al. Investigation of the mechanism of action of nonablative pulsed-dye laser therapy in photorejuvenation and inflammatory acne vulgaris. Br J Dermatol 2006; 155: 748-55.
– reference: Shiffman MA. Letter: Treatment of local, persistent cutaneous atrophy after corticosteroid injection with normal saline infiltration. Dermatol Surg 2010; 36: 436.
– reference: Parrett BM, Donelan MB. Pulsed dye laser in burn scars: current concepts and future directions. Burns 2010; 36: 443-9.
– reference: Chua SH, Ang P, Khoo LS et al. Nonablative 1450-nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective clinical study. Dermatol Surg 2004; 30: 1287-91.
– reference: Hengge UR, Ruzicka T, Schwartz RA et al. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol 2006; 54: 1-15; quiz 16-8.
– reference: Nuutinen P, Autio P, Hurskainen T et al. Glucocorticoid action on skin collagen: overview on clinical significance and consequences. J Eur Acad Dermatol Venereol 2001; 15: 361-2.
– reference: Jih MH, Friedman PM, Kimyai-Asadi A et al. Successful treatment of a chronic atrophic dog-bite scar with the 1450-nm diode laser. Dermatol Surg 2004; 30: 1161-3.
– reference: DeHoratius DM, Dover JS. Nonablative tissue remodeling and photorejuvenation. Clin Dermatol 2007; 25: 474-9.
– reference: Sommer S, Sheehan-Dare RA. Atrophie blanche-like scarring after pulsed dye laser treatment. J Am Acad Dermatol 1999; 41: 100-2.
– reference: Lee DH, Choi YS, Min SU et al. Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd:YAG laser for the treatment of acne scars: a randomized split-face clinical study. J Am Acad Dermatol 2009; 60: 801-7.
– reference: Allison KP, Kiernan MN, Waters RA et al. Pulsed dye laser treatment of burn scars. Alleviation or irritation? Burns 2003; 29: 207-13.
– reference: Seaton ED, Charakida A, Mouser PE et al. Pulsed-dye laser treatment for inflammatory acne vulgaris: randomised controlled trial. Lancet 2003; 362: 1347-52.
– reference: Epstein NN, Epstein WL, Epstein JH. Atrophic striae in patients with inguinal intertrigo: Pathogenesis. Arch Dermatol. 1963; 87: 450-7.
– reference: Canturk F, Canturk T, Aydin F et al. Cutaneous linear atrophy following intralesional corticosteroid injection in the treatment of tendonitis. Cutis 2004; 73: 197-8.
– volume: 15
  start-page: 406
  year: 2006
  end-page: 20
  article-title: Glucocorticoid therapy‐induced skin atrophy
  publication-title: Exp Dermatol
– volume: 60
  start-page: 801
  year: 2009
  end-page: 7
  article-title: Comparison of a 585‐nm pulsed dye laser and a 1064‐nm Nd:YAG laser for the treatment of acne scars: a randomized split‐face clinical study
  publication-title: J Am Acad Dermatol
– volume: 29
  start-page: 207
  year: 2003
  end-page: 13
  article-title: Pulsed dye laser treatment of burn scars. Alleviation or irritation?
  publication-title: Burns
– volume: 54
  start-page: 1
  year: 2006
  end-page: 15
  article-title: Adverse effects of topical glucocorticosteroids
  publication-title: J Am Acad Dermatol
– volume: 41
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  year: 1999
  end-page: 2
  article-title: Atrophie blanche‐like scarring after pulsed dye laser treatment
  publication-title: J Am Acad Dermatol
– volume: 362
  start-page: 1347
  year: 2003
  end-page: 52
  article-title: Pulsed‐dye laser treatment for inflammatory acne vulgaris: randomised controlled trial
  publication-title: Lancet
– volume: 155
  start-page: 748
  year: 2006
  end-page: 55
  article-title: Investigation of the mechanism of action of nonablative pulsed‐dye laser therapy in photorejuvenation and inflammatory acne vulgaris
  publication-title: Br J Dermatol
– volume: 36
  start-page: 443
  year: 2010
  end-page: 9
  article-title: Pulsed dye laser in burn scars: current concepts and future directions
  publication-title: Burns
– volume: 30
  start-page: 1161
  year: 2004
  end-page: 3
  article-title: Successful treatment of a chronic atrophic dog‐bite scar with the 1450‐nm diode laser
  publication-title: Dermatol Surg
– volume: 73
  start-page: 197
  year: 2004
  end-page: 8
  article-title: Cutaneous linear atrophy following intralesional corticosteroid injection in the treatment of tendonitis
  publication-title: Cutis
– volume: 36
  start-page: 436
  year: 2010
  article-title: Letter: Treatment of local, persistent cutaneous atrophy after corticosteroid injection with normal saline infiltration
  publication-title: Dermatol Surg
– volume: 87
  start-page: 450
  year: 1963
  end-page: 7
  article-title: Atrophic striae in patients with inguinal intertrigo: Pathogenesis
  publication-title: Arch Dermatol.
– volume: 15
  start-page: 361
  year: 2001
  end-page: 2
  article-title: Glucocorticoid action on skin collagen: overview on clinical significance and consequences
  publication-title: J Eur Acad Dermatol Venereol
– volume: 25
  start-page: 474
  year: 2007
  end-page: 9
  article-title: Nonablative tissue remodeling and photorejuvenation
  publication-title: Clin Dermatol
– volume: 62
  start-page: 1045
  year: 2010
  end-page: 9
  article-title: 595‐nm long pulsed dye laser and 1450‐nm diode laser in combination with intralesional triamcinolone/5‐fluorouracil for hypertrophic scarring following a phenol peel
  publication-title: J Am Acad Dermatol
– volume: 30
  start-page: 1287
  year: 2004
  end-page: 91
  article-title: Nonablative 1450‐nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective clinical study
  publication-title: Dermatol Surg
– ident: e_1_2_8_9_1
  doi: 10.1111/j.1524-4725.2004.30347.x
– ident: e_1_2_8_16_1
  doi: 10.1111/j.1365-2133.2006.07429.x
– ident: e_1_2_8_4_1
  doi: 10.1016/j.burns.2009.08.015
– ident: e_1_2_8_3_1
  doi: 10.1111/j.0906-6705.2006.00435.x
– ident: e_1_2_8_13_1
  doi: 10.1016/S0140-6736(03)14629-6
– ident: e_1_2_8_12_1
  doi: 10.1016/j.jaad.2009.06.054
– ident: e_1_2_8_2_1
  doi: 10.1001/archderm.1963.01590160042007
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  doi: 10.1046/j.0926-9959.2001.00272-4.x
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  doi: 10.1111/j.1524-4725.2009.01468.x
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  doi: 10.1016/j.jaad.2008.11.883
– volume: 73
  start-page: 197
  year: 2004
  ident: e_1_2_8_5_1
  article-title: Cutaneous linear atrophy following intralesional corticosteroid injection in the treatment of tendonitis
  publication-title: Cutis
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  doi: 10.1016/S0305-4179(02)00280-2
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  doi: 10.1016/S0190-9622(99)70413-5
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Snippet Summary Background One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective...
One of the important and distressing cutaneous side effects of steroid therapy is skin atrophy, which has no definite and effective treatment. To the best of...
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istex
SourceType Index Database
Enrichment Source
Publisher
StartPage E15
SubjectTerms Adrenal Cortex Hormones - adverse effects
Adult
atrophy
Atrophy - chemically induced
Cicatrix - chemically induced
Cicatrix - radiotherapy
Female
Humans
lasers
Lasers, Dye - therapeutic use
Low-Level Light Therapy
Male
Middle Aged
Pilot Projects
pulsed dye
Skin - pathology
Skin - radiation effects
steroid
Title Pulsed dye laser in treatment of steroid-induced atrophy
URI https://api.istex.fr/ark:/67375/WNG-MLKQMB3Z-4/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fjocd.12158
https://www.ncbi.nlm.nih.gov/pubmed/26282056
Volume 14
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