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 in | Journal of cosmetic dermatology Vol. 14; no. 4; pp. E15 - E20 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.12.2015
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Subjects | |
Online Access | Get full text |
ISSN | 1473-2130 1473-2165 |
DOI | 10.1111/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. |
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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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Cites_doi | 10.1111/j.1524-4725.2004.30347.x 10.1111/j.1365-2133.2006.07429.x 10.1016/j.burns.2009.08.015 10.1111/j.0906-6705.2006.00435.x 10.1016/S0140-6736(03)14629-6 10.1016/j.jaad.2009.06.054 10.1001/archderm.1963.01590160042007 10.1046/j.0926-9959.2001.00272-4.x 10.1111/j.1524-4725.2009.01468.x 10.1016/j.jaad.2005.01.010 10.1016/j.jaad.2008.11.883 10.1016/S0305-4179(02)00280-2 10.1016/S0190-9622(99)70413-5 10.1016/j.clindermatol.2007.05.006 10.1111/j.1524-4725.2004.30402.x |
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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. 2004; 30 1963; 87 2004; 73 2010; 36 2006; 54 2009; 60 2006; 15 2001; 15 2003; 29 1999; 41 2010; 62 2007; 25 2006; 155 2003; 362 Canturk F (e_1_2_8_5_1) 2004; 73 e_1_2_8_17_1 e_1_2_8_13_1 e_1_2_8_14_1 e_1_2_8_15_1 e_1_2_8_16_1 e_1_2_8_3_1 e_1_2_8_2_1 e_1_2_8_4_1 e_1_2_8_7_1 e_1_2_8_6_1 e_1_2_8_9_1 e_1_2_8_8_1 e_1_2_8_10_1 e_1_2_8_11_1 e_1_2_8_12_1 |
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 start-page: 100 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 – ident: e_1_2_8_8_1 doi: 10.1046/j.0926-9959.2001.00272-4.x – ident: e_1_2_8_6_1 doi: 10.1111/j.1524-4725.2009.01468.x – ident: e_1_2_8_7_1 doi: 10.1016/j.jaad.2005.01.010 – ident: e_1_2_8_14_1 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 – ident: e_1_2_8_11_1 doi: 10.1016/S0305-4179(02)00280-2 – ident: e_1_2_8_17_1 doi: 10.1016/S0190-9622(99)70413-5 – ident: e_1_2_8_15_1 doi: 10.1016/j.clindermatol.2007.05.006 – ident: e_1_2_8_10_1 doi: 10.1111/j.1524-4725.2004.30402.x |
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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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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 |
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