Prevention or treatment of hypertrophic burn scarring: a review of when and how to treat with the pulsed dye laser.

The purpose of this review is to investigate the use of Pulsed Dye Laser (PDL) as a therapeutic tool for hypertrophic burns scarring. The difference between keloids and hypertrophic scars is first described. The review then outlines the progress and assessment of hypertrophic scars for burns patients and the problem of their clinical management.

Electromagnetic interference from lasers and intense light sources in the treatment of patients with artificial pacemakers and other implantable cardiac devices.

Measurements of the electric and magnetic field strengths surrounding six laser systems and one intense pulsed light system were carried out. The results were compared to exposure limits published by cardiac device manufacturers to assess the risk of electromagnetic interference to implantable cardiac devices such as pacemakers or implantable cardioverter defibrillators. The majority of lasers assessed in this study were found to produce electric and magnetic field strengths below the published exposure limits for cardiac devices.

A new Monte Carlo program for simulating light transport through Port Wine Stain skin.

A new Monte Carlo program is presented for simulating light transport through clinically normal skin and skin containing Port Wine Stain (PWS) vessels. The program consists of an eight-layer mathematical skin model constructed from optical coefficients described previously. A simulation including diffuse illumination at the surface and subsequent light transport through the model is carried out using a radiative transfer theory ray-tracing technique.

Cutaneous lasers and skin camouflage make-up: a useful alternative intervention for periorbital hairy congenital melanocytic naevus.

Periorbital congenital melanocytic naevi can be very disfiguring and difficult to treat effectively. Although surgical excision and reconstruction is the most widely accepted treatment strategy, we describe a case in which cutaneous lasers treatment followed by the application of cosmetic skin camouflage make-up provided an alternative solution delivering a good cosmetic improvement.

Simulating light transport through skin for color prediction of port wine stain lesions: a review.

A survey of the literature is presented regarding the simulation of port wine stain (PWS) skin color. Knowledge of PWS features, such as the depths and diameters of affected vessels, is essential for informing laser treatment. These may be determined through the inverse application of a skin model.

Optical properties of human skin.

A survey of the literature is presented that provides an analysis of the optical properties of human skin, with particular regard to their applications in medicine. Included is a description of the primary interactions of light with skin and how these are commonly estimated using radiative transfer theory (RTT). This is followed by analysis of measured RTT coefficients available in the literature.

Susceptibility of the pilot balloon of the disposable laryngeal mask airway to puncture during laser therapy.

The tube of the laryngeal mask airway is frequently protected by foil during ablative laser procedures. The pilot balloon, however, is often left exposed. The effect of firing seven different cutaneous lasers at the pilot balloon of a disposable laryngeal mask airway was examined to assess its susceptibility to accidental laser strikes.

Adverse effects following Q-switched ruby laser treatment of pigmented lesions.

A retrospective study was conducted to investigate the incidence of adverse effects following Q-switched ruby laser treatment of pigmented lesions at the Wessex Specialist Laser Centre. Sixty-one patients received a total of 151 treatments between January 2006 and January 2008. This is the largest series to date of patients on whom adverse effects have been reported following Q-switched ruby laser treatment of an assortment of pigmented lesions.

Spectrophotometers for the clinical assessment of port-wine stain skin lesions: a review.

Reflectance spectrophotometry is the most established and widely used objective technique for the assessment of port-wine stain (PWS) skin, and has been applied extensively in other dermatological applications. To date, no review has been published regarding the different spectrophotometric devices used on PWS skin. This paper comprises such a review, introducing the reader to the relevant background material and then discussing scanning, narrow-band and tristimulus spectrophotometers in turn.

Determination of the effects of blood depth in the dermis on skin colour in a novel skin phantom using digital imaging.

A phantom of human port wine stain (PWS) skin, previously described by the authors, that takes into account its light propagation and scattering properties, was used to model varying depths of blood within PWS skin. Digital images of these phantoms were then acquired under controlled conditions, and the colour information was abstracted with a digital image processing suite. These colour data were analysed quantitatively for each depth of blood, and the relationship between depth of blood and colour was defined.

Adverse effects reported in pulsed dye laser treatment for port wine stains.

A retrospective study was conducted over a 762-day period to investigate the incidence of adverse effects following pulsed dye laser treatment for port wine stains using the Chromos 585 nm pulsed dye laser (PDL). Treatment energy densities typically ranged from 4.0 J/cm(2) to 7.

Ruby laser for the treatment of trichiasis.

Trichiasis, the misdirection of eyelashes arising from their normal sites of origin, may cause discomfort, corneal abrasions, ulceration and scarring. The therapies currently used for this condition have a variety of success rates and complications. In this report we describe epilation using a ruby laser to treat ten patients (11 lids).

Outcome of erbium:yttrium aluminium garnet laser resurfacing treatments.

Erbium:yttrium aluminium garnet (erbium:YAG) laser treatment was used to resurface skin abnormalities in patients suffering from conditions that included epidermal naevi, tuberous sclerosis, angiofibromata, neurofibromatosis, and scarring caused by acne or other means. Patients completed self-report questionnaires before their first laser test patch session, and again approximately 4 months after one treatment, so that its success could be evaluated from the patient's perspective. Disability and distress were quantified with the University of York Health Measurement Questionnaire (HMQ).

Construction of a novel port wine stain phantom and measurement of colour by digital imaging and reflectance spectrophotometry.

A novel skin phantom is described that is constructed with quantifiable amounts of skin pigments, as well as a light scattering medium in the form of barium sulphate suspension. The two predominant skin pigments (melanin and haemoglobin) are varied in controlled amounts within the phantoms to simulate skin colour in different situations. The phantoms were devised in order to simulate the changes in skin colour particularly after laser treatment of port wine stains, where superficial cutaneous vascularity is reduced.

Adverse effects reported in epilatory ruby laser treatment.

A retrospective study was conducted to investigate the incidence of reported adverse responses after epilatory laser treatment to control the growth of facial hair in patients with polycystic ovary syndrome. Forty-eight patients received a median of 6 (range 2-11) treatments with an Aesculap ruby laser during a 704 day monitoring period at Salisbury District Hospital. Nine adverse skin responses such as blistering, scabbing, sustained localised erythematous reactions or hyperpigmentation were reported.

Monitoring the ups and downs of pulsed dye laser energy output.

The internal energy meter reading of a Chromos pulsed dye laser (PDL) set at 50% of maximum pumping energy was recorded at the start of every clinical session over an 898 day period and compared with the measurement from an Ophir Optronics 'Nova' external energy meter. This quick and inexpensive process improved quality control procedures for the use of the PDL and enabled the performance of laser components such as the dye, pumping mechanism and optics to be monitored. The stability of the laser output energy was also monitored during three simulated clinics on days 665, 870 and 898.

How well does your ruby laser work?

The safe and effective use of cutaneous lasers is dependent upon the selection of a clinically appropriate laser energy level. Therefore, the accuracy of the stated laser output is critical. The energy output of an Aesculap ruby laser was recorded at the start of every clinical session over a 704-day period using an external energy meter.