Mohamed L. Elsaie

Photodynamic therapy in dermatology: a review

Photodynamic therapy (PDT) is used for the prevention and treatment of non-melanoma skin cancer. Until recently, clinically approved indications have been restricted to actinic keratoses, nodular and superficial basal cell carcinoma, and, since 2006, Bowen disease. However, the range of indications has been expanding continuously. PDT is also used for the treatment of non-malignant conditions such as acne vulgaris and leishmaniasis, as well as for treating premature skin aging due to sun exposure. The production of reactive oxygen intermediates like singlet oxygen depends on the light dose applied as well as the concentration and localization of the photosensitizer in the diseased tissue. Either cytotoxic effects resulting in tumor destruction or immunomodulatory effects improving inflammatory skin conditions are induced. Treating superficial non-melanoma skin cancer, PDT has been shown to be highly efficient, despite the low level of invasiveness. The excellent cosmetic results after treatment are beneficial, too.

Striae Distensae (Stretch Marks) and Different Modalities of Therapy: An Update

BACKGROUND Striae distensea (SD; stretch marks) are a well‐recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The origins of SD are poorly understood, and a number of treatment modalities are available for their treatment, yet none of them is consistently effective, and no single therapy is considered to be pivotal for this problem. With a high incidence and unsatisfactory treatments, stretch marks remain an important target of research for an optimum consensus of treatment. OBJECTIVE To identify the current treatment modalities and their effectiveness in the treatment of stretch marks. MATERIALS AND METHODS Review of the recent literature regarding clinical treatment of stretch marks with emphasis on the safety and efficacy of the newer optical devices and laser applications. RESULTS No current therapeutic option offers complete treatment, although there are a number of emerging new modalities that are encouraging. CONCLUSION The therapeutic strategies are numerous, and no single modality has been far more consistent than the rest. The long‐term future of treatment strategies is encouraging with the advance in laser technologies. The authors have indicated no significant interest with commercial supporters.

Lasers for tattoo removal: a review

Tattoos have existed and have been used as an expression of art by man for ages—and so have the techniques to remove them. Lasers based on the principle of selective photothermolysis are now being used to remove black as well as colorful tattoos with varying successes. The commonly used lasers for tattoo removal are the Q-switched 694-nm ruby laser, the Q-switched 755-nm alexandrite laser, the 1,064-nm Nd:YAG laser, and the 532-nm Nd:YAG laser. Newer techniques and methods are evolving in tattoo removal with lasers. Choosing the right laser for the right tattoo color is necessary for a successful outcome. Our review aims to understand the principles of laser tattoo removal and their applications for different types and colors of tattoos. The review also highlights the complications that can occur such as dyspigmentation, allergic reactions, epidermal debris, ink darkening, and so on, in this process and how to prevent them.

Nonablative radiofrequency for skin rejuvenation.

There is growing interest in a wide range of nonablative interventions that, predictably, are claimed to rejuvenate skin and subcutaneous tissue “safely and effectively.” Although for many years surgery in its many forms has been the criterion standard treatment in aesthetic aspect of aging, nonsurg

Cutaneous remodeling and photorejuvenation using radiofrequency devices

Radio frequency (RF) is electromagnetic radiation in the frequency range of 3-300GHz. The primary effects of RF energy on living tissue are considered to be thermal. The goal of the new devices based on these frequency ranges is to heat specific layers of the skin. The directed use of RF can induce dermal heating and cause collagen degeneration. Wound healing mechanisms promote the remodeling of collagen and wound contraction, which ultimately clinically enhances the appearance of mild to moderate skin laxity. Preliminary studies have reported efficacy in the treatment of laxity that involves the periorbital area and jowls. Because RF energy is not dependent on specific chromophore interaction, epidermal melanin is not at risk of destruction and treatment of all skin types is possible. As such, radiofrequency-based systems have been used successfully for nonablative skin rejuvenation, atrophic scar revision and treatment of unwanted hair, vascular lesions and inflammatory acne. The use of RF is becoming more popular, although a misunderstanding exists regarding the mechanisms and limitations of its actions. This concise review serves as an introduction and guide to many aspects of RF in the non ablative rejuvenation of skin.

Allergic contact dermatitis in children: common allergens and treatment: a review.

Purpose of review The following study reviews the recent literature pertaining to allergic contact dermatitis (ACD) in the pediatric population. This study also provides an overview of the most common allergens and discusses various therapeutic modalities. Recent findings The pathophysiology of ACD is intricate and multifaceted, resulting in a characteristic, delayed inflammatory response. Although commonly recognized in adults, its existence in the pediatric population was questioned. Recent literature suggests that pediatric ACD exists and is more common than previously recognized. The diagnosis relies on the clinical presentation combined with appropriate use and interpretation of a patch test. Although many studies have investigated ACD in children, few have documented the relevance of positive patch test reactions until recently. The most current prevalence estimates of positive patch test reactions range from 14 to 70% of children patch tested. Although that range is broad, these studies have demonstrated the relevance of positive reactions and confirmed ACD as a disease entity in children. Summary ACD is a previously underrecognized disease process in the pediatric population that can manifest as a serious dermatologic challenge for both patients and physicians. This review will address the prevalence, diagnostic methods, frequent allergens and treatment options in pediatric ACD.

Lasers in the treatment of nonmelanoma skin cancer.

BACKGROUND Nonmelanoma skin cancers (NMSCs) constitute the largest proportion of cancers worldwide, especially in the Western population, making it essential to develop methods to manage these cancers. Ultraviolet (UV) light being the most significant culprit in the development of NMSCs makes the sun‐exposed parts of the body, such as face and extremities, the most vulnerable to develop these tumors. Early diagnosis and emphasis on cosmesis are vital while treating them especially, in patients with multiple squamous and basal cell carcinomas. Lasers seem to be a useful therapeutic modality and are being explored to develop them as a tool for treating skin cancers. OBJECTIVE To review the use of lasers in the treatment of NMSCs. METHODS We reviewed articles that involved the use of lasers in the management of NMSCs and prepared a critical analysis of the same. RESULTS AND CONCLUSIONS Lasers as a single modality, as the coherent light source in photodynamic therapy (PDT), or as an adjunct to PDT or other treatment modalities are a potential method of NMSC eradication. Superficial NMSCs and most precancerous cutaneous lesions such as Bowens disease and actinic keratoses respond best, whereas deeper, more‐aggressive NMSCs show poor outcomes with laser treatments. The authors have indicated no significant interest with commercial supporters.

Evaluation of plasma skin regeneration technology for cutaneous remodeling

Plasma skin regeneration is a novel type of skin rejuvenation technology developed over the last 3 years. Plasma is the fourth state of matter in which electrons are stripped from atoms to form an ionized gas. Although high‐temperature plasmas have been used in surgery for over a decade, plasma had previously been used as a conduction medium for electric current. Unlike lasers, which rely on the principle of selective photothermolysis to deliver heat to specific targets in the skin, plasma technology delivers heat energy directly to tissue upon contact without reliance on skin chromophores. The plasma itself produces controlled thermal damage to the skin surface to elicit changes such as new collagen formation and improvement in photodamaged skin. The technology can be used at varying energies for different depths of effect, from superficial epidermal effects to deeper dermal heating.

Epidemiologic study of dermatologic disorders among children in South Sinai, Egypt

Background  Few epidemiologic surveys have been carried out to determine the prevalence of skin diseases in the population of Egypt, particularly in the Sinai Peninsula. Thus, the necessity of such research in South Sinai is pressing. This study aimed to determine the prevalence of various skin diseases among children in South Sinai.

Six-Month, Double-Blind, Randomized, Split-Face Study to Compare the Efficacy and Safety of Calcium Hydroxylapatite (CaHA) Mixed with Lidocaine and CaHA Alone for Correction of Nasolabial Fold Wrinkles

BACKGROUND Safety, pain, duration of effect, and patient satisfaction are important concerns for physicians performing dermal filler injections. OBJECTIVE This randomized, double‐blind, split‐face study compared the 6‐month safety profile of dermal injections of calcium hydroxylapatite (CaHA) mixed with lidocaine (RDF‐L) with that of CaHA alone (RDF) in nasolabial folds (NLFs). The study also assessed differences in pain perception, efficacy, and patient satisfaction of RDF‐L and RDF for correction of nasolabial wrinkles. METHODS Sixteen adult subjects with moderate to deep NLFs according to the Lemperle Rating Scale were enrolled. Pain perception was recorded from patients using a validated visual analog pain scale. Efficacy judged by a blinded injector and an independent observer was evaluated up to 24 weeks. Patient satisfaction surveys were also collected. Adverse events were recorded throughout the study. RESULTS/CONCLUSIONS Neither RDF‐L nor RDF led to significant adverse events. Comparable and limited local adverse events typical of dermal fillers were noted in both groups. No difference in duration of effect in the NLFs was shown between RDF‐L and RDF. Much less pain was reported on the RDF‐L side. In general, patients were extremely satisfied with the treatment on both sides. BioForm Medical (San Mateo, CA) provided Radiesse soft tissue filler, lidocaine, and other necessary supplies. Dr. Grunebaum has received compensation for presentations to the medical community about products manufactured by BioForm Medical.