Piero Campolmi

Monochromatic excimer light (308 nm): an immunohistochemical study of cutaneous T cells and apoptosis-related molecules in psoriasis

Background Various types of UVB radiation source (290–320 nm) are used in treating psoriasis and their therapeutic mechanism has been attributed to immunosuppressive properties. Recently, a new UVB source generated by a 308‐nm excimer laser has been introduced for the treatment of psoriasis.

Fractional CO2 laser: a novel therapeutic device upon photobiomodulation of tissue remodeling and cytokine pathway of tissue repair

Minimally ablative fractional laser devices have gained acceptance as a preferred method for skin resurfacing. Notable improvements in facial rhytides, photodamage, acne scarring, and skin laxity have been reported. The aim of the present work was to compare how different CO2 laser fluences, by modulating the secretory pathway of cytokines, are able to influence the wound‐healing process, and how these fluences are associated with different clinical results. Eighteen patients, all with photodamaged skin, were treated using a fractional CO2 laser (SmartXide DOT, Deka M.E.L.A., Florence, Italy) with varying laser fluences (2.07, 2.77, and 4.15 J/cm2). An immunocytochemical study was performed at defined end points in order to obtain information about specific cytokines of the microenvironment before and after treatment. The secretory pathway of cytokines changed depending on the re‐epithelization and the different laser fluences. Different but significant improvements in wrinkles, skin texture, and hyperpigmentation were definitely obtained when using 2.07, 2.77, and 4.15 J/cm2, indicating fractional CO2 laser as a valuable tool in photorejuvenation with good clinical results, rapid downtime, and an excellent safety profile.

Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias

Background Facial and leg telangiectasias are a frequent cosmetic concern for both females and males with various skin types and ages. To date the different treatments for these problems, in particular leg telangiectasias, have frequently failed or led to negative side‐effects.

In vivo non-invasive monitoring of collagen remodelling by two-photon microscopy after micro-ablative fractional laser resurfacing.

Non-linear optical microscopy is becoming popular as a non-invasive in vivo imaging modality in dermatology. In this study, combined TPF and SHG microscopy were used to monitor collagen remodelling in vivo after micro-ablative fractional laser resurfacing. Papillary dermis of living subjects, covering a wide age range, was imaged immediately before and forty days after treatment. A qualitative visual examination of acquired images demonstrated an age-dependent remodelling effect on collagen. Additional quantitative analysis of new collagen production was performed by means of two image analysis methods. A higher increase in SHG to TPF ratio, corresponding to a stronger treatment effectiveness, was found in older subjects, whereas the effect was found to be negligible in young, and minimal in middle age subjects. Analysis of collagen images also showed a dependence of the treatment effectiveness with age but with controversial results. While the diagnostic potential of in vivo multiphoton microscopy has already been demonstrated for skin cancer and other skin diseases, here we first successfully explore its potential use for a non-invasive follow-up of a laser-based treatment.

Vascular based non conventional dye laser treatment for basal cell carcinoma

ABSTRACT:  Basal cell carcinoma is the most common skin tumor in humans which can be removed in a variety of ways (depending on the type of the lesion, the affected area, and depth of the lesion). Laser therapy offers another option to the traditional methods of treatment; thus, the purpose of this work is to valuate the efficacy of dye laser in a selected group of patients affected by superficial basal cell carcinoma. We suggest that the success of pulse dye laser treatment lies in the fact that as all tumors, basal cell carcinomas contain an increased number of dilated blood vessels. Twenty patients (eight males and 12 females) with superficial basal cell carcinoma were given five treatments with a flashlamp‐pumped pulse dye laser every 20 days. The clinical follow up was 12–24 months after the fifth treatment. A complete response was obtained in 16 patients out of 20. Three recurrences and one no response was observed during the study. Pulse dye laser is effective and safe in the treatment of superficial basal cell carcinoma

Giant exophytic basal cell carcinoma treated with radiotherapy.

Basal cell carcinomas may attain giant proportions due primarily to recurrence or because the tumour is neglected. We report the case of a 66‐year‐old man who presented with a bleeding, polypoid, cutaneous tumour located on the left shoulder region of 13 years duration. The man had not received any previous treatment. The lesion was biopsied and histopathologically diagnosed as a solid type basal cell carcinoma with focal areas of squamous differentiation and keratinization. The man refused complete surgical removal and therefore was treated with roentgentherapy, with satisfactory results and no complications in the irradiated area. No recurrences had manifested after 1 year follow‐up.

Intense pulsed light in the treatment of non‐aesthetic facial and neck vascular lesions: report of 85 cases

Background  Intense pulsed light (IPL) treatment is one of the most effective procedures for patients with non‐aesthetic vascular lesions in addition to signs of skin photoageing, and it has been reported as very successful in the treatment of telangiectasias, spider nevi, erythrosis, and above all, rosacea and poikiloderma. Its use is based on the principle of selective photothermolysis, which exploits the haemoglobin absorption peak among its range of wavelengths.

CO2 laser therapy in a case of steatocystoma multiplex with prominent nodules on the face and neck

Background Steatocystoma multiplex is an uncommon disorder which usually begins in adolescence or early adult life. The condition can be hereditary, as an autosomal dominant trait, or nonhereditary, as in this case.

595 nm Pulsed dye laser for the treatment of superficial basal cell carcinoma

Dear Sirs, We read with interest a letter by K.P. Allison et al. concerning the treatment of superficial basal cell carcinoma (sBCC) with pulsed dye laser [1]. The Authors used a single 585-nm dye laser treatment in seven sBCCs obtaining only one sBCC out of seven effectively healed at 8 weeks follow-up. They concluded the letter by writing that ‘‘at the present this treatment is not a realistic alternative to other treatments, which yield much higher cure rates’’. In our study, 20 patients (8 Male and 12 Female; age 49–72 years, mean 63 years) with sBCCs were recruited and, about 20 days after a 3-mm punch biopsy or a cytological diagnosis, a 595-nm dye laser treatment (Dermobeam 2000, Deka M.E.L.A., Florence-Italy) was performed five times a month with the following parameters: pulse duration of 1.5 ms, energy density of 7.5 J/cm and a 7 mm diameter spot. The lesions were uniformly irradiated with the minimum of overlap including about 5 mm of apparently healthy skin at the periphery of the tumour and without using intralesional or topical anaesthetic. Dye laser was equipped with a cryogen spray cooling. The clinical follow-up was 9– 12 months (mean 10 months) after the fifth treatment (Figs. 1, 2). We obtained a complete response in 16 out of 20 sBCCs. Three recurrences (one at 3-months followup and two at 6-months follow-up) and one no response case were also observed during the study period. In our opinion, 595-nm wavelength is able to penetrate deeper into the skin [2] to the target (oxyhaemoglobin or nuclear chromatin), although the complete mechanism of damage is not perfectly elucidated (photoangiolysis of sublesional microcirculation, denaturing of epithelial basement membrane linking proteins and cellular destruction) [3]. Although our laser parameters, using 595 nm wavelength, with repeated sessions might represent the optimal protocol, further investigations into the treatment of sBCC are needed to confirm our preliminary data.

Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment

Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous potential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most common skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea). Next to these inflammatory skin reactions we have to consider also the possibility of the development of cutaneous conditions such as pseudolymphomatous reactions and pseudoepitheliomatous hyperplasia. The aim of this study is to underline the importance of an early diagnosis by performing a histological examination especially when we are in front of suspected papulonodular lesions arising from a tattoo, followed by a proper treatment, since cutaneous neoplastic evolution is known to be a rare but possible complication.