New Research Studies on XP And Actinic Cheilitis
Fractional CO2 Laser Effective for Xanthelasma Palpebrarum
Although a range of therapy exists for xanthelasma palpebrarum (XP), there is no general consensus on the optimal treatment for the condition. A recent study, published in Dermatologic Surgery, compared the efficacy and safety of super pulsed (SP) and fractional carbon dioxide (CO2) lasers in the treatment of XP. Researchers concluded that ablative fractional CO2 laser is an effective and safe therapeutic option for XP with significantly shorter downtime and higher patient satisfaction compared with SP CO2 laser.
The prospective, randomized, comparative clinical study included 20 adult patients with bilateral and symmetrical XP lesions. The lesions were randomly assigned to treatment by either single session of ablative SP CO2 laser or 3 to 5 sessions of ablative fractional CO2 laser with monthly intervals. All patients were assessed using digital photography and optical coherence tomography images.
XP lesions on both sides were removed with significant improvement in size, color and thickness. Although lesions treated by SP CO2 laser showed significantly better improvement regarding color and thickness of the lesions, downtime and patient satisfaction were significantly better for lesions treated with fractional CO2 laser. Scarring and recurrence were significantly higher in lesions treated by SP CO2 laser.
Esmat SM, Elramly AZ, Abdel Halim DM, Gawdat HI, Taha HI. Fractional CO2 laser is an effective therapeutic modality for xanthelasma palpebrarum: a randomized clinical trial. Dermatol Surg. 2014;40(12):1349-1355.
Ablative Fractional Laser-Assisted PDT for Actinic Cheilitis Treatment
Although photodynamic therapy (PDT) is a therapeutic option for actinic cheilitis (AC), the therapy has not shown the same satisfactory outcomes as it has for actinic keratosis, according to a study published in British Journal of Dermatology.
Researchers compared efficacy, recurrence rate, cosmetic outcome and safety between erbium:yttrium-aluminium-garnet ablative fractional laser-assisted methyl aminolevulinate-PDT (Er:YAG AFL MAL-PDT) and standard MAL-PDT and concluded ablative fractional laser pretreatment has significant benefit for the treatment of AC with PDT.
Thirty-three patients with histologically confirmed AC randomly received either 1 session of Er:YAG AFL MAL-PDT or 2 sessions of MAL-PDT. In the MAL-PDT group, the second session of MAL-PDT was administered 7 days later. Patients were followed at 1 week and 3 and 12 months, and all patients were biopsied at 3 and 12 months after the last treatment session. At the final 12-month follow-up, cosmetic outcomes were assessed. Adverse events were assessed at week 1 of the treatment phase and at each follow-up visit.
In the per protocol population, Er:YAG AFL MAL-PDT was significantly more effective (92% complete response rate) than MAL-PDT (59%; P=0.040) at the 3-month follow-up, and differences in efficacy remained significant at the 12-month follow-up (85% in Er:YAG AFL MAL-PDT and 29% in MAL-PDT). The recurrence rate was significantly lower for Er:YAG AFL-PDT (8%) than for MAL-PDT (50%) group at 12 months (P=0.029). No significant difference in cosmetic outcome or safety was observed between the laser therapies. n
Choi SH, Kim KH, Song KH. Efficacy of ablative fractional laser-assisted photodynamic therapy for the treatment of actinic cheilitis: 12-month follow-up results of a prospective, randomised, comparative trial. Br J Dermatol. Published online ahead of print November 15, 2014.