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Objective We wanted to evaluate dermoscopy as a tool to predict the efficacy of port‐wine stain (PWS) laser treatment. Study Design and Methods Large spot 532 nm laser was used for the treatment of 67 PWS. Efficacy was assessed with an objective 3D digital imaging analysis. Dermoscopy images were taken before the treatment and analyzed semi quantitatively for features and patterns. Results The following dermoscopic features: “superficial vessels,” “deep vessels,” “deep lakes,” “superficial lakes,” and “thick vessels total” were identified as positive determinants of maximal global clearance effect (GCEmax), whereas “thin long vessels,” “bright background total,” “whitish veil,” “white circles,” and “perifollicular erythema” were found to be negative determinants. Rapid response correlated positively with “superficial vessels,” “superficial lakes,” and “thick vessels total” scores and showed inverse correlations with “bright‐red background,” “bright background total,” “white circles,” “peacock eyes,” and “perifollicular erythema” scores. “Superficial vessels,” “thick vessels total,” and “pale‐pink patchy background” were predictors of the lack of response. Dominance of “deep vessels” was a predictor of 75% of responses and dominance of “brown areas” feature was the predictor of clearance. Patients responded to treatment differently, depending on the dermoscopic pattern of PWS. Conclusion Dermoscopy may be useful to predict the response of PWS to laser treatment: its rapidity, the risk of no response, and 75% response and clearance. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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A large spot 532 nm laser is effective in previously treated patients with facial CM.

IntroductionPlatelet activation is elevated in moderate to severe psoriasis, and the reduction in platelet activation during short-term treatment has already been demonstrated. Soluble P-selectin is a well-established marker of platelet activation.AimTo show whether the long-term treatment of psoriasis with biological drugs can reduce elevated platelet activation.Material and methodsAn observational study of 27 patients with chronic plaque psoriasis, treated with infliximab, adalimumab, etanercept, or ustekinumab for up to 12 months was conducted. Psoriasis area and severity index (PASI), serum P-selectin and interleukin (IL)-6 were monitored throughout the treatment.ResultsThere was no significant correlation between PASI and platelet activation in our patients. After 3 months of treatment, a significant reduction in PASI and IL-6 was found, while P-selectin was not significantly reduced. When a cohort of patients who had shown elevated P-selectin prior to the treatment was evaluated, a significant reduction in P-selectin was observed in all 8 patients following 3 months; a reduction that was sustained after 6 and 12 months of therapy.ConclusionsWe conclude that PASI is not a good predictor of platelet activity in patients with PASI near to 10. Biological drugs reduce platelet activation in patients who have increased platelet activation prior to treatment, and this effect is stable during chronic therapy.

For a long time, therapeutic strategies of atopic dermatitis (AD) have been dominated by the application of local or systemic steroids or other immunosuppressive agents, which have been limited by their potential for unwanted local or systemic side effects. Recently, the use of a new generation of topical nonsteroidal, immunomodulatory drugs has revolutionized the therapeutic options of this often recalcitrant allergic-inflammatory skin disease. Research work has focused on the identification of the exact mode of action and the immune specificities of the so-called 'topical immunomodulators' (TIMs) such as tacrolimus and pimecrolimus in AD. In addition to the previous findings about the mode of action of TIMs on T cells, other target cells of TIMs such as keratinocytes, mast cells, eosinophils and dendritic cells have been identified recently as potential therapeutic targets. In this overview, we provide a research update about the anti-inflammatory and anti-allergic properties of TIMs on effector cells of AD that may be involved in the complex pathophysiology of AD.

Large spot 532 nm laser is highly effective in the treatment of facial CM. 3D color and area image analysis provides an objective method to compare different methods of facial CM treatment in future studies. Lasers Surg. Med. 49:743-749, 2017. © 2017 Wiley Periodicals, Inc.