Clinical and dermoscopic evaluation of fractional carbon dioxide laser in management of keratosis pilaris in Egyptian type skin

Abstract

Background Numerous treatment modalities for keratosis pilaris have been tried with limited success. Aim To determine the efficacy, safety, and tolerability of fractional CO2 laser in the treatment of KP. Patients and methods This prospective, single‐blinded split‐body placebo‐controlled comparative study was conducted on 60 patients with bilateral KP of arms (group A) and thighs (group B). One side randomly received fractional CO2 laser treatment (power 12 W, time on 3 ms, PPI 5) in the form of two sessions four weeks apart. The contralateral control side was treated with a topical keratolytic (10% urea). Standardized digital clinical and dermoscopic photographs were obtained at each visit. Results Significant improvement has been demonstrated clinically and dermoscopically in both arm and thigh lesions after fractional CO2 laser. In group A, excellent improvement was noted in 10 patients (33.3%), good improvement in 18 patients (60%), and moderate improvement in 2 patients (6.7%) at the second visit. In group B, minimal improvement was noted in 2 (6.7%) patients, moderate improvement in 16 patients (53.3%), and good improvement in 12 patients (40%) at the second. Control sides showed minimal improvement on the arm lesions only. No side effects were reported in both groups. The mean pain score in group A was not significantly different from that group B (P = .057). Patient satisfaction was significantly higher in the laser‐treated side arm lesions (P < .001). Conclusion Fractional CO2 laser was associated with significant clinical and dermoscopic improvement of keratosis pilaris lesions in Egyptian patients.

Comparative study of the efficacy of fractional Er: YAG 2940 nm laser and Q‐switched Nd: YAG 1064 nm laser in keratosis pilaris

“…12 In another placebo-controlled study including 60 patients, clinically significant improvement has been demonstrated at the end of 2 sessions with fractional CO 2 laser therapy. 13 In our study, the efficiency of the fractional Er: YAG laser was similar to the efficiency of fractional CO 2 laser treatment in other studies. After three sessions of fractional Er:…”

Efficacy and Safety of Long-Pulsed 755-nm Alexandrite Laser for Keratosis Pilaris: A Split-Body Randomized Clinical Trial

“…Dermoscopy has been used to monitor the treatment outcome of KP in previous studies [ 15 , 16 ]. Apart from dermoscopy that measures the horizontal and superficial structures, HFUS was used as a monitoring method for detecting vertical and deep structures during KP treatment in our study.…”

A Review of the Scoring and Assessment of Keratosis Pilaris

“…This more extensive GIS accounts for worsening of disease severity and is typically used to score erythema, number of keratotic papules, and hyperpigmentation. Furthermore, the prospective study conducted by Ismail et al [30] trained the two independent assessors. They rated archival images separately, then reconciled their ratings through face-to-face agreement until concordance was achieved before rating patient images.…”

“…Thus, it would be promising to use in the nonerythematous variants of KP such as KPA. They noted there was no relevant validated scale, and they used a 4-point IGA score (0 least severe – 3 most severe), also used by Ismail et al [30], that had not been validated. However, both raters received training on using the scale by thorough rating of archival images and then discussing these ratings face-to-face until their separately rated scores were consistently equivalent.…”

“…A variation of the GIS is one ranging from −4 to 4, where in addition to the standard definitions outlined above, grade −4 = >75% worsening, grade −3 = 51-75% worsening, grade −2 = 26-50% worsening, grade −1 = 1-25% worsening, grade 0 = no change. This was employed by Saelim et al [28], Kootiratrakarn et al [16], Vachiramon et al [29], Ismail et al [30], and Maitriwong et al [31] using digital photographs. This more extensive GIS accounts for worsening of disease severity and is typically used to score erythema, number of keratotic papules, and hyperpigmentation.…”