Comparative study between fractional carbon dioxide laser versus retinoic acid chemical peel in the treatment of acanthosis nigricans

Oun, Ayat A Abu; Ahmed, Naglaa A.; Hafiz, Hala S A

doi:10.1111/jocd.14224

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…With an average age of 27.15 ± 8.93 SD and a range of ages from 18 to 44, 16 of them were female. [15]. This may be explained by the higher prevalence of hyperpigmentory lesions in females, where female hormonal activity is thought to be one of the main contributing reasons.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between Topical Metformin 30% cream and Topical Adapalene 0.1 % cream in the Treatment of Acanthosis Nigricans (Clinicodermoscopic study)

Atallah

Aboelwafa

Elkhodary

2023

Preprint

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Background: Acanthosis nigricans (AN) is a skin disorder with high prevalence. Dermatologists usually prescribe topical keratolytic, laser approaches, or chemical peels for aesthetic reasons. Adapalene is a topical retinoid with high degree of success in treating AN. Metformin is an insulin sensitizer that was suggested as a treatment modality for AN by targeting the insulin resistance associated with AN. Aim of the work: Compare the safety and effectiveness of topical 30% metformin cream versus topical adapalene 0.1 cream) in treatment of AN. Patients and methods: The current included 40cases with AN. Cases were randomly distributed into two groups (Each of 20 patients), Results: Between the examined groups, there is a statistically substantial variation with relation to improvement degree for all dermoscopic findings assessed after treatment. The degree of dermoscopic improvement was better in the adapalene group. Also, the degree of clinical improvement was better in the adapalene group. The mean ANASI score changed from 32.4 to 27.8 pre and post-operative for metformin group and from 26.8 to 18.4 for adapalene group. Percent of change is higher among adapalene group without a statistically significant difference between them. Conclusion: adapalene 0.1% cream was more effective for treating acanthosis nigricans than Metformin 30% cream, but it caused more local complications. Regarding the likelihood of recurrence, no variation between the two therapeutic regimens was found.

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Section: Discussionmentioning

confidence: 99%

Comparative Study between Topical Metformin 30% cream and Topical Adapalene 0.1 % cream in the Treatment of Acanthosis Nigricans (Clinicodermoscopic study)

Atallah

Aboelwafa

Elkhodary

2023

Preprint

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“…In terms of cosmetic intervention, short-term trials with melatonin and urea cream have been reported [ 83 , 84 ]. Treatment with topical retinoids, topical vitamin D analogs, oral retinoids, or alexandrite laser may also contribute to AN improvement [ 187 , 188 , 189 , 190 , 191 ]. The downside of applying tretinoin cream is the risk of relapse after ceasing treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The downside of applying tretinoin cream is the risk of relapse after ceasing treatment. As such, there is a recommendation for intermittent retinoid application for maintaining clinical results [ 187 , 188 , 189 , 190 , 191 ]. Another topical treatment option are chemical peels with trichloroacetic acid which leads to epidermal destruction, followed by inflammation of the skin and resulting in re-epithelization and rejuvenation [ 189 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted by Ehsani A. et al, when comparing long-pulsed alexandrite laser to topical tretinoin-ammonium lactate, the laser group showed a statistically significant reduction in pigmentation (25.67 ± 11.78 versus 18.33 ± 10.63%, p = 0.004) [ 190 ]. Fractional CO 2 laser and retinoic acid peel were found to be effective for neck AN [ 187 ]. Alternatively, fractional 1550-nm erbium fiber laser was identified as superior to 0.05% tretinoin cream for neck AN in one randomized trial with fewer side effects in the laser group.…”

Section: Discussionmentioning

confidence: 99%

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Acanthosis Nigricans: Pointer of Endocrine Entities

et al. 2022

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Acanthosis nigricans (AN) has been reported in relation to insulin resistance (IR). We aim to review AN through an endocrine and metabolic perspective focusing on IR in association with metabolic complications such as obesity, diabetes mellitus (DM), and metabolic syndrome (MS) with/without polycystic ovary syndrome (PCOS). We revised English papers on PubMed covering publications from the last 5 years. The current prevalence of AN varies from 4.5 to 74% (or even 100%, depending on the studied population), with equal distribution among females and males. Despite higher incidence with an age-dependent pattern, an alarming escalation of cases has been noted for obesity and MS in younger populations . Most frequent IR-associated sites are the neck, axilla, and knuckles, but unusual locations such as the face have also been reported. Quantitative scales such as Burke have been used to describe the severity of the dermatosis, particularly in correlation with IR elements. Dermoscopic examination are required, for instance, in cases with sulcus cutis, hyperpigmented spots, crista cutis, and papillary projections. A skin biopsy may be necessary, but it is not the rule. Both IR that clinically manifests with or without obesity/MS correlates with AN; most studies are cross-sectional, with only a few longitudinal. The approach varied from screening during school periodic checkups/protocols/programs to subgroups of individuals who were already known to be at high cardio-metabolic risk. AN was associated with type2DM, as well as type 1DM. Females with PCOS may already display metabolic complications in 60–80% of cases, with AN belonging to the associated skin spectrum. AN management depends on underlying conditions, and specific dermatological therapy is not generally required, unless the patient achieves metabolic control, has severe skin lesions, or desires cosmetic improvement. In IR cases, lifestyle interventions can help, including weight control up to bariatric surgery. In addition, metformin is a key player in the field of oral medication against DM type 2, a drug whose indication is extended to PCOS and even to AN itself, outside the specific panel of glucose anomalies. In terms of cosmetic intervention, limited data have been published on melatonin, urea cream, topical retinoids, vitamin D analogs, or alexandrite laser. In conclusion, awareness of IR and its associated clinical features is essential to provide prompt recognition of underlying conditions. AN represents a useful non-invasive surrogate marker of this spectrum in both children and adults. The pivotal role of this dermatosis could massively improve endocrine and metabolic assessments.

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“…In addition, various types of lasers have been used for managing AN as long-pulsed alexandrite laser, 5 ablative carbon dioxide laser, 6 fractional 1550-nm erbium fiber, 7 and fractional CO 2 laser 8 with variable treatment results.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Fractional Carbon Dioxide (CO2) Laser versus Q-Switched Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) and Potassium-Titanyl-Phosphate (KTP) Lasers in the Treatment of Acanthosis Nigricans

Elmasry¹,

Khalil²,

Badawi³

et al. 2023

CCID

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Background Acanthosis nigricans (AN) is a common chronic skin disorder clinically presents by velvety hyperpigmented lesions mainly at the flexural areas. Fractional photothermolysis has been reported to improve both pigmentary and textural changes by removing thin layers of skin with minimal thermal damage. Other options are the Q-switched (Qs) Nd:YAG (1064 nm) and Qs KTP (532 nm) lasers. Both can induce collagen remodeling by dermal photo-mechanical microdamage. Aim of the Work The aim of this study was to assess the clinical efficacy and the safety of fractional CO 2 laser versus Qs Nd:YAG and KTP lasers in the treatment of acanthosis nigricans. Methods This randomized-controlled split neck study was conducted on 23 patients suffering from AN. For each patient, one side of the neck was randomly assigned to fractional CO 2 laser and the other side to Qs Nd:YAG and KTP lasers every four weeks for four months followed by 4 monthly follow-up assessment. Acanthosis Nigricans Area and Severity Index (ANASI) score, melanin and erythema indices as well as Patient Satisfaction Scale (PSS) were used to assess improvement on each side separately. Results There was no statistically significant difference regarding the clinical improvement between the side treated with Fractional CO 2 laser and the side treated with Qs Nd:YAG and KTP lasers (P value >0.05). In most patients, both sides showed improvement during different sessions of therapy, as regards ANASI scores, melanin indices, patient satisfaction scores, and side effects. Conclusion In this study, we concluded that both fractional CO 2 and Q-switched lasers proved to be a safe and effective line of treatment of acanthosis nigricans.

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Comparative study between fractional carbon dioxide laser versus retinoic acid chemical peel in the treatment of acanthosis nigricans

Cited by 6 publications

References 20 publications

Comparative Study between Topical Metformin 30% cream and Topical Adapalene 0.1 % cream in the Treatment of Acanthosis Nigricans (Clinicodermoscopic study)

Comparative Study between Topical Metformin 30% cream and Topical Adapalene 0.1 % cream in the Treatment of Acanthosis Nigricans (Clinicodermoscopic study)

Acanthosis Nigricans: Pointer of Endocrine Entities

Efficacy of Fractional Carbon Dioxide (CO2) Laser versus Q-Switched Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) and Potassium-Titanyl-Phosphate (KTP) Lasers in the Treatment of Acanthosis Nigricans

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