Er:YAG Laser for the Treatment of Actinic Keratoses

Jiang, Shi‐Bin; Levine, Vicki J.; Nehal, Kishwer S.; Baldassano, Marisa; Kamino, Hideko; Ashinoff, Robin

doi:10.1046/j.1524-4725.2000.99283.x

Cited by 53 publications

(38 citation statements)

References 23 publications

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“…(1) Sufficient concentration of photosensitizer in the tumor and (2) sufficient light penetration through the whole depth of the tumor. The red light (usually 632 nm) ensured deeper penetration of the tissue for tumors not exceeding 2 mm depth, restricting its use to superficial basal cell carcinomas, offering sufficient reliable treatment for AK [5]. The future of PDT some scientists see in new generation of photo sensitizers with increased tissue penetration (perhaps via tissue infiltration with an intradermal injection), that will be activated by the infra-red range of wavelengths providing the necessary depth of penetration.…”

Section: Introductionmentioning

confidence: 99%

Combination of Er:YAG laser and photodynamic therapy in the treatment of nodular basal cell carcinoma

Smucler

Vlk

2008

Lasers Surg Med

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Backgrounds and Objectives: Photodynamic therapy (PDT), via topical aminolevulinic acid (ALA) is an effective treatment for basal cell carcinomas not exceeding a depth of 2 mm. This limits the treatment of basal cell carcinoma (non-melanoma skin cancer) to superficial forms and nodular therapy (only in aesthetically desired locations). This paper addresses the effectiveness of reducing tumor mass via initial Er:YAG laser ablation to depths that are therapeutically responsive to PDT with ALA. Study Design/Materials and Methods: This study compared three methods for the treatment of recurring nodular basal cell carcinomas (r nBCC). Method A utilized PDT with topical application of ALA methyl ester, method B with solitary Er:YAG laser ablation, and method C combined Er:YAG laser ablation reducing tumor size below 2 mm (method B) with subsequent ALA methyl ester PDT (method A). All three methods were used to treat to each patient, all subjects presenting with three or more basal cell carcinomas in order to eliminate differences in patient responsiveness to treatment. Patients were monitored and interviewed at 3, 6, and 12 month intervals to examine the progress of tumor elimination, aesthetic results as well as the patient's preference of treatment method. In all, 286 patients were treated, of whom 194 were checked at the prescribed intervals and then evaluated. Results: Statistically, the combination therapy demonstrated the most effective treatment at all time intervals, with a final efficacy of 98.97% versus 94.85% (PDT only) and 91.75% (Er:YAG laser only). The combined method also provided the best aesthetic results (scale: 1-best; 4-worst) of 1.23 AE 1.23, compared to 1.67 AE 0.76 (PDT only) and 1.83 AE 0.95 (Er:YAG laser only). Conclusions: Although 67% patients preferred solitary Er:YAG laser treatment over the PDT method (20%) and the combined treatment (13%), because of the simplicity of the treatment, the combination therapy has proven to be both clinically and aesthetically superior. Solitary Er:YAG laser ablation will remain however a fast, effective, and economical treatment alternative for simple manifestations of superficial basal cell carcinoma and has replaced PDT for uncomplicated cases at our facility. The combination of Er:YAG laser ablation and ALA-PDT aspires to be therapy of choice for BCC. Lasers Surg. Med. 40:153-158, 2008. ß

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Section: Introductionmentioning

confidence: 99%

Combination of Er:YAG laser and photodynamic therapy in the treatment of nodular basal cell carcinoma

Smucler

Vlk

2008

Lasers Surg Med

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“…In the past we noticed good longterm clinical results in treating widespread AK with laser resurfacing at our department. Laser resurfacing with CO 2 (carbon dioxide) and or Er:YAG (Erbium:Yttriumalluminum-garnet) is considered by many authors to be a fine treatment in patients with widespread AK [17][18][19][20][21][22][23][24][25]. In order to have more evidence-based information about recurrence rates and adverse effects we decided to perform a randomized clinical trial to compare Er:YAG laser resurfacing (laser resurfacing) with one of the standard treatment modalities, 5-FU.…”

Section: Introductionmentioning

confidence: 99%

A clinical comparison and long‐term follow‐up of topical 5‐fluorouracil versus laser resurfacing in the treatment of widespread actinic keratoses

et al. 2006

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“…Recently, regimens using the immune modifier imi- quimod as a 5% cream applied 3 times weekly broadly to the photodamaged area have also been reported to reduce AKs, [14][15][16][17] although this also entails weeks of progressive painful inflammation and erosion of the treated areas, followed by additional weeks of slow healing. 14,16 Less common treatments include dermabrasion, 6,13 chemical peels, 13,18 and laser therapy, 13,19 but although highly effective, these treatment modalities are available only to a small number of patients.…”

mentioning

confidence: 99%

A Trial of Short Incubation, Broad-Area Photodynamic Therapy for Facial Actinic Keratoses and Diffuse Photodamage

Touma¹,

Yaar²,

Whitehead³

et al. 2004

Arch Dermatol

229

131

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Er:YAG Laser for the Treatment of Actinic Keratoses

Cited by 53 publications

References 23 publications

Combination of Er:YAG laser and photodynamic therapy in the treatment of nodular basal cell carcinoma

Combination of Er:YAG laser and photodynamic therapy in the treatment of nodular basal cell carcinoma

A clinical comparison and long‐term follow‐up of topical 5‐fluorouracil versus laser resurfacing in the treatment of widespread actinic keratoses

A Trial of Short Incubation, Broad-Area Photodynamic Therapy for Facial Actinic Keratoses and Diffuse Photodamage

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