Histological Comparison of Two Cryopeeling Methods for Photodamaged Skin

Abstract

Background. Cryopeeling is a technique that uses cryotherapy not only on actinic keratoses lesions, but also all over the photodamaged skin. Objectives. To investigate the histological changes induced by two cryopeeling methods (liquid nitrogen (LN) and portable system (PS)). Methods. Sixteen patients (n = 16) with multiple actinic keratoses on the forearms were treated with cryopeeling technique using LN for one forearm and PS for the other, randomly. Skin biopsies were taken before and after the procedures. Results. There was no statistical difference between the epidermal and Grenz zone thicknesses or density of elastic fibers after treatments. The amount of melanin pigment was lower after PS treatment (P < 0.05). In a blind analysis of paired pre- and postprocedure slides, it was not possible to identify cases which underwent treatment, both in global analysis of quality of the skin and in specific analysis (considering only the aspect of stratum corneum). Discussion. The results indicate the inconsistency of histological improvement after treatments, and, likely, since the method causes superficial exfoliation, a reliable marker was not found in the analysis. Conclusions. Despite cosmetic benefits on photodamaged skin and efficient treatment of actinic keratoses lesions, cryopeeling was not able to induce measurable histological changes in solar elastosis, epidermal organization, or epidermal and Grenz zone thicknesses. One should keep in mind the possibility of hypopigmentation risk of the method.

Cryopeeling versus trichloroacetic acid peeling in the treatment of solar lentigines: Effect on epidermal Langerhans cells

“…In accordance with our results, histological analysis of photodamaged skin treated with cryopeeling technique showed a tendency for increase in epidermal thickening and decrease of pigment intensity (Deonizio et al, ). It has been suggested that cryopeeling allows the treatment of entire photodamaged area and would improve the appearance of the skin with additional benefit of preventing the appearance of malignant lesions (Deonizio & Mulinari‐Brenner, ).…”

“…It seems that cryopeeling would lead to better improvement of solar lentigines. Previous reports have shown excellent results with cryopeeling in treatment of actinic keratosis and photodamaged skin (Chiarello, ; Deonizio et al, ; Deonizio & Mulinari‐Brenner, ).…”

“…Nevertheless, patients with darker skin types need special caution; being more liable to side effects. Cryopeeling, a technique that uses cryotherapy diffusely throughout the whole area of sun‐damaged skin, has been shown to be well tolerated and effective in the treatment of photodamage and actinic keratosis (Chiarello, ; Deonizio & Mulinari‐Brenner, ; Deonizio, Werner, & Mulinari‐Brenner, ).…”

Spatially-Resolved Multiply-Excited Autofluorescence and Diffuse Reflectance Spectroscopy: SpectroLive Medical Device for Skin In Vivo Optical Biopsy

“…Moreover, the longer the source-to-detector separation (SDS) is, the more the deepest-travelling photons can be detected [17]. It is therefore of interest to take advantage of spatial resolution (several SDS) in order to probe photons that travel both within the epidermis (where cancers develop) and down to the upper dermis (as dermis fibers such as collagen and elastin are also impaired during carcinogenesis [18]).…”

Cutaneous Implications of Whole Body Cryotherapy

“…In the field of dermatology, cryotherapy has been used to provide exfoliation for treatment of actinic keratoses and photodamaged skin by a cryo-peeling technique. 5 WBC does not reach the similar tissue temperatures and remains non-ablative. Therefore one would expect to achieve only a mild clinical improvement for related skin disorders.…”