13th EADV Spring Symposium Athens, Greece, 2016-05-19/22
Laser and EBD (session, talks, symposium) : key points and news
Dr Le Pillouer-Prost Anne, Vice President of the French Laser Group, ESLD treasurer and newsletter key officer

Pr Fenniche Samy, President of the Tunisian laser Group, ESLD newsletter key officer

Laser session D2T1.1

1) Vascular laser – Dr G. Varju, Budapest

Complete and precise talk on the personal experience of the speaker with the CynergyTM vascular device (Multiplex 585/1064 LP nm) very useful for daily practice : if you need any advise to optimize your settings, don’t hesitate to get in touch with him by e-mail : g.varju@drderm.net

PDL conventional and non conventional uses

• Ulerythema ophryogenes : great experience on more than 20 cases with noticeable results after 2 to 3 sessions
• Advantages/risks ratio
  • Disadvantages
    § Cost of the dye kit

Nd-YAG LP : vascular indications, larger and deeper vessels

• Princeps report : E. Tanghetti et al., Lasers Surg Med 2011 (deoxyhemoglobin…)
• High penetration depth, less absorption
• Leg vein telangiectasia :
  • Delayed (6 months) and moreover nice results
  • If matting (as with sclerotherapy) : use PDL alone

Multiplex 585/1064 nm

• Examples
  o Spider angioma : 7 mm diameter spot, 15 ms, 6/60 J/cm²
• Advantages/risks ratio
  o Advantages
  § Possibility of superficial and deep effects
  o Disadvantages
  § Cost of the dye kit

2. Lasers for pigmented lesions : possibilities and risks – Dr M. Lapidoth

• Knowledge of histology (Book of Lever) is required and the cutaneous application of lasers and intense pulsed light sources for the treatment of pigmented lesions can be divided into the following categories:
  a) Epidermal pigmentation such as lentigines and café au lait patches
  b) Dermal pigmentation such as nevus of Ota, acquired bilateral nevus of Ota, and melanocytic nevi
• Selective photothermolysis (Anderson and Parrish) : Thermal relaxation time and pulse duration
  • In 2 cases you need thermal diffusion : hair removal (RTD to the stem cells) and vascular (RTD to the endothelial cells)
  • For pigmentary lesions
    § the TRT of the target is very short: melanosomes and melanocytes (x10)
    § melanine absorption curve and pigmentary laser wavelength : less the absorption – deeper the penetration (compromise requirement)
    black ink : alex (100%), ruby (130%), Nd :YAG (30%)
• Clinical examples
  • Hand lentigos : QS ruby laser or IPL
  • Cafe au lait macules : QS ruby
  • Segmental pigmentary disorder : QS ruby
  • Becker naevus : NO treatment except for hair removal
  • Ota : 8-12 sessions, excellent results, QS ruby laser better than Nd :YAG or Alex
  • Hemosiderine stains
  • Vitiligo : Hydroquinone plus ruby laser
  • Hair removal resistant cases : QS ruby laser better than Nd:YAG or Alex
  • Melasma :
    § ongoing process, laser can worsen melasma
    § laser efficacy only in 2 cases
    • « toning » treatment every 2 to 3 months at low fluence
    • Fractional Er:YAG laser at moderate fluence and application of hydroquinone after microporation

And much more!
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