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Combinational therapy such as taking tranexamic acid while using laser treatment has been proved potential efficacy by many experiments. However, there is few research which contains large samples and consistent observations.We evaluated clinical efficacy and safety of a new systemic treatment of drug-laser-photon therapy.Retrospective and randomized investigator-blinded study of 75 patients with mixed type melasma was analyzed. At each visit, standardized photographs were taken using VISIA. Modified melasma area and severity index (mMASI) scores were marked using photographs by two dermatologists.The mMASI score decreased significantly from 6.92 to 3.84 after the treatment. The VISIA analyze right cheek data shows: Spots (from 49.67 ± 3.43 to 56.09 ± 3.31), UV spots (from 41.39 ± 24.45 to 44.56 ± 25.86), and Brown spots (from 23.97 ± 17.89 to 28.16 ± 21.28) are statistically increased (p = 0.035, p = 0.018, p = 0.07). All patients feel varying degrees of improvement, about 10.17% felt very much improved, 30.51% felt much improved (51%-75%), 45.76% felt moderately improved (26%-50%), and 13.56% felt little improved (1%-25%).This study was no control group.The efficacy and safety profile of the combination of drug-laser-photon therapy systemic treatment in melasma patients has been proved. It has potential possibility to become a new, reliable, widely suitable therapy strategy.

Background and objectives Traditional surgical excision for a sebaceous cyst can completely eradicate the cyst, but the surgical processes are relatively complicated and may cause obvious scarring. Some patients are reluctant to choose this method because of the inconvenient procedures and the risk of conspicuous scarring, especially in esthetically important areas. We present a simple treatment method to prevent formation of a conspicuous scar. Study design/materials and methods First, the cyst wall was pre-separated from the surrounding tissues by injecting a large volume of anesthetic around the cyst. Then, the cyst contents were removed through a small hole created by using a CO2 laser on the skin surface, which adhered closely to the cyst. Finally, the cyst wall was removed using a hemostat that clamps it at the base. Between August 2017 and July 2019, 32 patients with 33 sebaceous cysts (12 infected and 21 uninfected) were treated by this method to remove the cyst contents and cyst wall. Mean operative time, complications, and patient satisfaction were evaluated. Results All patients were satisfied with the good esthetic outcome and the simplicity of the surgical procedure. Only two of the 33 cysts (6.0%) recurred 2 and 3 months postoperatively, including 0 of 21 uninfected cysts (0.0%) and 2 of 12 infected cysts (16.7%). No complications were found during the follow-up period. The mean operation time was 13 ± 2.1 minutes. Conclusions CO2 laser punch-assisted surgery was associated with minimal scarring and high patient satisfaction. With acceptable recurrence rates, it is a convenient, effective and minimally-invasive treatment option for sebaceous cysts. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

BACKGROUND AND PURPOSE Angiotensin-converting enzyme (ACE), an important part of the renin-angiotensin system, is implicated in stimulating the fibrotic processes in the heart, lung, liver and kidney, while an ACE inhibitor (ACEI) promotes physiological tissue repair in these organs. The mechanism is closely related to TGF-β1 pathways. However, the reported effects of applying ACEIs during scar formation are unclear. Hence, we explored the anti-fibrotic effects of an ACEI and the molecular mechanisms involved in a mouse scar model. EXPERIMENTAL APPROACH After a full-thickness skin wound operation, ACE wild-type mice were randomly assigned to receive either ramipril, losartan or hydralazine p.o. ACE knockout (KO) mice and negative control mice only received vehicle (water). Wound/scar widths during wound healing and histological examinations were recorded at the final day. The ability of ACEI to reduce fibrosis via TGF-β1 signalling was evaluated in vitro and in vivo. KEY RESULTS ACE KO mice and mice that received ramipril showed narrower wound/scar width, reduced fibroblast proliferation, decreased collagen and TGF-β1 expression. ACEI attenuated the phosphorylation of small mothers against decapentaplegic (Smad2/3) and TGF-β-activated kinase 1 (TAK1) both in vitro and in vivo. The expression of ACE-related peptides varied in murine models with different drug treatments. CONCLUSIONS AND IMPLICATIONS ACEI showed anti-fibrotic properties in scar formation by mediating downstream peptides to suppress TGF-β1/Smad and TGF-β1/TAK1 pathways. These findings suggest that dual inhibition of Smad and TAK1 signalling by ACEI is a useful strategy for the development of new anti-fibrotic agents.