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Evidence-based medicine (EBM) aims for the ideal that healthcare professionals make conscientious, explicit, and judicious use of the best available evidence gained from the scientific method to clinical decision-making. It seeks to assess the strength of the evidence for benefits of diagnostic tests and treatments, using techniques from science, engineering, and statistics, such as the systematic review of medical literature, meta-analysis, risk-benefit analysis, and randomized controlled trials. The limited success rate of EBM therapies suggests that the complex nature of hair loss may be inadequately served by the present levels of evidence, and that physicians treating hair loss may have fallen short of adequately researching a robust evidence to underpin their practices. Against this backdrop, the concept of precision medicine (PM) is evolving. PM refers to the customization of medical care to the patient’s individual characteristics based on the patient’s genetic background and other molecular or cellular analysis, while classifying patients into subpopulations that differ in their susceptibility to a particular medical condition, in the biology or prognosis of those medical conditions, or in their response to a specific treatment. With the advances in hair research, the powerful tools of molecular biology and genetics, and innovative technologies, we have the robust scientific data and tools to adapt the concept of PM to the practice of trichiatry. Finally, databases pertaining to the development and efficacy of PM must be analyzed and be used to form the basis of evidence-based personalized trichiatry.

Purpose The aim of this study was to evaluate the effectiveness and safety of hyaluronic acid (HA) dermal filler when used in the face for medical reconstructive purposes. Patients and methods Adult patients with moderately severe facial lipoatrophy (FLA), morphological asymmetry (MA) of the face, or debilitating scars (DS) on the face were included in a prospective, noncomparative, multicenter, postmarket clinical follow-up study. All patients were treated with an HA filler (Princess® FILLER), which was injected intradermally on study Day 1, with optional touch-up 2 weeks later. The effectiveness of the treatment was evaluated at Weeks 4 and 24, using a six-grade scale ranging from "excellent" to "worsening". The assessments were conducted by both the investigator and the patient and, at Week 4, by the independent photography reviewer as well. Adverse events were collected at each visit. Results Fifty-three patients were included in the study (FLA 23, MA 17, and DS 13), and 46 patients completed a 6-month follow-up (FLA 20, MA 15, and DS 11). At Week 4 (primary endpoint), the overall treatment success rate was 100% (FLA), 100% (MA), and 94% (DS), based on assessments made by the investigator, patients, and the independent reviewer, respectively. In most patients (~95%), the effect was sustained over 6 months. Treatment-related adverse events were reported in five patients (9%) and included injection site hematoma, injection site pain, and headache. Conclusion Dermal filling with HA gel is a viable treatment option for the correction of various deformities of the face resulting from FLA, MA, or DS.

Imiquimod 3.75% cream is licensed for the treatment of actinic keratosis (AK). Two case reports on the treatment of facial UV‐exposed skin shall open the discussion if subclinical AKs can be detected by the use of imiquimod cream in UV‐exposed areas even if no lesions can be found clinically. A 87‐year old female showing small scaly AK lesions on her right cheek was treated with imiquimod 3.75% cream. A 59‐year old female without obvious clinical signs of UV‐damage on the face experimentally applied imiquimod 3.75% cream twice daily on the entire face for 2 weeks. In the 87‐year old, inflammatory reaction developed from day 3 onward and showed field cancerization, the lesions healed without scarring. In the 59‐year old at the end of the treatment phase, distinct signs of inflammation appeared, then taking 2 weeks for healing without sequalae. These results open the discussion if the use of imiquimod 3.75% cream could be recommended preventively in UV‐exposed skin areas to obviate a later development of AKs/squamous cell carcinoma/nonmelanoma skin cancer.

The aim of this study was to investigate the safety and performance of Princess VOLUME Lidocaine in nasolabial fold correction. In this prospective, open label, multicenter, postmarket study subjects received injections of Princess VOLUME Lidocaine into both NLF at Baseline (Day 0) and if considered necessary by the investigator, at Week 2 (touch-up treatment). This study was conducted in Austria at the Department of Dermatology and Venereology, Medical University of Graz, at the medical aesthetic center MAZ WIEN, and at the medical aesthetic center Ordination Dr. Bartsch, Vienna. The 62 mainly female (95.2%) subjects had a median age of 52 years with two fully visible, approximately symmetrical NLFs, each scoring grade 2 or 3 on the nasolabial fold severity rating scale (NLF-SRS) developed by Croma-Pharma. The nasolabial fold severity was assessed by NLF-SRS and Global Aesthetic Improvement Scale (GAIS) 4, 24, and 36 weeks later. Adverse events (AEs) were recorded throughout the investigation. With 95.1% of subjects showing an improvement of at least 1 grade of the NLF-SRS at 24 weeks after the treatment, the primary endpoint was achieved, and clinical performance was demonstrated. Princess VOLUME Lidocaine was well tolerated, with only mild AEs, mainly injection site reactions, reported. Subject satisfaction (≥93.5%) and GAIS scores (≥93.5% improvement) were high. Princess VOLUME Lidocaine was effective in reducing NLFs as shown by an improvement in the severity of NLFs by at least one grade in 95.1% of subjects at Weeks 4 and 24.

Background Soft tissue fillers are typically used for rejuvenating an aging face; they are also employed in the treatment of certain pathologic conditions, including facial lipoatrophy, morphological asymmetry, and debilitating scars. Aims The aim of this clinical study was to evaluate the effectiveness and safety of Princess® Volume (PV) in patients with facial lipoatrophy (FLA), morphological asymmetry (MA), or debilitating scars (DS). Patients/methods This prospective, noncomparative, multicenter clinical study consisted of five visits spread across 36 weeks. Up to 60 adult patients suffering from moderate facial lipoatrophy, facial morphological asymmetry, or debilitating scars on the face were to be included. All patients were treated with an HA filler (PV). Results At Week 4, the treatment success rate in the SP was 98% (95% CI [90.4%, 100%]), as assessed by both the investigators and the patients. According to the independent reviewer, the success rate was 93% (95% CI [82.7%, 98.0%]). At Week 24, the effect was maintained in most patients, with success rates of 80% as evaluated by the investigator and 79% by the patient (95% CI [67.6%, 89.8%] and [65.6%, 88.4%], respectively). At Week 36, success rates dropped to 61% as assessed by the investigator and 59% by the patient (95% CI [46.8%, 73.5%] and [45.0%, 71.9%], respectively). Conclusions The clinical study has proven that Princess® Volume is a safe and effective therapeutic solution for the correction of soft tissue defects in FLA and facial MA, but limited success rate to DS.

Linked article: This article is commented on by A. Wollenberg et al., p. e169 in this issue. To view this article visit https://doi.org/10.1111/jdv.15401.

Platelet-rich plasma injections have been presented as an effective treatment for androgenetic alopecia; however, reliable study data concerning this therapy are lacking. The current randomized, placebo-controlled pilot study explored this novel therapy in 30 healthy male subjects with androgenetic alopecia. Five platelet-rich plasma treatments, at intervals of 4-6 weeks, and 2 follow-up examinations were performed. Twenty subjects were injected intracutaneously with platelet-rich plasma and 10 with physiological saline. Treatment efficacy was assessed by changes in hair number and diameter, measured with the TrichoScan system. A secondary objective was to assess clinical improvement, which was evaluated by an independent reviewer using patient photographs and a 5-point Likert scale. In addition, subject satisfaction was assessed by survey. No improvements were seen over the course of the trial, using TrichoScan measurements or visual assessment. In conclusion, these results suggest that treatment with platelet-rich plasma as a monotherapy does not improve hair growth in men with androgenetic alopecia.

Few dermatologic problems carry as much emotional overtones as the complaint of hair loss. The best way to alleviate the distress related to hair loss is to effectively treat it. In fact, one of the oldest medical professions is the Egyptian physician who specialized on diseases of the head. And yet, from ancient Egypt down to modern times, human hair has been the object of superstition and mystery. Remarkably and despite the genuine advances in effective medical treatments, hair cosmetics, and surgical procedures, phony hair loss solutions continue to be marketed with an amazing success. In 1860, a quasi-scientific interest in hair loss and hair care originated in a London barbershop and became known as trichology, with the Institute of Trichologists being founded. Other corporations successively followed internationally, but it was only in 2010 that the term dermatotrichologist was proposed for board-certified dermatologists dealing with the scientific study of the hair and scalp, in contrast to the trichologist who is rather associated with laity and cosmetics than with medical professionalism, or – worse – offers opportunities to possible imposters with a primary commercial interest. The new term “trichiatrist” is proposed, literally meaning the “medical treatment of the hair,” to designate the strictly medical professional dealing with the hair and scalp in health and disease. Trichiatrists differ from trichologists by virtue of being physicians. The quality and stringency of their graduate medical training is identical to that of other physicians.

Background The use of special silk textiles (Dermasilk) has shown positive effects on chronic inflammatory diseases like lichen sclerosus et atrophicus, atopic dermatitis, diabetic ulcerations, and vulvovaginal candidiasis. Objective Wearing T-shirts of this particular fabric could be useful in the management of patients with acne vulgaris on the back and trunk. Material and Methods Dermasilk T-shirts were given to 14 patients with acne vulgaris papulopustulosa on the back. The patients wore these shirts every night for 6 weeks, and their acne lesions were monitored. Dermasilk represents a polymerisate of fibroin, a silk protein, and antimicrobial AEM5772/5, an unsoluble colorless, odorless ammonium with antifungal and antibacterial ability. Results Photographic documentation before and after 6 weeks showed a clinically significant reduction in acne lesions on the back without any concomitant treatment or change in lifestyle and living conditions. Discussion The use of Dermasilk textiles in other subacute-chronic inflammatory skin diseases has shown positive effects. This is the first report on their safe and effective use in the management of acne vulgaris papulopustulosa corporis.

Background In the history of medicine, unexpected coincidences indicated the development of new treatment options. Objective One of the most peculiar ones concerns the finding of botulinum toxin, and this should be familiar to physicians using the drug. Methods A survey through the history of the “fat-poison” has been performed. Result A poison turned to one of the most popular drugs in aesthetic medicine. Conclusion Depending on the dose, a substance may be poisonous or not.

Solar lentigines are benign lesions usually found on sun-damaged skin. We investigated twelve cases of solar lentigines through dermoscopy and reflectance confocal microscopy, performed before, and 30 min and 10 days after, a single treatment with a Q-switched ruby laser. At baseline, all lesions showed characteristic features of solar lentigines in reflectance confocal microscopy analysis: regular honeycomb patterns, edged dermal papillae and cord-like rete ridges at the dermoepidermal junction. Thirty minutes post-laser treatment, blurred epidermal intercellular connections, dark structureless areas of different sizes and shapes in the lower epidermal layers, and hyporeflective dermal papillae, reflecting epidermal and dermal oedema, were observed. Ten days post-treatment highly reflective round-to polygonal areas and aggregated granules, representing extracellular melanin, were detected in all epidermal layers featuring regular honeycomb patterns. Reflectance confocal microscopy can be used to visualise dynamic skin processes, allowing non-invasive in vivo follow-up of skin lesions after treatment.

Summary Background: Molluscum contagiosum is a common, self-limiting viral disease of childhood caused by a poxvirus. Often the children themselves and their parents desire treatment for cosmetic reasons or because of pruritus. Laser therapy offers another option to the traditional methods of treatment. Methods: 19 children aged between 2 and 13 years (median:6) with molluscum contagiosum were treated in a prospective, non-randomized pilot study with the flashlamp pumped pulsed dye laser (wave length:585 nm, pulse duration 0,45 ms, spot size 7 mm, energy density 6–7 J/cm2). Results: All patients tolerated the laser treatment well. In 84.3% one laser treatment led to total remission. In 10.5% a further laser session was necessary and one patient was treated three times to achieve total remission. Conclusions: Treatment of molluscum contagiosum with the flashlamp pulsed dye laser is a safe and efficient treatment modality.

Zusammenfassung Hintergrund: Xanthelasma palpebrarum reprasentiert gutartige Fetteinlagerungen an den Augenlidern. Die Pathogenese dieser gelblichen Plaques ist nicht hinlanglich geklart. Ein Zusammenhang mit Hyperlipidamie, Diabetes mellitus und Schilddrusenfunktionsstorungen wird diskutiert. Ihre Behandlung wird meist mehr aus asthetischen als aus medizinischen Grunden angestrebt. Es wurde uber verschiedenste mehr oder weniger invasive Behandlungsalternativen zur Reduktion der Xanthelasmen berichtet. Neuere, minimal invasive Techniken sollten ein geringes Risiko von Nebenwirkungen wie Narbenbildung und postlasioneller Hyperpigmentierung aufweisen. Patienten und Methoden: Wir beschreiben erstmals den Einsatz eines KTP-Lasers (532 nm) zur Reduktion von Xanthelasma palpebrarum bei 14 PatientInnen an 33 Lidern. Ergebnisse: Die Mehrzahl der PatientInnen (71 %) tolerierte die KTP-Laser-Therapie ohne Lokalanasthesie. Nach ein bis drei Behandlungsdurchgangen konnte in 85,7 % eine aus asthetischer Sicht respektable Reduktion der Xanthelasmen erzielt werden. Unerwunschte Nebeneffekte traten nicht auf. Schlussfolgerung: KTP-Laser-Behandlung ist eine wenig invasive, sichere und effektive Behandlungsoption zur Reduktion von Xanthelasma palpebrarum ohne unerwunschte Nebeneffekte. Summary Background: Xanthelasma palpebrarum is a benign skin disorder of unknown etiology appearing as one or multiple yellowish plaques around the eyelids. Hyperlipidemia, thyroid dysfunction, and diabetes mellitus are possible pathogenetic triggers. Removal of xanthelasma is desired for aesthetic reasons. While there are many treatment options, search continue for newer methods with less scarring and post-inflammatory hyperpigmentation. Patients and Methods: We employed for the first time KTP laser (532 nm) for the treatment of 14 patients with xanthelasma palpebrarum on 33 eyelids. Results: More than 70 % of the patients tolerated KTP laser irradiation without any analgesia. 85.7 % showed respectable reduction of xanthelasma palpebrarum after one to three treatment sessions without side effects. Conclusions: KTP laser irradiation represents a minimally invasive, safe and effective treatment option for the reduction of xanthelasma palpebrarum without undesired side effects.

The correct classification of locoregional metastases of malignant melanoma to skin is central to the planning of treatment. Local recurrence means persistence of neoplastic cells at the local site by virtue of incomplete excision of the primary melanoma. Standard treatment is excisional surgery. In contrast, locoregional metastases of malignant melanoma (satellites, in-transit metastases) are metastases around a primary melanoma or between a primary melanoma and regional lymph nodes. They represent intralymphatic or hematogenous spread of neoplastic cells. We present a variety of available treatment options and discuss especially topical imiquimod as a novel approach for the palliative treatment of locoregional cutaneous melanoma metastases in selected patients.

Background Various approaches have been taken in the management of verrucae vulgares, but there is still no first-choice treatment. Thus, a study was designed to evaluate the efficacy of a flashlamp-pumped pulsed dye laser (FPDL) in the treatment of verrucae vulgares. Methods Within 18 months, 134 patients with recalcitrant or untreated verrucae vulgares on their hands or feet, or in other sites, were exposed to a 585-nm FPDL every 3.26 weeks. The following parameters were used: energy density, 8 J/cm2; spot size, 7 mm; pulse duration, 450 µs. Concomitant topical treatment was not recommended. Results Eight patients were lost to follow-up. The data of 126 patients were evaluated. Up to eight laser treatments led to total remission in 62.69% of patients and partial remission in 21.42%; 9.52% did not respond to this type of management; 6.34% of patients classified the method as too painful and withdrew after the first one or two treatments. In a median follow-up period of 5.38 months (2–16 months), one relapse occurred. Conclusions FPDL is safe and effective for the removal or reduction of verrucae vulgares, and requires less patient compliance compared with other treatment options.

BACKGROUND The growth of scalp hair is a cyclical process of successive phases of growth (anagen) and rest (telogen). In previous clinical trials in men with androgenetic alopecia, treatment with finasteride increased scalp hair counts in a defined area (i.e. increased hair density). OBJECTIVES The current study used a phototrichogram methodology to assess the effect of finasteride on the phases of the hair growth cycle. PATIENTS/METHODS Two hundred and twelve men, age 18-40 years, with androgenetic alopecia were randomized to receive finasteride 1 mg daily or placebo for 48 weeks. At baseline and at 24 and 48 weeks, macrophotographs were taken to measure total and anagen hair count in a 1-cm(2) target area of the scalp. RESULTS At baseline, mean total and anagen hair counts in the finasteride group were 200 and 124 hairs, respectively (% anagen = 62%) and the anagen to telogen ratio was 1.74 (geometric mean). In the placebo group, the respective values were 196 and 119 hairs (% anagen = 60%) and 1.57. At week 48, the finasteride group had a net improvement (mean +/- SE) compared with placebo in total and anagen hair counts of 17.3 +/- 2.5 hairs (8.3% +/- 1.4%) and 27.0 +/- 2.9 hairs (26% +/- 3.1%), respectively (P < 0.001). Furthermore, treatment with finasteride resulted in a net improvement in the anagen to telogen ratio of 47% (P < 0.001). In this study, treatment with finasteride 1 mg day(-1) for 48 weeks increased both total and anagen hair counts, and improved the anagen to telogen ratio. CONCLUSIONS These data provide direct evidence that finasteride 1 mg daily promotes the conversion of hairs into the anagen phase. These data support that finasteride treatment results in favourable effects on hair quality that contribute to the visible improvements in hair growth observed in treated patients.

Die Porokeratosis Mibelli ist eine seltene, hereditare epidermale Verhornungsstorung mit verschiedenen Sonderformen und bis heute unklarer Pathogenese. Sie ist klinisch durch erythematose Plaques mit typisch hyperkeratotischem Randwall und histologisch durch die kornoide Lamelle gekennzeichnet. Berichtet wird uber eine Porokeratosis gigantea, eine morphologische Variante der klassischen Porokeratosis Mibelli. Die Pathogenese der Porokeratosis wird unter besonderer Berucksichtigung der klonalen Hypothese und der Potenz zur malignen Transformation diskutiert.

Pachydermodactyly is a benign condition characterized by symmetrical, painless, diffuse swelling of the skin on the lateral aspects of the proximal interphalangeal joints of the fingers. Histopathological examination shows epidermal hyperplasia, an increase of dermal collagen bundles and a slightly increased number of fibroblasts. We report three adolescent males with pachydermodactyly. We also review 20 published cases, and discuss the differential diagnosis, clearly distinguishing pachydermodactyly from 'true' and 'false' knuckle pads.

Excess hair growth (hypertrichosis) may occur spontaneously or due to various triggers. The estimation of how much hair is too much hair is a matter of individual perception. In many cases undesired hair growth has a strong impact on a subject’s quality of life due to esthetic disturbance. In rare cases hypertrichosis is innate. Numerous triggers may result in excess hair growth: induced by drugs, paraneoplastic, or androgenetic. The most common cause of undesired hair growth in females is hirsutism, in more than 90% of cases due to hyperandrogenism and polycystic ovary syndrome. Various treatment options will be discussed in this chapter. Most effective reduction of hair growth have been reported after combination of topical, systemic, light assisted treatment options and lifestyle modification. In any case, treatment of excess hair growth represents a challenge for dermatologists and endocrinologists.

The controversial role of psychosocial stress in alopecia areata has been discussed widely, but there has been little research into patients' subjective stress experiences and coping. The aim of this study was to explore general and specific coping strategies in alopecia areata and to assess the role of psychosocial stress in the onset and course of alopecia areata from the patient's viewpoint. Forty-five patients conducted measurements of general coping strategies and body image. Qualitative data analysis was performed referring to interviews of stress experiences before the onset of alopecia areata, stress-reactivity, subjective disease models, consequences of alopecia areata and illness-related coping strategies. Patients do not have dysfunctional coping strategies in general, but they benefit from advantageous strategies in terms of better alopecia areata-specific coping and course of disease after 6 months. Psychological interventions in alopecia areata should focus on training general and alopecia areata-specific coping competences and regulating negative emotionality and insecurity, particularly at the first onset of alopecia areata.

Hirsutism represents a primary clinical indicator of androgen excess. The most common endocrine condition causing hirsutism is polycystic ovary syndrome (PCOS). Diagnosing PCOS is not easy as the signs and symptoms are heterogenous. The newest diagnostic guideline made by the Androgen Excess and PCOS Society in 2006, claims the presence of hyperandrogenism, and ovarian dysfunction (oligo / anovulation and / or polycystic ovaries). Obesity associated reproductive and metabolic dysfunctions may aggravate the symptoms of PCOS. PCOS might be underdiagnosed in non obese women because lean PCOS phenotypes might be underestimated for the syndrome. Effective medical treatment of PCOS and associated hirsutism depends on the endocrinological expertise and experience of the therapist in each individual case. An algorithm for the treatment has not been established yet.

Syringomas are benign lesions most commonly appearing around the eyelids and in malar areas, but they have also been described on other body sites. Depending on the site they may cause either aesthetic disturbance (e.g. face, neck, arms) or pruritus (e.g. vulva). This is the first report of argon laser treatment of syringoma in a patient with multiple vulvar syringomas in association with pruritus vulvae and carcinophobia.

Summary Background: Phosphatidylcholine, a lecithin extracted from soybeans can reduce serum cholesterol to some extent. Intravenous use may prevent fat embolism in polytrauma patients. When injected intralesionally in a formulation containing also deoxycholate and ethanol it is supposed to act as “fat burner” to reduce undesired fat deposits; there is little evidence-based scientific support for this indictaion. Objective: To evaluate the capability of phosphatidylcholin + deoxycholate + ethanol (PPC/DC/E) to reduce body fat with a half-side pilot study for the reduction of saddlebag trochanteric bulges. Methods: PPC/DC/E was injected into the right posterior trochanteric areas three times at weeks 0, 3 and 6. Treatment areas and the same regions of the contralateral side as a control were evaluated by sonography. Tape measurements were taken and the thickness of the subcutaneous adipose tissue (SAT) was measured with an optical device (Lipometer®) at baseline and at week 8 and week 20 (2 and 14 weeks after completign therapy). Results: In this half-side trial, no significant reduction of subcutaneous fat was achieved after three treatments with PPC/DC/E when compared to the untreated side.Transient inflammatory reactions occurred in all patients. Limitations: Only the commercially available formulation containing the three components was tested. Conclusion: The off-label use of PPC/DC/E as a “fat burner” did not produce measurable reduction of undesired trochanteric fat deposits.

Phosphatidylcholine, a lecithin extracted from soy beans, is able to lower serum cholesterol to some extent. When applied intralesionally within fat tissues, it is supposed to act as a "fat burner" and reduce undesired fat deposits. We applied intralesionally phosphatidylcholine within a lipoma of a young patient. To evaluate the volume of the lipoma sonographic imaging was performed before treatment and one month after the third application. Only a partial reduction of the lipoma could be achieved, and increased echographic density could be observed after the third intralesional application of phosphatidylcholine. Surgical excision was performed. Histologic examination showed focal fibrosis, inflammatory reaction with granulomatous features, and presence of pseudomembranous degeneration of fat tissue. Off-label intralesional use of phosphatidylcholine as "fat burner" for the reduction of aesthetically disturbing lipomas should be considered only on a case-to-case basis after careful consideration of possible undesired effects similar to those described in our patient.

Background and Objectives Genital warts represent benign epithelial proliferations induced by human papillomavirus. The goal of treatment is the clearance of visible warts. Different regimens are available. Flashlamp-pumped pulsed dye laser (FPDL) represents one of many treatment options for the management of viral warts (verrucae vulgares), its effectiveness being comparable with that of conventional therapies. We evaluated the effectivity of FPDL light for the treatment of genital warts. Study Design/Materials and Methods A prospective study was performed to examine the efficacy of FPDL in untreated genital warts in which 22 patients were included. Results All patients showed complete remission after 1.59 (1–5) laser sessions and no scarring was observed. Conclusions This study demonstrate that FPDL is a simple and safe, cost and time saving alternative treatment option for genital warts and should be listed in genital warts treatment guidelines. Lasers Surg. Med. 38:273–276, 2006. © 2006 Wiley-Liss, Inc.

Nevoid basal cell carcinoma (BCC) syndrome is a genetically linked disorder characterized by multiple BCCs associated with various skeletal abnormalities and sometimes with mental retardation. Because of the large number of lesions, treatment of BCCs in these patients may be extremely difficult. The value of different therapeutic options was assessed in a patient with multiple, disfiguring nevoid BCC syndrome. Surgical excision and split-skin grafting was used to remove three larger tumors. Photodynamic therapy led to healing of flat lesions; small papules within the treated areas, however, did not respond to this type of management. Three nodular BCCs treated with intralesional application of interferon alfa-2b were markedly reduced in size. Still, complete healing could not be achieved. Nodular lesions vaporized with the CO2 laser disappeared and showed no recurrence after 2 years of follow up. Our experience indicates that CO2 laser vaporization of BCCs allows the treatment of a large number of lesions in a single session, and is indicated when surgical treatment is not feasible for all lesions. Photodynamic therapy with 5-amino-levulinic acid may be a valid therapeutic option for flat lesions only. Intralesional application of interferon alfa-2b removes papular lesions of small size.

Summary Background Established skin resurfacing methods causing superficial wounds and extended recovery times have become less popular since the introduction of nonablative lasers. Objectives To evaluate the clinical efficacy of a nonablative 1450-nm diode laser system. Methods Nine patients (Fitzpatrick skin type II–IV) with periorbital wrinkling class I–II were treated three times at 3-weekly intervals with a 1450-nm diode laser. Clinical outcome was determined by 25 independent dermatologists evaluating standardized photographs taken before treatment and 1 month after treatment. Results The patients were satisfied with the procedure, and reported a mild to moderate improvement in all cases. Among 25 dermatologists, only two provided ratings which were significantly in favour of a positive treatment effect. Conclusions Nonablative laser treatment subjectively satisfies patients but does not convince objective judgement.

The goal of hair removal methods has always been permanent or at least long-term epilation. Laser technology and the axiom of selective photothermolysis allowed a new approach to this subject.The aim of this retrospective study was to determine the long-term efficacy of a solid state, 800nm pulsed near infrared diode laser system for the reduction of pigmented hair, and extending habitual hair plucking intervals.In 48 months 242 patients received 703 diode laser treatments on 477 sites. Treatment data and an anonymous patient questionnaire on data concerning undesired hair growth (e.g. predisposition, psychological aspects), and hair plucking habits were retrospectively evaluated to verify the benefit of 800-nm diode laser application for the reduction of excess hair.After an average of 1.97 treatments (range 1-6) sufficient reduction of pigmented hair was achieved for a mean period of 8.1 months. The habitual hair plucking interval was raised from a mean of 3.69 days before treatment to 15.19 days after laser epilation. The procedure was tolerated by 81.4% without local anesthetics and well accepted by 82.55% of the patients.800-nm diode laser assisted hair removal represents a safe and effective treatment option for the reduction of pigmented hair.