Acanthosis nigricans (AN), with an estimated prevalence of 19.4% in the U.S., presents as hyperpigmented, velvety plaques in intertriginous regions. Acanthosis Nigricans negatively affects psychological well-being and particularly impacts skin of color individuals. Addressing the underlying cause of acanthosis nigricans, as current guidelines recommend, is often challenging. This highlights the importance of skin directed treatment for acanthosis nigricans. This systematic review evaluated topical, laser, and oral treatments for acanthosis nigricans and provides evidence-based recommendations for clinical use. Adhering to PRISMA guidelines, we evaluated 19 clinical trials investigating topical, oral, and laser interventions for acanthosis nigricans. Oxford Centre for Evidence-Based Medicine guidelines were used to make clinical recommendations. We strongly recommend topical tretinoin (grade A) and endorse the appropriate use of adapalene gel, urea cream, and fractional carbon dioxide laser therapy (grade B). Further research is essential to enhance our understanding of alternative treatments to determine additional evidence-based recommendations. This review aims to guide clinicians in managing acanthosis nigricans, especially when direct treatment of underlying conditions is impractical.

This review aims to assess the efficacy and safety of laser therapy in managing scars resulting from cleft lip and/or palate (CL/P) repair surgeries, as well as to determine the optimal timing for intervention. A systematic search was conducted across four databases using a predefined search strategy. Studies included were randomized controlled trials, non-randomized studies, and case series focusing on laser therapy for CL/P scars. Data extraction and analysis were performed using Revman Software. A total of two randomized controlled trials, four non-randomized studies, and three case series were included in the analysis. The fractional CO2 laser was the most commonly utilized type of laser. Following laser therapy, there was a significant decrease in Vancouver Scar Scale (VSS) scores by 4.05 (95% CI, 2.10-5.99). Meta-analysis revealed that laser treatment groups exhibited a significantly lower mean VSS score (1.3; 95% CI, 0.02-2.67) compared to control groups. Moreover, initiating laser therapy intervention at one month postoperatively resulted in a significantly lower VSS score compared to initiation at three months postoperatively (difference of 1.70; 95% CI, 1.33-2.08). No severe complications were reported. Laser therapy demonstrates effectiveness and safety in improving CL/P scars, with earlier intervention yielding greater benefits.

Striae distensae are common dermatological complaint. Cold laser using low-level light/laser therapy (LLLT) offers healing and analgesic effects and was not yet compared to \'hot lasers\' efficacy. Study objective: to assess the efficacy and safety of LLLT in the management of stria alba compared to fractional carbon dioxide (FCO2) laser alone and to the combined use of both devices. Thirty patients with stria alba were randomized to receive either LLLT using diode 808 nm; 8-12 sessions, 2-3 sessions weekly (Group A) or FCO2 laser; 2 monthly sessions (Group B) or combined both devices simultaneously (Group C). Follow up was at 1 month and 3 months after last session. The efficacy of LLLT was statistically comparable to FCO2, despite numerical superiority of the latter. The combined group had the least numerical values in all efficacy outcomes. Patients in LLLT group did not experience any downtime. LLLT is effective in the management of stria alba comparable to the FCO2 laser. The lack of downtime with LLLT is reflected positively on patient\'s satisfaction. However, this is counterbalanced by the frequent weekly visits. Although adding LLLT to FCO2 laser palliates the laser side effects but it offers the least efficacy. Trial registration number NCT04165226 (clinicaltrials.gov).

Objectives: This study aimed to evaluate the vagina clinically, cytologically, and histologically before and after treating genitourinary syndrome of menopause (GSM) with fractional microablative carbon dioxide LASER (CO2L), radiofrequency (RF), and estrogen vaginal cream (CT). Methods: Women with moderate-to-severe symptoms of GSM, denoted by a GSM Visual analog scale (VAS) score of >4, were eligible for this study. The patients were randomized into treatment groups. In the energy groups, three vulvovaginal applications were administered monthly. The CT group used 0.5 mg vaginal estriol cream for 14 consecutive days, followed by twice a week for 4 months. The follow-up visits occurred 120 days after the beginning of the treatments. The same parameters obtained at the first visit were re-evaluated: GSM VAS score, Incontinence Quality of Life Questionnaire (I-QOL), gynecological examination determining Vaginal Health Index (VHI), vaginal smear for Vaginal Maturation Value (VMV), and vaginal biopsy. Results: Seventy-one women were included, 48 completed the study and provided adequate samples for analysis (CO2L [21 patients], RF [15 patients], and CT [12 patients]). GSM symptoms, I-QOL, and VHI significantly improved after all proposed treatments, with no significant differences between them. VMV did not change after any treatment; however, only 22.9% of the patients presented with cytological atrophy before treatment. Histological vaginal atrophy was identified in 6 (12.5%) pretreated vaginal samples. After the intervention, all histological parameters were normalized, no tissue damage was observed, and no major clinical complications were observed. Conclusion: CO2L and RF seem to be good alternatives to CT for GSM treatment, with no tissue damage.

An analog PID controller-based galvanometer scanner is widely used by fractional laser medical equipment (FLME) to scan lasers across tissue surfaces, achieving the desired therapeutic effect. This type of driver, primarily composed of passive components and operational amplifiers, can only accept commands from the central controller of the FLME, with a simple hardware circuit-based fault diagnosis; thus, the safety of the FLME is compromised. To address these issues, the failure mechanisms of galvanometers and their impact on the safety of FLME are thoroughly analyzed first. Then, an adaptive limit protection method, a coil open circuit fault diagnosis, a communication timeout protection based on two handshakes, and a galvanometer control timeout protection are proposed, respectively, based on a digital driver platform, to supplement the deficiencies in the original fault diagnosis and protection system. This ensures the safety of the FLME. Finally, the effectiveness of the proposed strategies is validated through experiments.
点阵激光治疗仪广泛使用基于模拟PID控制器的驱动器来控制振镜，将激光脉冲以点阵图形的方式扫描人体组织表面，以实现预期的治疗效果。然而，这类振镜驱动器由无源元件和运算放大器组成，它们只能单向接收点阵激光治疗仪中控系统的扫描定位指令，并且通常只能通过比较电路对振镜进行简单的故障诊断，这可能会降低点阵激光治疗仪的安全性。针对这些问题，该研究首先分析并总结了振镜可能出现的各种故障机理，以及这些故障对点阵激光治疗仪安全运行的影响。接着，在数字振镜驱动器的基础上，针对传统振镜系统故障诊断策略的不足，提出了自适应限位保护、线圈断路故障诊断、基于二次握手的通信超时故障诊断以及振镜控制超时故障诊断策略。这些策略的实施提高了点阵激光治疗仪扫描手具的整体安全性。最后，通过实验验证了这些保护策略的有效性。.

Treatment of lower limb ischemia in patients with diabetes is challenging because of the location of the ulcers and the complexity of their pathogenesis. Carbon dioxide fractional laser (CO2FL) therapy in conjunction with tibial periosteum distraction could become a substitute for conventional methods. We herein describe a patient diagnosed with ischemic diabetic foot with a complex ulcer in the upper third of the tibia. Laser irradiation (Deep FX mode with 30 mJ of energy and 10% density) was applied to the entire region of skin below the knee after surface anesthesia, and this treatment was performed twice a week until the ulcer healed. Computed tomography angiography showed successful establishment of a blood supply to the back of the right foot after treatment. Skin grafting was successfully performed, with only a few wounds remaining on the foot 8 months after treatment. The pain score was significantly decreased at the last follow-up. No complications occurred. This case report provides guidance for the performance of CO2FL, a fast, easy, accurate treatment in patients with diabetes. CO2FL can target lower limb arterial occlusive disease accompanied by refractory ulcers, addressing the underlying vascular occlusion and dysfunction as well as promoting microcirculation and wound healing.

BACKGROUND: Urinary incontinence is common in patients with genitourinary syndrome of menopause (GSM). A retrospective cohort study was conducted to analyse the clinical efficacy of carbon dioxide laser combined with pelvic floor functional exercise for GSM with urinary incontinence, aiming to provide evidence for its clinical treatment.
METHODS: Patients diagnosed with GSM and urinary incontinence and admitted to our hospital from January 2021 to December 2022 were included and allocated to a control group (pelvic floor function exercise) and combined group (carbon dioxide laser combined with pelvic floor function exercise). Confounding factors among the groups were balanced by the propensity score matching method. The clinical efficacy, GSM scale scores, urinary indicators, urinary incontinence quality of life scale (I-QOL) scores and the degree of urinary incontinence of the groups were compared.
RESULTS: A total of 192 patients were included in this study, and 36 cases were included in each group after the propensity scores were matched. No statistical difference in baseline data was found between the groups (p > 0.05). The combined group had higher total effective rate and I-QOL scores but lower GSM symptom scale scores than the control group. Urination during daytime and nighttime was less frequent in the combined group than in the control group, which showed a lower degree of urinary incontinence (p < 0.05).
CONCLUSIONS: Combining carbon dioxide laser treatment with pelvic floor exercises is potentially effective for patients with GSM and urinary incontinence. This combined approach not only alleviated GSM and urinary incontinence symptoms but also reduced the severity of urinary incontinence, promoted bladder function recovery and enhanced overall quality of life.

Melanoma, accounting for a significant proportion of skin cancer-related deaths, has variable survival outcomes based on the stage at diagnosis and treatment efficacy. Traditional treatments, while effective, pose risks of scarring and systemic side effects. Laser therapy offers an emerging non-surgical alternative, with CO2 lasers particularly showing promise in palliative care.A comprehensive search was conducted using PubMed, focusing on laser therapy for melanoma treatment. The search included studies on both stand-alone and adjunct laser therapies, with inclusion criteria requiring peer-reviewed articles detailing treatment outcomes for primary, recurrent, or metastatic melanoma.The literature shows that laser therapy for melanoma falls into four major types when categorized by laser medium: solid-state, diode, pulse-dye, and gas (CO2). Data on solid-state lasers for melanoma are limited and their use remains controversial. However, one study with high-energy pulsed neodymium lasers reported a 5-year survival of 82.9% with minimal adverse effects for primary melanoma. CO2 laser therapy has been effective for palliative treatment, with one study showing 54.8% of patients with recurrent melanoma surviving 5.4 years post-ablation. For metastatic melanoma, numerous studies have shown that CO2 laser therapy can provide symptomatic relief and disease control. Combination therapies using lasers and immune-based therapies have demonstrated enhanced outcomes and immune activation, highlighting the potential of laser therapies in melanoma management.While traditional treatments remain the standard for primary melanoma, laser therapies, particularly CO2 laser ablation, show substantial promise in palliative care for metastatic melanoma. Careful patient selection and assessment are crucial for achieving positive outcomes.

Objective: This study aimed to investigate the effectiveness of prophylactic photobiomodulation (PBM) in reducing postinflammatory hyperpigmentation (PIH) induced by carbon dioxide (CO2) laser resurfacing in a patient with periorbital syringomas. Background: PIH is a common condition characterized by abnormal skin pigmentation after an inflammatory process occurring in up to 20-30% of patients undergoing CO2 laser resurfacing. Methods: The patient was treated with PBM using a pulsed home-use device at 630 nm before and after CO2 laser treatment. The patient was asked to treat the right periorbital area before and after the CO2 laser treatment, which was continued once a day for 2 consecutive weeks. Results: At 12 weeks, PIH was significantly reduced on the treated side compared with the contralateral untreated side (leading to persistent erythema at 6 months). Conclusions: This is the first report of prophylactic treatment of CO2 laser-induced dyschromia using PBM.

A pyogenic granuloma is an acquired, benign tissue formation of the skin and/or oral mucosa. Surgical excision is the most common treatment for these lesions. In this case report a case of a 60-year-old woman with a pyogenic granuloma in region 21 is presented. An excisional biopsy was performed with a CO2 laser under local anesthesia and the specimen was examined by a pathologist. No recurrency were observed in this case.