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Thread: Are we starting to identify laser treatment resistant cases?

  1. #1
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    Default Are we starting to identify laser treatment resistant cases?

    Very interesting article that goes hand in hand with the hyperfusion of blood vessels by VEGF from birth. This study also evaluates irregular polygonal three dimensional blood vessels that are abnormally fused. These vessels, which could be several hundred per square inch would make it very difficult for lasers to successfully treat them due to their complex shapes. Vidocapillarosopic evaluation could aid in the treatment of these polygonal blood vessel sets built by angiogenesis.

    This would be similar to the VasculoRelaxoscope:

    http://drnase.com/recent_headlines.htm


    J Am Acad Dermatol. 2006 Jan;54(1):100-4. Epub 2005 Nov 11. Links


    Videocapillaroscopic alterations in erythematotelangiectatic rosacea.

    BACKGROUND: Rosacea is a common chronic dermatosis that involves the cutaneous microvasculature of the face. There are no objective measures for assessing the severity of erythematotelangiectatic rosacea. OBJECTIVE: Our purpose was to characterize and provide objective measures of vessel changes in erythematotelangiectatic rosacea by videocapillaroscopy. METHODS: We compared 30 patients with erythematotelangiectatic rosacea with 30 age- and sex-matched patients with facial seborrheic dermatitis and 30 healthy control subjects. Videocapillaroscopy was performed both on the cheeks and on the nailfold region. The analyzed parameters of the face were morphological (background color, vessel irregularities) and quantitative (polygonal net perimeter, telangiectasia, and vessel diameters). RESULTS: Characteristic alterations of skin vessels were observed in facial rosacea, with a pattern distinct from that of facial seborrheic dermatitis. In particular, rosacea showed neoangiogenesis and significantly larger polygons (13.21 +/- 3 vs 7.8 +/- 3 mm; mean +/- standard deviation, P < .001), more prominent telangiectases (267.8 +/- 108 vs 118.2 +/- 35 microm; P < .001) and larger mean vessel diameter (46.71 +/- 9 vs 24 +/- 10 microm; P < .001) compared with seborrheic dermatitis. Seborrheic dermatitis displayed more polygon irregularities and vessel tortuosity. In contrast, no differences were found in the nailfold region. LIMITATIONS: Vessel irregularities and overall erythema may be difficult to quantify. CONCLUSIONS: Videocapillaroscopy may represent a valid adjunctive method in the early diagnosis and measurement of erythematotelangiectatic rosacea.

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    This gear is available to Dr. Crouch?

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    Quote Originally Posted by alpha_waves
    This gear is available to Dr. Crouch?

    I think this is a little bit different. This goes deep down to the morphology. But I certainly could be wrong and would appreciate any input by Dr. Crouch.

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    Default Re: Are we starting to identify laser treatment resistant ca

    Quote Originally Posted by drnase
    Seborrheic dermatitis displayed more polygon irregularities and vessel tortuosity.
    seb derm a vascular problem? hmm so in theory it could be treated by lasers?

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    Sorry if this is considered a stupid question. If you are laser resistant does that mean NOTHING will happen after your treatment. Or does laser resistant mean worsening of your symptoms and nothing will help. Does that make sense, I'm kinda tired. Jen

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    Laser-resistant might mean you need to find a hardcore pre-treatment flushing protocol, explore setting options with your doctor, or find a different doc/machine for treatment.

    Also, anti-angiogeneic meds (clarithromycin) may help to shore up the progress a recalcitrant case makes with each treatment.

    I'd also submit that low-level red light therapy is, through my own anecdotal experiences, a very good way to reduce post-thermal laser inflammation, redness, and flushing.


    David
    35 year-old male
    Erythmatotelangiectatic rosacea & Ocular
    20 + laser treatments.
    Toleraine Soothing Light Facial Fluid for moisturizer. I don't use a special cleanser. Clonidine daily; klonopin sometimes.
    BEST and CURRENT TREATMENT I use: Low-Level Red Light Therapy LED array.
    Please feel free to PM me with your low-level red light therapy (LLRLT) questions. I'm happy to help if I can.

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