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Two-step treatment of bulky keloids on the cheeks after deep chemical peeling: intralesional cryosurgery followed by pulsed dye and ablative fractional CO2 laser

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Scarring of the face following chemical peeling is an uncommon and devastating complication. This case report describes the successful treatment of bulky mature keloids on both cheeks following deep chemical peeling by using a combined approach of intralesional cryosurgery followed by pulsed dye and ablative fractional CO2 laser therapy.

Level of evidence: Level V, therapeutic study.

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References

  1. Khunger N (2008) Standard guidelines of care for chemical peels. Indian J Dermatol Venereol Lepol 74:5–12

    Article  Google Scholar 

  2. Rubin MG (1995) Manual of chemical peels: superficial and medium depth. J.B. Lippincott Company, Philadelphia, pp 148–153

    Google Scholar 

  3. Meridian Plastic Surgeons, Indianapolis Plastic Surgery, (2014) Complications of chemical peels, dermabrasion, and laser resurfacing.http://www.meridianplastic.com/research/comlications-of-chemical-peels-dermabrasion 02.03.2014

  4. Fabbrocini G, Elston DM (2017) Chemical peels. http://emedicine.medscape.com/article/1829120-overview, Medscape. Accessed 26 July 2017

  5. Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang B (2010) Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing. J Clin Aesthet Dermatol 3:32–43

    PubMed  PubMed Central  Google Scholar 

  6. Har-Shai Y, Har-Shai L (2014) Intralesional cryosurgery for the treatment of upper lip keloid following deep chemical peeling. Eur J Plast Surg 37:679–682

    Article  Google Scholar 

  7. Har-Shai Y, Amar M, Sabo E (2003) Intralesional cryotherapy for enhancing the involution of hypertrophic scars and keloids. Plast Reconstr Surg 111:1841–1852

    Article  Google Scholar 

  8. Har-Shai Y, Dujovny E, Rohde E, Zouboulis CC (2007) Effect of skin surface temperature on skin pigmentation during contact and intralesional cryosurgery of keloids. J Eur Acad Dermatol Venereol 21:191–198

    Article  CAS  Google Scholar 

  9. Har-Shai Y, Brown W, Labbe D, Dompmartin A, Goldine I, Gil T, Mettanes I, Pallua N (2008) Intralesional cryosurgery for the treatment of hypertrophic scars and keloids following aesthetic surgery: the results of a prospective observational study. Int J Low Extrem Wounds 7:169–175

    Article  Google Scholar 

  10. Har-Shai Y, Mettanes I, Zilberstein Y, Genin O, Spector I, Pines M (2011) Keloid histopathology after intralesional cryosurgery treatment. J Eur Acad Dermatol Venereol 25:1027–1036

    Article  CAS  Google Scholar 

  11. Shin J, Cho JT, Park SI, Jung SN (2019) Combination therapy using non-ablative fractional laser and intralesional triamcinolone injection for hypertrophic scars and keloids treatment. Int Wound J. https://doi.org/10.1111/iwj.13213

  12. Forbat E, Ali FR, Al-Niaimi F (2017) Treatment of keloid scars using light-, laser-and energy-based devices: a contemporary review of the literature. Lasers Med Sci 32:2145–2154

    Article  CAS  Google Scholar 

  13. Lee YI, Kim J, Yang CE, Hong JW, Lee WJ, Lee JH (2019) Combined therapeutic strategies for keloid treatment. Dermatol Surg 45:802–810

    Article  CAS  Google Scholar 

  14. Gokalp H (2017) Evaluation of nonablative fractional laser treatment in scar reduction. Lasers Med Sci 32:1629–1635

    Article  Google Scholar 

  15. Quyang HW, Li GF, Lei Y, Gold MH, Tan J (2018) Comparison of the effectiveness of pulsed dye laser vs pulsed dye laser combined with ultrapulse fractional CO2 laser in the treatment of immature red hypertrophic scars. J Cosmet Dermatol 17:54–60

    Article  Google Scholar 

  16. Radmanesh M, Mehramiri S, Radmanesh R (2019) Fractional CO2 laser is as effective as pulsed dye laser for the treatment of hypertrophic scars. J Dermatolog Treat 25:1–4

    Google Scholar 

  17. Anderson RR, Parrish JA (1983) Selective photothermolysis: precise microsurgery by selective absorption of pulsed irradiation. Science 20:524–527

    Article  Google Scholar 

  18. Anderson RR, Parrish JA (1981) Microvasculature can be selectively damaged using dye lasers: a basic theory and experimental evidence in human skin. Lasers Surg Med 1:263–276

    Article  CAS  Google Scholar 

  19. Jang JU, Kim SY, Yoon ES, Kim WK, Park SH, Lee BI, Kim DW (2016) Comparison of the effectiveness of ablative and non-ablative fractional laser treatments for early stage thyroidectomy scars. Arch Plast Surg 43:575

    Article  Google Scholar 

  20. Tan OT, Murray S, Kurban AK (1989) Action spectrum of vascular specific injury using pulsed irradiation. J Investig Dermatol 92:868–871

    Article  CAS  Google Scholar 

  21. Kuo YR, Jeng SF, Wang FS, Chen TH, Huang HC, Chang PR, Yang KD (2004) Flashlamp pulsed dye laser (PDL) suppression of keloid proliferation through down-regulation of TGF-β1 expression and extracellular matrix expression. Lasers Surg Med 34:104–108

    Article  Google Scholar 

  22. Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34:426–438

    Article  Google Scholar 

  23. Taudorf EH, Danielsen PL, Paulsen IF, Togsverd-Bo K, Dierickx C, Paasch U, Haedersdal M (2015) Non-ablative fractional laser provides long-term improvement of mature burn scars–a randomized controlled trial with histological assessment. Lasers Surg Med 47:141–147

    Article  Google Scholar 

  24. Hochman B, Locali RF, Matsuoka PK, Ferreira LM (2008) Intralesional triamcinolone acetonide for keloid treatment: a systematic review. Aesthet Plast Surg 32:705–709

    Article  CAS  Google Scholar 

  25. Wohlrab J, Finke R, Franke WG, Wohlrab A (2012) Clinical trial for safety evaluation of hyaluronidase as diffusion enhancing adjuvant for infiltration analgesia of skin with lidocaine. Dermatol Surg 38:91–96

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. The Unit of Plastic Surgery, Carmel Medical Center, 7 Michal Street, Haifa, 3436212, Israel

    Yaron Har-Shai

  2. The Bruce Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Bat Galim, Haifa, Israel

    Yaron Har-Shai & Lior Har-Shai

  3. The Center for Aesthetic Dermatology, The Department of Dermatology, Tel Aviv Medical Center, The Sackler Faculty of Medicine, Tel Aviv, Israel

    Ofir Artzi

Authors
  1. Yaron Har-Shai
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  2. Lior Har-Shai
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  3. Ofir Artzi
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Correspondence to Yaron Har-Shai.

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Conflict of interest

The author Yaron Har-Shai has a financial interest in the Intralesional Cryosurgery technology. The authors Lior Har-Shai and Ofir Artzi have no financial interest to disclose.

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Har-Shai, Y., Har-Shai, L. & Artzi, O. Two-step treatment of bulky keloids on the cheeks after deep chemical peeling: intralesional cryosurgery followed by pulsed dye and ablative fractional CO2 laser. Eur J Plast Surg 43, 851–854 (2020). https://doi.org/10.1007/s00238-020-01651-x

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  • DOI: https://doi.org/10.1007/s00238-020-01651-x

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