P6140Excimer light for vitiligo and psoriasis: Number of session or cumulativedose, which is important?

Jagdish Sakhiya, MD, Sakhiya Skin Clinic Pvt Ltd, Surat, Gujarat, India

Objectives: We access the efficacy of monochromatic excimer light in vitiligo andpsoriasis vulgaris in form of cumulative dose and number of sessions. We analyzedwhether cumulative dose is important or number of sessions.

Methods: One hundred patients with vitiligo and psoriasis were enrolled in a pilotstudy: 40 patients with psoriasis, 60 with vitiligo. Energy was delivered as perprotocol in 50% patients while rest 50% were given as per cumulative dosage(ie, once a month or every fortnightly). Clinical response was assessed using photos,biopsies, and specific clinical scores. Patients were monitored for 6 months.

Results: We observed complete remission in [40% of patients with psoriasis,perifollicular repigmentation was seen in one-third of cases of vitiligo in patientsgiven according to number of sessions. 50% in psoriasis and 60% of vitiligo cases hadperifollicular pigmentation in cumulative dosage.

Conclusion: Our study confirms the use of monochromatic excimer light as a validchoice for the treatment of psoriasis and vitiligo and cumulative dose is moreimportant than number of sessions.

AB24

cial support: None identified.

Commer

P7114Fashions change but tattoos are forever: Time to regret

Arif Aslam, MBBCh, Royal Blackburn Hospital, Blackburn, United Kingdom;Caroline Owen, MBChB, Royal Blackburn Hospial, Blackburn, United Kingdom

Tattoos and body art are becoming increasingly popular and widely acceptablethroughout society. A recent survey suggests that 1 in 5 British adults have atattoo, and there are now more than 1500 tattoo parlors or art studios in the UK.This questionnaire survey study took place over a 6-month period in thedermatology department of a large district general hospital in England. Patientsaged 16 or over who had a visible tattoo during general skin examination wereasked to complete a short questionnaire. All responses were anonymous. Welooked at current age; what age people acquired their first tattoo; whether it wasperformed by an amateur or professional tattoo artist; how long they had hadtheir tattoo; whether they had 1 or multiple tattoos; whether they still liked theirtattoo(s); and whether they regretted their tattoo(s). We also determined the siteof tattoos and asked people whether if able to, they would have their tattoosremoved. 615 questionnaires were returned, of which 15 were incomplete. Ofthe 580 responses analyzed, 52.7% were male and 47.3% female. The overwhelm-ing majority of tattoos were performed by a professional artist. Almost half of thepatients were aged over 40. 44.8% of the patients had their first tattoo agedbetween 18 and 25 and almost half had between 2 and 5 tattoos. Almost one-thirdof the participants regretted their tattoo. Men are more likely to regret their tattooand are 3 times more likely to regret their tattoo if it was first performed underthe age of 16. Women over the age of 21 at the time of their first tattoo are theleast likely to regret their tattoo. The overwhelming majority who regret theirtattoo have them on their upper body. The average length of time since the firsttattoo in those who regret them is 18 years compared to 12 years amongst thosewho do not regret them. Interestingly, less than half of those who regret theirtattoo would actually have their tattoo removed if able to. A significant number ofpeople regret having a tattoo, and the longer they have had one, the more likelythis becomes. We feel that this should become an important health messagebecause tattoo removal is not freely available, and unwanted tattoos can affect lifechances and cause significant psychological morbidity.

cial support: None identified.

Commer

J AM ACAD DERMATOL

P6033In vivo reflectance confocal microscopy: A novel analytical technique forclinical efficacy assessment of skin brightening

Elizabeth Makino, MBA, SkinMedica, Inc, Carlsbad, California, United States; LisaGoberdhan, SkinMedica, Inc, Carlsbad, CA, United States; Rahul Mehta, PhD,SkinMedica, Inc, Carlsbad, CA, United States

Originally invented in 1955, reflectance confocal microscopy (RCM) has sinceburgeoned into a useful tool to support the diagnosis of malignant lesions in humanskin. Prompted by technological advances in the field including the use of laserbeams at different wavelengths, features of the skin can now be visualized in real-time. In vivo RCM produces horizontal cross sections of the skin at the cellular level,spanning from the upper skin surface down to the upper layers of the dermis. Theapplication of in vivo RCM as a diagnostic tool has mainly focused around supportingthe visual inspection and morphology of melanomas and nevi; melanosomes andmelanin are easily viewed in RCM images because of their strong contrast appearingbright white. In vivo RCM also enables a noninvasive way to monitor lesion changesover time. Hyperpigmentation, resulting from excess pigment or melanin in theskin, is an important cosmetic concern for patients. In an open-label, 12 week pilotstudy, we tested the cosmetic application of in vivo RCM to determine if changes infacial hyperpigmentation could be detected after using a skin care regimenincluding a novel cosmetic brightening complex. Twenty subjects were instructedto apply the skin brightening complex onto their facial skin, twice daily, for 12weeks. Subjects also applied a nonprescription triretinol product, moisturizer, andsunscreen. At baseline and weeks 4, 8, and 12, subjects were assessed for overallhyperpigmentation on a 10-point scale by the investigator. At all visits, images weretaken of a target lesion using the reflectance confocal microscope (VivaScope 1500,Lucid Inc) and spectrophotometer (CM-600D, KMSA, Inc). Standardized digitalphotographs were also taken of the subjects’ overall facial skin. Subjects completeda Self-Assessment Questionnaire at week 12. Reductions in mean overall hyperpig-mentation scores were observed at all follow-up visits. Assessments with RCM wereconsistent with the clinical observations, standardized digital photography images,and spectrophotometer measurements. Although additional studies are needed,results observed from this pilot study suggest that in vivo reflectance confocalmicroscopy may provide a novel and noninvasive adjunct to visual grading whenassessing reductions in facial hyperpigmentation.

id for by SkinMedica, Inc.

100% pa

P6921Infraorbital rejuvenation using PRP (platelet-rich plasma): A prospective,randomized, split-face trial

Boo Kyoung Kang, MD, Kyung Hee University, Seoul, South Korea; Jong Ho Lee,MD, Kyung Hee University, Seoul, South Korea; Min Kyung Shin, MD, PhD, KyungHee University, Seoul, South Korea; Nack In Kim, MD, PhD, Kyung HeeUniversity, Seoul, South Korea

Background: Platelet-rich plasma (PRP) is an autologous concentration of humanplatelets contained in a small volume of plasma. Recent research has shown thatapplication of PRP contributes to the acceleration of wound healing and rejuvena-tion of aging skin. Such properties of PRP and its efficacy makes it a potentialcandidate as a treatment modality for infraorbital rejuvenation, for which themainline of treatment currently involves invasive methods such as surgical rejuve-nation. The aim of the present workwas to examine the effects of PRPon infraorbitalrejuvenation.

Methods: A total of 20 Korean womenwere enrolled in this study. They were treatedwith PRP injection on one side of the face once a month for 3 months; the other sideof the face were treated with PPP (platelet poor platelet) or saline as control, 10patients each. Among them, 4 patients were dropped out for the reason of personalproblems, no wish to participate. Evaluations were done at baseline and 3 monthafter the final treatment. The outcome assessments included subjective satisfactionscale, erythema and melanin index by DermaSpectrometer. In addition, clinicalimprovement was evaluated by 3 blinded dermatologists by comparing photographsusing quartile grading scale.

Results: Fifteen of 16 participants reported ‘‘extremely satisfied’’ (12.5%), ‘‘verysatisfied’’ (25.0%), and ‘‘satisfied’’ (56.3%) in improvement of infraorbital wrinkles.All of the participants reported ‘‘very satisfied’’ (37.5%), and ‘‘satisfied’’ (62.5%) inimprovement of infraorbital tone. In the objective assessment, 3 blinded reviewersrated ‘‘good (percent improvement, 50-74%)’’ results in 2 of 16 (12.5%) participants,‘‘moderate (percent improvement, 25-49%)’’ in 3 (18.8%), ‘‘mild (percent improve-ment, \25%)’’ in 9 (56.3%), and ‘‘no improvement’’ in 2 (12.5%). The erythemaindex decreased from 8.52 to 7.37 in the group that received PRP treatment,whereas the erythema index slightly increased from 9.04 to 9.34 in the group thatreceived saline injection. The melanin index decreased from 34.42 to 31.86 in thegroup that received PRP treatment and that increased from 34.88 to 35.28 in thegroup that received saline injection.

Conclusion: PRP injection is effective for the treatment of infraorbital skinrejuvenation and not cause any obvious side effects.

cial support: None identified.

Commer

APRIL 2013