P6161The efficacy of combination therapy with a novel continuous dermalheating monopolar radiofrequency device and botulinum toxin type A forfacial contouring: A split-face study

Dong Hye Suh, MD, PhD, Arumdaun Nara Dermatologic Clinic, Seoul, SouthKorea; Ka-yeun Chang, PhD, MD, Arumdaun Nara Dermatologic Clinic, Seoul,South Korea; Minkyung Shin, MD, PhD, Kyung-Hee University, Seoul, SouthKorea; SangJun Lee, PhD, MD, Arumdaun Nara Dermatologic Clinic, Seoul, SouthKorea; Young-Jin Kim, PhD, MD, Arumdaun Nara Dermatologic Clinic, Seoul,South Korea

Background: Botulinum toxin type A can produce dramatic improvements inpatients with benign masseteric hypertrophy for Asian women. The use ofbotulinum toxin type A for lower facial contouring is a very popular cosmeticprocedure in Korea. However, in some cases after this treatment, the laxity of mid-face could be occurred as masseter muscle mass decreases.

Objective: The purpose of this study was to compare botulinum toxin type Amonotherapy with botulinum toxin type A plus a novel nonablative 4-MHzmonopolar radiofrequency treatment.

Methods: Thirteen female subjects ranging from 21 to 48 years of age with skin typesIII to V were enrolled and received single session of botulinum toxin type A (Botox)injection on both sides of faces. 25 to 30 U of Botox per side was injected at 3 pointsinto the prominent portions of the mandibular angle and followed by radiofre-quency (The Surgitron Dual Frequency RF S5 with Pellev�e handpiece [EllmanInternational, Inc, Oceanside, NY]) treatment on 1 side of cheek. Additional 2sessions of radiofrequency treatment were done in all subjects at 3-week intervals.

Results: The serial photographs and patient subjective evaluation showed anobvious facial change 2 to 6 months after treatment. After the treatments, surfacesmoothness and skin tension of the botulinum toxin plus radiofrequency treatmentis significantly improved than botulinum toxin monotherapy. No significant sideeffects were observed.

Conclusion: The monopolar radiofrequency plus botulinum toxin treatmentappeared superior to botulinum toxin monotherapy in aspect of both efficacy andpatients’ satisfaction. Especially it is more effective for rounded and drooped lowerface.

AB226

cial support: None identified.

Commer

P6319Treatment of melasma in Asian skin enhanced penetration tranexamicacid using a ultrasound after plasma fractional radiofrequency

Dong Hye Suh, MD, PhD, Arumdaun Nara, Seoul, South Korea; Hyun Joo Kim,MD, PhD, Arumdaun Nara, Seoul, South Korea; Ka-Yeun Chang, Phd, MD,Arumdaun Nara, Seoul, South Korea; Min-Kyung Shin, PhD, MD, Department ofDermatology, School of Medicine, Kyung Hee University, Seoul, South Korea;Sang Jun Lee, MD, PhD, Arumdaun Nara, Seoul, South Korea

Background: Melasma is a common hyperpigmentation disorder that can causerefractory cosmetic disfigurement, especially in Asians. Tranexamic acid has beenreported to be effective for the treatment of melasma.

Objective: This study was done to evaluate the effectiveness and the safety ofenhanced penetration of tranexamic acid with ultrasound after plasma fractionalradiofrequency for the treatment of melasma.

Methods: Twenty-one patients with melasma received every 2 weeks enhancedpenetration of tranexamic acid with ultrasound after plasma fractional radiofre-quency. They were followed up to 20 weeks after treatment completion. Efficacywas evaluated using objective and subjective ratings, Melasma Area and SeverityIndex (MASI).

Results: Using a 4-point scale (poor, fair, good, and excellent), 13/21 patients (61%)reporting good to excellent response. Two independent physician assessmentrevealed that 4 of 21 patients (19%) showed 76% to 100% improvement while 15 of25 patients (71%) showed at least 50% improvement. Mean MASI scores decreased.There were no significant adverse effects with treatments.

Conclusions: Enhanced penetration of tranexamic acid with ultrasound after plasmafractional radiofrequency is a safe and effective treatment for melasma in Asians.

cial support: None identified.

Commer

J AM ACAD DERMATOL

P6870Treatment of primary axillary hyperidrosis with subdermal Nd:YAG laser

Amalia Tsiatoura, MD, Cosmetic Derma Medicine Clinic, Athens, Greece;Anastasios Vekris, MD, Cosmetic Derma Medicine Clinic, Athens, Greece;Georgios Kontochristopoulos, PhD, 2nd Dermatologic Department A SyggrosHospital, Athens, Greece

Background: Axillary hyperidrosis is a common but difficult to treat condition withmajor social and emotional consequences.

Objective: The aim of this study is to present subdermal Nd:Yag laser as an effectiveand safe alternative in treating axillary hyperidrosis with permanent results.

Methods: 31 patients (21 men and 10 women) with axillary hyperidrosis receivedsubdermal 1, 064 nm ND-YAG laser treatment for primary axillary hyperidrosis.Treatment was performed in both axillae under tumescent local anesthesia. Patients’average age was 27 years. 25 of them had been treated with botulinum toxin Ainjections before. The average laser energy delivered was 4800 J per axilla with apower of 6 Wand repetition rate of 40 Hz. A 300-�m fiber was used in all cases. 70%of patients had follow up of 6 months and longer.

Results: The results were evaluated by the patient and the physician by iodine starchtest 1, 3, and 6 months after the treatment. One month after operation, 21 patients(67%) reported an improvement of at least 50% and 7 of them (22%) a 75% or betterdecrease in sweating. Nine patients (29%) were somewhat satisfied with animprovement of 30% to 50%, and 1 patient was not satisfied. Three patients had asecond touch up treatment after 3 months to achieve better results. The result wasmaintained six months after treatment in most of the cases. Only 2 patients reportedrecurrence after 6 months. Reported adverse effects were transient. Two patientshad a small area of skin necrosis in one axilla which in both cases healed in 3 weekswith topical treatment. Compensatory sweating was not reported.

Conclusion: The treatment of axillary hyperidrosis using the 1064-nm Nd:YAG laseris a safe and effective minor invasive procedure with promising results.

cial support: None identified.

Commer

P6074Treatment of the skin lesions of mastocytosis with different types of laser

Sergio Vano-Galvan, MD, PhD, Ramon y Cajal Hospital, Madrid, Spain; PabloBoixeda, MD, PhD, Ramon y Cajal Hospital, Madrid, Spain; Pedro Ja�en, MD, PhD,Ramon y Cajal Hospital, Madrid, Spain

Background: The great majority of patients diagnosed of mastocytosis present skinlesions, usually affecting visible skin areas. Quality of life of patients may bedecreased because of cosmetic reasons, especially in young people. Mastocytosis is arare disease. The therapeutic options to improve skin lesions in patients withmastocytosis are scarcely described.

Objective: To describe the effectiveness of different devices of laser in the treatmentof skin lesions of patients diagnosed of mastocytosis.

Methods: Prospective study including adult patients diagnosed of systemic masto-cytosis with skin lesions of the maculopapular variant. Four different types of laserwere used (pulsed dye laser 595 nm, sequential laser pulsed dye/Nd:YAG 1064 nm,Alexandrite Q-switched 755 nm, Alexandrite long-pulsed 755 nm) in each patient.Firstly, 2 sessions were performed with each laser to evaluate the effectivity. Thesessions were performed each 6 weeks using premedication with oral dexclorfenir-amine and topical lidocain. The evaluation of the improvement was performed bycomparison of digital images by 3 independent dermatologists. The response wasgraded as total response ([75% improvement), partial response (25-75% improve-ment) and no response (\25% improvement).

Results: A total of 12 patients (7 males and 5 females, with ages between 20 and 63)were included in the study. After the first 2 sessions, the pulsed dye laser 595 nmwasmost effective, using purpuric doses (spot 10 mm, energy 8 J/cm2, pulse 0.5 msec).After a total of 3 sessions with pulsed dye laser, a complete response was achieved in6 patients (50%), partial response in 4 patients (33%) and no response in 2 patients(17%). Adverse effects included moderate pain in 10 patients and blister develop-ment in 5 patients. No severe adverse effects such as anaphylactic reactions wereobserved.

Conclusion: Pulsed dye laser may be an effective therapeutic option to improve skinlesions in selected patients diagnosed of mastocytosis.

cial support: None identified.

Commer

APRIL 2013