1.
Clinical and histopathological comparison of microneedling combined with platelets rich plasma versus Fractional Erbium-Doped Yttrium Aluminium Garnet (Er: YAG) Laser 2940 nm in treatment of atrophic post traumatic scar: A randomized controlled study
Agamia N, Badawi A, Sorror O, Alrashidy M, Tawfik AT
The Journal of dermatological treatment. 2020;:1-24
Abstract
Background: Different modalities have been tried for treating atrophic post traumatic scars. Objective: To compare the efficacy of microneedling combined with PRP with that of Fractional Er: YAG laser in treating post-traumatic atrophic scars. Methods: 45 patients with atrophic post traumatic scars were subdivided into three groups. Group I subjected to four sessions of skin microneedling followed by topical application of platelet rich plasma (PRP) immediately after each session. Group II subjected to the same protocol of treatment but for 6 sessions. Group III subjected to 4 sessions of Fractional Er: YAG laser at four weeks intervals for four sessions. Response to treatment was assessed clinically using the Quartile Grading Scale and histopathologicaly using H&E stain, trichrome and Orcein special stains. Results: All patients showed significant clinical improvement regardless of the treatment. There was a significant difference in clinical and histopathological improvement between group I and III, but there was no significant difference in improvement neither between group I and II nor between group II and III. Conclusion: microneedling could be as effective as fractional laser when combined with PRP and when used for more sessions.
2.
Platelet-rich plasma versus combined fractional carbon dioxide laser with platelet-rich plasma in the treatment of vitiligo: a comparative study
Kadry M, Tawfik A, Abdallah N, Badawi A, Shokeir H
Clinical, cosmetic and investigational dermatology. 2018;11:551-559
Abstract
Purpose: The aim of this study was to assess the efficacy of platelet-rich plasma (PRP) vs combined fractional CO2 (Fr: CO2) laser with PRP in the treatment of stable nonsegmental vitiligo (NSV) lesions. Patients and methods: This prospective, randomized, intrapatient, comparative controlled study was conducted between June 2014 and June 2016 at National Institute of Laser Enhanced Sciences (NILES), Cairo University, Cairo, Egypt. Thirty NSV patients were treated with PRP, Fr: CO2 laser, and combined Fr: CO2 laser with PRP. Intrapatient lesions were divide randomly into four groups. Each group was treated by one modality. The fourth group served as a control.Patients received six treatment sessions with 2-week interval for 3 months and were followed up after 3 months. Results: A highly significant reduction was demonstrated through vitiligo analysis by computer-assisted grid (VACAG) in the combined Fr: CO2 laser with PRP and in the PRP only groups than other groups. These results were confirmed by mean improvement score by physician (MISP) and by VAS with no statistical difference between them. The combined Fr: CO2 laser with PRP group showed minimal side effects. Regardless of the modalities, better improvement was seen in the trunk than the face, extremities, and acral lesions with significant reduction in all regions. Face showed maximum response with combined Fr: CO2 laser with PRP. Trunk showed higher response with PRP. Upper limbs showed highest response with combined Fr: CO2 laser with PRP. Lower limbs showed the highest improvement with Fr: CO2 laser. Conclusion: According to our study, combined Fr: CO2 laser with PRP achieved superior repigmentation than intradermal (ID) PRP. However, Fr: CO2 alone showed poor improvement. Combined ablative Fr: CO2 laser and PRP therapy followed by sun exposure could be used effectively and safely to treat refractory NSV.