BACKGROUND:Laser-based therapies, including pulsed dye laser (PDL) and neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, have emerged as nonsurgical alternatives for the treatment of basal cell carcinoma (BCC), particularly in patients unsuitable for surgery. OBJECTIVE:The purpose of this systematic review was to summarize the laser settings and outcomes of PDL and Nd:YAG laser for the treatment of BCC. METHODS:PubMed, Cochrane, and EMBASE databases were searched, and studies reporting original outcome data on PDL and Nd:YAG laser treatments of BCCs were included. RESULTS:Of 670 articles, 28 met inclusion criteria. Nd:YAG laser therapy demonstrates a histologic clearance rate of 95% (157/167 BCCs) and clinical clearance rate of 95% (813/857 BCCs). PDL laser therapy demonstrates a histologic clearance rate of 64% (104/163 BCCs) and clinical clearance rate of 90% (863/958 BCCs). Frequently used laser settings are summarized with descriptive statistics. CONCLUSION:Nd:YAG laser and PDL may be considered as nonsurgical treatment options for low-risk BCC. Further studies are needed to optimize protocols and assess long-term outcomes.
BACKGROUND:Radiofrequency microneedling (RFMN) is a minimally invasive procedure that promotes skin remodeling and tightening through radiofrequency-generated thermal energy. On October 15, 2025, the US FDA issued a warning on RFMN devices due to reports of serious complications. OBJECTIVE:To assess the adverse events (AEs) related to commercially available RFMN devices, data were collected from the FDA's manufacturer and user facility device experience (MAUDE) database, which collects medical device reports for suspected injuries. METHODS:Search query for AEs involving RFMN devices from 2020 to 2025 included search terms for the mechanism of action, brand names, and device manufacturers. RESULTS:A total of 86 medical device reports associated with RFMN devices were reported in the MAUDE database from 2020 to 2025, with 145 reported AEs. The most reported side effects were fat loss, scarring, and postinflammatory erythema. CONCLUSION:The MAUDE database serves as a valuable tool for reporting AEs. Adjustment of settings based on the patient and indication as well as real-time device feedback mechanisms can further improve patient safety outcomes.
BACKGROUND:There is a lack of evidence-based consensus to assist clinicians in using photobiomodulation (PBM). OBJECTIVE:To create a consensus on the safe and effective use of PBM. METHODS:A systematic literature review of Embase and MEDLINE was conducted in June 2022 to identify publications reporting research on PBM. An international multidisciplinary panel was convened to draft recommendations informed by the systematic search; they were refined through 2 rounds of Delphi survey, 2 consensus meetings, and iterative review by all panelists until unanimous consensus was achieved. RESULTS:A multidisciplinary panel of experts (n = 21) was assembled based on publication history. The key findings that informed the consensus developed by the expert panel were as follows: PBM is a safe treatment modality for adult patients and red light PBM does not induce DNA damage. PBM is an effective treatment option for peripheral neuropathy, androgenic alopecia, wound ulcers due to multiple etiologies, decubitus ulcers, pain attributed to diabetic foot ulcers, and acute radiation dermatitis. CONCLUSION:The systematic literature search and structured Delphi consensus approach culminated in an evidence-based clinical practice guideline for safe and effective use of PBM in medical and aesthetic applications. Future research will further bolster our understanding of this evolving noninvasive technique.
BACKGROUND:Surgical procedures remain the gold standard for treating basal cell carcinoma (BCC), although commonly associated with cosmetic defects. The demand for noninvasive alternatives remains high. OBJECTIVE:To determine efficacy and safety of red light photodynamic therapy (PDT) with 10% 5-aminolevulinic acid (ALA) gel vs vehicle for treatment of superficial BCC. METHODS:This randomized, double-blind, vehicle-controlled, pivotal phase III study was conducted at 21 centers in the US. Eligible participants had ≥1 naïve superficial BCC and received 1-2 PDT cycles (2 PDTs each cycle) followed by clinical and histological assessment 12 weeks after start of the last PDT cycle. RESULTS:Of 187 randomized participants, 145 received PDT with 10% ALA gel and 42 with vehicle. Histological clearance was 75.9% with 10% ALA gel vs 19.0% with vehicle (P < .0001). Clinical clearance was 83.4% with 10% ALA gel vs 21.4% with vehicle (P < .0001). A total of 88.1% of participants treated with 10% ALA gel rated the esthetic outcome as very good or good. No previously unknown adverse events occurred. LIMITATIONS:Few participants with lesions on face/scalp; to date, a 60-month follow-up is still ongoing. CONCLUSION:10% ALA gel showed significantly higher clearance rates than vehicle with unproblematic safety and positive esthetic outcome.
INTRODUCTION:The mental health burden associated with vitiligo can significantly impact patients' quality-of-life. Although successful for repigmentation of stable vitiligo, adoption of surgical melanocyte transplantation remains limited due to time and skilled-expertise requirements. A cell harvesting device prepares autologous skin cell suspension (ASCS) at point of care, simplifying the process. OBJECTIVE:To confirm early and favorable repigmentation response and evaluate health-related quality-of-life changes following ASCS treatment of stable vitiligo. METHODS:In this large (N = 107), prospective, multicenter study, vitiligo lesions were laser-ablated and received ASCS treatment followed by at-home phototherapy. RESULTS:All Fitzpatrick skin types and major vitiligo subtypes were represented. Excellent repigmentation response (≥80%) was observed by week 4. By week-24, all lesions demonstrated improvement; 67% achieved >50% repigmentation, 42% achieved ≥80% repigmentation, and 8% achieved complete repigmentation. Vitiligo Noticeability Scale response was attained by 27.7% of lesions; 72.3% of patients reported treatment satisfaction. Significant improvement from baseline in Vitiligo Quality-of-Life Instrument (P < .05) was observed at week-24. LIMITATIONS:No control. CONCLUSIONS:The cell harvesting device provides a simplified, more accessible technique for melanocyte transplantation. ASCS is highly effective for repigmentation of stable vitiligo lesions, with positive patient-reported outcomes and improvement in quality-of-life, as demonstrated in this large, diverse population.
