Abstract
Background. Cryopeeling is a technique that uses cryotherapy not only on actinic keratoses lesions, but also all over the photodamaged skin. Objectives. To investigate the histological changes induced by two cryopeeling methods (liquid nitrogen (LN) and portable system (PS)). Methods. Sixteen patients (n = 16) with multiple actinic keratoses on the forearms were treated with cryopeeling technique using LN for one forearm and PS for the other, randomly. Skin biopsies were taken before and after the procedures. Results. There was no statistical difference between the epidermal and Grenz zone thicknesses or density of elastic fibers after treatments. The amount of melanin pigment was lower after PS treatment (P < 0.05). In a blind analysis of paired pre- and postprocedure slides, it was not possible to identify cases which underwent treatment, both in global analysis of quality of the skin and in specific analysis (considering only the aspect of stratum corneum). Discussion. The results indicate the inconsistency of histological improvement after treatments, and, likely, since the method causes superficial exfoliation, a reliable marker was not found in the analysis. Conclusions. Despite cosmetic benefits on photodamaged skin and efficient treatment of actinic keratoses lesions, cryopeeling was not able to induce measurable histological changes in solar elastosis, epidermal organization, or epidermal and Grenz zone thicknesses. One should keep in mind the possibility of hypopigmentation risk of the method.
Highlights
Cryotherapy using liquid nitrogen (LN) is the most common form of treatment of actinic keratosis [1]
Using LN, whose boiling point is −196∘C, the temperature to be achieved in the tissue for the treatment of malignancies is between −50∘C and −60∘C [5]
We analyzed a total of 16 patients and 31 skin biopsies from 16 forearms treated with LN (n = 16) and 15 forearms treated with portable system (PS) (n = 15)
Summary
Cryotherapy using liquid nitrogen (LN) is the most common form of treatment of actinic keratosis [1]. Cryopeeling is a technique that uses cryotherapy in a diffuse manner throughout the skin region affected by sun damage in order to promote cell renewal and desquamation, with possible benefits in the appearance of new lesions caused by photodamage. The field of cancerization is defined by the entire photodamaged area that, being without clinical lesions, demonstrates precancerous changes and genetic mutations, which precede tumor development In this context, cryopeeling is a technique that uses cryotherapy diffusely throughout the skin of the area affected by sun damage with possible benefits in the development of new lesions. Cryopeeling is a technique that uses cryotherapy on actinic keratoses lesions, and all over the photodamaged skin. Despite cosmetic benefits on photodamaged skin and efficient treatment of actinic keratoses lesions, cryopeeling was not able to induce measurable histological changes in solar elastosis, epidermal organization, or epidermal and Grenz zone thicknesses. One should keep in mind the possibility of hypopigmentation risk of the method
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