Photothermolysis Research Articles

Research Priorities in the Management of Hidradenitis Suppurativa.

There is a need for high-quality research to support the management of hidradenitis suppurativa. This letter offers suggestions for priority research topics derived from a stakeholder consensus meeting. Investigation of laser hair removal treatment, potentially in combination with medical treatment, was recognized as an important focus for future hidradenitis suppurativa research.

Efficacy of long pulse neodymium-doped yttrium aluminium garnet 1064 laser permanent hair reduction treatment in skin types V and VI Nigerian patients

Background: There are no studies examining the use, safety, efficacy, effective fluence and pulse duration of Laser hair reduction in Nigerians. This study aimed to document the safety, efficacy, effective fluence and pulse duration, and the number of Laser sessions to achieve permanent hair reduction. Methods: A retrospective review of Laser hair removal in 87 FitzPatrick skin type V and VI patients from January 2017 to August 2021 using the neodymium-doped yttrium aluminium garnet (Nd:Yag). The fluence (Joules/cm3), pulse duration (msecs), Laser site and interval between Laser sessions were documented. Data was summarized using frequencies and percentage proportion. Comparison of pulse duration, fluence, and the number of sessions between different body sites was tested using analysis of variance. Results: A total of 354 laser sessions were performed in 87 patients made up of 80 females and 7 males; mean age of 35.8±9.24 years. The face was the most frequently treated site (67.5% of the sessions). The mean number of laser sessions, pulse duration and fluence were 4.07±4.22, 19.38±1.48 (msec) and 18.22±1.29 (J/cm3) respectively. An average of 6 sessions was required to achieve permanent hair reduction: the face required a significantly lower number of sessions, p=0.043. Conclusions: The long pulse Nd:Yag 1064 laser is an effective and safe Laser for hair removal in skin types V and VI. The effective, safe pulse duration and fluence are 16 to 22 msec and 15 to 20 J/cm2 respectively. The face requires fewer number of Laser sessions.

Expert opinion about laser and intense pulsed light (IPL)-induced leukoderma or vitiligo: a cross-sectional survey study.

Vitiligo patients may desire laser hair removal, skin rejuvenation, vascular treatments, and other laser or intense pulsed light (IPL) assisted treatments. However, there is a risk of inducing new depigmented patches (Koebner phenomenon). In absence of guidelines on the safe use of laser or IPL in vitiligo patients, dermatologists tend to be reluctant to administer these treatments. The aim of this survey study was to provide an estimation of the occurrence and related risk factors of laser/IPL-induced leukoderma or vitiligo. A cross-sectional survey study was performed among 15 vitiligo experts from 11 countries, with 14 questions about affected patients, involved laser/IPL treatments and the physicians' approach. In a total of 11,300 vitiligo patients, laser/IPL-induced leukoderma or vitiligo was reported in 30 patients (0.27%). Of these, 12 (40%) patients had a medical history of vitiligo and seven (58%) of these patients had stable (> 12months) vitiligo before the treatment. Most frequently reported were hair removal procedures and localization of the face and legs. Side effects like blistering, crusting, and erosions occurred in 56.7% of the cases. These vitiligo experts based their advice on the risk of the laser treatment on stability of the vitiligo (43%) and activity signs (50%), and 50% discuss the risks before starting a laser treatment. Relevant activity signs are the Koebner phenomenon (57.1%), confetti-like lesions (57.1%) and hypochromic borders (50%). Laser-induced leukoderma or vitiligo is an uncommon phenomenon. Remarkably, a minority had a medical history of vitiligo of which 58% were stable. Consequently, most cases could not have been prevented by not treating vitiligo patients. However, a majority had laser/IPL-induced skin damage. Therefore, caution is advised with aggressive settings and test-spots prior to the treatment are recommended. This study showed significant variation in the current recommendations and approach of vitiligo experts regarding laser/IPL-induced leukoderma or vitiligo.

Effect of exercise training with laser phototherapy on homeostasis balance resistant to hypercoagulability in seniors with obesity: a randomized trial

The prevalence of obesity has increased the incidence of obesity-related coagulation disorders. The current study assessed the effectiveness of combined aerobic exercise and laser phototherapy on the coagulation profile and body measurements in older adults with obesity compared to aerobic exercise alone, which has not been adequately explored. We included 76 obese people (50% women and 50% men) with a mean age of 67.83 ± 4.84 years and a body mass index of 34.55 ± 2.67 kg/m2. The participants were randomly assigned to the experimental group (which received aerobic training with laser phototherapy) and the control group (which received aerobic training alone) for three months. From the baseline to the final analysis, the absolute changes in specific coagulation biomarker levels (fibrinogen, fibrin fragment D, prothrombin time, Kaolin-Cephalin Coagulation Time), and contributing parameters (C-reactive protein and total cholesterol), were assessed. In comparison to the control group, the experimental group showed significant improvements in all evaluated measures (p < 0.001). So, in comparison to aerobic exercise alone, combined aerobic exercise and laser phototherapy had superior positive effects on coagulation biomarkers and decreased the risk of thromboembolism throughout a three-month intervention period in senior obese persons. Therefore, we suggest adopting laser phototherapy for individuals with a greater risk of hypercoagulability.The research was entered into the database of clinical trials under the identification NCT04503317.

Robotic Tubularized Peritoneal Vaginoplasty

Introduction: For transfeminine patients desiring penetrative intercourse, several surgical reconstructive options exist including penile inversion vaginoplasty, peritoneal vaginoplasty, and sigmoid vaginoplasty. Penile inversion vaginoplasty requires preoperative laser hair removal that can be time consuming and costly. Sigmoid vaginoplasty requires bowel harvest and some patients are bothered by excess mucus secretion and odor. Peritoneal vaginoplasty, though without known long-term outcomes, foregoes the need for bowel harvest and preoperative laser hair removal. We present the first video of a robotic tubularized peritoneal vaginoplasty (RATPV) with penile skin inversion. Materials and Methods: We retrospectively reviewed all patients who underwent gender-affirming RATPV at our institution (July 2020–July 2022). Patient demographics, intraoperative details, and postoperative outcomes are described. RATPV involves dissecting and tubularizing a single anterior peritoneal flap (lateral borders: vas deferens, inferior border: retrovesical pouch). The distal end of the tubularized peritoneal flap is then anastomosed to the inverted nonhair bearing penile shaft skin. Results: In 33 patients, median age was 26 years old (interquartile range [IQR]: 24–37) and body mass index was 26 kg/m2 (IQR: 23–32). Median operative time was 406 minutes (IQR: 370–434) and robotic console time was 177 minutes (IQR: 154–220). Intraoperatively, median vaginal depth was 17 cm and diameter was 3+ cm. Median length of stay was 7 days. One-third (15) of patients had a complication within 30 days (40% Clavien–Dindo I, 60% Clavien II). There were no complications related to the robotic reconstruction. Conclusions: RATPV is a safe and effective option for individuals seeking gender-affirming vaginoplasty that obviates the need for laser hair removal before surgery. Patient Consent Statement: Authors have received and archived patient consent for video recording/publication in advance of video recording of procedure. No commercial associations occurred during the last 3 years that might create a conflict of interest with this video. Runtime of video: 5 mins 6 secs

Increasing Amount of Hair Reduction using Laser Correlates with Lower Probability of Recurrence in Patients with Pilonidal Disease

BackgroundHair at the gluteal cleft plays a key role in the development and recurrence of pilonidal disease (PD). We hypothesized that more hair reduction achieved using laser could correlate with lower chance of PD recurrence. MethodsPD patients who underwent laser epilation (LE) were categorized by Fitzpatrick skin type, hair color, and hair thickness. Photos taken at LE sessions were compared to determine hair reduction amount. LE sessions completed prior to the recurrences were recorded. Groups were compared using multivariate T-test. Results198 PD patients had mean age 18.1 ± 3.6 years. 21, 156, and 21 patients had skin types 1/2, 3/4, and 5/6, respectively. 47 patients had light- and 151 had dark-colored hair. 29 patients had fine hair, 129 medium, and 40 thick. Median follow-up was 217 days. 95%, 70%, 40%, and 19% of patients reached 20%, 50%, 75%, and 90% hair reduction after mean LE sessions of 2.6, 4.3, 6.6, 7.8 sessions, respectively. To reach 75% hair reduction, patients require a mean of 4.8–6.8 LE sessions, depending on different skin/hair characteristics. PD recurrence rate was 6%. Probability of recurrence after 20%, 50%, 75% hair reduction was decreased by 50%, 78%, 100%, respectively. Dark hair and skin type 5/6 were associated with higher recurrence rates. ConclusionPatients with dark-color and thick hair require more LE sessions to achieve certain degree of hair reduction. Patients with dark hair and skin type 5/6 were more likely to recur; more hair reduction correlated with lower chance of recurrence. Level of EvidenceLevel IV.

Novel laser hair removal in all skin types.

Laser has been long accepted as a solution for excess or unwanted hair growth yet traditional lasers are not always ideal for safe and effective outcome for all skin types and hair characteristics. A diode laser module combining three wavelengths (755, 810, and 1064 nm) in a single pulse was developed to provide a fast and long-term solution for subjects with various profiles. To evaluate the safety and efficacy of a Triple wavelength diode laser module for hair removal treatment in all skin types (Fitzpatrick I-VI). This was a prospective, dual centered, single-arm study. Subjects were treated with a novel diode laser module. Thirty-six subjects were enrolled, sixteen with Fitzpatrick skin types I-IV (46%) and twenty with Fitzpatrick skin types V-VI (54%). Treatment areas were axilla and bikini lines. Subjects underwent 4 treatment sessions at 6 weeks ± 5 days intervals and attended a follow-up visit 3months after the last treatment session. 2D digital photographs were taken at baseline and at the follow-up visit, and a hair count was conducted by three blinded evaluators. A significant reduction in hair count between baseline and the 3-month follow-up visit was observed in both axilla and bikini lines for all skin types. The mean hair reduction was 41.5± 19.4% and 48.1± 20.9% in the axilla and bikini line, respectively. A significant hair reduction was also observed within skin type groups; mean hair reduction 45.5± 16.9% and 40.3± 17.2% in skin types I-IV and V-VI, respectively, indicating similar efficacy for both light and dark skin types. No serious adverse events were reported. This study demonstrates that the Soprano Titanium laser platform is safe and effective for hair removal treatment in all skin types.

The Transfer of Expanded Forehead Superthin Flap Without Frontalis and Less Hair Follicles Pedicled by Superficial Temporal Vessels.

The expanded forehead flap pedicled with superficial temporal vessel(s) is a common method to treat facial scar deformity. However, local bulkiness and hair retention have limited the use of this flap. Five cadavers were used for anatomy to confirm the forehead "safety zone." A retrospective study was performed on 15 patients with facial scar deformity who were undergoing the expanded forehead superthin flap (without the expanded capsule, frontalis muscle, and with less hair follicles) pedicled with superficial temporal vessel(s) to transfer and repair the deformity. Through cadaver anatomy, the range where the subdermal vascular network laid superficial to the hair follicle level was named the "safety zone," whose average distance between the bilateral penetrating points was 10.2 cm (8.7-11.6 cm). Fifteen patients with facial scar deformity were treated with the superthin flap technique. The trimming size of the safety zone flap was (6-10) × (12-20) cm. The median time of thinning the safety zone was 35 minutes (range, 25-40 minutes). All flaps healed well. The median residual ratio of the hair follicle was 39.8% (29.9%-50.5%). All patients were satisfied with the contour of the flap. We firstly proposed a concept of forehead safety zone and used the superthin flap without the frontalis muscle and less hair follicles to treat facial scar deformity, and obtained an improved therapeutic effect. We think this is an appealing technique that can manifest facial concave and convex in the fine part, improve compliance of the flap, and reduce the times of laser hair removal.

Zastosowanie technologii laserowej w usuwaniu zbędnego owłosienia

Laser hair removal requires knowledge of their physical basis and the biophysical phenomena they induce in the skin. Lasers differ in such categories as wavelenght, Energy density and laser beam size. These elements are important while selecting the right device for the skin type and individual characteristics of the patient. Knowledge of the physiology of hair and the photothermolysis that occurs during epilation, allows the treatment to be carried out correctly and safely, and the entire proces of hair elimination to be controlled. Previous studies indicate a numer of factors that determine the effectiveness of the procedure, including the parameters of the device or skin type. Despite the high degree of safety and effectiveness of the laser epilation procedure, it is also pointed out that there are undesirable consequences that may appear in response to the effects of laser light.

A review article on pcos and its impact on quality of life in women correlation with age, basal metabolic index and various factors

Polycystic ovary syndrome (PCOS) is a hormonal disorder characterised by presence of oligomenorrhoea, anovulation and hyperandrogenism in females. PCOS mainly observed in women in adolescent age to pre-partum resulting in abortions. Symptoms mainly include irregular menstrual cycles, anovulation, acne, hirsutism and oligomenorrhea. The pathophysiology of PCOS involves the primary ovarian abnormalities, endocrine alterations and metabolic modifiers such as anti-Mullerian hormone, insulin resistance and chronic inflammation which causes metabolic disturbances and results hormone imbalance which results in hyperandrogenism therefore development of cysts in ovaries is observed. Diagnostic criteria are mainly done from the Rotterdam criteria of PCOSwhich includes mainly presence of menstrual irregularities, ultrasound scanning and Luteinizing Harmone (LH) and Follicle-stimulating hormone (FSH) ratio and raise of androgens level in body. Treatment options includes oral contraceptive pills, metformin therapy for insulin intolerance, local treatments for hirsutism by laser hair removal therapy, hormone replacement therapy for hyperandrogenism and acne. Non-pharmacological treatment includes diet changes, regular exercises and weight loss. Early diagnosis of PCOD can improve the quality of life and minimize the chances of causing cardiac problemsand further complications caused by PCOS such as hair loss, infertility and if left undiagnosed may result in uterus cancer.

Anterior cervical hypertrichosis: A rare location

We report the case of a twelve-year-old male who presented with isolated anterior cervical hypertrichosis persistent since birth. No notion of trauma or local inflammation or the use of a topical treatment was noted. The patient had no other clinical symptoms and no similar family history. A clinical examination found a tuft of hair, approx. 6 × 3 cm in size, at the level of the mid-neck region, consisting of fine, brown hairs, 3 cm in length (Fig. 1a), with a dermoscopic appearance showing terminal hair and fluffy hair without other associated signs. (Fig. 1b). The rest of the somatic examination was unremarkable. A laser hair removal treatment was offered to the patient with a good response.

Surgical treatment of hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory disease that primarily affects the apocrine skin glands. Management options include risk factor modification, pharmacologic agents, and surgery. Many surgical management techniques exist, including incision and drainage, laser hair removal, deroofing, limited or wide local excision. Deroofing is an interesting alternative for simple superficial fistulas and potentially even for more complex lesions. Surgical treatment can be combined with drug treatment. The indication depends on a comprehensive and multidisciplinary assessment considering the severity and number of target lesions.

Üst Dudak Lazer Epilasyonu Sırasında Dişlerde Oluşan Isının Değerlendirilmesi: Klinik Deney

Objective: The temperature of adjacent tissues during epilation has long been the subject of research. However, there is no literature on the heat that occurs in the teeth during laser epilation of the upper lip. This study measured the increase in the heat of the teeth during upper lip laser epilation. Material and Methods: The study included 51 patients. Three heat measurement sensors were placed on the labial surface of the anterior teeth. Before starting the procedure, the first measurement was taken, and the maximum values were recorded as °C. After the procedure, a visual analog scale (VAS) was applied. Paired samples t-tests and one-way ANOVA (p<0.05) test were applied for the statistical analysis. Results: A statistically significant difference was determined between the maximum and initial heat in the 3 sensors (S1F 36±1.7, S1Max 40.8±2.3, S2F 36.3±0.9, S2Max 40.3±1.8, S3F 36.3±0.9, S3Max 40.7±2.9). No statistically significant difference was determined between the 3 sensors in the distribution of the maximum and initial heat (p>0.05). A statistically significant difference was determined regarding the distribution of VAS values in the teeth and lips (p<0.001). The pain felt in the upper lip (6±2) was significantly greater than the pain felt in the teeth (5±2) (p<0.001). Conclusion: The increase in heat during upper lip laser epilation can be said to be safe for the dental pulp. The sensitivity and pain experienced during the procedure are due to the heat increase. The use of a white-coloured appliance is recommended during upper lip laser epilation.

Ethical Concerns in Dermatology and Cosmetic Applications

Our aim in this article is to consider ethical concerns and sensitivities in Dermatology and Cosmetic applications. It is appropriate for dermatologists to make cosmetic applications and use artificial intelligence aid as experts who know the structure and diseases of the skin best. The practice of cosmetology by physicians other than dermatologists creates ethical problems. Women are especially more interested in dermatology. Body dysmorphic disorders are more common in women. When dermatologists evaluate the cosmetic dermatology patient and create a treatment plan, if there are unrealistic expectations, the patient should be guided correctly by considering the patient's wishes. Social media applications, which have attracted attention in recent years, have caused an increase in body dysmorphic disorders in individuals. Cosmetology is a division that can never be separated from dermatology. Patients frequently apply to cosmetic dermatology because of hyperpigmentation problems, aging problems, hair problems, toxin applications, dermal filler procedures, chemical peels, and mesotherapy, and ablative laser procedures. Burns resulting from laser epilation applications performed in aesthetic centers, complications such as tissue necrosis caused by dermal filler procedures performed by non-physicians, cosmetic problems, soft tissue infections, and allergic reactions resulting from applications such as mesotherapy and platelet-rich plasma are diseases frequently seen in dermatology outpatient clinics. Another important issue is the materials used in platelet-rich plasma, mesotherapy, toxin application, and dermal filler applications must be in the Class 3 Medical device category. Patients who apply to clinics for treatment should be made aware of this issue and patients should be protected from the complications that these medications may cause. Physicians should not use products that do not have class 3 certificates in cosmetic dermatology to keep the cost of the product low, especially when choosing materials. In medicine, there is always an aesthetic concern beyond technical or even scientific concerns. We think that it is necessary to express and elaborate on the concerns arising from the ethical issues that are experienced or may be experienced in dermatology practices. Physicians always try to take the patient's psychological and pathological problems into consideration. However, ethical concerns should not be forgotten when treating the field of aesthetics.

Effects of the association between hydroxyapatite and photobiomodulation on bone regeneration

&lt;abstract&gt;&lt;sec&gt; &lt;title&gt;Background&lt;/title&gt; &lt;p&gt;Hydroxyapatite (HA)-based ceramics are widely used as artificial bone substitutes due to their advantageous biological properties, which include biocompatibility, biological affinity, bioactivity, ability to drive bone formation, integration into bone tissue and induction of bone regeneration (in certain conditions). Phototherapy in bone regeneration is a therapeutic approach that involves the use of light to stimulate and accelerate the process of repair and regeneration of bone tissue. There are two common forms of phototherapy used for this purpose: Low-Level Laser Therapy (LLLT) and LED (Light Emitting Diode) Therapy. Understanding the mechanisms of laser therapy and its effects combined with hydroxyapatite has gaps. Therefore, this review was designed based on the PICO strategy (P: problem; I: intervention; C: control; O: result) to analyze the relationship between PBM therapy and hydroxyapatite.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Methods&lt;/title&gt; &lt;p&gt;The bibliographic search, with the descriptors “hydroxyapatite AND low-level laser therapy” and “hydroxyapatite AND photobiomodulation” resulted in 43 articles in the PubMed/MEDLINE database, of which 1 was excluded for being a duplicate and another 33 due to inclusion/exclusion criteria, totaling 9 articles for qualitative analysis. In the Web of Science database, we obtained 40 articles, of which 7 were excluded for being duplicates, 1 for not having the full text available and another 17 due to inclusion/exclusion criteria, totaling 15 articles for qualitative analysis.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Results&lt;/title&gt; &lt;p&gt;The most used biomaterial was composed of hydroxyapatite and β-tricalcium phosphate in a proportion of 70%–30%. In photobiomodulation, the gallium-aluminum-arsenide (GaAlAs) laser prevailed, with a wavelength of 780 nm, followed by 808 nm.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Conclusions&lt;/title&gt; &lt;p&gt;The results indicated that the use of laser phototherapy improved the repair of bone defects grafted with the biomaterial, increasing the deposition of HA phosphate as indicated by biochemical estimators, spectroscopy and histological analyses.&lt;/p&gt; &lt;/sec&gt;&lt;/abstract&gt;

Clinical Cases of Anterior Cervical Hypertrichosis

Anterior cervical hypertrichosis (ACH) may be only an isolated aesthetic finding, but it may also be associated with other underlying conditions, including neurological and ocular disorders. In order to recognize this uncommon entity, it is imperative to provide detailed physical examination and clinical history to exclude the possible associated abnormalities in patients with ACH. In those cases that ACH represents only a cosmetic problem for the patient, laser hair removal is recommended. We hereby presented 2 cases of ACH in two young girls and discussed about all the differential diagnoses and how to rule out associated anomalies. The most useful workout to rule out associated underlying conditions are described, and cosmetic treatment with laser hair removal devices is also commented.

Comparative Study Between Normal Traditional Methods in Hair Removal and Recent Laser Technology

The types of laser instruments used for patients’ treatment were: Cynosure Elite Laser, Epicare Alexnrite Laser, Candle Gentle Yag Laser hair removal machine, Diod Lser hair removal, Gentle Laser plus. The studies' goal is to comparing traditional hair removal methods (such as wet shave or waxing) with laser technique in order to conduct clinical trials. The findings of the first group, in which 165 people took part, revealed that pain produced by wound infection in the time following the process is significantly associated with the existence and severity of postoperative wound infection. When it comes to preoperative hair removal, namely after shaving, it is highly connected with the existence and severity of skin injuries of various ranks suffered during the procedure. The second group, which included 190 competitors (160 females, 30 males). The findings revealed a breakdown of the adverse effects that were noticed and documented during the course of the research. 44.1 percent of the population has skin sensitivity, 2.8 percent has skin irritation, 14.5 percent has erythema, 24.1 percent has burns, and 14.5 percent has hyperpigmentation, according to the study. Additionally, a comparison and contrast of ethnicity, as well as the effects of traditional and laser treatment methods, were included in the study. The samples, which were identified by ethnicity, were collected from several clinics around the state and compared to the results of the study (which used traditional and laser methodologies) conducted in Erbil. There was no statistically meaningful variation between the two groups based on those assessments.

Facial Expansion: A Blueprint for Coverage.

The benefits of tissue expansion go unrealized if flap design and coverage concepts do not exist in preoperative thinking. Without proper analysis, the surgeon will likely burden the patient with more expanders than necessary. Tissue coverage needs can be simplified in forms of triangles and rectangles to determine expanded tissue advancement. Single or double back-cuts allow use of all the expanded tissue. Furthermore, early subtotal excisions, especially in children younger than 4 months, can reduce the number of expanders required. With methods presented herein, the face can be resurfaced with better color and less distortion. Eyebrows should be maintained and positioned by keeping the lower frontalis muscles intact. Cheeks can be covered with a large Schrudde design, and color can be improved by using upper neck skin preferentially over lower neck harvest. Laser hair removal allows larger swaths of forehead to be covered by hair-bearing scalp tissue. Prior incisional delay can expedite success with no tissue loss. The results speak for themselves when surfaces are covered with large, expanded flaps that are expeditiously harvested.

Targeted Drug Delivery System Based on Copper Sulfide for Synergistic Near-Infrared Photothermal Therapy/Photodynamic Therapy/Chemotherapy of Triple Negative Breast Cancer

Multi-modal synergistic therapy, especially the integration of near-infrared laser phototherapies and chemotherapy, is often sought after owing to its minimal invasiveness, low side effects, and improved anticancer therapeutic efficacy. Herein, CuS nanoparticles were first coated with zinc phthalocyanine derivant (Pc)-functionalized mesoporous silica (mSiO2-Pc) to achieve a drug delivery system (CuS@mSiO2-Pc) with photothermal/photodynamic therapy. Chemical drug DOX was subsequently loaded for chemotherapy, and hyaluronic acid (HA) was employed as a covering material with cancer targeting. The as-obtained CuS@mSiO2-Pc(DOX)@HA nanoparticles were nano-sized with good biocompatibility, effective DOX loading, and controllable DOX releasing. Expectedly, this multifunctional nanoplatform exhibits effective generation of reactive oxygen species and hyperthermia upon the near-infrared laser irradiation. Most importantly, the nanoparticles were targeted into 4T1 cells and showed significantly remarkable cytotoxicity under near-infrared laser irradiation, proving their synergistic therapeutic efficacy. Therefore, this targeted drug system based on CuS with synergistic photothermal therapy/photodynamic therapy/chemotherapy has great application prospects in clinical anticancer treatment for triple negative breast cancer.

Laser-Induced Smoke in Dermatologic Practice: A Survey to Explore Hazard Perceptions, Safety Measures and Unmet Needs.

Introduction: Inhalation of laser-induced smoke is a potential health hazard to exposed physicians and laser operators. To date, little is known about the perception of health hazards related to laser-induced smoke exposure among physicians and the actual use of safety measures to mitigate these risks. Methods: In May 2020, 514 members of the European Society for Lasers and Energy-Based Devices (ESLD) were invited by email to participate in an online survey. The survey comprised 16 questions including multiple-choice and open-ended questions. Results: Responses were received from 109 participants. The majority (90%) were aware of potential hazards and highlighted a desire for better protective measures (60%). A smoke evacuation system was frequently used with ablative lasers (66%) and fractional ablative lasers (61%), but less the case with non-ablative lasers (30%) and hair removal lasers (28%). The COVID-19 outbreak had no clear effect on the use of smoke evacuation systems. Prior to the COVID-19 outbreak, mainly surgical masks were used (40-57%), while high filtration masks (FFP1, FFP2 or FFP3) were used by only a small percentage (15-30%). Post COVID-19 outbreak, the use of high filtration masks increased significantly (54-66%), predominately due to an increase in the use of FFP2 masks. Reasons mentioned for inadequate protective measures were sparse knowledge, limited availability, discomfort, excessive noise, high room temperatures, and financial costs. Conclusion: While there is considerable awareness of the hazards of laser-induced smoke among physicians and laser operators, a substantial number of them do not use appropriate protective measures. The implementation of regulations on safety measures is hampered by sparse knowledge, limited availability, discomfort, excessive noise, financial issues, and high room temperatures.