SM4. Eumnpean Nail Society
(2) PLS is non-monochromatic light The light of an IPLS, due to the fact that it is non-monochromatic, can be used for several indications. By changing the barrier filters light of different wavelengths can be created, so that pigmented and vascular lesions can be treated with the same source. World-wide the photoderm VL Rashlamp is the most used IPLS. Major indications are vascular disturbances including rosacea teleangiectatica, port wine stains, but also inflammatations and teleangiectasias on the legs. A new and interesting field is the epilation with IPLS. A special device is on the market, which is in fact a photoderm, but specially trimmed for epilation. Non-pulsed intense light sources can also be used for photodynamic therapy. IPLS’ have there place besides lasers in the treatment of several dermatoses, but it is not yet the apparatus which can be used for all indications of light flash laser therapy.
SM3-13 Hair follicles laser targeting: Theory and applications M. Drosner. Lmen-etrter
For permanent destruction of the hair the tissue of matrix and papilla (both can rebuild individually a hair follicle) has to be destroyed. Because the target melanin only is present in the matrix the delivered thermal energy has to be high enough to destroy matrix and papilla being close together only in the early anagen phase. However, light scattering and absorption by other chromophores (hair shafts, hemoglobin, melanin in darker skin, water) on its long (2-5 mm) way down to the matrix and little pigmentation in other than black hair interfere with the thermal destruction. Several techniques are used to reach the goal of permanent removal of pigmented hair. Long pulsed light of lasers (alexandrite 755 nm, diode 800 nm, ruby 694 nm) or intense light sources (590-1200 nm) is applied with and without cooling devices. None of those have yet proved to achieve permanent hair removal. There are still many questions open to be answered: What are the optimal physical parameters (wavelength, pulse duration, energy fluenee? How many repeated treatments are necessary and how long should be the interval in between in each region of the body?
With most of these systems it is important to perform careful test treatments particularly in subjects that have darker skin phototypes. Laser hair removal systems continue to be evaluated, some showing long-term efficacy.
European Nail Society Symposium
SM4-1 Onychomycosis in children: Our experience in an outpatient clinic Rosamary Soto. Pilar de la Sotta. Deporrrnent Porrtificio
Onychomycois is less frequent in children below I5 than in adults. Appropriate nail samples were obtained for light microscopy and culture from patients with clinical suspicion of onychomycosis. Results: A number of 70 children were found to have ungual diseases in the last 6 years. Onychomycosis was confirmed in I8 of them (25.7%). I4 males and 4 females between 2 and IS years of age, with an average ?I 8 years. From this group, I2 children (67.7%) had a parent or grandparent with onychomycosis. The principal associated diseases were: nail malalignment in 5 cases, tinea pedis in 2, and tinea manuum in I case. Toenails were affected in I3 patients, fingernails in 2 and both in 3. The clinical types of onychomycosis were DLSO in I5 cases, SW0 in 2, and PSO in one. Cultures were positive for T. NbNm in 13 patients (72.2%) C. albicans in 3 (16.6%) C. parapsilosis in I (5.6%) and C. humicola in I case (5.6%). Management included topical therapy with amorolfine or ciclopirox nail lacquer (succeed in 4 pat), urea-bifonazole (failed in 2 pat with nail malalignment) oral griseofulvin (succeed in 3 pat, failed in I) oral terbinafine (succeed in 4 pat), oral itraconazole (succeed in 2 pat), 4 patients received no treatment. Onychomycosis is the principal nail disease in children in our outpatient clinic (25.7%). There is a high incidence of onychomycosis in the family of affected children (67.7%).
SM4-2 Squamous cell carcinoma of the nail bed R. Soto’, E. Hermosilla’.
SM3-14 1 Hair growth control: Long-term results Nicholas J. Lowe. Cranley Cavertdish
Clinic, Harcourt House, 19A WIM 9AD and UCH, London,
2Dpt of Allaton~opniholos~~ Chile, Chile UK
Several different lasers and laser related systems have been claimed for the treatment of unwanted hair growth. There has been variable success with these different systems.. They include long pulsed ruby and long pulsed alexandrite lasers. More recently diode laser systems have been evaluated for hair removal. A process utilizing carbon particles and Nd yag laser has also been developed. There is now relatively long term information on a long pulsed refrigerated Ruby system (Epilaser). The results suggest that with appropriate energy and treatment schedule that approximately 80% reduced hair growth is possible, two years after treatment.
S. Gonzalez*. ‘Dpt of Demnlology; PorrtiJcia
A 33 year old man, in good general condition, presented progressive nail changes on the second left toenail for a year. Despite the use of systemic and topical antimycotics and several surgical avulsions. no improvement was noted. Physical examination revealed secondary nail dystrophy, subungual debris, crusts, erythema and diffuse swelling of the distal toe. Laboratory findings: routine blood examination and affected toe x-rays were normal; KOH examination and culture where negative. Total surgical avulsion of the affected nail was performed. A 0.5 cm subungual solid tumor was found and excised. Histopathology showed an ulcerative squamous cell carcinoma of the nail bed with reticukar dermis invasion.