title: Nontuberculous mycobacterial infection after fractionated CO(2) laser resurfacing.
abstract: Nontuberculous mycobacteria are increasingly associated with cutaneous infections after cosmetic procedures. Fractionated CO2 resurfacing, a widely used technique for photorejuvenation, has been associated with a more favorable side effect profile than alternative procedures. We describe 2 cases of nontuberculous mycobacterial infection after treatment with a fractionated CO2 laser at a private clinic. Densely distributed erythematous papules and pustules developed within the treated area within 2 weeks of the laser procedure. Diagnosis was confirmed by histologic analysis and culture. Both infections responded to a 4-month course of a multidrug regimen. An environmental investigation of the clinic was performed, but no source of infection was found. The case isolates differed from each other and from isolates obtained from the clinic, suggesting that the infection was acquired by postprocedure exposure. Papules and pustules after fractionated CO2 resurfacing should raise the suspicion of nontuberculous mycobacterial infection.
authors.affiliation: University of North Carolina, Chapel Hill, NC 27514, USA
authors.forename: Donna A
authors.initials: DA
authors.lastname: Culton
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lachiewicz
authors.forename: Becky A
authors.initials: BA
authors.lastname: Miller
authors.forename: Melissa B
authors.initials: MB
authors.lastname: Miller
authors.forename: Courteney
authors.initials: C
authors.lastname: Mackuen
authors.forename: Pamela
authors.initials: P
authors.lastname: Groben
authors.forename: Becky
authors.initials: B
authors.lastname: White
authors.forename: Gary M
authors.initials: GM
authors.lastname: Cox
authors.forename: Jason E
authors.initials: JE
authors.lastname: Stout
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003357:Cosmetic Techniques / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000009:adverse effects*; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Mycobacterium abscessus; Mycobacterium chelonae; NTM; bacteria; cosmetic techniques; fractionated CO2 laser resurfacing; nontuberculous mycobacteria; nontuberculous mycobacterial infection; tuberculosis and other mycobacteria