title: Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis.
abstract: Cutaneous leishmaniasis is an endemic disease in Iran. Unfortunately, it can lead to unsightly atrophic scars with limited treatment options. Fractional CO2 laser is accepted for treatment of atrophic acne scars and recently has been used to treat cutaneous leishmaniasis, so we planned to use fractional CO2 laser on leishmaniasis scar. We conducted this study on 60 leishmaniasis scars on the face of 40 patients. The lesions were treated by a fractional CO2 laser with beam size of 120 μm, with energy of 50-90 mJ, and 50-100 spots/cm(2) density with two passes in three monthly sessions. Evaluation was done in the first and second months after the first treatment and 3 and 6 months after the last treatment. Digital photography was performed at each visit. Assessment of improvement rate by patient and physician was rated separately as follows: no improvement (0%), mild (<25%), moderate (25-50%), good (51-75%), and excellent (76-100%). Based on patients' opinion, in the first and second follow-up, 48.3 and 90% of them reported moderate to excellent healing, respectively (p < 0.001). In 3 and 6 months follow-up after the end of the experiment, most of the patients (88.3 and 95%, respectively) reported moderate to excellent healing of scars. Based on two observers' opinion, healing in the first follow-up in most of the patients (65%) was mild to moderate and 33% were reported as having no healing. In the second follow-up, only 5% of the patients were reported with no healing and 60% were reported as having moderate healing (p < 0.001). In 3 and 6 months follow-up, most of the patients (95 and 96.6%) were reported as having moderate to excellent healing (p = <0.001). Our results underlined the high efficacy of fractional CO2 laser for leishmaniasis scar. No significant adverse effects were noted.
authors.affiliation: Cutaneous Leishmaniasis Research Center, Department of Dermatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Banihashemi
authors.affiliation: Cutaneous Leishmaniasis Research Center, Department of Dermatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. nahidiy@mums.ac.ir.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Nahidi
authors.affiliation: Cutaneous Leishmaniasis Research Center, Department of Dermatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Maleki
authors.affiliation: Health Sciences Research Center, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical sciences, Mashhad, Iran.
authors.forename: Habibollah
authors.initials: H
authors.lastname: Esmaily
authors.affiliation: School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Moghimi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002921:Cicatrix / Q000469:parasitology / Q000473:pathology / Q000532:radiotherapy*; D005145:Face / Q000473:pathology; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D054020:Lasers, Gas / Q000627:therapeutic use*; D016773:Leishmaniasis, Cutaneous / Q000473:pathology; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology* / Q000528:radiation effects; D016896:Treatment Outcome; D055815:Young Adult
keywords: Atrophic scar; Cutaneous leishmaniasis; Fractional CO2 laser