Laser imaging, diagnosis among latest advancements in dermatology

Key Points

Phoenix - Medical applications were not part of the vision held by the earliest laser pioneers, but in 2010 (which marks the 50th anniversary of the first laser), this technology represents an essential tool for many medical specialties - including dermatology.

This year also marks the 30th anniversary of the American Society for Laser Medicine and Surgery (ASLMS), and material presented at the Society's 2010 annual conference highlighted future promise in the field.

"These noninvasive fat removal procedures are an emerging area and do not match traditional liposuction with respect to the amount of tissue that can be removed. However, there is significant consumer interest in these new techniques because of their potential convenience and benefit without the need for a more invasive procedure," Dr. Avram says.

Imaging and diagnosis

The development of lasers for imaging and diagnosis in dermatology is also ongoing.

Within this realm, one area of interest involves the development of continuous wave terahertz technology for imaging skin cancers and providing intraoperative guidance on tumor margins.

Terahertz imaging is used in airport full-body scanners, and in an initial study of a dermatologic application, researchers using a CO₂ laser-pumped far-infrared gas laser as the terahertz source reported its utility for identifying significant differences in the refractive indices of cancerous versus normal skin.

According to Dr. Anderson, professor of dermatology, Harvard Medical School; director, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston; and ASLMS president, "With the promise of laser imaging, I am beginning to view biopsy as a barbaric procedure for diagnosing dermatologic conditions." He adds that laser imaging also has exciting application for enhancing outcomes of laser procedures, as it can provide real-time intraoperative guidance via monitoring of tissue and vascular changes.

Tissue reactions

Other research aiming to overcome the limitations of current techniques goes back to the roots of the medical laser industry in terms of improved understanding of the physics of light and tissue interactions. For example, elucidation of changes in the optical properties of blood as it coagulates when heated by a laser is being considered as the basis for developing multiwavelength lasers that may be more effective in clearing vascular lesions, Dr. Barton says.

"We know from our clinical outcomes with existing technology that the responses achieved do not always coincide with those predicted based on physical models," she says.

Use of topical antiangiogenic therapy following laser treatment is also being investigated as a means to improve outcomes of laser treatment for port wine stains and other cutaneous vascular lesions. The aim of this approach is the prevention of reperfusion of photocoagulated blood vessels, Dr. Barton says.