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A lidocaine 7% and tetracaine 7% peel for local dermal anesthesia before cryotherapy treatment for actinic keratosis
P510
P512
A LIDOCAINE 7% AND TETRACAINE 7% PEEL FOR INDUCTION OF LOCAL DERMAL ANESTHESIA FOR NONABLATIVE FACIAL LASER RESURFACING Tina Alster, MD, Washington Institute of Dermatologic Laser Surgery, Washington, DC, United States; Daniel Stewart, DO, Midwest Cutaneous Research, Clinton Township, MI, United States
A LIDOCAINE 7% AND TETRACAINE 7% PEEL BEFORE PULSED DYE LASER THERAPY TO TREAT FACIAL LESIONS IN ADULTS Richard Fitzpatrick, MD, Dermatologic Associates of San Diego County, Inc., Encinitas, CA, United States; Ramsey Markus, MD, Baylor Dermatology, Houston, TX, United States; Tina Alster, MD, Washington Institute of Dermatologic Laser Surgery, Washington, DC, United States Objective: The lidocaine 7% and tetracaine 7% (LT) peel is a self-occlusive topical local anesthetic that has been studied for a variety of dermatologic procedures. The LT peel applies as a cream and, when exposed to air, dries and forms a flexible membrane that can be easily peeled off. Its efficacy and safety were compared with placebo peel for induction of local dermal anesthesia before pulsed dye laser (PDL) therapy for the treatment of facial vascular lesions in adult patients.
Introduction: The lidocaine 7% and tetracaine 7% (LT) peel is a self-occlusive topical local anesthetic that has been studied for a variety of dermatologic procedures. The LT peel applies as a cream and, when exposed to air, dries and forms a flexible membrane that can be easily peeled off. The efficacy and safety of the LT peel for local dermal anesthesia during nonablative facial skin resurfacing were evaluated in a randomized, double-blind, placebo-controlled study. Methods: The LT peel and a placebo cream were applied concurrently to the treatment area for 30 minutes and then removed before laser irradiation. Patients (N = 40; age 46.6 6 11.4 years [mean 6 SD]) were randomized in double-blind fashion to receive the LT peel on either the right or left side of the facial treatment area and the placebo cream on the contralateral treatment half. The primary efficacy measure was the patient’s evaluation of procedural pain using a 100-mm (0 mm = no pain; 100 mm = worst pain) Visual Analog Scale (VAS). Secondary efficacy measures included subject, independent observer, and investigator’s assessments of the adequacy of pain relief, and if the subject would use the product again for a similar procedure. Results: Mean VAS scores were significantly lower with the LT peel than with the placebo peel (31.0 vs. 54.5 mm; P \ .001). More patients reported adequate anesthesia with the LT peel than with the placebo peel (78% vs. 18%; P \.001). Based on the investigator’s assessment, 93% of patients receiving the LT peel and 58% of those receiving the placebo peel had no or slight pain (P \ .001). Local adverse events with the LT peel (transient erythema, edema, skin discoloration, contact dermatitis) occurred at rates similar to those of the placebo peel. Conclusion: The LT peel provided clinically useful local anesthesia for nonablative facial resurfacing in adult patients and was well tolerated.
Methods: This was a randomized, double-blind, placebo-controlled study. Adult patients (N = 60; mean age 44 years) received LT or placebo peel before undergoing facial PDL therapy (mean area: 60 cm2 LT peel, 64 cm2 placebo). The primary measure of efficacy was the subject’s evaluation of pain using the 100-mm (0 mm = no pain; 100 mm = worst pain) Visual Analog Scale (VAS). Results: The VAS score was significantly lower with LT peel compared with placebo peel (16.2 mm vs. 36.3 mm; P\.001). Significantly more patients reported adequate pain relief with LT peel than with placebo peel (90% vs. 37%; P \ .001). The investigator rated significantly more patients receiving adequate anesthesia with LT peel compared with placebo (93% vs. 47%; P \.001). LT peel was well tolerated. One LT patient experienced tingling that was mild in severity, starting 5 minutes before peel removal, but resolving within 2 hours without action. Conclusion: The novel LT peel was efficacious and well tolerated in providing clinically useful local dermal anesthesia for PDL therapy to treat facial vascular lesions in adult patients. Study funded by and poster sponsored by Zars Corporation
25% of research supported by Zars Corporation
P511 A LIDOCAINE 7% AND TETRACAINE 7% PEEL FOR LOCAL DERMAL ANESTHESIA BEFORE CRYOTHERAPY TREATMENT FOR ACTINIC KERATOSIS Leonard Goldberg, MD, Dermsurgery Associates, Houston, TX, United States Objective: The lidocaine 7% and tetracaine 7% (LT) peel is a self-occlusive topical local anesthetic that has been studied for a variety of dermatologic procedures. The LT peel applies as a cream and, when exposed to air, dries and forms a flexible membrane that can be easily peeled off. Its clinical effectiveness and safety were compared with a placebo peel for local dermal anesthesia before cryotherapy in adults. Methods: This was a randomized, double-blind, placebo-controlled study. Adult patients (N = 20; mean age 72.6 years) received concurrent 30-minute applications of the LT peel and the placebo peel randomized to the top/right or bottom/left side of the treatment surface. After peel removal, cryotherapy with liquid nitrogen spray for treatment of actinic keratosis on the face was performed. The primary measure of efficacy was the subject’s evaluation of pain using the 100-mm (0 mm = no pain; 100 mm = worst pain) Visual Analog Scale (VAS). Results: The VAS score was significantly lower with the LT peel compared with the placebo peel (17 mm vs. 47 mm; P = .002). Significantly more patients reported adequate pain relief with the LT peel than with the placebo peel (65% vs. 20%; P = .007). The investigator rated significantly more patients receiving adequate anesthesia with the LT peel compared with the placebo peel (80% vs. 25%; P = .005). The LT peel was well tolerated. Three patients in the LT group experienced minor transient local reactions. No patient experienced a severe reaction to the peel. Conclusion: A 30-minute application of a novel LT peel provided clinically useful topical local anesthesia before cryotherapy for the treatment of actinic keratosis on the face in adults. Sponsored by Zars Corporation
P44
J AM ACAD DERMATOL
P513 A PILOT STUDY ON THE USE OF A PLASMA SKIN REGENERATION DEVICE (PSR) IN FULL FACIAL REJUVENATION PROCEDURES Suzanne Kilmer, MD, Laser & Skin Surgery Center of Northern California, Sacramento, CA, United States; Natalie Semchyshyn, MD; Geeta Shah, MD; Richard Fitzpatrick, MD, Dermatology Associates, San Diego, CA, United States Purpose: Carbon dioxide laser resurfacing has decreased in popularity because of the high morbidity and downtime associated with its use. A new modality, the Plasma Skin Regeneration (PSR) System, allows precise and rapid treatment of tissue with minimal thermal injury. We evaluated the PSR technology in full facial rejuvenation procedures to assess recovery and outcome. Methods: Twenty-four patients were allocated to 3 groups treated with a single pass at 3 J, 3.5 J, or 4 J under topical anesthesia. Two-millimeter punch biopsy specimens were taken for histopathological analysis before treatment and at 90 days after treatment. Healing time, perioperative discomfort, duration and degree of erythema, quality of regenerated epidermis, and dermal remodeling, including neocollagenesis, were assessed. Results: All patients tolerated the procedure well and fully reepithelialized by day 7, with a shorter than anticipated recovery period. Erythema was mild to moderate by 1 week and nearly clear by 2 weeks. Mild hyperpigmentation was noted and responded to topical treatment. Patients were very pleased with improvement at day 30. Early biopsies showed collagen remodeling. Day 90 clinical and histological results will be presented. Conclusions: The Gyrus PSR system provides an attractive alternative to standard lasers that is well tolerated by patients, stimulates collagen remodeling, and provides excellent clinical outcome. Nothing to disclose.
MARCH 2005
P512
A LIDOCAINE 7% AND TETRACAINE 7% PEEL FOR INDUCTION OF LOCAL DERMAL ANESTHESIA FOR NONABLATIVE FACIAL LASER RESURFACING Tina Alster, MD, Washington Institute of Dermatologic Laser Surgery, Washington, DC, United States; Daniel Stewart, DO, Midwest Cutaneous Research, Clinton Township, MI, United States
A LIDOCAINE 7% AND TETRACAINE 7% PEEL BEFORE PULSED DYE LASER THERAPY TO TREAT FACIAL LESIONS IN ADULTS Richard Fitzpatrick, MD, Dermatologic Associates of San Diego County, Inc., Encinitas, CA, United States; Ramsey Markus, MD, Baylor Dermatology, Houston, TX, United States; Tina Alster, MD, Washington Institute of Dermatologic Laser Surgery, Washington, DC, United States Objective: The lidocaine 7% and tetracaine 7% (LT) peel is a self-occlusive topical local anesthetic that has been studied for a variety of dermatologic procedures. The LT peel applies as a cream and, when exposed to air, dries and forms a flexible membrane that can be easily peeled off. Its efficacy and safety were compared with placebo peel for induction of local dermal anesthesia before pulsed dye laser (PDL) therapy for the treatment of facial vascular lesions in adult patients.
Introduction: The lidocaine 7% and tetracaine 7% (LT) peel is a self-occlusive topical local anesthetic that has been studied for a variety of dermatologic procedures. The LT peel applies as a cream and, when exposed to air, dries and forms a flexible membrane that can be easily peeled off. The efficacy and safety of the LT peel for local dermal anesthesia during nonablative facial skin resurfacing were evaluated in a randomized, double-blind, placebo-controlled study. Methods: The LT peel and a placebo cream were applied concurrently to the treatment area for 30 minutes and then removed before laser irradiation. Patients (N = 40; age 46.6 6 11.4 years [mean 6 SD]) were randomized in double-blind fashion to receive the LT peel on either the right or left side of the facial treatment area and the placebo cream on the contralateral treatment half. The primary efficacy measure was the patient’s evaluation of procedural pain using a 100-mm (0 mm = no pain; 100 mm = worst pain) Visual Analog Scale (VAS). Secondary efficacy measures included subject, independent observer, and investigator’s assessments of the adequacy of pain relief, and if the subject would use the product again for a similar procedure. Results: Mean VAS scores were significantly lower with the LT peel than with the placebo peel (31.0 vs. 54.5 mm; P \ .001). More patients reported adequate anesthesia with the LT peel than with the placebo peel (78% vs. 18%; P \.001). Based on the investigator’s assessment, 93% of patients receiving the LT peel and 58% of those receiving the placebo peel had no or slight pain (P \ .001). Local adverse events with the LT peel (transient erythema, edema, skin discoloration, contact dermatitis) occurred at rates similar to those of the placebo peel. Conclusion: The LT peel provided clinically useful local anesthesia for nonablative facial resurfacing in adult patients and was well tolerated.
Methods: This was a randomized, double-blind, placebo-controlled study. Adult patients (N = 60; mean age 44 years) received LT or placebo peel before undergoing facial PDL therapy (mean area: 60 cm2 LT peel, 64 cm2 placebo). The primary measure of efficacy was the subject’s evaluation of pain using the 100-mm (0 mm = no pain; 100 mm = worst pain) Visual Analog Scale (VAS). Results: The VAS score was significantly lower with LT peel compared with placebo peel (16.2 mm vs. 36.3 mm; P\.001). Significantly more patients reported adequate pain relief with LT peel than with placebo peel (90% vs. 37%; P \ .001). The investigator rated significantly more patients receiving adequate anesthesia with LT peel compared with placebo (93% vs. 47%; P \.001). LT peel was well tolerated. One LT patient experienced tingling that was mild in severity, starting 5 minutes before peel removal, but resolving within 2 hours without action. Conclusion: The novel LT peel was efficacious and well tolerated in providing clinically useful local dermal anesthesia for PDL therapy to treat facial vascular lesions in adult patients. Study funded by and poster sponsored by Zars Corporation
25% of research supported by Zars Corporation
P511 A LIDOCAINE 7% AND TETRACAINE 7% PEEL FOR LOCAL DERMAL ANESTHESIA BEFORE CRYOTHERAPY TREATMENT FOR ACTINIC KERATOSIS Leonard Goldberg, MD, Dermsurgery Associates, Houston, TX, United States Objective: The lidocaine 7% and tetracaine 7% (LT) peel is a self-occlusive topical local anesthetic that has been studied for a variety of dermatologic procedures. The LT peel applies as a cream and, when exposed to air, dries and forms a flexible membrane that can be easily peeled off. Its clinical effectiveness and safety were compared with a placebo peel for local dermal anesthesia before cryotherapy in adults. Methods: This was a randomized, double-blind, placebo-controlled study. Adult patients (N = 20; mean age 72.6 years) received concurrent 30-minute applications of the LT peel and the placebo peel randomized to the top/right or bottom/left side of the treatment surface. After peel removal, cryotherapy with liquid nitrogen spray for treatment of actinic keratosis on the face was performed. The primary measure of efficacy was the subject’s evaluation of pain using the 100-mm (0 mm = no pain; 100 mm = worst pain) Visual Analog Scale (VAS). Results: The VAS score was significantly lower with the LT peel compared with the placebo peel (17 mm vs. 47 mm; P = .002). Significantly more patients reported adequate pain relief with the LT peel than with the placebo peel (65% vs. 20%; P = .007). The investigator rated significantly more patients receiving adequate anesthesia with the LT peel compared with the placebo peel (80% vs. 25%; P = .005). The LT peel was well tolerated. Three patients in the LT group experienced minor transient local reactions. No patient experienced a severe reaction to the peel. Conclusion: A 30-minute application of a novel LT peel provided clinically useful topical local anesthesia before cryotherapy for the treatment of actinic keratosis on the face in adults. Sponsored by Zars Corporation
P44
J AM ACAD DERMATOL
P513 A PILOT STUDY ON THE USE OF A PLASMA SKIN REGENERATION DEVICE (PSR) IN FULL FACIAL REJUVENATION PROCEDURES Suzanne Kilmer, MD, Laser & Skin Surgery Center of Northern California, Sacramento, CA, United States; Natalie Semchyshyn, MD; Geeta Shah, MD; Richard Fitzpatrick, MD, Dermatology Associates, San Diego, CA, United States Purpose: Carbon dioxide laser resurfacing has decreased in popularity because of the high morbidity and downtime associated with its use. A new modality, the Plasma Skin Regeneration (PSR) System, allows precise and rapid treatment of tissue with minimal thermal injury. We evaluated the PSR technology in full facial rejuvenation procedures to assess recovery and outcome. Methods: Twenty-four patients were allocated to 3 groups treated with a single pass at 3 J, 3.5 J, or 4 J under topical anesthesia. Two-millimeter punch biopsy specimens were taken for histopathological analysis before treatment and at 90 days after treatment. Healing time, perioperative discomfort, duration and degree of erythema, quality of regenerated epidermis, and dermal remodeling, including neocollagenesis, were assessed. Results: All patients tolerated the procedure well and fully reepithelialized by day 7, with a shorter than anticipated recovery period. Erythema was mild to moderate by 1 week and nearly clear by 2 weeks. Mild hyperpigmentation was noted and responded to topical treatment. Patients were very pleased with improvement at day 30. Early biopsies showed collagen remodeling. Day 90 clinical and histological results will be presented. Conclusions: The Gyrus PSR system provides an attractive alternative to standard lasers that is well tolerated by patients, stimulates collagen remodeling, and provides excellent clinical outcome. Nothing to disclose.
MARCH 2005