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Dermatology

New guidelines developed for laser-assisted drug delivery

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An evidence-based clinical practice guideline for the safe and effective use of laser-assisted drug delivery (LADD) for varying medical and cosmetic applications were recently developed by a multidisciplinary panel.

A systematic literature review identified 48 published studies of ablative fractional LADD including cosmetic studies (n = 4); oncologic (n = 21); and medical (n = 23). At the request of the expert panel,6 additional publications on nonablative fractional LADD were included. Thirty-four studies (63.0%) were deemed to have low risk of bias, 17 studies (31.5%) had moderate risk, and 3 (5.5%) had serious risk.

Key findings on LADD included:

-It is safe for individuals ≥12 years of age, with all Fitzpatrick skin type
-It is safe for immunosuppressed patients
-It is effective actinic keratosis, cutaneous squamous cell carcinoma in situ, actinic cheilitis, hypertrophic scars, and keloids
-It is useful for epidermal and dermal analgesia
-Drug delivery may be increased through the application of heat, pressure, or occlusion, or by using an aqueous drug solution
-Laser settings should be selected to ensure that channel diameter is greater than the delivered molecule
-With the exception of impaired wound healing, antibiotic prophylaxis is not recommended,
-For the treatment of the face and genitalia, antiviral prophylaxis is recommended
The guideline’s 15 recommendations address 5 areas of use of LADD: (I) indications and contraindications; (II) parameters to report; (III) optimization of drug delivery; (IV) safety considerations; and (V) prophylaxis for bacterial, viral, and fungal infections.

Reference
Labadie JG, Ibrahim SA, Worley B, et al. Evidence-Based Clinical Practice Guidelines for Laser-Assisted Drug Delivery. JAMA Dermatol. 2022 Aug 17. doi: 10.1001/jamadermatol.2022.3234. Epub ahead of print. PMID: 35976634.

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