Meshkinpour et al (2005) examined the safety and effectiveness of the ThermaCool TC radiofrequency system for treatment of hypertrophic and keloid scars and assessed treatment associated collagen changes. Six subjects with hypertrophic and 4 with keloid scars were treated with the ThermaCool device: 1/3 of the scar received no treatment (control), 1/3 received one treatment and 1/3 received 2 treatments (4-week interval). Scars were graded before and then 12 and 24 weeks after treatment on symptoms, pigmentation, vascularity, pliability, and height. Biopsies were taken from 4 subjects with hypertrophic scars and evaluated with hematoxylin and eosin (H & E) staining, multi-photon microscopy, and pro-collagen I and III immunohistochemistry. No adverse treatment effects occurred. Clinical and H & E evaluation revealed no significant differences between control and treatment sites. Differences in collagen morphology were detected in some subjects. Increased collagen production (type III > type I) was observed, appeared to peak between 6 and 10 weeks post-treatment and had not returned to baseline even after 12 weeks. The authors concluded that use of the thermage radiofrequency device on hypertrophic scars resulted in collagen fibril morphology and production changes. ThermaCool alone did not achieve clinical hypertrophic scar or keloid improvement. They noted that the collagen effects of this device should be studied further to optimize its therapeutic potential for all indications.
Yang et al (2015) stated that peri-orbital microcystic lymphatic malformations (LM) can cause severe symptoms, such as blepharoptosis, amblyopia, chemosis, strabismus, diminished vision, and blindness. In a retrospective study, these researchers evaluated the clinical outcome in peri-orbital microcystic LM patients with blepharoptosis who underwent surgical treatment combined with intralesional bleomycin injection. A total of 9 patients diagnosed as peri-orbital microcystic LM with blepharoptosis were included in this study. All of them underwent surgical treatment and bleomycin injection from January 2010 to January 2014. The lesion was resected through the lower eyebrow and/or a coronal incision at the first stage, and levator resection was performed at the second stage. Any persistent lesion or its recurrence was managed by intralesional bleomycin injection. Blepharoptosis and visual obstruction were corrected in all patients. Mean follow-up was months; 6 patients had recurrence during follow-up; and 2 patients who had partial eyelid closure after the second stage surgery recovered in 3 months. Amblyopia, astigmatism, and strabismus were not improved after treatment. All patients had excellent aesthetic improvement and corrected blepharoptosis. The authors concluded that resection through a lower eyebrow and coronal incision and levator resection performed in 2 stages can quickly correct the visual impairment caused by peri-orbital microcystic LM with blepharoptosis. They stated that intralesional bleomycin injection is a promising adjunctive therapy for residual or recurrent lesions after surgery.