Intraepidermal erbium:YAG laser resurfacing

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Intraepidermal erbium:YAG laser resurfacing Jeffrey S. Orringer, MD, Laure Rittié, PhD, Ted Hamilton, MS, Darius J. Karimipour, MD, John J. Voorhees, MD, FRCP, Gary J. Fisher, PhD Journal of the American Academy of Dermatology Volume 64, Issue 1, Pages 119-128 (January 2011) DOI: 10.1016/j.jaad.2010.02.058 Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Single-pass treatment of photodamaged human skin with Er:YAG laser does not disrupt basement membrane. Photodamaged forearm skin was treated with a single pass of Er:YAG laser as described in Methods section. Samples were obtained from untreated (A) and treated (B) skin 24 hours after treatment. Skin was sectioned and immunostained for laminin γ2 to reveal the contour of the basement membrane. Positive staining is red, counter staining is blue. Images are representative of 10 subjects. (Original magnification: ×20.) Journal of the American Academy of Dermatology 2011 64, 119-128DOI: (10.1016/j.jaad.2010.02.058) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Er:YAG laser treatment induces keratin 16 in human skin in vivo. Photodamaged forearm skin was treated with a single pass of Er:YAG laser as described in Methods section. Untreated (No Tx) and treated skin samples were obtained at indicated times posttreatment. Skin sections were immunostained to reveal expression of keratin 16 (KRT16). A, KRT16-positive staining is red; counterstaining is blue. Images are representative of 6 subjects. (Original magnification: ×40.) B, Quantification by image analysis of KRT16 staining at indicated times after Er:YAG laser treatment, in human skin in vivo; N = 6. Asterisk, P < .05. Journal of the American Academy of Dermatology 2011 64, 119-128DOI: (10.1016/j.jaad.2010.02.058) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Er:YAG laser treatment induces epidermal proliferation in human skin in vivo. Photodamaged forearm skin was treated with a single pass of Er:YAG laser as described in the Methods section. Skin samples were obtained from untreated (No Tx) and treated skin at indicated times posttreatment. Skin sections were immunostained for the proliferation marker Ki67. A, Ki67-positive staining is red, counterstaining is blue. Images are representative of 6 subjects. (Original magnification: ×40.) B, Quantification by image analysis of Ki67 staining at indicated times after erbium:YAG laser treatment, in human skin in vivo; N = 6. Asterisk, P < .05. Journal of the American Academy of Dermatology 2011 64, 119-128DOI: (10.1016/j.jaad.2010.02.058) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Er:YAG laser treatment induces transcription factor AP-1 in human skin in vivo. Photodamaged forearm skin was treated with a single pass of Er:YAG laser as described in the Methods section. Skin samples were obtained from untreated (No Tx) and treated skin at indicated times posttreatment. Skin sections were immunostained for transcription factor AP-1 components cJun (A) and JunB (C). A, cJun-positive staining is red; counter staining is blue. Images are representative of 6 subjects. (Original magnification: ×40.) B, Quantification by image analysis of cJun staining at indicated times after Er:YAG laser treatment, in human skin in vivo. N = 10; Asterisk, P < .05. C, JunB positive staining is red; counterstaining is blue. Images are representative of 6 subjects. (Original magnification: ×40.) D, Quantification by image analysis of JunB staining at indicated times after Er:YAG laser treatment, in human skin in vivo. N = 10. Asterisk, P < .05. Journal of the American Academy of Dermatology 2011 64, 119-128DOI: (10.1016/j.jaad.2010.02.058) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 Er:YAG laser treatment induces expression of matrix metalloproteinases in human skin in vivo. Photodamaged forearm skin was treated with a single pass of Er:YAG laser as described in the Methods section. Skin samples were obtained from untreated (No Tx) and treated skin at the indicated times posttreatment. Total RNA was prepared from the specimens and mRNA levels of MMP-1 (A), MMP-3 (B), and MMP-9 (C) were quantified by real-time reverse transcriptase polymerase chain reaction (RT-PCR). N = 10. Asterisk, P < .05. Journal of the American Academy of Dermatology 2011 64, 119-128DOI: (10.1016/j.jaad.2010.02.058) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 6 Er:YAG laser treatment induces expression of MMPs in epidermis and dermis in human skin in vivo. Photodamaged forearm skin was treated with single pass of Er:YAG laser as described in Methods section. Skin samples were obtained from untreated (No Tx) and treated skin 24 hours posttreatment. Skin samples were sectioned and used for laser capture microdissection or immunostaining. A and B, Epidermis and dermis were separately obtained by laser capture microdissection. Total RNA was prepared from specimens and MMP-1 mRNA (A) and MMP-3 mRNA (B) were quantified by real-time RT-PCR. N = 3. C-E, Skin sections were immunostained for MMP-1 (C), MMP-3 (D), and MMP-9 (E). Positive staining is red; counter staining, blue. Images are representative of 6 subjects. (Original magnification: ×10.) Journal of the American Academy of Dermatology 2011 64, 119-128DOI: (10.1016/j.jaad.2010.02.058) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 7 Er:YAG laser treatment induces collagen production in human skin in vivo. Photodamaged forearm skin was treated with single pass of Er:YAG laser as described in Methods section. Skin samples were obtained from untreated (No Tx) and treated skin at indicated times posttreatment. A, Total RNA was prepared from the specimens and mRNA levels of type I procollagen (COL1) and type III procollagen (COL3) mRNA levels were quantified by real-time RT-PCR. N = 10. Asterisk, P < .05. B, Type I procollagen protein was quantified by immunoassay (ELISA). N = 10. Asterisk, P < .05. C, Skin sections were immunostained for type I procollagen. Positive staining is red; counterstaining is blue. Images are representative of 10 subjects. (Original magnification: ×10.) Journal of the American Academy of Dermatology 2011 64, 119-128DOI: (10.1016/j.jaad.2010.02.058) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions