1. بسم الله الرحمن الرحيم Sudan University Of Sciences & Technology College of Graduate Studies The Utilization of Carbon Dioxide Laser (10600 nm) in Treatment of Skin tags A dissertation submitted for partial fulfillment of the requirements for the degree of post graduate diploma of laser applications in medicine/ dermatology BY: Dr. Yousif Tibin Mohammed Nour M. D. Dermatology Supervisor: Dr. Babikir Osman Elbashir Dr. Mahasin Mohamed Bello October 2014 بسم الله الرحمن الرحيم Sudan University Of Sciences & Technology College of Graduate Studies The Utilization of Carbon Dioxide Laser (10600 nm) in Treatment of Skin tags A dissertation submitted for partial fulfillment of the requirements for the degree of post graduate diploma of laser applications in medicine/ dermatology BY: Dr. Yousif Tibin Mohammed Nour M. D. Dermatology Supervisor: Dr. Babikir Osman Elbashir Dr. Mahasin Mohamed Bello October 2014

2. Askin tag is a small, soft, common, benign,usually pedunclated neoplasm that is found particularly in persons who are obese. It is usually skin colored or hyper pigmented, and it may appear as surface nodules or papillomas on healthy skin. Most skin tags vary in size from 2-5 mm in diameter, although larger skin tags up to 5 cm in diameter are some times evident. The most frequent localizations are the neck and the axillae, but any skin fold, including the groin, may be affected, figure.(1.5) Background

3. Figure (1.5) : skin tags.

4. The carbon dioxide laser (CO2 laser) was one of these lasers which still one of the most useful in this field. Background

5. General Objective: The objective of the study is to evaluate the effectiveness of Carbon-Dioxide laser and it’s complications in some Sudanese patients General Objective: The objective of the study is to evaluate the effectiveness of Carbon-Dioxide laser and it’s complications in some Sudanese patients OBJECTIVES

6. Pt. S/N Age yrs.Sex 144M 234M 332M 454F 542M 646M 739F 8 M 921M 1050M

7. Pt. S/N Sex 1M 2M 3M 4F 5M 6M 7F 8M 9M 10M

8. Pt. S/N Site of tags 1Neck 2 Face 3 4 5Axilla 6 7Neck 8 9 10Thigh

9. Pt. S/N Size of tags (mm) 12- 17 22-14 32-12 42-18 52-8 62-10 72-8 8 92-5 105

10. Pt. S/N No of sessions 12 22 31 42 51 62 71 81 91 101

11. Pt. S/N Complications After treatment 1Hypo 2 erosion 3Hypo 4 erosion 5Erosion pustule 6erosion 7Pustule 8erosion 9- 10Erosion

12. Pt. S/N Size of tags (mm) No of sessions Response to treatment Complications After treatment 12- 172v. goodHypo 22-142v. goodHypo erosion 32-121v. goodHypo 42-182GoodHypo erosion 52-81GoodErosion pustule 62-102Gooderosion 72-81v. good Pustule 82-81v. gooderosion 92-51v. good- 1051v. goodErosion

13. AgeFrequencyPercentage 15 – 24110% 25 – 34220% 35 – 44440% 45 - 54330% Total10100%

14. Site of skin tagsFrequencyPercentage Neck440% Neck + Face110% Face220% Axilla220% Thigh110% Total10100%

15. Reasons for removingFrequencyPercentage Cosmetics660% Irritation220% cosmetics+ irritation220% Total10100%

16. Response to laser treatmentFrequencyPercentage Excellent00% V. Good770% Good330% Bad00% Total10100%

17. ComplicationsFrequencyPercentage Hypo pigmentation220% Erosion330% Pustule110% None110% Hypo pigmentation+ erosion220% erosion+ Pustule110% Total10100%

18. Befor After 2 weeks Before After 2 weeks

19. Befor After 2 weeks

20. This is a prospective clinical descriptive study held in the Laser Institute clinic, Sudan University of Science and Technology 10 Sudanese patients are involved in this study, during the period from May to October 2014, after all patients agreed and signed a consent form. The laser used was CO2 laser 10600 nm. Materials And Methods

21. The parameters used were: power: 5 -8 watt, Exposure time : 0.2 sec, single mode, application direction: held cautiously perpendicular to the tag, duration: till shrinkage of the tag or removal of it. Materials And Methods

22. CO 2 Laser Surgical System.

23. The response of laser treatment for 7 patients (70%) was very good, 3 patients (30%) was good, and there were no excellent and bad response. The response to laser treatment for most patients (70%) was very good, because small sizes of tags which taken enough power in the first session, and others complete the treatment in the second session. Results

24. Response to laser treatment. PercentageFrequencyResponse to laser treatment 0%0Excellent 70%7V. Good 30%3Good 0%0Bad 100%10Total

25. From this study, we can conclude that the use of CO 2 laser in treating skin tags showed upper hand than other methods, because the CO 2 laser was easy to use, the response was very good to good, and the complications were, erosions,pustules, hypo pigmentation and hyper pigmentation Conclusion

26. It’s recommended to choose parameters according to the site of skin tags. Further researches are needed to establish the effectiveness of CO 2 laser 10600 nm parameters in the treatment of skin tags. More researches are needed in treating skin tags by other laser types. Long study period is needed for good assessment of treatment and to give more time for follow up. It’s recommended to choose parameters according to the site of skin tags. Further researches are needed to establish the effectiveness of CO 2 laser 10600 nm parameters in the treatment of skin tags. More researches are needed in treating skin tags by other laser types. Long study period is needed for good assessment of treatment and to give more time for follow up. Recommendations

27. Thanks