A dose-response study of a new directed energy technology aimed at selectively eliminating unwanted cellular lesions in the skin has shown selectivity in the dermis and epidermis within a range of energy levels. These findings, published online ahead of print in Lasers in Surgery and Medicine (Aug. 2, 2019), suggest the technology holds promise as a non-thermal treatment modality for benign and neoplastic skin conditions, and for the removal of epidermal lesions, the authors conclude.
“This first study of a totally new energy device in humans is important because it establishes and characterizes a safe range of energy ‘doses’ in normal skin to guide dosimetry for future studies of this device in abnormal skin conditions,” said lead author Dr. David Kaufman, in a press release.
Dr. Kaufman is a plastic surgeon in private practice in Folsom, Calif.
Dr. Kaufman - photo by the American Society for Laser Medicine & Surgery
The new technology, known as nanosecond pulsed electric fields (nsPEF), uses nanosecond-long pulses of electricity to induce regulated cell death with negligible thermal effects.
For the study, seven subjects with healthy tissue planned for abdominoplasty excision were enrolled. Five of the subjects were evaluated in a longitudinal, 60-day study of effects of the new technology, with doses of six nsPEF energy levels. A total of 30 squares of spot sizes 25 mm2 or less within the planned excision area were treated and then evaluated at 1 day, 5 days, 15 days, 30 days, and 60 days, before the excision surgery.
The researchers took photographs of each treated area over the different evaluation periods, and the photos were assessed by three independent and blinded dermatologists for erythema, flaking and crusting using a 5-point scale (0 = low, 4 = high). As well, punch biopsies of surgically removed tissue were processed and evaluated for tissue changes using hematoxylin and eosin, trichome, caspase-3, microphthalmia transcription factor, and elastin stains and evaluated by a dermatopathologist.
The skin of two subjects received additional treatments at 2 and 4 hours post-nsPEF and was evaluated in a similar manner.