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Letter to the Editor
2023
:3;
44
doi:
10.25259/CSDM_29_2023

Few passes of CO2 laser to aid to remove foreign body under skin

Department of Dermatology, Apollo Multispeciality Hospital, Kolkata, West Bengal, India
Corresponding author: Surajit Gorai, Department of Dermatology, Apollo Multispeciality Hospital, Kolkata, West Bengal, India. drsurajit@drgorai.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Gorai S. Few passes of CO2 laser to aid to remove foreign body under skin. CosmoDerma 2023;3:44.

Dear Sir,

CO2 laser (10600 nm) is considered gold standard for cutaneous resurfacing as it’s absorption is well-suited for water in the skin tissue (70% of total skin tissue contains water). Before the advent of fractional ablation, thermal destruction of tissue was more and leads to scarring and fibrosis.[1] Now, with newer technology of fractional photothermolysis, we can have magical result with minimum side effects. Cutaneous resurfacing in India is mainly used for photodamaged and acne scarred skin. It is also used to remove many epidermal and dermal lesions.[2] Although satisfaction with CO2 laser is high; yet, side effects are also not less. In 1st weeks, chance of postoperative erythema and infection is high. Chance of scarring, fibrosis, and depigmentation is also raised when increase fluence or higher concentration of fractional CO2 is used. Depth of penetration and dermal necrosis is also found to be high.[3]

Here, we report a case of traumatic scar where CO2 laser used in an interesting way. One male patient of 29 years of age presented to us with a scar tissue of 6 years old over left forehead just above the eyebrow. On examination, it was an elevated, firm, and irregular scar tissue measuring 2.5 cm in largest diameter [Figure 1]. Hence, we decided to perform CO2 laser (Lumenis, fractional CO2) with 17.5 j/cm2, concentration 5% in a single pass. After 2 sitting in 1 month gap, we have noticed a peculiar thing. On palpation, a foreign body like sensation was felt subcutaneously just above the eye brow. On the 3rd day of CO2 laser, a broken glass piece came out on its own [Figures 2 and 3]. An old scar with foreign body, that was impalpable before, become prominent and superficial on resurfacing. By this, we probably avoided an ugly, less cosmetic incision unknowingly.

Old scar just above the left eyebrow.
Figure 1:
Old scar just above the left eyebrow.
Foreign body just after 3rd CO2 pass.
Figure 2:
Foreign body just after 3rd CO2 pass.
Foreign body (a broken glass piece).
Figure 3:
Foreign body (a broken glass piece).

Few passes of CO2 laser may be helpful over a cosmetic area to remove a foreign body from scarred or granulomatous lesion.

Authors contributions

Dr. Surajit Gorai – Conceptualization, manuscript preparation, editing, submission.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflict of interest

There are no conflicts of interest.

Financial support and sponsorship

Nil.

References

  1. , . Single-pass CO2 laser skin resurfacing of light and dark skin: Extended experience with 52 patients. J Cosmet Laser Ther. 2003;5:39-42.
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  2. , . The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther. 2014;23:49.
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  3. , , , , , , et al. Highlights of thirty-year experience of CO2 laser use at the Florence (Italy) department of dermatology. Sci World J. 2012;2012:546528.
    [CrossRef] [PubMed] [Google Scholar]

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