EVENT NEWS: THE 25TH ANNUAL DERMATOLOGY SYMPOSIUM IN NYC
This year, Dr. Bard elected a unique and impressive way of presenting to the institution by introducing his recent collaborative ally, Mr. Charles Vorwaller- CEO of Aspen Laser to present about Photobiomodulation therapy as part of Dr. Bard's reserved space. "We have been performance testing Charles' Aspen Laser Apex Model for the better part of 6 months and found the technology to align with the many skin issues (like inflammatory skin disorders) that I found this event to be the ideal opportunity for me to endorse Aspen laser into the dermatological community."
Surprisingly, Aspen was the only laser company of its class at the event. "I was glad to bring Charles Vorwaller into the society of dermatologists-- he was the perfect educator about near-infrared and so many of the attendees were inspired by his science", continued Dr. Bard.
The 26th Annual Mount Sinai Winter Symposium took place in NYC during December, 2023. This nationally recognized, live CME event was attended by over 550 participants. The Mount Sinai Winter Symposium offered a comprehensive program addressing Medical and Surgical Dermatology, which was delivered by 40 sought-after faculty speakers and world-renowned leaders in the treatment of various skin diseases and conditions. Topics included the most current research on the diagnosis and treatment of medical dermatological conditions, such as psoriasis, eczema, alopecia, hidradenitis supportive, actinic keratosis, rosacea, and skin cancer. In addition, cosmetic procedures were performed in front of the audience allowing them to witness the latest techniques in skin rejuvenation.
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| (C) 2023 Dr. Robert L. Bard- Inflammatory Skin Disease/NIDI-Weill Cornell event |
One of the most comprehensive ways to confirm the results of any treatment is by clinically tracking the body's physiological response from underneath the skin. Diagnostic imaging captures measurable data about the injured or inflamed area, allowing both clinicians and patients the ability to identify therapeutic progress in real time. Widely preferred scanning modalities include the Doppler Blood Flow Ultrasound (or sonography) and Elastography, both using high‐frequency sound waves to view inside the body. Like an internal video camera, these high speed scanning innovations capture actual movement of the body's internal organs. This offers a vast amount of biometric information about the patient’s condition, in comparison to still images of conventional x‐rays. The ultrasound's ability to evaluate abnormalities within the soft tissue in research and clinical trials are widely used in recording evidence‐based biomarkers to trace therapeutic efficacy.
Elastography and Doppler Ultrasound are both physiologic technologies which show whether the cancer treatment is working or not. They provide effective therapeutic markers over a blood test.
Elastography measures hardness of tissue and tissue healing through elasticity. Hard scar formation or fatty changes is measured on the scale at the top right. FAT, which is soft, appears as blue (at 120) whereas the 480 level the scar tissue is harder. We know that scar tissue impedes muscle contractility greater than fatty changes, thus treatment can be appropriately applied to the type of tissue that needs regeneration.
SCANNING INFLAMMATORY SKIN DISORDERS AND TUMORS WITH ELASTOGRAPHY
Elastic ultrasound technology is an advancement where we can get real‐time images, this scan shows the tumor from beginning to end as we scan through it. Notice that the blue area is the softer tissue and the hard tissue (with more aggressive) cancer is the red. In this screen, we are able to have a comparative study of the regular ultrasound (below) and the elastogram on top. After the use of real‐time elastogram, we can freeze frame a significant image showing the red area of active tumor on the bottom. Fluid does not have elasticity, it does is not hard and it appears as black. Therefore the two top areas which we saw had low blood flow or no blood flow in the previous image have zero elastic qualities‐ meaning these areas that are dead and inactive. This also means that elastography is a usable treatment marker to show treatment effect. In other words, when you go from red to black, it means that the black area is a degenerated or dead inactive part of the cancer.
CASE STUDY #7: PSORIASIS / FOOT & ELBOW
3D DOPPLER: Normal posterior tibial and pedal arterial Doppler flows. No regional hyperemia. Triphasic waveforms. Peak vel 11cm/s. Hyperemia decreased to the dip joint. 3D shows abnormal dermis decreased from 2.1mm to 15mm.
ELASTOGRAM: Decreased edema psoriatic plaque (light blue) with early fibrosis of talar ligament (yellow).
PATIENT NARRATIVE“I have been suffering from PSORIASIS since I was 25. Periodically my psoriasis gets inflamed and gets very scaly and very itchy. (When I scratch, which is often it gets worse). I received my first treatment with the (Aspen) Laser back in March, 2023 and I received various treatments afterward. I continue to have this laser treatment on my right foot, which is the worst and on my right elbow. Lately, the scaling seems much flatter. I don't know whether it's the laser or some of the other home treatments I'm doing for myself… but it seems to be quite a bit improved”.
