Issue link: http://viewer.e-digitaledition.com/i/746763
Health Initiative Award Winner 2015 Innovation Award Winner 2015 Health Innovation in Patient Care Award Winner 2015 Award Winner 2015 TREATING A BLISTERING LASER BURN WITH POST¡INFLAMMATORY HYPERPIGMENTATION IN SKIN OF COLOR CAN BE VERY CHALLENGING. THERE IS NO PERFECT PROTOCOL, SO I WILL TELL YOU HOW I SUCCESSFULLY MANAGED THIS CASE. YOU MAY USE this treat- ment protocol as a general template to be adjusted by your experience and exper- tise, a nd your patient 's response, should you ever need it. TREATMENT PROTOCOL + Initial approach — For the first two weeks, I used Mupirocin ointment, BID topically, and Alcortin A cream QD. I also covered him with Keflex, 500 mg TID for 10 days. + Day 15 — I added Biafine cream BID for 14 days and continued the Alcortin A cream, QD. + Day 30 — I started LauriPure ointment BID and discontinued the Alcortin A cream. + Day 45 — I reduced t he Laur i P ure ointment to QD and started Dermatix Scar Cream QD, and Phyto+ hydrating bota nica l gel, BID (to sta r t treating the hyperpigmentation). I also started Alclometasone cream QD and initiated narrow band UVB phototherapy treat- ments to also even out dyschromia, two to three times per week, starting at 150 mJ, increasing 15 mJ per treatment with a maximum of 420 mJ. He completed a total of 18 phototherapy treatments. + Day 60 — I discontinued Aclometasone cream and increased Dermatix scar cream to BID. I discontinued the Phyto+ gel and started a topica l compounded cream for hy per pig mentation conta ining: hydroquinone 6 percent, retinoic acid 0.05 percent, kojic acid 3 percent and hydrocortisone 0.5 percent. I instructed him to use this compounded crea m twice daily. + Day 90 — The patient was essentially back to normal and was extremely grate- ful. I discontinued all treatments. F o r m o r e i n f o r m a t i o n , c o n t a c t C h a r l e s E . C r u t c h f i e l d I I I , M D , at C r utchf i el d D e r m atol ogy o r v i s it CrutchfieldDermatology.com. ■ TREATING A BLISTERING LASER BURN WITH POST¡INFLAMMATORY Case of the Month with Crutchfield Dermatology BY CHARLES E. CRUTCHFIELD III, MD 1 9 M D N E W S .C O M /// M D N E W S M I N N E S O TA ■ 2 016 D I A G N O S T I C S ❰❰❰❰❰ 1 9