Promising Non-Thermal Treatment for Skin Lesions

Nano-Pulsed Electric Fields

An in vivo study, which found that nanosecond pulsed electric fields (nsPEF) can affect cellular targets in the epidermal or dermal layers of the skin without affecting the integrity of dermal tissue, was selected as the September 2019 Lasers in Medicine and Surgery Editor’s Choice. Non-thermal nsPEF therapy applies nanosecond pulses of electrical energy to induce regulated cell death in cellular structures.

For this human study, authors David Kaufman, MD, et al, enrolled seven subjects with healthy tissue who were scheduled for abdominoplasty. Five subjects were treated over the course of 60 days with doses of six nsPEF energy levels (30 treatment squares of 25mm2 or less) within the planned excision area. Three independent, blinded dermatologists evaluated the treated areas for erythema, flaking and crusting using a 5‐point scale (0 = low, 4 = high) at 1 day, 5 days, 15 days, 30 days and 60 days prior to surgery. The researchers processed and evaluated punch biopsies of the surgically removed tissue for tissue changes using hematoxylin and eosin, trichome, caspase‐3, microphthalmia transcription factor and elastin stains.

The evaluators observed delayed epidermal loss followed by re‐epithelization by day 15 and a normal course of healing at most energy settings. Cellular structures such as melanocytes, sebaceous glands and hair follicles were damaged while acellular structures such as elastic fibers and collagen were largely unaffected. These results demonstrate that nsPEF could be a promising non-thermal treatment modality for both benign and neoplastic skin conditions, as well as for removing epidermal lesions, the authors note.

“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 Dr. Kaufman.

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