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Tratamientos actuales del acné: Medicamentos, luces, láseres y un nuevo láser Nd:YAG de 650 microsegundos de 1064 nm

Michael Gold, MD, David J. Goldberg, MD, JD, Mark Nestor, MD, PhD Journal of Cosmetic Dermatology, septiembre de 2017, volumen 16, número 3

Resumen
El tratamiento del acné, especialmente el acné severo, sigue siendo un desafío para los dermatólogos. Las terapias incluyen retinoides, antibióticos, hormonas, luces, láseres y varias combinaciones de estas modalidades. En la actualidad, el acné se considera una afección crónica en lugar de adolescente. El tratamiento adecuado depende del paciente y de la gravedad de la enfermedad. El propósito de este estudio fue revisar las terapias actuales para el acné de todas las intensidades e introducir el láser de 650-ls de 1064 nm para el tratamiento del acné.

1 | INTRODUCCIÓN El acné vulgar es el motivo más frecuente por el que las personas consultan a un dermatólogo.1 El acné afecta del 85 % al 90 % de los adolescentes,2 menores de 7 a 12 años,3 y hombres y mujeres adultos, incluyendo los de piel de color.4,5 Entre los adultos que tienen acné, el 64 % tiene entre 20 y 30 años y el 43 % entre 30 y 40 años. La prevalencia es mayor entre las mujeres que entre los hombres.68 Gollnick et al.9 y la Alianza Global para Mejorar los Resultados en el Acné10 han sugerido que el acné se considere una enfermedad crónica en lugar de una “simple aflicción autolimitada de los adolescentes”. Esta afirmación se basa en las características conocidas de una enfermedad crónica: un transcurso prolongado, recurrencia o recaída, brotes agudos o de inicio lento y efectos negativos en la calidad de vida. El acné persiste hasta la edad adulta en hasta el 50 % de los pacientes afectados y tiene secuelas negativas como ansiedad y depresión, aislamiento social, cicatrices e hiperpigmentación persistente.10 2 | PATOGÉNESIS DEL ACNÉ El acné es una enfermedad multifactorial de la unidad pilosebácea. El desarrollo de lesiones de acné se ha atribuido a cuatro factores patógenos: sobreproducción de sebo inducida por andrógenos, colonización del conducto pilosebáceo por Propionibacterium acnes, queratinización anormal en el folículo y secreción de mediadores inflamatorios en la piel.8 La primera etapa es el desarrollo de una microcomedona en la unidad pilosebácea. Esto es un tapón que se forma debido al aumento de la producción de sebo y queratinocitos que recubren el folículo piloso. La acumulación de sebo y queratinocitos desprendidos da como resultado la formación de comedones visibles más grandes. Al mismo tiempo, P. acnes coloniza el conducto pilosebáceo, lo que desencadena la liberación de mediadores inflamatorios en el tejido circundante y una respuesta de las células inmunocompetentes, lo que contribuye aún más al desarrollo de comedones.8,11 El acné ocurre con mayor frecuencia en la cara, el cuello, la espalda y el pecho, todas áreas que tienen muchas unidades pilosebáceas.12,13

3 | TRATAMIENTO DEL ACNÉ Las monoterapias tradicionales para el acné leve a moderado son los retinoides tópicos y los agentes antimicrobianos, tales como antibióticos y peróxido de benzoilo (BPO).

3.1 | Miembros de retinoides de la Alianza Global10 afirman que los retinoides deben considerarse la base para el tratamiento de todos los pacientes con acné, excepto aquellos con enfermedad más severa. Los retinoides tópicos (p. ej., tretinoína, tazaroteno, adapaleno) ayudan a normalizar la diferenciación anormal y

Gold MGoldberg DJNestor MSTratamientos actuales del acné: Medicamentos, luces, láseres y un nuevo láser Nd: YAG de 650 μs y 1064 nmJ Cosmet Dermatol2017;16:303318https://doi.org/10.1111/jocd.12367

Table of Contents

Laser Optical Engineer

Aerolase is the fastest growing medical laser company, serving the high growth dermatology and aesthetic laser market. Nestled in the picturesque Hudson Valley in Tarrytown, NY, the location is also ideal for access to NY City and other areas of the Northeast and Mid-Atlantic U.S. We are hiring in many areas and currently seek laser optical engineers with a passion for creating new things. The company offers a friendly, team-oriented work environment and competitive compensation including salary, bonus, stock options, 401k, and health/dental/life insurance plans.

About the Team:

  • We are a diverse team of friendly, creative hard-working people with a passion for achieving our objectives
  • We are creative, hands-on and innovative with a strong orientation toward high customer satisfaction
  • We have created a very team-spirited company culture and believe it is important to have open and effective cross-functional collaboration and communications – and enjoy our work!

About the Role:

We’re looking for an enthusiastic, creative and detail-oriented problem solver to help support the production, service and repair of our unique solid-state laser devices.

Must have expertise working with assembly and/or development of small, sensitive, high precision instruments, preferably solid-state laser technology, with a high caliber technology company.  We prefer design and hands-on experience in multiple laser technologies including solid state lasers, semiconductor lasers, non-linear optical materials and devices, optical benches, and beam directors. Experience with the technical aspects of developing laser and laser-based products is strongly preferred.

Candidates should have proven ability to address complex challenges with ingenuity and innovation, and capability to work independently to manage multiple simultaneous tasks, and see all tasks to completion. Also should have the ability to work well in a collaborative multidisciplinary team environment, define and analyze system performance specifications, and ensure adherence to those specifications in the application environment.

  • Perform sensitive manual optical assembly of lasers.
  • Test, troubleshoot repair and assemble lasers, subassemblies and various components, including high-voltage laser power supplies and other electronics.
  • Support the development and implementation of test fixtures, equipment, procedures and documentation for the engineering and operations functions.
  • Support product design and development activities related to new products and product improvements.
  • Support development and maintenance of quality and regulatory documents and procedures.
  • Provide customer technical support as needed including product service, maintenance, and troubleshooting.
  • With suppliers, act as a technical and operational liaison as needed.
  • Maintain thorough, complete and accurate written records; comply fully with the company’s quality system and any regulatory requirements.
  • Follow safety rules for working with high-voltages and high-power lasers.
  • Perform other duties as completion of responsibilities necessitates or as assigned by supervisor.
  1. Minimum 5 years of experience in an engineering role involving sensitive high precision instruments, preferably involving solid state lasers.
  2. Theoretical and practical knowledge and skills of adequate policies and procedures for the control of laser hazards and high voltage hazards, using relevant protective equipment, ensuring adequate safety education and training of other personnel.
  3. Understanding of system and component design, testing and troubleshooting.
  4. Enjoy working with your hands/mechanical ability.
  5. Strong analytical and problem solving skills.
  6. Proven technical and project management skills.
  7. Experience with manufacturing within a Quality Management System (especially medical).
  8. Strong interpersonal and communication skills.
  9. Self-motivated, detail oriented and well organized. Ability to make decisions and work independently Strong work ethic and desire to help the company successful by producing a reliable product.
  10. Not afraid to ask questions and make suggestions for improvement.
  11. Be able to work under pressure due to customer demands.
  12. Strong computer skills (Windows™ software).
  13. Ability to successfully manage multiple projects and daily responsibilities. Ability to discern and appropriately communicate sensitive issues.
  14. Ability to walk, stand, bend, reach, stoop/squat, and crouch. Ability to carry heavy items.
  15. Will require working indoors and outdoors – work environment includes the office, the production areas, mechanical rooms, and customer and supplier facilities. Also includes regular contact with high-voltage equipment and laser light emissions.

BS. in Physics, Mechanical or Optical Engineering, Master’s Degree preferred

  • We are a diverse team of friendly, creative hard-working people with a passion for achieving our objectives
  • We are creative, hands-on and innovative with a strong orientation toward high customer satisfaction 
  • We have created a very team-spirited company culture and believe it is important to have open and effective cross-functional collaboration and communications – and enjoy our work!

We’re looking for an enthusiastic, creative and detail-oriented problem solver to help support the production, service and repair of our unique solid-state laser devices.

Must have expertise working with assembly and/or development of small, sensitive, high precision instruments, preferably solid-state laser technology, with a high caliber technology company.  We prefer design and hands-on experience in multiple laser technologies including solid state lasers, semiconductor lasers, non-linear optical materials and devices, optical benches, and beam directors. Experience with the technical aspects of developing laser and laser-based products is strongly preferred.  

Candidates should have proven ability to address complex challenges with ingenuity and innovation, and capability to work independently to manage multiple simultaneous tasks, and see all tasks to completion. Also should have the ability to work well in a collaborative multidisciplinary team environment, define and analyze system performance specifications, and ensure adherence to those specifications in the application environment.

  • Perform sensitive manual optical assembly of lasers.
  • Test, troubleshoot repair and assemble lasers, subassemblies and various components, including high-voltage laser power supplies and other electronics.
  • Support the development and implementation of test fixtures, equipment, procedures and documentation for the engineering and operations functions.
  • Support product design and development activities related to new products and product improvements.
  • Support development and maintenance of quality and regulatory documents and procedures.
  • Provide customer technical support as needed including product service, maintenance, and troubleshooting.
  • With suppliers, act as a technical and operational liaison as needed.
  • Maintain thorough, complete and accurate written records; comply fully with the company’s quality system and any regulatory requirements.
  • Follow safety rules for working with high-voltages and high-power lasers.
  • Perform other duties as completion of responsibilities necessitates or as assigned by supervisor.
  1. Minimum 5 years of experience in an engineering role involving sensitive high precision instruments, preferably involving solid state lasers.
  2. Theoretical and practical knowledge and skills of adequate policies and procedures for the control of laser hazards and high voltage hazards, using relevant protective equipment, ensuring adequate safety education and training of other personnel.
  3. Understanding of system and component design, testing and troubleshooting.
  4. Enjoy working with your hands/mechanical ability.
  5. Strong analytical and problem solving skills.
  6. Proven technical and project management skills.
  7. Experience with manufacturing within a Quality Management System (especially medical).
  8. Strong interpersonal and communication skills.
  9. Self-motivated, detail oriented and well organized. Ability to make decisions and work independently Strong work ethic and desire to help the company successful by producing a reliable product.
  10. Not afraid to ask questions and make suggestions for improvement.
  11. Be able to work under pressure due to customer demands.
  12. Strong computer skills (Windows™ software).
  13. Ability to successfully manage multiple projects and daily responsibilities. Ability to discern and appropriately communicate sensitive issues.
  14. Ability to walk, stand, bend, reach, stoop/squat, and crouch. Ability to carry heavy items.
  15. Will require working indoors and outdoors – work environment includes the office, the production areas, mechanical rooms, and customer and supplier facilities. Also includes regular contact with high-voltage equipment and laser light emissions.

BS. in Physics, Mechanical or Optical Engineering, Master’s Degree preferred

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Staff Accountant / Junior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Staff Accountant / Junior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Duties:

• Provide support to the Controller and the management team
• Maintain day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Support the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Uploading annual budget and tracking actual to budget variances
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Participation in quarterly inventory reconciliations
• Assist team with projects such as policy creation, system implementation, client support etc.

• Some experience with and strong understanding of the monthly close process and technical accounting
• Detailed oriented, with ability to see the big picture
• Self-starter who can work independently and employ time management skills to meet deadlines.
• Knowledge of MS Excel (V-lookup, formulas, pivot tables).
• Strong interpersonal and communication skills
• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP
• 1-3 years’ experience in an accounting function (including internship)
• General Ledger/Operational Accounting experience
• Knowledge of Quickbooks or other reporting software a plus (more the better)
• Industry experience a plus

Senior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Senior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Duties:

• Provide support to the Controller and the management team
• Own day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Assist in establishing and maintaining policies & procedures in accordance with GAAP and Aerolase policy
• Key contributor to the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Assist in the preparation of management reports – (cash management, various projections, month end reporting package)
• Involvement with the annual budget process
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Prepare and submit payroll
• Participation in quarterly inventory reconciliation to the perpetual
• Ad hoc projects

• Strong knowledge of the monthly close process and technical accounting

• Detailed oriented, with ability to see the big picture

• Experience in continuous improvement and accounting best practices

• Self-starter who can work independently and employ time management skills to meet deadlines.

• System savvy – ability to learn new financial software

• Intermediate knowledge of MS Excel (V-lookup, formulas, pivot tables).

• Global consolidations experience a plus

• Strong interpersonal and communication skills

• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP

• 3+ years’ experience working as a staff/senior accountant

• General Ledger/Operational Accounting experience a must

• Extensive knowledge of Quickbooks and other reporting software

• Prior involvement with system implementation

• Prior public accounting experience (any size firm) a plus

• Industry experience a plus

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