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Figure 1 A Normal healing 1 week postoperatively. B, Documented Candida infection 3 days later.
Bacterial Infections Staphylococcus aureus is the most common organism implicated. Many physicians involved in laser resurfacing recommend a broad-spectrum prophylactic antibiotic such as cephalexin for 5 to 7 days postoperatively, but the effectiveness of this has not been conclusively demonstrated.
If an eruption occurs after prophylaxis and a smear demonstrates typical gram-positive cocci, resistant S. Recently Fitzpatrick 4 reported several patients in whom Pseudomonas infection developed after resurfacing because of colonization of the paranasal sinuses.
This should be treated with ciprofloxacin, 500 mg, twice daily.
Meticulous wound care is also important. Contact Dermatitis If the previously mentioned conditions have been ruled out, contact dermatitis should be considered Figure 2.
Resurfacing removes or thins the epidermis, so that access of topical antigens to the Langerhans cells in the dermis is greatly increased.
We have documented three patients with such a condition from the use of petroleum jelly. If an allergic dermatitis is suspected, the topical agent should be stopped and treatment begun with a strong steroid cream.
Usually a response will be seen in 3 to 5 days. Figure 2 A, Normal healing at 1 week.
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