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To the Editor: I found the negative results of the study by Dr Orringer et al¹ on the treatment of acne vulgaris with pulsed dye laser surprising because they are quite different from the positive ones I recently published with colleagues.² Several methodological concerns may explain the differences.

First, their study was small, with only 40 patients and only 26 patients completing the study. This was not a problem we experienced in our own trial. Second, because their analysis was performed on an intent-to-treat basis, the spot count and grading at the last visit attended by the patient were taken as the final results. This means that a significant percentage of patients who had failed to attend follow-up appointments may have been deemed treatment failures.

Third, the average number of laser pulses used to treat each patient was 385. In our study,² the entire face was treated, taking at least . . . [Full Text of this Article]

A. C. Chu, FRCP
a.chu@imperial.ac.uk
Imperial College
Hammersmith Campus
London, England

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