Aesthetic Dermatology MCQ - Nano-pulse stimulation technology

A 45-year-old man presents with multiple seborrhoeic keratoses on the trunk and seeks a treatment option that minimizes scarring and preserves surrounding tissue. He is offered Nano-Pulse Stimulation (NPS) therapy. Which of the following BEST describes the mechanism of action of NPS technology?

A. Thermal coagulation of target tissue via delivery of intense pulsed light
B. Induction of irreversible electroporation leading to cell necrosis
C. Delivery of ultrashort, high-voltage electrical pulses causing regulated cell death (apoptosis-like)
D. Non-selective mechanical destruction of target lesion using rapid acoustic waves
E. Photomechanical fragmentation of pigment-containing cells

Correct Answer:
C. Delivery of ultrashort, high-voltage electrical pulses causing regulated cell death (apoptosis-like) ✅

Explanation:
Nano-Pulse Stimulation (NPS) technology delivers nanosecond-duration, high-voltage electrical pulses to target cells. This disrupts the cell membrane and organelle membranes transiently, triggering intracellular signaling cascades that lead to regulated cell death (RCD), similar to apoptosis, rather than necrosis.

This mechanism allows for:

• Selective cellular clearance while preserving acellular structures such as dermal collagen and elastin

• Minimal scarring and pigmentary change, making it suitable for benign lesions like seborrhoeic keratoses, sebaceous hyperplasia, and warts

• Option A: Thermal coagulation is the mechanism for IPL/lasers.

• Option B: Irreversible electroporation causes immediate necrosis — NPS is non-thermal and induces RCD, not necrosis.

• Option D: Acoustic waves are the mechanism for Rapid Acoustic Pulse (RAP) used for cellulite, not lesion clearance.

• Option E: Photomechanical fragmentation is the mechanism for Q-switched lasers used in tattoo/pigment removal.

Key Point:
NPS technology represents a non-thermal, energy-based treatment that induces regulated cell death of targeted lesions while sparing surrounding dermal architecture, reducing the risk of scarring or dyspigmentation.