长脉冲半导体激光脱毛的长期疗效和安全性评价

目的 评价长脉冲半导体激光对于Ⅲ－Ⅴ型皮肤多毛患者脱毛的长期疗效和安全性。方法 用长脉宽半导体激光（波长800 nm，脉宽30 ms，光斑大小9 mm × 9 mm）对350例多毛患者进行多次治疗。治疗结束后22.5个月，回顾性分析了脱毛的疗效和不良反应，每个部位根据治疗次数分2组： < 6次组和≥6次组（腋窝分为 ＜ 4次组和≥4次组），比较不同部位这2组脱毛的疗效。结果 随访到并进行评价的多毛患者235例共375处部位。经2 ~ 18次脱毛治疗后，有效302处，总有效率为80.53%。不同部位2个治疗次数组疗效有一定差异，唇部≥6次组治疗部位38处，有效33处，有效率86.84%， ＜ 6次组治疗部位20处，有效7处，有效率35.00%；面颈（唇以外）≥6次组治疗部位38处，有效26处，有效率68.42%， ＜ 6次组治疗部位13处，有效4处，有效率30.77%；下肢≥6次组治疗部位50处，有效46处，有效率92.00%， ＜ 6次组治疗部位9处，有效5处；躯干≥6次组治疗部位23处，有效20处，有效率86.96%， ＜ 6次组治疗部位8处，有效4处；以上各部位≥6次组疗效均优于 ＜ 6次组（P < 0.05）。腋窝≥4次组治疗部位97处，有效91处，有效率93.81%， ＜ 4次组治疗部位9处，有效5处，两组疗效比较，P < 0.01。上肢部两组疗效比较，差异无统计学意义（P ＞ 0.05）。235例患者中有6例出现不良反应，包括色素沉着、毛囊性丘疹、瘙痒、水疱、白色毛发，未见色素减退及瘢痕形成。结论 长脉冲半导体激光对Ⅲ－Ⅴ型皮肤多毛患者脱毛安全有效。疗效与脱毛部位、治疗次数相关。     

血管角皮瘤101例激光治疗后临床疗效及不良反应分析

目的 探讨血管角皮瘤患者激光治疗后的临床疗效及不良反应。方法 收集第四军医大学西京皮肤医院激光美容中心2010年3月—2021年8月临床诊断为血管角皮瘤的患者101例，给予脉冲染料595 nm激光(PDL)、长脉冲1 064 nm(Nd:YAG)以及脉冲CO₂激光单独或联合治疗，术前术后采集照片，对比分析治疗前后临床疗效及术后出现的不良反应。结果 101例血管角皮瘤患者激光治疗后多数患者皮损明显改善或消退，痊愈率78.22%,有效率达到90.10%,16.83%的患者术后出现瘢痕、色素沉着斑或色素减退斑；以斑疹及丘疹、结节为主要皮损表现的患者有效率达98.36%及90.63%以上，不良反应率低，而以斑块为主的皮损出现不良反应发生率较高。结论 激光治疗对血管角皮瘤患者治疗有效，可根据皮损类型选择治疗仪器，预判术后疗效。     

308 nm准分子激光联合吡美莫司乳膏治疗儿童白癜风的疗效观察

目的 评价308 nm准分子激光联合吡美莫司乳膏治疗儿童白癜风的疗效及不良反应。 方法 随机选取49例皮损对称的稳定期儿童白癜风患者，采用自身对照方法，将对称的皮损随机分成A、B两组，A组：给予准分子激光照射，每周2次，疗程15周，联合外用吡美莫司乳膏，每日2次；B组：单独给予准分子激光照射，每周2次，疗程15周。分别于准分子激光治疗第15次及30次后进行疗效评价。结果 30次治疗结束后，A组显效率为77.1%，有效率为89.6%，B组显效率为52．1%，有效率为75.0%，A组有效率及显效率均显著优于B组（P ＝ 0.048，P ＝ 0.040）。两组不同部位皮损疗效比较，仅面部皮损予以联合治疗后显效率及有效率显著优于单用准分子激光治疗（P = 0.004）。结论 308 nm准分子激光对儿童白癜风是一项安全、有效的治疗方法，联合应用吡美莫司乳膏能增加面部皮损疗效。     

GentleYAG 1064nm激光与强脉冲光脱毛的疗效与安全性比较

目的比较GentleYAG激光脱毛与强脉冲光脱毛的疗效与安全性。方法应用GentleYAG激光与强脉冲光进行脱毛治疗,治疗后分析脱毛效果及不良反应。结果GentleYAG激光脱毛治疗在唇部、发际(有效率均为95.00%)疗效优于强脉冲光(有效率分别为70.00%,65.00%)脱毛治疗,差异有显著性;两种脱毛治疗方法在腋部、四肢(有效率分别为95.00%和90.00%,95.00%和95.00%)部位疗效相当,差异无显著性;GentleYAG激光脱毛治疗后不良反应低于强脉冲光,两者差异有显著性。结论GentleYAG激光脱毛效果在唇部、发际疗效优于强脉冲光,两种脱毛方法在腋部、四肢疗效相当,GentleYAG激光脱毛比强脉冲光脱毛的不良反应更少。     

595 nm脉冲染料激光治疗婴幼儿面部和四肢浅表血管瘤的疗效比较

目的：比较595 nm脉冲染料激光治疗婴幼儿面部及四肢浅表血管瘤的疗效及不良反应。方法：回顾性分析我科2017年12月至2020年1月收治的浅表血管瘤患者的临床资料，分为累及面部(面部组)和累及四肢(四肢组)两组。疗效评估由监护人和未参与治疗的皮肤科医生通过比较治疗前后病变照片共同完成。治疗效果分为：痊愈、显效、有效、无效，皮损大小和颜色改善分别为≥90%，60%~89%，30%~59%，<30%或病变扩大。 结果：共91例浅表血管瘤患者纳入分析，其中面部组43例，四肢组48例。面部组和四肢组分别有53.5%和72.9%的患者达到痊愈，分别有86%和100%患者皮损达到有效，两组间痊愈率和有效率差异均有统计学意义（均P<0.05）。面部组和肢体组的不良反应发生率分别为23.3%和16.7%，差异无统计学意义(P>0.05)。结论：595 nm脉冲染料激光治疗四肢浅表血管瘤疗效优于面部，不良反应无明显差异。     

点阵铒激光治疗浅表性瘢痕的疗效观察

目的研究点阵铒激光治疗浅表性瘢痕的有效性和安全性。方法应用点阵铒激光对292例浅表性瘢痕进行治疗,治疗次数为1～3次,对治疗前后照片进行对比,根据疗效判定标准进行疗效统计和安全性分析。结果治疗1、2、3次的总有效率分别为85.9%、95.1%和95.7%。8例出现色素沉着,无其它明显不良反应。结论点阵铒激光治疗浅表性瘢痕疗效好,副作用小,恢复快,疼痛较轻,术后护理方便,值得临床推广使用。     

CO2激光治疗20种皮肤病疗效观察

目的：评价CO2激光治疗多种皮肤病的疗效及其在皮肤科治疗上的应用。方法：利用CO2激光的热作用对病变组织进行凝固、汽化和／或切割治疗，而使病变组织破坏而清除。结果：共治疗皮肤性病科20个病种1516例患者，治疗次数1～2次，痊愈1459例(96.24％)，显效54例(3．56％)，有效3例(0．20％)，无效0例(0．00%)。结论：CO2激光对皮肤科多种疾病有较好疗效。     

Versapulse C激光治疗太田痣疗效观察

观察经Versapulse C with HELP G型激光治疗的800例太田痣患者疗效,分析其治疗次数、间隔时间、能量大小及治疗部位与临床疗效之间的关系. 800例太田痣患者显效率100%,临床疗效随治疗次数、能量增加而提高,5～6个月为最佳间隔时间,治疗部位以额部、颧部最好,颊部、颞部次之,眼睑最差,且年龄愈小,疗效愈好.Versapulse C激光治疗太田痣临床疗效确切,痊愈率高,临床疗效与治疗次数、间隔时间、能量大小、部位、年龄有关.     

308nm准分子激光联合白癜冲剂治疗面部白癜风临床观察

目的探讨308nm准分子激光联合复方中药治疗面部白癜风的疗效和安全性。方法将150例稳定期面部白癜风患者随机分为3组,每组各50例。治疗组予308nm准分子激光照射联合内服复方中药,对照1组单纯予308nm准分子激光照射;对照2组单纯内服复方中药。3组均连续治疗15周,分别于治疗第5,10和15周时评价临床疗效。结果治疗组治疗15周时的有效率为86.00%,对照1组为76.00%、对照2组为40.00%,差异有统计学意义(P=0.01);治疗组不良反应发生率为26.00,对照1组为20.00%,对照2组为19.75%,差异无统计学意义(P=0.65)。结论308nm准分子激光联合内服复方中药治疗白癜风比两者单独应用治疗白癜风的疗效好。     

308 nm准分子激光治疗白癜风疗效与影响因素分析

目的:评价308 nm准分子激光治疗白癜风的疗效及其影响因素。方法:采用308 nm准分子激光系统治疗103例白癜风患者171处皮损,每周治疗1～2次,共12～50次,治疗结束后评价疗效。结果:皮损的总显效率为59.06%,有效率为83.04%。疗效影响因素分析显示不同部位、年龄、病程以及皮损大小对治疗效果有显著影响。结论:308 nm准分子激光治疗白癜风疗效高、副作用少。     

调Q开关Nd：YAG染料激光治疗太田痣209例疗效观察

目的：评估调Q开关Nd:YAG染料激光治疗太田痣临床疗效。方法：应用调Q开关Nd:YAG染料激光治疗209例太田痣。波长700nm,脉宽30us,能量密度5．6J／cm^2。每次治疗后色素未消退,间隔3－6月再行下一次治疗。结果：调Q开关Nd:YAG染料激光治疗4－6次后,192例效果极显,17例效果显,治疗后患均无疤痕。结论：调Q开关Nd:YAG染料激光治疗太田痣效果满意、安全。     

A randomized,split-face clinical trial of Q-switched alexandrite laser versus Q-switched Nd:YAG laser in the treatment of bilateral nevus of Ota

Different types of Q-switched (QS) lasers have been used successfully to treat nevus of Ota. The purpose of this study was to compare the clinical efficacy and complication of QS alexandrite (QS Alex) laser versus QS neodymium:yttrium aluminum garnet (Nd:YAG) (QS Nd:YAG) laser for bilateral nevus of Ota. Seventeen patients with bilateral nevus of Ota were treated randomly with QS Alex in one half of face and QS Nd:YAG in the other half with an interval of at least 3 months between each. Subjective assessment was made by both patients and dermatologists. Patients were also examined for evidence of complications. All patients experienced improvement (p < 0.05). There was no statistically significant difference between the two sides (p > 0.05). The pain after a short period of laser therapy was more severe for QS Alex than for QS Nd:YAG laser. Vesicles developed in 1 patient after QS Alex therapy. Both QS Alex laser and QS Nd:YAG laser were equally effective at improving bilateral nevus of Ota. Patients tolerate QS Nd:YAG laser better than QS Alex laser.     

Successful treatment of a patient with multicolored nevus of Ota using a combination of 1064 and 532 nm Q-switched Nd:YAG lasers

ABSTRACT

Nevus of Ota (NO) is a hamartoma of dermal melanocytes usually presents as unilateral blue, gray or brown macules or patches. It can impose a high burden of cosmetic and psychological disturbances in affected individuals. Q-Switched lasers appear to be an effective treatment for this kind of dermal melanocytosis. Multicolored Ota nevus is a rare variant of this kind of nevus and its treatment may be more challenging compared with unicolor lesions. Herein we report a 21-year-old woman with a multicolored nevus of Ota (blue and brown), which showed a dramatic response to a combination of 1,064 nm and 532 nm Q-Switched Nd:YAG lasers. We also discuss different aspects of the Q-switched laser application of Ota nevus treatment. We also focus on laser combination therapy to treat the nevus of Ota.     

Efficacy and Safety of 1,064 nm Q-switched Nd:YAG Laser Treatment for Removing Melanocytic Nevi

Background

Until recently, the removal of melanocytic nevi has been performed with a CO₂ laser or Er:YAG laser. These lasers have been useful for removing affected spots. However, enlargement of spots or some sequelae, including depressed or hypertrophic scars, could develop as unwanted results. The Q-switched Nd:YAG laser has been used to remove deep-seated melanocytes, such as Ota nevus or tattoos. However, there have been no previous experiments performed to test the efficacy and safety of this laser treatment for melanocytic nevi.

Objective

The objective of this study was to investigate the efficacy and safety of the 1,064 nm Q-switched Nd:YAG laser for removing melanocytic nevi, including congenital nevomelanocytic and acquired nevomelanocytic nevi.

Methods

Two thousand and sixty four Korean patients with small melanocytic nevi were treated with a Q-switched Nd:YAG laser from 2005 to 2009. High-resolution photographs were taken in identical lighting and positions before and after the six weeks of treatment to observe the procedural efficacy.

Results

About 70% of the nevi treated using a 1,064 nm Q-switched Nd:YAG laser were completely removed after one session. The other 30% were completely treated within three sessions. The appearance of sequelae such as hollow scars noticeably decreased compared to the results seen in CO₂ or Er:YAG laser treatments.

Conclusion

Use of the 1,064 nm Q-switched Nd:YAG laser is a safe and effective treatment modality for melanocytic nevi.     

Q开关Nd:YAG激光治疗色素增加及血管增生等皮肤病的疗效分析

目的：观察Q开关Nd:YAG激光治疗色素增加及血管增生等皮肤病的临床疗效与治愈次数，以及影响疗效的有关因素。方法：用Q开关Nd:YAG激光（1064nm,532nm或585nm波长）治疗3977例色素啬及血管增生等皮肤病，观察，分析其疗效和美容效果。结果：Q形状d:YAG激光治疗色素增加及血管增生等皮肤病均有效，其中雀斑、美容文刺、文身和太田闱总有效率均达95％以上，痊愈率由高到低依次为：雀斑、美容文刺、面部色素恙、雀斑样痣、老年斑、文身、颧部褐青色痣、咖啡斑、外伤性文身、炎症后色素沉着、多毛症、太田痣、毛细血管扩张、蜘蛛痣、蓝痣、鲜红斑痣和毛表皮痣。治愈次数1－9次。结论：Q开关Nd:YAG激光治疗色素增加皮肤病的疗效及美容效果很好，而对多毛症和血管增生皮肤病疗效及美容效果相对较差。     

A retrospective analysis of the clinical efficacies and recurrence of Q-switched Nd:YAG laser treatment of nevus of Ota in 224 Chinese patients

Background: Nevus of Ota can be treated successfully using the Q-switched (QS) laser; but few studies are long-term retrospective of the efficacy and influencing factor, studies on the recurrence is even less. Purpose: Retrospective analysis of the clinical characteristics and recurrence of QS Nd:YAG laser treatment of nevus of Ota in 224 Chinese patients at Laser Cosmetology Center of Department of Dermatology, the Second Hospital, Xi’an Jiaotong University. Methods: The data of 224 patients with nevus of Ota were analyzed retrospectively, which included the correlation among lesion color, treatment sessions, gender, age, lesion types and effect, and all patients were followed up for 2–10 years. Results: Higher number of treatment sessions that were conducted using the QS Nd:YAG laser system was positively associated with better responses to treatment. 99.11% of patients acquired more than 75% improvement with an average of 3.7 sessions. Only eight patients (3.57%) who had been completely cleared developed recurrence at the same site as before. Conclusion: The treatment of nevus of Ota with QS Nd:YAG laser is safe and effective with rare recurrence.     

Laser therapy of pigmented lesions: pro and contra

Although frequently performed, laser removal of pigmented lesions still contains certain controversial issues. Epidermal pigmented lesions include solar lentigines, ephelides, café au lait macules and seborrheic keratoses. Dermal lesions include melanocytic nevi, blue nevi, drug induced hyperpigmentation and nevus of Ota and Ito. Some lesions exhibit both an epidermal and dermal component like Becker's nevus, postinflammatory hyperpigmentations, melasma and nevus spilus. Due to the wide absorption spectrum of melanin (500-1100 nm), several laser systems are effective in removal of pigmented lesions. These lasers include the pigmented lesion pulsed dye laser (510 nm), the Q-switched ruby laser (694 nm), the Q-switched alexandrite laser (755 nm) and the Q-switched Nd:YAG laser (1064 nm), which can be frequency-doubled to produce visible green light with a wavelength of 532 nm. The results of laser therapy are usually successful. However, there are still many controversies regarding the use of lasers in treating certain pigmented lesions. Actually, the essential question in removing pigmented lesions with lasers is whether the lesion has atypical features or has a malignant potential. Dermoscopy, used as a routine first-level diagnostic technique, is helpful in most cases. If there is any doubt whether the lesion is benign, then a biopsy for histologic evaluation is obligatory.     

Q开关激光多疗程治疗太田痣无效二例

报道2例激光治疗多次无效的太田痣.患者均为女性,均在出生后数月发病,累及左侧面部,皮损表现为颧部、面颊部灰褐色至褐青色斑片,巩膜无蓝染.1例怀孕期斑片扩展至左耳后及左颈后.组织病理显示真皮深层及皮下脂肪组织间散在分布黑素细胞及噬黑素细胞,胶原纤维明显增生.免疫组化CD34标记血管内皮细胞分布无异常.对一般用于太田痣的激光治疗反应差.Q开关翠绿宝石激光(波长755 nm)和或Q开关Nd:YAG激光(波长1064 nm)累计治疗10余次几乎无效(1例治疗12次,1例治疗13次),且激光即刻反应特殊,即使高能量多次重复照射,皮疹处均无紫癜或渗血,而周围正常皮肤较低能量下即可见明显的紫癜和渗血.     

Comparison of biophysical properties of skin measured by using non-invasive techniques in the KM mice following 595 nm pulsed dye, 1064 nm Q-Switched Nd:YAG and 1320 nm Nd:YAG laser non-ablative rejuvenation

BACKGROUNDS/AIMS: The aim of the study was to compare the changes of the biophysical properties and to objectify the effects of 595 nm pulsed dye, 1064 nm Q-switched Nd:YAG and 1320 nm Nd:YAG lasers non-ablative rejuvenation by non-invasive techniques. METHODS: KM mice were used for the study. The 595 nm pulsed dye, 1064 nm Q-switched Nd:YAG and 1320 nm Nd:YAG laser treatments were evaluated with biophysical parameter measurements including skin elasticity, skin color, skin trans-epidermal water loss (TEWL) and skin hydration. RESULTS: All three lasers improved the biophysical properties in the skin of KM mice. In skin elasticity measurements, the 1064 nm laser treatment showed the lowest ratio (0.61+/-0.09) while the 1320 nm laser showed the highest one (0.76+/-0.07) on day 60. For erythema values, a significant increase was observed immediately after the 1064 nm laser treatment (196.67+/-19.17), but the lowest values occurred with the 1320 nm laser treatment (189.83+/-16.54). None of the three lasers resulted in obvious changes of skin melanin. TEWL increased immediately after laser irradiation, then began to recover and decreased 60 days after the 595 and 1064 nm laser treatments. With the 1320 nm laser treatment the TEWL began to decrease from day 7 and obtained the lowest mean values (5.23+/-1.13). The water-holding capacity increased initially for the 595 and 1320 nm laser irradiation, while decreased for the 1064 nm laser. At day 60 of the experiment, skin hydration values in all animals were superior to those of the controls. The 1320 nm laser treatment caused the highest ratio (1.29+/-0.26). Both the values of TEWL and skin hydration for the 1320 nm laser treated areas differed significantly from the other two lasers. CONCLUSIONS: Our data showed the 1064 nm Q-switched Nd:YAG laser treatment was most effective in improving the skins' mechanical properties, while the 1320 nm Nd:YAG laser can enhance greatly the skin barrier function and the water-holding capacity. Moreover, we demonstrated the biophysical properties differed considerably between different areas.     

倍频Q开关Nd:YAG 532 nm激光治疗179例颧部褐青色痣回顾性分析

目的：评价倍频Q开关Nd:YAG 532 nm激光治疗颧部褐青色痣的临床疗效、影响因素及安全性。方法：回顾性分析2011年6月～2015年6月我院皮肤科门诊确诊为颧部褐青色痣并单独接受倍频Q开关Nd:YAG 532 nm激光治疗的患者,比较治疗次数、开始治疗的年龄、治疗后不良反应。结果：符合条件的179例患者中,治疗≥3次的患者治愈率为73.0%,显著高于治疗1次的治愈率3.7%(P<0.01)及治疗2次的治愈率16.4%(P<0.01)。入选的患者年龄范围为14～49岁,以年龄进行分组,>30岁组的患者有效率（38.1%）显著低于25～30岁组(41.7%,P<0.01)及≤25岁组(66.2%,P<0.01)。72例（40.22%）患者出现不同程度色素沉着,3～6个月自行消退;2例（1.11%）患者出现水疱,无瘢痕形成。结论：早期、多次使用倍频Q开关Nd:YAG 532 nm激光治疗颧部褐青色痣安全有效。