长脉宽1064nm Nd:YAG激光治疗甲真菌病

目的:评价长脉宽1064nm Nd:YAG激光治疗甲真菌病的疗效。方法:60例甲真菌病患者给予长脉宽1064nm Nd:YAG激光治疗,每周1次。结果:治疗结束后6个月有效率为60%。完成4次(23例)和8次治疗(32例)患者的有效率分别为34.8%和78.1%(P0.01)。结论:Nd:YAG1064nm激光治疗甲真菌病有效,疗效与治疗次数相关。     

紫翠宝石755nm激光治疗太田痣的疗效观察

<正>129例太田痣患者接受紫翠宝石755nm激光治疗,共治疗4~6次,治疗间隔2~3个月。结果:129例患者4次治疗有效率为93.0%(120例),6次治疗后有效率为98.4%(127例)。认为紫翠宝石755nm激光治疗太田痣疗效肯定,所有患者治疗后反应轻微,且均无永久色素改变、瘢痕、皮肤质地改变、创面感染及其他严重不良反     

不同疗程长脉宽 Nd∶YAG 1064 nm 激光治疗甲真菌病的疗效观察

目的：比较不同疗程长脉宽Nd∶YAG 1064 nm 激光治疗甲真菌病的疗效及安全性。方法：对43例甲真菌病患者行长脉宽Nd∶YAG 1064 nm激光治疗,随机分为两组,A组为1疗程组,每周治疗1次,共4次;B组为2疗程组,共治疗8次,分别于治疗后12周、24周进行随访,采用卡方检验比较两组患者真菌学及临床疗效的差异。结果：43例患者共治疗病甲138个,其中A组患者24例,病甲70个;B组患者19例,病甲68个。在12周及24周,两组患者的真菌学疗效均无统计学差异（χ2值分别为0.16、0.46,P值均＞0.05）;12周,A、B两组的临床有效率分别为58.6％、75.0％,差异有统计学意义（χ2＝4.19,P＜0.05）;24周,A、B两组的临床有效率分别为42.9％、58.8％,差异无统计学意义（χ2＝3.52,P＞0.05）。治疗过程中除疼痛外未发生其他不良反应。结论：长脉宽Nd∶YAG激光是治疗轻中度甲真菌病的一种安全有效的方法,适当延长疗程可提高近期（12周）临床疗效。     

长脉宽1064nm Nd∶YAG激光或595nm脉冲染料激光或两者联合治疗会阴部婴幼儿血管瘤疗效分析

目的:总结分析长脉宽1 064 nm掺钕钇铝石榴石(Nd∶YAG)激光、595 nm脉冲染料激光(PDL)或两者联合治疗会阴部婴幼儿血管瘤临床疗效、不良反应及其影响疗效的有关因素。方法:应用长脉宽1 064 nm Nd∶YAG激光、脉冲染料激光或两者联合治疗会阴部婴幼儿血管瘤35例,治疗间隔4~8周。统计治疗效果并分析影响疗效的因素。结果:35例患儿,其中男3例、女32例,年龄40 d~2岁,皮损面积0.1~15 cm2。治疗有效率为100%,治疗次数1~5次。常见的不良反应为红肿和水疱,一般3~5 d内修复,其中2例出现糜烂及渗出,5例痊愈后皮肤质地有变化,2例遗留色素沉着,未见感染、瘢痕等其他不良反应。结论:长脉宽1 064 nm Nd∶YAG激光及595 nm脉冲染料激光治疗会阴部婴幼儿血管瘤安全有效,不良反应轻微,值得推广应用。     

1064nmNd:YAG激光治疗化脓性肉芽肿103例疗效观察

目的探讨1 064nm Nd:YAG激光治疗化脓性肉芽肿的临床疗效。方法采用1 064nm Nd:YAG激光治疗化脓性肉芽肿103例,光斑直径6mm,脉宽9.5~10.5ms,能量密度90~115 J/cm~2,3~4周后复诊,疗效不佳者可进行第2次治疗,观察治愈率和不良反应。结果 1次治愈者48例,2次治愈者52例,2例患者治疗后遗留皮色赘生物,行冷冻治疗后消退,总治愈患者102例,治愈率99.03%,1例患者出现瘢痕,不良反应发生率0.97%,1例患者治疗无效。结论 Nd:YAG激光治疗化脓性肉芽肿治愈率高,不良反应发生率低。     

不同疗程长脉宽Nd∶YAG 1064nm激光治疗甲真菌病的疗效观察

目的:比较不同疗程长脉宽Nd∶YAG 1 064 nm激光治疗甲真菌病的疗效及安全性。方法:对43例甲真菌病患者行长脉宽Nd∶YAG 1 064 nm激光治疗,随机分为两组,A组为1疗程组,每周治疗1次,共4次;B组为2疗程组,共治疗8次,分别于治疗后12周、24周进行随访,采用卡方检验比较两组患者真菌学及临床疗效的差异。结果:43例患者共治疗病甲138个,其中A组患者24例,病甲70个;B组患者19例,病甲68个。在12周及24周,两组患者的真菌学疗效均无统计学差异(2值分别为0.16、0.46,P值均>0.05);12周,A、B两组的临床有效率分别为58.6%、75.0%,差异有统计学意义(2=4.19,P<0.05);24周,A、B两组的临床有效率分别为42.9%、58.8%,差异无统计学意义(2=3.52,P>0.05)。治疗过程中除疼痛外未发生其他不良反应。结论:长脉宽Nd∶YAG激光是治疗轻中度甲真菌病的一种安全有效的方法,适当延长疗程可提高近期(12周)临床疗效。     

585nmQ开关激光与595nm可调脉宽激光治疗毛细血管扩张

目的　比较 5 85nmQ开关激光与 5 95nm可调脉宽激光治疗毛细血管扩张的疗效。方法　用 5 85nmQ 开关MedliteIV激光仪与 5 95nm可调脉宽Vbeam激光仪分组治疗毛细血管扩张共 2 3 8例 ,观察疗效和不良反应 ,并进行比较。结果　两组治愈率和有效率差异显著 ,术后色素改变发生率无显著性差异。结论　 5 95nm可调脉宽脉冲染料激光疗效明显优于 5 85nmQ 开关激光。     

长脉冲Nd:YAG 1064nm激光治疗化脓性肉芽肿疗效观察

目的:探讨长脉冲Nd∶YAG 1 064 nm激光治疗化脓性肉芽肿的疗效和安全性。方法:采用长脉冲Nd∶YAG 1 064 nm激光治疗化脓性肉芽肿32例,能量密度:70~100 J/cm2,脉宽:45 ms,光斑大小:6 mm。1个月后复查,皮损未愈者再次治疗至皮损消失。观察患者治疗后效果及不良反应。结果:长脉冲Nd∶YAG 1 064 nm激光治疗化脓性肉芽肿1次痊愈率为75%,2次痊愈率为87.5%,总痊愈率为100%,愈后无1例患者出现瘢痕、色素沉着或色素减退,随访3个月无复发。结论:长脉冲Nd∶YAG1 064 nm激光治疗化脓性肉芽肿临床疗效好,安全性高及不良反应少,值得临床推广。     

长脉宽1064 nm Nd:YAG激光治疗女性黄褐斑的Split-face模式观察

目的运用Split-face模式探讨长脉宽1 064 nm Nd:YAG激光治疗女性黄褐斑的有效性和安全性。方法选取24例双侧面部皮损对称的女性黄褐斑患者,固定选择右侧面部进行长脉宽1 064 nm Nd:YAG激光治疗5次,所有患者每次激光治疗前及末次治疗后第4、第8周均行MASI评分、VISIA皮肤图像分析、CK无创皮肤检测和反式共聚焦显微镜(RCM)检查,并记录治疗和随访期间出现的相关不良反应。结果 MASI评分、RCM总分、VISIA绝对分值及CK的血红蛋白、黑色素值均显示,首次治疗前治疗侧和对照侧差异无统计学意义(P>0.05);末次治疗后4周治疗侧分值较对照侧低,差异有统计学意义(P<0.05);治疗侧末次治疗后4周分值较首次治疗前低,差异有统计学意义(P<0.05);不管是根据Fitzpatrick皮肤分型,还是伍氏灯和玻片压诊分型,各型患者疗效与复发率差异均无统计学意义(P>0.05)。所有患者无明显不良反应发生。结论长脉宽1 064 nm Nd:YAG激光治疗女性黄褐斑安全、有效。     

准长脉宽1064 nm Nd:YAG激光联合超分子水杨酸治疗面部轻中度痤疮的临床疗效观察

目的探讨准长脉宽1064 nm Nd:YAG激光联合超分子水杨酸治疗面部轻中度痤疮的临床疗效。方法将99例患者随机平均分为激光和水杨酸的联合治疗组,水杨酸治疗组,激光治疗组。3组均治疗2周1次,总共治疗5次,比较3组患者临床疗效。结果第3次治疗后联合治疗组有效率明显高于激光治疗组,差异有统计学意义(P<0.05)。除第一次治疗外,后续治疗联合治疗组有效率均高于水杨酸治疗组,差异有统计学意义(P<0.05),激光治疗组与水杨酸治疗组有效率比较差异无统计学意义(P>0.05)。结论准长脉宽1064 nm Nd:YAG激光联合超分子水杨酸治疗面部轻中度痤疮起效快,效果显著,安全性高,复发率低,医患满意度高。     

Photorejuvenation using long-pulsed alexandrite and long-pulsed neodymium:yttrium-aluminum-garnet lasers: a pilot study of clinical outcome and patients' satisfaction in Koreans

Long-pulsed 755-nm alexandrite and long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers have been used for photorejuvenation of the face. The aim of this study was to investigate the safety and efficacy of long-pulsed alexandrite and long-pulsed Nd:YAG lasers for photorejuvenation in Korea. One hundred and sixteen Korean patients with photo-aged facial skin were enrolled. Sixty-two patients with facial pigmentation underwent long-pulsed alexandrite laser treatment. Eleven patients that wanted to improve facial pigmentation with minimal pain had quasi-long-pulsed alexandrite laser treatment. Forty three patients had long-pulsed Nd:YAG laser therapy. Outcome assessments included standard photographs and global evaluation by blinded investigators. The self-assessment grade was provided in questionnaires. Forty-four percent of patients reported excellent or good improvement of their pigmentary lesions (>50% improvement) using a long-pulsed alexandrite laser. Of patients who underwent long-pulsed Nd:YAG laser treatment, 36% reported excellent or good improvement in skin tightening, 50% in facial flushing and 45% in pigmentary lesions. We conclude that long-pulsed alexandrite and long-pulsed Nd:YAG lasers are safe and effective for facial photorejuvenation in Koreans.     

调Q开关紫翠宝石激光治疗颧部褐青色痣疗效观察

目的：评价调Q开关紫翠宝石激光治疗颧部褐青色痣的疗效。方法：用调Q开关紫翠宝石激光治疗43例颧部褐青色痣患者，治疗前后照相对进行评分，并观察不良反应。结盟果：43例患才治疗1-4次，治疗间隔为2-3个月。有效率为72.1%，痊愈率为25.6%。3例患者出现暂时性的色素减退。结论：调Q开关紫翠宝石激光治疗颧部褐青色痣安全、有效。     

Successful treatment of Becker’s Nevus with long-pulsed 1064-nm Nd:YAG and 755-nm alexandrite laser and review of the literature

Background: Becker’s Nevus is an aesthetically troublesome condition secondary to hyperpigmentation and hypertrichosis. Although several lasers have been employed with varying degrees of success, the exact devices and treatment parameters have yet to be elucidated. Objective: To assess the combination Nd:YAG and alexandrite laser as a safe and efficacious treatment for Becker’s Nevus. Methods: In a 20-year-old Fitzpatrick Skin Type IV male, a Becker’s Nevus was treated with six sessions of long-pulsed 1064 nm Nd:YAG laser at six-week intervals followed by five sessions of long-pulsed 755 nm alexandrite laser at three-month intervals. Results: This patient experienced a significant reduction in both hyperpigmentation and hypertrichosis after these treatment sessions. No serious adverse events were reported. Conclusion: This case supports the use of combination long-pulsed 1064 nm laser and 755 nm laser as a safe and efficacious treatment for Becker’s Nevus.     

皮秒翠绿宝石激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效与安全性比较

【摘要】 目的 通过前瞻性、半脸对照研究，比较皮秒翠绿宝石激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效与安全性。方法 2015年10月至2017年10月在中国医学科学院皮肤病医院激光科收集面部对称性萎缩性痤疮瘢痕患者，左侧面部痤疮瘢痕采用超脉冲CO2点阵激光治疗，右侧采用皮秒翠绿宝石激光点阵模式治疗，治疗间隔为2个月，共治疗3次。治疗前后由皮肤科医生根据ECCA评价表对瘢痕进行评分，患者根据四分法自评临床疗效。记录治疗时疼痛程度和不良反应。两侧间、治疗前后ECCA评分及疼痛程度评分比较采用配对t检验，组间四分法评分比较采用 Wilcoxon 秩和检验。结果 治疗前皮秒激光侧和点阵激光侧间ECCA评分差异无统计学意义（t = 1.06，P = 0.300），治疗3次后差异有统计学意义［（70.98 ± 21.48）分比（58.04 ± 17.63）分，t = 3.76，P = 0.001］。与治疗前相比，皮秒激光侧瘢痕改善评分（2.21 ± 1.09）分，CO2点阵激光侧（2.83 ± 1.11）分，两组差异有统计学意义（z = 2.70，P = 0.007）。与CO2点阵激光侧相比，皮秒激光侧不良反应更少，表现为一过性红斑、水肿，治疗疼痛评分亦明显降低［（3.71 ± 0.62）分比（6.23 ± 1.06）分，t = 11.93，P < 0.001］。结论 皮秒翠绿宝石激光与超脉冲CO2点阵激光均能有效改善萎缩性痤疮瘢痕，CO2点阵激光疗效更显著，而皮秒激光不良反应更少。     

Novel 755-nm diode laser vs. conventional 755-nm scanned alexandrite laser: Side-by-side comparison pilot study for thorax and axillary hair removal

Background: Alexandrite (755 nm) and diode lasers (800–810 nm) are commonly used for hair removal. The alexandrite laser technology is somewhat cumbersome whereas new diode lasers are more robust. Recently, alexandrite-like 755 nm wavelength diodes became available. Objectives: To compare the efficacy, tolerability, and subject satisfaction of a 755 nm diode laser operated in conventional (HR) and non-conventional in-motion (SHR) modes with a conventional scanned alexandrite 755 nm laser for chest and axillary hair removal. Materials and methods: A prospective, single-center, proof of principle study was designed to evaluate the safety, efficacy and handling of a 755 nm diode laser system in comparison to a standard alexandrite 755 nm scanning hair removal laser. Results: The new 755 nm diode is suitable to be used in SHR and HR mode and has been tested for its safety, efficacy and handling in a volunteer with success. Overall, both systems showed a high efficacy in hair reduction (88.8% 755 nm diode laser vs. 77.7% 755 nm alexandrite laser). Also, during the study period, no severe adverse effects were reported. Conclusion: The new 755 nm diode laser is as effective and safe as the traditional 755 nm alexandrite laser. Additionally, treatment with the 755 nm diode laser with HR and SHR modes was found to be less painful.     

Pupil damage after periorbital laser treatment of a port-wine stain

BACKGROUND: The increase in the number of laser treatments has led to an increase in the number of therapy-related adverse effects. Herein we report a case in which long-term adverse effects occurred after periorbital laser treatment of a treatment-resistant port-wine stain using a long-pulsed alexandrite laser without protective eyewear. OBSERVATIONS: A 33-year-old woman with a therapy-resistant port-wine stain was treated periorbitally with a 755-nm long-pulsed alexandrite laser after several treatment sessions with the pulsed-dye laser; she was not given protective eye shields. Within a few days of the session, she reported disorders in the motility of her left pupil and a painful sensitivity to light, which was not completely resolved after 12 months of follow-up. CONCLUSIONS: We recommend that both patients and operators use protective eyewear with every laser procedure. When treatment is administered near the eye, eye shields should be placed behind the eyelid or a safe distance should be maintained between the laser and the eyeball by treating up to the orbital rim only.     

Combination of 595-nm pulsed dye laser,long-pulsed 755-nm alexandrite laser,and microdermabrasion treatment for keratosis pilaris: retrospective analysis of 26 Korean patients

Abstract

Keratosis pilaris (KP) has beenpresented as small keratotic follicular papules with or without surrounding erythema. Various treatments with laser or light therapy have been used for the management of KP with various clinical outcomes. In the present study, we investigated the efficacy and safety of a combination therapy for KP. A total of 29 anatomical sites with KP in 26 patients were treated using a 595-nm pulsed dye laser (PDL) with nonpurpuragenic fluences, a long-pulsed 755-nm alexandrite laser, and microdermabrasion. Clinical improvement was assessed by comparing preand posttreatment clinical photographs and patient satisfaction rates. Evaluation of the clinical results three months after the treatments showed that 12 of the 29 anatomical sites (41.4%) demonstrated Grade 3 clinical improvement, ten (34.5%) had Grade 2 clinical improvement, four (13.8%) showed Grade 1 improvement, and three (10.3%) showed Grade 4 improvement. We observed that KP lesions improved not only in erythema and skin texture, but also in brownish dyschromias. Potential adverse events were not observed, except prolonged posttherapy scaling. Our observations demonstrate that combination therapy using a 595-nm PDL, a long-pulsed 755-nm alexandrite laser, and microdermabrasion can have a positive therapeutic effect on KP.     

不同波长的Q-开关激光治疗眶周色素沉着症疗效比较

目的：评价三种Q-开关激光治疗眶周色素沉着症的疗效。方法：83例患者随机分为A、B、C3组，A组和C组分别采用532nm和1064nm Q-开关Nd：YAG激光治疗，B组采用Q-开关翠绿宝石激光(755nm)治疗。结果：A组和C组疗效差，B组经4次及以上的治疗，总有效率可达82．1％，3组的总有效率的差异有显著性。结论：Q-开关翠绿宝石激光治疗眶周色素沉着症有较满意疗效，无明显副作用，可作为首选治疗方法。     

Laser hair removal

Since 1996, there have been numerous advances in hair laser removal that utilize melanin as a chromophore. All of the devices on the market may be used in patients with light skin (phototypes I-III) and yield hair reduction near 75%. The ruby (694 nm) laser, alexandrite (755 nm) laser, and diode (810 nm) laser, as well as intense pulsed light are commonly used devices for hair laser removal. The long-pulsed Nd:YAG (1064 nm) laser represents the safest device for hair removal in dark-skinned patients because of its long wavelength, although the diode laser, alexandrite laser, and intense pulse light may be used. For treatment of light hair, combination radiofrequency and optical devices as well as photodynamic therapy are under investigation.     

Treatment of Ota's nevus by Q-switched alexandrite laser : therapeutic outcome in relation to clinical and histopathological findings

Ota's nevus is a dermal melanocytic disease which causes serious cosmetic problems for affected individuals. Recently Q-switched lasers with a pulse duration of 100 nsec or less became available for patient treatment. We evaluated the clinical efficacy of the Q-switched alexandrite laser (755 nm, 100 nsec) in relation to the histopathological findings. Fifty-five Korean patients with Ota's nevus were treated with a Q-switched alexandrite laser for three sessions (7.5 J/cm2) at three month intervals. Skin biopsies were taken in all of the patients before treatment and immediately after treatment in five patients. Clinical effectiveness and side effects were evaluated by direct observation and photographs. Pigment clearing was excellent in 27 patients (49%), good in 17 patients (31%), fair in 7 patients (13%) and poor in 4 (7%) patients. Postinflammatory hyperpigmentation developed in 30 patients (55%) which resolved within four months. But there were no serious complications including scarring or textural change. The therapeutic outcome was not affected by color but by depth of the nevus. Nevi of Ota with depth of 1 mm or less were associated with excellent or good results. Q-switched alexandrite laser is a very effective and safe tool for treating Ota's nevus. Depth of 1 mm or less of dermal melanocytes was a good prognostic marker.