Q开关Nd:YAG激光1064nm联合532nm波长治疗颧部褐青色痣临床观察

目的 观察Q开关Nd:YAG激光1064 nm联合532 nm波长治疗颧部褐青色痣的临床疗效及不良反应.方法 应用Q开关Nd:YAG激光1064 nm联合532 nm波长治疗70例患者,开始选择波长为1064 nm,光斑直径3～4 mm,能量密度3.5 ～ 4.5 J/cm2,频率10 Hz,脉宽10 ns.之后对某些疗效不佳且色素较浅层患者改用或交替选择532 nm波长,光斑直径3～4 mm,能量密度1.5～2.0 J/cm2,频率1～5Hz.治疗间隔时间为2～3个月,一般治疗3～4次.结果 治疗4次后治疗组有效率为100％,痊愈率为75.00％,疗效与治疗次数呈正相关.36例(51.43％)患者出现色素沉着,12例(17.14％)出现暂时性色素减退.结论 Q开关Nd: YAG激光1064 nm联合532 nm波长治疗颧部褐青色痣效果满意,虽然术后色素沉着发生率较高,但均能随时间逐渐消退,未见其他不良反应及并发症.     

光动力疗法治疗乳房外Paget病临床研究

目的 探讨荧光诊断指导下光动力治疗肛周皮肤湿疹样癌的临床意义。方法 肛周Paget病6例,前期3例行普通光动力治疗(PDT),后期3例行荧光诊断指导下光动力治疗,普通PDT组给以光敏剂Photofrin 2mg/kg,48h后给以功率100～150mW /cm2、能量密度150～300J/cm2,波长630 nm半导体激光照射病灶;荧光诊断指导PDT组（FPDT）给以局部20％ALA湿敷（激光照射前3h）和静脉给光敏剂喜泊分5mg/kg（激光照射前48h）,并给以同样剂量激光照射,激光照射前给以405nm蓝紫光行荧光诊断确定病灶的范围以指导治疗。治疗后48h和72h, 1、3和6个月观察患者病灶局部反应并长期随访。结果 治疗后48h 2组均可见病灶局部明显变暗、发黑、变硬,120h局部开始结痂,渗出减少,皮肤修复时间长。治疗后6个月普通PDT组CR1例,PR2例;FPDT组CR2例,PR1例。结论　光动力学疗法是肛周Paget病的有效治疗方法,荧光诊断对于确定病灶范围、指导临床治疗意义重大。     

595nm脉冲染料激光治疗儿童皮肤微静脉畸形疗效分析

目的探讨595nm脉冲染料激光治疗儿童微静脉畸形的疗效。方法应用595nm脉冲染料激光治疗351例皮肤微静脉畸形患儿,观察疗效及副作用。结果 351例患者中治疗次数最少1次,最多13次,间隔4～6周,总有效率43%;皮损位于面部的患儿138例,不同部位皮损治疗次数最少1次,最多13次,有效率在22.7%～44%之间,疗效之间无统计学差异。不良反应发生4例(1.1%)。结论 595nm脉冲染料激光治疗微静脉畸形疗效确切,不良反应少见。     

调Q红宝石激光治疗太田痣

加有调 Q 装置的红宝石激光具有脉冲短,能量发射高的特点。能特异性选择性地破坏细胞器的黑色体.本研究以波长694nm,脉冲宽40ns,光斑直径5mm,能量密度6～10J/cm~2的调 Q红宝石激光治疗15例太田痣患者。均经活检病理确诊。治疗时局麻或神经阻滞麻醉或不作麻醉。每次治疗间隔为1～6个月(多为2～3个月).治疗次数2～7次(多为4次),     

Q开关Nd:YAG激光联合谷胱甘肽、维生素C治疗黄褐斑疗效分析

目的探讨大光斑、小功率Q开关Nd∶YAG激光联合谷胱甘肽、维生素C治疗黄褐斑的疗效和安全性.方法12例女性黄褐斑患者接受Medlite C6 Q开关Nd∶YAG激光,波长1064 nm,光斑6 mm,能量2.5～3.0 J/cm2,共治疗8次,间隔1周,第9次后治疗间隔改为1个月,共治疗6次.同时联合还原谷胱甘肽900 mg和维生素C2g静脉滴注,每天一次,共14 d为1个疗程,疗程间隔3个月.治疗前后均拍照,并算出治疗前后黄褐斑面积和严重指数(MASI).结果12例患者中治愈1例,显效5例,好转6例,无效0例.所有患者的平均MASI值由治疗前的13.8±4.3降到7.1±2.4(P＜ 0.05),差异有统计学意义.所有患者均无色素沉着和色素脱失等不良反应,治疗后患者毛孔缩小,皮肤更细腻.结论大光斑、小功率Q开关Nd∶YAG激光联合谷胱甘肽、维生素C治疗黄褐斑疗效好,安全性高,无需停工期,不良反应小,可作为治疗黄褐斑的一种选择.     

皮肤血管病及淋巴管病

20062098Nd:YAG激光治疗皮肤血管性病变980例回顾性临床分析/于海生(广西医科大一附院美容整形外科),陈石海∥中国美容医学.-2006,15(2).-183~185治疗毛细血管畸形、毛细血管瘤、毛细血管扩张和血管痣等皮肤血管性病变,选择能量范围4~22J/cm2,波长532nm,脉宽8~20ms,光斑直径1~6mm。结果Nd:YAG激光对不同皮肤血管性病变的疗效有显著性差异(P<0.05)。多因素分析显示:毛细血管畸形的疗效与病变面积、颜色、病程、治疗次数、激光能量及光斑大小有关;毛细血管瘤的疗效与治疗面积、次数、激光能量及光斑大小有关;血管痣的疗效与治疗次数、激光…     

Q开关Nd：YAG激光治疗雀斑样痣疗效观察

目的 评价Q开关Nd：YAG激光对单纯性雀斑样痣的疗效。方法 用Q开关Nd：YAG激光(532nm，光斑直径2～3mm，频率5Hz)治疗26例单纯性雀斑样痣患者，治疗前后相对比进行评价，并观察不良反应。结果 26例患者治疗1～3次，治疗间隔为2～3个月。有效率为76．92％，痊愈率为50％。结论 单纯性雀斑样痣患者用Q开关Nd：YAG激光安全而有效。     

太田母斑的激光疗法

应用满足选择性光热疗法(SP)条件的脉冲Q-开关红宝石激光(波长:694nm,照射时间:30nsec)治疗114例太田母斑患者(男25,女89,年龄8～63岁,照射功率6J/cm~2,治疗3～4个月。 效果判定分显效、有效、稍有效、无效、恶化5级。以治疗前病变部位皮肤色泽为100％,     

半导体激光治疗多毛症的疗效观察

目的：观察Lightsheer半导体激光脱毛治疗的疗效。方法：应用半导体激光机治疗90例多毛症患者，波长800nm、脉冲宽度5～100ms、能量密度值10～60J／cm^2，术前脱毛治疗区常规备皮。治疗选择脉宽100ms．能量28～35J／cm^2为宜，一般从低能量开始，治疗间隔依据不同部位毛发的休止期时间，1～3个月左右治疗一次。结果：随访12个月90例患者均获得满意效果，且无1例出现瘢痕、色素沉着等不良反应。结论：与传统方法相比，激光脱毛有其独特的选择性光热作用及周围皮肤组织的非侵人性和操作简便的优势。     

激光联合混合波长治疗颧部褐青色痣

<正>选择Nd:YAG激光,波长1 064nm,光斑直径3~4mm,能量密度3.5~4.5J/cm2,频率10Hz,脉宽10ns,对某些疗效不佳且色素较浅层患者改用或交替选择532nm波长,光斑直径3~4mm,能量密度1.5~2.0J/cm2,频率1~5Hz,治疗间隔时间为2~3个月,一般治疗3~4次。结果:36例(51.43%)患者出现色素沉着,12例(17.14%)出现暂时性色素减退。认为Q开关Nd:YAG激光1064nm联合532nm波长治疗颧部褐青色痣效果     

Laser surgical planning with magnetic resonance imaging-based 3-dimensional reconstructions for intralesional Nd:YAG laser therapy of a venous malformation of the neck

BACKGROUND: Three-dimensional (3-D) imaging using computed tomography or magnetic resonance imaging data is well known for surgical planning of complex lesions in neurosurgery. In dermatology, percutaneous and intralesional Nd:YAG laser therapy is well established for numerous types of vascular malformations. Diagnostic imaging using ultrasound, computed tomography, or magnetic resonance imaging is necessary to plan the laser therapy of those malformations. The therapeutic problem is to localize the venous malformation exactly before treatment on sectional 2-dimensional images. OBSERVATIONS: We describe a 27-year-old woman with a venous malformation of the neck. The data of diagnostic magnetic resonance imaging were used for a 3-D reconstruction of the venous malformation to demonstrate the anatomical extent and subcutaneous involvement for laser surgical planning. Percutaneous and intralesional laser therapy was performed at 3-month intervals with the Nd:YAG laser using the 3-D reconstruction as a road map for the Nd:YAG laser. Eight weeks after the last laser treatment, the bulky lesions of the neck showed regression. Using the 3-D reconstruction for laser surgical planning, physicians could perform intralesional laser treatment more exactly. The complex anatomy of the venous malformation could be elucidated by studying the 3-D images before and during laser surgery. CONCLUSION: The use of magnetic resonance imaging-based 3-D reconstructions for laser surgical planning can demonstrate the often unexpected extent and improve the intralesional laser therapy in the treatment of venous malformations.     

Anetoderma treated with combined 595-nm pulsed-dye laser and 1550-nm non-ablative fractionated laser

Anetoderma is a skin disorder characterized by a focal loss of dermal elastic tissue whereby patients present with soft, depressible lesions. We postulated that a series of combination treatment using the 595-nm pulsed dye laser (PDL) and the 1550-nm non-ablative fractionated laser (NAFL) would improve the anetoderma lesions. Our patient with biopsy proven anetoderma received 3 treatments with a combination of 595-nm PDL and 1550-nm NAFL spaced 3 weeks apart. Skin biopsies were performed at baseline and immediately prior to the third treatment. Stains for hematoxylin and eosin and Verhoeff Van Gieson (VVG) were performed. Improvement in lesion color, texture, and overall appearance was noted after the second treatment and continued following the third treatment. Post-treatment VVG staining demonstrated an increase in dermal elastin fibers and a decrease in elastin fiber fragmentation. Thus, the combination of 595-nm PDL and 1550-nm NAFL should be considered as a treatment modality for anetoderma.     

308 nm准分子激光联合CO2点阵激光治疗稳定期白癜风的疗效观察

 目的:观察308 nm准分子激光联合CO2点阵激光对于稳定期白癜风的治疗效果及安全性。方法：选取118例稳定期白癜风患者,使用随机数字表法分为观察组和对照组,观察组59例（皮损总数328处）,对照组59例（皮损总数319处）。观察组采用308 nm准分子激光联合CO2点阵激光治疗,对照组单纯采用308 nm准分子激光治疗。治疗3个月后,比较两组疗效及不良反应发生情况。结果：治疗后,观察组及对照组总有效率分别为89.94%和84.64%,两组总有效率比较,差异有统计学意义(X²=6.59,P=0.014),两组不良反应总发生率分别为23.34%和22.15%,两组比较差异无统计学意义( X²=1.29,P=0.088)。结论：308 nm准分子激光联合CO2点阵激光对于稳定期白癜风具有良好的疗效。     

大光斑低能量Q开关1064nm Nd:YAG激光治疗雀斑

目的:评价大光斑低能量模式Q开关1064 nm Nd:YAG激光治疗雀斑的疗效和安全性。方法:应用大光斑低能量模式Q开关1064 nm Nd:YAG激光治疗15例成人女性雀斑患者。治疗参数:波长1064 nm,脉宽10 ns,光斑7 mm,能量密度1.5~2.0 J/cm2,频率10 hz,每2~3周一次,治疗3~5次。末次治疗结束后随访6个月。结果:8例患者76%~100%皮损颜色变淡,4例51%~75%皮损颜色变淡,3例26%~50%皮损颜色变淡。所有患者治疗后仅有轻微红斑,数小时内消退,治疗后无色沉发生。随访6个月后2例患者复发。结论:大光斑低能量Q开关1064 nm Nd:YAG激光治疗雀斑安全有效。     

Treatment of hemorrhagic lymphatic malformation of the tongue with a pulsed-dye laser

Hemorrhagic lymphatic malformation (formerly called hemolymphangioma) of the tongue is an uncommon malformation that may pose both functional and cosmetic problems for the patient. The challenge has been to find a conservative treatment with low morbidity and better results than those achieved with surgical excision, which has been the mainstay of therapy. We report a case of successful treatment of a hemorrhagic lymphatic malformation of the tongue with a variable-pulse 595-nm pulsed-dye laser (Vbeam; Candela Corp, Wayland, Mass). In this patient, pulsed-dye laser treatment of the hemorrhagic lymphatic malformation achieved satisfactory functional and cosmetic outcomes. Its use in superficial vascular lesions of the mucosa should be considered.     

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.     

The dual 980‐nm and 1470‐nm diode laser for vascular lesions

Transcutaneous use of dual diode lasers is a new option in dermatology. The aim of the study was to demonstrate the transcutaneous application of a dual laser in dermatologic outpatients. We used a laser system that combines 980 nm and 1470 nm wavelengths for treatment of vascular lesions. Fifty‐six adult Caucasian patients of Fitzpatrick skin type I‐III, 32 females and 24 males with mean age of (41 ± 3.7) years were included. We treated 497 vascular lesions of skin and lips. Complete clearance was achieved in cherry angiomas, venous lakes, lip hemangioma, and spider nevi in 100% after a single treatment. Patients with couperose and/or facial telangiectasia needed several treatment sessions. Mild to moderate pain during the laser shots was noted in all patients. No adverse events were recorded. The dual 980‐nm/1470‐nm diode laser is a safe and effective tool for common vascular lesions.     

New clinical outcomes utilizing a 1064-nm Nd:YAG laser for lipolysis of the torso oblique region

Abstract

Objectives: The safety and efficacy of a 1064-nm Nd:YAG laser (Cynosure, Westford, USA) utilizing a 300-μm optical fiber and a 1-mm diameter micro-cannula were evaluated as a treatment for reduction in the appearance or elimination of unwanted fat in the lower back/flanks (‘love handles’). In addition, the use of the laser for tightening the skin and collagen regeneration in the area of lipolysis was assessed through biopsies. Methods: Ten subjects with unwanted flaccidity and fat deposits in the oblique region of the torso were enrolled in the study. Subjects underwent a single laser lipolysis treatment followed by aspiration of the treatment area. The total tumescence used, laser energy delivered, and tissue removed was recorded for each subject. All subjects had baseline photographs taken and their weight recorded prior to treatment. Pregnancy tests (if applicable) were performed prior to treatment as well. Three subjects had 4-mm biopsies taken at baseline and 6 months to evaluate collagen regeneration. Collagen and elastic tissue fibers were evaluated using special routine stains and histochemical stains designed to highlight these dermal components. Follow-up visits were conducted at 1 week, 1 month, 3 months and 6 months following treatment to evaluate side effects, weight loss and laxity. Additionally, patients kept an evaluation log for each of the first 7 days following treatment. At the 6-month conclusion, patient satisfaction was recorded. Results: Laser lipolysis procedures with subsequent aspiration were performed bilaterally on the flanks of 10 subjects. At 1-week post-treatment, 80% of the subjects demonstrated reduction in laxity. Similarly, 100% of patients showed visible skin improvement at 1 month, with 70% recording a score of 2 (good improvement). Three-month evaluations yielded one patient (10%) with a score of 3 (excellent improvement) and seven patients (70%) with a score of 2. Histology reports confirmed the visual clinical outcomes, describing thicker collagen bundles at 6 months, as well as coagulation of blood vessels and adipocytes. Side effects were mild and transient in nature, and the majority of discomfort, redness, bruising, swelling, and tingling experienced was resolved within 1 week post-procedure. The treatment was well tolerated and efficacious, with 90% of patients rating their results as good or excellent and 100% of patients reporting that they would recommend the procedure. Conclusion: The use of the 1064-nm Nd:YAG laser with a 300-μm fiber demonstrated the ability to treat adipose tissue in the highly vascular flank area with favorable efficacy and safety. Patients exhibited a quick recovery time and excellent tolerance, as well as visually improved skin.     

The efficacy of excimer laser (308 nm) for vitiligo at different body sites

BACKGROUND: The treatment with XeCl-excimer laser generated 308-nm UVB radiation has shown promising results in patients with vitiligo. OBJECTIVE: In this controlled, prospective trial we studied the primary efficacy (start and grade of repigmentation) and patient's satisfaction of XeCl-excimer laser for treatment of vitiligo patches at different body sites and re-evaluated the achieved repigmentation 12 months after the end of therapy. METHODS: Twenty-five patients with generalized or localized vitiligo with a total of 85 lesions at different body sites were enrolled in this study. Vitiligo patches were treated with 308-nm XeCl-excimer laser 3 times a week for 6 to 10 weeks. The overall repigmentation grade of each treated lesion was evaluated once a week on a 5 point scale rating from 0 (no repigmentation), 1 (1-5%), 2 (6-25%), 3 (26-50%), 4 (51-75%), to 5 (76-100%). RESULTS: Twenty-four patients completed the study. Within 6 to 10 weeks of treatment 67% of the patients (16/24) developed follicular repigmentation of at least one of their vitiligo lesions. Lesion repigmentation started after a mean of 13 treatments in lesions located on the face, trunk, arm, and/or leg (high-responder location), and after a mean of 22 treatments in lesions located on the elbow, wrist, dorsum of the hand, knee, and/or dorsum of the foot (low-responder location). Untreated control lesions and lesions located on the fingers did not achieve any repigmentation. After 10 weeks of treatment repigmentation of more than 75% was found in 25% (7/28) of lesions of the high-responder location group versus 2% (1/43) of lesions of the low-responder location group. In most cases, laser-induced repigmentation was persistent, as determined 12 months after the end of treatment. CONCLUSIONS: 308-nm excimer laser is an effective modality for the treatment of vitiligo. However, similar to other non-surgical treatment modalities, the therapeutic effect is mainly dependent on the location of vitiligo lesions.     

Comparison of the 308-nm excimer laser and a 308-nm excimer lamp with 311-nm narrowband ultraviolet B in the treatment of psoriasis

BACKGROUND: Psoriasis is a chronic, genetically determined inflammatory disease, characterized by an immunomediated pathogenesis, which affects approximately 1-3% of the population. Various modalities have been used for psoriasis treatment, including ultraviolet (UV) radiation. Narrowband UVB (311 nm) phototherapy is a well-established, widely used and highly efficient treatment for psoriasis, but a big disadvantage is that large areas of unaffected skin are irradiated along with the psoriatic lesions. OBJECTIVES: This investigation evaluates a 308-nm excimer laser and a 308-nm excimer lamp in comparison with 311-nm narrowband UVB in the treatment of patch psoriasis by using two different dose-increase schemes. MATERIALS AND METHODS: Fifteen patients with plaque psoriasis were enrolled in the study (first regime). Three different psoriatic lesions were treated with the 308-nm excimer laser, the 308-nm excimer lamp or 311-nm narrowband UVB three times per week. UVB doses were increased slowly and stepwise (1, 1, 2, 2, 3, 3, ...multiple MEDs). Sixteen patients were enrolled in the second regime. Two plaques were treated with the 308-nm excimer laser or with the 308-nm lamp with an accelerated scheme (2, 2, 4, 4, 6, 6, ...multiple MEDs) three times per week. We increased the UVB doses every second treatment (first and second regime) during the whole treatment. If blistering occurred, the blistered plaque was not treated on the next scheduled treatment. At every third visit and 1, 2 and 4 months after the last treatment a Psoriasis Severity Index (PSI) score was assigned in both regimes. RESULTS: Using Friedman analysis, the PSI scores did not show a statistically significant difference (P > 0.05) comparing 308-nm laser therapy, 308-nm lamp therapy and 311-nm narrowband therapy after 10 weeks in the first regime. The mean number of treatments to achieve clearance was 24. With the accelerated scheme, clearance could be achieved with fewer treatments and with half the cumulative dose of the first regime. Nevertheless, the side-effects such as blistering and crusting were also increased. CONCLUSIONS: Both 308-nm light sources can clear patch psoriasis in a similar manner to standard phototherapy, with the advantage of the ability to treat exclusively the affected skin and with a reduced cumulative dose, thus perhaps reducing the long-term risk of carcinogenicity.