532-nm Nd:YAG and 595-nm Pulsed Dye Laser Treatment of Leg Telangiectasia Using Ultralong Pulse Duration

BACKGROUND: Telangiectatic leg veins have been treated using lasers with variable success. OBJECTIVE: We aimed to examine the efficacy and tolerability of a 595-nm pulsed dye laser (PDL) and a 532-nm Nd:YAG laser using ultralong pulse duration to improve leg telangiectasias with a single treatment. METHODS: Ten subjects with leg telangiectasias up to 1.0 mm in diameter participated in the study. The telangiectatic patch was divided into two approximately equal adjacent areas. The first area was treated with a 532-nm Nd:YAG laser at a fluence of 20 J/cm2 and a pulse duration of 50 ms using a contact cooling device. The second area was treated with a 595-nm PDL at a fluence of 25 J/cm2 and a pulse duration of 40 ms using cryogen spray precooling. Each area was treated once only. Photographic evaluation was used for an assessment of response. RESULTS: Two of 10 subjects had less than 25%, 3 had 25% to 50%, 2 had 50% to 75%, and 3 had more than 75% improvement after single treatment with a 532-nm Nd:YAG laser. Similarly, 2 of 10 subjects had less than 25%, 2 had 25% to 50%, and 6 had 50% to 75% improvement with the 595-nm PDL. Hyperpigmentation occurred in one subject treated with the 532-nm Nd:YAG laser and two subjects treated with the 595-nm PDL. No blistering, crusting, hypopigmentation, or scarring were observed. CONCLUSION: Both lasers using ultralong pulse width improved leg telangiectasias after a single treatment with minimal adverse reactions.     

Long-Pulsed (6-ms) Pulsed Dye Laser Treatment of Rosacea-Associated Telangiectasia Using Subpurpuric Clinical Threshold

BACKGROUND: The pulsed dye laser (PDL), especially the 585-nm short-pulse width (450 micros) laser, has been extensively used in the treatment of facial telangiectasias. However, the resultant posttreatment purpura lasts for days and may not be cosmetically acceptable. OBJECTIVE: To examine the effect of long-pulsed (6 ms) PDL at subpurpuric clinical threshold in the treatment of rosacea-associated telangiectasia. METHODS: Twelve patients with rosacea-associated telangiectasia were recruited into the study. We used the 595-nm PDL at a pulse duration of 6 ms and titrated the fluence between 7 and 9 J/cm2 to produce immediate purpura lasting only a few seconds. Pretreatment cooling was achieved by cryogen spray. Assessment was made by comparing pretreatment and posttreatment photographs. Patients were evaluated 6 to 8 weeks after one PDL treatment. Results were reported as the percentage of reduction in the number of telangiectasias. Patients were asked for their own evaluation of improvement after treatment in terms of excellent, moderate, or poor outcome. Side effects such as pigmentary disturbance and scarring were also documented. RESULTS: Two of 12 patients had more than 75% improvement. Another two had 50% to 75% improvement, and five had 25% to 50% improvement. Overall, 9 (75%) of 12 patients had more than 25% improvement after a single treatment of PDL. None of the patients reported any lasting posttreatment purpura or complications. CONCLUSION: The long-pulsed 595-nm PDL using subpurpuric clinical threshold was effective for treatment of rosacea associated telangiectasia.     

Evaluating the Efficacy of Treatment of Resistant Port-Wine Stains With Variable-Pulse 595-nm Pulsed Dye and 532-nm Nd:YAG Lasers

Background. Some port wine stains (PWSs), despite multiple treatments with the 585-nm 0.45-ms pulsed dye laser (PDL), fail to improve substantially.
Objective. To determine the efficacy and tolerability of variable pulse width 595-nm PDL and 532-nm Nd:YAG laser in the treatment of resistant PWS.
Methods. Twenty-two patients whose PWS failed to achieve more than 75% lightening after more than 15 treatments with the 585-nm 0.45-ms PDL were recruited. A homogenous patch of PWS was divided into five areas. Area 1 (control area) was treated with 585-nm, 0.45-ms PDL (fluence 7.5 J/cm²). Areas 2 and 3 were treated with 595-nm PDL at fluence 15 J/cm² (with cryogen spray cooling) and pulse durations of 1.5 and 10 ms, respectively. Areas 4 and 5 were treated with a 532-nm Nd:YAG laser at 2 ms, 7 J/cm² and 10 ms, 16 J/cm², respectively (with a contact cooling tip). The response was assessed by photographic evaluation.
Results. Three patients had further lightening in area 2, and two patients had further lightening in area 3. Each of three patients had further lightening in areas 4 and 5, respectively. One patient had further lightening in the control area.
Conclusion. In individual patients, it may be effective to treat resistant PWS with the variable-pulse width 595-nm PDL and the 532-nm Nd:YAG laser.     

Treatment of Facial Telangiectasia Using a Dual-Wavelength Laser System (595 and 1,064 nm): A Randomized Controlled Trial with Blinded Response Evaluation

BACKGROUND AND OBJECTIVE Pulsed dye (PDL) 595- and 1,064-nm Nd:YAG lasers are used for the treatment of vascular lesions. PDL-heated blood exhibits increased absorption of radiation at 1,064 nm, suggesting that the use of combined sequential dual wavelengths may offer benefits over single-wavelength treatments. This study compares the treatment efficacy of combined sequential dual-wavelength versus single delivery of 595-nm PDL or 1,064-nm Nd:YAG wavelengths in facial telangiectasia in a split face study design using subpurpuric parameters.
MATERIALS AND METHODS Twenty patients were studied using the sequential delivery of PDL and Nd:YAG wavelengths on one side of the nose. The other side received either PDL or Nd:YAG treatment. Vessels (<0.6 mm in diameter) were treated with a 7-mm spot size at 10 J/cm², 10 ms with the PDL, followed by the Nd:YAG at 70 J/cm², 15 ms with a multiplex interpulse delay of 100 ms. Subjects received a single treatment, and results were evaluated after 4-week follow-up. Improvement was determined by blinded assessment of photographs taken before and after final evaluation.
RESULTS The efficacy of the dual-wavelength laser treatment when compared to Nd:YAG or PDL laser alone was significantly more evident than either single-wavelength treatment ( p <.05). There was no statistically significant difference in efficacy between the single-wavelength treatment groups.
CONCLUSION The sequential delivery of 595- and 1,064-nm-wavelength radiation with an interpulse delay suggests that the synergistic approach to laser therapy for facial telangiectasia is a superior method compared to standard single wavelength therapy.     

Using the ultra-long pulse width pulsed dye laser and elliptical spot to treat resistant nasal telangiectasia

Thick linear telangiectasia on the ala nasi and nasolabial crease can be resistant to treatment with the potassium–titanyl–phosphate (KTP) laser and the traditional round spot on a pulsed dye laser (PDL). We evaluated the efficacy of a 3 mm?×?10 mm elliptical spot using the ultra-long pulse width on a Candela Vbeam® PDL for treatment of PDL- and KTP laser-resistant nasal telangiectasia. Nasal telangiectasia resistant to PDL (12 patients) and KTP laser (12 patients) in 18 patients were treated with a 3 mm?×?10 mm elliptical spot on the ultra-long pulse pulsed dye laser (ULPDL) utilising long pulse width [595 nm, 40 ms, double pulse, 30:20 dynamic cooling device (DCD)]. Six patients had previously received treatment with both PDL and KTP laser prior to ULPDL (40 treatments, range1–4, mean 2.2). Complete clearance was seen in ten patients, and eight patients displayed more than 80% improvement after ULPDL treatment. Self-limiting purpura occurred with round spot PDL and erythema with KTP laser and ULPDL. Subtle linear furrows along the treatment sites were seen in three patients treated with the KTP laser. ULPDL treatment delivered using a 3 mm?×?10 mm elliptical spot was non-purpuric and highly effective in the treatment of nasal telangiectasia resistant to KTP laser and PDL.     

Cooling gel improves pulsed KTP laser treatment of facial telangiectasia

BACKGROUND AND OBJECTIVE: Pulsed KTP lasers effectively treat facial telangiectasia without purpura production. Transient side effects following treatment include erythema, edema, and vesiculation leading to crust formation. The aim of this study was to investigate the utility of an aqueous gel in reducing side effects associated with pulsed KTP laser treatment of facial telangiectasia. STUDY DESIGN/MATERIALS AND METHODS: Nineteen patients with extensive facial telangiectasias were treated with a pulsed KTP laser (Versapulse, Coherent, Palo Alto, CA). The laser was used with the water cooled handpiece chilled to 4C, a 4 mm spot size, a 10-millisecond pulse duration and a fluence of 9.5 J/cm2. One side of the face was treated with the laser using the cooling handpiece alone. The other side was treated using the cooling handpiece applied to a 2-mm film of aqueous gel spread over the treatment area. RESULTS: Treatment side effects, including pain, erythema, edema, vesiculation, and crusting were scored following treatment with and without the aqueous gel. Use of the aqueous gel in conjunction with the cooling handpiece decreased the incidence and severity of pain, erythema, edema, and crusting following pulsed KTP laser treatment of facial telangiectasia. Most patients demonstrated 50-75% clearance of their telangiectasias 1 month after one treatment session, and use of the gel did not alter the treatment efficacy. CONCLUSIONS: The application of an aqueous gel during pulsed KTP laser treatment of facial telangiectasia improves treatment associated side effects without affecting vessel clearance.     

Cutaneous Compression for the Laser Treatment of Epidermal Pigmented Lesions with the 595-nm Pulsed Dye Laser

BACKGROUND The 595-nm pulsed dye laser has been the standard of care for many vascular lesions and has rarely been used in the treatment of epidermal pigmented lesions.
OBJECTIVE The objective was to investigate the effectiveness and safety of a compression technique for the treatment of epidermal pigmented lesion using a modified 595-nm pulsed dye laser with no epidermal cooling.
METHODS Twelve subjects (mean age 58 years) underwent treatments using a modified 595-nm dye laser with a compression handpiece and no epidermal cooling. Treatments were performed with radiant exposures of 7 to 12 J/cm², 7-mm spot size, and 1.5-ms pulse duration. Each subject received one to four treatments, 4 to 6 weeks apart. Follow-up evaluations were held before each treatment and 4 months after last treatment.
RESULTS Clearance of 75% to 100% was obtained in 43, 59, 76, and 79% of the lesions treated after one, two, three, and four treatments respectively. The fourth treatment was evaluated 4 months posttreatment. Side effects included immediate erythema and edema and rare cases of transient hyperpigmentation and atrophy. No purpura and long-lasting side effects were observed.
CONCLUSION The compression technique with a modified 595-nm pulsed dye laser system is effective and safe for the treatment of epidermal pigmented lesions.     

Effect of Pulse Width of a 595-nm Flashlamp-Pumped Pulsed Dye Laser on the Treatment Response of Keloidal and Hypertrophic Sternotomy Scars

BACKGROUND: Flashlamp-pumped pulsed dye lasers (PDLs) have successfully treated keloidal and hypertrophic scars. OBJECTIVE: The objective was to investigate the effect of pulse width of a PDL in treating keloidal and hypertrophic scars. METHODS: On each of 19 patients, keloidal or hypertrophic median sternotomy scars were divided into two segments. Both segments on all patients were randomly treated with a 595-nm PDL at a fluence of 7 J/cm(2) and pulse widths of 0.45 and 40 ms to both segments, every 4 weeks for a total of three treatments. Scar volume, height, erythema, and pliability were measured at Weeks 0, 4, 8, and 24. RESULTS: The volume of segments treated with 0.45- and 40-ms pulses decreased significantly after two treatments. Segments treated with a 0.45-ms pulse width showed significantly greater improvement than those treated with 40-ms pulses after three treatments. Elasticity of 0.45-ms segments was significantly higher than those of 40-ms segments, following two treatments. Pulse width had no significant effect in improvement of scar erythema. CONCLUSIONS: A pulse width of 0.45 ms of PDL was more effective in decreasing scar size and improving scar pliability than that of 40 ms. A 595-nm PDL was safe and effective in treatment of hypertrophic scars and keloids in dark-skinned individuals. This study was supported in part by an educational grant from the Dermatological Society of Thailand.     

Laser treatment of leg and facial telangiectasia

Background: Recent investigations have shown that lasers with longer pulse durations are more effective in the treatment of telangiectasia. Objective: We report on use of a 532-nm pulse diode laser and a dynamic cooling device in the treatment of both facial and lower-extremity telangiectasia. Methods: Treatments were performed by means of a 4-W, 532-nm pulse diode laser with pulse durations of 40 ms or 100 ms in a series of 77 patients with facial and/or lower-extremity telangiectasia measuring less than 1 mm in diameter. The dynamic cooling tip was used to protect the epidermis when fluences of 100 ms were applied. Patients who underwent treatment of lower-extremity telangiectasia were required to wear venous compression stockings for the first 5 days after treatment. A clearance rating scale was used to define the degree of clearance. Results: After 1 treatment, a clearance rate of greater than 90% of facial telangiectasia was demonstrated in 98% of patients. Among patients with lower-extremity telangiectasia, a clearance rate of greater than 50% was obtained after a single session in 38 treatments. Patient satisfaction was high, and minimal untoward sequelae were encountered. Conclusions: The 532-nm pulse diode laser has been primarily used for treatment of facial telangiectasia; however, it is also effective in treating lower-extremity telangiectasia involving vessels less than 1 mm in diameter. The use of a dynamic cooling device enables the application of fluences higher than those previously used.     

Treatment of telangiectasias with the 532-nm and the 532/940-nm diode laser

Recently, a dual-wavelength 532/940-nm laser has become available for treatment of facial vascular lesions as an alternative to the flashlamp pumped-dye lasers. Most facial vascular lesions will respond to the 532-nm wavelength. However, some of the larger and deeper lesions are resistant to this laser. The 940-nm wavelength can be used to treat these resistant lesions. Sixteen patients with 532-nm laser-resistant vascular lesions were treated with the 940-nm laser. Fourteen of these 16 patients had improvement in their telangiectasia in response to these treatments. Most facial l telangiectasias respond well to treatment with the 532-nm laser. However, some of the larger and deeper lesions will not respond well to this laser. The 940-nm wavelength laser can be used to treat these 532-nm laser resistant lesions.     

Treatment of inflammatory facial acne vulgaris with combination 595-nm pulsed-dye laser with dynamic-cooling-device and 1,450-nm diode laser

BACKGROUND AND OBJECTIVES: The 585-nm pulsed-dye laser and the 1,450-nm diode laser have been found effective for the treatment of mild-to-moderate inflammatory facial acne. This study was designed to evaluate the efficacy and safety of the combined treatment with the 595-nm pulsed-dye laser and the 1,450-nm diode laser for inflammatory facial acne. STUDY DESIGN/MATERIALS AND METHODS: Fifteen patients with inflammatory facial acne were treated with a combination of the 595-nm pulsed-dye laser and the 1,450-nm diode laser. Patients' subjective response to treatment was evaluated regarding improvement in acne, acne scarring, oiliness, and redness of the skin. RESULTS: All patients had reductions in acne lesion counts. Mean lesion counts decreased 52% (P < 0.01), 63% (P < 0.01), and 84% (P < 0.01) after one, two, and three treatments, respectively. Patients described moderate-to-marked improvement in acne, acne scarring, and post-inflammatory erythema. Adverse effects were limited to mild, transient erythema. CONCLUSIONS: The combination of the 595-nm pulsed-dye laser and the 1,450-nm diode laser is safe and effective for the treatment of inflammatory facial acne, acne scarring, and post-inflammatory erythema.     

A Pilot Study on the Treatment of Facial Rhytids Using Nonablative 585-nm Pulsed Dye and 532-nm Nd:YAG Lasers

BACKGROUND: There have been reports of successfully using the pulsed dye laser and long-pulse Nd:YAG laser to improve skin wrinkles. OBJECTIVE: To evaluate the efficacy of these lasers in the treatment of moderate to severe wrinkles. METHODS: Seven subjects had one side of their periorbital wrinkles treated with pulsed dye laser (585 nm, 0.45 ms, 2.5 J/cm2, single-pass 10% overlap, three treatments at 6 weeks apart). The second part of the study involved using the long-pulse Nd:YAG laser (532 nm, 2 ms, 7.0 J/cm2 with cooling, three laser passes, three treatments at 6 weeks apart) to treat the contralateral wrinkles in five subjects. Pretreatment and posttreatment photographs were taken, and blinded assessors were asked to choose the better of the two unlabeled photographs. RESULTS: Assessors found that two of the seven subjects had a better posttreatment photograph in the pulsed dye laser-treated group. Three of five subjects had a better posttreatment photograph in the long-pulse Nd:YAG laser-treated group. None of the subjects reported any subjective improvements. CONCLUSION: Neither the pulsed dye laser nor the long-pulse Nd:YAG laser at the previously mentioned parameters produced any improvement in moderate to severe facial wrinkles.     

Q-switched double frequency Nd:YAG 532-nm nanosecond laser vs. double frequency Nd:YAG 532-nm picosecond laser for the treatment of solar lentigines in Asians

Solar lentigines are common pigmentary lesions. Q-switched lasers are effective treatment options but postinflammatory hyperpigmentation (PIH) is common in darker skin. The objective of the study is to compare the efficacy and safety in solar lentigines of Asian skin treated by Q-switched potassium titanyl phosphate (KTP) 532-nm nanosecond laser vs. KTP 532-nm picosecond laser for the treatment of solar lentigines in Asians. Thirty patients with at least 2 solar lentigines on the upper extremities were enrolled. A total of 30 paired lentiginous lesions were randomly treated with a single treatment of either Q-switched KTP 532-nm nanosecond laser vs. KTP 532-nm picosecond laser. In terms of efficacy, mean luminance score was evaluated at baseline, at 6th, and 12th week. Degree of pigment clearance was assessed by a blinded physician and the patients. Satisfaction score was rated by patients using visual analogue scale. Adverse events were also recorded. Twenty-eight patients completed the study. Both lasers showed significant improvement in mean luminance score from baseline (p?<?0.05). Likewise, there was no significant difference in pigment clearance between two lasers either assessed by physician or patients. However, patients’ satisfaction score was significantly higher with the picosecond laser (p?=?0.014). Adverse events and pain were not different between groups. Q-switched KTP 532-nm nanosecond laser and KTP 532-nm picosecond laser are safe and effective for treating solar lentigines in Asians. Based on cost-effectiveness, Q-switched KTP 532-nm nanosecond laser remains the main treatment while KTP 532-nm picosecond laser can be considered as a treatment option.     

Objective and Quantitative Improvement of Rosacea-Associated Erythema After Intense Pulsed Light Treatment

BACKGROUND: Despite the widespread and quite successful use of various lasers and light sources to treat facial erythema, the literature contains little, if any, objective and quantitative improvement. In addition, very few studies specifically address rosacea-associated erythema. OBJECTIVE: To assess quantitatively the degree of improvement in patients with rosacea after intense pulsed light treatment. The three main parameters that were objectively measured were blood flow, telangiectasia, and erythema. METHODS: Four patients with rosacea-associated erythema and telangiectasia were treated five times at 3-week intervals with the Photoderm VL (Lumenis, Needham, MA). The 515-nm filter, a single pulse duration of 3 ms, and various fluences were used. Blood flow was measured by the scanning laser Doppler. Close-up photography ensured reproducibility and enabled quantification of telangiectasia and erythema by subsequent computer image analysis. Measurements were taken at baseline and at 1 month after the last treatment. RESULTS: The scanning laser Doppler demonstrated a 30% decrease in blood flow (P<0.05). A 29% decrease in actual area of the cheek occupied by telangiectasia was noted (P<0.05). A 21% decrease in the intensity of erythema was noted (P<0.05). CONCLUSION: As demonstrated by truly objective and quantitative means, intense pulsed light is effective for reducing rosacea-associated blood flow, telangiectasia, and erythema.     

Intense Pulsed Light and Laser Treatment of Facial Telangiectasias and Dyspigmentation: Some Theoretical and Practical Comparisons

Background and Objective. A comparative overview is presented, both theoretical and clinical, for intense pulsed light (IPL) and laser treatment of facial telangiectasias and pigmented lesions.
Materials and Methods. A narrative approach describes light penetration into the epidermis, dermis, dermal-epidermal junction, and facial ectasias. Based on mathematical models, we examine some temperature profiles for monochromatic and broadband light sources. Specifically, temperature elevations of representative vascular targets are discussed. Also, clinical scenarios are reviewed for both IPL and laser. Although multiple monochromatic devices are reviewed, only the 532 and 595 nm wavelengths are emphasized.
Results. In theory, an IPL can be filtered to simulate 532 and 595 nm laser light in the treatment of telangiectasias and dyschromias. In comparing our experiences with the different devices, all three (IPL, 532 nm laser, and 595 nm laser) are capable of achieving a reduction in ectasias and hyperpigmented macules.
Conclusions. With an optimal set of parameters, IPLs and lasers are comparable in the treatment of vascular and pigmented lesions with respect to treatment efficiency and safety.     

Laser Treatment of Erythema and Telangiectasia Associated with Rosacea

The response of rosacea-associated erythema and telangiectasia to treatment with the pulsed tunable dye laser (PDL) was evaluated in 12 patients. Improvements in erythema, telangiectasia, flushing, the physician's and the patient's perception of overall severity, treatment tolerability, and the adverse side effects were examined. With the sole exception of the patient's assessment of overall severity we have found highly significant improvements in all other parameters evaluated, with excellent tolerance of treatment. We therefore conclude that the PDL is a safe and effective treatment for the erythemato-telangiectatic component of rosacea. Paper received 13 March 2001; accepted after revision 26 June 2001.     

Millisecond 1064-nm Neodymium:YAG Laser Treatment of Facial Telangiectases

BACKGROUND: Millisecond pulse duration 1064-nm Neodymium:YAG (Nd:YAG) lasers have been shown to be effective in the treatment of some lower leg telangiectases. OBJECTIVE: To evaluate the efficacy and complication rate of a millisecond pulse duration 1064-nm Nd:YAG laser in the treatment of facial telangiectases. METHODS: Fifteen subjects were evaluated. RESULTS: Moderate to significant improvement was seen in 73% patients at day 30 and in 80% of patients at 3 months. These results were seen in the treatment of both blue/red and red facial telangiectases. CONCLUSION: The millisecond pulse duration 1064-nm Nd:YAG laser is effective for treatment of facial telangiectases.     

Treatment of Vascular Skin Lesions with the Variable Pulse 595 nm Pulsed Dye Laser

BACKGROUND: In the dermatology field, variable-pulse 595 nm pulsed dye lasers (PDLs) are now being widely used to treat vascular skin lesions. However, there is little information available on variable-pulse 595 nm PDL treatment of dark-skinned patients. OBJECTIVE: The objective of this study was to evaluate the outcome of variable-pulse 595 nm PDL treatment on Korean patients. METHOD: Two hundred thirty-nine patients (Fitzpatrick skin phototypes III to V) with vascular skin lesions, such as nevus flammeus, telangiectasia, or hemangioma, were included in this study. All patients were treated with a variable-pulse 595 nm PDL, and the outcomes were assessed by comparing preoperative and postoperative photographs. RESULTS: The average number of treatments per patient was 4.29, and 51.9% of patients showed a good (51-75% clearance) to excellent (76-100% clearance) response. For nevus flammeus, 48.0% of the patients achieved good to excellent results. The gender and age of the patients did not influence the clinical response; however, lesions of the head and neck were found to respond more favorably to treatment. For telangiectasia, 78.0% of patients showed good to excellent results, and, again, the gender and age of the patients did not alter the treatment outcome. For hemangioma, the male to female ratio of patients was 1.0:3.1 and 54.1% of the patients achieved a good to excellent response. Superficial hemangioma showed a better clinical response than deep hemangioma, and the lesions of younger patients responded more favorably than those of older patients. CONCLUSION: The variable-pulse 595 nm PDL was found to be effective for treating several vascular skin lesions in dark-skinned patients. However, there were differences in treatment outcome owing to disease, age, and the location of the lesions.     

595nm可调脉宽染料激光与强脉冲光治疗毛细血管扩张

目的：评价595nm可调脉宽染料激光与强脉冲光（IPL）治疗毛细血管扩张的疗效和不良反应。方法：用595nm可调脉宽脉冲染料激光仪与强脉冲光分组治疗毛细血管扩张共326例,按照就诊时间随机单盲将患者分为两组,A组：164例,应用595nm可调脉宽染料激光治疗;B组：162例,应用强脉冲光治疗。根据血管的粗细适当选择脉宽及能量密度,照射病变部位,观察局部治疗皮肤反应,即以照射部位皮肤变为紫灰色,扩张血管消失为适度。每月治疗1次,共治疗1～3次,分析两组患者的疗效和不良反应。结果：164例毛细血管扩张患者,经过595nm可调脉宽V-beam激光1～3次治疗后,85例痊愈,63例显效,总有效率90.2%;IPL组的总有效率在第1、2、3次治疗后分别为3.1%、21.6%和43.2%。与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.01）。同一类型皮肤与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.05）。两组治疗后皮肤反应轻微,595nm激光组治疗后会暂时出现局部水肿和紫癜,两组术后色素改变发生率无显著性差异（P〈0.05）。结论：595nm可调脉宽脉冲染料激光治疗毛细血管扩张疗效明显优于强脉冲光,且皮肤反应轻微,疗效确切,临床效果满意。     

Treatment of superficial cutaneous vascular lesions: experience with the KTP 532 nm laser

Whilst most facial telangiectasias respond well to short-pulse-duration pulsed dye laser therapy, studies have shown that for the treatment of larger vessels these short-duration pulses are sub-optimal. Long-pulse frequency-doubled neodymium:YAG lasers have been introduced with pulse durations ranging from 1–50 ms and treatment beam diameters of up to 4 mm. We report the results of KTP/532 nm laser treatment for superficial vascular skin lesions. The aim was to determine the efficacy of the KTP/532 nm laser in the treatment of superficial cutaneous vascular lesions at a regional dermatology centre in a 2 year retrospective analysis. Patients were referred from general dermatology clinics to a purpose-built laser facility. A test dose was performed at the initial consultation and thereafter patients were reviewed and treated at 6 week intervals. Outcome was graded into five classifications by the patient and operator independently based on photographic records: clear, marked improvement, partial response, poor response, and no change or worsening. Over the 2 year period, 204 patients with 246 diagnoses were treated [156 female; median age 41 (range 1–74) years; Fitzpatrick skin types I–III]. Equal numbers of spider angioma (102) and facial telangiectasia (102) were treated. Of those patients who completed treatment and follow up, 57/58 (98%) of spider angiomas and 44/49 (90%) of facial telangiectasia markedly improved or cleared. Satisfactory treatment outcomes, with one clearance and two partial responses, occurred in three of five patients with port-wine stain. Few patients experienced adverse effects: two declined further treatment due to pain, and a small area of minimal superficial scarring developed in one case. Two patients developed mild persistent post-inflammatory hyperpigmentation, and one subject experienced an episode of acute facial erythema, swelling and blistering after one treatment. The KTP/532 nm frequency-doubled neodymium:YAG laser is a safe and effective treatment for common superficial cutaneous vascular lesions in patients with Fitzpatrick skin types I–III.