585 nm Q开关脉冲激光、强脉冲光及长脉宽Nd:YAG激光治疗皮肤血管性疾病临床疗效比较

目的:观察比较585nmQ开关脉冲激光、强脉冲光及长脉宽1064nm Nd:YAG激光治疗皮肤血管性疾病的临床疗效和不良反应.方法:分别应用585nm Q开关脉冲激光(能量密度3.0～6.0 J/cm2,脉宽10ns)、590～1200 nm强脉冲光(能量密度30～60 J/cm2,脉宽3.0～5.5 ms)以及长脉宽1064nm Nd:YAG激光(能量密度120-145J/cm2,脉宽20～50ms)共治疗1415例毛细血管扩张、977例蜘蛛痣、742例血管瘤及442例鲜红斑痣患者.结果:585 nm Q开关脉冲激光、强脉冲光及长脉宽Nd:YAG激光治疗毛细血管扩张的有效率分别为86.3%、89.7%及88.6%;治疗蜘蛛痣的有效率分别为97.2%、96.5%及98.8%;治疗血管瘤的有效率分别为51.2%、59.6%及74.2%;治疗鲜红斑痣的有效率分别为28.4%、33.1%及40.3%.长脉宽Nd:YAG激光治疗血管瘤及鲜红斑痣的瘢痕发生率分别为8.5%和10.7%.结论:3种治疗方法对毛细血管扩张、蜘蛛痣及鲜红斑痣疗效无明显差异;长脉宽1064nm Nd:YAG激光治疗血管瘤的有效率明显优于585nm Q开关脉冲激光及强脉冲光,但瘢痕发生率也较高.     

Q开关Nd:YAG激光治疗常见皮肤病疗效观察

目的：观察各种常见色素性、血管性皮肤病激光治疗的疗效。方法：应用国产Q开关Nd：YAG激光，采取波长1064nm、532nm治疗各种常见色素性、血管性皮肤病共588例。结果：588例患者均达到显效或治愈。结论：Q开关Nd：YAG激光对各种常见色素性、血管性皮肤病治疗效果显著。     

Q开关Nd:YAG激光治疗色素增加性皮肤病疗效分析

目的观察Q开关Nd:YAG激光治疗色素增加性皮肤病的临床疗效及治疗次数、间隔时间以及安全性。方法用Q开关Nd:YAG激光(1 064 nm,532 nm波长)治疗570例色素增加性皮肤病,观察、分析其疗效。结果 Q开关Nd:YAG激光治疗色素增加性皮肤病均有效。其中老年斑、雀斑、蓝黑纹身、雀斑样痣、褐青色痣、太田痣总有效率均达87.14%以上。黄褐斑总有效率为85.20%。咖啡斑、炎症后色素沉着总有效率分别为65.00%及60.00%。毛表皮痣总有效率为30.00%。痊愈率由高到低依次为老年斑、雀斑、雀斑样痣、蓝黑纹身、褐青色痣、太田痣、黄褐斑、咖啡斑、炎症后色素沉着、毛表皮痣。治疗次数1～13次,间隔时间1周～半年。临床疗效与治疗次数呈正相关,不良反应少。结论Q开关Nd:YAG激光治疗色素增加性皮肤病的疗效显著,安全性较好。毛表皮痣治疗效果相对较差。     

皮肤美容及整容

20051275 Q开关Nd:YAC 激光治疗常见皮肤病疗效观察/梁勇(广东佛山市顺德区桂洲医院)//岭南皮肤性病科杂志.-2004,11(3),-265—267 应用国产Q开关ND:YAG激光,采取波长1064 nm、532 nm治疗各种常见色素性、血管性皮肤病共588 例(其中太田痣49例,雀斑150例,文身73例,文眉34     

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。     

Q开关Nd:YAG激光联合强脉冲光治疗色素性皮肤病的临床效果

目的研究Q开关Nd:YAG激光联合强脉冲光治疗色素性皮肤病的效果。方法选择2016年1月~2017年10月本院色素性皮肤病患者82例,依据治疗方法分为观察组、对照组各41例,分别接受Q开关Nd:YAG激光联合强脉冲光治疗、单一强脉冲光治疗,比较两组效果。结果观察组总有效率为73.17%,对照组总有效率为46.34%,P0.05;观察组不良反应发生率为7.32%,对照组发生率4.88%,P0.05。结论 Q开关Nd:YAG激光联合强脉冲光治疗色素性皮肤病能够提升临床治疗效果,保证治疗安全性,可在临床推广。     

长脉宽1 064 nm Nd:YAG激光治疗血管性皮肤病的原理及其应用

几十年来,随着激光技术的不断发展,激光治疗血管性皮肤病的疗效也逐渐增强,特别是长脉宽1 064 nm Nd:YAG激光,它是基于选择性光热作用理论发展起来的用于血管性皮肤病治疗且疗效引起国际上众多皮肤病学者及美容学学者的关注,在欧美发达国家逐渐取代脉冲染料激光,成为血管性皮肤病治疗的新标准。     

Q开关Nd:YAG激光联合咪喹莫特乳膏治疗扁平疣的疗效观察

目的观察Q开关Nd:YAG激光联合咪喹莫特乳膏治疗面部扁平疣的临床疗效。方法将62例扁平疣患者随机分成治疗组(32例)和对照组(30例),治疗组使用Q开关532 nm Nd:YAG激光治疗,后期外用喹莫特乳膏,对照组单外用咪喹莫特乳膏,观察疗效。结果治疗组的痊愈率为78.1%,总有效率为96.9%,对照组的痊愈率为46.7%,总有效率为76.7%,2组疗效差异均有统计学意义(P0.01)。结论 Q开关Nd:YAG联合咪喹莫特乳膏治疗扁平疣疗效好,值得临床推广。     

585 nm脉冲染料激光治疗跖疣113例临床疗效观察

目的：利用585nm脉冲染料激光治疗跖疣并分析临床疗效。方法：采取回顾性的研究分析,总结分析了113例使用脉冲染料激光治疗和89例使用Nd:YAG激光治疗的跖疣患者资料。分析疗效与年龄、病程、疣体数量、治疗次数等的关系。结果：脉冲染料激光组有效率达100%,痊愈达76.1%。疗效与疣体数量、治疗次数有关。副作用发生率低,无一例出现严重副作用。Nd:YAG激光治疗复发率高,副作用大。结论：脉冲染料激光治疗跖疣是一种无创、有效、安全的方法。     

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。     

调Q Nd:YAG激光联合局部用药治疗扁平疣疗效观察

目的观察调Q Nd:YAG激光联合维A酸乳膏和重组人干扰素α-2b凝胶治疗扁平疣的疗效。方法将70例扁平疣患者随机分为两组,实际完成疗程67例,A组34例,B组33例,两组均予调Q Nd:YAG激光532nm波长治疗1～4次,每次间隔2周。A组采用调Q Nd:YAG激光治疗痂脱落后外用0.1%维A酸乳膏,每晚1次;白天外用重组人干扰素α-2b凝胶,4次/d,共4周。B组单采用调Q Nd:YAG激光治疗。结果 A组治愈率(94.12%)、有效率(97.06%)、复发率(6.25%)与B组治愈率(69.70%)、有效率(75.76%)、复发率(30.43%)相比,差异均有统计学意义(P均<0.05)。结论调QNd:YAG激光联合维A酸乳膏和重组人干扰素α-2b凝胶治疗扁平疣安全性高,治愈率高,复发率低。     

Variable pulse frequency-doubled Nd:YAG laser versus flashlamp-pumped pulsed dye laser in the treatment of port wine stains

The flashlamp-pumped pulsed dye laser (FPDL) is regarded as the gold standard in the treatment of port wine stains. The purpose of this prospective, intra-individual, comparative clinical study was to investigate whether a frequency-doubled variable pulsed Nd:YAG laser (frequency-doubled Nd:YAG) is equally as safe and effective as established lasers. Forty-three patients with port wine stains were included in the study. Test treatments were performed using the frequency-doubled Nd:YAG laser (532 nm; 4 mm psi; 5-50 ms; 5.5 to 15 J/cm2) versus the FPDL (585 nm; 450 micros; 7 mm psi; 6 J/cm2). After 6 weeks, a full lesional treatment was performed using the device and the parameters showing the best clearance and the fewest side effects. The clearance of the lesions was generally good to fair. With the exception of poor results at 5 ms and 5.5 J/cm2 with the frequency-doubled Nd:YAG laser, there were no significant differences between the two laser devices. Scar formation, nevertheless, occurred in only 3% of the FPDL-treated sites versus up to 18% of the frequency-doubled Nd:YAG sites, increasing with pulse duration. In port wine stains, the FPDL remains the therapy of choice because of the somewhat better results and a lower frequency of side effects, especially scarring.     

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.     

532-nm and 1064-nm Q-switched Nd:YAG laser therapy for reduction of pigmentation in macular amyloidosis patches

Background Macular amyloidosis is a primary form of skin amyloidosis with deposition of small to moderate amyloid material in the upper dermis and mild pigmentary incontinence with resultant clinical hyperpigmentation. Objectives To determine the efficiency of Q‐switched Nd:YAG laser (532 and 1064 nm) in reducing the pigmentations due to skin macular amyloidosis. Methods A prospective, side by side, controlled, clinical trial study was designed. Twenty subjects with clinical diagnosis and pathology confirmation of macular amyloidosis were treated with Q‐switched Nd:YAG laser: 532 nm in a part of their plaques and with 1064 nm in another part of their plaques. Assessment of efficiency was done by colorimetric scores based on Mexameter measurement and also digital photographs before laser therapy and 8 weeks after treatment. Results Mexameter‐based data analysis showed that the two lasers (Q‐switched 532 and 1064 Nd:YAG) are effective in reducing the degree of macular amyloidosis patches pigmentation, and 532 nm is meaningfully more effective than 1064 nm in this matter. Photograph‐based analysis showed that 90% of cases treated by 532 nm had good or very good response, and for the 1064 nm–treated patches, 60% of cases had the good or very good response. Conclusions The results of study showed the net positive effect of Q‐switched Nd:YAG laser, either 532 nm or 1064 nm, in pigment reduction of macular amyloidosis patches, but the 532‐nm laser was more effective than 1064 laser.     

Laser Removal of Tattoos

Tattoos are placed for different reasons. A technique for tattoo removal which produces selective removal of each tattoo pigment, with minimal risk of scarring, is needed. Nonspecific methods have a high incidence of scarring, textural, and pigmentary alterations compared with the use of Q-switched lasers. With new advances in Q-switched laser technology, tattoo removal can be achieved with minimal risk of scarring and permanent pigmentary alteration. There are five types of tattoos: amateur, professional, cosmetic, medicinal, and traumatic. Amateur tattoos require less treatment sessions than professional multicolored tattoos. Other factors to consider when evaluating tattoos for removal are: location, age and the skin type of the patient. Treatment should begin by obtaining a pre-operative history. Since treatment with the Q-switched lasers is painful, use of a local injection with lidocaine or topical anaesthesia cream may be used prior to laser treatment. Topical broad-spectrum antibacterial ointment is applied immediately following the procedure. Three types of lasers are currently used for tattoo removal: Q-switched ruby laser (694nm), Q-switched Nd:YAG laser (532nm, 1064nm), and Q-switched alexandrite laser (755nm). The Q-switched ruby and alexandrite lasers are useful for removing black, blue and green pigments. The Q-switched 532nm Nd:YAG laser can be used to remove red pigments and the 1064nm Nd:YAG laser is used for removal of black and blue pigments. The most common adverse effects following laser tattoo treatment with the Q-switched ruby laser include textural change, scarring, and pigmentary alteration. Transient hypopigmentation and textural changes have been reported in up to 50 and 12%, respectively, of patients treated with the Q-switched alexandrite laser. Hyperpigmentation and textural changes are infrequent adverse effects of the Q-switched Nd:YAG laser and the incidence of hypopigmentary changes is much lower than with the ruby laser. The development of localized and generalized allergic reactions is an unusual complication following tattoo removal with the Q-switched ruby and Nd:YAG lasers. Since many wavelengths are needed to treat multicolored tattoos, not one laser system can be used alone to remove all the available inks and combination of inks. While laser tattoo removal is not perfect, we have come a long way since the advent of Q-switched lasers. Current research is focusing on newer picosecond lasers, which may be more successful than the Q-switched lasers in the removal of the new vibrant tattoo inks.     

Laser removal of pigmented and vascular lesions

Twenty years of laser dermatology has resulted in current technology which allows variable spot sizes, different wavelengths, and a variety of effective cooling devices. These developments have made the treatment of cutaneous pigmented and vascular lesions safe and efficacious by targeting selected chromophores while minimizing damage to the surrounding tissue. Vascular lesions are targeted by a variety of wavelength lasers including the KTP (532 nm), pulsed dye (585-595 nm), and the Nd:YAG (1064 nm) laser systems. Pigmented lesions may be treated with a wide variety of lasers due to the broad absorption spectrum of melanin. Intense pulsed light (IPL), with its widely adjustable parameters, has established itself as a useful adjunctive for the treatment of a variety of pigmented and vascular lesions. The purpose of this review article is to present the current treatment options for the common aesthetic complaints of pigmented and vascular lesions.     

Nonvascular uses of pulsed dye laser in clinical dermatology

Lasers are fast becoming the vogue of dermatology ranging from ablative, nonablative, fractional photothermolysis to vascular lasers. There are a range of vascular lasers including potassium titanyl phosphate (KTP 532 nm), pulsed dye laser (PDL ?595 nm), diode (810 nm), and Nd:YAG (1064 nm). PDL is a laser that emits yellow light using Rhodamine dye as it is lasing medium. Typical vascular lesions which are treated by PDL include port wine stain, hemangioma, telangiectasia, spider angioma, and rosacea. This article focuses on the use of PDL beyond primary vascular conditions. We review the evidence, or lack thereof, of the use of PDL in acne vulgaris, scars, striae, warts, molluscum, psoriasis, rejuvenation, basal cell carcinoma (BCC), and miscellaneous dermatological sequelae.     

Combination visible and infrared lasers for skin rejuvenation

Noninvasive techniques for skin rejuvenation are quickly being established as a new standard in the treatment of mild rhytides and overall skin toning. Multiple laser wavelengths and modalities have been tried for this procedure with varying degrees of success. These lasers include 532 nm, 585 nm, 1064 nm, 1320 nm, 1450 nm, and 1540 nm wavelengths. This study evaluates a combination technique by using a long-pulsed 532 nm potassium titanyl phosphate (KTP) laser and a long-pulsed 1064 nm Neodynium:yttrium aluminum garnet (Nd:YAG) laser, both separately and combined, for noninvasive photorejuvenation and skin toning/collagen enhancement, and establishes efficacy and degree of success. A total of 150 patients were treated with the long-pulsed KTP 532 nm (Aura; Laserscope, San Jose, CA) and long-pulsed Nd:YAG 1064 nm (Lyra; Laserscope) lasers both separately and combined. Patients included skin types I through V. The fluences varied between 7 and 15 J/cm2 at 7 to 20 ms pulse duration with a 2-mm handpiece, and 6 to 15 J/cm2 and 30 to 50 ms with a 4-mm handpiece for KTP. The Nd:YAG fluences were set at 24 to 30 J/cm2 for a 10-mm handpiece and 30 J/cm2 for a SmartScan Plus scanner (Laserscope, San Jose, CA). These energies were delivered at 30 to 65 ms pulse durations. All patients were treated at least 3 times and at most 6 times at monthly intervals, and were observed for up to 18 months after the last treatment. All 150 patients exhibited a mild to moderate degree of improvement in the appearance of rhytides, moderate degree of improvement in skin toning and texture, and great improvement in the reduction of redness and pigmentation. The KTP used alone was superior to the Nd:YAG laser in terms of results. The KTP and Nd:YAG laser combination was superior to either laser used alone.     

Both the flashlamp-pumped dye laser and the long-pulsed tunable dye laser can improve results in port-wine stain therapy

BACKGROUND: At present, laser therapy of port-wine stains (PWS) using the flashlamp-pumped dye laser (FPDL) at 450 micros is accepted as the optimal approach. A few years ago, a new long-pulsed tunable dye laser (LPTDL, 1.5 ms) was introduced for the treatment of leg veins. OBJECTIVES: To investigate the efficacy and side-effects of FPDL vs. LPTDL therapy of PWS. METHODS: Sixty-two patients with untreated PWS underwent test treatments with the FPDL (585 nm; 7-mm spot size; 5.75--7.0 J cm(-2) fluence) and LPTDL (585, 590, 595, 600 nm; 5-mm spot size; 11--20 J cm(-2) fluence). With the LPTDL, the epidermis was additionally cooled (Spray cooling device). The fading was evaluated clinically 6 weeks after the test treatments. RESULTS: Optimal fading was achieved by the LPTDL (> or = 585 nm) in 30 patients and by the FPDL in 12 patients. No difference was found in 20 patients. At 585 nm, the lasers worked equally well in 12 (FPDL) and 13 (LPTDL) patients, respectively. Results were independent of the localization of the PWS and of the patient's age. In spite of the longer pulse duration, the LPTDL treatment did not result in more side-effects as long as sufficient cooling was provided. CONCLUSIONS: The results provide evidence that wavelengths longer than 585 nm can increase the efficacy of treatment in some PWS. Owing to the reduced light absorption by haemoglobin at longer wavelengths and consequently increased depth of the vascular injury, larger vessels can be damaged more adequately using an increased fluence. The LPTDL at 585 nm seemed to be slightly superior to the FPDL, while accepting that due to technical reasons the laser parameters were not directly comparable. Availability of both lasers increases the therapeutic possibilities in PWS.