585nm脉冲染料激光治疗增生性血管瘤

皮肤血管瘤通常分为浅表型,深在型和混合型。90％以上的损害在9岁前可逐渐消退。大部分仅影响美容,但有些可致血液动力障碍,组织破坏或致命功能损伤。此种情况可试用系统皮质类固醇或干扰素治疗,或加用放疗、外科治疗,但这些治疗均有潜在危险性。以往曾有报告应用脉冲染料激光治疗浅表性血管瘤有效,而对深在性损害的疗效不佳。     

强脉冲光联合点阵铒激光治疗痤疮后增生性瘢痕的效果观察

目的观察痤疮后增生性瘢痕患者应用强脉冲光联合点阵铒激光治疗后效果。方法随机将我院91例痤疮后增生性瘢痕患者分组,对照组45例给予强脉冲光治疗,观察组46例联合点阵铒激光治疗,对比治疗疗效。结果观察组VSS评分低于对照组,总有效率高于对照组(P <0.05)。结论强脉冲光联合点阵铒激光有效改善瘢痕色泽、血管分布、厚度及柔软度,治疗痤疮后增生性瘢痕效果显著。     

585 nm脉冲染料激光治疗面部毛细血管扩张疗效观察

我科1999年6月-2006年5月应用闪光灯-泵脉冲染料激光治疗42例面部毛细血管扩张患者,取得满意疗效,现报告如下. 1病例与方法     

2940 nm 铒激光治疗凹陷性痤疮瘢痕的疗效与安全性观察

目的：观察2940 nm铒玻璃激光治疗痤疮凹陷性瘢痕的疗效与安全性。方法：选取25例诊断为凹陷性痤疮瘢痕的患者,使用2940 nm铒激光治疗,每4周1次,共3次。治疗前后拍照并使用EC-CA权重评分、VISIA皮肤图像分析仪评估疗效,使用CK皮肤检测仪评估皮肤屏障功能。结果：治疗结束后,所有病例均有改善,临床有效率为28％。痤疮凹陷性瘢痕ECCA权重评分明显下降,与治疗前比较,差异有统计学意义（P＜0.05）,毛孔、紫质显著减少（P＜0.05）;治疗后1周与治疗前相比,经皮水分丢失量、油脂增多（P＜0.05）,含水量减少（P＜0.05）,治疗前与治疗1月后相比,经皮水分丢失量、含水量、油脂无明显差异（P值均＞0.05）。结论：2940 nm铒激光治疗痤疮凹陷性瘢痕有效,术后1月后皮肤屏障功能恢复。     

染料激光与曲安奈德联合治疗增生性瘢痕的疗效观察

对68例外观较红的增生性瘢痕进行治疗，其中20例和36例患者分别进行了联合治疗与单独用染料激光、单独局封的自身对照研究，2例进行了组织学研究。联合治疗的总有效率为92.6%，其疗效明显优于单独激光或局封。组织学研究表明，染料激光照射后，瘢痕内血管血栓形成，内皮细胞损伤，甚至管腔闭塞，并有胶原纤维的溶解。因此，染料激光联合曲安奈德局封是治疗增生性瘢痕的有效方法。     

2940nm铒激光治疗凹陷性痤疮瘢痕的疗效与安全性观察

目的:观察2 940 nm铒玻璃激光治疗痤疮凹陷性瘢痕的疗效与安全性。方法:选取25例诊断为凹陷性痤疮瘢痕的患者,使用2 940 nm铒激光治疗,每4周1次,共3次。治疗前后拍照并使用ECCA权重评分、VISIA皮肤图像分析仪评估疗效,使用CK皮肤检测仪评估皮肤屏障功能。结果:治疗结束后,所有病例均有改善,临床有效率为28%。痤疮凹陷性瘢痕ECCA权重评分明显下降,与治疗前比较,差异有统计学意义(P<0.05),毛孔、紫质显著减少(P<0.05);治疗后1周与治疗前相比,经皮水分丢失量、油脂增多(P<0.05),含水量减少(P<0.05),治疗前与治疗1月后相比,经皮水分丢失量、含水量、油脂无明显差异(P值均>0.05)。结论:2 940 nm铒激光治疗痤疮凹陷性瘢痕有效,术后1月后皮肤屏障功能恢复。     

脉冲染料激光联合二氧化碳点阵激光对兔耳增生性瘢痕的影响

目的:评价脉冲染料激光(PDL,585 nm)联合二氧化碳点阵激光(CO 2FL,10600 nm)对兔耳增生性瘢痕的影响。方法:对20只雌性新西兰大耳兔进行造模,每只兔耳共有8处瘢痕,其中2处为对照,2处给予脉冲染料激光、2处给予二氧化碳点阵激光、2处给予联合治疗,两周治疗1次,共治疗2次。两组于治疗14天和28天后,检测瘢痕的瘢痕增生指数(SEI)、瘢痕内成纤维细胞密度、胶原纤维面积、细胞凋亡以及TGF-β1、Smad3表达的水平变化。结果:联合治疗组SEI指数、成纤维密度指标、胶原纤维面积、TGF-β1、Smad3表达明显低于脉冲染料激光组、二氧化碳点阵激光组及对照组(均P<0.05),细胞凋亡率高于上述3组(均P<0.05)。结论:PDL联合CO 2FL激光对增生性瘢痕的干预效果优于脉冲染料激光和二氧化碳点阵激光单独治疗。     

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。     

595nm脉冲染料激光联合5-Fu治疗病理性瘢痕临床观察

目的探讨595nm脉冲染料激光联合5-Fu局部注射治疗增生性瘢痕及瘢痕疙瘩的临床疗效,评估新的治疗途径。方法对22例病理性瘢痕患者的191个皮损进行595nm脉冲染料激光联合5-Fu局部注射治疗,其中治疗前、后医生依据同一评判标准分别进行评估并记录,并对所得数据进行统计学分析。结果痊愈41个,显效124个,有效率为86.39%。接受3个疗程治疗的患者中,1个疗程后痊愈10个,显效33个,有效率为46.74%;2个疗程后痊愈15个,显效47个,有效率为67.39%;3个疗程后痊愈20个,显效62个,有效率为89.13%;显示皮损有效率随疗程的增加而逐渐增高,3个疗程间皮损有效率差异有统计学意义(P<0.05)。结论 595nm脉冲染料激光联合5-Fu局部注射能有效治疗病理性瘢痕,且不良反应小,其疗程与疗效相关,即疗程越长,疗效越好。     

585 nm脉冲染料激光治疗血管角皮瘤11例疗效观察

目的：评价脉冲染料激光治疗血管角皮瘤的疗效。方法：采用585nm脉冲染料激光治疗11例血管角皮瘤患者。结果：痊愈5例(45.45％),显效4例(36．36％);有效2例(18．18％),有效率为81．8l％,治疗1次有效率为54．55％。仅1例患者治疗部位出现色素减退。结论：585nm脉冲染料激光治疗血管角皮瘤安全、有效。     

Complications of 585-nm pulsed dye laser therapy

Background Port-wine stains (PWS) are a congenital, progressive ectasia of the superficial cutaneous vascular plexus that occur in 0.3%–0.5% of children at birth. They should be considered a disease with physical and psychologic complications. Treatment with the flashlamp pulsed dye laser (FPDL) has proven to be effective. Because treatment results in selective vascular injury, the risk of complications is minimal. The purpose of this study was to determine the cutaneous side-effects and complications and their frequency in patients with PWS treated with the FPDL. Eighty-nine patients who had been treated with the FPDL for PWS were included in this study. Methods Patients were treated at 3-month intervals using slightly overlapping pulses with fluences of 6.0–9.0 J/cm². Treating physicians were responsible for evaluating the patients. All patients were reviewed and side-effects and complications were recorded. Results Pigmentary changes were the most frequently observed complications. Hyper-and hypopigmentation appeared in 16.8% and 2.4% of patients, respectively. Cutaneous depressions occurred in 2.2% of patients. One patient developed a hypertrophic scar, and another patient presented with transient cutaneous pustulosis. All these changes usually resolved spontaneously and completely in a few months. Conclusions Most of the side-effects and complications produced by the FPDL are usually transitory, and it is essentially a very secure technique.     

Successful treatment of generalized essential telangiectasia with the 585-nm flashlamp-pumped pulsed dye laser

Generalized essential telangiectasia (GET) is a rare vascular condition with limited treatment options. We report the successful treatment of GET with the 585-nm flashlamp-pumped pulsed dye laser (FLPDL).     

Resolution of retracted scar after 585-nm pulse dye laser surgery

BACKGROUND: Laser scar revision has been an effective method for improving several aspects of scarring through ablative and non-ablative sources. The 585-nm pulsed dye laser (PDL) is an important non-ablative instrument for reducing scar bulk and symptoms. OBJECTIVE: To describe the use of a 585-nm PDL for the treatment of a retracted and atrophic facial scar. METHODS: We report the case of a 26-year-old patient who presented with a retracted facial scar following surgical excision of an aggressive benign tumor. Treatment was carried out using the 585-nm PDL. RESULTS: Treatment of the scar using two low-level PDL therapies significantly altered the appearance of the scar and augmentation of the retracted defect was avoided. CONCLUSION: Treatment of this retracted and atrophic facial scar with the 585-nm PDL was very effective and safe.     

Evaluation of the clinical and immunohistological efficacy of the 585-nm pulsed dye laser in the treatment of psoriasis

Background  The 585-nm pulsed dye laser (PDL) therapy is useful for the patients with psoriasis. PDL treatment is based on selective photothermolysis of the dermal vasculature.
Objective  The objectives of this study were to evaluate the clinical and immunohistological effects of PDL on psoriasis and to examine the association between psoriatic dermal vasculature and the clinical effects.
Methods  Eleven patients with recalcitrant psoriasis were treated with 585-nm PDL. Biopsy specimens obtained before and after treatment were stained with CD31. All microvessels to the depth of 400 µm from the rete ridge were counted and the internal diameters were measured.
Results  The mean percent reduction of plaque severity score was 42. The mean microvessel count decreased significantly from 63 to 35.6 ( P  < 0.001). There was a strong positive correlation between the plaque severity score and microvessel number ( P  < 0.001) and a strong negative correlation between the microvessel count of an untreated area and degree of the change in the microvessel count after treatment ( P  = 0.005).
Conclusions  The findings of this study suggest that PDL treatment improves psoriasis. Moreover, PDL treatment decreased the number of dermal papillary microvessels. Dermal papillary microvessels are important pathogenetic targets of psoriasis, and PDL therapy, which selectively targets superficial vessels, is therefore a valid therapeutic approach.

Conflicts of interest

None declared     

Resolution of retracted scar after 585-nm pulse dye laser surgery.

BACKGROUND: Laser scar revision has been an effective method for improving several aspects of scarring through ablative and non-ablative sources. The 585-nm pulsed dye laser (PDL) is an important non-ablative instrument for reducing scar bulk and symptoms. OBJECTIVE: To describe the use of a 585-nm PDL for the treatment of a retracted and atrophic facial scar. METHODS: We report the case of a 26-year-old patient who presented with a retracted facial scar following surgical excision of an aggressive benign tumor. Treatment was carried out using the 585-nm PDL. RESULTS: Treatment of the scar using two low-level PDL therapies significantly altered the appearance of the scar and augmentation of the retracted defect was avoided. CONCLUSION: Treatment of this retracted and atrophic facial scar with the 585-nm PDL was very effective and safe.     

A comparative study of a 595-nm with a 585-nm pulsed dye laser in refractory port wine stains

BACKGROUND: The pulsed dye laser (PDL) is the treatment of choice for port wine stains (PWS); however, some patients' PWS become refractory to further treatments. Technological advances have enabled new machines with the advent of surface cooling devices to deliver longer wavelengths and higher fluence more safely. These advances have the potential to achieve improved response rates in refractory PWS. There are few studies comparing the efficacy of standard PDL treatments for refractory PWS with the wider choice of treatment variables available from newer PDL machines. OBJECTIVES: To determine if there is any advantage of using a longer wavelength (595 nm) and pulse widths (1.5 ms, 6 ms and 20 ms) over conventional PDL settings (wavelength 585 nm, pulse width 1.5 ms) in refractory PWS. METHODS: Eighteen consecutive consenting patients with Fitzpatrick skin types 1-4 with a mean age 35 years (range 17-59 years) with refractory PWS were treated routinely with three separate test areas using 595-nm PDL (using three different pulse width settings of 1.5 ms, 6 ms and 20 ms), compared with test areas treated with 585-nm PDL (pulse width 1.5 ms). All test areas were treated with an identical fluence (15 J cm(-2)), spot size (7 mm) and cooling setting (dynamic cooling 60 ms, delay 60 ms). RESULTS: We found a statistically significant advantage of 595-nm PDL (pulse width 1.5 ms) over 595-nm PDL (pulse width 6 ms) (P < 0.05) in the treatment of refractory PWS; however, we found no significant advantage using longer pulse widths of 20 ms compared with 1.5 ms with the 595-nm PDL. There was no statistically significant advantage in using a 595-nm PDL over a 585-nm PDL using identical pulse widths of 1.5 ms, spot size, fluence and cryogen cooling settings; however, the number of directly comparable test areas was smaller. Some individual patients in our study obtained a better response with certain 595-nm PDL settings (pulse width 1.5 ms and 6 ms) compared with 585-nm PDL (pulse width 1.5 ms). CONCLUSIONS: Our experience of high fluence PDL in the treatment of refractory PWS suggests patients treated with 585 nm (pulse width 1.5 ms) improve to a similar degree as patients treated with 595-nm PDL (pulse width 1.5 ms). However, the use of the 595-nm PDL with longer pulse widths yields no extra advantage. For those patients who have failed to improve with high-fluence 585-nm PDL (pulse width 1.5 ms), test areas using 595-nm PDL (pulse width 1.5 ms and 6 ms) should be undertaken to ascertain if individual patients may benefit from the longer pulse width 595-nm PDL.     

Role of the 585-nm pulsed dye laser in the treatment of acne in comparison with other topical therapeutic modalities

Background: Acne vulgaris is a disease of the pilosebaceous unit characterized by the development of inflammatory and/or non-inflammatory lesions that may progress to scars. The increase of bacterial resistance and adverse effects, the teratogenicity of retinoids and lack of response to usual therapies has led to the investigation of new therapeutic alternatives. Objective: To evaluate the role of the pulsed dye laser in the treatment of acne in comparison with other topical therapeutic modalities. Methods: We studied 45 patients with mild to moderate acne. Patients were randomly divided into three groups: group A received treatment with pulsed dye laser therapy every 2 weeks, group B received topical preparations and group C was subjected to chemical peeling using trichloroacetic acid 25%. Results: At 12 weeks of treatment, there was a significant improvement of the lesions within each group with the best results seen in group A; however, no significant difference was detected between the three treatment protocols after the treatment period. Remission in the follow-up period was significantly higher in the first group. Conclusions: Pulse dye laser therapy mainly improves the inflammatory lesions of acne with few adverse effects.     

Combined treatment with 595-nm pulsed dye laser and 1550-nm erbium-glass fractional laser for traumatic scars

Facial scars can be caused by a traumatic event or indeed surgical procedures. Several treatment modalities have been suggested including surgical or resurfacing techniques, autologous fat transfer, and injection of fillers. However, these approaches have varying degrees of success and associated side effects. We report two Korean patients with traumatic scars. Both patients received combined consecutive treatment with 595-nm pulsed dye laser (PDL) and 1550-nm erbium-glass fractional laser. Both patients showed remarkable clinical improvements after a course of sessions. Therefore, simultaneous combined treatment with PDL and fractional laser may be considered a reasonable therapeutic option for traumatic facial scars.