595nm脉冲染料激光治疗鲜红斑痣440例回顾性分析

目的总结595 nm脉冲染料激光治疗鲜红斑痣的临床疗效,分析脉冲染料激光在不同分组鲜红斑痣患者中的疗效差异。方法用595nm脉冲染料激光治疗鲜红斑痣共440例。根据患者年龄、皮损类型、皮损面积及治疗次数进行分类,皮肤科医生根据患者治疗前后皮损照片对比评价临床疗效。通过统计学方法分析上述各个因素对疗效的影响。记录各种不良反应和并发症。结果 595 nm脉冲染料激光治疗鲜红斑痣总有效率为83.41%,疗效与患者年龄、皮损类型、皮损面积及治疗次数有关。年龄越小、皮损面积越小者疗效越好,不良反应发生率低。结论 595 nm脉冲染料激光治疗鲜红斑痣总有效率较高,不良反应发生率低。但临床痊愈比例不高,少部分患者对脉冲染料激光治疗无效。     

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。     

595 nm脉冲染料激光治疗546例鲜红斑痣疗效评价

目的评价595 nm脉冲染料激光治疗鲜红斑痣临床疗效和不良反应。方法应用美国Candela公司生产的595 nm脉冲染料激光治疗鲜红斑痣546例,根据患者年龄、皮损类型等采用不同参数进行激光照射治疗。结果 595 nm脉冲染料激光治疗鲜红斑痣总有效率为70.33%(384/546),疗效与患者年龄、皮损类型等因素关系密切,不良反应发生率低,且耐受性好。结论 595 nm脉冲染料激光治疗鲜红斑痣安全有效。     

595 nm脉冲染料激光治疗鲜红斑痣1560例临床研究

目的 评价595 nm脉冲染料激光治疗不同年龄段鲜红斑痣患者的临床疗效和不良反应。方法 应用美国Candela公司生产的595 nm脉冲染料激光治疗鲜红斑痣1560例,根据患者年龄、皮损类型等采用不同参数进行激光照射治疗。结果 595 nm脉冲染料激光治疗鲜红斑痣总有效率为76.73%（1197/1560）,疗效与患者年龄、皮损类型等因素关系密切,不良反应发生率低,且耐受性好。结论 595 nm脉冲染料激光治疗鲜红斑痣安全有效。     

普萘洛尔联合595 nm脉冲染料激光治疗婴幼儿血管瘤疗效观察

目的研究口服普萘洛尔联合595 nm脉冲染料激光治疗婴幼儿血管瘤疗效。方法选取2016年1月-2017年10月就诊于新疆维吾尔自治区人民医院皮肤性病科的婴幼儿血管瘤患儿60例,所有患儿被分为实验组及对照组,每组各30例患者。实验组患儿接受595 nm脉冲染料激光照射联合口服普萘洛尔治疗,对照组患儿仅接受595 nm脉冲染料激光治疗。结果实验组[96. 67%(29/30)]疗效高于对照组[86. 67%(26/30)],实验组患儿的愈合时间及激光治疗次数均少于对照组,差异有统计学意义(P 0. 05)。两组患儿不良反应发生率差异无统计学意义。结论口服普萘洛尔联合595 nm脉冲染料激光治疗对于婴幼儿血管瘤患儿有显著疗效,相对于单纯激光治疗,联合治疗可以有效缩短治疗时间、提高治疗效果,未增加不良反应。     

脉冲染料激光治疗高原地区面部毛细血管扩张症372例疗效观察

目的探讨595nm脉冲染料激光治疗高原地区面部毛细血管扩张症的临床疗效。方法用595nm脉冲染料激光治疗仪治疗面部毛细血管扩张症372例,根据病变程度调整治疗参数,以激光照射瞬间皮损呈浅灰色或轻微紫癜色为适宜能量密度,光斑间可有10%～30%的重叠。结果 372例患者通过1～3次激光治疗后,扩张毛细血管完全消除,有效率为100%。治疗后皮肤无损伤,且有明显的美白淡斑、收缩毛孔及嫩肤的功效。结论用595nm脉冲染料激光治疗高原地区的面部毛细血管扩张症安全性高,且疗效确切。     

卡替洛尔滴眼液湿敷联合595nm脉冲染料激光治疗婴儿浅表性血管瘤的效果观察

目的 观察婴儿浅表性血管瘤应用卡替洛尔滴眼液湿敷联合595nm脉冲染料激光治疗效果。方法 采用随机数字表法将我院81例婴儿浅表性血管瘤患儿分组,对照组40例应用595nm脉冲染料激光治疗,观察组患儿联合卡替洛尔滴眼液湿敷,对比两组患儿治疗后临床疗效及不良反应发生率。结果 观察组总有效率高于对照组,不良反应发生率低于对照组(P 0.05)。结论卡替洛尔滴眼液湿敷联合595 nm脉冲染料激光能够进一步提升婴儿浅表性血管瘤治疗效果,且安全性高。     

595nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤疗效观察

目的探讨595 nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤的疗效。方法应用595 nm脉冲染料激光治疗40例婴幼儿皮肤真性血管瘤并观察疗效。结果 40例患者中,治疗3次以内6例,治疗3次及以上34例。治愈18例(45%),显效15例(37.5%),有效3例(7.5%),无效3例(7.5%),总有效率82.5%。结论 595 nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤疗效确切、安全,可在临床推广。     

595nm脉冲染料激光治疗儿童寻常疣的临床疗效评价

目的:评价595 nm脉冲染料激光治疗儿童寻常疣的临床疗效及安全性。方法:将84例患儿分为两组,治疗组(42例)采用595 nm脉冲染料激光治疗,对照组(42例)采用液氮冷冻治疗,每隔2周治疗1次,最多6次。结果:治疗组痊愈率和有效率分别为71.4%和90.5%,高于对照组的40.0%和73.8%,治疗组和对照组平均治愈次数分别是(2.35±0.98)和(3.43±1.21)次,治疗组不良反应发生率(16.7%)明显低于对照组(81.0%),差异均有统计学意义(均P0.05)。结论:595 nm脉冲染料激光治疗儿童寻常疣临床疗效显著优于液氮冷冻。     

血管角皮瘤101例激光治疗后临床疗效及不良反应分析

目的 探讨血管角皮瘤患者激光治疗后的临床疗效及不良反应。方法 收集第四军医大学西京皮肤医院激光美容中心2010年3月—2021年8月临床诊断为血管角皮瘤的患者101例，给予脉冲染料595 nm激光(PDL)、长脉冲1 064 nm(Nd:YAG)以及脉冲CO₂激光单独或联合治疗，术前术后采集照片，对比分析治疗前后临床疗效及术后出现的不良反应。结果 101例血管角皮瘤患者激光治疗后多数患者皮损明显改善或消退，痊愈率78.22%,有效率达到90.10%,16.83%的患者术后出现瘢痕、色素沉着斑或色素减退斑；以斑疹及丘疹、结节为主要皮损表现的患者有效率达98.36%及90.63%以上，不良反应率低，而以斑块为主的皮损出现不良反应发生率较高。结论 激光治疗对血管角皮瘤患者治疗有效，可根据皮损类型选择治疗仪器，预判术后疗效。     

外用噻吗洛尔和激光治疗婴幼儿血管瘤疗效比较

目的：比较外用噻吗洛尔和激光治疗婴幼儿浅表型血管瘤的疗效。方法： 回顾性分析91例外用0.5%噻吗洛尔与85例PDL和Nd:YAG双波长激光治疗的婴幼儿浅表型血管瘤的疗效,瘤体连续2个月无继续改善停止治疗。结果： 噻吗洛尔组总有效率84.6%,激光组总有效率88.2%,差异无统计学意义（P＞0.05）。激光组平均治疗时间及瘤体消退76%～100%的时间分别为2.95±1.30和2.27±1.21个月,短于噻吗洛尔组的7.57±3.28和6.57±2.22个月,两组比较差异均有统计学意义（均P＜0.01）。结论： 两种方法治疗婴幼儿浅表型血管瘤疗效相近,激光治疗较外用噻吗洛尔控制快、疗程短。     

Randomized,controlled trial split‐faced study of 595‐nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood

The high prevalence of acne vulgaris in teenagers has increased comorbidities. Lasers offer alternative options for acne treatment because they have rapid action, low systemic adverse effects, and do not require everyday treatment. To study the efficacy and patients’ satisfaction of 595‐nm pulse dye laser (PDL) treatment of acne vulgaris and acne erythema in adolescents and early adulthood, we designed a blocked‐randomized, split‐faced 595‐nm PDL (fluence 8 J/cm³ pulse duration 10 ms, spot size 7 mm, 2 session every 2 weeks) study in patients with mild to moderate acne by comparing the laser‐treated and non‐treated side. The acne lesion counts, acne erythema grading, and acne severity grading were evaluated at baseline and 2, 4, and 8 weeks. Thirty patients were recruited. The results showed no statistically significant difference except the papule count at week 4 which was ?1.828 on the treated side and 0.103 on the non‐treated side of the face, P‐value 0.0018. There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face. The mean scores of patients’ satisfaction on the laser‐treated side were 75, 81, and 81%, respectively. The PDL treatment in this study reveals no significant improvement in acne therapy; however, the patients were satisfied with this laser treatment.     

Treatment of port-wine stains with the 595-nm pulsed dye laser: a pilot study in Chinese patients

The 595-nm pulsed dye laser (PDL) is one of the newest developments in the treatment for port-wine stains (PWS). The aim of this study was to investigate the effectiveness of the treatment of PWS in Chinese patients using the 595-nm PDL. In total, 184 patients with PWS over the face, neck and trunk or limbs were enrolled in the study. All the patients were treated with the 595-nm PDL 3-6 times, with a 4-week interval between each treatment. Treatment parameters varied for each patient according to the colour and location of the PWS. The efficacy of treatments and any side-effects were evaluated. Results were graded as percentage resolution (0-25%, 25-50%, 50-75% and 75-100%). Of the 184 patients who completed the study, 115 (62.5%) achieved excellent improvement, 38 (20.7%) achieved good results, and 31 (16.8%) had an unsatisfactory outcome (moderate and poor response). We found > 75% improvement for 76% of facial PWS (95/125), 43% of neck PWS and 20.8% of trunk or limb PWS. Pain and topical erythema were commonly reported immediately after the laser treatments. Prominent hyperpigmentation occurred in only 11 cases (6.0%) with poor improvement, and resolved within 6 months. The 595-nm PDL appears to be safe, effective and well tolerated in the treatment of PWS in Chinese patients.     

Laser-mediated photodynamic therapy of actinic keratoses

OBJECTIVE: To assess the safety and efficacy of the long-pulsed pulsed dye laser (LP PDL) (595 nm) with photodynamic therapy (PDT) for treatment of actinic keratoses (AKs). DESIGN: Prospective, controlled study with 10-day and 2-, 4-,6-, and 8-month follow-ups. SETTING: Clinical research center. PATIENTS Volunteer sample of 41 patients (age range, 35-91 years; skin types I-III) with AKs. INTERVENTION: Single treatment with application of topical 20% 5-aminolevulinic acid for 3 hours or 14 to 18 hours, followed by LP PDL irradiation at 595 nm. Controls received LP PDL irradiation alone. MAIN OUTCOME MEASURES: Safety assessments, treatment and recovery times, and efficacy assessments, including patient mean percentage of lesions cleared and distribution of patients by percentage of lesions cleared for different anatomic sites. RESULTS: We observed no to slight pain; slight to moderate erythema; no purpura, crusting, or scarring; treatment time of 1 lesion per second; and resolution of erythema by 7 to 14 days. The patient mean (95% confidence interval) percentage of head lesions (2620 lesions) cleared after 1 treatment was 99.47% (99.44%-99.50%) at 10 days, 98.19% (98.15%-98.23%) at 2 months, 92.94% (92.73%-93.14%) at 4 months, 91.65% (91.15%-92.15%) at 6 months, and 90.32% (78.10%-100%) at 8 months. For extremities (949 lesions), these were 83.1% (81.4%-84.9%) at 10 days, 75.5% (73.4-77.6) at 2 months, 70.9% (68.9%-72.8%) at 4 months, 92.0% (84.0%-100%) at 6 months, and 100% at 8 months. For trunk (53 lesions), these were 85% (74%-100%) at 10 days, 85% (74%-100%), and 65% (50%-80%) at 4 months. No difference in safety or efficacy was found between the 3-hour and 14- to 18-hour incubation times. In the laser-only control group, no decrease in lesions was observed. Among 31 patients with head lesions, 28 (90%) at 10 days, 19 (70%) at 2 months, 9 (47%) at 4 months, 5 (42%) at 6 months, and 5 (56%) at 8 months were completely (100%) clear following a single treatment. Skin biopsy specimens of nonresponding lesions demonstrated a high rate of squamous cell carcinoma and other non-AK neoplasms. CONCLUSIONS: Treatment of AKs using LP PDL (595 nm) at nonpurpuric parameters following topical application of 5-aminolevulinic acid is safe and effective. The advantages may include minimal discomfort, rapid incubation treatment and recovery times, excellent posttreatment cosmesis, high efficacy rates with respect to head lesions, and practical applicability to large body surface areas.     

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.     

强脉冲光及595nm染料激光治疗面部痤疮后红斑自身对比研究

目的 评价及对比强脉冲光和595 nm染料激光治疗痤疮后红斑的临床疗效及安全性.方法 采用随机自身左右面部对照临床试验研究方法,选取20例患有痤疮后红斑的患者,每例患者的两侧面颊随机分配接受强脉冲光或595 nm染料激光治疗3次,每次间隔4周.分别在每次治疗前以及最后1次治疗1个月后使用VISIA拍照,测量红斑值;通过四分红斑严重程度表评价治疗前后双侧面部红斑严重程度.每次治疗后均填写疼痛评分表、不良反应记录表,最后1次随访通过问卷形式对患者进行满意度调查.结果 强脉冲光侧平均红斑值治疗前472.25±86.02,治疗后357.15±82.71;595 nm染料激光侧治疗前476.40±74.25,治疗后360.05±64.83,经重复测量资料方差分析,可以认为随治疗时间延长,患者红斑值有所降低(F=197.666,P＜0.001);强脉冲光侧治疗效果优于595 nm染料激光侧(F=1 173.909,P＜0.001).强脉冲光侧治疗前后四分红斑值差异有统计学意义(Z=28.735,P＜ 0.001),595 nm染料激光侧差异亦有统计学意义(Z=31.450,P＜0.001).激光术后VAS视觉评分发现,595 nm染料激光治疗侧疼痛度低于强脉冲光,两者差异有统计学意义(t=2.468,P＜0.05).评价满意和非常满意的患者595 nm染料激光17例,强脉冲光15例,两组差异无统计学意义(Z=2.696,P＞0.05).强脉冲光不良反应包括红斑、灼烧感、紧绷感、水疱、色素沉着,595 nm染料激光不良反应包括红斑、紫癜反应,均在数小时至数天消失.结论 应用强脉冲光及595 nm染料激光治疗痤疮后红斑均安全有效,适合临床推广应用,强脉冲光相较于595 nm染料激光疗效更优,但疼痛度更高.     

Pulsed dye laser vs. intense pulsed light for port-wine stains: a randomized side-by-side trial with blinded response evaluation

Background  Pulsed dye lasers (PDLs) are considered the treatment of choice for port-wine stains (PWS). Studies have suggested broadband intense pulsed light (IPL) to be efficient as well. So far, no studies have directly compared the PDL with IPL in a randomized clinical trial.
Objectives  To compare efficacy and adverse events of PDL and IPL in an intraindividual randomized clinical trial.
Methods  Twenty patients with PWS (face, trunk, extremities; pink, red and purple colours; skin types I–III) received one side-by-side treatment with PDL (V-beam Perfecta, 595 nm, 0·45–1·5 ms; Candela Laser Corporation, Wayland, MA, U.S.A.) and IPL (StarLux, Lux G prototype handpiece, 500–670 and 870–1400 nm, 5–10 ms; Palomar Medical Technologies, Burlington, MA, U.S.A.). Settings depended on the preoperative lesional colour. Treatment outcome was evaluated by blinded, clinical evaluations and by skin reflectance measurements.
Results  Both PDL and IPL lightened PWS. Median clinical improvements were significantly better for PDL (65%) than IPL (30%) ( P  = 0·0004). A higher proportion of patients obtained good or excellent clearance rates with the PDL (75%) compared with IPL (30%) ( P  = 0·0104). Skin reflectance also documented better results after PDL (33% lightening) than IPL (12% lightening) ( P  = 0·002). Eighteen of 20 patients preferred to receive continued treatments with PDL ( P  = 0·0004). No adverse events were observed with PDL or IPL.
Conclusions  Both the specific PDL and IPL types of equipment used in this study lightened PWS and both were safe with no adverse events. However, the PDL conveyed the advantages of better efficacy and higher patient preference.     

Prospective,open‐label,rater‐blinded and self‐controlled pilot study of the treatment of proliferating superficial infantile hemangiomas with 0.5% topical timolol cream versus 595‐nm pulsed dye laser

Topical timolol and 595‐nm pulsed dye laser (PDL) are both widely used in the treatment of superficial infantile hemangiomas (IH). However, to date, there is no reliable study comparing the therapeutic outcomes between the two treatment options. We designed the present study to evaluate and compare the efficacy and safety of timolol cream and PDL in the treatment of superficial proliferating IH. Twenty‐one patients with superficial IH were included in the study. Each lesion was divided into two regions; one part was treated with 0.5% topical timolol cream four times daily, and the other part was treated monthly with PDL. Both treatments were continued for 2–6 months. Five independent and blinded assessors were asked to judge the results in both the topical timolol‐treated and PDL‐treated parts by comparing photographs taken before and after treatment. Both treatments resulted in significant clinical improvements after 3.39 sessions in the 2‐month follow up. The average visual evaluation showed that PDL had significantly better results than topical timolol (6.55 ± 2.26 to 4.98 ± 2.92, P < 0.01). No patients experienced permanent side‐effects during the treatment. Our short‐term study revealed that PDL had better results compared with topical timolol cream application in the treatment of superficial proliferating IH. Further studies with longer follow‐up time and larger sample size are required to validate our findings.     

卤米松乳膏减轻激光治疗鲜红斑痣术后炎症反应的临床研究

目的：评价外用卤米松乳膏减轻脉冲染料激光（PDL）治疗鲜红斑痣（PWS）后急性炎症反应的疗效。方法：PWS患者40例,随机分为两组：试验组PDL治疗后即刻外用卤米松乳膏;对照组PDL治疗后即刻外用凡士林霜。所有受试者均给予单次595 nm PDL治疗,参数为8.0~13.5 J/cm2能量密度,1.5 ms的脉宽,7 mm的光斑。并于术后3、7及30天进行随访。结果：试验组红斑评分为 0.4±0.82,对照组为 0.9±0.91,结痂严重程度实验组为1.15±0.77,对照组为1.65±1.22,实验组与对照组比较差异均有显著性(P＜0.05)。红斑持续天数实验组3.7±8.11/天,显著低于对照组的7.3±10.49/天（P＜0.05）。结论：外用卤米松乳膏可以有效减轻PDL治疗鲜红斑痣的术后急性炎症反应。