两种308nm紫外线治疗白癜风的对照研究

目的:对比分析308 nm准分子光和308 nm高能窄谱发光二极管(LED)紫外线治疗白癜风的临床疗效差异及安全性。方法:选择不同临床类型的白癜风患者76例,共246处色素脱失斑,每例患者选择相近或对称部位的皮损随机分组,一组皮损进行308 nm准分子光治疗,对应的另一组皮损进行308 nm高能窄谱LED紫外线治疗。每周治疗二三次,连续治疗20次。观察、记录疗效及不良反应。结果:治疗20次后,308 nm准分子光组的有效率为50.41%,308 nm高能窄谱LED紫外线组的有效率为52.03%,两组差异无统计学意义(P0.05)。随着治疗次数的增加,两组患者的治疗有效率均有显著增加(P0.05)。两组患者不同部位皮损疗效差异均有统计学意义(P0.05),其中面颈部的疗效均优于其他部位,躯干和四肢的疗效优于肢端。结论:308 nm准分子光和308 nm高能窄谱LED紫外线治疗白癜风的临床疗效均安全有效。     

308nm单频准分子光与311nm窄谱中波紫外线照射治疗特应性皮炎的临床疗效比较

目的观察308nm单频准分子光与311nm窄谱中波紫外线治疗特应性皮炎的临床疗效与不良反应。方法将入选的97例特应性皮炎患者随机分为两组,治疗组48例予308nm单频准分子光照射治疗,对照组49例予311nm窄谱中波紫外线进行照射治疗。两组患者均2次/周,连续治疗24次。治疗前、后采用欧洲AD评分标准(SCORAD)对AD的临床严重度进行评分,用视觉模拟尺度(VAS)评分法对瘙痒程度进行评分。疗程结束后,评价两组患者的临床疗效及安全性。结果治疗组与对照组的有效率分别为89.58%和71.43%,治疗组SCORAD积分和VAS积分下降情况优于对照组。以上差异均有统计学意义(P0.01)。两组患者中均未见严重不良反应。结论 308nm单频准分子光治疗特应性皮炎的临床疗效好,起效快,而且不良反应少。     

单频准分子光与窄谱中波紫外线治疗白癜风疗效观察

目的观察308nm单频准分子光(MEL)与311nm窄谱中波紫外线(NB-UVB)照射治疗白癜风的临床疗效。方法53例患者随机选25例为治疗组单独使用308nmMEL治疗,28例为对照组单独使用311nmNB-UVB进行治疗,在完成15次以上的治疗后,两组进行临床疗效比较。结果治疗组与对照组的有效率分别为60.0%和78.6%,两种方法疗效的差异无显著性(χ2=0.142,P>0.05)。治疗组与对照组出现第一个色素岛的平均照射次数分别为8.48和6.36次,其差异亦无显著性(t=1.933,P>0.05)。结论308nmMEL照射治疗白癜风的临床疗效与311nmNB-UVB相似,对这种新型光源的临床应用尚需进一步深入研究。     

自体表皮移植联合光疗治疗白癜风临床观察

目的观察自体表皮移植术(AET)联合308nm准分子光(MEL)或311nm窄谱中波紫外线(NB-UVB)治疗局限性稳定期白癜风的临床疗效和安全性。方法将入选的150例白癜风患者随机分为3组,每组50例。全部患者行AET治疗,治疗1组术后2周时联合308nm MEL照射治疗,治疗2组术后2周时联合311nm NB-UVB照射治疗,均2次/周,均治疗30次。对照组术后未进行光疗。结果治疗1组和治疗2组患者有效率(95.08%和88.10%)均优于对照组患者的有效率(78.36%),差异有统计学意义(P0.05);治疗1组和治疗2组患者有效率差异亦有统计学意义(P0.05),且其对于躯干和四肢部皮损的疗效优于对照组(P0.05)。两个治疗组不良反应发生率显著高于对照组的不良反应发生率,但是两个治疗组不良反应发生率差异无统计学意义(P0.05)。结论 AET联合308nm MEL或311nm NB-UVB治疗局限性稳定期白癜风的疗效优于单纯AET,且联合308nm MEL的疗效与311nm NB-UVB相当,但该两种联合治疗方法的不良反应高于对照组。     

308nm准分子光和308nm LZD紫外线治疗白癜风的效果对比观察

目的观察对比308nm准分子光疗法和308 nm高能窄谱发光二极管(LZD)紫外线疗法治疗白癜风的效果。方法选择2015年2月～2017年3月期间我院皮肤科收治的82例白癜风患者,随机分为LZD组和准分子光组各41例。准分子光组患者采用308nm准分子光疗法治疗,LZD组患者采用308 nm LZD紫外线疗法治疗,持续25次。记录比较两组患者治疗效果、治疗前后血清炎性因子变化和不良反应发生率。结果两组患者治疗总有效率无明显差异(P 0.05);两组患者治疗后血清白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平均有明显下降(P 0.05),治疗后两组患者血清IL-17、TNF-α水平无明显差异(P0.05);两组患者治疗过程中不良反应发生率无明显差异(P 0.05)。结论 308nm LZD紫外线与308nm准分子光治疗白癜风均安全有效,且疗效相当。     

308nm准分子激光治疗稳定期白癜风疗效观察

目的观察308nm准分子激光治疗稳定期寻常型局限或散发白癜风患者的临床疗效。方法随机将85例寻常型稳定期白癜风患者分为治疗组与对照组,分别采用308nm准分子激光与窄谱中波紫外线(NB-UVB)照射治疗,两组患者均每周2次,共12周,分别于4周、8周、12周记录疗效,进行对比观察。结果治疗组有效率为60.46%,且起效快,最早复色开始时间为3周,NB-UVB组最早复色时间为5周。结论 308nm准分子激光照射对于稳定期局限型、散发型白癜风患者是一种较好的治疗方法,尤其是对于皮损位于面部、颈部和躯干部的患者,无明显的不良反应。     

中药内服外涂联合窄谱中波紫外线治疗局限性白癜风临床观察

目的观察自拟祛白汤内服及增色酊外涂联合窄谱中波紫外线(311nm)局部照射治疗白癜风的有效性和安全性。方法将入选的156例白癜风患者随机分为3组。治疗组52例,内服祛白汤,2次/d,外涂增色酊(1~3)次/d,予311nm窄谱中波紫外线局部照射,初始剂量经光斑贴试验测定为0.5 J/cm2,2次/周,疗程3月;对照Ⅰ组51例,内服祛白汤,2次/d,外涂增色酊(1~3)次/d;对照Ⅱ组52例,仅给予311nm窄谱中波紫外线局部照射,初始剂量经光斑贴试验0.5 J/cm2,2次/周,疗程3月。结果治疗组、对照Ⅰ组、对照Ⅱ组的有效率分别为85.0%,35.3%,55.67%,治疗组与对照Ⅰ组、对照Ⅱ组比较,差异均有统计学意义(P0.05),对照Ⅰ组和对照Ⅱ组比较差异无统计学意义;结论中药内服外涂配合窄谱中波紫外线(311nm)局部照射治疗白癜风疗效显著,值得推广使用。     

308nm准分子激光与NB-UVB治疗白癜风的效果对比分析

目的对比分析308nm准分子激光(MEL)与311nm窄谱中波紫外线(NB-UVB)治疗白癜风的治疗效果。方法选择2015年9月～2017年9月我院收治的白癜风患者104例为研究对象,依照治疗方法分为MEL组(n=52,给予308nm的MEL治疗)和UVB组(n=52,给予311nm的NB-UVB治疗),比较其治疗效果和不良反应。结果 MEL组75.00%的治疗总有效率显著高于UVB组的55.76%(P 0.05);MEL组7.69%的不良反应总发生率显著低于UVB组的23.08%(P 0.05)。结论 308nm的MEL对白癜风患者治疗效果更好,安全性更高。     

中波高能紫外线与308 nm准分子激光治疗白癜风的短期疗效比较

【摘要】 目的 比较中波高能紫外线和308 nm准分子激光治疗白癜风的短期疗效。 方法 中波高能紫外线组患者40例,每周照射2次;308 nm准分子激光组40例,每周1次。评估两组治疗8周后的皮损复色情况。 结果 经过8周的阶段治疗,中波高能紫外线组有83.6%皮损可出现不同程度的复色反应,达显效以上复色为42.1%;308 nm准分子激光组86.1%有皮损不同程度色素生成,达到显效以上为50%。对于面部白癜风皮损中波高能紫外线的疗效低于308 nm准分子激光（χ2 = 4.32,P < 0. 05）,在其余部位两组有效率差异无统计学意义。在皮损起始复色的累积剂量方面,两者差异无统计学意义（t = 0.89,P > 0.05）,在达到显效以上复色方面,高能中波紫外线的治疗次数和累积剂量明显多于308 nm准分子激光（P < 0. 01）。两者均适用于儿童患者及活动期皮损。 结论 中波高能紫外线或308 nm准分子激光治疗白癜风均可在短期内起效且安全,308 nm准分子激光疗效更明显。     

308nm准分子光联合薄芝糖肽治疗白癜风临床疗效观察

目的观察308 nm准分子光联合薄芝糖肽治疗白癜风的疗效及不良反应。方法将87例白癜风患者随机分为治疗组44例,对照组43例。治疗组每周2次皮损处照射308 nm准分子光,同时肌内注射薄芝糖肽注射液2 m L,隔日1次;对照组仅每周2次皮损处照射308 nm准分子光。2组疗程均为12周,每4周随访1次,观察疗效及不良反应。结果治疗12周后治疗组与对照组的有效率及痊愈率比较差异均有统计学意义(P0.05)。结论 308 nm准分子光联合薄芝糖肽治疗白癜风疗效显著,不良反应发生率低。     

Efficacy of laser treatment of tattoos using lasers emitting wavelengths of 532 nm, 755 nm and 1064 nm

BACKGROUND: Multifunctional laser devices can be used to treat tattoos successfully. OBJECTIVES: To report the efficacy of laser treatment in professional, amateur, accidental and permanent make-up tattoos from our own experience and to compare it with the literature. METHODS: We retrospectively studied 74 consecutive patients with professional, amateur, make-up and accidental tattoos between June 1998 and November 2000. Patients were treated with a Q-switched Nd:YAG laser (wavelengths of 532 nm and 1064 nm), a Q-switched alexandrite laser (755 nm) and a variable pulse Nd:YAG laser (532 nm). RESULTS: Fourteen patients (19%) achieved a complete response (>95% lightening of treated tattoos), 23 (31%) an excellent response (76-95% lightening) and 21 (28%) a good response (51-75% lightening). Sixteen patients (22%) showed only a slight improvement (< or =50% lightening). Make-up tattoos and blue-black professional tattoos were most successfully treated. Multicoloured professional tattoos needed more treatments (mean +/- SD 5.7 +/- 5.4) in comparison with single-colour tattoos (3.5 +/- 2.0). The amateur tattoos needed fewer treatments (2.8 +/- 1.1) in comparison with professional tattoos. With accidental tattoos the results depended on the particles which had penetrated the skin. In contrast to literature reports, newer tattoos showed a trend to better treatment results than older tattoos. CONCLUSIONS: Using modern Q-switched lasers, tattoos are removed successfully with minimal risk of scarring and permanent pigmentary alterations. Even multicoloured tattoos can be treated successfully and with a low rate of side-effects.     

三种波长发光二极管光对光老化皮肤的作用研究

【摘要】 目的 探讨并比较530 nm、630 nm以及850 nm发光二极管（LED）光对光老化皮肤的作用。 方法 选择14例皮肤光老化受试者,随机于其一侧前臂伸侧三个区域,分别给予530、630及850 nm LED光照射,每周3次,共12次。对照射部位皮肤进行皮肤镜检查,并比较照射前、照射第2、4和6周皮肤角质层含水量、经皮水分丢失量（TEWL）以及反映皮肤颜色的皮肤亮度（L*值）和皮肤黑素指数（MI值）的变化。同时,随机选择5例、5例、4例受试者在试验前和试验第6周分别取530、630及850 nm LED光照射皮肤进行组织病理检查。 结果 经12次630、850 nm LED光照射后,经皮肤镜检查,分别有10例、7例受试者皮肤纹理变浅,色素沉着减少;7例受试者530 nm LED光照射部位皮肤纹理加深,色素沉着增加。经630和850 nm LED光照射后,14例受试者皮肤角质层含水量均明显升高（6周时分别为37.9 ± 7.7和34.5 ± 7.1 au,照射前分别为33.1 ± 6.1和32.0 ± 7.0 au,照射前后比较,均P < 0.05）,TEWL值均明显降低（6周时分别为9.8 ± 2.5和10.9 ± 2.5 g·m-2·h-1,照射前分别为14.0 ± 1.8和14.2 ± 2.6 g·m-2·h-1,照射前后比较,均P < 0.05）,L*值与MI值均未发现明显改变（P > 0.05）。530 nm组皮肤角质层含水量及TEWL值较照射前差异均无统计学意义（P > 0.05）,L*值显著降低（P < 0.05）,MI值明显增高（P < 0.05）。组织病理检查显示,照射前真皮具有典型的光化性胶原纤维、弹性纤维变性损害,照射后3组均出现新生胶原纤维、弹性纤维,排列较照射前整齐致密。 结论 630和850 nm LED光均可以改善光老化皮肤外观、屏障功能,促进胶原纤维和弹性纤维增生和重排,530 nm LED光会增加皮肤色素沉着。     

Skin temperature changes induced by UV irradiation at 254 nm and 300 nm

Skin temperatures 24 h after irradiation at both 254 and 300 nm have been examined using the technique of thermography. Increases in skin temperature have been recorded at both wavelengths but the magnitude of these differences after 254 nm irradiation is influenced by the ambient temperature. The apparent disagreement between two groups of observers working in the field of UV erythema may well have been explained.     

Reversing precancerous actinic damage by mixing wavelengths (1064 nm, 532 nm)

Abstract

Background: Premalignancies resulting from photodamage, such as actinic keratosis and carcinoma in situ, can be treated with various modalities. Most of these treatments may reverse or treat these conditions although they often involve considerable skin irritation over a long period of time, are very uncomfortable for the patients or they need many office visits and sometimes are very expensive, such as photodynamic therapy (PDT). Objective: To study the effectiveness of a mixed session of Q-switched KTP 532 nm and Nd:YAG 1064 nm laser treatment on precancerous lesions resulting from solar damage. Methods: Ten patients with long-standing actinic damage/keratosis or carcinoma in situ were subjected to only one session of mixed Q-switched KTP 532 nm and Nd:YAG 1064 nm laser treatment. Lesions were evenly and repeatedly scanned with both wavelengths until light pain or purpura presented. Results: All patients responded extremely well within a period of 20 days, with just one session, with virtually no pain, minimum irritation, no down time at all and excellent cosmetic outcome. Conclusion: The use of a mixed Q-switched 532 nm and Nd:YAG 1064 nm laser session seems to be ideal for treating precancerous lesions resulting from photodamage since it can be a fast, painless and simple office procedure with no down time and minimum discomfort for the patient. This method proves to be much more selective than traditional intense pulse light (IPL) photorejuvenation.     

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.     

The effect of ultraviolet radiation with peaks at 300 nm and 350 nm in the treatment of atopic dermatitis

Using a monochromator, 10 patients with atopic dermatitis were treated with 300 +/- 5 nm rays (UVB) and with 350 +/- 32 nm (UVAB) rays to compare the efficacy of these 2 wavebands. In each patient, 2 well-defined dermatitis patches were irradiated with 1 of the 2 wavelengths 5 d per week for 2 weeks. Each patch was subject to evaluation on 7 effect variables, the sum of which comprised the total score. The effect of these wavelengths on the 2 variables considered to be of greatest importance was subjected to statistical analysis. The UVAB light proved to be superior to the UVB light for both total score and overall evaluation score.     

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.     

Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris

In this study we have evaluated the use of blue light (peak at 415 nm) and a mixed blue and red light (peaks at 415 and 660 nm) in the treatment of acne vulgaris. One hundred and seven patients with mild to moderate acne vulgaris were randomized into four treatment groups: blue light, mixed blue and red light, cool white light and 5% benzoyl peroxide cream. Subjects in the phototherapy groups used portable light sources and irradiation was carried out daily for 15 min. Comparative assessment between the three light sources was made in an observer-blinded fashion, but this could not be achieved for the use of benzoyl peroxide. Assessments were performed every 4 weeks. After 12 weeks of active treatment a mean improvement of 76% (95% confidence interval 66-87) in inflammatory lesions was achieved by the combined blue-red light phototherapy; this was significantly superior to that achieved by blue light (at weeks 4 and 8 but not week 12), benzoyl peroxide (at weeks 8 and 12) or white light (at each assessment). The final mean improvement in comedones by using blue-red light was 58% (95% confidence interval 45-71), again better than that achieved by the other active treatments used, although the differences did not reach significant levels. We have found that phototherapy with mixed blue-red light, probably by combining antibacterial and anti-inflammatory action, is an effective means of treating acne vulgaris of mild to moderate severity, with no significant short-term adverse effects.     

Q开关1064nm和532nm Nd:YAG激光对大鼠皮肤非剥脱性嫩肤作用的比较

目的:比较Q开关1064 nm和Q开关532 nm Nd:YAG激光照射对大鼠皮肤的非剥脱性嫩肤作用.方法:分别使用上述两种激光的三种不同能量密度对大鼠背部皮肤进行照射,动态观测皮肤弹性和皮肤含水量变化,光镜下观察大鼠背部皮肤真皮层厚度的变化,测定局部皮肤羟脯氨酸含量.结果:末次照射后第4周,大鼠试验侧的皮肤弹性和含水量都明显好于对照侧;试验侧皮肤羟脯氨酸含量和真皮层厚度都较对照侧显著提高(P<0.05).结论:Q开关1064 nm Nd:YAG激光较532 nm Nd:YAG激光具有更为明显非剥脱性嫩肤效果.