激光个性化治疗酒渣鼻的疗效分析

目的观察不同分期酒渣鼻采用不同激光治疗的临床疗效。方法根据患者病情所处的不同阶段,个性化制定治疗方案:红斑期(Ⅰ期)患者采用强脉冲光(IPL)消除毛细血管,收缩毛孔;丘疹脓疱期(Ⅱ期)患者采用585nm脉冲染料激光(PDL)凝固较粗血管;鼻赘期(Ⅲ期)患者采用超脉冲CO2合并铒点阵激光切割气化鼻赘,收缩毛孔;Ⅱ期和Ⅲ期患者在治疗的后期均可采用IPL去除残余红斑,收缩毛孔。每次治疗2～3个月后观察疗效,及治疗次数对疗效的影响。结果 40例患者临床痊愈率达70%,总有效率达92.5%,无色素沉着及瘢痕等并发症。结论针对不同分期酒渣鼻使用个性化激光治疗方案,效果好,安全性高,值得推广。     

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激光和585nm脉冲染料激光治疗色素性、血管性皮肤病1686例

目的评估Q开关Nd:YAG激光和585nm脉冲染料激光治疗色素性皮肤病和血管性皮肤病的疗效。方法分别采用Q开关Nd:YAG激光治疗色素性皮肤病400例、585nm脉冲染料激光治疗血管性皮肤病1177例,并采用二者治疗病毒疣109例,观察疗效。结果Q开关Nd:YAG激光对色素性皮肤病的有效率由高到低依次为:雀斑(100%)、文身(87.50%)、脂溢性角化(84.60%)、斑痣(46.70%)、咖啡斑(40.40%);585nm脉冲染料激光对血管性皮肤病的有效率由高到低为:蜘蛛痣(98.30%)、草莓状血管瘤(91.40%)、红斑期酒渣鼻(83.30%)及颜面毛细血管扩张(80.00%);二者对病毒疣的有效率分别为:寻常疣90.10%、尖锐湿疣66.70%、扁平疣52.60%。结论Q开关Nd:YAG激光治疗色素性皮肤病、585nm脉冲染料激光治疗血管性皮肤病及二者治疗病毒疣疗效较好。     

长脉宽1064nm Nd∶YAG激光或595nm脉冲染料激光或两者联合治疗会阴部婴幼儿血管瘤疗效分析

目的:总结分析长脉宽1 064 nm掺钕钇铝石榴石(Nd∶YAG)激光、595 nm脉冲染料激光(PDL)或两者联合治疗会阴部婴幼儿血管瘤临床疗效、不良反应及其影响疗效的有关因素。方法:应用长脉宽1 064 nm Nd∶YAG激光、脉冲染料激光或两者联合治疗会阴部婴幼儿血管瘤35例,治疗间隔4~8周。统计治疗效果并分析影响疗效的因素。结果:35例患儿,其中男3例、女32例,年龄40 d~2岁,皮损面积0.1~15 cm2。治疗有效率为100%,治疗次数1~5次。常见的不良反应为红肿和水疱,一般3~5 d内修复,其中2例出现糜烂及渗出,5例痊愈后皮肤质地有变化,2例遗留色素沉着,未见感染、瘢痕等其他不良反应。结论:长脉宽1 064 nm Nd∶YAG激光及595 nm脉冲染料激光治疗会阴部婴幼儿血管瘤安全有效,不良反应轻微,值得推广应用。     

深肤色人种的激光脱毛

当今激光技术飞速发展，提高了激光脱毛的临床疗效，并使我们增加了对毛发生理及激光-组织相互作用的认识。配有冷却装置的长脉宽、长波长激光的应用，使得激光脱毛能够安全有效地应用于深肤色人种（皮肤Ⅳ～Ⅵ型）。目前主要用于深肤色人种脱毛的光源有长脉宽翠绿宝石（755nm）、长脉宽半导体（800nm）、长脉宽Nd：YAG（1064nm）激光和强脉冲光（590．1200nm）。但其中长脉宽Nd：YAG激光在深肤色人种脱毛中更为安全。     

595nm脉冲染料激光联合口服甲硝唑治疗酒渣鼻临床观察

目的:观察595 nm脉冲染料激光联合口服甲硝唑治疗红斑毛细血管扩张型和丘疹脓疱型酒渣鼻的临床疗效.方法:治疗组31例,用595 nm脉冲染料激光治疗,每4周1次,连续治疗3次,同时口服甲硝唑,每天3次,每次0.2克,连续28天;对照组30例,外用5%过氧化苯甲酰凝胶,每天一次,连续12周,同时口服甲硝唑片,用法用量及疗程同治疗组.观察比较两组治疗前后丘疹脓疱数目、红斑毛细血管扩张评分情况.结果:治疗组总有效率100%,显效率为83.8%.对照组总有效率为93.33%,显效率为56.67%,两组显效率和红斑血管扩张评分比较差异有统计学意义(P<0.05),总有效率和丘疹脓疱数目差异无统计学意义(P>0.05).结论:595 nm脉冲染料激光联合口服甲硝唑治疗酒渣鼻疗效显著,尤其对红斑毛细血管扩张型病变疗效明显,值得临床推广.     

可变脉宽1064nm Nd:YAG激光联合强脉冲光治疗鲜红斑痣疗效评价

目的:评价可变脉宽1064 nm Nd:YAG激光联合强脉冲光(IPL)治疗鲜红斑痣的疗效。方法:将329例鲜红斑痣患者随机分为2组,分别给予可变脉宽Nd:YAG 1064 nm激光单独照射(165例)以及可变脉宽Nd:YAG 1064 nm激光与强脉冲光联合照射(164例)。结果:联合治疗组总有效率(91.46%)优于单独照射组(79.96%),P0.01。结论:可变脉宽1064 nm Nd:YAG激光联合IPL较单独可变脉宽Nd:YAG 1064 nm激光治疗鲜红斑痣有效。     

长脉宽1064 nm Nd：YAG激光脱毛的作用机制和临床应用

长脉宽1 064 nm Nd：YAG激光用于脱毛以来,因其具有穿透深、脉宽长、可选择的能量密度范围大等优点,适用于对各种皮肤类型（尤其是Ⅳ～Ⅵ型皮肤）和除白色以外的各种颜色毛发的患者进行脱毛,已经成为激光脱毛领域的研究热点.文中对长脉宽1 064 nm Nd：YAG激光在脱毛治疗方面的作用机制、临床应用情况作一综述.     

长脉宽与Q开关1064 nm Nd:YAG激光对皮肤作用的比较

目的:比较长脉宽1064 nm Nd:YAG激光和Q开关1064 nm Nd:YAG激光照射对小鼠皮肤的影响.方法:分别使用长脉宽1064 nm Nd:YAG激光(脉宽为3 ms、50 ms)和Q开关1064 nm Nd:YAG激光(脉宽5 ns)对小鼠背部脱毛后的皮肤进行照射,共照射4次,每次间隔1周.检测照射后不同时间点的皮肤弹性、皮肤羟脯氨酸含量,真皮内胶原增生情况以及红斑指数和经表皮失水量的变化情况.结果:从首次照射后第3或4周至第7周,各实验组的皮肤弹性都明显好于对照组;首次照射7周后各组实验侧的皮肤羟脯氨酸含量和真皮内胶原厚度都较对照组显著增大(P＜0.01),但各实验组之间无显著差异;苦味酸一天狼猩红染色-偏振光法检查显示各组增生的胶原主要为I型胶原.首次激光照射后即刻,各实验组的经表皮失水量及Q开关1064 nm Nd:YAG激光实验组的红斑指数都较其对照组显著增高(P＜0.01),并于1周内恢复.结论:长脉宽1064 nm Nd:YAG激光可以取得与Q开关1064 nm Nd:YAG激光对皮肤相似的效果,且不良反应较轻.     

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。     

Laser treatment of rosacea

Rosacea is a common condition often resulting in persistent erythema and telangiectasia as well as rhinophyma in a number of patients. Over the last two decades lasers have been increasingly used in the treatment of these permanent changes. The literature is reviewed in terms of the different laser systems, side-effects and comparison with other surgical techniques. Laser studies on rosacea-associated telangiectasia and erythema are limited. Copper-bromide, krypton and KTP lasers have been used with good to excellent results. However, the most commonly applied system is the flash lamp-pumped pulsed dye laser. Rhinophyma can be treated with a variety of different surgical methods, including laser resurfacing. CO(2) lasers are the most widely used lasers, others are the Er:YAG and Nd:YAG lasers. Cosmetic end results are comparable to partial excision with a scalpel or electrosurgery. There does not appear to be an increased risk of infection or scarring, but the conventional surgical methods are quicker to perform and more cost effective.     

Lasers for facial rejuvenation: a review

BACKGROUND: Different types of laser are used for resurfacing and collagen remodeling in cutaneous laser surgery. METHODS: A systematic review was performed of the different types of laser currently employed for skin rejuvenation. These systems are either ablative [high-energy pulsed or scanned carbon dioxide (CO2) laser emitting at a wavelength of 10,600 nm, single- or variable-pulse or dual ablative/coagulative mode erbium:yttrium aluminum garnet (Er:YAG) laser emitting at a wavelength of 2940 nm, or systems combining both 10,600 nm and 2940 nm wavelengths] or nonablative [Q-switched neodymium:yttrium aluminum garnet (Nd:YAG) laser emitting at a wavelength of 1064 nm, Nd:YAG laser emitting at a wavelength of 1320 nm, or diode laser emitting at a wavelength of 1450 nm]. Different protocols, patient selection, treatment techniques, and complications are discussed for each system. RESULTS: New-generation CO2 resurfacing lasers have been successful in the treatment of photodamaged skin and scarring, with a postoperative morbidity dependent on the depth of thermal damage. Because of its minimal penetration, the pulsed Er:YAG laser, usually used in the treatment of more superficial rhytides, produces less postoperative morbidity. Novel ablative systems have been developed and a further understanding of laser-tissue interaction has led to the design of nonablative systems for the treatment of rhytides, scarring, and photodamaged skin, the efficacy and profile of which remain to be evaluated in the long term. CONCLUSIONS: There are several effective techniques for scar revision and the treatment of aged skin, but all have their drawbacks due to a lack of precise depth control and unwanted damage to the lower layers of the dermis. The Er:YAG laser is the treatment of choice for fine lines and superficial scars, whereas the CO2 laser is better for deeper rhytides and scars. In the future, a combination of lasers may be used for facial rejuvenation.     

Facial scars after a road accident: Combined treatment with PDL and Q‐switched ND:YAG laser

We report the case of a woman who presented with several facial scars following a road accident. Treatment was carried out using combined laser treatment with pulsed dye laser (PDL) and the Q‐switched neodymium:yttrium‐aluminum‐garnet laser (QS Nd:YAG laser). No side effects or complications from treatment were noted or reported. The patient had very good cosmetic results with this combined technique. A variety of facial scars – erythematous, pigmented, atrophic and hypertrophic – may occur as a result of trauma, surgery, burns and skin disease. Surgery with other adjunctive methods including radiotherapy, intralesional steroids and pressure therapy has shown variable results. Laser treatment has been attempted for scar revision since the 1980s. The PDL is the optimal treatment for reducing scar bulk and symptoms. It also decreases the erythema and telangiectasia associated with scars, normalizes the skin surface texture and improves scar pliability. The QS Nd:YAG laser (1064?nm) is highly effective for traumatic tattoo removal, resulting in complete clearance in the majority of cases.     

Treatment of early-stage erythematotelangiectatic rosacea with a Q-switched 595-nm Nd:YAG laser

Erythematotelangiectatic rosacea presents as persistent erythema and telangiectasia with frequent flushing and blushing on the facial and extrafacial skin. Additionally, papulopustular rosacea shows acneiform papules, pustules, and nodules with persistent plaque-form edema. Despite garnering only grade-C or -D level recommendations, a 585-nm or 595-nm flashlamp-pumped pulsed-dye laser can be considered as an effective therapeutic modality for the treatment of rosacea in patients who are refractory to topical and/or systemic treatments. In this report, treatment with a Q-switched 595-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with low non-purpuragenic fluence proved to be safe and effective in treating early-stage erythematotelangiectatic rosacea in two female Korean patients. Laser treatment for rosacea was delivered with the settings of pulse energy of 0.4–0.5 J/cm², pulse duration of 5–10 ns, 5-mm spot size, 5 Hz, and 500 shots. Additionally, we found that remarkable therapeutic effects were achieved for both rosacea and melasma by combining Q-switched quick pulse-to-pulse 1,064-nm Nd:YAG and Q-switched 595-nm Nd:YAG laser treatments, which required only the changing of handpieces equipped with solid dye. In conclusion, we suggest that treatment with a Q-switched 595-nm Nd:YAG laser with low fluence may provide an additional therapeutic option for treating early-stage erythematotelangiectatic rosacea.     

Laser treatment of cutaneous angiokeratomas: A systematic review

Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium‐doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium‐doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas. Twenty‐five studies were included. Quality ratings were assigned using the Oxford Centre for Evidence‐Based Medicine scheme. Several laser modalities are effective in treating multiple variants of angiokeratomas. Vascular lasers like PDL, Nd:YAG, and argon are the most studied and of these, PDL offers the safest side effect profile. Nd:YAG may be more effective for hyperkeratotic angiokeratomas. Combination treatment with multiple laser modalities has also demonstrated some success. Lasers are a promising treatment option for angiokeratomas, but current use is limited by the lack of treatment guidelines. There are limited high quality studies comparing laser treatments to each other and to non‐laser options. Additional studies are needed to establish guidelines and to optimize laser parameters.     

Laser therapy in cutaneous and genital warts: A review article

Traditional treatment modalities for wart require long‐term treatment course and usually have high recurrence rates and unwanted side effects. In this review article, we evaluated different types of laser therapy in the treatment of warts. Published articles since 2000 up to July 2020 about laser therapy in genital and non‐genital warts were searched and assessed. Fifty articles were selected for the final review, including 22 pulsed dye laser (PDL), 10 neodymium‐yttrium‐aluminum‐garnet (Nd: YAG), 3 erbium‐doped yttrium‐aluminum‐garnet (Er: YAG), 14 carbon dioxide (CO₂) laser and one systematic review. Complete response rates were different in terms of laser type used (0%‐100%, 9.1%‐100%, 83.3%‐100%, and 59.15%‐100% for PDL, Nd: YAG, Er: YAG, and CO₂ laser, respectively). There was no significant difference between conventional treatment modalities and laser therapy regarding efficacy and recurrence rate. Combination of lasers with keratolytic agents, immunomodulators and photodynamic therapy can be helpful especially in immunosuppressed patients, refractory, and recurrent lesions. PDL has the lowest occurrence of adverse effects relative to other types of lasers.     

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.     

酒渣鼻的激光和光动力疗法

酒渣鼻是一种常见的慢性炎症性皮肤疾病,其临床特点为面部红斑伴丘疹脓疱或毛细血管扩张,病情发展晚期可有鼻赘形成.酒渣鼻分为4种亚型,针对不同亚型临床特点可采用相应的激光和光化学疗法,主要包括脉冲染料激光、强脉冲光疗法、光动力疗法及二氧化碳激光磨削.概述上述疗法在酒渣鼻治疗中的机制,疗效和不良反应发生.

Abstract：

Rosacea is a common chronic inflammatory disease of the skin.It is characterized by erythematous changes of the facial skin accompanied by papules,pustules or telangiectasias,and eventually,it may progress into rhinophyma.Rosacea can be categorized into four subtypes.To get a satisfactory outcome,appropriate lasers and photochemotherapies should be selected from pulsed dye laser,intense pulsed laser,photodynamic therapy and carbon dioxide laser according to the subtype of rosacea.This review states the mechanisms,efficacy,side effects as well as targeting subtypes of these phototherapies for rosacea.     

Erbium:yttrium aluminum garnet laser versus Q-switched neodymium:yttrium aluminum garnet laser for the treatment of xanthelasma palpebrarum

Background: Several lasers have been used for the treatment of xanthelasma palpebrarum (XP), such as Q-switched neodymium:yttrium aluminum garnet (QSNd:YAG) and erbium:yttrium aluminum garnet (Er:YAG) laser. Up to now, a comparative study among these laser options in the treatment of XP has not been reported. Objective: The aim of this study was to compare the clinical efficacy and response rates of QSNd:YAG and Er:YAG in the treatment of XP. Methods: Sixty patients with a total of 102 XP lesions were randomly and equally divided into two groups. The first group was treated with QSNd:YAG at a fluence of 10 joule/cm², 10 Hz and 2 mm spot size, and the second group was treated with Er:YAG at 200-300 millijoule, 4 Hz and 2 mm spot size. Results: In the Er:YAG group, the percentage of patients who required 3 or 4 sessions and wound healing time were higher compared to those of the QSNd:YAG group. Furthermore, the percentage of patients who had an improvement score of 4 was higher in the Er:YAG than that in the QSNd:YAG group. Conclusion: Er:YAG is an efficient, successful and minimally invasive method without long-lasting adverse effects.     

Long pulse 1,064‐nm neodymium‐doped yttrium aluminum garnet laser in aesthetic dermatology

Long pulse 1,064‐nm neodymium‐doped yttrium aluminum garnet (Nd:YAG) laser is a very versatile laser due to its deep penetration and absorption by hemoglobin, melanin, and water, which has gained increasing popularity over recent years for the treatment of leg veins and permanent hair removal as well as skin rejuvenation. The long‐pulse Nd:YAG laser was appointed as treatment of choice for the treatment of 0.5–3.0 mm deoxygenated, unsightly leg veins. Hair removal is another application of long pulse Nd:YAG lasers, and decreased light absorption by melanin at 1,064 nm reduces the risk of pigmentary side effects, which makes long pulse Nd:YAG laser the safest laser in darker skin types. The long pulse Nd:YAG lasers are also being employed for skin rejuvenation based on their ability to heat dermal water and stimulate collagen production. We have reviewed the parameters of Nd:YAG laser and shared our experiences in these indications that may be useful for good clinical response with minimal side effects.