TREATMENT OF NEVUS OF OTA WITH THE Q-SWITCHED RUBY-LASER
TREATMENT OF NEVUS OF OTA WITH THE Q-SWITCHED RUBY-LASER
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DOI：
10.1056/nejm199412293312604
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发表时间：
1994-12-29
影响因子：
158.5
通讯作者：
TAKAHASHI, H
中科院分区：
文献类型：
--
作者：
WATANABE, S;TAKAHASHI, H
背景太田痣是一种良性的蓝灰色褐色病变的眼睛和周围的皮肤，已报告发生在约1在200人在日本。先前的治疗要么无效，要么造成疤痕。Q开关红宝石激光器可以产生非常短的高能量脉冲，并且可以选择性地靶向含有色素的细胞，例如真皮黑色素细胞。我们用Q开关红宝石激光治疗了114名太田痣患者（25名男性和89名女性）的皮肤病变，激光的波长为694.3 nm，脉冲持续时间为30纳秒，脉冲能量为每平方厘米体表面积6 J。治疗间隔为3至4个月。五位不熟悉患者的皮肤科医生独立比较了每位患者治疗前和治疗后的全套照片，并使用标准标准确定了受影响区域色素减轻的百分比。在35名接受了四到五次治疗的患者中，33名患者的反应非常好（减轻70%或更多），2名患者的反应良好（减轻40%至69%）。在接受三种治疗的31名患者中，4名患者的反应非常好，26名患者的反应良好，1名患者的反应一般（减轻10%至39%）。在接受两种治疗的25例患者中，2例反应极佳，16例反应良好，7例反应一般。在接受一种治疗的23名患者中，3名反应良好，13名反应一般，7名无反应（减轻9%或更少）。没有患者出现增生性或萎缩性瘢痕; 8例患者在首次治疗后两个月内出现炎症后色素沉着过度。Q开关红宝石激光选择性光治疗太田痣是一种安全有效的方法。多次治疗可提高应答率。
Background. Nevus of Ota is a benign bluish gray-brown lesion of the eye and the surrounding skin that has been reported to occur in about 1 in 200 people in Japan. Prior treatments have either been ineffective or caused scarring. The Q-switched ruby laser can produce very short high-energy pulses and can selectively target cells that contain pigment, such as dermal melanocytes.Methods. We treated the skin lesions of 114 patients (25 male and 89 female) with nevi of Ota with a Q-switched ruby laser set to deliver pulses of 6 J per square centimeter of body-surface area at a wavelength of 694.3 nm, with a pulse duration of 30 nanoseconds. The interval between treatments ranged from three to four months. Five dermatologists who were not familiar with the patients independently compared a full set of pretreatment and post-treatment photographs of each patient and determined the percentage of pigment lightening of the affected areas using standard criteria.Results. Of the 35 patients who received four or five treatments, 33 had an excellent response (lightening of 70 percent or more), and 2 had a good response (lightening of 40 to 69 percent). Of the 31 patients who received three treatments, 4 had an excellent response, 26 a good response, and 1 a fair response (lightening of 10 to 39 percent). Of the 25 patients who received two treatments, 2 had an excellent response, 16 a good response, and 7 a fair response. Of the 23 patients who received one treatment, 3 had a good response, 13 a fair response, and 7 no response (lightening of 9 percent or less). No patient had hypertrophic or atrophic scarring; eight patients had postinflammatory hyperpigmentation for up to two months after the first treatment.Conclusions. Selective photothermolysis with the Q-switched ruby laser is a safe and effective method for lightening nevi of Ota. Multiple treatments increase the response rate.