An overview of clinical and experimental treatment modalities for port wine stains.

An overview of clinical and experimental treatment modalities for port wine stains.
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DOI:
10.1016/j.jaad.2011.11.938
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发表时间:
2012-08
影响因子:
13.8
通讯作者:
Heger, Michal
Heger, Michal
中科院分区:
医学1区
文献类型:
--
作者:
Chen, Jennifer K.;Ghasri, Pedram;Aguilar, Guillermo;van Drooge, Anne Margreet;Wolkerstorfer, Albert;Kelly, Kristen M.;Heger, Michal

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葡萄酒色斑(PWS)是最常见的皮肤血管畸形,发生在0.3%至0.5%的人群中。闪光灯泵浦的脉冲染料激光器(选择性光热疗法)的非侵入性激光照射目前包括PWS的金标准治疗;然而,大多数PWS不能完全清除后选择性光热疗法。在这篇综述中,讨论了临床上使用的PWS治疗方式(脉冲染料激光,翠绿宝石激光,钕:钇铝石榴石激光和强脉冲光)和技术(组合方法,多次通过和表皮冷却)。对1990年至2011年期间发表的临床研究进行了回顾性分析,以确定每种临床使用的方式/技术的治疗效果。此外,已导致高度的治疗复发的因素被确定,并解决了新兴的实验治疗策略,包括使用光动力疗法,免疫调节剂,血管生成抑制剂,低压,和特定部位的药物激光治疗。
Port wine stains (PWS) are the most common vascular malformation of the skin, occurring in 0.3% to 0.5% of the population. Noninvasive laser irradiation with flashlamp-pumped pulsed dye lasers (selective photothermolysis) currently comprises the gold standard treatment of PWS; however, the majority of PWS fail to clear completely after selective photothermolysis. In this review, the clinically used PWS treatment modalities (pulsed dye lasers, alexandrite lasers, neodymium:yttrium-aluminum-garnet lasers, and intense pulsed light) and techniques (combination approaches, multiple passes, and epidermal cooling) are discussed. Retrospective analysis of clinical studies published between 1990 and 2011 was performed to determine therapeutic efficacies for each clinically used modality/technique. In addition, factors that have resulted in the high degree of therapeutic recalcitrance are identified, and emerging experimental treatment strategies are addressed, including the use of photodynamic therapy, immunomodulators, angiogenesis inhibitors, hypobaric pressure, and site-specific pharmaco-laser therapy.
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