Pulsed Dye Laser at Subpurpuric Settings for the Treatment of Pulsed Dye Laser-Induced Ecchymoses in Patients With Port-Wine Stains
Pulsed Dye Laser at Subpurpuric Settings for the Treatment of Pulsed Dye Laser-Induced Ecchymoses in Patients With Port-Wine Stains
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DOI：
10.1097/dss.0000000000001255
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发表时间：
2018-02-01
影响因子：
2.4
通讯作者：
Geronemus, Roy G.
中科院分区：
文献类型：
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作者：
Brauer, Jeremy A.;Farhadian, Joshua A.;Geronemus, Roy G.
背景：术后紫癜是脉冲染料激光（PDL）治疗葡萄酒斑（PWSs）患者的主要主诉。目的评价在非紫癜性环境下使用PDL治疗pws内PDL治疗后出现的淤血的安全性和有效性。材料与方法前瞻性、随机、对照研究，使用595纳米PDL治疗pws和激光诱导的瘀斑。在基线时对葡萄色斑进行全面治疗。两天后，随机选择一半病变的瘀斑在紫癜下部位再次用PDL治疗。4 ~ 8周后重复治疗，随访1个月。评估挫伤减少和PWS清除情况。三位匿名评估者使用4分制对临床改善进行评分（1 = 1%-25%改善，2 = 26%-50%改善，3 = 51%-75%改善，4 = 76%-100%改善）。结果20例成人，头部、躯干和四肢21例pws均得到治疗。第一次治疗后，治疗组挫伤减少的平均评分为2.43，对照组为1.93 (p = 0.012)；第二次治疗后为2.83比2.40 （p = 0.021）。无明显不良事件发生。结论脉冲染料激光治疗可安全有效地减少pws患者的治疗性紫癜。
BACKGROUND Post-procedure purpura is a major complaint of patients with port-wine stains (PWSs) treated with pulsed dye laser (PDL).OBJECTIVE To assess the safety and efficacy of using PDL at nonpurpuric settings to treat ecchymoses that develop within PWSs after treatment with PDL.MATERIALS AND METHODS Prospective, randomized, controlled study using 595-nm PDL for treatment of PWSs and laser-induced ecchymoses. Port-wine stains were treated in entirety at baseline. Two days later, ecchymoses on randomly selected half of the lesion were re-treated with PDL at subpurpuric settings. Treatment series was repeated 4 to 8 weeks later, and follow-up was at 1 month. Reduction in bruising and PWS clearance were assessed. Three masked evaluators graded clinical improvement using a 4-point scale (1 = 1%-25% improvement, 2 = 26%-50% improvement, 3 = 51%-75% improvement, and 4 = 76%-100% improvement).RESULTS Twenty adults with 21 PWSs on the head, trunk, and extremities were treated. After first treatment, reduction of bruising was graded a mean value of 2.43 for the treatment side, compared with 1.93 for the control side (p = .012); after the second treatment, 2.83 compared with 2.40 (p = .021). No significant adverse events occurred.CONCLUSION Pulsed dye laser can be used safely and effectively to reduce treatment-induced purpura in patients with PWSs.