Cryogen spray cooling and higher fluence pulsed dye laser treatment improve port-wine stain clearance while minimizing epidermal damage
Cryogen spray cooling and higher fluence pulsed dye laser treatment improve port-wine stain clearance while minimizing epidermal damage
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DOI：
10.1046/j.1524-4725.1999.99100.x
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发表时间：
1999-10-01
影响因子：
2.4
通讯作者：
Nelson, JS
中科院分区：
文献类型：
--
作者：
Chang, CJ;Nelson, JS
背景。当将冷冻剂喷射到皮肤表面适当短的时间（大约几十毫秒）时，冷却仍然局限于表皮，同时使更深的鲜红斑痣 (PWS) 血管的温度保持不变。 目的。本研究的目的是比较非冷却激光治疗 (NC-LT) 和冷冻剂喷雾冷却激光治疗 (CSC-LT) 对大量 PWS 胎记患者的疗效和安全性。方法。对 7 年期间接受脉冲染料激光（lambda = 585 nm；tau(p) = 450 mu sec）治疗的 196 名头部或颈部 PWS 胎记患者进行了回顾性审查。受试者的年龄范围在 2 个月至 62 岁之间；其中女性 109 人，男性 87 人，均为亚裔。 98 名患者接受了 NC-LT，使用 5-7 J/cm(2) 的光剂量。随后，38 名患者接受了使用 8-10 J/cm(2) 光剂量的 CSC-LT。主要功效测量是对 NC-LT PWS 的漂白反应评分进行定量评估，并在盲法基础上与 CSC-LT PWS 进行比较。结果。根据卡方分析，与 NC-LT 组相比，接受 CSC-LT 的 PWS 的漂白反应评分存在临床和统计学显着差异（P < .001）。 NC-LT 组中有 3.1% (n = 3) 的患者出现永久性疤痕。 CSC-LT 治疗组未观察到永久性疤痕。 NC-LT 组和 CSC-LT 组中分别有 57% (n = 56) 和 48% (n = 47) 的患者出现短暂色素沉着过度。在两组中，所有患者的暂时性色素沉着过度均在 1 年内得到缓解。 NC-LT 组中有两名患者出现迟发性永久性色素沉着不足。 CSC-LT 组中未观察到永久性色素沉着不足。结论。 CSC 允许使用更高的入射光剂量，从而改善 PWS 清除，而不会产生永久性疤痕或色素沉着等并发症。
BACKGROUND. When a cryogen spurt is applied to the skin surface for an appropriately short period of time (on the order of tens of milliseconds), the cooling remains localized in the epidermis, while leaving the temperature of the deeper port-wine stain (PWS) blood vessels unchanged.OBJECTIVE. The objective of this study was to compare the efficacy and safety of noncooled laser treatment (NC-LT), and cryogen spray cooled laser treatment (CSC-LT) of PWS birthmarks in a large series of patients.METHODS. A retrospective review was conducted of 196 patients with head or neck PWS birthmarks treated with the pulsed dye laser (lambda = 585 nm; tau(p) = 450 mu sec) over a 7-year period. Subjects' ages ranged between 2 months and 62 years; there were 109 females and 87 males, all of whom were Asian. Ninety-eight patients received NC-LT using light dosages of 5-7 J/cm(2). Subsequently, 38 patients received CSC-LT using light dosages of 8-10 J/cm(2). The primary efficacy measure was the quantitative assessment of the blanching response scores of NC-LT PWSs as compared, on a blinded basis, to CSC-LT PWSs.RESULTS. Based on chi-squared analysis, there were clinical, and statistically significant, differences in the blanching response scores favoring PWS receiving CSC-LT as compared to the NC-LT group (P < .001). Permanent scarring was noted in 3.1% (n = 3) of the patients in the NC-LT group. Permanent scarring was not observed in the CSC-LT treatment group. Transient hyperpigmentation was noted in 57% (n = 56) and 48% (n = 47) of the patients in the NC-LT and CSC-LT groups, respectively. In both groups, the transient hyperpigmentation resolved in all patients within 1 year. Two patients in the NC-LT group developed delayed permanent hypopigmentation. Permanent hypopigmentation was not observed in the CSC-LT group.CONCLUSION. CSC permitted the use of higher incident light dosages leading to improved PWS clearance without producing complications such as permanent scarring or dyspigmentation.