Treatment of resistant port-wine stains with a variable-pulse pulsed dye laser
Treatment of resistant port-wine stains with a variable-pulse pulsed dye laser
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DOI：
10.1111/j.1524-4725.2007.33197.x
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发表时间：
2007-08-01
影响因子：
2.4
通讯作者：
Nozaki, Motohiro
中科院分区：
文献类型：
--
作者：
Kono, Taro;Sakurai, Hiroyuki;Nozaki, Motohiro
背景：传统的脉冲染料激光(PDL)波长为585 nm，脉冲宽度为0.45ms，通常不能完全清除大多数鲜红斑痣(PWSS)。目的本研究中，我们证明了配备冷冻喷雾冷却(CSC)的可变脉冲脉冲染料激光(VPPDL)在治疗对PDL治疗耐药的PWS中的有效性。所有患者之前至少接受过8次PDL治疗(平均12.8+/-5.9次)，并已达到治疗平台期。使用波长为595 nm、光斑尺寸为7 mm的VPPDL。治疗剂量为9~15J/cm(2)，脉冲持续时间1.5~10ms。对于每个皮损，每隔8周进行四次治疗。结果好转8例，良9例，可11例，差12例。激光治疗过程中未见并发症发生。结论VPPDL的治疗效果优于PDL，VPPDL可用于治疗耐PDL的PWSS。然而，直径小于30微米的血管对PDL和VPPDL治疗都有抵抗力。
BACKGROUND The conventional pulsed dye laser (PDL), operating at a wavelength of 585 nm and a pulse duration of 0.45 ms, usually does not achieve complete clearance in the majority of port-wine stains (PWSs).OBJECTIVE In this study, we demonstrate the efficacy of a variable-pulse pulsed dye laser (VPPDL) equipped with cryogen spray cooling (CSC) in the treatment of PWS that have become resistant to PDL treatment.METHODS Forty Asian patients with Fitzpatrick skin types III to IV were enrolled in this study. All patients had previously been treated by the PDL at least eight times (mean, 12.8 +/- 5.9) and had reached a treatment plateau. A VPPDL with a wavelength of 595 nm and a spot size of 7 mm was used. The patients were treated with fluences between 9 and 15 J/cm(2) and pulse durations of 1.5 to 10 ms. Four treatments were administered at 8-week intervals for each lesion. Three months after the last treatment, all patients were evaluated for the degree of improvement by two independent clinicians.RESULTS Eight patients had excellent improvement, 9 had good improvement, 11 had fair improvement, and 12 had poor improvement. No complications were observed during the course of laser treatment. Vessels larger than 30 mu m were not seen in the biopsy specimens obtained after the final treatment.CONCLUSION The VPPDL is more effective than the PDL and the VPPDL should be used for treating PDL-resistant PWSs. Nonetheless, vessels less than 30 mu m in diameter are resistant to both PDL and VPPDL treatment.