Chowdhury M M, Harris S, Lanigan S W
Department of Dermatology, Princess of Wales Hospital, Bridgend, UK.
Br J Dermatol. 2001 Apr;144(4):814-7. doi: 10.1046/j.1365-2133.2001.04138.x.
The pulsed dye laser (PDL; 585 nm, 450 micros pulse) has been established as the treatment of choice for port-wine stains (PWS), but only few patients have total clearance. A modulated potassium titanyl phosphate (KTP) laser (532 nm) has been developed that allows the adjustment of energy fluences within the 5-50 J cm-2 range with laser pulse widths between 1 and 50 ms at pulse rates from 1 to 20 pulses s(-1).
To determine the efficacy and side-effect rate of the KTP laser in treating PDL-resistant PWS.
Thirty patients were recruited. The site and colour of the PWS were recorded and assessed with erythemameter readings, videomicroscopy and photography both before and after treatment. All patients had test areas treated on their first visit and were then reviewed at 2-monthly intervals. Repeat treatments were given if no adverse effects had occurred and if the treated areas had shown between 25 and 100% lightening.
Thirty patients were assessed, age range 11-63 years (mean 35.4) with 19 females. The PWS affected the face in 21 (70%) patients, leg in five (17%) and other sites in four (13%). Patients had one to four tests or treatments (mean 2.2) with the KTP laser. Overall, 16 (53%) patients showed > 25% response and five (17%) showed > 50% response to treatments with the KTP laser. Best responses were found with fluences ranging from 18 to 24 J cm(-2) with pulse width 9-14 ms. No correlation was found with the colour of the PWS or the number of previous treatments with PDL. Patients preferred the KTP laser treatments compared with the PDL (visual analogue score mean 9.8; n = 5) with less discomfort during treatments and minimal purpura post-treatment. Six patients (20%) developed side-effects: scarring (n = 2, 7%), hyperpigmentation (n = 3, 10%) and prolonged healing phase of over 4 weeks (n = 1, 3%).
We have shown that the KTP laser can further lighten PDL-resistant PWS and that it is a useful addition to the laser treatment of PWS. Further studies need to assess the efficacy and side-effects of the KTP laser in previously untreated PWS.
脉冲染料激光（PDL；585nm，450微秒脉冲）已被确立为治疗葡萄酒色斑（PWS）的首选方法，但仅有少数患者能完全清除。已开发出一种调Q倍频磷酸钛氧钾（KTP）激光（532nm），其能在5 - 50J/cm²范围内调节能量密度，激光脉冲宽度在1至50毫秒之间，脉冲频率为1至20次/秒。
确定KTP激光治疗对PDL抵抗的PWS的疗效和副作用发生率。
招募了30名患者。在治疗前后，记录PWS的部位和颜色，并用红斑仪读数、视频显微镜检查和摄影进行评估。所有患者在首次就诊时均对测试区域进行治疗，然后每两个月复查一次。如果没有出现不良反应且治疗区域有25%至100%的颜色变浅，则进行重复治疗。
评估了30名患者，年龄范围为11 - 63岁（平均35.4岁），其中女性19名。PWS累及面部的患者有21名（70%），累及腿部的有5名（17%），累及其他部位的有4名（13%）。患者接受了1至4次KTP激光测试或治疗（平均2.2次）。总体而言，16名（53%）患者对KTP激光治疗的反应大于25%，5名（17%）患者的反应大于50%。能量密度在18至24J/cm²、脉冲宽度为9至14毫秒时效果最佳。未发现与PWS的颜色或先前接受PDL治疗的次数有相关性。与PDL相比，患者更喜欢KTP激光治疗（视觉模拟评分平均为9.8；n = 5），治疗期间不适感较轻，治疗后紫癜最少。6名患者（20%）出现了副作用：瘢痕形成（n = 2，7%）、色素沉着（n = 3，1%）和愈合期延长超过4周（n = 1，3%）。
我们已表明KTP激光可进一步减轻对PDL抵抗的PWS，它是PWS激光治疗的一种有益补充。需要进一步研究评估KTP激光在先前未治疗的PWS中的疗效和副作用。
