Sommer S, Seukeran D C, Sheehan-Dare R A
Dermatology Laser Centre, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, U.K.
Br J Dermatol. 2003 Oct;149(4):770-5. doi: 10.1046/j.1365-2133.2003.05467.x.
There is relatively little information about treatment of port wine stains (PWS) of the lower limb. Few studies have specifically addressed the efficacy of pulsed dye laser (PDL) treatment of a PWS on the lower limb and there is no information on the relative efficacy at different sites on the lower limb. It has been suggested that treatment is not as successful when compared with the face and postinflammatory hyperpigmentation has been reported to be a significant problem.
To review retrospectively patients who attended for PDL treatment of PWS affecting the lower limb and assess the efficacy and adverse effects with particular reference to skin site.
A retrospective review was carried out of patients attending the Leeds Dermatology Laser Centre for treatment of a PWS on the lower limb with a 585-nm PDL.
A total of 52 sites in 39 patients were treated: 17 on the thigh, 31 on the lower leg and four on the foot. The mean number of sessions per patient was 14, with an excellent outcome in seven treatment sites (13.5%), good in 13 (25%), moderate in 21 (40.4%) and poor outcome in 11 (21.1%). Patients were generally pleased with their results with a mean improvement of 7 on a scale of 0-10. Perifollicular persistence of the PWS was observed in six sites (11.5%). Adverse effects occurred in 36 patients (92.3%), most commonly hyperpigmentation (87%). Six patients (15.4%) developed atrophic scarring and four (10.3%) hypopigmentation. Atrophie blanche-like changes were seen in four patients on the lower leg. Hypertrophic scarring was not seen.
Although physician-assessed good or excellent responses of 38.5% are lower than frequently reported for other skin sites and adverse effects may be more frequent, patient satisfaction with treatment was generally high. Patients with PWS on the lower limb merit a trial of PDL treatment.
关于下肢葡萄酒色斑（PWS）治疗的信息相对较少。很少有研究专门探讨脉冲染料激光（PDL）治疗下肢PWS的疗效，且没有关于下肢不同部位相对疗效的信息。有人认为，与面部相比，治疗效果不太理想，并且据报道炎症后色素沉着是一个严重问题。
回顾性分析接受PDL治疗下肢PWS的患者，评估疗效和不良反应，特别关注皮肤部位。
对在利兹皮肤科激光中心接受585nm PDL治疗下肢PWS的患者进行回顾性分析。
共治疗了39例患者的52个部位：大腿17个，小腿31个，足部4个。每位患者的平均治疗次数为14次，7个治疗部位（13.5%）效果极佳，13个（25%）效果良好，21个（40.4%）效果中等，11个（21.1%）效果不佳。患者总体对治疗结果满意，在0至10分的评分中平均改善了7分。在6个部位（11.5%）观察到PWS的毛囊周围残留。36例患者（92.3%）出现不良反应，最常见的是色素沉着（87%）。6例患者（15.4%）出现萎缩性瘢痕，4例（10.3%）出现色素减退。4例小腿患者出现类白色萎缩样改变。未观察到肥厚性瘢痕。
尽管医生评估的38.5%的良好或极佳反应低于其他皮肤部位的常见报道，且不良反应可能更频繁，但患者对治疗的满意度普遍较高。下肢患有PWS的患者值得尝试PDL治疗。
