Iyer Shilesh, Fitzpatrick Richard E
University of California, Los Angeles, CA, USA.
Dermatol Surg. 2005 Aug;31(8 Pt 1):898-903. doi: 10.1097/00042728-200508000-00002.
Subpurpuric treatments with the pulsed dye laser can be effective for treatment of vascular lesions, although less so than when purpuric fluences are used. Increased efficacy may be achieved by performing multiple passes at the time of treatment. We performed a split-face bilateral paired comparison of multiple low-fluence subpurpuric passes compared with a single high-fluence purpuric pass in the treatment of facial telangiectasias.
Nine patients were included in the study. One cheek was chosen to be treated with four passes of a nonpurpuric fluence, and the contralateral cheek was treated with a single purpuric pass. Reductions in vessel density, diameter, arborization, and background erythema were evaluated 3 weeks after treatment.
We found a 43.4% reduction in surface area covered by telangiectasias on the cheek treated with a single purpuric pass compared with 35.9% on the cheek treated with four subpurpuric passes. The purpuric fluences produced greater reduction in vessel diameter and arborization, whereas the subpurpuric protocol was more effective in reducing background erythema. Purpuric fluences were also noted to produce more significant edema and transient hyperpigmentation in one patient.
The multipass subpurpuric approach to treatment with the pulsed dye laser is both cosmetically acceptable and effective, although purpuric treatments may be required to effectively eliminate larger-caliber, more highly networked vessels.
脉冲染料激光进行亚紫癜性治疗对血管病变有效，尽管其效果不如使用紫癜性能量密度时显著。通过在治疗时进行多次照射可能提高疗效。我们对面部毛细血管扩张症的治疗进行了一项双侧面部配对比较，将多次低能量密度亚紫癜性照射与单次高能量密度紫癜性照射进行对比。
9名患者纳入本研究。选择一侧脸颊用非紫癜性能量密度进行4次照射，对侧脸颊用单次紫癜性照射。治疗3周后评估血管密度、直径、分支及背景红斑的减少情况。
我们发现单次紫癜性照射治疗的脸颊上毛细血管扩张覆盖的表面积减少了43.4%，而4次亚紫癜性照射治疗的脸颊上减少了35.9%。紫癜性能量密度使血管直径和分支减少得更多，而亚紫癜性方案在减少背景红斑方面更有效。还注意到紫癜性能量密度在1例患者中产生了更显著的水肿和短暂性色素沉着。
脉冲染料激光的多次亚紫癜性治疗方法在美容上是可接受且有效的，尽管可能需要紫癜性治疗来有效消除更大口径、网络更密集的血管。
