Noborio R, Kurokawa M, Kobayashi K, Morita A
Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
J Eur Acad Dermatol Venereol. 2009 Apr;23(4):420-4. doi: 10.1111/j.1468-3083.2008.03086.x.
The 585-nm pulsed dye laser (PDL) therapy is useful for the patients with psoriasis. PDL treatment is based on selective photothermolysis of the dermal vasculature.
The objectives of this study were to evaluate the clinical and immunohistological effects of PDL on psoriasis and to examine the association between psoriatic dermal vasculature and the clinical effects.
Eleven patients with recalcitrant psoriasis were treated with 585-nm PDL. Biopsy specimens obtained before and after treatment were stained with CD31. All microvessels to the depth of 400 microm from the rete ridge were counted and the internal diameters were measured.
The mean percent reduction of plaque severity score was 42. The mean microvessel count decreased significantly from 63 to 35.6 ( P < 0.001). There was a strong positive correlation between the plaque severity score and microvessel number ( P < 0.001) and a strong negative correlation between the microvessel count of an untreated area and degree of the change in the microvessel count after treatment (P = 0.005).
The findings of this study suggest that PDL treatment improves psoriasis. Moreover, PDL treatment decreased the number of dermal papillary microvessels. Dermal papillary microvessels are important pathogenetic targets of psoriasis, and PDL therapy, which selectively targets superficial vessels, is therefore a valid therapeutic approach.
585纳米脉冲染料激光（PDL）疗法对银屑病患者有效。PDL治疗基于对真皮血管的选择性光热解作用。
本研究的目的是评估PDL对银屑病的临床和免疫组织学影响，并研究银屑病真皮血管与临床疗效之间的关联。
11例顽固性银屑病患者接受585纳米PDL治疗。治疗前后获取的活检标本用CD31染色。对从 rete 嵴起400微米深度内的所有微血管进行计数并测量内径。
斑块严重程度评分的平均降低百分比为42。微血管平均计数从63显著降至35.6（P < 0.001）。斑块严重程度评分与微血管数量之间存在强正相关（P < 0.001），未治疗区域的微血管计数与治疗后微血管计数的变化程度之间存在强负相关（P = 0.005）。
本研究结果表明PDL治疗可改善银屑病。此外，PDL治疗减少了真皮乳头微血管的数量。真皮乳头微血管是银屑病重要的致病靶点，因此选择性靶向浅表血管的PDL疗法是一种有效的治疗方法。
