Dahan S
Clinique Saint Jean-Languedoc, 20, route de Revel, 31077 Toulouse cedex, France.
Ann Dermatol Venereol. 2011 Sep;138 Suppl 2:S167-70. doi: 10.1016/S0151-9638(11)70084-9.
Management of couperosis and rosacea has been totally renewed by laser and vascular laser techniques, with efficacy targeted on the telangiectases and to a lesser extent on the erythrosis. Laser management of hypertrophic rosacea or rhinophyma depends on surgical treatment with decortication, continuous CO(2) ablative laser or Erbium, fractionated at high power, then vascular laser treatment for the telangiectases: lasers with pulsed dye, KTP, or pulsed lights for red laser telangiectases and long pulse Nd-Yag laser for blue telangiectases. For papulopustular rosacea, vascular laser treatment (pulsed dye and KTP) and intense pulsed light will be begun once the inflammation has been treated. The major indication for vascular lasers and intense pulsed light is found in erythematotelangiectatic rosacea, with high efficacy for the telangiectases. Diffuse erythrosis is difficult to treat, requiring a high number of laser and/or intense pulsed light sessions.
酒渣鼻和玫瑰痤疮的治疗已因激光和血管激光技术而彻底革新,其疗效主要针对毛细血管扩张,对红斑的疗效稍差。肥厚性酒渣鼻或鼻赘的激光治疗取决于手术剥脱、连续二氧化碳剥脱性激光或高功率分次铒激光治疗,然后针对毛细血管扩张进行血管激光治疗:脉冲染料激光、KTP激光或用于红色激光毛细血管扩张的脉冲光以及用于蓝色毛细血管扩张的长脉冲钕钇铝石榴石激光。对于丘疹脓疱型酒渣鼻,一旦炎症得到治疗,就开始进行血管激光治疗(脉冲染料激光和KTP激光)和强脉冲光治疗。血管激光和强脉冲光的主要适应证见于红斑毛细血管扩张型酒渣鼻,对毛细血管扩张有很高的疗效。弥漫性红斑难以治疗,需要多次激光和/或强脉冲光治疗。