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二氧化碳激光治疗表皮痣:疗效及长期随访

Carbon dioxide laser treatment of epidermal nevi: response and long-term follow-up.

作者信息

Alonso-Castro L, Boixeda P, Reig I, de Daniel-Rodríguez C, Fleta-Asín B, Jaén-Olasolo P

机构信息

Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain.

出版信息

Actas Dermosifiliogr. 2012 Dec;103(10):910-8. doi: 10.1016/j.adengl.2012.10.001. Epub 2012 Nov 13.

Abstract

BACKGROUND AND OBJECTIVES

Epidermal nevi, which are benign skin growths, have been treated using a range of approaches, with varying results. Topical treatments are ineffective and, while surgical excision is a more definitive treatment, it causes scar formation. In recent decades, epidermal nevi have been treated with various types of laser therapy. We describe our experience with the use of carbon dioxide (CO(2)) laser therapy to treat epidermal nevi and inflammatory linear verrucous epidermal nevi (ILVEN).

PATIENTS AND METHODS

Twenty patients (15 with epidermal nevi and 5 with ILVEN) underwent CO(2) laser treatment at our hospital between 2002 and 2010.

RESULTS

Response was good (>50% reduction in lesion size) in 50% of cases and excellent (>75% reduction) in 30%. A greater resistance to treatment was observed in patients with ILVEN (only 40% had a good response). Long-term follow-up (at least 18 months) showed a recurrence rate of 30%. The side effects were hypopigmentation (25% of patients) and scarring (20%).

CONCLUSIONS

We consider CO(2) laser therapy to be the treatment of choice for epidermal nevi as it is well tolerated and has proven to be safe and effective in the long term. While the response in patients with ILVEN was limited, CO(2) laser therapy might be a good option for selected cases or for palliative treatment since no other treatments have yet proven effective in this setting.

摘要

背景与目的

表皮痣是一种良性皮肤增生,已有多种治疗方法用于治疗表皮痣,但疗效各异。局部治疗无效,虽然手术切除是一种更彻底的治疗方法,但会导致瘢痕形成。近几十年来,各种类型的激光疗法被用于治疗表皮痣。我们描述了使用二氧化碳(CO₂)激光疗法治疗表皮痣和炎性线状疣状表皮痣(ILVEN)的经验。

患者与方法

2002年至2010年间,20例患者(15例表皮痣患者和5例ILVEN患者)在我院接受了CO₂激光治疗。

结果

50%的病例反应良好(皮损大小减少>50%),30%的病例反应极佳(减少>75%)。ILVEN患者对治疗的抵抗性更强(只有40%反应良好)。长期随访(至少18个月)显示复发率为30%。副作用为色素减退(25%的患者)和瘢痕形成(20%)。

结论

我们认为CO₂激光疗法是表皮痣的首选治疗方法,因为它耐受性良好,且长期来看已被证明是安全有效的。虽然ILVEN患者的反应有限,但CO₂激光疗法对于某些特定病例或姑息治疗可能是一个不错的选择,因为在这种情况下尚无其他治疗方法被证明有效。

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