Klein Annette, Bäumler Wolfgang, Buschmann Marius, Landthaler Michael, Babilas Philipp
Department of Dermatology, University Hospital Regensburg, Regensburg, 93042, Germany.
Lasers Surg Med. 2013 Apr;45(4):216-24. doi: 10.1002/lsm.22136.
Indocyanine green (ICG)-augmented diode laser therapy (ICG + DL) represents a new treatment modality for capillary malformations (CM). However, an increase of the ICG-concentration or the use of an intense pulsed light (IPL) device as light source may further optimize treatment outcomes in CM.
This proof-of-concept trial including 15 patients (skin type II to III) with CM evaluated the efficacy and safety of ICG-augmented diode laser therapy (808 nm) at a total dose of 4 mg/kg body weight (b.w.). Additionally, five patients with extensive CM received IPL therapy before and after ICG-administration (ICG + IPL).
ICG was intravenously administered to 15 patients with CM at a total dose of 4 mg/kg b.w. Immediately after ICG injection, diode laser pulses with different radiant exposures (20-110 J/cm(2) ) were applied as one single treatment. Five patients with extensive CM additionally received IPL (555-950 nm) therapy. Safety and efficacy were assessed both 1 and 3 months after the single treatment by a blinded investigator and the patient. Furthermore, color of the CM was objectively measured by means of a color meter (colorStriker™, Eduard Mathai GmbH, Hannover, Germany). Treatment with the flashlamp-pumped pulsed dye laser (FPDL) and the IPL alone (five patients) served as reference treatment.
According to the assessment by the patients and the blinded investigator, the clearance rate was slightly better after ICG + DL therapy than after FPDL treatment (P = 0.1, P = 0.8). In one out of five patients, IPL with and without ICG injection induced poor to moderate clearance of CM and persisting erythema in another patient. The correlation between the visual assessment by the blinded investigator and the colorimetric measurements was poor.
A minority of patients with CM may benefit from ICG + DL therapy, but efficacy cannot be improved by higher ICG doses.
吲哚菁绿（ICG）增强二极管激光治疗（ICG + DL）是一种用于治疗毛细血管畸形（CM）的新方法。然而，增加ICG浓度或使用强脉冲光（IPL）设备作为光源可能会进一步优化CM的治疗效果。
这项概念验证试验纳入了15例皮肤类型为II至III型的CM患者，评估了总剂量为4mg/kg体重（b.w.）的ICG增强二极管激光治疗（808nm）的疗效和安全性。此外，5例广泛CM患者在ICG给药前后接受了IPL治疗（ICG + IPL）。
对15例CM患者静脉注射ICG，总剂量为4mg/kg b.w.。ICG注射后立即以单次治疗的方式施加不同辐照剂量（20 - 110J/cm²）的二极管激光脉冲。5例广泛CM患者还接受了IPL（555 - 950nm）治疗。在单次治疗后1个月和3个月，由一名盲法研究者和患者评估安全性和疗效。此外，通过色差仪（colorStriker™，Eduard Mathai GmbH，德国汉诺威）客观测量CM的颜色。单独使用闪光灯泵浦脉冲染料激光（FPDL）和IPL（5例患者）治疗作为对照。
根据患者和盲法研究者的评估，ICG + DL治疗后的清除率略优于FPDL治疗（P = 0.1，P = 0.8）。在5例患者中，1例患者接受有或无ICG注射的IPL治疗后CM清除效果差至中等，另1例患者出现持续性红斑。盲法研究者的视觉评估与比色测量之间的相关性较差。
少数CM患者可能从ICG + DL治疗中获益，但更高剂量的ICG并不能提高疗效。
