Ohmaru Youkou, Ohmaru Koichi, Koga Noriyuki, Migita Hisashi, Kiyokawa Kensuke
Department of Plastic, Reconstructive and Maxillofacial Surgery, Kurume University, Fukuoka, Japan.
Laser Ther. 2011;20(4):301-6. doi: 10.5978/islsm.12-or-00.
A small mass of melanocytic nevi on the face is commonly treated by surgical resection. This method is associated with cosmetic complications, such as scarring and scar contracture. The use of CO2 Laser treatment to avoid these complications is increasing. However, scarring or recurrence may still occur after CO2 Laser treatment. To resolve these problems, we developed a new Combined Laser Therapy (CLT) protocol using three laser instruments.
We used CO2 Laser, Nd:YAG Laser and Q-Switched Ruby Laser. The first treatment was a minimal mass reduction using CO2 Laser. The surface is covered with carbonized tissue. The second treatment with Nd:YAG Laser which removes the carbonized tissue, because the laser specifically absorbs black chromatophores. Finally, any surviving nevus cells containing melanin are destroyed with Q-Switched Ruby Laser.
This method was used for 12 cases presenting with small masses of melanocytic nevi on the face. The maximum size of the mass was 20 mm. All cases resulted in a cosmetic improvement and there was no scarring or recurrence. Either satisfactory or greatly improved cosmetic results were obtained in all cases.
We think that the wound healing without scarring observed in all of our cases is related to the administration of both CLT and auto-simultaneous Low reactive Level Laser Therapy (LLLT) in these cases. Therefore, this method may provide the better treatment than surgical resection in the future.
面部少量黑素细胞痣通常采用手术切除治疗。该方法会引发诸如瘢痕形成和瘢痕挛缩等美容并发症。为避免这些并发症而使用二氧化碳激光治疗的情况日益增多。然而,二氧化碳激光治疗后仍可能出现瘢痕形成或复发。为解决这些问题,我们研发了一种使用三种激光仪器的新型联合激光疗法(CLT)方案。
我们使用了二氧化碳激光、钕:钇铝石榴石激光和调Q红宝石激光。首次治疗是使用二氧化碳激光进行最小程度的肿物缩小。表面覆盖有碳化组织。第二次治疗使用钕:钇铝石榴石激光去除碳化组织,因为该激光能特异性吸收黑色色素细胞。最后,用调Q红宝石激光破坏任何残留的含黑色素痣细胞。
该方法用于12例面部有少量黑素细胞痣肿物的患者。肿物最大尺寸为20毫米。所有病例均获得美容改善,且无瘢痕形成或复发。所有病例均取得了满意或极大改善的美容效果。
我们认为,在所有病例中观察到的无瘢痕伤口愈合与这些病例中联合激光疗法(CLT)和自体同步低反应水平激光疗法(LLLT)的应用有关。因此,该方法未来可能比手术切除提供更好的治疗效果。