Ma Gang, Wu Pinru, Lin Xiaoxi, Chen Hui, Li Wei, Hu Xiaojie, Jin Yunbo
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China; Department of Cosmetic Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
Int J Dermatol. 2014 May;53(5):638-42. doi: 10.1111/ijd.12384. Epub 2014 Mar 6.
Tuberous sclerosis is an autosomal dominant disorder with hamartomas in multiple organ systems. Facial angiofibromas (AF) are a common cutaneous manifestation of tuberous sclerosis. They may lead to significant cosmetic and psychological problems. Many treatment modalities have been used with variable satisfaction. Fractional photothermolysis (FP) is a novel concept of laser therapy, which induces non-contiguous microscopic thermal injury.
This study was designed to evaluate the efficacy and side effects of Nd:YAG laser treatment for facial AF by using spot-like irradiation technique similar to FP.
Twelve patients (skin types III-IV, aged 17-45 years) with facial AF received monthly treatment with Nd:YAG laser in a pinpoint coagulation fashion. Clinical improvements were evaluated in five categories. Side effects were monitored at each follow-up visit.
Excellent improvement was seen in 10 patients and good improvement in two at one month after the final treatment session. After 12 months of follow-up, no patient had significant recurrence of AF. Five patients were followed up for three years with few pinpoint-sized regrowth occurring; none of these patients received additional treatments. Side effects included transient erythema and edema in each patient but no bleeding, infection, dyspigmentation, or scarring.
The present study indicates that Nd:YAG laser is an effective and safe management for the fractional treatment of facial AF.
结节性硬化症是一种常染色体显性疾病，多个器官系统出现错构瘤。面部血管纤维瘤（AF）是结节性硬化症常见的皮肤表现。它们可能导致严重的美容和心理问题。许多治疗方法的使用效果不一。分次光热解（FP）是一种新型激光治疗概念，可诱导非连续的微观热损伤。
本研究旨在通过使用类似于FP的点状照射技术，评估Nd:YAG激光治疗面部AF的疗效和副作用。
12例面部AF患者（皮肤类型为III-IV型，年龄17-45岁）每月接受Nd:YAG激光点状凝固治疗。从五个方面评估临床改善情况。每次随访时监测副作用。
最后一次治疗后1个月，10例患者改善显著，2例改善良好。随访12个月后，无患者AF显著复发。5例患者随访3年，仅有少量点状复发；这些患者均未接受额外治疗。副作用包括每位患者均出现短暂红斑和水肿，但无出血、感染、色素沉着或瘢痕形成。
本研究表明，Nd:YAG激光是面部AF分次治疗的一种有效且安全的治疗方法。
