Thajudheen Chandroth Ponnambath, Jyothy Kannangath, Priyadarshini Arul
Dr. Thaj Laser Skin-Hair Clinic, 2nd Floor, Balakrishan Hospital, 100 Feet Road, Coimbatore, Tamil Nadu, India.
J Cutan Aesthet Surg. 2014 Jan;7(1):32-6. doi: 10.4103/0974-2077.129973.
Port-wine stain (PWS) is one of the commonly encountered congenital cutaneous vascular lesions, with an equal sex distribution. Pulsed dye lasers (PDL) have revolutionized the treatment of both congential and acquired cutaneous vascular lesions. The pulsed dye lasers owing to its superior efficacy and safety profile have become the gold standard for the management of port-wine stains.
To evaluate the efficacy and side effects of pulsed dye laser for the management of Port-wine stain on Indian skin.
Seventy five patients of Fitzpatrick skin types IV&V with PWS underwent multiple treatments with PDL (V beam-Candela) over a period of six years at monthly intervals. Laser parameters were wavelength 595nm, spot sizes 7-10mm, fluence 6-12 j/cm2, pulse duration 0.45-10ms, along with cryogen cooling. Serial photographs were taken before and after every session. Clinical improvement scores of comparable photographs using a quartile grading (o=<20%, 1=21-40%, 2=41-60%, 3=61-80%, 4=>80%) were judged independently by two dermatologists after the series of treatment. Minimum number of treatments was 6 and maximum 17. They were followed up at six monthly intervals to observe re darkening of PWS.
No patient showed total clearance.Grade3 improvement was observed in 70 % of children and 50% of adults after 8-10 sessions. Children showed better and faster response than adults. Thirty percent of patients developed post inflammatory hyper pigmentation which resolved over a period of six to eight weeks. Two patients had superficial scarring due to stacking of pulses. None of the patients showed re darkening of PWS till now.
Pulsed dye laser is an effective and safe treatment for port-wine stain in Indian skin.
葡萄酒色斑（PWS）是常见的先天性皮肤血管病变之一，男女发病率相等。脉冲染料激光（PDL）彻底改变了先天性和后天性皮肤血管病变的治疗方法。由于其卓越的疗效和安全性，脉冲染料激光已成为治疗葡萄酒色斑的金标准。
评估脉冲染料激光治疗印度人皮肤葡萄酒色斑的疗效和副作用。
75例 Fitzpatrick 皮肤类型为 IV 型和 V 型的葡萄酒色斑患者，在六年时间里每月接受一次 PDL（V 光束 - 坎德拉）多次治疗。激光参数为波长 595nm、光斑大小 7 - 10mm、能量密度 6 - 12J/cm²、脉冲持续时间 0.45 - 10ms，同时使用冷冻剂冷却。每次治疗前后均拍摄系列照片。在一系列治疗后，由两位皮肤科医生独立根据四分位数分级（0 = <20%，1 = 21 - 40%，2 = 41 - 60%，3 = 61 - 80%，4 = >80%）对可比照片的临床改善评分进行判断。最少治疗次数为 6 次，最多为 17 次。每六个月对患者进行随访，观察葡萄酒色斑是否再次变黑。
没有患者实现完全清除。8 - 10 次治疗后，70%的儿童和 50%的成人达到 3 级改善。儿童的反应比成人更好、更快。30%的患者出现炎症后色素沉着，在六至八周内消退。两名患者因脉冲叠加出现浅表瘢痕。到目前为止，没有患者的葡萄酒色斑再次变黑。
脉冲染料激光是治疗印度人皮肤葡萄酒色斑的一种有效且安全的方法。
