采用联合脉冲染料激光（PDL）和射频（RF）能量设备治疗难治性葡萄酒色斑（PWS）。

Treatment of recalcitrant port-wine stains (PWS) using a combined pulsed dye laser (PDL) and radiofrequency (RF) energy device.

机构信息

Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York; Laser and Skin Surgery Center of New York, New York, New York.

Laser and Skin Surgery Center of New York, New York, New York.

出版信息

J Am Acad Dermatol. 2017 Feb;76(2):321-326. doi: 10.1016/j.jaad.2016.03.004.

DOI:10.1016/j.jaad.2016.03.004

PMID:28088993

Abstract

BACKGROUND

Pulsed dye laser (PDL) is the treatment of choice for port-wine stains (PWS). Some PWS are recalcitrant to this modality. A number of reasons for PDL treatment resistance have been described, including inadequate heat generation.

OBJECTIVE

We evaluated PDL combined with radiofrequency (RF) energy into a single device to target larger and deeper blood vessels and overcome PDL resistance.

METHOD

This was an open-label, prospective, single-center investigation of a novel device combining RF energy with PDL conducted to treat recalcitrant PWS. Ten patients with 11 recalcitrant PWS were enrolled. Each PWS was divided into 5 treatment areas: PDL alone, RF alone, PDL+RF, RF+PDL, and untreated control. Patients underwent a maximum of 6 treatments, scheduled 4 to 6 weeks apart with follow-up evaluation at 4 and 12 weeks after the final treatment. Colorimetry and standardized digital photography were performed at all visits. Lesional biopsy specimens were collected for selected patients.

RESULTS

Areas treated with RF followed by PDL and PDL followed by RF showed the greatest improvement based on blinded review of digital photographs, reaching statistical significance (P value < .05) at the 12-week follow-up evaluation when compared with baseline. Adverse events, including purpura, erythema, edema, scabbing, crusting, and blistering, resolved without sequelae; a small residual scar was noted in 1 patient.

LIMITATIONS

Small sample size and short follow-up period are limitations.

CONCLUSION

Combined RF/PDL technology is promising for the treatment of recalcitrant PWS.

摘要

背景

脉冲染料激光（PDL）是治疗葡萄酒色斑（PWS）的首选方法。但有些 PWS 对此治疗方法有抗性。已经描述了 PDL 治疗抵抗的许多原因，包括热量产生不足。

目的

我们评估了将射频（RF）能量与 PDL 结合到单个设备中，以靶向更大和更深的血管，并克服 PDL 抗性。

方法

这是一项针对新型设备的开放性、前瞻性、单中心研究，该设备将 RF 能量与 PDL 结合，用于治疗难治性 PWS。纳入了 10 名患有 11 处难治性 PWS 的患者。每个 PWS 分为 5 个治疗区：PDL 单独治疗、RF 单独治疗、PDL+RF、RF+PDL 和未治疗对照。患者最多接受 6 次治疗，每 4 至 6 周间隔一次，在最后一次治疗后的 4 周和 12 周进行随访评估。在所有就诊时均进行比色和标准化数码摄影。对选定患者采集皮损活检标本。