Radmanesh Mohammed, Radmanesh Ramin
a Department of Dermatology , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran.
b Medical School, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran.
J Cosmet Laser Ther. 2017 Oct;19(6):334-336. doi: 10.1080/14764172.2017.1314508. Epub 2017 Apr 7.
The hypertrophic Port Wine Stain (PWS) is only partially and superficially treated with the Pulsed dye laser (PDL) because of its limited depth of penetration. We used combined PDL and fiberoptic 1444-nm Nd-YAG laser to treat a case with hypertrophic PWS.
After tumescent anesthesia, few holes were made by a 16-gauge needle on different sides of the lesion. The fiberoptic tip of 1444-nm Nd-YAG laser was inserted within the holes and was pushed forward while triggering. In a fan pattern and by a back and forth movement, the subcutaneous and deep dermal areas were coagulated. The skin and outer mucosal surfaces were then treated by PDL. The fiberoptic system used was Accusculpt 1444-nm Nd-YAG laser (Lutronic lasers, South Korea), and the PDL used was 585 nm Nlite system (Chromogenex UK). The parameters used for PDL were fluence = 9 Joules/cm and the spot size was 5 mm. The parameters used for fiberoptic 1444-nm Nd-YAG laser were: Pulse rate = 30 Hz, pulse energy = 300 mJ, power = 6 W, and the total energy = 4000 J for the whole face and mucosa.
Little sign of regression and moderate purpura were detected immediately after combined fiberoptic Nd-YAG and PDL therapy. The lesion gradually regressed within 4 months with satisfactory color and volume change.
Combined fiberoptic Nd-YAG laser and PDL can be used for the treatment of deeper and superficial layers of hypertrophic PWS.
由于脉冲染料激光（PDL）穿透深度有限，对肥厚性葡萄酒色斑（PWS）仅能进行部分和表面治疗。我们采用联合PDL和光纤1444纳米钕钇铝石榴石激光治疗1例肥厚性PWS患者。
肿胀麻醉后，用16号针在病损不同侧穿刺几个孔。将1444纳米钕钇铝石榴石激光的光纤头插入孔内，触发时向前推进。以扇形并来回移动的方式，对皮下和真皮深层进行凝固。然后用PDL治疗皮肤和外黏膜表面。所用光纤系统为Accusculpt 1444纳米钕钇铝石榴石激光（韩国Lutronic激光公司），所用PDL为585纳米Nlite系统（英国Chromogenex公司）。PDL的参数为：能量密度=9焦耳/平方厘米，光斑大小为5毫米。光纤1444纳米钕钇铝石榴石激光的参数为：脉冲频率=30赫兹，脉冲能量=300毫焦，功率=6瓦，全脸和黏膜的总能量=4000焦耳。
光纤钕钇铝石榴石激光和PDL联合治疗后立即出现轻微消退迹象和中度紫癜。病损在4个月内逐渐消退，颜色和体积变化令人满意。
光纤钕钇铝石榴石激光和PDL联合可用于治疗肥厚性PWS的深层和表层。
