Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University Medical School, Shanghai, China.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
J Eur Acad Dermatol Venereol. 2018 Feb;32(2):260-264. doi: 10.1111/jdv.14490. Epub 2018 Jan 25.
Patients with port-wine stain (PWS) suffer physically and psychologically because of the high incidence (0.3%-0.5%) of the disease. Pulsed-dye laser (PDL) at 595 nm is the gold standard of the treatment for PWS. Nevertheless, clinicians intend to determine whether the dual-wavelength laser (DWL; 595-nm PDL + 1064-nm Nd:YAG) is an adequate choice in the treatment of non-treated PWS. This study is the first prospective within-patient controlled research seeking to investigate the safety and efficacy of DWL for the treatment of non-treated PWS.
A total of 61 patients with non-treated flat facial PWS, who were treated using the Cynergy laser system in our clinic, were included in this study. Each PWS lesion was divided into two adjacent test treatment sites of similar size and colour. The two sites were randomly assigned to PDL or DWL treatment in a blinded manner of participants. In each case, two sets of treatment parameters were used: (i) 595-nm PDL and (ii) 595-nm PDL + 1064-nm Nd:YAG. Both had a 10 mm spot size, an epidermal cooling system and 1-s interpulse interval between two pulses. Clinical efficacy and safety outcomes were evaluated by visual assessment 2 months after treatment.
Comparison by visual evaluation suggests that the responses of non-treated PWS to treatment by PDL and DWL were not significantly different. Moreover, three patients developed scarring after DWL treatment.
Compared with PDL, DWL exhibits a higher risk of potential scarring and has no advantage in efficacy of treating non-treated PWS.
患有葡萄酒色斑(PWS)的患者由于该疾病的高发病率(0.3%-0.5%)而在身体和心理上都受到影响。595nm 的脉冲染料激光(PDL)是治疗 PWS 的金标准。然而,临床医生希望确定双波长激光(DWL;595nm PDL+1064nm Nd:YAG)是否是治疗未治疗 PWS 的合适选择。这项研究是首次在患者体内进行的对照研究,旨在研究 DWL 治疗未治疗 PWS 的安全性和疗效。
本研究共纳入 61 例在我院接受 Cynergy 激光系统治疗的非治疗性扁平面部 PWS 患者。每个 PWS 病变分为两个相邻的、大小和颜色相似的测试治疗部位。这两个部位以参与者盲法的方式随机分配至 PDL 或 DWL 治疗。在每种情况下,均使用两组治疗参数:(i)595nm PDL 和(ii)595nm PDL+1064nm Nd:YAG。两种均使用 10mm 光斑大小、表皮冷却系统和两个脉冲之间 1s 的脉冲间隔。治疗 2 个月后通过视觉评估评估临床疗效和安全性结局。
视觉评估比较表明,非治疗性 PWS 对 PDL 和 DWL 治疗的反应没有显著差异。此外,三名患者在 DWL 治疗后出现了瘢痕。
与 PDL 相比,DWL 具有更高的潜在瘢痕形成风险,并且在治疗未治疗 PWS 的疗效方面没有优势。