All authors are affiliated with the Department of Dermatology, Razi Hospital, Tehran University of Medical Science, Tehran, Iran.
Dermatol Surg. 2021 Apr 1;47(4):e122-e126. doi: 10.1097/DSS.0000000000002819.
Although pulsed-dye laser (PDL) 595 nm is known as the gold standard for treatment of port-wine stains (PWS), complete clearance of lesions occurs in a minority of cases.
To compare the efficacy and safety of double-pass pulsed-dye laser (DPL), long pulse duration (20 m/s) followed by short pulse duration (1.5 m/s) within 20 minutes interval, with single-pass pulsed-dye laser (SPL) for (1.5 m/s) in the treatment of PWS.
Twenty-four patients with PWS underwent 3 sessions of PDL. Each lesion was randomly divided into 2 portions to receive DPL or SPL. Colorimetric and dermoscopic evaluations were used to determine the response objectively. In addition, improvement was scored subjectively using the visual analog scale (VAS).
According to colorimetric analysis, the mean blanching rates for DPL and SPL treated sites were 48% (SD = 0.215) and 37% (SD = 0.213), respectively (p = .001). With VAS, 3.79 (SD = 0.93) and 3.33 (SD = 0.91) improvement scores were reported in the DPL and SPL treated areas, respectively (p = .008). Dermoscopic images showed that larger deep vessels were the most common remnant vessels in both treatment areas.
Compared with SPL, DPL with 20 minutes interval seems to be a more effective and safe method for the treatment of PWS.
虽然脉冲染料激光(PDL)595nm 被认为是治疗葡萄酒色斑(PWS)的金标准,但病变的完全清除仅发生在少数情况下。
比较双脉冲染料激光(DPL),即 20 分钟内先后使用长脉宽(20m/s)和短脉宽(1.5m/s),与单次脉冲染料激光(SPL,1.5m/s)治疗 PWS 的疗效和安全性。
24 例 PWS 患者接受 3 次 PDL 治疗。每个病变随机分为两部分,分别接受 DPL 或 SPL 治疗。采用比色和共聚焦显微镜评估来客观地确定反应。此外,采用视觉模拟评分(VAS)进行主观改善评分。
根据比色分析,DPL 和 SPL 治疗部位的平均变白率分别为 48%(SD=0.215)和 37%(SD=0.213)(p=0.001)。VAS 评分显示,DPL 和 SPL 治疗区的改善评分分别为 3.79(SD=0.93)和 3.33(SD=0.91)(p=0.008)。共聚焦显微镜图像显示,两种治疗区最常见的残留血管均为较大的深部血管。
与 SPL 相比,20 分钟间隔的 DPL 似乎是治疗 PWS 的更有效和安全的方法。