Arsiwala Shehnaz Z, Arsiwala Nazneen
Dermatocosmetic and Laser Centre, Prince Aly Khan Hospital, Mumbai, Maharashtra, India.
Indian Dermatol Online J. 2023 Aug 29;14(5):585-593. doi: 10.4103/idoj.idoj_325_22. eCollection 2023 Sep-Oct.
Lasers have revolutionized the interventional dermatology field over the last two decades. Dermatologic conditions previously untreatable are now treated with lasers and lights. A large number of laser systems with advances in technologies have expanded applications of lasers for conditions like birth marks, acne scars, wrinkles, pigmentation, etc. Newer avenues and protocols are now set to treat skin conditions with lasers. The applicability of laser for any indication is dependent on laser tissue interaction which is well documented. For a successful outcome with laser therapy, a right end point of treatment should be achieved. The laser physician often adjusts parameters for laser therapy depending on tissue response, the ultimate aim being achieving optimum outcome with minimum side effects. Gadget based skin evaluation techniques are now an integral part of dermatology and are extending to interventional dermatology too. Application of dermoscopy before, during, and after lasers in various indications has been documented and reviewed. The representative cases highlighted in article emphasize the added dimension to non-invasive diagnostic capabilities of a dermatologist by enabling subsurface microscopy and enhancing therapy outcomes, and incorporation of these into daily practice offers value addition to not only evaluation but also gauging response to therapies. Use of dermoscopy before, during, and after laser therapies is an invaluable non-invasive tool to assess the right indication, initiate appropriate priming, achieve good end point, gauge untoward side effects, achieve good results, and engage patient confidentiality. Comparison of high magnification digital images is also enabled by digital videodermoscopy. Structured studies and protocols are needed to standardize the use of dermoscopy integrated with laser procedures.
在过去二十年中,激光彻底改变了介入皮肤科领域。以前无法治疗的皮肤病现在可以用激光和光来治疗。随着技术进步,大量激光系统扩大了激光在胎记、痤疮疤痕、皱纹、色素沉着等病症中的应用。现在有了新的途径和方案来用激光治疗皮肤疾病。激光对任何适应症的适用性取决于激光与组织的相互作用,这已有充分记录。为了使激光治疗取得成功,应达到正确的治疗终点。激光医生通常会根据组织反应调整激光治疗参数,最终目标是以最小的副作用实现最佳效果。基于设备的皮肤评估技术现在已成为皮肤科不可或缺的一部分,并且也在扩展到介入皮肤科。在各种适应症中,激光治疗前、治疗期间和治疗后的皮肤镜应用已有记录和综述。文章中突出的代表性案例强调了通过实现皮下显微镜检查和提高治疗效果,为皮肤科医生的非侵入性诊断能力增加的维度,将这些纳入日常实践不仅为评估提供了价值,也为衡量治疗反应提供了价值。在激光治疗前、治疗期间和治疗后使用皮肤镜是一种非常宝贵的非侵入性工具,可用于评估正确的适应症、启动适当的预处理、实现良好的终点、衡量不良副作用、取得良好效果以及保护患者隐私。数字视频皮肤镜还能够对高倍数字图像进行比较。需要进行结构化研究和制定方案,以规范皮肤镜与激光手术结合使用的方法。