Thomas Kevin V, Le Todd, Messele Feben, Garland Catharine B, Monroe Eric J, Metry Denise, Levin Yakir, Kelly Kristen M, Arkin Lisa M
University of Wisconsin School of Medicine and Public Health (UW-SMPH), Madison, Wisconsin, USA.
University of California Irvine School of Medicine, Irvine, California, USA.
Pediatr Dermatol. 2025 Jul-Aug;42(4):716-727. doi: 10.1111/pde.15991. Epub 2025 May 29.
Adjuvant laser therapy of vascular anomalies is based on the principle of selective photo-thermolysis, through targeted destruction of selected chromophores with minimal injury to surrounding tissue. Choice of laser wavelength, treatment parameters, and predicted response to therapy are dependent on the dominant chromophore within the vascular anomaly, lesional location, and target depth, with relatively superficial and mucosal lesions producing the best response to therapy. Lasers can be safely combined with multi-modal approaches for vascular anomalies, including sclerotherapy, surgical excision, and systemic therapy. In this manuscript, we review the laser literature on a range of vascular anomalies, and provide indications, appropriate therapeutic and warning endpoints in the skin, pearls/pitfalls, and multi-disciplinary approaches for pediatric dermatologists pursuing laser as adjuvant therapy for vascular anomalies.
血管异常的辅助激光治疗基于选择性光热解原理，通过对选定的发色团进行靶向破坏，对周围组织造成最小损伤。激光波长的选择、治疗参数以及对治疗的预期反应取决于血管异常内的主要发色团、病变位置和目标深度，相对浅表和黏膜病变对治疗的反应最佳。激光可安全地与血管异常的多模式治疗方法联合使用，包括硬化疗法、手术切除和全身治疗。在本手稿中，我们回顾了一系列血管异常的激光文献，并为寻求将激光作为血管异常辅助治疗的儿科皮肤科医生提供了适应症、皮肤治疗的适当终点和警告终点、经验教训以及多学科治疗方法。
