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激光疗法在卡波西肉瘤治疗中的应用:皮肤病学治疗选择的综合综述

Laser Therapy Approaches in the Treatment of Kaposi's Sarcoma: A Comprehensive Review of Dermatologic Options.

作者信息

Battilotti Chiara, Cassalia Fortunato, Svara Francesca, Latini Alessandra, Cameli Norma, Nisticò Steven Paul

机构信息

Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.

Unit of Dermatology, Department of Medicine, University of Padua, Padua, Italy.

出版信息

Dermatol Pract Concept. 2025 Jul 31;15(3):5332. doi: 10.5826/dpc.1503a5332.

Abstract

INTRODUCTION

Kaposi's sarcoma (KS) is a multicentric angioproliferative disease associated with human herpesvirus 8 and often exacerbated by immunosuppression. Effective treatment includes systemic and local therapies, with laser treatments gaining prominence in dermatological practice.

OBJECTIVES

This narrative review evaluated the efficacy and safety of laser treatment modalities in the management of cutaneous and mucosal KS lesions to guide dermatological decision-making.

METHODS

A comprehensive English-language literature search was conducted using PubMed and Scopus up to November 2024. Search terms included "Kaposi's sarcoma", "laser therapy," and "laser treatment." Case reports and observational studies with defined patient characteristics, standardized laser protocols, and documented outcomes were included.

RESULTS

The Nd:YAG laser emerged as the leading modality for thick, nodular KS lesions, demonstrating deep tissue penetration and high efficacy with minimal adverse effects. The pulsed dye laser (PDL) was highly effective for superficial cutaneous and mucosal lesions, with excellent cosmetic outcomes and minimal recurrence. The CO laser showed promise in ablating small lesions but had limitations due to scarring risks and potential biohazard concerns. Argon lasers were historically important but are now less favored due to lower specificity for vascular targets and higher risk of non-vascular tissue damage.

CONCLUSIONS

Laser therapy offers versatile and effective treatment options for KS. Nd:YAG and PDL lasers are particularly promising due to their high efficacy, favorable safety profiles, and low recurrence rates. Further research is needed to refine laser protocols and validate long-term outcomes in different patient populations.

摘要

引言

卡波西肉瘤(KS)是一种多中心血管增殖性疾病,与人类疱疹病毒8相关,常因免疫抑制而加重。有效的治疗方法包括全身和局部治疗,激光治疗在皮肤科实践中越来越受到重视。

目的

本叙述性综述评估了激光治疗方式在治疗皮肤和黏膜KS病变中的疗效和安全性,以指导皮肤科的决策。

方法

截至2024年11月,使用PubMed和Scopus进行了全面的英文文献检索。检索词包括“卡波西肉瘤”、“激光疗法”和“激光治疗”。纳入了具有明确患者特征、标准化激光方案和记录结果的病例报告和观察性研究。

结果

Nd:YAG激光成为治疗厚结节性KS病变的主要方式,显示出深层组织穿透能力,疗效高且不良反应最小。脉冲染料激光(PDL)对浅表皮肤和黏膜病变非常有效,美容效果极佳且复发率低。CO激光在消融小病变方面显示出前景,但由于存在瘢痕形成风险和潜在的生物危害问题而有局限性。氩激光在历史上很重要,但由于对血管靶点的特异性较低和非血管组织损伤风险较高,现在不太受青睐。

结论

激光疗法为KS提供了多种有效的治疗选择。Nd:YAG激光和PDL激光因其高疗效、良好的安全性和低复发率而特别有前景。需要进一步研究来完善激光方案并验证不同患者群体的长期疗效。

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