Boixeda P, Sánchez-Miralles E, Azaña J M, Arrazola J M, Moreno R, Ledo A
Department of Dermatology, Hospital Ramón y Cajal, Madrid, Spain.
J Dermatol Surg Oncol. 1994 Dec;20(12):808-12. doi: 10.1111/j.1524-4725.1994.tb03709.x.
Tuberous sclerosis is a complex disorder of hamartoma formation in many organs, particularly the skin, brain, eye, kidney, and heart. The characteristic skin lesions are angiofibromas (AF), the shagreen patch, periungual fibromas, and "ash-leaf" white macules. Treatment for AF has previously included electrocoagulation, electrodesiccation and curettage, dermabrasion, excision, cryosurgery, and oral 13-cis retinoic acid. Both argon and CO2 lasers have been used in isolated cases to treat AF.
The purpose of this work is the study of the application of three different lasers in the treatment of facial AF.
Ten patients with facial AF were treated with CO2, argon, and pulsed dye lasers. Patients' AF were graded with regard to the size and color of the lesions. A 2-3-cm2 test was assayed on the face of all patients with each laser before performing a complete treatment and in order to choose the best laser.
Results were considered excellent in seven patients and good in three patients, with decrease of erythema and flattening of the AF. Minimal scarring was noted in two patients. Transient erythema was observed in patients treated with the CO2 laser. All patients or their parents considered the treatment cosmetically satisfactory.
We found the CO2 laser to be a better therapeutic tool than the argon laser to treat AF, especially in those patients with multiple and protuberant AF. The argon laser would be more useful in those patients with very red AF and light complexion, and the pulsed dye laser in those with very red and flat AF.
结节性硬化症是一种多器官错构瘤形成的复杂疾病，尤其是皮肤、脑、眼、肾和心脏。特征性皮肤损害为血管纤维瘤（AF）、鲨鱼皮斑、甲周纤维瘤和“叶状白斑”。AF的治疗方法以前包括电凝、电干燥刮除术、磨皮术、切除术、冷冻手术和口服13 - 顺式维甲酸。氩激光和二氧化碳激光都曾在个别病例中用于治疗AF。
本研究旨在探讨三种不同激光在面部AF治疗中的应用。
10例面部AF患者接受了二氧化碳、氩和脉冲染料激光治疗。根据病变的大小和颜色对患者的AF进行分级。在进行全面治疗前，用每种激光在所有患者面部进行2 - 3平方厘米的测试，以选择最佳激光。
7例患者效果极佳，3例患者效果良好，红斑减轻，AF变平。2例患者出现轻微瘢痕。接受二氧化碳激光治疗的患者出现短暂红斑。所有患者或其家长认为治疗在美容方面令人满意。
我们发现，对于治疗AF，二氧化碳激光比氩激光是更好的治疗工具，特别是对于那些有多个突出AF的患者。氩激光对那些AF非常红且肤色浅的患者更有用，而脉冲染料激光对那些AF非常红且扁平的患者更有用。
