Dover J S, Geronemus R, Stern R S, O'Hare D, Arndt K A
Division of Dermatology, New England Deaconess Hospital, Boston, MA.
J Am Acad Dermatol. 1995 Feb;32(2 Pt 1):237-40. doi: 10.1016/0190-9622(95)90133-7.
Despite good results in the treatment of most port-wine stains (PWS) with continuous-wave visible-light lasers, light PWS and those in certain locations respond less favorably and have a higher risk of scarring. Robotized scanning devices such as the Hexascan device have been developed for continuous-wave laser sources to produce greater target specificity, to increase reproducibility of results, and to decrease the incidence of adverse effects.
The purpose of this study was to compare the effects of the same wavelength of light (585 nm) on test sites within PWS with the flashlamp-pumped pulsed dye laser and a continuous-wave tunable dye laser scanned through a Hexascan robotized scanning device.
Two adjacent, noncontiguous sites within PWS were treated in 29 patients, one site with the flashlamp-pumped pulsed dye laser and the other with an argon-pumped continuous-wave tunable dye laser affixed to a Hexascan device.
Twenty-eight patients completed the study. The pulsed dye laser was found to be superior to the continuous-wave dye laser with the Hexascan device in 45% of patients, whereas the continuous-wave tunable dye laser with the Hexascan device was considered superior in 15%. There was no difference in the remaining 40%. Undesirable side effects were infrequent with both treatments. There was no significant difference in hypopigmentation or atrophic and hypertrophic scarring, but hyperpigmentation was more frequent with the continuous-wave dye laser with the Hexascan device.
Both the pulsed dye laser and continuous tunable-wave dye laser with the Hexascan device produce slight lightening after one treatment. The pulsed dye laser produces slightly greater lightening than the continuous-wave tunable dye laser with the Hexascan device 6 weeks after treatment of test areas within PWS in 40% of those treated. It also produced slightly less hypopigmentation and hyperpigmentation.
尽管连续波可见光激光治疗大多数葡萄酒色斑(PWS)取得了良好效果,但浅色PWS以及某些部位的PWS反应较差,且瘢痕形成风险较高。已开发出如Hexascan设备这样的机器人扫描装置用于连续波激光源,以提高目标特异性、增加结果的可重复性并降低不良反应的发生率。
本研究的目的是比较相同波长(585nm)的光通过闪光灯泵浦脉冲染料激光和通过Hexascan机器人扫描装置扫描的连续波可调谐染料激光对PWS内测试部位的影响。
对29例患者的PWS内两个相邻、不连续的部位进行治疗,一个部位用闪光灯泵浦脉冲染料激光治疗,另一个部位用固定在Hexascan装置上的氩泵浦连续波可调谐染料激光治疗。
28例患者完成了研究。发现脉冲染料激光在45%的患者中优于配备Hexascan装置的连续波染料激光,而配备Hexascan装置的连续波可调谐染料激光在15%的患者中被认为更优。其余40%无差异。两种治疗的不良副作用均不常见。色素减退、萎缩性和肥厚性瘢痕形成方面无显著差异,但配备Hexascan装置的连续波染料激光色素沉着更常见。
配备Hexascan装置的脉冲染料激光和连续可调谐波染料激光在一次治疗后均产生轻微的色素减退。在PWS内测试区域治疗6周后,40%接受治疗的患者中,脉冲染料激光产生的色素减退比配备Hexascan装置的连续波可调谐染料激光略大。其色素减退和色素沉着也略少。