Fitzpatrick R E, Lowe N J, Goldman M P, Borden H, Behr K L, Ruiz-Esparza J
Department of Dermatology, University of California, San Diego.
J Dermatol Surg Oncol. 1994 Nov;20(11):743-8. doi: 10.1111/j.1524-4725.1994.tb03197.x.
Port-wine stains, or capillary malformations, occur in 0.3-0.5% of newborns and have been shown to be very responsive to treatment with a pulsed dye laser (585 nm, 450 microseconds). Lesional characteristics that may help predict the ease of response to therapy have not been delineated. There exists a great range of variation in response to treatment.
A retrospective study of 133 patients with 140 port-wine stain malformations being treated with the flashlamp-pumped pulsed dye laser was undertaken. Lesion characteristics such as color and location, patient age, and skin type were evaluated as to their correlation with clinical response. Adverse sequelae were evaluated as well.
Charts of treated patients were reviewed and results tabulated. The five treating physicians were each responsible for reviewing and evaluating their own patients. Patients were treated at 8-12-week intervals using slightly overlapping pulses with fluences from 5.5 to 7.5 J/cm.2
Factors favoring a positive clinical response were pink lesion color, lesion location of the head and neck, patient age less than 10 years, and patient skin types I-III. Factors having a more negative impact on clinical result include purple lesion color, lesion location on the distal extremities, patient age > 50 years, and skin types IV and V.
Examination of various patient and lesional characteristics shows trends that may be useful in a predictive manner regarding ease of treatment with the flashlamp-pumped pulsed dye laser.
葡萄酒色斑,即毛细血管畸形,在0.3% - 0.5%的新生儿中出现,并且已显示对脉冲染料激光(585纳米,450微秒)治疗反应非常良好。尚未明确可能有助于预测治疗反应难易程度的病变特征。治疗反应存在很大差异。
对133例患有140处葡萄酒色斑畸形且正在接受闪光灯泵浦脉冲染料激光治疗的患者进行回顾性研究。评估病变特征(如颜色和位置)、患者年龄和皮肤类型与临床反应的相关性。同时评估不良后遗症。
查阅接受治疗患者的病历并将结果列表。五位治疗医生各自负责审查和评估自己的患者。患者每隔8 - 12周接受治疗,使用略微重叠的脉冲,能量密度为5.5至7.5 J/cm²。
有利于产生积极临床反应的因素包括病变颜色为粉红色、病变位于头颈部、患者年龄小于10岁以及患者皮肤类型为I - III型。对临床结果有更负面影响的因素包括病变颜色为紫色、病变位于远端肢体、患者年龄>50岁以及皮肤类型为IV型和V型。
对各种患者和病变特征的检查显示出一些趋势,这些趋势可能有助于以预测的方式判断闪光灯泵浦脉冲染料激光治疗的难易程度。