Taylor C R, Anderson R R
Wellman Laboratories of Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
J Dermatol Surg Oncol. 1994 Sep;20(9):592-7. doi: 10.1111/j.1524-4725.1994.tb00152.x.
Melasma and postinflammatory pigmentation are cosmetic problems with limited options for treatment.
To determine whether selective photothermolysis of pigmented cells by Q-switched ruby laser treatment would produce clinical benefit in these disorders.
Eight subjects with melasma or postinflammatory hyperpigmentation refractory to traditional treatments were treated with Q-switched ruby laser pulses (694 nm, 40 nanoseconds) at fluences of 15-7.5 J/cm2, and followed. Histology was obtained before and after treatment.
Regardless of fluence, no permanent improvement and, in some cases, darkening was seen in each type of lesion. Except for small depression at high fluences in black patients, there were no textural changes after healing. Immediately after treatment, there was epidermal and dermal injury, with extracellular melanin. Several months later, epidermal pigmentation had returned to baseline and dermal macrophages were apparently focally increased.
The Q-switched ruby laser by itself does not provide an effective treatment for refractory melasma or postinflammatory hyperpigmentation.
黄褐斑和炎症后色素沉着是美容问题，治疗选择有限。
确定调Q红宝石激光对色素细胞进行选择性光热解治疗在这些疾病中是否会产生临床益处。
对8名传统治疗难治的黄褐斑或炎症后色素沉着过度患者，采用调Q红宝石激光脉冲（694nm，40纳秒），能量密度为15 - 7.5J/cm²进行治疗，并随访。治疗前后获取组织学检查结果。
无论能量密度如何，每种类型的皮损均未见永久性改善，在某些情况下还出现了色素沉着加深。除黑人患者高能量密度下有小凹陷外，愈合后无质地改变。治疗后即刻，出现表皮和真皮损伤，伴有细胞外黑色素。数月后，表皮色素沉着恢复至基线，真皮巨噬细胞明显局灶性增多。
调Q红宝石激光本身对难治性黄褐斑或炎症后色素沉着过度无效。
