Taylor C R, Anderson R R
Department of Dermatology, Wellman Laboratories of Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Int J Dermatol. 1993 Dec;32(12):908-12. doi: 10.1111/j.1365-4362.1993.tb01417.x.
Disorders of cutaneous pigmentation are a common problem, which can cause substantial cosmetic morbidity. Traditional treatments are often ineffective and sometimes associated with further hyperpigmentation, hypopigmentation, or scarring. Because the Q-switched ruby laser has proven useful for the treatment of tattoos and, in a small number of cases, benign disorders of the epidermal melanin, we decided to apply this modality systematically to additional benign pigmented lesions.
Thirty-four benign pigmented epidermal lesions including lentigines, café-au-lait macules, and nevi spili in nine white patients were exposed to single pulses of a Q-switched ruby laser (694 nm, 40 ns pulse duration) at 4.5 and/or 7.5 J/cm2.
After one treatment, substantial clearing occurred at each fluence in all lentigines and café-au-lait macules. Initial improvement was achieved in a small nevus spilus after two treatments at 4.5 J/cm2 and a larger nevus spilus after one treatment at 7.5 J/cm2 with complete removal of the junctional or compound nevi portion but no improvement in the café-au-lait portion. Complete return of the background pigment was observed by 1 year. There was no scarring. Immediately after treatment, histology revealed vacuolization of keratinocytes and melanocytes, and occasional subepidermal blisters.
These findings show that while the Q-switched ruby laser may not be entirely useful for treating nevi spili, it does provide an effective treatment for lentigines and café-au-lait macules.
皮肤色素沉着紊乱是一个常见问题，可导致严重的美容问题。传统治疗方法往往无效，有时还会导致进一步的色素沉着过度、色素沉着不足或瘢痕形成。由于调Q红宝石激光已被证明可用于治疗纹身，并且在少数情况下可用于治疗表皮黑色素的良性疾病，我们决定将这种方法系统地应用于其他良性色素沉着病变。
对9名白人患者的34个良性色素沉着表皮病变，包括雀斑、咖啡斑和斑痣，使用调Q红宝石激光（694nm，40ns脉冲持续时间）以4.5和/或7.5J/cm²的能量进行单次脉冲照射。
一次治疗后，所有雀斑和咖啡斑在每种能量密度下均有明显消退。一个小斑痣在4.5J/cm²能量下治疗两次后有初步改善，一个大斑痣在7.5J/cm²能量下治疗一次后，交界痣或混合痣部分完全去除，但咖啡斑部分无改善。1年后观察到背景色素完全恢复。无瘢痕形成。治疗后立即进行的组织学检查显示角质形成细胞和黑素细胞空泡化，偶尔有表皮下水疱。
这些结果表明，虽然调Q红宝石激光可能不完全适用于治疗斑痣，但它确实为雀斑和咖啡斑提供了一种有效的治疗方法。
