Grevelink J M, van Leeuwen R L, Anderson R R, Byers H R
Massachusetts General Hospital Dermatology Laser Center, Harvard Medical School, Boston, USA.
Arch Dermatol. 1997 Mar;133(3):349-53.
Laser irradiation of congenital melanocytic nevi is a controversial treatment. Recurrence of lesions after laser treatment appears to be the rule, and the effects of laser irradiation on cellular biological behavior and the possible mutagenic responses of nevomelanocytes that have received nonlethal doses of irradiation are still unclear. Without treatment, there is an increased potential for malignant degeneration over a life-time. The purpose of this study was to examine the effects of Q-switched lasers on congenital nevi and to explain the mechanism(s) behind the response of the nevi to laser treatment. Five congenital nevi were divided into 3 equal parts: 1 part was treated with the Q-switched ruby laser at a wavelength of 694 nm, 1 part was treated with the Q-switched neodymium: YAG laser at a wavelength of 1064 nm, and 1 part was left untreated to serve as control. At intervals ranging from 3 days to 3 months after laser irradiation, the lesions were excised and evaluated by routine staining. This clinical study was conducted entirely at the Massachusetts General Hospital Dermatology Laser Center, Boston, Mass.
Both the superficial and the deep portions of the congenital melanocytic nevi were affected by the 2 lasers, as evidenced by macroscopic inspection as well as microscopic evaluation. However, the Q-switched laser treatment did not destroy all nevomelanocytes, particularly in the deeper, less pigmented portions of the lesions.
Both the Q-switched ruby laser and the neodymium: YAG laser often removed only the superficial portion of the congenital melanocytic nevi. The Q-switched ruby laser (694 nm) appeared to be more effective in removing nevomelanocytes than the Q-switched neodymium: YAG laser (1064 nm).
先天性黑素细胞痣的激光照射是一种有争议的治疗方法。激光治疗后病变复发似乎是常态，激光照射对细胞生物学行为的影响以及接受非致死剂量照射的痣黑素细胞可能的诱变反应仍不清楚。未经治疗，一生中发生恶性变的可能性会增加。本研究的目的是研究调Q激光对先天性痣的影响，并解释痣对激光治疗反应背后的机制。将5个先天性痣平均分成3部分：1部分用波长694nm的调Q红宝石激光治疗，1部分用波长1064nm的调Q钕：钇铝石榴石激光治疗，1部分不治疗作为对照。在激光照射后3天至3个月的不同时间间隔，切除病变并通过常规染色进行评估。这项临床研究完全在马萨诸塞州波士顿市麻省总医院皮肤科激光中心进行。
通过肉眼检查和显微镜评估证明，先天性黑素细胞痣的浅表和深部均受到这两种激光的影响。然而，调Q激光治疗并未破坏所有痣黑素细胞，尤其是在病变较深、色素较少的部分。
调Q红宝石激光和钕：钇铝石榴石激光通常仅去除先天性黑素细胞痣的浅表部分。调Q红宝石激光（694nm）在去除痣黑素细胞方面似乎比调Q钕：钇铝石榴石激光（1064nm）更有效。
