Kopera D, Hohenleutner U, Landthaler M
Department of Dermatology, University of Graz, Austria.
Dermatology. 1997;194(4):338-43. doi: 10.1159/000246131.
A histopathological and immunohistochemical study was initiated to assess changes in benign human pigmented skin lesions after quality switched ruby laser (QSRL) irradiation.
A total of 196 solar lentigines on 8 patients' forearms were irradiated in vivo, 13 biopsies were taken. Hematoxylin-eosin staining and immunohistochemical techniques using anti-S-100 and Fontana-Masson stainings, as well as cryosections stained with nitroblue tetrazolium chloride (NBTC), were employed for the evaluation of the specimens.
Immediately after QSRL impact selective photothermal damage (vacuolization) of all pigmented epidermal and basal melanocytes, keratinocytes, superficial dermal melanocytes and melanophages could be observed in solar lentigines. Cryosections stained with NBTC featured minimal thermal damage of the surrounding tissue. One Becker's nevus was also exposed to the QSRL, biopsies were taken before and immediately after QSRL exposure. In this lesion, superficially located pigments were selectively damaged, but a fair amount of pigmented cells in adnexal structures persisted throughout this single course of QSRL treatment. Recurrence of lentigines was not observed. In Becker's nevus, following initial fading of the lesion, clinically reactive hyperpigmentation occurred 4 weeks later.
We found that pigmented lesions featuring a moderate amount of pigment exclusively in and around the basal cell layer, like solar (actinic) lentigo, can be successfully removed by a single QSRL exposure selectively damaging epidermal and basal pigmented structures. Further investigations concerning QSRL treatment of dermally pigmented skin lesions have to be initiated.
开展一项组织病理学和免疫组织化学研究，以评估调Q红宝石激光（QSRL）照射后良性人类色素沉着性皮肤病变的变化。
对8例患者前臂上的196处日光性雀斑样痣进行体内照射，取13处活检组织。采用苏木精-伊红染色、抗S-100免疫组织化学技术、Fontana-Masson染色以及用氯化硝基四氮唑蓝（NBTC）染色的冰冻切片对标本进行评估。
QSRL照射后立即观察到日光性雀斑样痣中所有色素沉着的表皮和基底黑素细胞、角质形成细胞、浅表真皮黑素细胞和噬黑素细胞出现选择性光热损伤（空泡化）。用NBTC染色的冰冻切片显示周围组织的热损伤最小。还对1例贝克痣进行了QSRL照射，在照射前和照射后立即取活检组织。在该病变中，浅表部位的色素被选择性损伤，但在附属器结构中仍有相当数量的色素细胞在这一单程QSRL治疗过程中持续存在。未观察到雀斑样痣复发。在贝克痣中，病变最初消退后，4周后出现临床反应性色素沉着。
我们发现，仅在基底细胞层及其周围有中等量色素沉着的色素性病变，如日光性（光化性）雀斑样痣，单次QSRL照射可选择性损伤表皮和基底色素性结构，从而成功去除病变。必须启动关于QSRL治疗真皮色素沉着性皮肤病变的进一步研究。
