Ogata H
Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan.
Keio J Med. 1997 Dec;46(4):188-95. doi: 10.2302/kjm.46.188.
Q-switched ruby laser (QSRL) and Q-switched Nd-YAG laser (QSNYL) treatment of dermal melanocytosis, especially nevus of Ota, has produced favorable results that are mediated by selective photothermolysis. However, the precise effects of irradiation on melanosomes and cells containing melanosomes remain unclear, and an optimal method of irradiation has not been found. In this study synthetic melanin powder and pigmented dermal tissue obtained from five blue nevus lesions, also classified as dermal melanocytosis, were used as targets to identify the specific effects of these forms of irradiation in vitro. Morphological changes were assessed by microscopy after irradiation with QSRL and QSNYL at a fluence of 5 J/cm2, the fluence ordinarily utilized in clinical applications. Light microscopy revealed that most of the synthetic melanin powder retained in 1% agar was no longer visible after QSRL irradiation. In contrast, melanin powder particles were partly crushed by QSNYL irradiation. Electron microscopic examination of melanosomes in the blue nevus tissue after irradiation showed expansion and various other forms of disruption. Statistical analysis by 2-way analysis of variance (ANOVA) of the length of the major axis of the melanosomes indicated that QSRL irradiation caused significantly greater melanosome expansion than QSNYL irradiation. These findings indicate that QSRL irradiation had a greater photothermal effect on dermal melanosomes than QSNYL irradiation. This suggests that QSRL is more efficacious in the treatment of dermal melanocytosis than QSNYL.
调Q红宝石激光（QSRL）和调Q钕钇铝石榴石激光（QSNYL）治疗皮肤黑素细胞增多症，尤其是太田痣，已产生了由选择性光热解介导的良好效果。然而，照射对黑素小体和含有黑素小体的细胞的确切影响仍不清楚，并且尚未找到最佳的照射方法。在本研究中，从五个也被归类为皮肤黑素细胞增多症的蓝痣病变中获得的合成黑色素粉末和色素沉着的皮肤组织被用作靶标，以在体外确定这些照射形式的特定效果。在用临床应用中通常使用的5 J/cm2的能量密度进行QSRL和QSNYL照射后，通过显微镜评估形态学变化。光学显微镜显示，在QSRL照射后，保留在1%琼脂中的大部分合成黑色素粉末不再可见。相比之下，黑色素粉末颗粒在QSNYL照射下部分被粉碎。照射后对蓝痣组织中黑素小体的电子显微镜检查显示有膨胀和各种其他形式的破坏。通过对黑素小体主轴长度进行双向方差分析（ANOVA）的统计分析表明，QSRL照射比QSNYL照射引起的黑素小体膨胀明显更大。这些发现表明，QSRL照射对皮肤黑素小体的光热效应比QSNYL照射更大。这表明QSRL在治疗皮肤黑素细胞增多症方面比QSNYL更有效。
