Haedersdal M, Efsen J, Gniadecka M, Fogh H, Keiding J, Wulf H C
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Denmark.
Arch Dermatol. 1998 Feb;134(2):175-81. doi: 10.1001/archderm.134.2.175.
The pulsed dye laser is the treatment of choice for children with port-wine stains (PWSs). Evaluation of treatment outcome and adverse effects is traditionally based on subjective clinical scoring systems. We intend to objectify treatment results and adverse reactions after 1 treatment with the pulsed dye laser.
A before-and-after trial using skin reflectance to detect changes in skin redness and pigmentation, ultrasonography to evaluate changes in echostructure and skin thickness, and 3-dimensional surface contour analysis to detect changes in surface texture.
Twelve children with PWSs.
A university dermatological department.
The skin reflectance-determined change in skin redness correlated with the clinical response (r = 0.46, P < .002). The percentage of reflectance-determined lightening was equal for pink, red, and dark red PWSs (median, 42.9%). Skin pigmentation increased after laser treatment (P < .007). Ultrasonography revealed lower dermal echogenicity of preoperative PWSs than of postoperative PWSs (P < .007) and healthy skin (P < .001). An increase in echogenicity reflected a decrease in the dermal water (blood) content. Variations were found in the dermal localization of the PWS. Skin thickness was significantly higher in the PWS before treatment than after (P < .001). The preoperative lesional thickness correlated inversely with the ultrasound-assessed treatment response (r = 0.35, P < .04). The surface contour parameters decreased significantly after laser treatment, indicating a flattening of the skin surface. The contour changes correlated positively with treatment response. By clinical evaluation, no hypopigmentation or texture changes were detected.
The evaluation of treatment outcome and adverse effects is refined by the use of skin reflectance, ultrasonographic, and surface contour analysis.
脉冲染料激光是治疗儿童葡萄酒色斑（PWS）的首选方法。传统上，治疗效果和不良反应的评估基于主观临床评分系统。我们旨在客观化脉冲染料激光单次治疗后的治疗结果和不良反应。
一项前后对照试验，使用皮肤反射率检测皮肤发红和色素沉着的变化，超声检查评估回声结构和皮肤厚度的变化，以及三维表面轮廓分析检测表面纹理的变化。
12名患有PWS的儿童。
大学皮肤科。
皮肤反射率测定的皮肤发红变化与临床反应相关（r = 0.46，P <.002）。粉色、红色和暗红色PWS的反射率测定的变亮百分比相等（中位数，42.9%）。激光治疗后皮肤色素沉着增加（P <.007）。超声检查显示，术前PWS的真皮回声低于术后PWS（P <.007）和健康皮肤（P <.001）。回声增加反映真皮含水量（血液）减少。发现PWS在真皮中的定位存在差异。治疗前PWS的皮肤厚度明显高于治疗后（P <.001）。术前病变厚度与超声评估的治疗反应呈负相关（r = 0.35，P <.04）。激光治疗后表面轮廓参数显著降低，表明皮肤表面变平。轮廓变化与治疗反应呈正相关。通过临床评估，未检测到色素减退或质地变化。
使用皮肤反射率、超声检查和表面轮廓分析可完善治疗效果和不良反应的评估。
