Dermatologisches Ambulatorium des Stadtspitals Triemli, Zürich.
Ther Umsch. 1998 Aug;55(8):522-8.
The use of lasers for cutaneous lesions has expanded rapidly since its inception in the early 1960s. The principle of selective photothermolysis dramatically improved the efficacy and safety of dermatologic laser systems. Selective photothermolysis is accomplished by choosing an appropriate wavelength and pulse duration. According to the target chromophores (hemoglobin, melanin and H2O), lasers may be grossly divided into 3 groups; systems to treat vascular lesions, pigmented lesions and the surgical lasers for skin ablation. Although vascular lesions can be treated with many lasers, the flash lamp pumped dye laser remains the laser of choice for port wine stains. Cw-lasers can treat telangiectases without purpura and are safer when used in conjunction with scanning devices. Q-switched lasers have enhanced our ability to treat pigmented lesions, especially tattoos. The carbon dioxide laser remains the "workhorse" in dermatology. Safety and versatility are maximized when coupled with a scanning device or utilized in a high-powered, rapidly pulsed mode. Despite the expanding list of laser-responsive lesions, other therapeutic modalities, sometimes at least equally effective and cheaper, must be carefully considered. This requires skill in dermatology and basic laser principles. Lasers add a substantial dimension in treating various skin disorders but are increasingly fraught with overuse.
自20世纪60年代初问世以来，激光在皮肤病变治疗中的应用迅速发展。选择性光热作用原理极大地提高了皮肤科激光系统的疗效和安全性。通过选择合适的波长和脉冲持续时间来实现选择性光热作用。根据靶色团（血红蛋白、黑色素和水），激光大致可分为3类：治疗血管性病变的系统、色素性病变的系统以及用于皮肤磨削的外科激光。尽管许多激光都可用于治疗血管性病变，但闪光灯泵浦染料激光仍是治疗葡萄酒色斑的首选激光。连续波激光可治疗毛细血管扩张且不会引起紫癜，与扫描装置联合使用时更安全。调Q激光增强了我们治疗色素性病变尤其是纹身的能力。二氧化碳激光仍然是皮肤科的“主力军”。与扫描装置联合使用或以高功率、快速脉冲模式使用时，安全性和多功能性可得到最大化。尽管对激光有反应的病变种类不断增加，但必须仔细考虑其他治疗方式，有时这些方式至少同样有效且成本更低。这需要皮肤科方面的技能和基本的激光原理知识。激光在治疗各种皮肤疾病方面增添了重要手段，但过度使用的情况也日益增多。
