Troilius A, Wrangsjö B, Ljunggren B
Department of Dermatology, University Hospital, Malmö, Sweden.
Br J Dermatol. 1998 Jul;139(1):59-65. doi: 10.1046/j.1365-2133.1998.02314.x.
There is a commonly held conception among referring doctors that very small children with congenital capillary malformations, so-called port-wine stains (PWS), should not be treated until they are older. Our experience leads us to believe that the flashlamp pulsed dye laser is a safe and effective treatment even for infants. We have not encountered any persistent pigmentation changes, post-treatment scarring or other adverse effects. It is important to quantify the psychological disabilities associated with this disorder to assess the need for and the benefits of treatment. Questionnaires were distributed to 259 patients and their families who visited our clinic because of their PWS. Patients who were on the waiting list for laser treatment, undergoing treatment or had completed their treatment received different questionnaires. The response rate was 89%. High emotional distress was encountered. During the age period 10-20 years, 73% (125 patients) were most disturbed by their PWS. That the PWS influenced their life negatively was experienced by 75% (171 patients), and 62% (106 patients) were convinced that their life would change radically if their PWS could be eliminated. Suffering from low self-esteem (in comparison with the same age group) was reported by 47% (87% patients). The PWS made their school life and education more difficult according to 28% (51 patients) of the sample. Of the families of patients, 76% (106 relatives) considered the patient to be negatively affected in some way by the PWS. After the laser treatment, all of these distress parameters were significantly relieved, together with a need to cover their PWS, their fear of going into conflict or quarrels, their social relationships, problems with the opposite sex, rage attacks, depressions and abnormal reactions from their peers. We believe there is potential psychological benefit in starting the treatments of PWS (including non-facial) at as early an age as possible.
转诊医生中普遍存在一种观念，即患有先天性毛细血管畸形（即所谓的葡萄酒色斑，PWS）的幼儿不应在年龄较大之前接受治疗。我们的经验使我们相信，闪光灯脉冲染料激光即使对婴儿也是一种安全有效的治疗方法。我们没有遇到任何持续性色素沉着变化、治疗后疤痕或其他不良反应。量化与这种疾病相关的心理障碍，对于评估治疗的必要性和益处很重要。我们向259名因PWS前来我们诊所就诊的患者及其家属发放了问卷。等待激光治疗、正在接受治疗或已完成治疗的患者收到了不同的问卷。回复率为89%。结果发现患者存在高度的情绪困扰。在10至20岁年龄段，73%（125名患者）因PWS而受到最大困扰。75%（171名患者）感到PWS对他们的生活产生了负面影响，62%（106名患者）确信如果PWS能够消除，他们的生活将发生根本性改变。47%（87名患者）报告存在自卑（与同年龄组相比）情况。28%（51名患者）的样本表示PWS使他们的学校生活和教育更加困难。在患者家属中，76%（106名亲属）认为患者在某种程度上受到PWS的负面影响。激光治疗后，所有这些困扰参数都得到了显著缓解，同时包括遮盖PWS的需求、对发生冲突或争吵的恐惧、社交关系、与异性相处的问题、愤怒发作、抑郁以及同龄人异常反应等问题也得到了缓解。我们认为尽早开始对PWS（包括非面部PWS）进行治疗可能会带来心理益处。
