Haedersdal M, Gniadecka M, Efsen J, Bech-Thomsen N, Keiding J, Wulf H C
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Denmark.
Acta Derm Venereol. 1998 Nov;78(6):445-50. doi: 10.1080/000155598442764.
The pulsed dye laser is the treatment of choice for port-wine stains. In this study we evaluate the importance of preoperative skin pigmentation and skin redness for the development of side effects from one treatment with the pulsed dye laser. A risk assessment is performed and skin reflectance measurement objectifies postoperative pigmentary changes. Fourteen human volunteers (skin types I to V) were laser-treated on the inside of the proximal brachium. Photographic documentation was used for blinded, clinical evaluation of side effects 3 and 6 months postoperatively. Skin was artificially reddened using topical application of 10% nicotinic acid cream. The development of pigmentary alterations and texture changes depended on the preoperative pigmentation and redness degrees. The risk of inducing clinically visible pigmentary alterations and texture changes increased with higher preoperative skin pigmentation and redness degrees, and with the application of increasing laser doses. Pigmentary alterations were induced at a lower fluence level than texture changes. The risk of side effects was higher 3 months postoperatively than 6 months postoperatively, substantiating a gradual disappearance of side effects. Skin reflectance measurements documented postoperative hyperpigmentation that faded partially from 3 to 6 months postoperatively. This is the first human experimental model for port-wine stains which provides quantitative data on the relationship between preoperative skin colours and postoperative clinically disturbing side effects.
脉冲染料激光是治疗葡萄酒色斑的首选方法。在本研究中，我们评估了术前皮肤色素沉着和皮肤发红对脉冲染料激光单次治疗产生副作用的重要性。进行了风险评估，皮肤反射率测量可客观反映术后色素变化。14名人类志愿者（皮肤类型I至V）在近端臂内侧接受激光治疗。术后3个月和6个月使用照片记录对副作用进行盲法临床评估。通过局部涂抹10%烟酸乳膏使皮肤人为发红。色素改变和质地变化的发生取决于术前色素沉着和发红程度。术前皮肤色素沉着和发红程度越高，以及激光剂量增加，诱发临床可见色素改变和质地变化的风险就越高。色素改变比质地变化在更低的能量密度水平下诱发。术后3个月的副作用风险高于术后6个月，证实了副作用会逐渐消失。皮肤反射率测量记录了术后色素沉着过度，其在术后3至6个月部分消退。这是首个关于葡萄酒色斑的人体实验模型，提供了术前皮肤颜色与术后临床不良副作用之间关系的定量数据。
