调Q开关翠绿宝石激光治疗282例色素性皮肤病临床分析

摘要

目的 观察调Q开关翠绿宝石激光在皮肤科色素性疾病治疗中的疗效及不良反应.方法 用Q开关翠绿宝石激光治疗282例皮肤色素性疾病包括脂溢性角化症、斑痣、褐青色痣、黄褐斑、咖啡斑、口周黑子、雀斑、雀斑样痣、色素沉着斑、色素性毛痣、色素痣、太田痣、外伤粉尘沉着、文身、伊藤痣、遗传性对称性色素异常.观察就诊患者的疗效及不良反应.结果 脂溢性角化症、雀斑3次治愈率100％.斑痣4次治疗有效率64.7％,治愈率17.6％.太田痣6次治疗有效率91.7％,治愈率达61.1％.咖啡斑3次治疗有效率达46.1％,治愈率达23.1％.文身3次治疗有效率达100％,治愈率达50.0％.雀斑样痣2次治疗有效率达66.7％.外伤粉尘沉着4次治疗有效率达86.7％,治愈率达46.7％.色素沉着、口周黑子1次治愈率可达50％.伊藤痣、褐青色痣、黄褐斑、遗传性对称性色素异常病例数较少,需进一步观察.色素痣和色素性毛痣效果差,不推荐使用.结论 Q开关翠绿宝石激光对太田痣、雀斑、脂溢性角化症、文身、外伤粉尘沉着、口周黑子、色素沉着治疗效果好.对于咖啡斑、雀斑样痣、斑痣等有一定疗效.%Objective To assess the efficacy and adverse events of Q-switching alexandrite laser in 282 patients with pigmentary skin diseases. Methods The clinical profiles of 282 patients with pigmentary skin diseases, including seborrheic keratosis, naevus spilus, nevus fuscoceruleus zygomaticus, chloasma, cafe-au-lait spots, lentigo, freckles, labial lentigo, pigmentation, pigmented hairy epidermal nevus, melanocytic nevus, naevus of Ota, traumatic tattoo, tattoo, naevus of Ito, dyschromatosis symmetrica hereditaris who were treated with Q-switching alexandrite laser were analyzed for determination of the efficacy and adverse events. Results The complete remission rate of 100% was reported for seborrheic keratosis and freckles following three consecutive laser treatments. The effective and com plete remission rates were 64.7% and 17.6% for naevus spilus following three consecutive treatments, 91.7% and 61.1 % for naevus of ota following six consecutive treatments, 46.1% and 23.1% for caf6-au-lait spots following three consecutive treatments, 100% and 50.0% for tattoo following three consecutive treatments and 86.7% and 46.7% for traumatic tattoo following four consecutive treatments. The effective rate was 66.7% for lentigo following two consecutive treatments and the remission rate might culminate to 50% for labial lentigo and pigmentation. Further study was necessary inasmuch that the number of patients with naevus of Ito, dyschromatosis symmetrica hereditaris, nevus fuscoceruleus zygomaticus and chloasma were limited. Laser was not recommended for pigmented hairy epidermal nevus and melanocytic nevus owing to the poor outcomes. Conclusion The Q-switching alexandrite laser is effective for the treatment of naevus of Ota, traumatic tattoo, amateur tattoo, freckles, seborrheic keratosis, labial lentigo and pigmentation yet has limited efficacy for cafe-au-lait spots, lentigo naevus spilu and chloasma.