Argon Laser for the Treatment of Pigmented Skin Lesions

色素性皮膚病變的氬雷射治療

陳明庭(Ming-Ting Chen) ； 簡守信(Sou-Hsin Chien)

《中華民國重建整形外科醫學會雜誌》 1卷1期 (1992/02) Pp. 31-35

https://doi.org/10.7096/JPRSA.199202.0031

摘要

氬雷射之波長為480及514nm，而血紅素以及黑色素以及黑色素的吸收光譜也在這附近。因此氬雷射光在被黑色素選擇性吸收後，黑色素細胞會被破壞，並造成表層皮膚灼傷，再生皮膚的黑色素細胞如果與周圍皮膚同量，則為理想的治療目標，選擇治療的黑色姆斑，最好其黑色素細胞是在表皮或者較表層的眞皮上，這樣對正常組織的破壞較小，本篇報告自1983到1987使用氬雷射治療45例色素性皮膚病變的臨床經驗。我們所使用的機器是Spectrophysics Model 770, 有三種大小的手把，分別為1mm，2mm以及5mm。常用的電量為0.6W-1.4W，照射時間為0.2-0.5秒，一般而言，使用較小的手把以及較短的照射時間，可以得到較好的結果，45個病例中約有三分之二以上可以獲得明顯的改善，併發症占百分之二十，包括形成肥厚性瘢痕以及色素沉積。肥厚性瘢痕多發生在上唇及下巴等運動較頻繁的地方。因此在治療嘴部附近的黑色姆斑時，能量的調節要更小心。
Ota's nevus的治療方式包括磨皮術，乾冰治療，手術切除及植皮等，效果均不是十分滿意。在23個Ota's nevus的病人中有三位曾經接受過磨皮術或者乾冰治療。黑色姆斑的分佈變成散在性。這三位病人在接受氬雷射光治療後都獲得明顯的改善。基於這樣的觀察，合併療法也就是先使用磨皮術或乾冰治療將比較表層的黑色姆斑除去後，對剩餘散在的黑色素細胞再以氬雷射治療可能是一種可以嚐試的新治療方式，以加速傷口的復原。此一假設還需更進一步的觀察與研究。總結而言，氬雷射是治療色素性皮膚病變的有效工具。

並列摘要

The argon laser produces an intense blue-green light with major energy peak at 480 and 514 nm. The wavelengths are near the peak absorbency frequencies of hemoglobin and melanin. After absorption of Laser energy, heat is produced and creates local destruction. The destruction is not limited to the tissue containing melanin, the heat is conducted to the superficial tissue adjacent to the target. If the lesion is located in the superficial layer of the dermis, normal tissue is less destructed. This paper presents our clinical experience using argon laser for the treatment of 45 cases of pigmented skin lesions from 1983 to 1987. The argon laser used is Spectrophysics model 770. Spot size varied between 1 mm, 2 mm and 5 mm. Power range varying between 0.6 and 1.4 W. Pulse duration varied from 0.2 to 0.5 second. Over two-thirds of the cases can achieve considerable improvement. The complication rate is 20% which includes hypertrophic scar and hyperpigmentation. Hypertrophic scar occurred usually on the upper lip and chin areas. Careful selection of the patients and special attention to this perioral lesion can reduce this incidence of complication.
Treatment of Ota's nevus includes dermabrasion, dry ice therapy, surgical excision and skin graft etc. With unsatisfactory result. Among the 23 Ota's nevus, 3 cases had received dermabrasion or dry ice therapy before and their lesion had changed from homogenous to spotty. AU these 3 spotty Ota's nevus achieved considerable improvement after argon laser therapy. Combination therapy with dermabrasion or dry ice therapy first follow by argon laser may be beneficial due to rapid wound healing. Further study is needed to prove this observation. Argon Laser is a useful tool for the treatment of pigmented skin lesions.

並列關鍵字

Argon Laser ； Pigmented Skin Lesions