Biomedical Engineering Reference
In-Depth Information
(
A
)
(
B
)
Figure 2.26
Pyogenic granuloma (
A
) before and (
B
) after CO
2
laser. Lesions had recurred after electrosurgery. Small scar persists.
component if a histologic specimen is necessary or CO
2
vapor-
ization of the lesion followed by PDL therapy to the remaining
fl at macular lesion if necessary.
The Nd:YAG laser can be applied with a 3-7 mm spot and
fl uences ranging from 100 to 250 J/cm
2
. A lower range of fl u-
ences is applied with the larger spot sizes (60-100 J/cm
2
) (196),
pulse duration of 20-50 ms, with cooling with variable results.
Often a scar will result but other modalities are also likely to
produce a scar. Often more than one pulse must be delivered.
Like all applications of the Nd:YAG laser, at last 30 seconds
should elapse between pulses to allow for postpulse cooling.
12. Ross EV. Laser versus intense pulsed light: Competing technologies in
dermatology. Lasers Surg Med 2006; 38: 261-72.
13. Goldman MP, Weiss RA, Weiss MA. Intense pulsed light as a non-
ablative approach to photoaging. Dermatol Surg 2005; 31: 1179-87;
discussion 1187.
14. Goldman MP, Eckhouse S. Photothermal sclerosis of leg veins. ESC
Medical Systems, LTD Photoderm VL Cooperative Study Group.
Dermatol Surg 1996; 22: 323-30.
15. Ross EV, Meehan KJ, Domankevitz Y, et al. Use of a variable long-pulse
alexandrite laser in the treatment of facial telangiectasia. Dermatol
Surg 2010; 36: 470-4.
16. Wall TL, Grassi AM, Avram MM. Clearance of multiple venous lakes
with an 800-nm diode laser: a novel approach. Dermatol Surg 2007; 33:
100-3.
17. Fisher JC. Biophysics of resurfacing of human skin by means of
lasers. In: Carniol PJ, ed. Laser Skin Rejuvenation. Philadelphia:
Lippincott-Raven, 1998: 1-48.
18. Rubin IK, Farinelli WA, Doukas A, Anderson RR. Optimal wave-
lengths for vein-selective photothermolysis. Lasers Surg Med 2012; 44:
152-7.
19. Goldberg DJ, Marcus J. The use of the frequency-doubled Q-switched
Nd:YAG laser in the treatment of small cutaneous vascular lesions.
Dermatol Surg 1996; 22: 841-4.
20. Kauvar AN, Rosen N, Khrom T. A newly modifi ed 595-nm pulsed dye
laser with compression handpiece for the treatment of photodamaged
skin. Lasers Surg Med 2006; 38: 808-13.
21. Borghese A, Merola SS. Time-resolved spectral and spatial description
of laser-induced breakdown in air as a pulsed, bright, and broadband
ultraviolet-visible light source. Appl Opt 1998; 37: 3977-83.
22. Eadie E, Miller P, Goodman T, Moseley H. Time-resolved measurement
shows a spectral distribution shift in an intense pulsed light system.
Lasers Med Sci 2009; 24: 35-43.
23. Town G, Ash C, Eadie E, Moseley H. Measuring key parameters
of intense pulsed light (IPL) devices. J Cosmet Laser Ther 2007; 9:
148-60.
24. Eremia S, Li CY. Treatment of face veins with a cryogen spray variable
pulse width 1064 nm Nd:YAG Laser: a prospective study of 17 patients.
Dermatol Surg 2002; 28: 244-7.
25. Sarradet DM, Hussain M, Goldberg DJ. Millisecond 1064-nm
neodymium:YAG laser treatment of facial telangiectases. Dermatol
Surg 2003; 29: 56-8.
26. Nootheti P, Pettit K, Yosowitz G, Goldman M. Clinical Improvement
of Photodamaged Skin After a Single Intense Pulsed Light Treatment.
Am J Cosmet Surg 2007; 24: 15-20.
27. Bjerring P, Christiansen K, Troilius A, Dierickx C. Facial photo rejuve-
nation using two different intense pulsed light (IPL) wavelength bands.
Lasers Surg Med 2004; 34: 120-6.
28. Weiss RA, Ross EV, Tanghetti EA, et al. Characterization of an opti-
mized light source and comparison to pulsed dye laser for superfi cial
and deep vessel clearance. Lasers Surg Med 2011; 43: 92-8.
29. Wenzl JE, Burgert EO Jr. The spider nevus in infancy and childhood.
Pediatrics 1964; 33: 227-32.
30. Larsson PA, Liden S. Prevalence of skin diseases among adolescents
12-16 years of age. Acta Derm Venereol 1980; 60: 415-23.
31. Tan OT, Gilchrest BA. Laser therapy for selected cutaneous vascular lesions
in the pediatric population: a review. Pediatrics 1988; 82: 652-62.
acknowledgment
This chapter is extensively updated from: Goldman MP,
Fitzpatrick RE: 'Laser Treatment of Cutaneous Vascular Lesions'
in Cutaneous Laser Surgery: The Art and Science of Selective
Photothermolysis 2nd Ed. Goldman MP, Fitzpatrick RE (eds)
Mosby, Louis, 1999.
references
1. Tan OT, Carney JM, Margolis R, et al. Histologic responses of port-wine
stains treated by argon, carbon dioxide, and tunable dye lasers. A pre-
liminary report. Arch Dermatol 1986; 122: 1016-22.
2. Anderson RR, Parrish JA. Microvasculature can be selectively damaged
using dye lasers: a basic theory and experimental evidence in human
skin. Lasers Surg Med 1981; 1: 263-76.
3. Bosschaart N, Faber DJ, van Leeuwen TG, Aalders MC. In vivo low-
coherence spectroscopic measurements of local hemoglobin absorption
spectra in human skin. J Biomed Opt 2011; 16: 100504.
4. Keijzer M, Pickering JW, van Gemert MJ. Laser beam diameter for port
wine stain treatment. Lasers Surg Med 1991; 11: 601-5.
5. Lucassen GW, Verkruysse W, Keijzer M, van Gemert MJ. Light distribu-
tions in a port wine stain model containing multiple cylindrical and
curved blood vessels. Lasers Surg Med 1996; 18: 345-57.
6. Gilchrest BA, Rosen S, Noe JM. Chilling port wine stains improves the
response to argon laser therapy. Plast Reconstr Surg 1982; 69: 278-83.
7. Garden JM, Tan OT, Kerschmann R, et al. Effect of dye laser pulse
duration on selective cutaneous vascular injury. J Invest Dermatol 1986;
87: 653-7.
8. Paul BS, Anderson RR, Jarve J, Parrish JA. The effect of temperature and
other factors on selective microvascular damage caused by pulsed dye
laser. J Invest Dermatol 1983; 81: 333-6.
9. Tanghetti E, Sierra RA, Sherr EA, Mirkov M. Evaluation of pulse-
duration on purpuric threshold using extended pulse pulsed dye laser
(cynosure V-star). Lasers Surg Med 2002; 31: 363-6.
10. Jackson BA, Arndt KA, Dover JS. Are all 585 nm pulsed dye lasers
equivalent? A prospective, comparative, photometric, and histologic
study. J Am Acad Dermatol 1996; 34: 1000-4.
11. Greve B, Raulin C. Prospective study of port wine stain treatment with
dye laser: comparison of two wavelengths (585 nm vs. 595 nm) and
two pulse durations (0.5 milliseconds vs. 20 milliseconds). Lasers Surg
Med 2004; 34: 168-73.
