皮秒激光在皮肤病学中的应用

Lunardi Bintanjoyo, D. Indramaya
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引用次数: 0

摘要

摘要背景:激光是皮肤科最重要的治疗手段之一。激光通过几种机制与发色团相互作用,这取决于影响和脉冲持续时间。早期的激光器通过光热相互作用工作,脉冲持续时间为1微秒至1秒。研制了一种皮秒激光器,以限制光热效应,产生光力学效应和等离子体感应。目的:了解皮秒激光治疗皮肤病的作用机理及应用。综述:非分数皮秒激光器是通过光力学相互作用工作的。当脉冲持续时间小于惯性约束时间时,光力学相互作用发生,导致能量较低的发色团断裂,即“冷消融”。分数皮秒激光器的工作原理是激光诱导光击穿(LIOB)。在LIOB中,加速的种子电子引起电子雪崩,产生称为等离子体的自由电子集合,这些电子会烧毁组织。皮肤的LIOB总是伴随着光破坏。在LIOB中,空泡和碎片经皮消除,真皮胶原蛋白和弹性蛋白增加。皮秒激光可用于需要破坏发色团的疾病以及胶原蛋白和弹性蛋白疾病。这是目前去除纹身(太田痣和获得性双侧太田痣样斑,或ABNOM)的一线治疗方法。对太阳色斑、雀斑、咖啡黑斑(CALM)有良好的疗效和安全性。这是一种额外的治疗中度至重度黄褐斑和增生性疤痕,与其他治疗联合使用。分数皮秒激光对萎缩性痤疮疤痕的炎症后色素沉着(PIH)有中度改善和低风险,并对白纹有改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Application of Picosecond Laser in Dermatology
ABSTRACT Background: Lasers are one of the most important treatment modalities in dermatology. Lasers interact with chromophores through several mechanisms that depend on fluence and pulse durations. Early lasers worked by photothermal interaction with pulse durations of 1 microsecond to 1 second. A picosecond laser is developed to confine photothermal effects and produce photomechanical effects and plasma induction. Purpose: To understand the mechanism of action and application of picosecond lasers for dermatological disorders. Review: Non-fractional picosecond lasers work by photomechanical interaction. Photomechanical interaction happens when pulse duration is less than inertial confinement time, causing fractures of chromophores with lower energy, or “cold ablation”. Fractional picosecond lasers work by laser-induced optical breakdown (LIOB). In LIOB, accelerated seed electrons cause an electron avalanche that produce a collection of free electrons called plasma, which ablates tissues. LIOB in the skin is always followed by photodisruption. In LIOB, vacuoles and debris were eliminated transdermally and dermal collagen and elastin increased. Picosecond laser may be applied in disorders requiring destruction of chromophores and for collagen and elastin disorders. It is currently the first-line treatment for tattoo removal (Nevus of Ota and Acquired Bilateral Nevus of Ota-like macules, or ABNOM). It has good efficacy and safety for solar lentigines, freckles, and cafe-au-lait macules (CALM). It is an additional treatment for moderate to severe melasma and hypertrophic scars, in combination with other treatments. The fractional picosecond laser showed moderate improvement and low risk of postinflammatory hyperpigmentation (PIH) for atrophic acne scars and produced improvement in striae alba.
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