Author/Editor		Ahčan, Uroš; Zorman, Peter; Ralca, Simon; Recek, Dejan; Majaron, Boris
Title		Lasersko zdravljenje benignih kožnih žilnih nepravilnosti
Translated title		Laser treatment of benign cutaneous vascular lesions
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 7-8
Publication year		2004
Volume		str. 577-83
Language		slo
Abstract		Background. Congenital and acquired vascular lesions of the skin and subcutis are a common health problem from aesthetic and also from psycho-social point of view. However, recent advances in laser technology have enabled an efficient and safe treatment. This study presents our experience with treatment of cutaneous vascular lesions using modern laser systems. Most common benign cutaneous vascular lesions are described. Patients and methods. In years 2002 and 2003, 109 patients, 4 to 80 (mean 39) years old, Fitzpatrick skin type 1-4, with 210 benign cutaneous vascular lesions were treated using the Dualis VP® laser system (Fotona, Slovenia) which incorporates the KTP and Nd: YAG lasers. Vascular lesions in the upper layers of the skin with diameter up to 1 mm were treated with the KTP laser (wavelength 532 nm). For larger vessels in deeper layer we used the Nd:YAG laser (wavelength 1064 nm). Patients graded the pain during treatment on a scale of 1 -10. Clinical outcomes were evaluated 1-3 months after the last treatment: according to the percentage of clearance of the lesion compared to the adjacent normal skin and for the presence af adverse effects. According to these criteria each lesion was assigned a score: poor (0-25%), fair (26-50%), good (51-75%), excellent (76-100%). Results. Immediate response after application of a laser beam with proper characteristics was whitish grey discoloration of treated area. Treatment results after 1-3 months were excellent in 48.1% good 40.9% fair in 8.6% and poor in 2.4%. Patients without prior anaesthesia graded pain during treatment from 1 to 8 (mean 4.0) and patients with EMLA anaesthesia from 1 to 6 (mean 2. 6). Side effects were frequent but minimal and transient. Erythema disappeared in several days after treatment while crusting persisted for 14 days. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Prirojene in pridobljene benigne žilne spremembe kože in podkožja so pogost zdravstveni problem, ki predstavlja estetsko motnjo in neredko psiho-socialni problem. Razvoj laserske tehnologije v zadnjih letih je omogočil učinkovito in varno zdravljenje. V prispevku so opisane najpogostejše benigne žilne nepravilnosti in naše izkušnje pri uporabi sodobnih laserskih naprav za odstranjevanje le-teh. Bolniki in metode. V letih 2002 in 2003 smo z laserskim sistemom Dualis VP® (Fotona d. d., Slovenija), ki združuje KTP in Nd:YAG laserja, zdravili 109 bolnikov, starih od 4 do 80 let (povprečno 39 let) z 210 benignimi kožnimi žilnimi spremembami. Glede na tip kože smo bolnike razvrstili po Fitzpatrickovi razdelitvi v prve štiri razrede. Za zdravljenje žilnih sprememb premera do 1 mm v vrhnjih plasteh kože smo uporabili laser KTP valovne dolžine 532 nm. Za večje in globlje ležeče žilne spremembe smo uporabili laser Nd: YAG valovne dolžine 1064 nm. Bolniki so bolečino med zdravljenjem ocenili na skali od 1 do 10. Uspešnost zdravljenja smo 1-3 mesece po zadnjem zdravljenju ocenili kot spremembo barve glede na sosednjo zdravo kožo ter prisotnost trajnih nezaželenih pojavov ter oceno izboljšanja podali kot: slabo (0-25%), zadovojivo (26-50%), dobro (51-75%), odlično (76-100%). Rezultati. Takojšnji rezultat aplikacije laserskega žarka ustreznih lastnosti je bilo bledo sivo razbarvanje zdravljenega področja. Rezultat zdravljenja po 1-3 mesecih je bil v 48,1% odličen, v 40,9% dober, v 8,6% zadovoljiv ter v 2,4% slab. Bolniki brez anestezije pred posegom so bolečino med zdravljenjem ocenili od 1 do 8 (povprečno 4,0), pri uporabi lokalne anestezije v obliki mazila EMLA pa od 1 do 6 (povprečno 2,0). Stranski učinki so bili pogosti, vendar minimalni in prehodni. Eritem je izginil v nekaj dneh, medtem ko so kraste ostale tudi do 14 dni po zdravljenju. (Izvleček skrajšan pri 2000 znakih).
Descriptors		VASCULAR DISEASES LASER COAGULATION PORT-WINE STAIN GRANULOMA, PYOGENIC HEMANGIOMA TELANGIECTASIS VARICOSE VEINS TREATMENT OUTCOME