In young children, benign vascular tumors (VT) are most often manifested as congenital hemangioma and infantile hemangioma. There are considered clinical variants, pathogenesis, evaluation of severity and approaches to assessing the effectiveness of laser surgical treatment for VT in infants. For the first time, there are presented numerical criteria for selecting the optimal laser system to provide the relevant photo-obstruction of the pathological vascular bed, reducing the risk for the development of side effects in the early and remote period after the laser radiation exposure. Comparison of the values of the coefficients of complete absorption of oxyhemoglobin and hemoglobin at different stages of vascular tumor development shows the optimal laser treatment of vascular tumors can be realized by the laser radiation with a wavelength of 578 nm, since it is absorbed to the maximum extent by the main vascular photothermophores - oxyhemoglobin and hemoglobin. Taking into account the features of the angioarchitecture of the pathological vascular bed of the papillary dermis, to prevent the occurrence of petechial hemorrhages (purpura) immediately after the procedure, laser irradiation should be carried out in a pulsed mode with a pulse duration of 15-20 ns. To prevent thermal damage to the reticular layer of the dermis, it is advisable to use a laser pen with a diameter of 0.6-1 mm. The choice of optimal conditions for radiation exposure ensures high efficiency of the laser treatment of vascular tumors, which have been becoming one of the most promising directions in modern hospital-replacing technologies in pediatric laser surgery.
Introduction: Surgical methods for removing eyelid nevus are associated with a risk of developing such side effects as scarring or loss of eyelashes. Although current laser modalities have shown promising results, eyelid laser surgery may cause skin discoloration and noticeable scarring. This study aims at evaluating the efficacy and safety of the dual-wavelengths copper vapor laser (CVL) treatment of eyelid intradermal nevus of Miescher (NM). Patients and Methods: We present three adult female patients with eyelid intradermal nevus treated with CVL. CVL settings were as follows: the average power of 0.6-0.8 W, under a power ratio of 3:2 at wavelengths of 511 nm and 578 nm, exposure time of 0.3 seconds, the light spot diameter of 1 mm. Results: The dual-wavelength CVL treatment of medium- and large-sized NM provides the complete removal of eyelid dome-like NM after one and two sessions with a month interval correspondingly. The duration of skin healing accounted for two weeks. Conclusion: The complete removal of eyelid NM lesions without side effects demonstrates the safety and efficacy of dual-wavelengths CVL in treating such skin lesions. This laser treatment mode of benign skin neoplasms seems promising for dermatologists and cosmetologists’ clinical practice.
Background. Granulomas of the vermilion border of the lips (GVBL); as a complication of lip tattooing; inevitably poses cosmetic problems. Surgical excision and cryodestruction are associated with an increased risk of scarring and recurrence of GVBL. Laser therapy can selectively destroy a pigment and achieve the desired cosmetic result with minimal risk of side effects. So laser treatment was reported to be a more relevant method of treatment of GVBL.
Aim. To evaluate the effectiveness of treatment of GVBL with copper vapor laser (CVL) radiation.
Case report. 39-year-old female patient; without manifestations of systemic sarcoidosis; reported a 2-year history of granulomas of the lips vermilion border. She had a permanent makeup cosmetic tattoo before the onset of granulomas after lip tattooing. Histopathological examination revealed the presence of pigment in the upper and middle layers of the dermis. GVBL treatment was performed using a CVL during a single procedure; with an average CVL power of 0.60.8 W; with a ratio of 3:2 at wavelengths of 511 nm and 578 nm; exposure time 0.3 s. Light spot diameter 1 mm. CVL treatment led to a pronounced elimination of all GVBL without side effects within five years.
Discussion. CVL allows a combined mode of exposure; consisting of grinding large granules of pigment to sizes that can be absorbed by the lymphatic system and suppressing VEGF expression using radiation with a wavelength of 578 nm.
Conclusions. The CVL treatment provided an excellent cosmetic result due to selective photodestruction of the pigment and complete remodeling of the vascular bed associated with GVBL. The high clinical efficiency of eliminating post-tattooing foci of GVBL using CVL without side effects allows us to suggest this method for dermatologists and cosmetologists as a highly effective and inexpensive way to eliminate complications of permanent makeup.
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