R963山田裕道様.indd

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1 The Laser Application to Dermatology Hiromichi YAMADA Department of Dermatology, International Goodwill Hospital, Nishigaoka, Izumi-Ku, Yokohama, Kanagawa Received August 16, 2010 Laser therapy in dermatology was developed with the appearance of Q-switched lasers, having a nanosecond-domain pulse width, and a flash lamp-pumped pulse dye laser, having a microsecond domain pulse width. This follows the induction of the idea of photothermolysis by Dr. Anderson. Q-switched ruby laser and Q-switched alexandrite laser were used for the treatment of dermal melanocytosis such as Nevus Ota and abberant Mongolian spots. Flash lamp-pumped pulse dye laser was used for the treatment of haemangiomas such as portwine stain nevus and strawberry mark. Long pulse alexandrite laser, having a milisecond-domain pulse width, was used for the treatment of basal pigmentation, such as lentigo senilis and ephelides, hair removal and cosmetic therapy. A new concept of skin laser device, called fractional photothermolysis, is designed to create microscopic thermal wounds to achieved skin rejuvenation. Carbon dioxide fractional laser provides remarkable results, as well, in improving acne scars and skin texture. Key Words: Q-switched ruby laser, Q-switched alexandrite laser, Flash lamp-pumped pulse dye laser, Long pulse alexandrite laser, Carbon dioxide fractional laser Maiman Bridges Patel 3 CO nm 488 nm nm CO nm Anderson 5 Selective photothermolysis Q 1 96

2 Special Issue 2 3 selective photothermolysis 2 thermal relaxation time Fig Dermal melanocytosis Q Q 630 nm 694 nm 755 nm 694 nm 755 nm 50 nsec Q20 50 nsec Argon 1 3 Q Q 4 portwine stain nm 450 μsec 418 nm 542 nm 577 nm nm 585 nm 595 nm 480 μsec 480 μsec 2 5 Fig. 1 Optical absorption spectrum. 694 nm 755 nm

830 nm follicular stem cell follicular stem cell thermal relaxation time 40 100 msec 3 10 msec 10 50 msec 5 30 msec 10 40 J/cm 2 LPIRGentleLASE 2 20 msec 3 msec on-off

After three months with one treatment of the long pulse alexandrite laser. The lentigo senilis has almost disappeared. 9 10.6 μm 3 10 11 12 Fig.

3 830 nm follicular stem cell follicular stem cell thermal relaxation time msec 3 10 msec msec 5 30 msec J/cm 2 LPIRGentleLASE 2 20 msec 3 msec on-off 3 msec 20 msec 6 Q 1 2 GentleLASE755 nm 3 msec 6 40 J/cm 2 off 7 Fig. 2 Fig. 2 Seventy-four year-old female with lentigo senilis. Before treatment. After three months with one treatment of the long pulse alexandrite laser. The lentigo senilis has almost disappeared μm Fig nm60 mw 150 mw 1000 mw nm Fig. 3 Five days after birth with polydactyly. Before treatment. After six weeks using CO 2 laser excision. The edge of excision has already re-epitherilized.

Special Issue Fig. 4 Sixteen year-old female with granuloma teleangiectagia. Before treatment.

9 LLLT24 % 41 % 13 % LLLT 78 % 21 LLLT Fig. 5 Sixteen year-old female with epidermal nevus. Before treatment.

6 Ninety-six year-old female with squamous cell carcinoma. Before treatment. After 4 months using CO 2 laser excision.

4 Special Issue Fig. 4 Sixteen year-old female with granuloma teleangiectagia. Before treatment. After one month using CO 2 laser excision. 8.1 LLLT Ca-ATPase 17 18,19 Stellate ganglion block: SGB LLLT24 % 41 % 13 % LLLT 78 % 21 LLLT Fig. 5 Sixteen year-old female with epidermal nevus. Before treatment. After nine weeks with CO 2 laser abration. Epidermal nevus has almost disappeared. Fig. 6 Ninety-six year-old female with squamous cell carcinoma. Before treatment. After 4 months using CO 2 laser excision. The surface of excision has already re-epitherilized. 10 W 4 low reactive level laser therapy: LLLT 13,14 15 LLLT Chow 16 LLLT Lancet 8.2 LLLT LLLT Aδ C 22,23 C LLLT LLLT % 75.0/ % 87.5 % 15 LLLT nm 3 msec J/cm 2 on Fig

Fig. 7 Sevnty-one year-old female treated with Laser Facial. Before treatment. After four months with six treatments of the long pulse alexandrite laser. The wrinkling of the skin has decreased. 9.

5 Fig. 7 Sevnty-one year-old female treated with Laser Facial. Before treatment. After four months with six treatments of the long pulse alexandrite laser. The wrinkling of the skin has decreased. 9.2 micro laser beam mm 1 cm burn-like thermal damage micro laser beam ice pick scarskin texture Nd-YAG 1440 nm Er-Glass 1550 nm 25 CO μm Er-YAG 2940 nm2 micro laser beam non-ablative fractional resurfacing 2 micro laser beam ablative fractional resurfacing CO 2 CO Q nm 755 nm 1 Q Q 1 1 T. H. Maiman: Nature 187 (1960) W. B. Bridges: Appl. Phys. Lett. 4 (1964) C. N. Patel: Sci. Am. 219 (1966) R. R. Anderson and J. A. Parish: Science 220 (1983) D. M. Cauger: Aesthetic trends & technologies 3 (2004) issue K. Hira, H. Yamada, Y. Takahashi, and H. Ogawa: European Academy of Dermatlogy and Venereology 16 (2002) H. Yamad and H. Ogawa: Laser Therapy 7 (1995) R. T. Chow, M. I. Johnson, R. AB. Loopes-Martins, and J. M. Bjordal: Lancet 374 (2009) Y. Maegawa, T. Itoh, T. Hosokawa, K. Yaegashi, and M. Nishi: Lasers in Surgery and Medicine 27 (2000) A. Miura and M. Kawatani: Pain Res. 11 (1996) K. Jimbo, K. Noda, K. Suzuki, and K. Yoda: Neurosci Lett. 240 (1998) T. Hashimoto, O. Kenmotsu, H. Otsuka, and R. Numazawa: Laser Theray 9 (1997) K. Tsuchiya, M. Kawatani, C. Takeshige, and T. Sato: Neuroscience Letters 161 (1993)

Comparative Studyof Q-switched Nd: YAG Laser and Q-switched Ruby Laser Treatments for Deep-seated Ota's Nevus Takashi Suzuki, M.D.*1, Kenji Hosaka, M.

Comparative Studyof Q-switched Nd: YAG Laser and Q-switched Ruby Laser Treatments for Deep-seated Ota's Nevus Takashi Suzuki, M.D.*1, Kenji Hosaka, M.D.*2, Kaoru Aihara, M.D.*3 *1 Nevus Research Center