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Current Therapy of Skin Laser Surgery Takeshi SHIMBASHI * (Received July 15, 1996) It has been remarkably progressed in cutaneous laser surgery. Anderson elucidated the theory of selected photothermolysis and the most selective target destruction is achieved. Now it is possible to get good clinical result in treating of dermal melanocytosis which is not easy to be treated well. Key Words: Selective photothermolysis, Ultrapulse CO2 laser, Laser, Q-switched alexandrite laser, Q-switched Nd:YAG Laser *Dept. Plast & Reconstr. Surg. The Skin Laser Center The Jikei University School of Medicine (3-25-8 Nishishimbashi, Minato-ku, Tokyo 105)

Fig. 1 Portwine stain, a) before surgery, and b) after surgery by dye laser (SPTL1-b). Fig. 2 Nevus of Ota, a) before surgery, and b) after surgery by Q-switched ruby laser.

Fig. 5 Cafe-au lait macule, a) before surgery, and b) after surgery by Q-switched ruby laser. Fig. 3 Decorative tattoo, a) before surgery, and b) after surgery by Q-switched ruby laser. Fig. 6 Nevocellular nevus, a) before surgery, and b) after surgery by Q-switched ruby laser. Fig. 4 Senile freckle, a) before surgery, and b) after surgery by Q-switched ruby laser.

3) M. P. Goldman and R. E. Fitzpatrick: Treatment of cutaneous vascular lesions. Cutaneous Laser Surgery (Mosby, St. Louis, 1994). 4) R. R. Anderson: Laser tissue interaction. Cutaneous Laser Surgery (Mosby, St. Louis, 1994). 5) R. E. Fitzpatrick, M. P. Goldman and J. Ruiz- Esparza: J. Dermatol. Surg. Oncol. 20 (1994) 449. 6) R. E. Fitzpatrick and M. P. Goldman: Clinics in Dermatology 13 (1995) 35. 7) T. Shimbashi and T. Kojima: Aesth. Plast. Surg. 19 (1995) 225. 8) S. L. Kilmer, R. G. Wheeland, D. J. Goldberg and R. R. Anderson: Arch Dermatol. 130 (1994) 1515. 9) J. B. Mulliken: Classification of vascular birthmarks. Vascular birthmarks, hemangiomas and malformations (Saunders, Philadelphia, 1988). 10) M. P. Goldman and R. E. Fitzpatrick: Treatment of cutaneous vascular lesions. Cutaneo us Laser Surgery (Mosby, St. Louis, 1994). 11) O. T. Tan, J. M. Carney, R. Margolis, Y. Seki, J. B. Meng and R. R. Anderson: Arch Dermatol. 122 (1986) 1016. 12) 0. T. Tan and T. J. Stafford: Perspectives in Plastic Surgery 3 (1989) 145. 15) J. S. Dover, R. J. Margolis, L. L. Polla, S. Watanabe, G. J. Hruza, J. A. Parrish and R. R. Anderson: Arch Dermatol. 125 (1989) 43. 17) M. J. Murphy and M. Y. Huang: Ann. Acad. Med. Singapore 23 (1994) 60. 19) C. R. Taylor, T. J. Flotte, R. W. Gange and R. R. Anderson: J. Am. Acad. Dermatol. 30 (1994) 743. 1) R. R. Anderson and J. A. Parish: Science. 220 21) Y. Tse, V. J. Levine, S. A. McClain and R. (1983) 524. Ashinoff: J. Dermatol. Surg. Oncol. 20 (1994) 795. 2) R. R. Anderson and J. A. Parish: J. Invest. Dermatol. 77 (1981) 13.

E. Gonzalez, N. Michaud and R. R. Anderson: Arch Dermatol. 126 (1990) 893. 36) A. Scheibner, G. Kenny, W. White and R. G. Wheeland: J. Dermatol. Surg. Oncol. 16 (1990) 1091. 26) C. R. Taylor and R. R. Anderson: Int. J. Dermatol. 37) R. E. Fitzpatrick, M. P. Goldman and J. Ruiz- 32 (1993) 908. Esparza: J. Am. Acad. Dermatol. 28 (1993) 745. 27) D. J. Goldberg: J. Dermatol. Surg. Oncol. 19 38) R. E. Fitzpatrick and M. P. Goldman: Arch (1993) 376. 28) J. S. Nelson and J. Applebaum: Ann. Plast. Surg. 29 (1992) 231. Dermatol. 130 (1994) 1508. 39) S. E. Dozier, D. G. Diven, D. Jones, M. Brysk, R. L. Sanchez and M. Motamedi: Dermatol. Surg. 21 (1995) 237. 40) T. J. Stafford, R. Lizek and 0. T. Tan: Lasers Surg. 30) R. E. Fitzpatrick, M. P. Goldman and J. Ruiz- Med. 17 (1995) 32. Esparza: J. Dermatol. Surg. Oncol. 18 (1993) 341. 31) J. H. Scheepers and A. A. Quaba: British J. Plast. Surg. 46 (1993) 247. 32) T. S. Alster: Plast. Reconstr. Surg. 96 (1994) 1660. 33) T. J. Stafford, Ot. tan: Clinics Dermatol. 13 (1995) 69. 41) T. S. Alster: J. Am. Acad. Dermatol. 33 (1995) 69. 42) B. D. Zelickson, D. A. Mehregan and A. A. Zarrin: Lasers Surg. Med. 15 (1994) 364. 43) S. L. kilmer and R. R. Anderson: J. Dermatol. Surg. Oncol. 19 (1993) 330. 34) R. C. Grekin, R. M. Shelton, J. Geisse and I. 44) G. J. Rosenberg and R. 0. Gregory: Clinics in Plastic Frieden: J. Dermatol. Surg. Oncol. 19 (1993) 380. Surgery 23 (1996) 29. 35) C. R. Taylor, R. W. Gange, J. S. Dover, T. J. Flotte,