Der gütegeschaltete Rubinlaser in der Dermatotherapie

Abstract

The Q-switched ruby laser (QSRL) with its wavelength of 694 nm and a pulse duration of around 40 nsec is an effective modality for the removal of tattoos and cutaneous pigmented lesions. Based on the principle of selective photothermolysis, selective damage to cutaneous pigment or pigmented cells is possible, allowing the scar-free elimination of endogenous or exogenous pigment in the skin. Main indications for the treatment with the QSRL are tattoos (amateur, professional, accidental, or cosmetic) and lentigines but the QSRL can also be used for lightening or even removing other pigmented lesions such as nevus spilus or café au lait macules. Furthermore, pigmented lesions of mucous membranes can be removed easily. Since treatment results in postinflammatory hyperpigmentation, myoplasma, and Becker' nevus have proven to be inconsistent, the QSRL cannot be routinely recommended for these lesions. Melanocytic lesions are generally not treated, with the exception of nevus of Ota and nevus of ito where there exacts a lack of therapeutic alternatives. Non-pigmented cells, which exist in nearly all melanocytic lesions, do not absorb the light of the QSRL and, therefore, do not react to this particular treatment. No information is available on the risk of partially damaged cells to become malignant after QSRL treatment. The QSRL is an excellent therapy for the removal of endogenous and exogenous pigment because of both the excellent treatment results and the lack of side effects, which are limited to transient hypo- and hyperpigmentation. The QSRL has occurred a wide range of applications within the field of dermatology.

Fraktionierte Photothermolyse

“…B. [23,30,51,54]); zudem besteht das Risiko von lang anhaltenden oder sogar persistierenden Hyperpigmentierungen [28,54] …”

Pseudo-Melanoma after Laser Therapy

“…Treatment with an alexandrite laser, Q-switched ruby laser or neodymium: YAG laser can eliminate superficial melanocytes [15, 16, 17, 18, 19, 20, 21]. However, these laser devices are unable to destroy deeper melanocytic nests [18, 20, 21].…”

“…Especially for pigmented lesions this development [8, 14, 15, 16, 17, 18] is accompanied by significant dangers for the patient. The exact clinical classification of a pigmented lesion even by an experienced dermatologist who is also applying dermatoscopy carries a significant risk of clinical misdiagnosis.…”

Entfernung von Tätowierungen mit dem gütegeschalteten Rubinlaser (694 nm) und dem gütegeschalteten Nd:YAG-Laser (532 und 1064 nm)

“…Reid et al konnten somit 1983 über die erfolgreiche Entfernung schwarzer Tattoos mit dem gütegeschalteten Rubinlaser berichten [31]. Das rote Licht des gütegeschalteten Rubinlasers (694 nm; 25 bis 40 ns) wird gut von schwarzen und grünen Fremdpigmenten sowie vom körpereigenen Melanin absorbiert, wodurch ein relativ großes Indikationsspektrum möglich wird, jedoch auch die Gefahr ungewollter Nebeneffekte (Pigmentstörungen) besteht [10,19,25, 26,[28][29][30].Der gütegeschaltete Nd:YAG (Neodym: Yttrium-Aluminium-Granat)-Laser hingegen emittiert infrarotes Licht (1064 nm) mit einer Impulsdauer zwischen 5 und 20 ns. Diese höheren WelDas Tragen dekorativer Tätowierun-gen gewinnt unabhängig vom sozialen Status seit den letzten Jahren zunehmend an Popularität, nicht zuletzt erkennbar an den zahlreichen Tattoo-Studios.…”