585nm脉冲染料激光治疗儿童传染性软疣的临床观察

Childhood molluscum contagiosum treated with 585 nm pulsed dye laser: a clinical observation

目的 探讨585 nm脉冲染料激光治疗儿童传染性软疣的有效性和安全性.方法 对2016年9月至2017年2月于淄博市妇幼保健院就诊并确诊为传染性软疣的50例患儿,用585 nm脉冲染料激光治疗,能量6.0~9.0 J/cm2,脉宽0.5 ms,光斑5mm.若治疗1次未愈,1个月后再次行激光治疗;若连续≥2次激光治疗后皮损消退<30%,则停止治疗.随访6个月,根据皮损消退情况评估临床疗效,并记录不良反应与复发情况等.结果 所有患儿完成本研究.术后痊愈44例(88%),有效率为94% (47例),其中治疗1次痊愈32例(64%).术后即刻可出现紫癜,短期内有色素沉着、色素减退等,无明显远期不良反应.随访发现,治疗后已脱落的疣体同一部位均未新发疣体.结论 脉冲染料激光治疗传染性软疣安全、有效,耐受性好.

Objective To evaluate the efficacy and safety of 585 nm pulsed dye laser for the treatment of molluscum contagiosum in children.Methods Between September 2016 and February 2017,50 children with confirmed molluscum contagiosum were enrolled from Maternal and Child Health Care Hospital of Zibo.These children were treated with 585 nm pulsed dye laser at energy of 6.0-9.0 J/cm2,pulse width of 0.5 ms and spot size of 5 mm.If a patient was not cured after 1 session of the laser treatment,another session of the laser treatment would be performed 1 month after the first treatment.If the proportion of regressed skin lesions was less than 30% after more than 2 consecutive sessions of the laser treatment,the treatment would be stopped.After the treatment,the patients were followed up for 6 months.During the follow-up,clinical efficacy was evaluated according to regression of skin lesions,and adverse reactions and recurrence were recorded.Results All the patients completed the trial.After the treatment,44 (88%)patients were cured,and the response rate was 94% (47/50).After 1 session of the treatment,32 (64%)patients were cured.After the laser treatment,purpura occurred instantly,hyperpigmentation and hypopigmentation occurred in a short-term period,and no obvious long-term adverse reactions were observed.During the follow-up,no new wart was found at the site of regressed warts after the treatment.Conclusion The 585 nm pulsed dye laser shows good efficacy,safety and tolerance in the treatment of molluscum contagiosum.