AURAN
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LASER TREATMENT FOR SKIN DISEASES- 3 - RESULTS AND DISCUSSION The immediate results of the surgical laser treatment prove a complete disappearance of both benign and malignant lesions. The imediate results of PDT show the complete response of 169 malignances, significant response of 17 malignances was noticed and partial response of 9 malignances turned out to be. As regards 23 port wine staine (PWS) and 10 telangiectasias treated with Copper vapour laser, the results proved to be excellent, the colour of the lesion was similar to the normal skin and no scar formed was found in 7 patients (20 lesions), good cases can be described when the colour of the lesion improved repidly and there was no scar formed in 4 patients (8 lesions), and poor results spoke about themselves the colour of the lesion remained unchanged in 2 patients (5 lesions). The rest 33 patients (40 lesions) who were treated with low power lasers (Helium-Neon and Gold vapour) for biostimulations in order to heal the wounds and regenerate the tissues showed satisfactory results just after 5-10 procedures. During each procedure lesion was irradiated 15-30 minutes with 30-50 mw red light. But most cases were provided with additional therapy (e.g. medicamental treatment). Thus, it is difficult to estimate the efficacy of such treatment. 265 patients with malignant skin lesions (335) treated with CO2 laser were followed up for the period from 4 to 8 years. The average follow up for these patients took 51.2 months. During this period 18 resurrences were established. 345 patients with malignant skin lesions (613) treated with Nd: YAG laser were followed up for the period from 0.5 t< 6 years. The average follows up for these patients was 33.4 months. During this period 7 recurrences were established. 64 patients with malignant skin lesions (195) for whom PDT was applied were followed up for the period from 1 to 7 years. The average follow up for these patients was 35 months. During this period the recurrent disease was noticed in t patients with malignant melanoma, and 7 patients had other malignant diseases. Among all 392 benign skin lesions treated with CO2 laser there were established 12 recurrences 5 hemangiomasa and verrucae. The average follow up was 36.4 months. Among all 1017 benign skin lesions treated with Nd: YAG laser, there were noticed only 6 recurrences: 3 hemangioma and 3 verrucae. The average follows up took 32.4 months. The Copper vapour laser employment for the treatment c vascular pathology has been begun since September 1995. Thus. there are no distant results. There was only one complication of scarring after CO; laser treatment, but scarring took place in 4 patients for whom PDT was applied to and in 12 patients who were treated with Nd:YAG laser. There was no bleeding noticed as laser related complication during Nd:YAG laser destruction or PDT, ever, when vascular pathology was treated. But it should be mentioned that there was bleeding noticed during two procedures of CO2 laser surgery. Our experience as well as the literature data1,2,3,4,5,6,7 assures that each type of the skin lesion requires the treatment of different laser. It depends upon the tissue structure as well as the laser wavelength and light irradiance.
Table 5 and 6 present our experience plus literature data concerning the selection of laser type for various cases of skin lesion tratment.
CONCLUSIONS For treatment of some skin diseases such as hemangiomas, malignant skin tumours (TI-T2), verruces, nevi, keratomas and papillomas, laser improves patient care. Lasers have many technical advantages over the traditional therapies and are associated with higher cine rates better cosmetic results, and more patients satisfaction. The results of laser trestment, especially laser surgery, are dependent on both the skill of the surgeon and the laser equipment The right selection of the laser type for each skin lesion is important in the achievement of the best treatment results. |
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