Zusammenfassung
Basierend auf der 1916 von Albert Einstein inaugurierten Theorie der stimulierten Emission von Licht wurden in den 1960er-Jahren die ersten Laser entwickelt. Der erste klinische Einsatz eines Lasers in einer Universitätshautklinik in Deutschland erfolgte 1978 in der Dermatologischen Klinik der Ludwigs-Maximilian-Universität München unter der Leitung des damaligen Direktors, Herrn Prof. Dr. med. Dr. h.c. mult. O. Braun-Falco. Seitdem ist eine rasante Weiterentwicklung der Lasermedizin zu verzeichnen. Heute ist die Lasertechnologie eine interdisziplinär genutzte Therapieform, die insbesondere in der Dermatologie klinisch wie auch wissenschaftlich fest verwurzelt ist. Die Behandlung zahlreicher Indikationen der klassischen und auch der ästhetischen Dermatologie erfolgt heute standardmäßig – teilweise ausschließlich – mittels Lasertechnologie. In der vorliegenden Arbeit soll auf aktuelle Entwicklungen der Lasermedizin eingegangen werden. Hier zeichnet sich in der jüngsten Vergangenheit ein Trend zu Kombinationsbehandlungen ab. Mit dem Ziel der Wirkungsverstärkung werden hierbei verschiedene Lichtsysteme komplementär angewendet oder der Laser mit einer dezidierten Arzneimittelapplikation kombiniert.
Abstract
Based on the theory of stimulated emission of radiation that was proposed by Albert Einstein in 1916, the first lasers were developed in the 1960s. The first clinical use of laser technology in a German university took place in 1978 in the Department of Dermatology of the Ludwig-Maximilian-University in Munich under the guidance of the former director, Prof. Dr. med. Dr. h.c. mult. Otto Braun-Falco. In the following years, laser technology developed rapidly. Today laser technology is a widely used interdisciplinary therapeutic procedure that has deep clinical and scientific roots in dermatology. There are many conditions in both classic and aesthetic dermatology that are routinely – and sometimes exclusively – treated with lasers. Here we review recent developments in laser medicine. There seems to be a trend to combination procedures. To enhance efficacy, different laser systems are together or lasers are combined with specific topical medications.
Literatur
Haina D, Landthaler M, Waidelich W (1981) Physikalische und biologische Grundlagen der Laseranwendung in der Dermatologie. Hautarzt 32(8):397–401
Landthaler M, Haina D, Waidelich W (1982) Argonlasertherapie des Adenoma sebaceum. Hautarzt 33(6):340–342
Landthaler M, Haina D, Waidelich W, Braun Falco O (1981) Therapeutische Laseranwendungen in der Dermatologie. Hautarzt 32(9):450–454
Landthaler M, Dorn M, Haina D et al (1983) Morphologische Untersuchungen zur Behandlung von Naevi flammei mit dem Argonlaser. Hautarzt 34(11):548–554
Landthaler M, Haina D, Waidelich W, Braun-Falco O et al (1982) Behandlung zirkumskripter Lymphangiome mit dem Argonlaser. Hautarzt 33(5):266–270
Anderson RR, Parrish JA (1981) Microvasculature can be selectively damaged using dye lasers: a basic theory and experimental evidence in human skin. Lasers Surg Med 1(3):263–276
Anderson RR, Parrish JA (1983) Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 220(4596):524–527
Brunnberg S, Lorenz S, Landthaler M, Hohenleutner U (2002) Evaluation of the long pulsed high fluence alexandrite laser therapy of leg telangiectasia. Lasers Surg Med 31(5):359–362
Hohenleutner S, Badur-Ganter E, Landthaler M, Hohenleutner U (2001) Long-term results in the treatment of childhood hemangioma with the flashlamp-pumped pulsed dye laser: an evaluation of 617 cases. Lasers Surg Med 28(3):273–277
Hohenleutner U, Landthaler M (2002) Laser treatment of childhood haemangioma: progress or not? Lancet 360(9332):502–503
Hohenleutner U, Walther T, Wenig M et al (1998) Leg telangiectasia treatment with a 1.5 ms pulsed dye laser, ice cube cooling of the skin and 595 vs 600 nm: preliminary results. Lasers Surg Med 23(2):72–78
Landthaler M, Hohenleutner U (1990) Laser treatment of congenital vascular malformations. Int Angiol 9(3):208–213
Landthaler M, Hohenleutner U (2006) Laser therapy of vascular lesions. Photodermatol Photoimmunol Photomed 22(6):324–332
Lorenz S, Scherer K, Wimmershoff MB et al (2003) Variable pulse frequency-doubled Nd:YAG laser versus flashlamp-pumped pulsed dye laser in the treatment of port wine stains. Acta Derm Venereol 83(3):210–213
Scherer K, Lorenz S, Wimmershoff M et al (2001) Both the flashlamp-pumped dye laser and the long-pulsed tunable dye laser can improve results in port-wine stain therapy. Br J Dermatol 145(1):79–84
Ulrich H, Baumler W, Hohenleutner U, Landthaler M (2005) Neodymium-YAG Laser for hemangiomas and vascular malformations – long term results. J Dtsch Dermatol Ges 3(6):436–440
Werner A, Baumler W, Zietz S et al (2008) Hereditary haemorrhagic telangiectasia treated by pulsed neodymium:yttrium-aluminium-garnet (Nd:YAG) laser (1,064 nm). Lasers Med Sci 23(4):385–391
Babilas P, Schreml S, Eames T et al (2010) Split-face comparison of intense pulsed light with short- and long-pulsed dye lasers for the treatment of port-wine stains. Lasers Surg Med 42(8):720–727
Klein A, Baumler W, Landthaler M, Babilas P (2011) Laser and IPL treatment of port-wine stains: therapy options, limitations, and practical aspects. Lasers Med Sci 26(6):845–59
Landthaler M, Haina D, Seipp W et al (1987) Zur Behandlung von Naevi flammei mit dem Argon-Laser. Hautarzt 38(11):652–659
Landthaler M, Hohenleutner U, Abd el Raheem TA (1995) Therapy of vascular lesions in the head and neck area by means of argon, Nd: YAG, CO2 and flashlamp-pumped pulsed dye lasers. Adv Otorhinolaryngol 49:81–86
Babilas P, Schreml S, Szeimies RM, Landthaler M (2010) Intense pulsed light (IPL): a review. Lasers Surg Med 42(2):93–104
Wlotzke U, Hohenleutner U, Abd-El-Raheem TA et al (1996) Side-effects and complications of flashlamp-pumped pulsed dye laser therapy of port-wine stains. A prospective study. Br J Dermatol 134(3):475–480
Renfro L, Geronemus RG (1993) Anatomical differences of port-wine stains in response to treatment with the pulsed dye laser. Arch Dermatol 129(2):182–188
Babilas P, Shafirstein G, Baumler W et al (2005) Selective photothermolysis of blood vessels following flashlamp-pumped pulsed dye laser irradiation: in vivo results and mathematical modelling are in agreement. J Invest Dermatol 125(2):343–352
Trelles MA, Weiss R, Moreno-Moragas J et al (2010) Treatment of leg veins with combined pulsed dye and Nd:YAG lasers: 60 patients assessed at 6 months. Lasers Surg Med 42(9):609–614
Jia W, Sun V, Tran N et al (2010) Long-term blood vessel removal with combined laser and topical rapamycin antiangiogenic therapy: implications for effective port wine stain treatment. Lasers Surg Med 42(2):105–112
Nelson JS, Jia W, Phung TL, Mihm MC Jr (2011) Observations on enhanced port wine stain blanching induced by combined pulsed dye laser and rapamycin administration. Lasers Surg Med 43(10):939–942
Loewe R, Oble DA, Valero T et al (2010) Stem cell marker upregulation in normal cutaneous vessels following pulsed-dye laser exposure and its abrogation by concurrent rapamycin administration: implications for treatment of port-wine stain birthmarks. J Cutan Pathol 37(Suppl 1):76–82
Morice MC, Serruys PW, Sousa JE et al (2002) A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med 346(23):1773–1780
Saunders RN, Metcalfe MS, Nicholson ML (2001) Rapamycin in transplantation: a review of the evidence. Kidney Int 59(1):3–16
Guba M, Breitenbuch P von, Steinbauer M et al (2002) Rapamycin inhibits primary and metastatic tumor growth by antiangiogenesis: involvement of vascular endothelial growth factor. Nat Med 8(2):128–135
Kwon YS, Hong HS, Kim JC et al (2005) Inhibitory effect of rapamycin on corneal neovascularization in vitro and in vivo. Invest Ophthalmol Vis Sci 46(2):454–460
Babilas P, Shafirstein G, Baier J et al (2007) Photothermolysis of blood vessels using indocyanine green and pulsed diode laser irradiation in the dorsal skinfold chamber model. Lasers Surg Med 39(4):341–352
Shafirstein G, Moreno M, Klein A et al (2011) Treatment of leg veins with indocyanine green and lasers investigated with mathematical modelling. Int J Hyperthermia 27(8):771–781
Lorenz S, Brunnberg S, Landthaler M, Hohenleutner U (2002) Hair removal with the long pulsed Nd:YAG laser: a prospective study with one year follow-up. Lasers Surg Med 30(2):127–134
Raff K, Landthaler M, Hohenleutner U (2004) Optimizing treatment parameters for hair removal using long-pulsed Nd:YAG-lasers. Lasers Med Sci 18(4):219–222
Wimmershoff MB, Scherer K, Lorenz S et al (2000) Hair removal using a 5-msec long-pulsed ruby laser. Dermatol Surg 26(3):205–210
Cameron H, Ibbotson SH, Dawe RS et al (2008) Within-patient right-left blinded comparison of diode (810 nm) laser therapy and intense pulsed light therapy for hair removal. Lasers Med Sci 23(4):393–397
McGill DJ, Hutchison C, McKenzie E et al (2007) A randomised, split-face comparison of facial hair removal with the alexandrite laser and intense pulsed light system. Lasers Surg Med 39(10):767–772
Lask G, Friedman D, Elman M et al (2006) Pneumatic skin flattening (PSF): a novel technology for marked pain reduction in hair removal with high energy density lasers and IPLs. J Cosmet Laser Ther 8(2):76–81
Xia Y, Moore R, Cho S, Ross EV (2010) Evaluation of the vacuum-assisted handpiece compared with the sapphire-cooled handpiece of the 800-nm diode laser system for the use of hair removal and reduction. J Cosmet Laser Ther 12(6):264–268
Manstein D, Herron GS, Sink RK et al (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34(5):426–438
Babilas P, Schreml S, Eames T et al (2011) Experience with non-ablative fractional photothermolysis with a dual-mode laser device (1,440/1,320 nm): no considerable clinical effect on hypertrophic/acne scars and facial wrinkles. Lasers Med Sci 26(4):473–479
Karsai S, Czarnecka A, Junger M, Raulin C (2010) Ablative fractional lasers (CO(2) and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytides. Lasers Surg Med 42(2):160–167
Ortiz AE, Tremaine AM, Zachary CB (2010) Long-term efficacy of a fractional resurfacing device. Lasers Surg Med 42(2):168–170
Munavalli GS, Turley A, Silapunt S, Biesman B (2011) Combining confluent and fractionally ablative modalities of a novel 2790 nm YSGG laser for facial resurfacing. Lasers Surg Med 43(4):273–282
Shin J, Lee JS, Hann SK, Oh SH (2012) Combination treatment by 10,600 nm ablative carbon dioxide fractional laser and narrow band UVB in refractory non-segmental vitiligo: a prospective, randomized half-body comparative study. Br J Dermatol 166(3):658–661
Babilas P, Schreml S, Landthaler M, Szeimies RM (2010) Photodynamic therapy in dermatology: state-of-the-art. Photodermatol Photoimmunol Photomed 26(3):118–132
Babilas P, Szeimies RM (2010) The use of photodynamic therapy in dermatology. G Ital Dermatol Venereol 145(5):613–630
Steinbauer JM, Schreml S, Kohl EA et al (2010) Photodynamic therapy in dermatology. J Dtsch Dermatol Ges 8(6):454–464
Park MY, Sohn S, Lee ES, Kim YC (2010) Photorejuvenation induced by 5-aminolevulinic acid photodynamic therapy in patients with actinic keratosis: a histologic analysis. J Am Acad Dermatol 62(1):85–95
Xi Z, Shuxian Y, Zhong L et al (2011) Topical 5-aminolevulinic acid with intense pulsed light versus intense pulsed light for photodamage in Chinese patients. Dermatol Surg 37(1):31–40
Clementoni MT, B-Roscher M, Munavalli GS (2010) Photodynamic photorejuvenation of the face with a combination of microneedling, red light, and broadband pulsed light. Lasers Surg Med 42(2):150–159
Forster B, Klein A, Szeimies RM, Maisch T (2010) Penetration enhancement of two topical 5-aminolaevulinic acid formulations for photodynamic therapy by erbium:YAG laser ablation of the stratum corneum: continuous versus fractional ablation. Exp Dermatol 19(9):806–812
Haedersdal M, Sakamoto FH, Farinelli WA et al (2010) Fractional CO(2) laser-assisted drug delivery. Lasers Surg Med 42(2):113–122
Lee WR, Shen SC, Al-Suwayeh SA et al (2010) Laser-assisted topical drug delivery by using a low-fluence fractional laser: imiquimod and macromolecules. J Control Release 153(3):240–248
Klein A, Szeimies, RM, Bäumler W et al (2012) Indocyanine green-augmented diode laser treatment of port wine stains: clinical and histological evidence for a new treatment option from a randomized controlled trial (RCT). Br J Dermatol (im Druck)
Klein A, Bäumler W, Koller M et al (2012) Indocyanine green-augmented diode laser therapy of telangiectatic leg veins: a randomized controlled proof-of-concept trial. Lasers Surg Med (im Druck)
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Babilas, P., Landthaler, M. Neue Entwicklungen in der Lasertherapie. Hautarzt 63 (Suppl 1), 59–66 (2012). https://doi.org/10.1007/s00105-011-2297-4
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DOI: https://doi.org/10.1007/s00105-011-2297-4