Q-switched Ruby Laser Research Articles

フラクショナルQ スイッチルビーレーザーの展望

フラクショナルQ スイッチルビーレーザーの展望

Comparison of the Q-switched ND: YAG and ruby lasers in treating semi-permanent make up

Background: Lasers based on the principle of selective photothermolysis are now being used to remove semi-permanent make up with various outcomes. Choosing the right laser for the specific semi-make up color is necessary for successful outcome. Objectives: The purpose of this study was to compare the effect of Q-switched Nd:YAG laser and Q- switched Ruby laser irradiation on black color semi- permanent make up on rat skin. And, in order to set a guideline for the black color semi-permanent make. Methods: Six black artificial tattoos on rat skin were treated with two kinds of Q-switched lasers: a Medlite II Biomedical Q-switched Nd:YAG laser (1064nm, 20 nanoseconds, 2.0mm spot size, 6J/cm2) and Melastar Q-switched Ruby laser (694nm, 40 nanoseconds, 2.5mm spot size, 8-10 J/cm2). The authors used each lasers to irradiate pair of artificial tattoos on the same day of semi-permanent make up, 3 days after, 5 days after, 1 week after, 3 weeks after and 5 weeks after. Each artificial tattoos were irradiated 6 times. Then, checked the pigment level of laser irradiated sites with Mexameter® Pigmentation probe. And obtained the sample of tissue after 6 times irradiation. Results: Overall, the Q-switched Nd:YAG laser had a significant difference in semi-permanent make up lightening compared to the Q-switched ruby laser according to RMI and histopathological result. Conclusion: The Q-switched Nd:YAG laser was slightly superior to the Q-switched ruby laser on removing black semi-permanent make up.

Commentary on a Prospective Trial Comparing Q-Switched Ruby Laser and a Triple Combination Skin-Lightening Cream in the Treatment of Solar Lentigines.

Commentary on a Prospective Trial Comparing Q-Switched Ruby Laser and a Triple Combination Skin-Lightening Cream in the Treatment of Solar Lentigines.

老人性色素斑に対するレーザー治療に伴う炎症後色素沈着の発症についての後ろ向き研究：Qスイッチルビーレーザーと半波長QスイッチNd:YAGレーザーの比較

老人性色素斑に対するレーザー治療に伴う炎症後色素沈着の発症についての後ろ向き研究：Qスイッチルビーレーザーと半波長QスイッチNd:YAGレーザーの比較

Laser treatment of congenital melanocytic nevi: a review of the literature.

Congenital melanocytic nevi (CMN) are nevi that are present from birth and occur in approximately 1% of newborns. CMN may be cosmetically disfiguring and are at risk for malignant transformation. For these two reasons, CMN are frequently treated. A variety of treatment modalities have been utilized with variable efficacy, including excision, dermabrasion, curettage, chemical peels, radiation therapy, cryotherapy, electrosurgery, and lasers. The current treatment of choice for CMN is surgical excision. However, some CMN occur in cosmetically sensitive areas, where a surgical scar is less acceptable, or in inoperable locations. For these reasons, there has been increasing interest in the potential for laser treatment of CMN. The lasers that have been studied to date for the treatment of CMN include pigment-specific lasers, including ruby (694nm), alexandrite (755nm), and Nd:yttrium aluminum garnet (YAG) (1064nm), as well as ablative laser treatment with CO2 laser (10,600nm) and Er:YAG (2940nm). To date, ruby lasers have been studied most extensively in the treatment of CMN. Ruby laser has been shown to improve the cosmetic appearance of some CMN and may be cautiously considered for lesions located in cosmetically sensitive areas that are less amenable to surgical excision. For very large CMN, ruby laser has been tried as an alternative to extensive surgical and grafting procedures. Dual treatment with Q-switched ruby laser and normal mode ruby laser may provide the best outcomes; however, multiple treatment sessions should be anticipated. The practicality and expense of multiple treatments should be discussed with the patient prior to initiating treatment. Importantly, because of the persistence of dermal nevus cells, lifelong follow-up is required for all laser-treated CMN, even those with excellent cosmetic effect.

Synergy Effect of Combination of Fractional CO2 and Fractional Q-switched Ruby Laser Treatment for Skin Rejuvenation

Synergy Effect of Combination of Fractional CO2 and Fractional Q-switched Ruby Laser Treatment for Skin Rejuvenation

Adult onset dyschomatosis universalis.

Dear Editor: Dyschromatosis universalis hereditaria (DUH) is a rare hereditary skin disorder that is characterized by a mixture of small and irregularly sized hyperpigmented and hypopigmented macules of a mottled or reticulated pattern. The usual onset age of DUH is 6 years1. The common pattern of inheritance is generally autosomal dominant; however, rarely, a few cases show a sporadic pattern. Some authors named this form as dyschromatosis universalis (DU) instead of DUH2. We report a case of DU in a 29-year-old female patient with no family history and a late onset of the disease. A 29-year-old Korean woman presented with asymptomatic multiple pinhead to rice sized mottled hypopigmented macules with diffuse hyperpigmented patches on the abdomen and left upper arm (Fig. 1A). The hyperpigmented lesions, which had been noted 1 year previously, started initially on the abdomen and gradually spread to the left upper arm. She has no history of systemic disease or any previous cutaneous disease. She also denied any family history of skin discoloration or similar skin lesions. Fig. 1 (A) Multiple pinhead to rice sized mottled hypopigmented macules with diffuse hyperpigmented patches. (B) A closer view. (C) A biopsy specimen taken from a hyperpigmented lesion on the abdomen showed increased abundant melanin pigments in the epidermis ... A biopsy specimen taken from the hyperpigmented lesion on the abdomen showed increased abundant melanin pigments in the epidermis, with normal number and distribution of melanocytes on hematoxylin-eosin, Fontana Masson, and MART-1 stainning (Fig. 1B). In contrast, the histopathologic finding of a hypopigmented macule suggested a reduced amount of melanin pigments in the lesion area (Fig. 1C). On the basis of these findings, the diagnosis was concluded to be DU. We recommended treatment with Q-switched Nd:YAG laser for the hyperpigmented lesions; however, she refused the therapy. She has been followed without any changes. Rycroft et al.3 reported a case with no family history, but was associated with short stature and high tone deafness. In addition, Shono amd Toda4 reported a case with no family history and associated with photosensitivity and a neurosensory hearing defect. Also, Kim et al.2 reported a case that occurred in the patient at age 20 years, with a sporadic pattern and with no comorbid conditions. Some authors suggest that DU is a more appropriate name for the sporadic cases rather than DUH2. DU should be differentiated from other conditions showing both hyperpigmentation and hypopigmentation, such as generalized Dowling-Degos disease, xeroderma pigmentosum, dyskeratosis congenita and chronic radiodermatitis. DU generally does not involve a family history and present only dyschromatosis without systemic disorder. Various therapeutic trials, such as psoralen and ultraviolet A irradiation, thin split-thickness skin autograft, and Q-switched ruby laser have been tried to treat these lesions; however, there is no definitely effective treatment for both hyperpigmented and hypopigmented lesions. Recently, Kim et al.5 reported that they successfully treated the hyperpigmented lesions of DUH with a Q-switched Nd:YAG laser. Only a few cases of DU have been reported worldwide, and we could find only three cases in the Korean literature (Table 1)2,3,4. Particularly, adult-onset DU like our case is very unusual. Thus, we here report a case of DU occurring in a 29-year-old female patient with no family history. Table 1 Reported cases of dyschromatosis universalis in global literatures (including Korea)

Current Concepts in Aesthetic Laser Medicine: The 694-Nm Q-Switched Ruby-Laser

Quality-switched (q-switched) laser systems are the gold standard for the treatment of benign pigmented lesions and tattoo removal. A frequently used system is the q-switched ruby laser that emits monochromatic light at the wavelength of 694 nm. This system is used for the removal of age spots (senile lentigines), seborrhoeic keratosis, tattoos, and other dyschromatoses. The increasing need for the removal of, for example, age spots and unwanted tattoos, reflects both the wish of our ageing society to preserve a youthful appearance and the steadily growing prevalence of tattoos. This review highlights the potential, limitations, and novel treatment concepts of using q-switched ruby laser systems.

Fractional CO2 laser is as effective as Q-switched ruby laser for the initial treatment of a traumatic tattoo

Background and objective: Q-switched laser treatments are considered the standard method for removing both regular and traumatic tattoos. Recently, the removal of tattoo ink using ablative fractional lasers has been reported. Ablative fractional CO2 laser and q-switched ruby laser treatments were used in a split-face mode to compare the safety and efficacy of the two types of laser in removing a traumatic tattoo caused by the explosion of a firework. Study design/Patients and methods: A male patient suffering from a traumatic tattoo due to explosive deposits in his entire face was subjected to therapy. A series of eleven treatments were performed. The right side of the face was always treated using an ablative fractional CO2 laser, whereas the left side was treated only using a q-switched ruby laser. Results: After a series of eleven treatments, the patient demonstrated a significant lightening on both sides of his traumatic tattoo, with no clinical difference. After the first six treatments, the patient displayed greater lightening on the right side of his face, whereas after another five treatments, the left side of the patient's face appeared lighter. No side effects were reported. Conclusions: In the initial stage of removing the traumatic tattoo, the ablative fractional laser treatment appeared to be as effective as the standard ruby laser therapy. However, from the 6th treatment onward, the ruby laser therapy was more effective. Although ablative fractional CO2 lasers have the potential to remove traumatic tattoos, they remain a second-line treatment option.

Q-switched laser depigmentation in vitiligo, most effective in active disease

In widespread vitiligo, when repigmentation therapies are no longer feasible, Q-switched lasers can be used to remove the remaining disfiguring pigmentation. However, little literature is available on the long-term effects of Q-switched laser treatment in patients with vitiligo, and the variables influencing the effect of treatment are unknown. To evaluate retrospectively the effectiveness, safety and patient satisfaction of Q-switched ruby (QSR) laser-induced depigmentation in widespread vitiligo. We performed a retrospective study on well-documented patients with vitiligo with widespread lesions who received depigmentation therapy with the QSR laser between 2000 and 2012 in our institute. Eligible patients were asked to visit our institute for assessment of depigmentation and to fill in a questionnaire on patient satisfaction and disease variables. After a mean follow-up of 13 months, 48% of the 27 included patients showed > 75% depigmentation. Patients with active disease at the time of treatment had significantly better results than patients with stable disease (P < 0·05). Twenty-three (85%) patients were satisfied after treatment. Eighteen patients (67%) reported temporary side-effects after treatment. None of the patients reported adverse effects, such as scars or infections. Q-switched ruby laser therapy is effective in approximately half of patients treated; it is a safe treatment with a high patient satisfaction. Patients with active vitiligo show better results after treatment than patients with stable vitiligo. Therefore, in patients with stable vitiligo resistant to trial treatment, we advise postponing treatment until their vitiligo becomes active.

Treatment of melasma in Caucasian patients using a novel 694-nm Q-switched ruby fractional laser

BackgroundMelasma is a common hypermelanosis of the face. The use of a classical Q-switched ruby laser (QSRL) to treat melasma is discussed controversially and is associated with frequent adverse effects, such as hyper- or hypopigmentation. Recently a fractional-mode (FRx) QSRL was developed to minimize the adverse effects of classical QSRL. The objective of this research was to evaluate the efficacy and safety of a novel FRx-QSRL in the treatment of melasma in Caucasian patients.MethodsWe performed a retrospective study of 25 Caucasian melasma patients (Fitzpatrick skin types I to III). Patients received one to three FRx-QSRL treatments (Tattoostar FRx, Asclepion Laser Technologies, Jena, Germany) at pulse energies of 4 to 8 J/cm2. Three blinded investigators independently evaluated the melasma area and severity index (MASI) score before treatment and at the four- to six-week follow-ups. At additional three-month follow-ups, patients evaluated subjective improvement, pain and over-all satisfaction with the treatment according to a numeric analogue score (NAS). Side effects were documented.ResultsAt four to six weeks post laser treatment for a mean of 1.4 sessions, we observed a significant (P = 0.0001) reduction of the MASI score from 6.54 to 1.98 (72.3%). Patients rated the pain of the intervention at a mean 2.46 points (0 = no pain; 10 = maximum pain), the improvement at a mean 5.55 points (0 = no improvement; 10 = maximum improvement) and the overall satisfaction at a mean 4.66 points (0 = not satisfied; 10 = maximum satisfaction). After three months, post-inflammatory hyperpigmentation (PIH) and/or recurring melasma were observed in 7 (28%) and 11 (44%) patients, respectively.ConclusionThe 694-nm FRx-QSRL is a safe and effective option for treating melasma in Caucasian patients. Over periods of >3 months, PIH and/or recurring melasma may develop at significant rates and may reduce patient satisfaction. Multiple treatment sessions with lower pulse energies and/or a post-interventional therapy with hypopigmenting ointments and UV protection may help to minimize these complications.

Switch on the Laser for Vitiligo Therapy

For many patients with vitiligo, the primary objective of management is restoration of pigment to the vitiliginous plaques. But when the vitiligo is extensive, repigmentation may not be realistic, and depigmentation may be the best option. In times past, this could only be achieved with depigmenting chemicals. More recently, there have been reports that the same results could be achieved with Q-switched ruby (QSR) lasers. These authors conducted a retrospective evaluation of the …

Correct calibration procedure for the Q-switched ruby laser and checking the treatment irradiation pattern

There are many Q-switched lasers. The Q-switched ruby laser is the one most popularly used in dermatology, aesthetic surgery and plastic surgery, to remove pigmented lesions or tattoos. Correct and regular calibration of such a system is essential. However, some clinics fail to perform this with the excuse of having no measuring instrument (MI) in their offices or treatment rooms in some of their hospitals or clinics, or even the case of well-known medical universities in Japan. The present article explains the precise calibration procedure and beam pattern checking for the Q-switched ruby systems in the first author's clinic.In the case of treatment with a medical laser, the calibration and the irradiated pattern (IP) check of the laser being used for treatment are the most important factors for treatment efficacy and safety. If these factors change, the treatment result could be different from that expected. Such kind of data are not acceptable as scientific information for a presentation or published paper. With such unreliable results and incorrect beam pattern, replicating such a study would be impossible Regular calibration check: In our clinic, we have 2 Q-switched ruby laser systems. On a daily basis, the beam patterns, both the optical axis of the beam and its treatment footprint, are checked on dedicated printed sheets and footprint paper, respectively, at the beginning of the day and after the last procedure. Every two weeks we calibrate our systems in-house using a precise MI. Every six months we calibrate the systems in-house with the MI, and then we send the systems back to the manufacturers for calibration. Once every year, we have our MI calibrated by an accredited facility in Japan. In this way, we are not only ensuring accurate and safe treatment for our patients, but we are also producing accurate system and treatment data which can be replicated by others, the basis of evidence-based medicine.

Correct calibration procedure for the Q-switched ruby laser and checking the treatment irradiation pattern.

There are many Q-switched lasers. The Q-switched ruby laser is the one most popularly used in dermatology, aesthetic surgery and plastic surgery, to remove pigmented lesions or tattoos. Correct and regular calibration of such a system is essential. However, some clinics fail to perform this with the excuse of having no measuring instrument (MI) in their offices or treatment rooms in some of their hospitals or clinics, or even the case of well-known medical universities in Japan. The present article explains the precise calibration procedure and beam pattern checking for the Q-switched ruby systems in the first author's clinic. In the case of treatment with a medical laser, the calibration and the irradiated pattern (IP) check of the laser being used for treatment are the most important factors for treatment efficacy and safety. If these factors change, the treatment result could be different from that expected. Such kind of data are not acceptable as scientific information for a presentation or published paper. With such unreliable results and incorrect beam pattern, replicating such a study would be impossible Regular calibration check: In our clinic, we have 2 Q-switched ruby laser systems. On a daily basis, the beam patterns, both the optical axis of the beam and its treatment footprint, are checked on dedicated printed sheets and footprint paper, respectively, at the beginning of the day and after the last procedure. Every two weeks we calibrate our systems in-house using a precise MI. Every six months we calibrate the systems in-house with the MI, and then we send the systems back to the manufacturers for calibration. Once every year, we have our MI calibrated by an accredited facility in Japan. In this way, we are not only ensuring accurate and safe treatment for our patients, but we are also producing accurate system and treatment data which can be replicated by others, the basis of evidence-based medicine.

Use of Carbon Dioxide Laser to Treat Lentigo Maligna and Malignant Melanoma In Situ, Lentigo Maligna Type

Archives of Facial Plastic SurgeryVol. 14, No. 6 Free AccessUse of Carbon Dioxide Laser to Treat Lentigo Maligna and Malignant Melanoma In Situ, Lentigo Maligna TypeMichael McLeod, Katlein Franca, Katherine Ferris, and Keyvan NouriMichael McLeodSearch for more papers by this author, Katlein FrancaSearch for more papers by this author, Katherine FerrisSearch for more papers by this author, and Keyvan NouriCorrespondence: Dr Nouri, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 12th Ave NW, Ste 2175, Miami, FL 33136 (E-mail Address: knouri@med.miami.edu).Search for more papers by this authorPublished Online:1 Nov 2012AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail We read with great interest the recent article published by Lee et al titled “Carbon Dioxide Laser Treatment for Lentigo Maligna: A Restrospective Review Comparing 3 Different Treatment Modalities.”1While the carbon dioxide ablative laser may offer some usefulness as a third-line treatment, the nature of its emitted light has stark limitations. Most notably, the 10 600-nm wavelength is not actively absorbed by melanocytes; instead, the laser targets water as a chromophore. In addition, the 10 600-nm wavelength may not penetrate deep enough to destroy the atypical melanocytes extending down the periadnexal structures, using reasonable fluences.2,3 Future studies may wish to explore a laser wavelength that is more actively absorbed by melanocytes, such as using indocyanine green as a photosensitizer followed by treatment with the titanium sapphire laser.4,5An important distinction needs to be made between lentigo maligna and malignant melanoma in situ, lentigo maligna type. These 2 lesions exhibit histologic nuances that likely result in differences in their biological behavior.6,7 Lentigo maligna is histologically characterized by atypical melanocytic hyperplasia along the dermoepidermal junction, whereas malignant melanoma in situ, lentigo maligna type, exhibits atypical melanocytic hyperplasia along the dermoepidermal junction along with confluence and nesting of the melanocytes at higher layers in the epidermis (ie, above the dermoepidermal junction). This histologic distinction is important because malignant melanoma in situ, lentigo maligna type, likely progresses to lentigo maligna melanoma much more quickly than the often quoted rates of 4.7% if diagnosed by age 45 years and 2.2% when diagnosed by age 65 years.4,8,9Thus, if the carbon dioxide laser is used to treat lentigo maligna, it should be used only if other modalities are not applicable and if the histologic characteristics are consistent with lentigo maligna and not malignant melanoma in situ, lentigo maligna type.Financial Disclosure: None reported.REFERENCESLee H, Sowerby LJ, Temple CL, Yu E, Moore CC. Carbon dioxide laser treatment for lentigo maligna: a retrospective review comparing 3 different treatment modalities.. Arch Facial Plast Surg. 2011;13(6):398–403 Abstract, Google ScholarMadan V, August PJ. Lentigo maligna: outcomes of treatment with Q-switched Nd:YAG and alexandrite lasers.. Dermatol Surg. 2009;35(4):607–612 19309345 Google ScholarLee PK, Rosenberg CN, Tsao H, Sober AJ. Failure of Q-switched ruby laser to eradicate atypical-appearing solar lentigo: report of two cases.. J Am Acad Dermatol. 1998;38(2, pt 2):314–317 9486705 Google ScholarMcLeod M, Choudhary S, Giannakakis G, Nouri K. Surgical treatments for lentigo maligna: a review.. Dermatol Surg. 2011; 21631635 Google ScholarMamoon AM, Gamal-Eldeen AM, Ruppel ME, Smith RJ, Tsang T, Miller LM. In vitro efficiency and mechanistic role of indocyanine green as photodynamic therapy agent for human melanoma.. Photodiagnosis Photodyn Ther. 2009;6(2):105–116 19683211 Google ScholarTannous ZS, Lerner LH, Duncan LM, Mihm MCJr, Flotte TJ. Progression to invasive melanoma from malignant melanoma in situ, lentigo maligna type.. Hum Pathol. 2000;31(6):705–708 10872664 Google ScholarTannous ZS, Mihm MC, Flotte TJ, González S. In vivo examination of lentigo maligna and malignant melanoma in situ, lentigo maligna type by near-infrared reflectance confocal microscopy: comparison of in vivo confocal images with histologic sections.. J Am Acad Dermatol. 2002;46(2):260–263 11807439 Google ScholarWeinstock MA, Sober AJ. The risk of progression of lentigo maligna to lentigo maligna melanoma.. Br J Dermatol. 1987;116(3):303–310 3567069 Google ScholarDavis J, Pack GT, Higgins GK. Melanotic freckle of Hutchinson.. Am J Surg. 1967;113(4):457–463 6023013 Google ScholarFiguresReferencesRelatedDetails Volume 14Issue 6Nov 2012 InformationCopyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.To cite this article:Michael McLeod, Katlein Franca, Katherine Ferris, and Keyvan Nouri.Use of Carbon Dioxide Laser to Treat Lentigo Maligna and Malignant Melanoma In Situ, Lentigo Maligna Type.Archives of Facial Plastic Surgery.Nov 2012.462-462.http://doi.org/10.1001/archfaci.2012.874Published in Volume: 14 Issue 6: November 1, 2012PDF download

Effectiveness of combined pulsed dye and Q-switched ruby laser treatment for large to giant congenital melanocytic naevi

There is no consensus on the most appropriate treatment for patients with large to giant congenital melanocytic naevi (CMN) because of the risk of melanoma development. Surgical excision followed by skin grafting or expanded skin coverage may cause unfavourable scarring. There is a balance to be achieved between minimizing the disfiguring appearance and the risk of malignant change. The pulsed dye laser (PDL) is commonly used for vascular lesions and is highly absorbed by melanin and haemoglobin. Its pulse duration is longer than that of Q-switched ruby lasers (QsRL), which can have nonspecific photothermolytic effects on surrounding nonpigmented naevus cells. To investigate the effectiveness of combined treatment with the PDL and QsRL for large to giant CMN. Six patients with large to giant CMN were enrolled in this study. Treatment consisted of one pass of PDL treatment followed by one pass of QsRL treatment. Multiple rounds of treatment were applied to all patients. All patients responded to this combined regimen, and the lesional colour was effectively reduced. The mean number of rounds of laser treatment required to achieve skin lightening was 7·7. No patients suffered severe hypertrophic scarring. No cases of recurrence or malignant transformation were observed. The histological results from the patient who underwent the most laser therapy in this study showed a remarkable reduction in the number of melanocytic naevus cells after treatment. This technique may enable the removal of most of the pigmented lesion and melanocytic naevus cells with minimal scarring.

Amiodarone-induced facial pigmentation

British Journal of Hospital MedicineVol. 73, No. 8 Images in MedicineAmiodarone-induced facial pigmentationU Rao, A AgarwalU RaoSearch for more papers by this author, A AgarwalSearch for more papers by this authorU Rao; A AgarwalPublished Online:16 Aug 2013https://doi.org/10.12968/hmed.2012.73.8.473AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Karrer S, Hohenleutner U, Szeimies RM, Landthaler M (1999) Amiodarone-induced pigmentation resolves after treatment with the Q-switched ruby laser. Arch Dermatol 135: 251–3 Crossref, Medline, Google Scholar Kounis NG, Frangides C, Papadaki PJ, Zavras GM, Goudevenos J (1996) Dose-dependent appearance and disappearance of amiodarone-induced skin pigmentation. Clin Cardiol 19: 592–4 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetailsCited byAmiodarone8 December 2012 | Reactions Weekly, Vol. 1431, No. 1 1 August 2012Volume 73Issue 8ISSN (print): 1750-8460ISSN (online): 1759-7390 Metrics History Published online 16 August 2013 Published in print 1 August 2012 Information© MA Healthcare LimitedPDF download

Skin markings methods and guidelines: A reality in image guidance radiotherapy era

Preparation of site of radiation delivery is an important process in radiation treatment planning and plays a crucial role during a course of radiotherapy to achieve reproducibility of set-up and accuracy of treatment delivery. The preparation of treatment area is done by markings of field center, field edge or other reference point of planned field. Both non-invasive (marker pen, henna) and invasive methods (tattoo) are available for marking with limitations of each. Tattoo with a needle pricked at angle of 30° to 1-2 mm depth to create tattoo 2-3 mm diameter in size is an ideal procedure. Visibility, permanent nature, social-religious belief, and mobility of skin are one of the main concerns about tattoo. Tattoo removal can be done performed if desirable by patients by various modern ways, which will be esthetically available. Dermabrasion, cryotherapy, surgery, QSRL (Q-switched ruby laser) are common methods of tattoo removal. Esthetic dissatisfaction, allergy, dermatoses, keloids, infection, fanning/fading of tattoo are associated problems. In IMRT and IGRT treatment, delivery dependence on tattoo in reduced and use of surrogate markers including particularly for bony set-up and implanted markers (e.g. gold seeds) for tumor localization and treatment verification is increasing. However, these are complex procedures and require an expertise. Ease of set-up and less time required for tattooing are one of the main advantages of tattoo as compared to external or internal marker set-up. Tattoo still remains a crucial method of positioning, especially in developing countries and in palliative treatment settings.

Use of a Fractional Q-Switched Ruby Laser for Treatment of Facial Lentigines

Introduction: Fractional laser technology is associated with decreased posttreatment morbidity but has not been applied to Q-switched ruby lasers (694 nm). Standard Q-switched ruby lasers have been used effectively for the treatment of pigmented lesions but require postoperative wound care and significant recovery time. The objective is to report on the suitability of a new fractional handpiece for a Q-switched ruby laser for the treatment of facial lentigines. Materials and Methods: Five patients with facial lentigines were treated with or without topical anesthetic with a fractional Q-switched ruby laser at a fluence that caused tissue whitening. Results: Patients were treated 1 to 2 times. All patients experienced clinical improvement in hyperpigmentation with minimal posttreatment erythema and crusting. Conclusions: The fractional Q-switched ruby laser is an ideal treatment for facial lentigines, causing clinical improvement with minimal posttreatment morbidity.

Qスイッチルビーレーザーによる太田母斑の10年間の治療成績(第3報) —特に副作用としての脱色素斑の発生し易い条件の検討—

Qスイッチルビーレーザーによる太田母斑の10年間の治療成績(第3報) —特に副作用としての脱色素斑の発生し易い条件の検討—