超脉冲CO_2激光治疗色素痣后皮损复发的组织病理学分析  

Histopathological analysis of repigmentation of melanocytic nevi after ultrapulse CO_2 laser treatment.

作　　者：钱黎华 余红[2] 凌波[2] 

机构地区：[1]上海申德医院皮肤科,上海200336 [2]上海第二医科大学附属新华医院

出　　处：《中国实用美容整形外科杂志》2005年第5期287-289,共3页

摘　　要：目的从组织病理学角度分析面部色素痣经超脉冲CO2激光治疗后皮损复发的原因。方法1999年12月至2002年10月,129例临床诊断为色素痣的患者接受了超脉冲CO2激光治疗,在以后随访的89例患者中有7例出现皮损复发。皮损复发的部位经外科手术切除后进行了组织病理学的检查。结果表皮中痣细胞的再生(病例1、2、3、7)、真皮浅层痣细胞的残留(病例4、5、6)、真皮乳头层纤维增生(微观瘢痕)的厚度不够(病例4),真皮深部大量的痣细胞远未得到清除(病例2、3、4、5、7)以及炎症后噬色素细胞的形成(病例1、4、5、6、7)都是色素再次出现的原因。皮损复发的7例患者中未发现痣细胞恶变以及假性黑色素瘤的形成。结论所有复发病例中,痣细胞都未被真正完全清除。因此通过激光治疗色素痣的方法用于美容应慎重选择。Objective To analyze histopathologically the reason of the repigmentation of facial nevi after ultrapulse CO2 laser treatment. Methods One hundred and twenty - nine cases with clinically - diagnosed facial pigmented nevus were treated with ultrapulse CO2（Coherent） laser between December 1999 and October 2000. Surgical ablation of the recurrent lesion was performed when 7 of 89 patients complained the undesired cosmetic effect during the follow - up. These 7 patients with recurrent pigmented nevus were enrolled in the histopathological study. Results Reasons of repigmentation were studied including regeneration of nevus cells in the epidermis （case 1,2, 3, 7）, residual nevus cells in the upper dermis （case 4, 5,6）, Too thinness of fibrogenesis zone （microscopic scar） to obscure the remaining nevi located in deeper dermis （case 4）, intact nevus cells in deeper dermis forming a nidus （case 2, 3, 4, 5,7）. No psudomelanoma and malignant transformation were observed. Conclusions In the cases of recurrence, no lesions had complete histological removal of all melanocytes after ultrapulse CO2 laser treatment. One should be cautious to choose the laser treatment of nevomelanocytic lesions for cosmetic purposes.

关 键 词：色素痣 超脉冲CO2激光 皮损复发 病理学 

分 类 号：R758.5[医药卫生—皮肤病学与性病学]