CHAPTER 38: CUTANEOUS LASER SURGERY

Question 1

emit a beam of light whose output power is constant over time, resulting in a long, continuous exposure.

Answer 1

Continuous-wave lasers

Question 2

Shutter the continu- ous beam into short segments, producing interrupted emis- sions of constant laser emission.

Answer 2

Quasi–continuous-wave lasers

Question 3

produce short, high-energy pulses of light.

Answer 3

Pulsed lasers

Question 4

are able to generate extremely high-energy pulses over very short (nanoseconds or picoseconds) pulse durations and are used primarily for treating pigmented lesions.

Answer 4

Q-switched (quality-switched) lasers

Question 5

It is The target structures that absorb laser light , with the most common in the skin being water, hemoglobin, and melanin

Answer 5

chromophores

Question 6

is an extremely useful instrument for the treatment of vascular lesions. These lasers have traditionally been used for port wine stains, telangiectasias, erythematotelangiectatic rosacea, and hemangiomas.

Answer 6

pulsed dye laser (PDL)

Question 7

is the treatment of choice for port wine stains.

Answer 7

pulsed dye laser (PDL)

Question 8

are suited to treatment of individual telan- giectasias of the face, cherry angiomas, and small spider angio- mas.

Answer 8

potassium titanyl phosphate (KTP) laser

Question 9

are best used for larger and deeper vessels, such as large-vessel venous malformations, vascular blebs in port wine stains, blue reticular veins, venous lakes, and lower extremity spider veins

Answer 9

Long-pulsed laser
include the alexandrite (755 nm), diode (800 nm, 940 nm), and neodymium:yttrium-aluminum-garnet (Nd:YAG; 1064 nm).

Question 10

although technically not a laser, uses a flashlamp that emits a noncoherent broad spec- trum of light (400–1200 nm) at various pulse durations and intervals

used for the treatment of facial telangiectasia and rosacea.

Answer 10

intense pulsed light (IPL)

Question 11

are used to treat epidermal pigmented lesions and tattoos.

the target chromophore is the melanosome.

Answer 11

Q-switched lasers

Question 12

are hyperpigmented macules composed of an increased number of basal melanocytes.

Answer 12

Lentigines

Question 13

used to treat solar lentigines and those associated with certain syndromes (e.g., Peutz-Jeghers),
Café au lait macules and Becker’s nevus,
Nevus of Ota and nevus of Ito

Answer 13

Q-switched lasers

Question 14

tx for melasma

Answer 14

First-line treatment includes strict sun protection, discontinu- ing any offending systemic medication, and the use of topical agents such as **hydroquinone and retinoids. **

Laser treatment is often ineffective

Question 15

laser tx for the ff tattoo:

Traumatic, Amateur black, professional black and blue tattoo:

green, red, yellow, violet, red, and flesh tattoo:

Answer 15

**Traumatic, Amateur black, professional black and blue tattoo: **
QS ruby;
QS alexandrite;
QS Nd:YAG (1064 nm)

green, red, yellow, violet, red, and flesh tattoo:

QS Nd:YAG (532 nm)

Question 16

Hair removal lasers target the *________
, and given the size of the target chromophore, longer pulse durations are required to generate enough heat to damage the bulbar stem cells.

Answer 16

melanin within the follicle

Question 17

emits an invisible infrared beam of 10,600 nm and can be used in continuous-wave or superpulsed mode

effective for the treatment of actinic damage and photoaging, large plantar and peri- ungual warts

for refractory keloids.

xanthelasma, rhinophyma, and syringomas.
actinic cheilitis and superficial basal and squamous cell carcinomas.

Answer 17

CO2 laser

Question 18

emits an invisible near-infrared beam of 2940 nm, resulting in significantly more efficient absorption by water (16 times) and a more explosive ablative effect than with the CO2 laser.

The decreased thermal injury and collagen ablation is an advan- tage for treatment of scars, photodamaged skin, rhytids, and rhinophyma

Answer 18

Erbium:yttrium-aluminum-garnet laser
or
Er:YAG laser

Question 19

an ablative laser is adminis- tered in a pixilated pattern over a grid. These lasers created small columns of thermal injury, or microthermal zones (MTZ), which are separated by areas of untreated skin.

for acne scars, residual hemangioma residuum, and pigmentary disor- ders. such as melasma

Answer 19

fractional photothermolysis or
Fractional resurfacing