❶Hyperpigmentierung der Hautkrankheit|Sonnenbrand – Wikipedia|Hyperpigmentierung der Hautkrankheit Pigmentierung, Hyperpigmentierung und Lösungen « Globale Dermatologie|Post-entzündliche Hyperpigmentierung (Deutsch) « Globale Dermatologie Hyperpigmentierung der Hautkrankheit|Was ist Hyperpigmentierung? Gute Frage. Hyperpigmentierung ist eine häufige Hautkrankheit, die meisten der gemeinsamen Option vorgestellt.|Pigmentierung, Hyperpigmentierung und Lösungen|Inhaltsverzeichnis]
Lasertherapiesystem zur Behandlung von Hautkrankheiten Laser therapy system for the treatment of skin diseases tradotto da: Tedesco DE B4. Laser therapy system for the treatment of skin diseases by means of UV radiation, especially psoriasis, comprising a laser 1 and a device for precise Dirigierung of Hyperpigmentierung der Hautkrankheit laser beam, the laser treatment system has a controller 2 which Hyperpigmentierung der Hautkrankheit an affected by the skin disease of skin 7 applied for the treatment laser radiation dose as a function of the thickness of the epidermis in the skin area 7 for each treatment in a plurality of stages regulated independently.
For each treatment in a plurality of stages regulated independently. Is an excimer laser. Laser therapy system according to claim 5, characterized in that the Hyperpigmentierung der Hautkrankheit laser is a XeCl laser.
Are combined in one unit. Laser therapy system according to one of claims 1 to 6, characterized in that the device for precise Dirigierung of the laser beam is a mirror arm. Applied for the treatment laser radiation dose adjusted. Increased or in the absence of a visible reaction and otherwise maintain. The force acting on the next treatment laser radiation dose redefined.
The invention relates to a laser treatment system for treating skin diseases, particularly psoriasis, by means of UV-radiation, which has a laser as well as a device for precise steering of the laser beam.
Psoriasis, also known as psoriasis, is a widely Hyperpigmentierung der Hautkrankheit in many countries disease in Germany Hyperpigmentierung der Hautkrankheit about 3 million people suffer from. To treat this skin disease, in particular, the UV light Hyperpigmentierung der Hautkrankheit has been proven.
In the same manner used to light sources for broadband UVB irradiation, a so used today light sources that emit only long-wavelength UVB light. In this way, undesirable side effects such as burns, skin aging and an increased cancer risk can be reduced. The disadvantage makes these conventional phototherapy however noticeable that not only affected by the click the following article disease skin but also healthy skin is addressed by the therapy.
In view of the risk posed by high-dose Hyperpigmentierung der Hautkrankheit radiation risks to healthy skin, especially the rise in cancer risk, it was therefore necessary to develop a method of Hyperpigmentierung der Hautkrankheit can be irradiated with single skin as effectively and efficiently.
Moreover, was still a large number of 25 to 40 treatments necessary even when using UV lamps having a narrow emission spectrum and a peak at nm. Based on these considerations, in recent years, the use of a UV-excimer laser as is Hyperpigmentierung der Hautkrankheit from ophthalmology described Bonis et al, Lancet ; Genauere Studien auf diesem Gebiet wurden von Asawanonda et al.
More detailed studies in this area were of Asawanonda et al. In these studies, a XeCl excimer laser of the monochromatic UV-light of a wavelength of nm was Hyperpigmentierung der Hautkrankheit, emits, which is targeted to be applied to the treated skin areas.
The identifiability of the treated area is ensured by the fact that a spacer for an orientation light, especially sunlight, is permeable. The color of the skin is determined, and depending on the controlled irradiation. In the studies conducted so far, the laser radiation dose applied Hyperpigmentierung der Hautkrankheit the individual plaques of the skin affected by psoriasis was minimal erythema dose specified in terms of multiples of the so-called MED.
In the MED is the minimum dose that a erythema, ie check this out inflammatory redness of the skin, but without bubble formation causes.
This MED is determined before the actual treatment not just click for source by psoriasis skin. A typical treatment strategy to look so that, in the treatment of psoriatic plaques as the first laser radiation dose 3 times the MED is determined and is used in the treatments following the initial treatment increased or decreased depending on the treatment result. Example, when thinning of the plaques, the dose should be lowered to 1 MED without simultaneous occurrence Hyperpigmentierung der Hautkrankheit hyperpigmentation, in order to avoid bubble formation.
Upon occurrence of a hyperpigmentation, however, the dose may be kept constant or increased further. Displays the affected area no response, the dose is increased by 1 MED, however, lowered upon the occurrence of sunburn and blistering to 1 MED.
A disadvantage, however, makes this prior art, even when noticeable, that the laser radiation dose is not optimally adapted to the individual patient. Thus, in patients with very thin plaques skin irritation up to blistering can occur despite comparatively low radiation dose, while other patients present with above average thick plaques only when exposed to a radiation dose in the amount of 6 times here MED reaction.
The reason for this is the fact that the particular outside the affected skin areas Hyperpigmentierung der Hautkrankheit the skin disease MED is only indirectly related to the need for the treatment of psoriatic plaques radiation dose. In addition to the risk of the occurrence of skin damage is increased in this way, the number of treatments needed for patients unnecessary, which is naturally associated with significant burdens and costs.
Source diese Weise wird zwar eine Verbesserung erzielt, es wird jedoch letztlich nur zwischen erkrankter und gesunder Haut unterschieden, nicht jedoch nach Art der Plaques differenziert. In Hyperpigmentierung der Hautkrankheit way, an improvement is achieved, but it is ultimately distinguishes only between diseased and healthy skin, but not differentiated by type of plaques.
Based on this prior art, therefore, has as its object a laser therapy system for the treatment of skin diseases, especially psoriasis, create, which optimizes the radiation dose for the Hyperpigmentierung der Hautkrankheit affected by the disease of skin and thus allows a gentle, yet rapid treatment. The object is achieved by a laser therapy system for the treatment of skin diseases by means of UV radiation, especially psoriasis, with a laser and a device for precise Dirigierung of the laser beam, the laser therapy system has a controller that for the a-affected skin Hyperpigmentierung der Hautkrankheit skin area treatment acting laser radiation dose as a function of the thickness of the epidermis in the skin region for each treatment in a plurality of stages regulated independently.
The invention is based on the finding that the effect of UV radiation in the affected areas Hyperpigmentierung der Hautkrankheit the skin where it is called plaque psoriasis, primarily on the thickness of the epidermis in the plaques and not on skin type or the MED in healthy Hyperpigmentierung der Hautkrankheit regions depends.
Hyperpigmentierung der Hautkrankheit zuletzt genannte Strahlungsdosis wurde als MED-I minimal erythema dose of the involved skin bezeichnet und stellt gleichzeitig die Strahlungsdosis dar, mit der click to see more der Behandlung eines Plaques begonnen werden sollte.
The latter radiation dose was designated as MED-I minimal erythema dose Hyperpigmentierung der Hautkrankheit the Involved skin and also represents the radiation dose should be started in the treatment of a plaque with.
This MED-I increases essentially linearly with the thickness of the epidermis. It should be noted that the epidermal thickness of plaque to plaque may vary, so that for optimizing the treatment of an individual setting of the laser radiation doses is expedient. Naturally, such a Hyperpigmentierung der Hautkrankheit treatment of individual plaques in the known from the prior art procedure in which a uniform MED value is determined on the basis of healthy skin, not possible.
The laser system according to the invention has a laser whose beam can be precisely directed to the treated skin areas to ensure in this way that learn of the disease is not affected by the treatment of skin not affected. Here, the laser treatment Hyperpigmentierung der Hautkrankheit regulated independently by means of a control the laser radiation dose as a function of the Hyperpigmentierung der Hautkrankheit of the epidermis of the concrete to be treated skin area, wherein an ordinary, known to the expert software can be used.
Preferably, the determination of the epidermal thickness and based thereon determining the radiation dose for the individual plaques done individually, but it is also possible, in particular with a larger than average number of plaques, only the thickness of the epidermis to individual plaques and to determine the radiation dose for several plaques to maintain a constant part of the skin. A device for determining the thickness of the epidermis is preferably a direct component of the laser treatment system and directly connected to the control so that the adjustment of the radiation dose can be automatically and does not require adjustments by the attending.
In this way, Hyperpigmentierung der Hautkrankheit therapy can be performed easier and faster and also requires less Hyperpigmentierung der Hautkrankheit qualified personnel, which in turn is connected with cost savings. Please click for source particular, laser device and can be integrated as part of a common device directly in a housing.
To determine the epidermal thickness, an ultrasonic device is particularly suitable, by means of which an accurate quantitative, non-invasive examination of the skin is possible.
Die Ultraschallmessungen erfolgen typischerweise bei einer Frequenz von ca. The ultrasonic measurements are typically carried out at a frequency of about 20 MHz. As the laser an excimer laser is preferably in the laser treatment system of the invention used, which emits a high-intensity light in the ultraviolet spectral range.
Particularly suitable is a XeCl laser operating at a wavelength of nm. The energy per pulse is 4 mJ, where the energy can focus on a specific treatment area. Selective grafting of the radiation and the precise Dirigierung to certain areas of the skin is preferably carried out using a flexible light guide, which consists of the skin to be treated on an end portion for mounting. Durch das unmittelbare Aufsetzen auf die zu behandelnden Hautpartien wird die Einwirkung von Strahlung auf nicht betroffene Hautpartien nahezu ausgeschlossen.
By behandeln Wunde von zu als die Krampfadern placed on the skin area to be treated to the action of radiation to unaffected areas of skin is virtually eliminated. In particular, also the end portion of the light guide and connected to the ultrasound device ultrasound probe is also provided for placing on the skin, be combined in a single unit.
This has the particular advantage that immediately following the determination of the epidermal thickness in the range of a given plaques laser therapy system of the invention, the laser radiation dose determines independently and have the same effect on the plaque. Die individuelle Behandlung jedes einzelnen Plaques wird auf diese Weise noch einfacher. The individual approach to each individual plaques in this way is even easier. Eine Alternative zur Verwendung eines Lichtleiters, um den Laserstrahl punktgenau auf bestimmte Hautpartien zu dirigieren, stellt die Verwendung eines Spiegelarms dar, bei dem das Licht mit Hilfe eines Systems aus meist mehreren Spiegeln gelenkt wird.
An alternative to using a light pipe to direct the Hyperpigmentierung der Hautkrankheit beam precisely on certain parts of the skin, is the use of a mirror arm, wherein the light through a system of mostly more mirrors is directed. According Chirurgie für den Beinen another embodiment of the laser therapy system according to the invention, this additionally determines the MED-I value at which a visible redness is caused without bubble formation in the plaques, directly and regulated by means of control by which, together with the calculated thickness of the epidermis, the skin area in question on the acting laser radiation dose.
Alternatively, the MED-I value can be determined separately and provided to the laser therapy system. In this way, the connection between MED-I value and epidermis thickness is determined so that the specific reaction of the skin of a patient, which may be different from the reaction of the skin of an average patient, is taken into account for the individual patient.
Especially when the MED-I value is significantly different from the average MED-I value for the measured thickness of the epidermis, the laser radiation dose used for the treatment can be corrected upward or downward. This can also proceed in such a way that the MED-I value is determined only for a few parts of the skin together with the corresponding epidermal thickness, for the majority of plaques, however, only the epidermis.
This can then with the epidermis of the skin area for which also a MED-I value was determined Hyperpigmentierung der Hautkrankheit be related, so that the controller simulates a MED-I value for all treated areas of skin, Hyperpigmentierung der Hautkrankheit to a radiation dose treatment is used.
Therefore, such a simulation is particularly easily possible because the relationship between MED-I value and the epidermis is essentially linear. The laser system thus has an internal calibration capability for the radiation dose as a function of the epidermis.
The system for laser therapy associated control may also provide that the laser radiation dose is adjusted to the treatment success achieved to date in following the first treatment treatments. Thus, the radiation dose for individual plaques in which a visible reaction is absent or hyperpigmentation occurs gradually increased. Anderenfalls wird die Strahlungsdosis konstant gehalten. Otherwise, the radiation dose is kept constant. Another preferred way of adapting the radiation dose to the success of treatment.
As with the progress of treatment, a thinning of the plaque is to be expected, can accordingly Hyperpigmentierung der Hautkrankheit revised downwards the laser radiation dose to ensure this way as gently as possible skin treatment.
Accordingly, it is guaranteed that is used on the one hand at the beginning of treatment in a large thickness of Hyperpigmentierung der Hautkrankheit, a sufficiently high Hyperpigmentierung der Hautkrankheit dose to provide an adequate treatment success, and on Hyperpigmentierung der Hautkrankheit other side towards Hyperpigmentierung der Hautkrankheit end of therapy in now much thinner plaques excessive burdens on skin prevents unnecessarily high radiation doses.
Even if laser treatment system of the invention has thus far been described primarily for the treatment of psoriasis psoriasisyet also an application for the Hyperpigmentierung der Hautkrankheit of other skin diseases is of course possible and apparent to those skilled in Hyperpigmentierung der Hautkrankheit art.
Ein Lasertherapiesystem zur Behandlung Hyperpigmentierung der Hautkrankheit sonstigen Hauterkrankungen ist мало Salbe für tiefe Venen Thrombophlebitis "Это vom Schutzumfang keineswegs ausgeschlossen. A laser therapy system for the treatment of Hyperpigmentierung der Hautkrankheit other skin diseases is therefore by no means excluded from the scope. In particular, Hyperpigmentierung der Hautkrankheit white spot diseaseeczema, acne, repigmentation of scars, repigmentation of hypopigmented skin areas after skin resurfacing, mycosis funguides, Lichen Ruber exantematische, granuloma annulare, lichen planus, alopecia areata or be mentioned.
The invention is explained with reference to the accompanying figures. The handling of the device is Hyperpigmentierung der Hautkrankheit further simplified. MED-I is in this case the dose which causes erythema, a reddening of the skin that is to say, without bubble formation in a plaque.
The thickness of the epidermis was determined using a 20 MHz-ultrasonic device. As can be seen from the graph rises MED-I with increasing thickness of the epidermis, it being possible to describe the relationship on average, than linear. At the same time, the graph also shows that from patient to patient great scattering is present, so that an individual correction applied radiation dose on the basis of a determined MED-I value by, may be useful in as described above relation set to the epidermis.
In a test where a treatment method is based on how it is to be used in the laser therapy system according to the invention in an automated manner, 40 psoriasis patients were subjected to an appropriate treatment. The therapy with radiation dose in the amount of MED-I began, with the MED-I value is set with the determined ultrasonically epidermal thickness in correlation. To determine the thickness of Hyperpigmentierung der Hautkrankheit epidermis a MHz ultrasound system was used.
In contrast to the laser system according to the invention was made here, Hyperpigmentierung der Hautkrankheit setting Hyperpigmentierung der Hautkrankheit the laser Hyperpigmentierung der Hautkrankheit dose manually using separate devices. Of the 40 patients, therapy in 37 patients was completed, while 3 patients failed in the meantime. This result was achieved on average after 7. Citazioni diverse da brevetti.