summary
Verruca palpebralis is a kind of wart, which is characterized by a pale yellow soft flat wart-like protuberance on the eyelid skin, which often occurs symmetrically in bilateral inner canthus. One or several small yellow spots gradually become larger, swell and merge, showing a round or oval shape, which can form a horseshoe shape or an irregular shape around the inner canthus, but it does not exceed the eye socket, generally the size of rice grains to broad beans, with no conscious symptoms, slow development and no self-fading. People think that the disease is formed by tissues and cells containing lipids in the skin, but sometimes it is accompanied by hyperlipidemia, lipoproteinemia and atherosclerosis, so it is also considered as the external skin manifestation of lipid metabolism disorder in the system.
At present, the most ideal treatment is Erbiun laser. Of course, ultrapulsed CO2 laser (Altro Palse) is also a good method. However, Er laser therapy is welcomed by doctors and specific surgical patients because of its advantages such as clear boundary between diseased tissue and normal tissue, deep treatment depth, less intraoperative bleeding, less postoperative pain and inconspicuous scar.
Disease introduction
Verruca palpebrae, also known as xanthoma palpebrae, is a common xanthoma and a kind of lipid metabolism disorder. Because it is easy to occur in the eyelids, it will affect the appearance.
Verruca palpebrae is more common in middle-aged women, especially before and after menopause. Can occur in patients with hepatobiliary diseases, such as liver cirrhosis and cardiovascular diseases (coronary heart disease, etc.). ) or hyperlipidemia, but more patients do not have obvious positive signs and laboratory test results of the above diseases.
The rash of verruca palpebrae is soft orange papules or patches, which can be millet-shaped to 1 min, single or multiple, or can be fused into raised flat patches. This kind of wart often occurs in the upper eyelid and lower eyelid, especially in the inner canthus of the upper eyelid. Sometimes the damage covers more than half of the eyelids, and even develops to the outside of the upper and lower eyelids and spreads into a horseshoe shape, which seriously affects the facial beauty.
Equipment introduction
At present, the MCL29 Er laser beauty dermabrasion machine developed by Hasle Ping-Medtec Company is used. Erbium laser is a kind of solid-state pulsed laser with the wavelength of 294nm, and its energy can be quickly absorbed by tissues, so that skin tissues can be vaporized and separated instantly and peeled off accurately, and skin pigment tissues can be removed accurately and thoroughly, and it can be recovered safely and quickly without leaving pigmentation.
The Multipulse ultra-pulse CO2 laser instrument of Asclepion Company in the United States is a laser with the wavelength of 10600nm, which provides high-energy CO2 laser (infrared beam) and low-energy semiconductor laser (visible red light). The utility model has the advantages of little damage, and avoids the disadvantages of ordinary continuous CO2 laser, such as damage to surrounding normal tissues, eschar generation, difficult wound healing and the like. Fast recovery, little impact on work and life, and easier to be accepted by patients.
Principles of treatment
Erbium laser is a solid-state pulsed laser with a wavelength of 2.94 microns, which is in the infrared region of the spectrum invisible to human eyes. When erbium laser pulse acts on the skin, the energy is quickly absorbed by the tissue, causing the superficial skin temperature to rise rapidly, resulting in instantaneous vaporization and separation of the tissue and accurate peeling. Because of its superficial effect and rapid wound healing, it is most suitable for darker skin and Asian skin types.
CO2 laser has very small divergence angle and high energy density. After focusing, it can reach several kilowatts per square centimeter. In medical treatment, it can be used to vaporize, cauterize or cut the focus tissue, so CO2 laser therapeutic instrument is also called laser knife. However, the unfocused original beam can irradiate the lesion tissue, which can produce coagulation. CO2 laser is infrared light with wavelength of 10.6nM, which goes deep into tissues. After beam expansion, deep tissue can be treated by heating.
adapt to
Xanthoma palpebrae, also known as xanthoma palpebrae, is the most common xanthoma palpebrae and a metabolic disorder skin disease. Once it appears, it mostly occurs near the bilateral inner canthus, which belongs to the middle part of human face and is often symmetrically distributed. The rash is persistent, progressive and multiple, and can be combined with each other. Therefore, it seriously affects the beauty effect of human face, and it is very necessary to remove these two particularly dazzling macula from the beauty point of view. There are a large number of such patients in our outpatient department, and most of them are over-nourished and well-off rich people, so people say that this is also a modern disease of wealth.
Contraindications
(1) Patients are prohibited from using pacemakers, cardiac electrodes or other metals.
(2) pregnant women.
(3) Those with exemption defect, hypertension and coronary heart disease are prohibited.
(4) Patients with scar constitution and skin infection at the treatment site.
(5) Suspected skin cancer patients.
(6) People with unrealistic expectations.
Method step
First, scrub the treated area with bromogeramine and disinfect it. Then, the laser is applied to the diseased skin. The transmitted energy instantly vaporizes the water in the tissue, and at the same time takes away the aged and diseased skin tissue without damaging the surrounding healthy tissue. It can stimulate the production of new collagen layer and restore skin elasticity while treating. Individuals who are sensitive to pain can use anesthetics locally. When the local anesthetic is used and then treated, the skin will not feel any pain. After treatment, the anesthetic effect subsided, and there was no obvious pain because the local laser was no longer stimulated. Clean skin tissue can be seen after laser gasification. There is no bleeding during the treatment, and healthy normal tissues can be preserved. After the treatment, apply anti-inflammatory ointment on the skin of the treatment area, and return to the clinic three months later.
Matters needing attention
(1) prevention of pigmentation: mainly avoid light as much as possible and choose winter treatment; In addition, for the newly healed wound, it can be covered with gauze for a period of time, which helps to reduce pigmentation.
(2) After 7 ~14 days, the scab was removed, and temporary skin erythema or pigmentation appeared in the affected area. After 1 month, erythema and pigmentation gradually subsided, and pigmentation basically returned to normal after 3 months. Avoiding light within 3 months after treatment is the key to prevent the aggravation of pigmentation.
(3) Postoperative care: Patients should be told not to wet the wound to prevent infection. Avoiding sunlight and radiation can effectively reduce pigmentation. Patients with chloasma, freckles and nevus have a long recovery period of pigmentation, so they should be informed in advance to understand and cooperate with the treatment.
FREQUENTLY ASKED QUESTIONS
1, Q: Is it safe to treat verruca palpebrae with laser?
A: Once the eyelid wart appears, it mostly occurs near the bilateral inner canthus, which belongs to the middle part of the face, thus seriously affecting the cosmetic effect of the face. These two particularly dazzling maculae are very necessary from the perspective of cosmetic surgery. There are a large number of such patients in our outpatient department, and most of them are over-nourished and well-off rich people, so people say that this is also a modern disease of wealth. At present, the most suitable treatment is Erbiun laser, of course, ultra-pulsed carbon dioxide laser is also a good method. However, Er laser therapy is welcomed by doctors and specific surgical patients because of its advantages such as clear boundary between diseased tissue and normal tissue, deep treatment depth, less intraoperative bleeding, less postoperative pain and inconspicuous scar.
2. Q: Who is the most common xanthoma patient?
A: Verruca palpebrae mostly occurs in middle-aged obese women, and it is rare in men. This rash is only manifested in this specific part of the eyelid. The small yellow rash starts from the inside of the upper eyelid, which is as big as a grain of rice at first and develops slowly. Slightly higher than the skin surface, it is completely separated from normal skin, but the boundary is irregular, like a small piece of butter sticking to the surface. When the rash develops to the maximum, it can occupy all the upper eyelids, which is very eye-catching and easy to find early. We should not only think about the treatment of xanthoma of eyelid, but also consider the general situation it represents, check the cardiovascular system, find out the root cause and carry out symptomatic treatment.