Zusammenfassung
Hintergrund und Fragestellung
Die Diffusion von Pigmenten in umliegendes Gewebe stellt eine wesentliche Komplikation bei kosmetischen, aber auch bei Schmutztätowierungen dar. Heute sind gütegeschaltete Lasersysteme die effektivste und nebenwirkungsärmste Behandlungsmethode.
Patienten/Methodik
Vier Patienten mit diffundierten Schmutz- und Schmucktätowierungen am Auge wurden mit dem gütegeschalteten Rubinlaser und dem gütegeschalteten Nd:YAG-Laser behandelt.
Ergebnisse
Alle Patienten zeigten eine zumindest deutliche, 2 eine komplette Aufhellung der ausgelaufenen Pigmentierung. Dauerhafte Nebenwirkungen im Sinne einer Hyper- oder Hypopigmentierung, Narben oder Farbumschlag wurden bei keinem der Patienten beobachtet.
Schlussfolgerung
Wir konnten mit dem gütegeschalteten Rubin- und Nd:YAG-Laser eine effektive und nebenwirkungsarme Methode zur Behandlung diffundierter Schmuck- und Schmutztätowierungen aufzeigen. Erklärungsversuche für den Grund der Pigmentdiffusion werden aufgezeigt, für eine eindeutige Klärung des Pathomechanismus bedarf es jedoch fortführender feingeweblicher und elektronenmikroskopischer Untersuchungen.
Abstract
Background and Objective
Pigment fanning or spread is one complication of decorative tattooing, but is also seen after traumatic tattoos. The reason for this spreading remains unclear. While excision of the diffused pigment was previously considered the treatment of choice , today destruction of the pigment with Q-switched laser systems is the therapy with the highest efficiency and lowest rate of side effects. Therefore areas of pigment spread should be excised only in rare exceptional cases.
Patients/Methods
4 patients with pigment fanning after permanent make up and traumatic tattooing of the periorbital region were treated with the Q-switched ruby (694 nm) and Q-switched Nd:YAG (1064 nm) lasers.
Results
All patients showed a significant (70–80%) clearance of the spread pigment; two had complete clearing. Side effects such as hyper- or hypopigmentation, scarring or ink darkening were not seen.
Conclusions
The Q-switched ruby- and Q-switched Nd:YAG-lasers are a therapeutic modality for pigment fanning with high efficiency and low rate of side effects. Attempts of explanation for pigment spread after tattoos are given, but further histological and electron microscopical investigations are needed to find the pathogenetic mechanism.
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Graudenz, K., Greve, B. & Raulin, C. Diffundierte Schmutz- und Schmucktätowierungen. Hautarzt 54, 756–759 (2003). https://doi.org/10.1007/s00105-003-0493-6
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DOI: https://doi.org/10.1007/s00105-003-0493-6