I. What skin diseases can be treated by far infrared rays? What are the principles and precautions of its application?
In the field of dermatology, far infrared ray treatment can be used to treat boils, folliculitis, purulent sweat gland inflammation, chronic ulcers, perineuritis, frostbite and phlebitis. Infrared rays are invisible light rays produced by thermal light sources with wavelengths of 760nm~1500nm. Clinically, the main application of its thermal effects can cause local vasodilation, accelerated blood flow, vigorous metabolism, accelerated tissue regeneration ability, and improve the body’s ability to resist infection, as well as relax muscles and have antispasmodic and analgesic effects. However, patients with bleeding tendency or suspected local malignant changes should be cautiously treated with far infrared light.
Second, what is ultraviolet therapy? What effect does it have on the skin?
Ultraviolet light (UV) is invisible light with a wavelength of 200~400nm, and can be divided into short-wave ultraviolet light (UVC), medium-wave ultraviolet light (UVB) and long-wave ultraviolet light (UVA), whose wavelengths are 200~290nm, 290~320nm and 320~400nm respectively. above 290nm. UV irradiation can have erythema formation, pain relief, promote local blood and lymph circulation, improve local nutrition, accelerate tissue growth, enhance skin barrier, pigmentation, sterilization, and promote vitamin D synthesis.
Third, what does UVB phototherapy mean? Which diseases can be used for treatment?
UVB phototherapy refers to the application of medium-wave ultraviolet radiation (UVB) to treat skin diseases. UVB phototherapy can regulate cellular target factors and growth factors, induce anti-inflammatory factors and immunosuppressive factors, promote the accelerated apoptosis of germ cells, change and improve the body’s immune function, and promote the regeneration and recovery of epidermal cells, which is safe and efficient. It can be used to treat psoriasis, white epilepsy, pityriasis rosea, atopic dermatitis, seborrheic dermatitis, herpes zoster, eczema, boils, folliculitis, perineal inflammation, dermatitis, baldness and premature baldness, etc.
What are the precautions for phototherapy?Are there any side effects of UVB phototherapy?
1.Phototherapy should be carried out in a relatively closed place;
2.Shower before treatment and try to remove the scales;
3, scalp lesions, shave your head once a week;
4.When irradiating and within 8 hours after the light should wear sunglasses and avoid sunlight;
5, during the treatment period, avoid using other photosensitive drugs or food, including cosmetics, detergents, shading agents, clothes containing dyes, etc., certain diets such as ashwagandha, purple clouds, figs, mud snails, and food enhancers, occupational exposure to coal tar, spices, dyes, etc., some drugs such as sulfonamide, chlorpromazine and other phenothiazines, tetracyclines, nalidixic acid, ranitidine, estrogen, etc;
6. Avoid alcohol during treatment; routine blood and urine, liver and kidney function and eye examination should be done before and after treatment.
UVB phototherapy side effects risk of skin cancer, liver function damage, cataracts and many other long-term side effects
V. What is PUVA therapy? Which skin diseases are usually suitable for treatment?
Photochemotherapy (PUVA), also known as black light therapy, refers to the use of psoralens with photosensitizing effects followed by UVA (black light) irradiation to treat certain skin diseases. Among them, psoralens is a strong photosensitizing drug, the representative drug is 8-methylpsoralens (8-MOP), and UVA is a wavelength of 320-400nm long-wave ultraviolet light, and UVB and UVC compared to UVA has the advantage of activating photosensitive substances, but not easy to cause erythema reaction.PUVA irradiation of the skin can cause two opposite biological reactions, one can cause skin phototoxic reactions. One is that it can cause skin phototoxic reactions, which can inhibit DNA synthesis and cell division, psoriasis is characterized by a short epidermal cell cycle and rapid DNA synthesis, so it can be used to treat psoriasis; on the other hand, it can enhance melanocyte activity and increase the number, so it can be used to treat leukodystrophy. uva can penetrate the dermis, so there is also damage to the subepidermal cell infiltration, so the effect on mycosis fungoides Granuloma, atopic dermatitis and lichen planus are also effective in diseases that are not caused by epithelial proliferation. In summary, PUVA can be used to treat: psoriasis, vitiligo, mycosis fungoides, pustulosis, parapsoriasis, herpes zoster, bacterial eczema, other: acne vulgaris, atopic dermatitis and lichen planus.
VI. What are the contraindications and side effects of PUVA therapy?
Although PUVA therapy is relatively safe, with few side effects, especially on internal organs without significant toxic side effects, common side effects are skin pigmentation, erythema reaction, skin pruritus, nausea, dizziness, bleeding under the nail and nail pain, cataracts and carcinogenic effects, and also reported to cause a temporary increase in serum glutaminase, so PUVA also has its contraindications children, the elderly and infirm and pregnant women. Light-sensitive diseases, especially pigmented dry skin disease; skin blisters or oozing more serious; serious organic diseases, especially liver disease patients; melanoma patients or past history of melanoma disease; patients who have received radiation therapy; 7) cataract or other crystal disease patients.
VII. How to do PUVA photochemotherapy with oral medication?
PUVA and other therapies, such as PUVA plus aromatic retinoic acid for severe plaque psoriasis, PUVA plus MTX for psoriasis, and PUVA plus corticosteroids for patients with erythrodermic or pustular psoriasis, have achieved very good results.
VIII. What is photodynamic therapy? Which diseases are it applicable to?
Photodynamic therapy (PDT) is a new technology that uses photodynamic response for disease diagnosis and treatment. In clinical practice, photodynamic therapy is usually referred to as photodynamic therapy only, while photodynamic diagnosis is referred to as fluorescence diagnosis (Photodynamic Diagnosis, PDD). The latter, when irradiated with specific wavelengths of red light, causes the cells to produce reactive monomorphic oxygen species, which kills tumor cells or actively growing cells without affecting normal cells. Some investigators have already used topical ALA-PDT to treat male patients with urethral CA with satisfactory results without affecting the urethral mucosa around CA, demonstrating that ALA-PDT can selectively kill epidermal cells infected with HPV and ultimately achieve wart removal. Photodynamic therapy can also be used to treat many benign and malignant tumors of the skin, such as SCC, BCC, Bowen’s disease, etc.
IX. What are the properties of lasers? What are the types of lasers commonly used in dermatology?
Laser is the light radiated from the resonant cavity by the inversion of the ion number of the material capable of generating laser under special conditions, and it has the characteristics of high power, monochromaticity, directionality and good coherence in addition to the same properties of general light. Lasers commonly used in dermatology can be divided into continuous lasers and pulsed lasers according to their energy release mode. The former, such as carbon dioxide laser, helium-neon laser, argon ion laser, etc., and the latter, such as various Q-switched lasers, pulsed carbon dioxide laser, etc. In the department of dermatology and venereology, it can be used for laser surgery, laser physiotherapy and laser kinetic therapy, etc. In recent years, the theory of “photothermal separation” has been proposed, and the scope of laser treatment has become more extensive. It is necessary to pay attention to eye protection during various laser treatments.
X. What lasers are suitable for the treatment of vascular lesions?
Lasers that are suitable for the treatment of vascular lesions (nevus, capillary dilation, angiokeratoma, spider nevus, etc.) are: 511nm or 578nm copper vapor pulsed laser, 578nm or 585nm tunable dye pulsed laser.
XI. What lasers are suitable for the treatment of pigmented lesions? What are the noteworthy ones?
694nm Q-switched pulsed ruby laser, 755nm Q-switched alexandrite laser, 1064nm Nd:YAG Q-switched laser can be used to treat deep brown or black skin lesions, such as nevus of Ota, foreign body pigmentation, black tattoos, etc.; 532nm Q-switched laser, 510nm dye laser can be used to treat superficial brown or red skin lesions, such as bright red nevus, freckles, coffee spots, etc.
The main side effects of laser treatment for skin diseases are edema, hyperpigmentation, hypopigmentation and scar formation. Laser treatment of pigmented lesions should pay attention to whether the patient is scarred, as well as good protection for the eyes.
Twelve, the principle of ultrasound treatment of skin diseases and the scope of application?
The frequency of the sound wave exceeds 16Hz and becomes a mechanical vibration wave that cannot cause normal human hearing, called ultrasound. The use of ultrasound physical energy in a variety of ways to achieve the purpose of the treatment of disease in the human body, called ultrasound therapy. After ultrasound acts on human skin, sound energy is transformed into heat energy; in addition, coupled with the mechanical oscillation of ultrasound itself, the local temperature of the treatment can be increased, under the effect of warmth, the local blood circulation is strong, cell phagocytosis is enhanced, metabolism is increased, so it can improve the body’s defense ability, accelerate the absorption of inflammation, in addition, the right amount of ultrasound has a dissipative effect on connective tissue. According to the mechanism of ultrasound, it can be used in dermatology to treat inflammatory skin diseases, such as boils, carbuncles and cystic acne, etc. It can also be used for the treatment of keloid patients; ultrasound with vitamin E cream, cumene and other drugs for the treatment of limited scleroderma also has good efficacy; the use of ultrasound can be used for the treatment of post-inflammatory hyperpigmentation and chloasma caused by various factors; the use of ultrasound mechanical friction effect. The mechanical friction effect of ultrasound can regulate cell membrane permeability and strengthen local blood circulation and metabolic function, which can lead to the gradual disappearance of fine wrinkles, and when used with anti-wrinkle cream, the effect of wrinkle removal is better.
XIII. What are the principles and indications of radiation therapy for skin diseases? What are the precautions?
Radiation therapy uses certain equipment or nuclides to produce radiation to treat certain malignant tumors and some benign skin diseases. The commonly used radiation sources in dermatology are X-rays, nuclides and gas pedals, but in recent years the application of X-rays in dermatology has been greatly reduced, and the application of isotopes tends to be eliminated. Radiation therapy should pay attention to protection, especially in important areas such as the eye, thyroid, thymus, breast, and gonads. The same part of the X-ray exposure should not be excessive, so as not to cause radiation dermatitis.
1.X-ray treatment selects X-rays with appropriate penetration depth to reach the diseased tissue. The depth of penetration is related to the voltage. Depending on the voltage, X-ray therapy can be divided into super soft X-ray therapy, soft X-ray therapy, low voltage short distance X-ray therapy and superficial X-ray therapy. It can be applied to treat limited neurodermatitis and chronic eczema, limited pruritus, hyperhidrosis of hands and feet, keloid, strawberry and cavernous hemangioma, basal cell carcinoma, etc.
2.Radionuclide therapy mainly uses phosphorus-32 and strontium-90 to emit pure beta rays with strong energy, small penetrating power, superficial effect and no damage to deep tissues. It can be applied to the treatment of limited neurodermatitis and chronic eczema, strawberry and cavernous hemangioma, etc.
3.Accelerator Commonly used is the electron linear gas pedal, the penetrating power of its generated electron beam can be adjusted. In the treatment of superficial skin lesions, a 0.5cm thick Plexiglas plate is placed in the path of the electron beam passing through to correct the high dose area to the superficial part of the skin. The commonly used energy is 4~6Mev, and the dose of this energy is sharply reduced at 2~3cm under the skin, thus not causing systemic damage to the patient. It can be applied to treat diseases with extensive infiltration of human skin, such as mycosis fungoides and squamous cell carcinoma of the skin.