Laser Treatment of Skin Lesions under Dermal Vasoconstriction

Abstract

A method for treating a skin lesion can include reducing a temperature at a treatment site to a temperature range sufficient to induce vasoconstriction in the dermis of the treatment site and applying laser light to the skin lesion through a medium while maintaining the temperature at the treatment site within the temperature range. The medium can include a first portion and a second portion, the laser light sequentially passing through the first portion and the second portion, the second portion including a contact surface that contacts the treatment site, the second portion having a higher thermal conductivity than the first portion. The method can further include identifying the skin lesion and analyzing one or more characteristics of the skin lesion.

Description

Technical Field

[0001] Priority Claim This application claims priority to U.S. Provisional Patent Application No. 63 / 035,569, filed Jun. 5, 2020, the entire disclosure of which is hereby incorporated by reference herein. Technical Field The present invention relates to dermatological laser treatment.

Background Art

[0002] Background Melanin is biosynthesized in melanocytes (melanin cells) located in the basement membrane of the skin. Melanin is transported in the form of melanosomes via the dendritic processes of melanocytes to surrounding keratinocytes. When melanin is overproduced or existing melanin is more actively transferred to keratinocytes by a certain stimulus, various pigmented lesions may be formed, or existing pigmentation may be aggravated. Excessive melanin production may be caused by ultraviolet (UV) exposure or inflammatory skin reactions.

Summary of the Invention

Problems to be Solved by the Invention

[0003] In dermatology, laser treatment has been widely used to treat various vascular and pigmented skin lesions, tattoos, skin benign tumors, premalignant lesions, non-melanoma skin cancers in situ, and microinvasive skin cancers. Conventional laser treatment methods for skin lesions are generally safe and effective, but side effects such as burns, wound infections, allergic reactions to local anesthesia, and chronic or permanent side effects such as post-inflammatory erythema (PLE), post-inflammatory hyperpigmentation (PIH), and scars may occur.

Means for Solving the Problems

[0004] Summary Generally, a method of treating a skin lesion can include reducing the temperature of a treatment site to a temperature range sufficient to induce vasoconstriction in the dermis of the treatment site and applying laser light to the skin lesion through a medium while maintaining the temperature of the treatment site within that temperature range.

[0005] In some embodiments, the medium can include a first portion and a second portion, the laser light sequentially passes through the first portion and the second portion, the second portion includes a contact surface that contacts the treatment site, and the second portion has a higher thermal conductivity than the first portion.

[0006] In some embodiments, the first portion and the second portion can be optically transparent.

[0007] In some embodiments, the first portion can include quartz, sapphire, quartz crystal, poly(methyl methacrylate), or polystyrene.

[0008] In some embodiments, the second portion can include quartz, sapphire, quartz crystal, poly(methyl methacrylate), or polystyrene.

[0009] In some embodiments, a beam splitter can be positioned between the first portion and the second portion.

[0010] In some embodiments, the first portion and the second portion can be separated by sealed air.

[0011] In some embodiments, reducing the temperature of the treatment site can include contacting the treatment site with the contact surface of the second portion of the medium.

[0012] In some embodiments, contacting the treatment site with the contact surface of the second portion of the medium can include compressing the surface of the treatment site with the contact surface of the second portion of the medium.

[0013] In some embodiments, reducing the temperature of the treatment site can include administering a drug that induces vasoconstriction of the treatment site before applying the laser light.

[0014] In some embodiments, the laser light can have a wavelength of from about 300 nm to about 2500 nm.

[0015] In some embodiments, the laser light is pulsed light.

[0016] In some embodiments, the laser light has a fluence of 0 to 3000 J / cm 2 2.

[0017] In some embodiments, the method can further include applying an antifreeze solution to the surface of the treatment site or to the contact surface of the second portion of the medium.

[0018] In some embodiments, a temperature range of the treatment site sufficient to induce vasoconstriction in the dermis of the treatment site can be from 0°C to 20°C.

[0019] In some embodiments, the medium can have a temperature of from -30°C to 0°C.

[0020] In some embodiments, the method can further include identifying a skin lesion and analyzing one or more characteristics of the skin lesion.

[0021] In some embodiments, the one or more characteristics can be the location, border, size, thickness, or pigment level of the skin lesion.

[0022] In some embodiments, the skin lesion is a pigmented lesion.

[0023] In some embodiments, the skin lesion is a non-pigmented lesion.

[0024] Generally, an apparatus for treating skin lesions can include a light source that generates laser light and a medium that transmits the laser light, the medium including a first portion and a second portion, the laser light sequentially passing through the first portion and the second portion, the second portion including a contact surface that contacts a treatment site, and the second portion having a higher thermal conductivity than the first portion. Apparatus.

[0025] In some embodiments, the laser light can have a wavelength of from about 300 nm to about 2500 nm.

[0026] In some embodiments, the laser light can be pulsed light.

[0027] In some embodiments, the laser light can have a fluence of 0 to 3000 J / cm 2 of.

[0028] In some embodiments, the first portion and the second portion can be optically transparent.

[0029] In some embodiments, the first portion can include quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

[0030] In some embodiments, the second portion can include quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

[0031] In some embodiments, the apparatus can further include a beam splitter located between the first portion and the second portion.

[0032] In some embodiments, the first portion and the second portion can be separated by sealed air.

[0033] In some embodiments, the apparatus can further include a cooling unit that reduces the temperature of the medium to a target temperature range.

[0034] In some embodiments, the target temperature range of the medium can be -30°C to 0°C.

[0035] In some embodiments, the cooling unit can include a thermoelectric cooler, cooling air, a cooling gas, or a coolant.

[0036] In some embodiments, it further includes a metal unit disposed between the cooling unit and the medium.

[0037] In some embodiments, the metal unit can include a temperature sensor.

[0038] In some embodiments, the temperature sensor can detect the temperature of the medium.

[0039] In some embodiments, the temperature sensor can detect the temperature of the cooling unit.

[0040] In some embodiments, the temperature sensor can detect the temperature of the treatment site.

[0041] In some embodiments, the skin lesion is a pigmented lesion.

[0042] In some embodiments, the skin lesion is a non-pigmented lesion.

[0043] Generally, a system for treating skin lesions can include a light source that generates laser light, a medium that transmits the laser light, the medium including a first portion and a second portion, the laser light sequentially passing through the first portion and the second portion, the second portion including a contact surface that contacts a treatment site, the second portion having a higher thermal conductivity than the first portion, the medium, a cooling unit that reduces the temperature of the medium to a target temperature range, a beam splitter positioned between the first portion and the second portion, the beam splitter sending an image of the skin lesion to an image capture device, and a controller operatively coupled to the image capture device, the controller analyzing one or more characteristics of the skin lesion and inducing the laser light to treat the skin lesion according to the one or more characteristics.

[0044] In some embodiments, the laser light can have a wavelength of from about 300 nm to about 2500 nm.

[0045] In some embodiments, the laser light can be pulsed light.

[0046] In some embodiments, the laser light can have a fluence of 0 to 3000 J / cm 2 of.

[0047] In some embodiments, the first portion and the second portion can be optically transparent.

[0048] In some embodiments, the first portion and the second portion can be separated by sealed air.

[0049] In some embodiments, the first portion can include quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

[0050] In some embodiments, the second portion can include quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

[0051] In some embodiments, the target temperature range of the medium can be from -30°C to 0°C.

[0052] In some embodiments, the cooling unit can include a thermoelectric cooler, cooling air, a cooling gas, or a coolant.

[0053] In some embodiments, the image can be a real-time image.

[0054] In some embodiments, one or more characteristics can be the location, border, size, thickness, or pigment level of the skin lesion.

[0055] In some embodiments, the skin lesion is a pigmented lesion.

[0056] In some embodiments, the skin lesion is a non-pigmented lesion.

[0057] Generally, a system for treating a skin lesion includes a light source that generates laser light, and a medium that transmits the laser light, the medium including a first part and a second part, the laser light sequentially passing through the first part and the second part, the second part including a contact surface that contacts the treatment site, the second part having a higher thermal conductivity than the first part, and a cooling unit that reduces the temperature of the medium to the target temperature range.

[0058] In some embodiments, the laser light can have a wavelength of from about 300 nm to about 2500 nm.

[0059] In some embodiments, the laser light can be pulsed light.

[0060] In some embodiments, the laser light can have a fluence of 0 to 3000 J / cm 2 2.

[0061] In some embodiments, the first part and the second part can be optically transparent.

[0062] In some embodiments, the first part and the second part can be separated by sealed air.

[0063] In some embodiments, the first part can include quartz, sapphire, crystal, poly(methyl methacrylate) or polystyrene.

[0064] In some embodiments, the second part can include quartz, sapphire, crystal, poly(methyl methacrylate) or polystyrene.

[0065] In some embodiments, the target temperature range of the medium can be -30°C to 0°C.

[0066] In some embodiments, the cooling unit can include a thermoelectric cooler, cooling air, cooling gas or coolant.

[0067] In some embodiments, the system can further include a metal unit disposed between the cooling unit and the medium.

[0068] In some embodiments, the metal unit can include a temperature sensor.

[0069] In some embodiments, the temperature sensor can detect the temperature of the medium.

[0070] In some embodiments, a controller can be operatively coupled to the temperature sensor to control the temperature of the medium.

[0071] In some embodiments, the temperature sensor can detect the temperature of the cooling unit.

[0072] In some embodiments, the controller can be operatively coupled to the temperature sensor to control the temperature of the cooling unit.

[0073] In some embodiments, the temperature sensor can detect the temperature of the treatment site.

[0074] In some embodiments, the controller is operatively coupled to a temperature sensor to control the temperature of the treatment site.

[0075] In some embodiments, the skin lesion is a pigmented lesion.

[0076] In some embodiments, the skin lesion is a non-pigmented lesion.

[0077] Other aspects, embodiments and features will become apparent from the following description, drawings and claims. BRIEF DESCRIPTION OF THE DRAWINGS

[0078] BRIEF DESCRIPTION OF THE DRAWINGS

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Mode for Carrying Out the Invention

[0079] Detailed Description As used herein, the term "comprising" means including but not limited to.

[0080] As used herein, the term "pigmented lesion" includes any lesion containing any type of pigment. The pigment can be natural (e.g., melanin or oxyhemoglobin) or artificial (e.g., tattoo pigment).

[0081] By utilizing the fact that pigmented lesions absorb light of a predetermined wavelength, various lasers can be used to treat pigmented lesions of the skin. In other words, pigmented lesions are chromophores for the predetermined wavelength of laser light. Usually, a laser having a pulse width shorter than the thermal relaxation time (TRT) of the chromophore can be used to treat pigmented lesions, because the shorter the TRT, the more the target pigment can be selectively destroyed with high output energy, minimizing damage to the surrounding skin tissue, while minimizing the absorption time of photoelectrons by the chromophore, thereby minimizing the conversion to thermal energy and the diffusion to adjacent skin tissues and cells. However, the high output energy applied by the laser inevitably causes an inflammatory reaction and tissue damage, and then a wound healing process will occur. In fact, many laser skin treatment modalities utilize the wound healing process to promote skin regeneration. However, if the laser treatment causes an excessive reaction, undesirable side effects, PLE, PIH, and scars may occur.

[0082] Laser therapy can also be used for non-pigmented skin lesions. Except for melanin, most of the chromophores in the skin such as water, oxyhemoglobin, and sebaceous glands are mostly present in the dermis. Currently, when laser therapy targets dermal lesions, the fluence and energy levels must be kept low enough to prevent possible epidermal burns and damage to the surrounding dermal tissue and vasculature. There are existing cooling devices used for lasers, but most of them are designed to prevent epidermal burns and cannot sufficiently cool the dermis to enable effective and efficient treatment with sufficient energy while preventing tissue damage and various side effects. Under these limitations, to target dermal lesions such as collagen, hair, and sebaceous glands, the energy levels delivered by existing lasers are not sufficient, and multiple, long laser treatment sessions are often required.

[0083] When tissue damage occurs after laser therapy, inflammatory cells migrate to the damaged site through the dermal capillaries, interact with the cells around the damaged site, and secrete various cytokines that cause an inflammatory response. These cytokines also initiate the wound healing process that generates new skin tissue in the damaged skin. Cytokines, when causing an excessive inflammatory response, can promote the formation of new blood vessels and the overgrowth of the extracellular matrix, and stimulate melanocytes to produce excessive amounts of melanin at the damaged site. As a result, common side effects such as PLE, scarring, and PIH can occur from laser therapy. In some cases, these may be temporary phenomena that may disappear as the wound heals. However, in cases of severe tissue damage, the side effects are extremely serious, persist for a long time, and as a result, erythema may persist and undesirable pigmentation may occur.

[0084] The lasers most commonly used for skin lesions use light at wavelengths that are readily absorbed by oxyhemoglobin in the vascular system, similar to the target chromophore. Absorption of high - power energy by oxyhemoglobin can lead to capillary bleeding (petechiae), followed by skin edema and purpura. As the fluence of the laser light increases, capillary damage also increases. Currently, local anesthetic creams, prescription drugs before and after laser treatment, and / or wet dressings are used to minimize the pain or side effects caused by laser treatment, but their effects are very limited. So far, in conventional laser treatment modalities, side effects such as PLE, PIH, and scarring are considered inevitable, and more emphasis has been placed on post - treatment management rather than prevention of side effects.

[0085] The dermis is most profoundly affected by high - power energy from laser light because its vascular system contains oxyhemoglobin in red blood cells, which is a chromophore for many types of conventional lasers in dermatology. Dermal capillaries can be damaged by absorption of high - power energy, and inflammatory cells moving through the capillaries can produce cytokines that cause an inflammatory response. Once initiated, the inflammatory response can induce further massive migration of inflammatory cells to the damaged site, exacerbating the ongoing reaction. As a result, the expansion and persistence of the inflammatory response by the migrated inflammatory cells can delay skin regeneration at the damaged site, which is most often associated with severe levels of PLE, PIH, and scarring.

[0086] To overcome the drawbacks of conventional laser therapy, it is possible to induce dermal vasoconstriction and trigger the short reflex action of the autonomic nervous system to maintain body temperature. Figure 1A is a schematic diagram of blood flow in the normal capillary system of the dermis. Figure 1B is a schematic diagram of blood flow under dermal vasoconstriction. Due to the reflex action and subsequent dermal vasoconstriction, it is possible to temporarily contract the precapillary sphincter and divert blood flow only to the vascular plexus in front of the sphincter (Figure 1B). By doing so, blood flow to the main dermal capillaries can be blocked for a short time. When the amount of red blood cells decreases in the dermal capillaries, chromophores outside the target that respond to laser light (e.g., oxyhemoglobin) decreases. As a result, damage to the capillaries can be reduced, thereby reducing the amount of inflammatory cells migrating to the damaged site. As a result, the inflammatory response and side effects to laser light can be significantly reduced, thereby promoting faster wound healing and skin regeneration. Therefore, this method is named "Vasculature Salvage Laser Surgery (VSLS)".

[0087] Dermal vasoconstriction can be achieved by reducing the skin temperature to the target range using a cooling device operatively coupled to the laser. However, none of the existing cooling methods are sufficient to induce dermal vasoconstriction adequately to prevent side effects associated with laser treatment. Currently, there are two types of cooling methods for lasers, namely contact cooling and non-contact cooling. In the case of contact cooling, the skin contacts a solid medium at a temperature above 0°C. The cooling gas can reduce the temperature to below 0°C, but it operates for only a very short time, about 10 to 100 milliseconds. None of these methods are sufficient to induce dermal vasoconstriction. Furthermore, dynamic cooling devices, mainly used for long-pulse lasers whose main purpose is dermal heating to induce hair removal, vascular lesions, and skin tightening, use a cooling burst of refrigerant for a few milliseconds before the laser shot. If there is a mismatch between the cooling burst and the laser shot, blisters and scars may form. Contact cooling is used for intense pulsed light (IPL) with a pulse duration in the millisecond range. However, IPL is spectral light, different from light of a single wavelength like a laser. For Q-switch lasers, due to the very short pulse duration in the nanosecond range and relatively low energy level, a separate cooling device is not used. However, the absence of separate cooling limits the fluence and energy levels of laser applications, resulting in an ineffective and inefficient treatment, serious side effects, and an inadequate outcome.

[0088] When laser light is applied under dermal vasoconstriction, much higher energy can be applied at once compared to conventional methods. For example, in the case of a 532 nm Q-switch laser with a 3 mm beam spot size, the laser manufacturer usually recommends a fluence range of 0.6 - 1.0 J / cm 2 and the clinician recommends 0.6 - 0.8 J / cm 2The fluence range of is most commonly used. In conventional laser therapy, absorption by oxyhemoglobin is too strong, resulting in rupture of major capillaries at higher fluences. This is accompanied by serious side effects such as pain, swelling, petechial hemorrhage, patchy hemorrhage, and severe PIH. However, when the treated area is cooled to a temperature sufficient to induce dermal vasoconstriction, up to 20 times the energy can be applied at once without any significant side effects.

[0089] Figure 2 is a schematic diagram of laser treatment for skin lesions under dermal vasoconstriction. In some embodiments, the skin lesion can be a pigmented skin lesion. In some other embodiments, the skin lesion can be a non-pigmented skin lesion. By this method, the skin lesion 101 of the skin 102 can be treated using the laser light 103 while minimizing the undesirable side effects caused by the laser. By this method, the dermal vascular system of the treatment site 120 can be preserved as much as possible while obtaining the desired therapeutic effect. The treatment site 120 includes the skin surface in contact with the medium of the laser light and a certain volume of skin under that skin surface affected by the laser light 103. By temporarily reducing the amount of red blood cells in the capillaries of the treatment site 120 during laser treatment, the amount of unnecessary chromophores that react to the laser light 103 can be reduced, thereby minimizing the effect of laser energy on the capillaries. This can be achieved by reducing the temperature of the treatment site 120 to a target temperature range sufficient to induce vasoconstriction in the dermis of the treatment site 120 (Figure 2, B), and applying the laser light 103 to the skin lesion while maintaining the temperature of the treatment site 120 within the target temperature range (Figure 2, C). In some embodiments, the treatment site 120 can be pretreated with a local anesthetic and epinephrine 150 to promote further vasoconstriction (Figure 2, A). In some other embodiments, the treatment site 120 can be compressed to minimize blood flow. By this method, damage to the dermal vascular system can be minimized while treating the skin lesion (Figure 2, D), and side effects such as PLE, PIH, and scarring can be significantly reduced (Figure 2, E). In some embodiments, the method can further include identifying the skin lesion and analyzing one or more characteristics of the skin lesion. In some embodiments, the one or more characteristics are the location, boundary, size, thickness, or pigment level of the skin lesion.

[0090] As shown in FIG. 3, an apparatus 100 for treating a skin lesion 101 of skin 102 using a laser beam 103 while minimizing undesirable side effects of the laser can include a light source (not shown) that generates the laser beam 103 and a medium 104 through which the laser beam 103 passes. The medium 104 can include a first portion 105 and a second portion 106. The laser beam 103 can sequentially pass through the first portion 105 and the second portion 106. The second portion 106 can include a contact surface 107 that contacts the surface of the treatment site 120. In some embodiments, the second portion 106 can have a higher thermal conductivity than the first portion 105. In some embodiments, the apparatus 100 can include a cooling unit 108 that reduces the temperature of the medium 104 to a target temperature range. The cooling unit 108 can include a thermoelectric cooler, cooling air, a cooling gas, or a coolant. In some embodiments, the coolant can be cooling water.

[0091] As shown in FIG. 4, the apparatus 200 can further include a metal unit 109 disposed between the medium 104 and the cooling unit 108. The metal unit 109 can be cooled by the cooling unit 108 and can then cool the medium 104. The metal unit 109 can further include a temperature sensor (not shown). The temperature sensor can detect the temperature of the cooling unit 108, the temperature of the medium 104, and / or the temperature of the treatment site 120.

[0092] In some embodiments, the laser light 103 can be pulsed light. The laser light can be long-pulsed light or short-pulsed light. The typical pulse durations of long-pulsed light or short-pulsed light should be well-known to those skilled in the art. In some embodiments, the laser light 103 can have a wavelength of about 300 nm to about 2500 nm. In some embodiments, the light source of the laser light 103 can be a Q-switched laser. For example, a Q-switched ruby laser at 694 nm, a Q-switched alexandrite laser at 755 nm, or a Q-switched Nd:YAG laser at 532 nm / 1064 nm can be used. In some other embodiments, the light source of the laser light 103 can be a picosecond-region laser that delivers much higher energy at pulse durations much shorter than those of Q-switched lasers. In some embodiments, the light source of the laser light 103 can be a long-pulsed laser having a wavelength of 308 nm, 511 nm, 532 nm, 578 nm, 755 nm, or 1064 nm. In some embodiments, the light source of the laser light can be an infrared laser (e.g., 1450 nm, etc.), a thulium laser (e.g., 1927 nm, etc.), or any other laser including wavelengths such as 1210 nm, 1728 nm, 1760 nm, 2306 nm, and 2346 nm, etc.

[0093] To induce vasoconstriction in the dermis of the treatment site 120, the temperature of the cooling unit 108 can be from -30°C to 0°C, preferably from -20°C to 0°C. The medium 104 can be cooled directly or indirectly (e.g., via the metal unit 109) by the cooling unit 108 and can similarly reach a temperature of from -30°C to 0°C, preferably from -20°C to 0°C. The contact surface 107 of the medium 104 can contact the surface of the treatment site 120 to lower the temperature of the treatment site 120. To maintain dermal vasoconstriction, the temperature of the treatment site 120 can be maintained at 0°C to 20°C, preferably 5°C to 15°C, at the surface by adjusting the cooling time and the temperature of the cooling unit 108. In a preferred embodiment, the temperature of the treatment site 120 is also maintained at 5°C to 15°C at the surface.

[0094] When the treatment site 120 is cooled to a temperature sufficient to induce dermal vasoconstriction, the laser light 103 can be applied at 0 - 3000 J / cm 2 In some embodiments, the laser light 103 can be applied at 0.5 - 3000 J / cm 2 In some embodiments, a long - pulse Nd:YAG laser can be used to apply 0 - 1000 J / cm 2 In some embodiments, a yellow laser (e.g., 511 nm, 578 nm, etc.) can be used to apply 0 - 3000 J / cm 2 Generally, a Q - switched laser or any other laser applicable to the method can be used to apply 0 - 100 J / cm 2 In some embodiments, the laser light 103 can be applied at 0 - 5 J / cm 2 In a preferred embodiment, the laser light 103 can be applied at 2 - 4 J / cm 2 In some embodiments, the laser light 103 can be applied at 2 - 4 J / cm

[0095] When the medium is cooled to a temperature range of - 30°C to 0°C, water from the surrounding air may condense and freeze on the surface of the medium, which may cause cloudiness of the medium. This may cause the laser light to scatter, which may affect the efficiency and safety of laser treatment. In some embodiments, the medium 104 can be made of two or more parts having different thermal conductivities for each part, thereby preventing cloudiness. To efficiently cool the treatment site 120, the part in contact with the skin can be made of a material having the highest thermal conductivity. In some embodiments, the medium 104 can include a first part 105 and a second part 106, and the second part 106 has a higher thermal conductivity than the first part 105.

[0096] In some embodiments, the first portion 105 can include quartz, sapphire, quartz crystal, poly(methyl methacrylate), or polystyrene. In some embodiments, the second portion 106 can include quartz, sapphire, quartz crystal, poly(methyl methacrylate), or polystyrene. In some embodiments, the first portion can include quartz crystal, and the second portion can include sapphire.

[0097] In some embodiments, in order to prevent fogging of the contact surface 107, an antifreeze liquid 140 can be applied between the contact surface 107 and the treatment site 120. The antifreeze liquid 140 should effectively transmit light even below the freezing temperature. The antifreeze liquid 140 can be applied on the contact surface 107 or on the surface of the treatment site 120. In some embodiments, the antifreeze liquid 140 can include glycerin and / or oil.

[0098] As shown in FIG. 5, the system 300 can include an apparatus 200 as shown in FIG. 4 and a controller 112. In some embodiments, the system 300 can further include a beam splitter 110 between the first portion 105 and the second portion 106 to classify, pass through, and / or reflect an image 111 of the treatment site 120. In some embodiments, the controller 112 can identify, process, and analyze the image 111 obtained by the beam splitter 110. The beam splitter 110 can send an image including the skin lesion 101 to the image capture device 113. In some embodiments, the image can be a real-time image. In some embodiments, the controller 112 can be operatively coupled to the image capture device 113 to analyze the characteristics of the skin lesion 101 and direct the laser light 103 to treat the skin lesion 101 according to the characteristics. The characteristics of the skin lesion can include the location, boundary, size, thickness, and pigment level (i.e., pigment density or concentration) of the lesion. Based on these characteristics, various parameters of the laser light 103, such as the beam size, frequency, and beam-to-beam overlapping ratio, can be determined.

[0099] In some embodiments, the controller 112 can be operatively coupled to a cooling unit 108 to a temperature sensor (not shown). The temperature sensor can detect the temperature of the cooling unit 108, the temperature of the medium 104, and / or the temperature of the treatment site 120. In some embodiments, the controller 112 can be operatively coupled to the temperature sensor to control the temperature of the cooling unit 108, the temperature of the medium 104, and / or the temperature of the treatment site 120.

[0100] As shown in FIG. 6, the apparatus 400 can include a first portion 105 and a second portion 106 separated by a sealed air 130. In some embodiments, the metal portion 109, similar to the first portion 105 and the second portion 104, can constitute a sealed path for the laser light 103. In some embodiments, a beam splitter 110 can be disposed between the first portion 105 and the second portion 106 to classify, pass, and / or reflect an image 111 of the treatment site 120. In some embodiments, it can include an image capture device 113 and / or a controller 112.

[0101] FIG. 7 is a schematic diagram of laser treatment for a skin lesion 101 under dermal vasoconstriction, including an analysis using a lesion recognition algorithm. The method of treating the skin lesion 101 of the skin 102 using the laser light 103 while minimizing the undesirable side effects of the laser can further include an analysis using a lesion recognition algorithm that includes capturing an image of the skin lesion 101 and analyzing its characteristics such as location, boundary, size, thickness, and pigment level (FIG. 7, F).

[0102] Figures 8A - 8F show an example of a lesion recognition algorithm for treating skin lesions. In some embodiments, the lesion can be identified by the controller 112 (Figure 8A). The characteristics of the lesion can be analyzed, and the boundaries of laser irradiation can be determined (Figures 8B and 8C). Based on the characteristics of the lesion, various parameters such as appropriate beam size, frequency, and beam overlap rate for each shot can be calculated and applied accordingly (Figure 8D). In some embodiments, additional laser shots can be further applied to any areas that are missed or require a certain degree of beam overlap (Figure 8E). In some embodiments, any post - laser treatment can be performed after laser treatment (Figure 8F). Although these steps have been described in detail, this embodiment is merely an example, and those skilled in the art should understand that various changes, substitutions, switches or orders, and modifications can be made without departing from the spirit and scope disclosed herein.

[0103] Figure 9 is a diagram of laser treatment using a lesion recognition algorithm. Based on the lesion recognition algorithm, the intensity and coordinates of each laser shot can be precisely controlled, so that a single - shot laser light can be applied to any given location to treat skin lesions. Thereby, problems such as uneven irradiation, excessive irradiation, or insufficient irradiation of laser light can be eliminated.

[0104] Laser treatment by this method can significantly reduce common side effects of conventional laser treatment, such as pain, swelling, petechial hemorrhage, and ecchymosis, even at a much higher level of laser energy than conventional laser treatment methods. Figure 10A shows 0.6 - 1.0 J / cm 2Photographs of pigmented lesions immediately after conventional laser treatment using a 532 nm Q-switched laser with fluence energy are shown. The photographs in the left column show the treatment sites immediately after conventional laser treatment, showing punctate bleeding and purpuric skin edema at the treatment sites. The photographs in the right column show the treatment sites 1 minute (top), 5 minutes (middle), and 30 minutes (bottom) after conventional laser treatment, demonstrating side effects that worsen over time. Figure 10B shows 3J / cm 2 Photographs of the treatment sites immediately after laser treatment by the present method using a 532 nm Q-switched laser with fluence energy are shown. No punctate bleeding, bleeding, or skin edema was observed, and only immediate blackening was observed.

[0105] Figure 11A is a photograph showing the treatment of the epidermis including pigmented lesions after laser treatment by the present method. For example, using a 532 nm Q-switched Nd:YAG laser, a fluence of about 2 - 4 J / cm 2 can be applied to the pigmented lesion to treat the pigmented lesion. When this level of energy is applied in a single pass to the pigmented lesion while cooling and maintaining the surface of the treatment site at 0°C - 20°C, only the epidermis of the pigmented lesion peels off about 2 weeks after treatment, as shown in Figure 11A. No dermal damage is observed. This method can be used as an alternative to conventional ablative laser surgery without actually excising the tissue, thereby preventing serious side effects such as PLE, PIH, and scarring. In the case of a 532 nm Q-switched Nd:YAG laser, the main chromophores in the skin are melanin and oxyhemoglobin. Therefore, when oxyhemoglobin is mostly removed from the treatment site by dermal vasoconstriction, melanin, the only remaining chromophore that mostly exists in the basement membrane between the epidermis and the dermis, can absorb most of the energy applied to the treatment site (Figure 11B). As a result, the epidermis including the pigmented lesion can be treated without damaging the dermis, enabling much faster recovery compared to conventional ablative laser surgery.

[0106] Laser treatment by this method can bring about a much better long-term prognosis than conventional laser treatment methods. Figures 12A to 12D show photographs before and 2 weeks after laser treatment by this method. Photographs of two patients with pigmented lesions before treatment (Figures 12A and 12C) and 2 weeks after (Figures 12B and 12D) by this method are shown. In both cases, no PIH or PLE was observed, and complete recovery was observed only about 2 weeks after treatment for each patient. Figures 13A to 13D show photographs of pigmented lesions before treatment (Figure 13A), 1 month after conventional excision-type CO2 laser treatment (Figure 13B), 2 months after (Figure 13C), and 9 months after (Figure 13D). A significant level of PLE and PIH was observed until at least 2 months after treatment (Figures 13B and 13C), and PIH still remained 9 months after treatment (Figure 13D).

[0107] As a non-limiting example, the following table shows a comparison of typical fluence ranges between conventional laser treatment and laser treatment by this method (「VSLS」) for epidermal and / or dermal pigmented lesions.

[0108] [Table 1] Figure 14 shows exemplary comparisons between the conventional method and the present method for a Q-switched Nd:YAG laser at 532 nm (Qx-max, 3 mm laser spot size, Fotona Inc., Slovenia), a Q-switched ruby laser at 694 nm (Sinon-I, 3 mm laser spot size, Alma Inc., Germany), and a long-pulse alexandrite laser at 755 nm (Pento 755 nm, 3 mm laser spot size, NSON, South Korea). The rows labeled 532C, 694C, and 755C represent the control treatment spots by the conventional method using lasers at 532 nm, 694 nm, and 755 nm, respectively. The rows labeled 532V, 694V, and 755V represent the treatment spots by the present method using lasers at 532 nm, 694 nm, and 755 nm, respectively. Column D0 (day 0) shows the treatment spots where biopsies were taken for histological examination immediately after each treatment. Columns D1, D2, D3, and D7 show the treatment spots where biopsies were taken 1 day, 2 days, 3 days, and 7 days after each treatment, respectively. The D21 spot (21 days after treatment) was not biopsied.

[0109] 3 J / cm 2 For the 532 nm Q-switched Nd:YAG laser of 3 J / cm², on day 0 and day 1, damage was caused to the epidermal and dermal vascular systems by both the conventional method and the present method. On day 2, with the conventional treatment method, the epidermis and dermis were separated, and there was significant damage to the dermis. In contrast, with the present method, both the epidermis and dermis recovered very quickly without causing damage to the dermal vascular system. Figure 15 shows the histological comparison of the treatment spots of the 532 nm Q-switched Nd:YAG laser for the conventional method (left column) and the present method (right column).

[0110] 9 J / cm 2 For the 694 nm Q-switched ruby laser of 9 J / cm², the results were the same as those for the 532 nm Nd:YAG laser. Figure 16 shows the histological comparison of the treatment spots of the 694 nm Q-switched ruby laser for the conventional method (left column) and the present method (right column).

[0111] 40 J / cm 2In the case of a 755 nm long pulse alexandrite laser, the recovery of the dermis was much faster from the third day when this method was used compared to the conventional method. Figure 17 shows a histological comparison of the treatment spots of the 755 nm long pulse laser for the conventional method (left column) and this method (right column).

[0112] Using the methods and devices disclosed herein, various pigmented skin lesions, including seborrheic keratosis, melasma, freckles, solar lentigines, pigmented nevi, and dermal melanocytosis, can be treated. By changing the wavelength, pulse width, and other parameters and types of the laser using these methods and devices, nevus of Ota, congenital pigmented nevus, Becker's nevus, tattoo removal, laser hair removal, sebaceous glands, and other vascular pigmented skin lesions and benign skin tumors can also be treated. Using these methods and devices, epidermal-derived non-cancerous, pre-cancerous lesions and other optional skin lesions including non-melanoma skin cancer, such as viral warts, actinic keratosis, actinic cheilitis, Bowen's disease, Bowenoid papulosis, superficial basal cell carcinoma, intraepithelial squamous cell carcinoma, microinvasive squamous cell carcinoma, and extramammary Paget's disease, can also be treated.

[0113] Other embodiments are within the scope of the following claims.

Claims

1. An apparatus for treating skin lesions, comprising: a light source that generates laser light; a medium that transmits the laser light, the medium including a first portion and a second portion; and the laser light sequentially passes through the first portion and the second portion; the second portion includes a contact surface that contacts a treatment site; the second portion has a higher thermal conductivity than the first portion; the first portion and the second portion are continuously connected to each other in the medium via an interface; an apparatus.

2. The apparatus according to claim 1, wherein the laser light has a wavelength of about 300 nm to about 2500 nm.

3. The apparatus according to claim 1, wherein the laser light is pulsed light.

4. The laser light has a fluence of 0 to 3000 J / cm ２ The apparatus according to claim 1.

5. The apparatus according to claim 1, wherein the first portion and the second portion are optically transparent.

6. The apparatus according to claim 1, wherein the first portion includes quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

7. The apparatus according to claim 1, wherein the second portion includes quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

8. The apparatus according to claim 1, further comprising a beam splitter located between the first portion and the second portion.

9. The apparatus according to claim 1, further comprising a cooling unit that reduces the temperature of the medium to a target temperature range.

10. The apparatus according to claim 9, wherein the target temperature range of the medium is -30°C to 0°C.

11. The apparatus according to claim 9, wherein the cooling unit includes a thermoelectric cooler, cooling air, cooling gas, or coolant.

12. The apparatus according to claim 9, further comprising a metal unit disposed between the cooling unit and the medium.

13. The apparatus according to claim 12, wherein the metal unit includes a temperature sensor.

14. The apparatus according to claim 13, wherein the temperature sensor can detect the temperature of the medium.

15. The apparatus according to claim 13, wherein the temperature sensor can detect the temperature of the cooling unit.

16. The apparatus according to claim 13, wherein the temperature sensor can detect the temperature of the treatment site.

17. The apparatus according to claim 1, wherein the skin lesion is a pigmented lesion.

18. The apparatus according to claim 1, wherein the skin lesion is a non-pigmented lesion.

19. A system for treating skin lesions, comprising: A light source that generates laser light, A medium that transmits the laser light, the medium including a first portion and a second portion, The laser light sequentially passes through the first portion and the second portion, and the second portion includes a contact surface that contacts a treatment site, A medium in which the second portion has a higher thermal conductivity than the first portion, A cooling unit that reduces the temperature of the medium to a target temperature range, A controller operatively coupled to an image capture device to analyze one or more characteristics of the skin lesion, The controller that induces the laser light to treat the skin lesion according to the one or more characteristics, A system comprising the first portion and the second portion being continuous with each other in the medium via an interface.

20. The system according to claim 19, wherein the laser light has a wavelength of about 300 nm to about 2500 nm.

21. The system according to claim 19, wherein the laser light is pulsed light.

22. The laser light has a fluence of 0 to 3000 J / cm ２ The system according to claim 19, having a fluence of

23. The system according to claim 19, wherein the first portion and the second portion are optically transparent.

24. The system according to claim 19, wherein the first portion includes quartz, sapphire, crystal, poly(methyl methacrylate) or polystyrene.

25. The system according to claim 19, wherein the second portion includes quartz, sapphire, crystal, poly(methyl methacrylate) or polystyrene.

26. The system according to claim 19, wherein the target temperature range of the medium is -30°C to 0°C.

27. The system according to claim 19, wherein the cooling unit includes a thermoelectric cooler, cooling air, cooling gas or coolant.

28. A beam splitter located between the first portion and the second portion, the beam splitter further comprising a beam splitter that sends an image of the skin lesion to an image capture device, the system according to claim 19.

29. The system according to claim 28, wherein the image is a real-time image.

30. The system according to claim 19, wherein the one or more characteristics are the location, boundary, size, thickness or pigment level of the skin lesion.

31. The system according to claim 19, wherein the skin lesion is a pigmented lesion.

32. The system according to claim 19, wherein the skin lesion is a non-pigmented lesion.

33. A system for treating skin lesions, a light source that generates laser light, a medium that transmits the laser light, the medium including a first portion and a second portion, the laser light sequentially passing through the first portion and the second portion, the second portion including a contact surface that contacts a treatment site, the second portion having a higher thermal conductivity than the first portion, the medium, a cooling unit that reduces the temperature of the medium to a target temperature range, comprising, the first portion and the second portion being continuously connected to each other in the medium via an interface, the system.

34. The system according to claim 33, wherein the laser light has a wavelength of about 300 nm to about 2500 nm.

35. The system according to claim 33, wherein the laser light is pulsed light.

36. The laser light has a fluence of 0 to 3000 J / cm ２ The system according to claim 33, having such fluence.

37. The system according to claim 33, wherein the first portion and the second portion are optically transparent.

38. The system according to claim 33, wherein the first portion includes quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

39. The system according to claim 33, wherein the second portion includes quartz, sapphire, crystal, poly(methyl methacrylate), or polystyrene.

40. The system according to claim 33, wherein the target temperature range of the medium is -30°C to 0°C.

41. The system according to claim 33, wherein the cooling unit includes a thermoelectric cooler, cooling air, cooling gas, or coolant.

42. The system according to claim 33, further comprising a metal unit disposed between the cooling unit and the medium.

43. The system according to claim 42, wherein the metal unit includes a temperature sensor.

44. The system according to claim 43, wherein the temperature sensor is capable of detecting the temperature of the medium.

45. The system according to claim 44, wherein a controller is operatively coupled to the temperature sensor to control the temperature of the medium.

46. The system according to claim 43, wherein the temperature sensor is capable of detecting the temperature of the cooling unit.

47. The system according to claim 46, wherein a controller is operatively coupled to the temperature sensor to control the temperature of the cooling unit.

48. The system according to claim 43, wherein the temperature sensor is capable of detecting the temperature of the treatment site.

49. The system of claim 48, wherein a controller is operably coupled to the temperature sensor to control the temperature of the treatment site. **Claim 50** The system of claim 33, wherein the skin lesion is a pigmented lesion. **Claim 51** The system of claim 33, wherein the skin lesion is a non-pigmented lesion.

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