Comparative Histological Studies of the Tunable Dye (at 577 nm) Laser and Argon Laser: The Specific Vascular Effects of the Dye Laser

This study compares the histological changes occurring after argon laser and dye laser (operating at 577nm) treatment of normal human skin. The initial effect of the argon laser is a diffuse nonspecific epidermal and upper dermal necrosis with subsequent cell death and a neutrophilic response at 48hr. These changes occur at 15 joules/cm2 and their extent closely correlates with the energy applied. In sharp contrast, the immediate effect of the dye laser is erythrocyte aggregation, vessel rupture, and hemorrhage. At 48hr, there is a pattern of acute vasculitis in the upper dermis and a prominent perivascular neutrophilic response in the mid-dermis. Focal epidermal necrosis does occur but is relatively minimal, while skin appendages and collagen are preserved. The energy to produce these alterations is relatively small, approximately 3 J/cm2. Thus, the dye laser at 577nm can selectively damage the cutaneous vascular plexus and may provide a basis for treatment of cutaneous vascular lesions.