摘要或動機

臉部皮膚會長出小小骨頭喔！皮膚多發性粟粒型骨瘤的發現，X光顯像，治病機轉與雷射在治療上的應用。本篇研究是探討一種特殊又不易偵測的骨瘤，皮膚多發性粟粒型骨瘤(MMOC)，利用各種X光顯像技術，應用在痤瘡病患，偵測其分佈、發生率和疾病之可能相關；並利用組織病理發現去推測致病機轉；且利用各種雷射光，在體內與體外進行治療性的探索，並獲致重要的結論如下：(1)MMOC非常常見，每個人都有可能發生，但臨床不易被偵測，跟性別無關，但與年齡增長成正相關；(2)病灶分佈包括額頭、眼皮、鼻子、臉頰及頸部，與痤瘡的病灶分佈十分類似，但與痤瘡的疾病活性與疤痕的嚴重度並無相關。(3)利用乳房攝影的斜切照影技術，是最簡易有效的偵測方式。(4)病理組織中有些皮膚腫瘤伴有MMOC存在，並非此腫瘤有其特異性。(5)MMOC是一個因為皮膚毛囊皮脂腺在不明顯的發炎下所造成的轉化型骨形成反應。(6)紅寶石雷射及銣-雅鉻雷射對色素性骨瘤是一有效的去除技術。鉺-亞鉻雷射及二氧化碳雷射磨皮技術，對嚴重痤瘡疤痕並有MMOC患者，亦為一良好治療方式。Multiple Miliary Osteoma Cutis(MMOC) is a kind of special condition and difficult to detect clinically. By using different kinds of X-ray techniques and compared the clinical data from the patients with acne of face, by observing the changes of skin tissue specimens for searching the possible mechanism of osteogenesis and by using scanning electron microscopic observation and energy dispersive Xray analysis for evaluating the biophysical effects on osteoma after Ruby, ND-YAG, Erbium:YAG or CO2 Laser irradiation, we concluded that: MMOC, a very common condition, may develop in everyone. MMOC can be easily demonstrated by the modified mammographic technique. The density of calcification in MMOC is not related to the sex of patients, the activity of acne, and the severity of atrophic scar but correlated with the age of the patients. MMOC, a non-specific condition, results from metaplastic ossification occurring within preexisting subclinical inflammatory processes of the pilosebaceous unit and may be found incidentally in different kinds of facial tumor. Ruby or ND-YAG laser may have some explosive effect on pigmented MMOC. CO2 or Erbium:YAG laser dermabrasion can be used to treat MMOC with acne scar.