黄褐斑的光电治疗进展
|
摘要
黄褐斑是一种常见的发生于女性面部的色素增加性疾病,发病因素多样,具体机制尚未完全阐明。黄褐斑的治疗包括局部外用、系统口服、序贯治疗以及联合治疗,目前认为联合治疗是最佳的治疗方案。在联合治疗中光电治疗占有非常重要的地位,主要包括强脉冲光、调Q激光、皮秒激光、非剥脱性点阵激光、剥脱性点阵激光以及其他激光。其中强脉冲光、调Q激光及皮秒激光的疗效及安全性已经得到了广泛认可,其他光电疗法的疗效及安全性仍待研究。
Melasma is a common acquired condition of symmetric hyperpigmentation, typically occurring on the face, with higher prevalence in females. The etiology of melasma is multifactorial and the pathogenesis has not been fully elucidated.Treatments for melasma include topical, oral, procedural,and combination treatments, of which the combination treatments has been the most accepted. Laser and light therapy for melasma include intense pulsed light, Q-switch lasers, picosecond lasers,nonablative fractional lasers, ablative fractional lasers and other laser and light treatments. Of which the first three were well accepted by physicians and patitents, but the efficacy and safety of other approaches were still controversial.
Melasma is a common acquired condition of symmetric hyperpigmentation, typically occurring on the face, with higher prevalence in females. The etiology of melasma is multifactorial and the pathogenesis has not been fully elucidated.Treatments for melasma include topical, oral, procedural,and combination treatments, of which the combination treatments has been the most accepted. Laser and light therapy for melasma include intense pulsed light, Q-switch lasers, picosecond lasers,nonablative fractional lasers, ablative fractional lasers and other laser and light treatments. Of which the first three were well accepted by physicians and patitents, but the efficacy and safety of other approaches were still controversial.
引文
[1]Sarkar R,Ailawadi P,Garg S.Melasma in men:A review of clinical,etiological,and management issues[J].J Clin Aesthet Dermatol,2018,11(2):53-59.
[2]Trivedi MK,Yang FC,Cho BK.A review of laser and light therapy in melasma[J].Int J Womens Dermatol,2017,3(1):11-20.
[3]Ogbechie-Godec OA,Elbuluk N.Melasma:an up-to-date comprehensive review[J].Dermatol Ther(Heidelb),2017,7(3):305-318.
[4]Rodrigues M,Pandya AG.Melasma:clinical diagnosis and management options[J].Australas J Dermatol,2015,56(3):151-163.
[5]朱丽萍,刘海洋,庞勤,等.联合治疗黄褐斑的研究进展[J].中华皮肤科杂志,2016,49(2):147-150.
[6]Hassan AM,Elfar NN,Rizk OM,et al.Pulsed dye laser versus intense pulsed light in melasma:a split-face comparative study[J].J Dermatol Treat,2018,29(7):725-732.
[7]Polnikorn N.Treatment of refractory dermal melasma with the MedLite C6 Q-switched Nd:YAG laser:two case reports[J].J Cosmet Laser Ther,2008,10(3):167-173.
[8]Choi E,Lee DW,Seo SH,et al.Low-fluence Q-switched Nd:YAGlaser for the treatment of melasma in Asian patients[J].J Cosmet Dermatol,2018,17(6):1053-1058.
[9]Fabi SG,Friedmann DP,Niwa MA,et al.A randomized,split-face clinical trial of low-fluence Q-switched neodymium-doped yttrium aluminum garnet(1 064 nm)laser versus low-fluence Q-switched alexandrite laser(755 nm)for the treatment of facial melasma[J].Lasers Surg Med,2014,46(7):531-537.
[10]Zhou HL,Hu B,Zhang C.Efficacy of 694nm fractional Q-switched ruby laser(QSRL)combined with sonophoresis on levorotatory vitamin C for treatment of melasma in Chinese patients[J].Lasers Med Sci,2016,31(5):991-995.
[11]Lee MC,Lin YF,Hu S,et al.A split-face study:comparison of picosecond alexandrite laser and Q-switched Nd:YAG laser in the treatment of melasma in Asians[J].Lasers Med Sci,2018,33(8):1733-1738.
[12]Chalermchai T,Rummaneethorn P.Effects of a fractional picosecond1,064 nm laser for the treatment of dermal and mixed type melasma[J].J Cosmet Laser Ther,2018,20(3):134-139.
[13]Choi YJ,Nam JH,Kim JY,et al.Efficacy and safety of a novel picosecond laser using combination of 1 064nm and 595nm on patients with melasma:A prospective,randomized,multicenter,splitface,2%hydroquinone cream-controlled clinical trial[J].Lasers Surg Med,2017,49(10):899-907.
[14]Hantash BM,Bedi VP,Sudireddy V,et al.Laser-induced transepidermal elimination of dermal content by fractional photothermolysis[J].J Biomed Opt,2006,11(4):41115.
[15]Karsai S,Fischer T,Pohl L,et al.Is non-ablative 1550nm fractional photothermolysis an effective modality to treat melasma?Results from a prospective controlled single-blinded trial in 51 patients[J].JEur Acad Dermatol Venereol,2012,26(4):470-476.
[16]Kim HS,Kim EK,Jung KE,et al.A split-face comparison of lowfluence Q-switched Nd:YAG laser plus 1550 nm fractional photothermolysis vs.Q-switched Nd:YAG monotherapy for facial melasma in Asian skin[J].J Cosmet Laser Ther,2013,15(3):143-149.
[17]Barysch MJ,Rummelein B,Kolm I,et al.Split-face study of melasma patients treated with non-ablative fractionated photothermolysis(1540 nm)[J].J Eur Acad Dermatol Venereol,2012,26(4):423-430.
[18]Geddes ER,Stout AB,Friedman PM.Retrospective analysis of the treatment of melasma lesions exhibiting increased vascularity with the 595-nm pulsed dye laser combined with the 1927-nm fractional low-powered diode laser[J].Lasers Surg Med,2017,49(1):20-26.
[19]Tawfic SO,Abdel HD,Albarbary A,et al.Assessment of combined fractional CO2 and tranexamic acid in melasma treatment[J].Lasers Surg Med,2019,51(1):27-33.
[20]Tian W C.Novel technique to treat melasma in Chinese:The combination of 2 940nm fractional Er:YAG and 1 064nm Q-switched Nd:YAG laser[J].J Cosmet Laser Ther,2016,18(2):72-74.
[21]Grimes PE,Yamada N,Bhawan J.Light microscopic,immunohistoch emical,and ultrastructural alterations in patients with melasma[J].Am J Dermatopathol,2005,27(2):96-101.
[22]Lee HI,Lim YY,Kim BJ,et al.Clinicopathologic efficacy of copper bromide plus/yellow laser(578 nm with 511 nm)for treatment of melasma in Asian patients[J].Dermatol Surg,2010,36(6):885-893.
[23]Hammami GH,Boukari F,Fontas E,et al.Copper bromide laser vs triple-combination cream for the treatment of melasma:a randomized clinical trial[J].JAMA Dermatol,2015,151(7):791-792.
[24]Cameli N,Abril E,Mariano M,et al.Combined use of monopolar radiofrequency and transdermal drug delivery in the treatment of melasma[J].Dermatol Surg,2014,40(7):748-755.
[2]Trivedi MK,Yang FC,Cho BK.A review of laser and light therapy in melasma[J].Int J Womens Dermatol,2017,3(1):11-20.
[3]Ogbechie-Godec OA,Elbuluk N.Melasma:an up-to-date comprehensive review[J].Dermatol Ther(Heidelb),2017,7(3):305-318.
[4]Rodrigues M,Pandya AG.Melasma:clinical diagnosis and management options[J].Australas J Dermatol,2015,56(3):151-163.
[5]朱丽萍,刘海洋,庞勤,等.联合治疗黄褐斑的研究进展[J].中华皮肤科杂志,2016,49(2):147-150.
[6]Hassan AM,Elfar NN,Rizk OM,et al.Pulsed dye laser versus intense pulsed light in melasma:a split-face comparative study[J].J Dermatol Treat,2018,29(7):725-732.
[7]Polnikorn N.Treatment of refractory dermal melasma with the MedLite C6 Q-switched Nd:YAG laser:two case reports[J].J Cosmet Laser Ther,2008,10(3):167-173.
[8]Choi E,Lee DW,Seo SH,et al.Low-fluence Q-switched Nd:YAGlaser for the treatment of melasma in Asian patients[J].J Cosmet Dermatol,2018,17(6):1053-1058.
[9]Fabi SG,Friedmann DP,Niwa MA,et al.A randomized,split-face clinical trial of low-fluence Q-switched neodymium-doped yttrium aluminum garnet(1 064 nm)laser versus low-fluence Q-switched alexandrite laser(755 nm)for the treatment of facial melasma[J].Lasers Surg Med,2014,46(7):531-537.
[10]Zhou HL,Hu B,Zhang C.Efficacy of 694nm fractional Q-switched ruby laser(QSRL)combined with sonophoresis on levorotatory vitamin C for treatment of melasma in Chinese patients[J].Lasers Med Sci,2016,31(5):991-995.
[11]Lee MC,Lin YF,Hu S,et al.A split-face study:comparison of picosecond alexandrite laser and Q-switched Nd:YAG laser in the treatment of melasma in Asians[J].Lasers Med Sci,2018,33(8):1733-1738.
[12]Chalermchai T,Rummaneethorn P.Effects of a fractional picosecond1,064 nm laser for the treatment of dermal and mixed type melasma[J].J Cosmet Laser Ther,2018,20(3):134-139.
[13]Choi YJ,Nam JH,Kim JY,et al.Efficacy and safety of a novel picosecond laser using combination of 1 064nm and 595nm on patients with melasma:A prospective,randomized,multicenter,splitface,2%hydroquinone cream-controlled clinical trial[J].Lasers Surg Med,2017,49(10):899-907.
[14]Hantash BM,Bedi VP,Sudireddy V,et al.Laser-induced transepidermal elimination of dermal content by fractional photothermolysis[J].J Biomed Opt,2006,11(4):41115.
[15]Karsai S,Fischer T,Pohl L,et al.Is non-ablative 1550nm fractional photothermolysis an effective modality to treat melasma?Results from a prospective controlled single-blinded trial in 51 patients[J].JEur Acad Dermatol Venereol,2012,26(4):470-476.
[16]Kim HS,Kim EK,Jung KE,et al.A split-face comparison of lowfluence Q-switched Nd:YAG laser plus 1550 nm fractional photothermolysis vs.Q-switched Nd:YAG monotherapy for facial melasma in Asian skin[J].J Cosmet Laser Ther,2013,15(3):143-149.
[17]Barysch MJ,Rummelein B,Kolm I,et al.Split-face study of melasma patients treated with non-ablative fractionated photothermolysis(1540 nm)[J].J Eur Acad Dermatol Venereol,2012,26(4):423-430.
[18]Geddes ER,Stout AB,Friedman PM.Retrospective analysis of the treatment of melasma lesions exhibiting increased vascularity with the 595-nm pulsed dye laser combined with the 1927-nm fractional low-powered diode laser[J].Lasers Surg Med,2017,49(1):20-26.
[19]Tawfic SO,Abdel HD,Albarbary A,et al.Assessment of combined fractional CO2 and tranexamic acid in melasma treatment[J].Lasers Surg Med,2019,51(1):27-33.
[20]Tian W C.Novel technique to treat melasma in Chinese:The combination of 2 940nm fractional Er:YAG and 1 064nm Q-switched Nd:YAG laser[J].J Cosmet Laser Ther,2016,18(2):72-74.
[21]Grimes PE,Yamada N,Bhawan J.Light microscopic,immunohistoch emical,and ultrastructural alterations in patients with melasma[J].Am J Dermatopathol,2005,27(2):96-101.
[22]Lee HI,Lim YY,Kim BJ,et al.Clinicopathologic efficacy of copper bromide plus/yellow laser(578 nm with 511 nm)for treatment of melasma in Asian patients[J].Dermatol Surg,2010,36(6):885-893.
[23]Hammami GH,Boukari F,Fontas E,et al.Copper bromide laser vs triple-combination cream for the treatment of melasma:a randomized clinical trial[J].JAMA Dermatol,2015,151(7):791-792.
[24]Cameli N,Abril E,Mariano M,et al.Combined use of monopolar radiofrequency and transdermal drug delivery in the treatment of melasma[J].Dermatol Surg,2014,40(7):748-755.