Q开关1064nm Nd:YAG激光联合果酸治疗黄褐斑临床应用
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摘要
目的观察Q开关1064nm Nd:YAG激光联合果酸换肤与单用Q开关1064nm Nd:YAG激光或者果酸换肤治疗黄褐斑进行疗效对比。方法 78例女性黄褐斑患者随机分为A、B、C三组,A组单用Q开关1064nm Nd:YAG激光进行治疗,B组单用果酸进行剥脱治疗,C组采用Q开关1064nm Nd:YAG激光联合果酸剥脱治疗,治疗前后分别运用MASI评分对比各组患者的临床疗效。结果三组MASI评分都有所下降,C组下降最明显(P<0.05);A组有效率60.0%,B组有效率40.0%,C组84.6%,三组间对比差异均具有统计学意义(P<0.05);同时都未出现明显的不良反应。三组半年随访复发率无统计学差异。结论 Q开关1064nm Nd:YAG激光联合果酸换肤术治疗有效率明显高于单一的使用Q开关激光或果酸换肤治疗。
Objective To compare the efficacy of Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser(LFQS) monotherapy with combined LFQS and glycolic acid(GA) peeling in female patients with melasma.Methods Seventy-eight females with mixed type melasma were randomized divided into groups A,B and C to receive 12 weekly treatment.The group A was given LFQS monotherapy.The group B was given GA peeling only.The group C was given LFQS plus GA peeling.The clinical efficacy was assessed using the mMASI score.Results The mMASI score decreased in three groups somehow,The group C decrease more than those in groupA and B(P<0.05).The effective rate among group A,B and C were 60.0%,40.0% and 84.6%,respectively.The results suggest difference statistically significant between the three groups(P<0.05).No severe adverse reactions were founded.Conclusion The efficacy of LFQS combined with GA peeling higher than single treatment with LFQS or GA peeling.
Objective To compare the efficacy of Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser(LFQS) monotherapy with combined LFQS and glycolic acid(GA) peeling in female patients with melasma.Methods Seventy-eight females with mixed type melasma were randomized divided into groups A,B and C to receive 12 weekly treatment.The group A was given LFQS monotherapy.The group B was given GA peeling only.The group C was given LFQS plus GA peeling.The clinical efficacy was assessed using the mMASI score.Results The mMASI score decreased in three groups somehow,The group C decrease more than those in groupA and B(P<0.05).The effective rate among group A,B and C were 60.0%,40.0% and 84.6%,respectively.The results suggest difference statistically significant between the three groups(P<0.05).No severe adverse reactions were founded.Conclusion The efficacy of LFQS combined with GA peeling higher than single treatment with LFQS or GA peeling.
引文
[1] Sheth VM,Pandya AG.Melasma:a comprehensive update:part I[J].J Am Acad Dermatol,2011,65(4):689-697.
[2] Sarkar R,Puri P,Jain RK,et al. Melasma in men:A?clinical,aetiological and histological study. J?Eur Acad Dermatol Venereol,2011,24(7):768-772
[3] Pasricha JS,Khaitan BK,Dash S. Pigmentary disorders in India. Dermatol Clin 2007;25:343-352.
[4] Vázquez M,Maldonado H,Benmamán C,et al. elasma in men:A clinical and histological study. Int J Dermatol 1988;27:25-27.
[5] Pérez M,Sánchez JL,Aguiló F. Endocrinologic profile of patients with idiopathic melasma. J Invest Dermatol 1983;81:543-545.
[6] Sanchez NP,Pathak MA,Sato S,et al. Melasma:A clinical,light microscopic,ultra structural,and immunofluorescence study. J Am Acad Dermatol 1981;4:698-710.
[7] Sanchez NP,Pathak MA,Sato S,et al. Melasma:a clinical,light microscopic,ultrastructural,and immunofluorescence study. J Am Acad Dermatol 1981;4:698-710.
[8] Kang WH,Yoon KH,Lee ES,et al. Melasma:histopathological characteristics in 56 Korean patients. Br J Dermatol 2002;146:228-237.
[9] Anderson RR,Margolis RJ,Watenabe S,et al. Selective photothermolysis of cutaneous pigmentation by Q-switched Nd:YAG laser pulses at 1064,532,and 355 nm. J Invest Dermatol 1989;93:28-32.
[10] Vasanop Vachiramon,MD,Sinijchaya Sahawatwong,MD,et al. Treatment of Melasma in Men With Low-Fluence Q-Switched Neodymium-Doped Yttrium-Aluminum-Garnet Laser Versus Combined Laser and Glycolic Acid Peeling.J Dermatol Surg 2015;41:457-465.
[11] On HR,Hong WJ,Roh MR.Low-pulse energy Q-switched Nd:YAG laser treatment for hair-dye-induced Riehl's melanosis[J].J Cosmet Laser Ther,2015,17(3):135-138.
[12] Graber EM,Tanzi EL,Alster TS.Side effects and complications of fractional laser photothermolysis:experience with 961 treatments[J]. Dermatol Surg,2008,34(3):301-305;discussion 305-307.
[13] Pandya AG,Hynan LS,Bhore R,et al.Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method [J].J Am Acad Dermatol,2011,64(1):78-83.
[14] Sarkar R,Garg V,Bansal S,et al.Comparative Evaluation of Efficacy and Tolerability of Glycolic Acid,Salicylic Mandelic Acid,and Phytic Acid Combination Peels in Melasma[J].Dermatol Surg,2016,42(3):384-391.
[15] Usuki A,Ohashi A,Sato H,et al. The inhibitory effect ofglycolic acid and lactic acid on melanin synthesis in melanoma cells.Exp Dermatol 2003;12(Suppl 2):43-50.
[16] Coleman WP III,Brody HJ. Efficacy of low-strength glycolic acid application in the treatment of melasma. Arch Dermatol 2003;139:811.
[17] Sarkar R,Kaur C,Bhalla M,et al.The combination of glycolic acid peels with a topical regimen in the treatment of melasma in darkskinned patients:a comparative study. Dermatol Surg 2002;28:828-832.
[18] Kumari R,Thappa DM. Comparative study of trichloroacetic acid versus glycolic acid chemical peels in the treatment of melasma. Indian J Dermatol Venereol Leprol 2010;76:447.
[2] Sarkar R,Puri P,Jain RK,et al. Melasma in men:A?clinical,aetiological and histological study. J?Eur Acad Dermatol Venereol,2011,24(7):768-772
[3] Pasricha JS,Khaitan BK,Dash S. Pigmentary disorders in India. Dermatol Clin 2007;25:343-352.
[4] Vázquez M,Maldonado H,Benmamán C,et al. elasma in men:A clinical and histological study. Int J Dermatol 1988;27:25-27.
[5] Pérez M,Sánchez JL,Aguiló F. Endocrinologic profile of patients with idiopathic melasma. J Invest Dermatol 1983;81:543-545.
[6] Sanchez NP,Pathak MA,Sato S,et al. Melasma:A clinical,light microscopic,ultra structural,and immunofluorescence study. J Am Acad Dermatol 1981;4:698-710.
[7] Sanchez NP,Pathak MA,Sato S,et al. Melasma:a clinical,light microscopic,ultrastructural,and immunofluorescence study. J Am Acad Dermatol 1981;4:698-710.
[8] Kang WH,Yoon KH,Lee ES,et al. Melasma:histopathological characteristics in 56 Korean patients. Br J Dermatol 2002;146:228-237.
[9] Anderson RR,Margolis RJ,Watenabe S,et al. Selective photothermolysis of cutaneous pigmentation by Q-switched Nd:YAG laser pulses at 1064,532,and 355 nm. J Invest Dermatol 1989;93:28-32.
[10] Vasanop Vachiramon,MD,Sinijchaya Sahawatwong,MD,et al. Treatment of Melasma in Men With Low-Fluence Q-Switched Neodymium-Doped Yttrium-Aluminum-Garnet Laser Versus Combined Laser and Glycolic Acid Peeling.J Dermatol Surg 2015;41:457-465.
[11] On HR,Hong WJ,Roh MR.Low-pulse energy Q-switched Nd:YAG laser treatment for hair-dye-induced Riehl's melanosis[J].J Cosmet Laser Ther,2015,17(3):135-138.
[12] Graber EM,Tanzi EL,Alster TS.Side effects and complications of fractional laser photothermolysis:experience with 961 treatments[J]. Dermatol Surg,2008,34(3):301-305;discussion 305-307.
[13] Pandya AG,Hynan LS,Bhore R,et al.Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method [J].J Am Acad Dermatol,2011,64(1):78-83.
[14] Sarkar R,Garg V,Bansal S,et al.Comparative Evaluation of Efficacy and Tolerability of Glycolic Acid,Salicylic Mandelic Acid,and Phytic Acid Combination Peels in Melasma[J].Dermatol Surg,2016,42(3):384-391.
[15] Usuki A,Ohashi A,Sato H,et al. The inhibitory effect ofglycolic acid and lactic acid on melanin synthesis in melanoma cells.Exp Dermatol 2003;12(Suppl 2):43-50.
[16] Coleman WP III,Brody HJ. Efficacy of low-strength glycolic acid application in the treatment of melasma. Arch Dermatol 2003;139:811.
[17] Sarkar R,Kaur C,Bhalla M,et al.The combination of glycolic acid peels with a topical regimen in the treatment of melasma in darkskinned patients:a comparative study. Dermatol Surg 2002;28:828-832.
[18] Kumari R,Thappa DM. Comparative study of trichloroacetic acid versus glycolic acid chemical peels in the treatment of melasma. Indian J Dermatol Venereol Leprol 2010;76:447.