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脉冲染料激光治疗寻常痤疮:一项随机对照试验。

Treatment of acne vulgaris with a pulsed dye laser: a randomized controlled trial.

作者信息

Orringer Jeffrey S, Kang Sewon, Hamilton Ted, Schumacher Wendy, Cho Soyun, Hammerberg Craig, Fisher Gary J, Karimipour Darius J, Johnson Timothy M, Voorhees John J

机构信息

Department of Dermatology, University of Michigan Medical School, Ann Arbor, USA.

出版信息

JAMA. 2004 Jun 16;291(23):2834-9. doi: 10.1001/jama.291.23.2834.

Abstract

CONTEXT

The high prevalence of acne vulgaris and its significant morbidity underscore the need for convenient, low-risk, and efficacious therapy. Treatment with various lasers has been reported to improve acne.

OBJECTIVE

To evaluate the clinical efficacy of pulsed dye laser therapy in the treatment of acne.

DESIGN, SETTING, AND PATIENTS: Randomized, single-blind, controlled, split-face clinical trial of a volunteer sample of 40 patients aged 13 years or older with facial acne conducted at an academic referral center from August 2002 to September 2003.

INTERVENTION

One or 2 nonpurpuric pulsed dye laser treatments to half of the face (fluence of 3 J/cm2), serial blinded clinical assessments (lesion counts), and grading of acne severity using standardized bilateral serial photographs.

MAIN OUTCOME MEASURES

Comparison of the changes in lesion counts from baseline to 12 weeks between treated and untreated sides of the face and changes in photographic evidence of acne severity as graded by a panel of dermatologists blinded to treatment assignment.

RESULTS

After 12 weeks, using intent-to-treat analysis with last observation carried forward, there were no significant differences between laser-treated and untreated skin for changes in mean papule counts (-4.2 vs -2.2; P =.08), mean pustule counts (0 vs -1.0; P =.12), or mean comedone counts (2.9 vs 1.6; P =.63). Grading of serial photographs confirmed the clinical assessments, showing no significant mean (SE) differences in Leeds scores (range, 1-12) for treated skin (3.98 [0.32] at baseline and 3.94 [0.27] at week 12) compared with untreated skin (3.83 [0.32] at baseline and 3.79 [0.28] at week 12) (P>.99).

CONCLUSIONS

In this study, the nonpurpuric pulsed dye laser therapy did not result in significant improvement of facial acne. More research is needed before this laser therapy may be recommended as an acne treatment.

摘要

背景

寻常痤疮的高患病率及其显著的发病率凸显了对方便、低风险且有效的治疗方法的需求。据报道,使用各种激光进行治疗可改善痤疮。

目的

评估脉冲染料激光治疗痤疮的临床疗效。

设计、地点和患者:2002年8月至2003年9月在一家学术转诊中心对40名年龄在13岁及以上的面部痤疮志愿者样本进行的随机、单盲、对照、半脸临床试验。

干预措施

对脸部一半区域进行一次或两次非紫癜性脉冲染料激光治疗(能量密度为3 J/cm²),进行系列盲法临床评估(皮损计数),并使用标准化的双侧系列照片对痤疮严重程度进行分级。

主要观察指标

比较治疗侧和未治疗侧脸部从基线到12周皮损计数的变化,以及由对治疗分配不知情的皮肤科医生小组对痤疮严重程度的照片证据进行分级的变化。

结果

12周后,采用末次观察结转的意向性分析,激光治疗皮肤和未治疗皮肤在平均丘疹计数变化(-4.2对-2.2;P = 0.08)、平均脓疱计数变化(0对-1.0;P = 0.12)或平均粉刺计数变化(2.9对1.6;P = 0.63)方面均无显著差异。系列照片分级证实了临床评估结果,显示与未治疗皮肤相比,治疗皮肤的利兹评分(范围为1 - 12)在基线时为3.98(0.32),在第12周时为3.94(0.27),未治疗皮肤在基线时为3.83(0.32),在第12周时为3.79(0.28),差异均无统计学意义(P>0.99)。

结论

在本研究中,非紫癜性脉冲染料激光治疗并未使面部痤疮得到显著改善。在推荐这种激光治疗作为痤疮治疗方法之前,还需要更多的研究。

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