乳酸作为黄褐斑治疗的新型剥脱剂。

Lactic acid as a new therapeutic peeling agent in melasma.

作者信息

Sharquie Khalifa E, Al-Tikreety Mohammad M, Al-Mashhadani Sabeeh A

机构信息

Department of Dermatology, College of Medicine, University of Baghdad, Baghdad, Iraq.

出版信息

Dermatol Surg. 2005 Feb;31(2):149-54; discussion 154. doi: 10.1111/j.1524-4725.2005.31035.

DOI:10.1111/j.1524-4725.2005.31035

PMID:15762205

Abstract

BACKGROUND

Melasma is a common disfiguring skin problem. Multiple modalities have been used in the treatment of melasma, such as bleaching agents and chemical peels. Many chemicals have been used in the skin peeling for melasma, such as Jessner's solution and glycolic acid. Lactic acid is an alpha-hydroxy acid that has not been used before in chemical peeling of melasma.

OBJECTIVE

The purpose of the present work is to evaluate the efficacy and safety of lactic acid in chemical peeling of melasma.

METHODS

This study was conducted at the outpatient Department of Dermatology and Venereology, Baghdad Teaching Hospital, in the period between April 2001 and August 2002. Twenty patients with melasma were included in this study; 18 (90%) were female and 2 (10%) were male, with an age range from 24 to 38 years and a mean of 29 +/- 4.264 SD. Full clinical examination was done of all patients, including Wood's light. The severity of melasma was assessed by the Melasma Area Severity Index (MASI). Pure lactic acid, full strength (92%; pH 3.5), was used as a new peeling agent. The chemical peeling sessions were done every 3 weeks until the desired response was achieved, but not more than six sessions. Follow-up was carried out for 6 months after the last session. All patients had skin type IV; morphologic forms of melasma were a mask-like shape in seven patients (35%), a butterfly shape in nine patients (45%), and a horseshoe shape in 4 patients (20%).

RESULTS

Eight patients defaulted from the study after the first session for unknown reasons. Twelve patients completed the study. Eleven patients were female (91.7%), and one patient was male (8.3%). Their ages ranged from 24 to 38 years, with a mean of 29.25 +/- 4.9 SD. Wood's light examination showed increased contrast in all patients (epidermal melasma). The number of sessions ranged from two to six. All 12 patients showed marked improvement, as calculated by the MASI score before and after treatment, and the response was highly statistically significant. No side effect was recorded in all treated patients.

CONCLUSION

Lactic acid was found to be a new effective and safe peeling agent in the treatment of melasma.

摘要

背景

黄褐斑是一种常见的损容性皮肤问题。多种方法已被用于黄褐斑的治疗，如漂白剂和化学剥脱术。许多化学物质已被用于黄褐斑的皮肤剥脱，如杰斯纳溶液和乙醇酸。乳酸是一种α-羟基酸，此前尚未用于黄褐斑的化学剥脱。

目的

本研究的目的是评估乳酸在黄褐斑化学剥脱中的疗效和安全性。

方法

本研究于2001年4月至2002年8月期间在巴格达教学医院皮肤科和性病科门诊进行。本研究纳入了20例黄褐斑患者；18例（90%）为女性，2例（10%）为男性，年龄范围为24至38岁，平均年龄为29±4.264标准差。对所有患者进行了全面的临床检查，包括伍德灯检查。黄褐斑的严重程度通过黄褐斑面积严重程度指数（MASI）进行评估。纯乳酸，全强度（92%；pH 3.5），用作一种新的剥脱剂。化学剥脱疗程每3周进行一次，直至达到预期效果，但不超过6次疗程。最后一次疗程后进行6个月的随访。所有患者均为IV型皮肤；黄褐斑的形态学表现为7例患者（35%）呈面具样，9例患者（45%）呈蝴蝶样，4例患者（20%）呈马蹄样。

结果

8例患者在第一次疗程后因不明原因退出研究。12例患者完成了研究。11例患者为女性（91.7%），1例患者为男性（8.3%）。他们的年龄范围为24至38岁，平均年龄为29.25±4.9标准差。伍德灯检查显示所有患者（表皮型黄褐斑）的对比度增加。疗程次数为2至6次。通过治疗前后的MASI评分计算，所有12例患者均显示出明显改善，且反应具有高度统计学意义。所有接受治疗的患者均未记录到副作用。