Sami Nevien A, Attia Abeer T, Badawi Ashraf M
Dermatology Unit, National Institute of Laser Enhanced Sciences, Cairo University, Egypt.
J Drugs Dermatol. 2008 Jul;7(7):627-32.
Achieving an effective management of acne vulgaris with minimal complications remains a difficult challenge for physicians. Moreover, the rise in antibiotic-resistant strains reduce the future usefulness of current mainstay therapies, and accordingly, the need for alternative therapies is mandatory. Phototherapy has been shown to be an effective treatment for acne, and there has been a renewed interest in photodynamic therapy as a treatment modality for this condition.
To evaluate the effectiveness of pulsed dye laser (PDL), intense pulsed light (IPL) and light-emitting diode (LED) phototherapy for the treatment of moderate to severe acne vulgaris.
Forty-five patients with moderate to severe acne were randomly divided into 3 equal groups. Group 1 was treated with a PDL, group 2 was treated with IPL, and group 3 was treated with a blue-red combination LED. Treatment was continued until a > or = 90% clearance of patient lesions was achieved. Clinical assessments were conducted before starting treatment, at 1 month as a midpoint evaluation, and after the final treatment session.
Patients treated with the PDL reached a > or = 90% clearance of their inflammatory lesions after a mean of 4.1 +/- 1.39 sessions, while patients treated with IPL required a mean of 6 +/- 2.05 sessions. Patients treated with the LED required a mean of 10 +/- 3.34 sessions. At the mid-point evaluation, the percent reduction in acne lesions treated with the PDL was 90% or more, in cases of IPL and the LED, the percent reductions were 41.7% and 35.3%, respectively. Laser and light phototherapy sessions were well tolerated with minimal adverse events experienced as being mild and usually self-limiting.
The encouraging results of the present study contributes evidence of phototherapy as useful therapeutic option for treatment of moderate to severe acne, and validates further studies to evaluate treatments with a larger number of patients and for a longer period of follow-up.
对医生而言,实现寻常痤疮的有效管理并将并发症降至最低仍是一项艰巨的挑战。此外,抗生素耐药菌株的增加降低了当前主流疗法未来的有效性,因此,必须寻求替代疗法。光疗已被证明是治疗痤疮的有效方法,并且光动力疗法作为这种疾病的一种治疗方式重新引起了人们的兴趣。
评估脉冲染料激光(PDL)、强脉冲光(IPL)和发光二极管(LED)光疗治疗中度至重度寻常痤疮的有效性。
45例中度至重度痤疮患者被随机分为3组,每组人数相等。第1组接受PDL治疗,第2组接受IPL治疗,第3组接受红蓝组合LED治疗。持续治疗直至患者皮损清除率达到≥90%。在开始治疗前、第1个月作为中期评估以及最后一次治疗后进行临床评估。
接受PDL治疗的患者平均经过4.1±1.39次治疗后,其炎性皮损清除率达到≥90%,而接受IPL治疗的患者平均需要6±2.05次治疗。接受LED治疗的患者平均需要10±3.34次治疗。在中期评估时,接受PDL治疗的痤疮皮损减少百分比为90%或更高,接受IPL和LED治疗的患者,皮损减少百分比分别为41.7%和35.3%。激光和光疗治疗过程耐受性良好,不良事件轻微,通常为自限性。
本研究令人鼓舞的结果为光疗作为中度至重度痤疮的有效治疗选择提供了证据,并验证了进一步开展研究以评估更多患者、更长随访期治疗效果的必要性。