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The Asian dermatologic patient: review of common pigmentary disorders and cutaneous diseases.

作者信息

Ho Stephanie G Y, Chan Henry H L

机构信息

Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.

出版信息

Am J Clin Dermatol. 2009;10(3):153-68. doi: 10.2165/00128071-200910030-00002.


DOI:10.2165/00128071-200910030-00002
PMID:19354330
Abstract

The Asian patient with Fitzpatrick skin types III-V is rarely highlighted in publications on cutaneous disorders or cutaneous laser surgery. However, with changing demographics, Asians will become an increasingly important group in this context. Although high melanin content confers better photoprotection, photodamage in the form of pigmentary disorders is common. Melasma, freckles, and lentigines are the epidermal disorders commonly seen, whilst nevus of Ota and acquired bilateral nevus of Ota-like macules are common dermal pigmentary disorders. Post-inflammatory hyperpigmentation (PIH) occurring after cutaneous injury remains a hallmark of skin of color. With increasing use of lasers and light sources in Asians, prevention and management of PIH is of great research interest. Bleaching agents, chemical peels, intense pulsed light (IPL) treatments, and fractional skin resurfacing have all been used with some success for the management of melasma. Q-switched (QS) lasers are effective for the management of epidermal pigmentation but are associated with a high risk of PIH. Long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers and IPL sources pose less of a PIH risk but require a greater number of treatment sessions. Dermal pigmentary disorders are better targeted by QS ruby, QS alexandrite, and QS 1064-nm Nd:YAG lasers, but hyper- and hypopigmentation may occur. Non-ablative skin rejuvenation using a combination approach with different lasers and light sources in conjunction with cooling devices allows different skin chromophores to be targeted and optimal results to be achieved, even in skin of color. Deep-tissue heating using radiofrequency and infra-red light sources affects the deep dermis and achieves enhanced skin tightening, resulting in eyebrow elevation, rhytide reduction, and contouring of the lower face and jawline. For management of severe degrees of photoaging, fractional resurfacing is useful for wrinkle and pigment reduction, as well as acne scarring. Acne, which is common in Asians, can be treated with topical and oral antibacterials, hormonal treatments, and isotretinoin. Infra-red diode lasers used with a low-fluence, multiple-pass approach have also been shown to be effective with few complications. Fractional skin resurfacing is very useful for improving the appearance of acne scarring. Hypertrophic and keloid scarring, another common condition seen in Asians, can be treated with the combined used of intralesional triamcinolone and fluorouracil, followed by pulsed-dye laser. Esthetic enhancement procedures such as botulinum toxin type A and fillers are becoming increasingly popular. These are effective for rhytide improvement and facial or body contouring. We highlight the differences between Asian skin and other skin types and review conditions common in skin of color together with treatment strategies.

摘要

相似文献

[1]
The Asian dermatologic patient: review of common pigmentary disorders and cutaneous diseases.

Am J Clin Dermatol. 2009

[2]
Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q-switched ruby, and Q-switched Nd:YAG nanosecond lasers: A retrospective photographic review.

Lasers Surg Med. 2016-2

[3]
Fractional resurfacing in the Asian patient: Current state of the art.

Lasers Surg Med. 2017-1

[4]
New application of the long-pulsed Nd-YAG laser as an ablative resurfacing tool for skin rejuvenation: a 7-year study.

J Cosmet Dermatol. 2013-9

[5]
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[6]
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Int J Dermatol. 2018-7-24

[7]
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Lasers Med Sci. 2015-1

[8]
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Dermatol Surg. 2002-7

[9]
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Ann Plast Surg. 2007-11

[10]
A retrospective analysis on the management of pigmented lesions using a picosecond 755-nm alexandrite laser in Asians.

Lasers Surg Med. 2016-1

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