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分次激光治疗肥厚性瘢痕:8例临床经验

Fractional photothermolysis for the treatment of hypertrophic scars: clinical experience of eight cases.

作者信息

Niwa Ane Beatriz Mautari, Mello Ana Paula F, Torezan Luís Antonio, Osório Nuno

机构信息

Clínica Nuno Osório, São Paulo-SP, Brazil.

出版信息

Dermatol Surg. 2009 May;35(5):773-7; discussion 777-8. doi: 10.1111/j.1524-4725.2009.01127.x. Epub 2008 Mar 23.

Abstract

BACKGROUND

Hypertrophic scars are common problems and represent a challenging condition to treat. Fractional photothermolysis has been effective at resurfacing photodamaged skin, acne scars, and atrophic scars, but there are few reports on its use for hypertrophic scars.

OBJECTIVE

To evaluate the safety and efficacy of 1,550-nm erbium-doped fiber laser treatment of hypertrophic scars in eight patients.

METHODS

Eight patients (skin phototypes II-IV) with hypertrophic scars received monthly treatments with a 1,550-nm erbium-doped fiber laser. Energy settings ranged from 35 to 50 mJ, and eight to 10 passes were applied with treatment levels 6 to 8. An independent physician evaluator assessed the treatment response by comparing pre- and posttreatment clinical photographs using a quartile grading scale (grade 1, < or =25%=minimal to no improvement; grade 2, 26-50%=moderate improvement; grade 3, 51-75%=marked improvement; grade 4, >75%=near total improvement.

RESULTS

At four weeks after the last treatment session, a mean grade of 2.4 was achieved based on an independent physician's clinical assessment. Improvement in pigmentation occurred in all hyperpigmented scars.

CONCLUSION

Hypertrophic scars can be effectively and safely improved with 1,550-nm erbium-doped fiber laser treatment.

摘要

背景

增生性瘢痕是常见问题,也是一种具有挑战性的治疗病症。分次光热解在修复光损伤皮肤、痤疮瘢痕和萎缩性瘢痕方面已取得成效,但关于其用于增生性瘢痕治疗的报道较少。

目的

评估1550纳米掺铒光纤激光治疗8例增生性瘢痕患者的安全性和有效性。

方法

8例(皮肤光型II-IV)增生性瘢痕患者每月接受一次1550纳米掺铒光纤激光治疗。能量设置范围为35至50毫焦,以6至8级治疗水平进行8至10次照射。一名独立的医生评估者通过使用四分位数分级量表(1级,≤25%=改善极小或无改善;2级,26-50%=中度改善;3级,51-75%=显著改善;4级,>75%=几乎完全改善)比较治疗前后的临床照片来评估治疗反应。

结果

在最后一次治疗后四周,根据独立医生的临床评估,平均评分为2.4级。所有色素沉着瘢痕的色素沉着均有改善。

结论

1550纳米掺铒光纤激光治疗可有效且安全地改善增生性瘢痕。

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