Beylot C
Université Victor Segalen Bordeaux 2, 101, boulevard Wilson, 33200 Bordeaux.
Ann Dermatol Venereol. 2009 May;136 Suppl 4:S152-9. doi: 10.1016/S0151-9638(09)74544-2.
In esthetic dermatology, filling and laser treatments are two essential techniques. Several recent studies on calcium hydroxyapatite in filling treatments and facial volumetry, in esthetics, but also in HIV patients, have been published. It was also tested in accentuated melomental folds where it is superior to hyaluronic acid. In aging of the skin of the dorsal aspect of the hands, hyaluronic acid provides slightly better results than collagen. Filler rhinoplasty can correct minor deformations of the nose. Lipofilling is advantageous for linear scleroderma of the face, at least in the forehead region, and adipocyte stem cells may be a future solution for facial aging or lipoatrophy. The risk of local and/or general sarcoid reactions related to interferon in patients having undergone filling injections has been reported. In the field of laser treatment, fractionated photothermolysis has motivated much more research and seem particularly valuable in treating acne scars, aging of the dorsal aspect of the hands, and, more anecdotally, in colloid milium and pearly penile papules. Laser is also useful in preventing surgical scars where a mini-diode can also be used. For axillary hyperhidrosis, subdermic Nd-YAG laser competes with botulinum toxin, with longer-lasting results. Solutions are appearing for treatment of red or white striae cutis distensae. Intense pulsed light is the reference technique for poikiloderma of Civatte, and seems effective, with new devices, for melasma. However, inappropriately used by nonphysicians, IPL can cause serious ocular accidents; one case of uveitis has been reported.
在美容皮肤科,填充治疗和激光治疗是两项关键技术。最近有几项关于羟基磷灰石在填充治疗及面部容积测量中的研究发表,这些研究不仅涉及美容领域,还包括HIV患者。它也在明显的颏部褶皱处进行了测试,结果显示其优于透明质酸。在手部背部皮肤老化方面,透明质酸的效果略优于胶原蛋白。填充隆鼻可以矫正鼻子的轻微畸形。脂肪填充对面部线状硬皮病有利,至少在前额区域是这样,脂肪干细胞可能是面部衰老或脂肪萎缩问题未来的解决方案。有报道称,接受填充注射的患者会出现与干扰素相关的局部和/或全身结节反应风险。在激光治疗领域,点阵光热解引发了更多研究,在治疗痤疮瘢痕、手部背部皮肤老化方面似乎特别有价值,此外在胶体粟丘疹和阴茎珍珠状丘疹的治疗中也有一定应用(不过更多是 anecdotal 性质)。激光在预防手术瘢痕方面也有用,小型二极管激光也可用于此。对于腋窝多汗症,皮下Nd - YAG激光可与肉毒杆菌毒素竞争,且效果更持久。目前正在出现治疗红色或白色膨胀纹的解决方案。强脉冲光是治疗皮肤异色病的参考技术,对于黄褐斑,新设备似乎也有效果。然而,如果非专业医生不当使用,强脉冲光会导致严重的眼部事故,已有一例葡萄膜炎的报道。