Department of Dermatology, Ulsan University Hospital, Ulsan, Korea.
J Eur Acad Dermatol Venereol. 2010 Jul;24(7):773-80. doi: 10.1111/j.1468-3083.2009.03525.x. Epub 2009 Dec 11.
Various laser and light therapy have been increasingly used for the treatment of acne vulgaris.
Twenty patients with facial acne were treated using intense pulsed light (IPL) on one side of the face and pulsed dye laser (PDL) on the other to compare the efficacy and safety of IPL and PDL. Treatment was performed 4 times at 2-week intervals. Treatment effectiveness was determined using lesion counts, acne severity, patient subjective self-assessments of improvement, and histopathological examinations, which included immunohistochemical staining for transforming growth factor-beta (TGF-beta).
Numbers of total acne lesions decreased following both treatments. For inflammatory lesions such as papules, pustules and nodules, IPL-treated sides showed an earlier and more profound improvement than PDL-treated sides. However, at 8 weeks after the 4th treatment, a rebound aggravation of acne was observed on IPL-treated sides. On the contrary, PDL produced gradual improvements during the treatment sessions and these improvements lasted 8 weeks after the 4th treatment. Non-inflammatory lesions as open and closed comedones also showed improvement following both treatments and PDL-treated sides showed better improvement as the study proceeded. Histopathological examinations showed amelioration in inflammatory reactions and an increase in TGF-beta expression after both treatments, which were more prominent for PDL-treated sides.
Both PDL and IPL were found to treat acne effectively, but PDL showed a more sustained effect. TGF-beta might play a key role in the resolution of inflammatory acne lesions.
各种激光和光疗已越来越多地用于治疗寻常痤疮。
20 例面部痤疮患者采用强脉冲光(IPL)和脉冲染料激光(PDL)分别治疗一侧面部,比较 IPL 和 PDL 的疗效和安全性。每 2 周治疗 1 次,共治疗 4 次。通过皮损计数、痤疮严重程度、患者对改善的主观自我评估以及包括转化生长因子-β(TGF-β)免疫组织化学染色在内的组织病理学检查来评估治疗效果。
两种治疗方法均可减少总痤疮皮损数量。对于炎性皮损,如丘疹、脓疱和结节, IPL 治疗侧比 PDL 治疗侧更早、更明显地改善。然而,在第 4 次治疗后 8 周,IPL 治疗侧出现痤疮反弹加重。相反,PDL 在治疗过程中逐渐改善,在第 4 次治疗后 8 周仍持续改善。非炎性皮损,如开放性和闭合性粉刺,两种治疗方法均有改善,且随着研究的进行,PDL 治疗侧的改善更为明显。组织病理学检查显示,两种治疗方法均可改善炎症反应并增加 TGF-β表达,PDL 治疗侧更为明显。
PDL 和 IPL 均可有效治疗痤疮,但 PDL 显示出更持久的效果。TGF-β可能在炎症性痤疮皮损的消退中起关键作用。