Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Dermatolog Treat. 2011 Feb;22(1):43-8. doi: 10.3109/09546630903473552. Epub 2010 Jul 24.
Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application.
To determine the effectiveness and safety of fractional photothermolysis treatment of various atrophic scars in Korean patients.
Fifty-nine patients with atrophic scars (caused by acne, trauma, herpes zoster, and burns) were treated with fractional photothermolysis using either Fraxel™ SR 750 or Fraxel™ SR 1500 instruments. Each patient underwent one to three treatment sessions 3-4 weeks apart. The assessment of treatment response was conducted by three dermatologists, who independently evaluated a series of photographs using a quartile grading scale. Skin biopsies were taken before treatment and 4 weeks after the final treatment, and were examined for procollagen-1, matrix metalloproteinase-1 (MMP-1), and elastin by immunofluorescence staining.
Four weeks after the final treatment, the mean overall improvement in objective grade was 2.0 when the Fraxel SR 750 was employed and 2.9 when the Fraxel SR 1500 was used. Confocal microscopy revealed an increase in procollagen-1 in dermis, with no difference or a slight increase in the levels of elastin and MMP-1. Side effects were minimal.
After short-term follow-up, fractional photothermolysis appeared to be a safe and effective option for atrophic scar treatment of Asian skin.
各种方法已被用于治疗疤痕,但疗效有限且存在问题的副作用限制了它们的应用。
确定在韩国患者中使用分幅光热解疗法治疗各种萎缩性疤痕的有效性和安全性。
59 例萎缩性疤痕患者(由痤疮、创伤、带状疱疹和烧伤引起)接受了分幅光热解治疗,使用 Fraxel™ SR 750 或 Fraxel™ SR 1500 仪器。每位患者每 3-4 周接受一次至三次治疗。通过三位皮肤科医生对一系列照片进行四分位等级评定,对治疗反应进行评估。在治疗前和最后一次治疗后 4 周采集皮肤活检,并通过免疫荧光染色检测原胶原蛋白-1、基质金属蛋白酶-1(MMP-1)和弹性蛋白。
在最后一次治疗后 4 周时,当使用 Fraxel SR 750 时,客观等级的平均总体改善为 2.0,当使用 Fraxel SR 1500 时为 2.9。共聚焦显微镜显示真皮中原胶原蛋白-1增加,而弹性蛋白和 MMP-1水平无差异或略有增加。副作用极小。
在短期随访后,分幅光热解似乎是亚洲皮肤萎缩性疤痕治疗的一种安全有效的选择。