Ho S G Y, Yeung C K, Chan N P Y, Shek S Y, Kono T, Chan H H L
Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Lasers Surg Med. 2011 Jan;43(1):1-7. doi: 10.1002/lsm.21010.
Post-inflammatory hyperpigmentation (PIH) is characterized by an acquired increase in pigmentation secondary to an inflammatory process, and is a commonly observed response to cutaneous injury in Fitzpatrick types III-VI patients.
To determine the effectiveness and safety of using topical treatment, laser treatment, or combination topical and laser treatments to treat acne PIH in Oriental patients.
This is a retrospective study of 34 randomly selected Chinese patients with acne PIH. They were divided into three groups, and treated with topical agents, 595 nm long pulsed dye laser and/or 1064 nm Q-switched Nd:YAG, or combination topical and laser treatments. An independent clinician assessed pre- and post-treatment photographs to determine efficacy and timing to visible and optimum improvement.
There was significant global and focal improvement of acne PIH in patients in all three groups. However, no significant difference was found between the groups. An investigator global assessment showed improvement with all treatment modalities, with 70.6% moderate to marked improvement seen in the combination treatment group, compared to 55.6% in the laser only group, and 50% in the topical treatment only group. Visible and optimum improvement was seen by 3 months in majority of patients treated. One patient developed PIH as a result of laser treatment.
Topical treatment, laser therapy, and combination topical and laser treatments all appear to be effective management strategies for acne PIH in Fitzpatrick types III and IV skin with little complications. Topical agents may be considered as first-line therapy for acne PIH, taking into consideration its effectiveness, ease of use and cost. Combined topical and laser therapy is also effective, and may be considered as second-line treatment.
炎症后色素沉着（PIH）的特征是继发于炎症过程后色素沉着获得性增加，是 Fitzpatrick III - VI 型患者皮肤损伤后常见的反应。
确定使用局部治疗、激光治疗或局部与激光联合治疗对东方患者痤疮后色素沉着的有效性和安全性。
这是一项对 34 例随机选择的中国痤疮后色素沉着患者的回顾性研究。他们被分为三组，分别接受局部用药、595nm 长脉冲染料激光和/或 1064nm 调 Q 开关 Nd:YAG 激光治疗，或局部与激光联合治疗。一名独立的临床医生评估治疗前后的照片以确定疗效以及达到可见和最佳改善的时间。
所有三组患者的痤疮后色素沉着在整体和局部均有显著改善。然而，各组之间未发现显著差异。研究者的整体评估显示所有治疗方式均有改善，联合治疗组有 70.6%的患者有中度至显著改善，单纯激光治疗组为 55.6%，单纯局部治疗组为 50%。大多数接受治疗的患者在 3 个月时出现可见和最佳改善。有 1 例患者因激光治疗出现色素沉着。
局部治疗、激光治疗以及局部与激光联合治疗似乎都是 Fitzpatrick III 型和 IV 型皮肤痤疮后色素沉着的有效管理策略，且并发症较少。考虑到其有效性、易用性和成本，局部用药可被视为痤疮后色素沉着的一线治疗方法。局部与激光联合治疗也有效，可被视为二线治疗。
