Issa Maria Cláudia Almeida, de Britto Pereira Kassuga Luiza Erthal, Chevrand Natalia Stroligo, do Nascimento Barbosa Livia, Luiz Ronir Raggio, Pantaleão Luciana, Vilar Enoi Guedes, Rochael Mayra Carrijo
Dermatology, Fluminense Federal University, Praia de Icarai, 139/702 Niteroi, Rio de Janeiro, CEP 24230-001, Brazil.
Lasers Surg Med. 2013 Feb;45(2):81-8. doi: 10.1002/lsm.22105. Epub 2012 Dec 31.
Striae distensae (SD) treatment still remains a therapeutic challenge to dermatologists. Ablative fractional laser and radiofrequency (RF) enhance skin-drug permeability for SD treatment.
To clinically evaluate the efficacy and safety as well as patient's satisfaction in relation to a method using ablative fractional RF associated with retinoic acid 0.05% cream and an acoustic pressure wave ultrasound (US) in patients with alba-type SD on the breast.
Eight patients with alba-type SD on the breast were treated with three step procedure: (1) fractional ablative RF for skin perforation; (2) topical application of retinoic acid 0.05% on the perforated skin; and (3) US was applied to enhance the retinoic acid penetration into the skin. Other eight patients with alba-type SD on the abdominal area were submitted to RF treatment isolated without retinoic acid or US. Three of them were submitted to skin biopsies.
Three patients with SD on the breast area improved from "severe" to "moderate;" two patients improved from "severe" to "mild;" two patients from "moderate" to "mild;" one patient from "marked" to "mild." Clinical assessment demonstrated significant improvement in the appearance of SD in all patients treated with RF associated with retinoic acid 0.05% cream and US (P = 0.008), with low incidence of side effects and high level of patient's satisfaction. Among the patients treated only with RF, two patients improved from "severe" to "marked;" one patient from "marked" to "moderate;" and one patient improved from "marked" to "mild." Four patients did not show any sort of improvement. Clinical assessment demonstrated no significant improvement in the appearance of SD treated with RF isolated with low incidence of side effects, but low-level of patient's satisfaction.
Ablative fractional RF and acoustic pressure US associated with retinoic acid 0.05% cream is safe and effective for alba-type SD treatment.
膨胀纹（SD）的治疗仍然是皮肤科医生面临的一项治疗挑战。剥脱性分数激光和射频（RF）可增强皮肤对药物的渗透性，用于SD的治疗。
临床评估一种联合使用0.05%维甲酸乳膏的剥脱性分数射频和声波压力波超声（US）治疗乳房白色型SD患者的疗效、安全性及患者满意度。
8例乳房白色型SD患者接受三步治疗：（1）剥脱性分数射频进行皮肤打孔；（2）在打孔皮肤上局部应用0.05%维甲酸；（3）应用超声增强维甲酸渗透入皮肤。另外8例腹部白色型SD患者仅接受单纯射频治疗，未使用维甲酸或超声。其中3例患者接受了皮肤活检。
乳房部位3例SD患者从“重度”改善为“中度”；2例患者从“重度”改善为“轻度”；2例患者从“中度”改善为“轻度”；1例患者从“显著”改善为“轻度”。临床评估显示，所有接受联合0.05%维甲酸乳膏和超声的射频治疗的患者，SD外观均有显著改善（P = 0.008），副作用发生率低，患者满意度高。在仅接受射频治疗的患者中，2例患者从“重度”改善为“显著”；1例患者从“显著”改善为“中度”；1例患者从“显著”改善为“轻度”。4例患者未显示任何改善。临床评估显示，单纯射频治疗的SD外观无显著改善，副作用发生率低，但患者满意度低。
联合0.05%维甲酸乳膏的剥脱性分数射频和声波压力超声治疗白色型SD安全有效。
