Eimpunth S, Wanitphakdeedecha R, Triwongwaranat D, Varothai S, Manuskiatti W
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Clin Exp Dermatol. 2014 Apr;39(3):292-7. doi: 10.1111/ced.12267.
Recent evidence suggests that vascular abnormalities are involved in the pathogenesis of melasma. Copper bromide (CuBr) laser, which emits dual wavelengths (511 and 578 nm), enabling simultaneous and selective destruction of melanin-containing cells and blood vessels, may be of benefit in the treatment of melasma.
To investigate the efficacy and adverse effects (AEs) of CuBr laser for melasma treatment in patients with skin phototypes III-V.
We enrolled 24 Thai women with melasma to receive six CuBr laser treatments, 2 weeks apart. Objective (colour measurement) and subjective (clinical evaluation of photographs by three dermatologists blinded to the order of the photographs) assessments were obtained at baseline, after three and six treatments, and at the 3-month follow-up visit. A visual analogue scale (VAS) was used for patient assessment of change at baseline, after six treatments and at the 3-month follow-up. AEs were recorded at every follow-up visit.
Of the 24 patients, 20 completed the study. Mean melanin index (MI) showed no statistically significant improvement compared with baseline measurements at any of the follow-up visits. There were significant improvements in clinical evaluation after three treatments (P = 0.00); however, this difference was no longer visible after six treatments. At follow-up 1 week after the end of the full course of six treatments, there was an improvement in VAS (P = 0.02). However, there was no improvement as measured by clinical evaluation or MI. Mild, transient AEs including erythema, burning sensation, scaling, hyperpigmentation and crusting were noted.
CuBr laser did not show effectiveness in improving melasma in patients with skin phototypes III-V.
最近的证据表明，血管异常参与了黄褐斑的发病机制。溴化铜（CuBr）激光发射511和578纳米的双波长，能够同时选择性地破坏含黑色素细胞和血管，可能对黄褐斑的治疗有益。
探讨CuBr激光治疗皮肤光型III-V型黄褐斑患者的疗效和不良反应（AE）。
我们招募了24名患有黄褐斑的泰国女性，接受6次CuBr激光治疗，每次治疗间隔2周。在基线、3次和6次治疗后以及3个月随访时进行客观（颜色测量）和主观（由3名对照片顺序不知情的皮肤科医生对照片进行临床评估）评估。使用视觉模拟量表（VAS）让患者在基线、6次治疗后和3个月随访时评估变化情况。每次随访时记录AE。
24名患者中，20名完成了研究。与任何随访时的基线测量相比，平均黑色素指数（MI）无统计学显著改善。3次治疗后临床评估有显著改善（P = 0.00）；然而，6次治疗后这种差异不再明显。在6次治疗全疗程结束后1周的随访中，VAS有改善（P = 0.02）。然而，通过临床评估或MI测量没有改善。观察到包括红斑、烧灼感、脱屑、色素沉着和结痂在内的轻度、短暂性AE。
CuBr激光对皮肤光型III-V型的黄褐斑患者改善效果不佳。
