Son In Pyeong, Park Kui Young, Kim Beomjoon, Kim Myeung Nam
Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
Ann Dermatol. 2014 Apr;26(2):156-61. doi: 10.5021/ad.2014.26.2.156. Epub 2014 Apr 30.
Treatments including intralesional corticosteroid injection, pressure therapy, cryotherapy, and various laser therapies have had limited success for keloids and hypertrophic scars.
This trial evaluated the efficacy of a combination of 578 nm copper bromide laser and the more traditional intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to scar color.
Keloids or hypertrophic scars of 12 Korean patients were treated five times by the combined treatment at 4-week intervals. Clinical improvement was assessed by the physicians' global assessment (PGA) comparing pre- and post-treatment photographs, as well as 4 weeks after the last treatment. Erythema intensity was quantified using a mexameter.
Most scars showed significant clinical improvement in PGA and decreased erythema intensity after 5 treatments. All patients showed improvements in symptoms like pruritus.
The combined treatment is effective for keloids and hypertrophic scars, especially when the telangiectatic portion of the scars is prominent. The adjunctive use of 578 nm copper bromide laser decreased the telangiectatic side effects of an intralesional corticosteroid injection by reducing the vascular components of scars.
包括病灶内注射皮质类固醇、压力疗法、冷冻疗法以及各种激光疗法在内的治疗方法,对瘢痕疙瘩和增生性瘢痕的治疗效果有限。
本试验评估了578纳米溴化铜激光与更传统的病灶内注射皮质类固醇联合治疗瘢痕疙瘩和增生性瘢痕在改善瘢痕颜色方面的疗效。
12名韩国患者的瘢痕疙瘩或增生性瘢痕接受联合治疗,每隔4周治疗1次,共治疗5次。通过医生整体评估(PGA)比较治疗前后的照片以及最后一次治疗后4周的照片来评估临床改善情况。使用皮肤红斑仪对红斑强度进行量化。
大多数瘢痕在接受5次治疗后,PGA显示出显著的临床改善,红斑强度降低。所有患者的瘙痒等症状均有改善。
联合治疗对瘢痕疙瘩和增生性瘢痕有效,尤其是当瘢痕的毛细血管扩张部分较为突出时。578纳米溴化铜激光的辅助使用通过减少瘢痕的血管成分,降低了病灶内注射皮质类固醇的毛细血管扩张副作用。