Ueda Atsuto
Division of Dermatology, Miyazaki Hospital, Nagasaki, JAPAN.
Laser Ther. 2014 Sep 30;23(3):211-20. doi: 10.5978/islsm.14-CR-01.
Lichen pilaris is a very common disease typically seen among young adults on their upper arms as a manifestation of hyperkeratotic lesions occurring in the pores. Only a few treatments have been reported as significantly effective, so often natural resolution over time is the only option. The present study examined the use of a 1064 nm Q-switched Nd:YAG laser (QSNY) in quasi long-pulsed mode, in an attempt to treat a case of lichen pilaris.
A 33-year-old male presented with light-brown aggregated papules observed on both sides of the upper arms. The affected areas were treated every other week (QSNY, pulse width 300 µs, pulse energy 3.0 J/cm(2), spot size 6 mm and repetition rate 10 Hz). Clinical photography was taken of the lesions at baseline and three months after the final treatment in addition to macrophotography and 3-D photography, biopsies being taken at both time points for histological comparison.
The clinical photography and objective image evaluation demonstrated shrinkage of pores and improvement of the unevenness of the skin. Histological examination suggested that the effect of the micropulsed QSNY on the horny layer, epidermal keratinocytes and dermal collagen resulted in a peeling effect and increased dermal collagen density, which eventually led to the shrinkage of the pores and improvement of the skin condition.
The results of this single patient case report suggest that the micropulsed QSNY could be an effective treatment option for lichen pilaris, improvement of which is often difficult. Further studies with an appropriately-sized population are merited to confirm these preliminary results.
毛发苔藓是一种非常常见的疾病,多见于年轻人的上臂,表现为毛孔处的角化过度性病变。据报道,只有少数治疗方法有显著疗效,因此随着时间推移自然消退往往是唯一的选择。本研究探讨了使用1064nm调Q Nd:YAG激光(QSNY)以准长脉冲模式治疗一例毛发苔藓的情况。
一名33岁男性,双侧上臂出现淡褐色聚集性丘疹。每隔一周对患处进行治疗(QSNY,脉冲宽度300µs,脉冲能量3.0J/cm²,光斑大小6mm,重复频率10Hz)。在基线时以及最后一次治疗后三个月对病变进行临床摄影,此外还进行了宏观摄影和三维摄影,并在两个时间点取活检进行组织学比较。
临床摄影和客观图像评估显示毛孔缩小,皮肤平整度改善。组织学检查表明,微脉冲QSNY对角质层、表皮角质形成细胞和真皮胶原的作用产生了剥脱效果,并增加了真皮胶原密度,最终导致毛孔缩小和皮肤状况改善。
本单病例报告结果表明,微脉冲QSNY可能是治疗往往难以改善的毛发苔藓的一种有效治疗选择。值得进行进一步的适当规模人群研究以证实这些初步结果。