Ali Faisal R, Al-Niaimi Firas
Dermatological Surgery and Laser Unit, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
Lasers Med Sci. 2016 Feb;31(2):373-81. doi: 10.1007/s10103-015-1853-z. Epub 2015 Dec 22.
Topical medicaments are the mainstay of the dermatologists' therapeutic arsenal. Laser-assisted drug delivery enhances the ability of topically applied medicaments to penetrate the skin. We discuss the mechanisms of laser-assisted drug delivery and animal models that have informed clinical practice. We review clinical studies that have employed laser-assisted drug delivery for a range of indications to date including non-melanoma skin cancer, vitiligo, scarring, vaccination, local anaesthesia, analgesia, viral warts, infantile haemangiomas and cosmetic uses. Studies thus far suggest that laser pre-treatment improves transepidermal absorption of topical agents and allows for a much deeper penetration of drugs than is possible with topical medicaments alone. This may allow more efficacious action of current treatments, such that conventional duration of treatment can be shortened or lower concentrations of active agents be used, potentially obviating side effects of treatment. The prospect of using laser technologies to facilitate transdermal vaccination and as an adjunct for inflammatory dermatoses and cosmetic indications remains in its infancy. As larger trials are published, involving greater numbers of patients and utilising various laser and topical medicament parameters, we will enhance our understanding of this nascent modality of treatment delivery.
局部用药是皮肤科医生治疗手段的主要支柱。激光辅助药物递送可增强局部应用药物穿透皮肤的能力。我们讨论了激光辅助药物递送的机制以及为临床实践提供依据的动物模型。我们回顾了迄今为止将激光辅助药物递送用于一系列适应症的临床研究，这些适应症包括非黑色素瘤皮肤癌、白癜风、瘢痕形成、疫苗接种、局部麻醉、镇痛、病毒疣、婴儿血管瘤和美容用途。迄今为止的研究表明，激光预处理可改善局部用药的经皮吸收，并使药物的渗透深度比单独使用局部药物时更深。这可能使当前治疗更有效，从而可以缩短传统治疗时间或使用更低浓度的活性剂，有可能避免治疗的副作用。利用激光技术促进经皮疫苗接种以及作为炎症性皮肤病和美容适应症辅助手段的前景仍处于起步阶段。随着更多涉及大量患者并利用各种激光和局部用药参数的大型试验发表，我们将加深对这种新兴治疗方式的理解。
