Kaminaka Chikako, Furukawa Fukumi, Yamamoto Yuki
Departments of *Dermatology, and †Cosmetic Dermatology and Photomedicine, Wakayama Medical University, Wakayama, Japan.
Dermatol Surg. 2017 Sep;43(9):1120-1133. doi: 10.1097/DSS.0000000000001120.
The low-fluence Q-switched 1,064-nm neodymium:yttrium-aluminum-garnet laser (QSNYL) is popular for melasma treatment among Asians.
This study was to evaluate the clinical and histological effects of the low-fluence QSNYL for treatment of melasma and solar lentigenes.
In this randomized split-face clinical study, 22 patients with melasma or solar lentigo received low-fluence QSNYL weekly for 10 sessions on one cheek. The treatment efficacy was determined by Mexameter skin colorimetry, physician and patient assessment, and by evaluating histological changes.
The treated sides had statistically significant reductions in the melanin and erythema indices (EI); 50.0% of melasma and 62.5% of solar lentigo patients had >50% clearance after the final treatment. The increased EI, vascularity, and mast cell activity in patients with melasma and large-sized solar lentigo showed no improvement. The recurrence rates were 16.7% and 12.7% for melasma and solar lentigo, respectively. Postinflammatory hyperpigmentation developed in 1 patient, but no serious side effects were noted.
Low-fluence QSNYL is effective in treating melasma and small type solar lentigo in Asians. The authors' study also demonstrated that lesion thickness, vascularity, and mast cell activity can be used to predict the efficacy of the treatment of these lesions.
低能量调Q开关1064nm钕钇铝石榴石激光（QSNYL）在亚洲人黄褐斑治疗中很受欢迎。
本研究旨在评估低能量QSNYL治疗黄褐斑和日光性雀斑样痣的临床及组织学效果。
在这项随机半脸临床研究中，22例黄褐斑或日光性雀斑样痣患者一侧脸颊每周接受低能量QSNYL治疗，共10次。通过Mexameter皮肤比色法、医生和患者评估以及评估组织学变化来确定治疗效果。
治疗侧的黑色素和红斑指数（EI）有统计学意义的降低；50.0%的黄褐斑患者和62.5%的日光性雀斑样痣患者在最终治疗后色素清除率>50%。黄褐斑和大型日光性雀斑样痣患者增加的EI、血管形成和肥大细胞活性未见改善。黄褐斑和日光性雀斑样痣的复发率分别为16.7%和12.7%。1例患者出现炎症后色素沉着，但未观察到严重副作用。
低能量QSNYL对亚洲人黄褐斑和小型日光性雀斑样痣有效。作者的研究还表明，皮损厚度、血管形成和肥大细胞活性可用于预测这些皮损的治疗效果。
