Tawfik Abeer, Osman Mai Abdelraouf, Rashwan Iman
Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences (N.I.L.E.S.), Cairo University, Giza, Egypt.
Dermatology Department, New Cairo Hospital, Cairo, Egypt.
Dermatol Surg. 2018 Mar;44(3):413-420. doi: 10.1097/DSS.0000000000001336.
Acne keloidalis nuchae (AKN) is a dermatological condition characterized by follicular-based papules and pustules that later form hypertrophic or keloid-like scars. Laser-assisted hair reduction such as 810-nm diode laser and 1,064-nm Nd:YAG laser have been used for treating AKN with promising results.
To evaluate the therapeutic effect and safety of alexandrite laser in the treatment of different lesions of AKN.
Seventeen male patients with AKN received 6 sessions of 755-nm alexandrite laser. Papule and pustule count, keloidal plaque size, pliability, tenderness, and itching were assessed at the fourth session and 4 weeks after the sixth session. Patient satisfaction and Dermatology Life Quality Index (DLQI) questionnaire were performed at the end of treatment. Patients were followed up for 3 months after the final treatment.
There was a significant decrease in the mean papule, pustule count, keloidal plaque size, and pliability at the fourth and sixth laser sessions when compared with baseline. Reduction of the hair density in the treated area is the only complication observed, which was accepted by the patients because of its reversible course. There was a statistically significantly higher percentage of improvement in the early lesions (papulopustular) compared with late (keloidal plaque) lesions. By the end of laser sessions, DLQI scores were significantly reduced. Temporary hair loss was noted in 4 patients in the treated sites. No lesional recurrence was detected in the follow-up period.
Using 755-nm alexandrite laser for treatment of AKN is a safe and effective procedure with low recurrence rates. Alexandrite laser can significantly improve the quality of life of those patients suffering from this disfiguring chronic disorder.
瘢痕疙瘩性痤疮（AKN）是一种皮肤病，其特征为毛囊性丘疹和脓疱，随后形成肥厚性或瘢痕疙瘩样瘢痕。诸如810纳米二极管激光和1064纳米Nd:YAG激光等激光辅助脱毛技术已被用于治疗AKN，并取得了有前景的结果。
评估翠绿宝石激光治疗AKN不同皮损的疗效和安全性。
17例男性AKN患者接受6次755纳米翠绿宝石激光治疗。在第4次治疗时和第6次治疗后4周评估丘疹和脓疱数量、瘢痕疙瘩斑块大小、柔韧性、压痛和瘙痒情况。在治疗结束时进行患者满意度和皮肤病生活质量指数（DLQI）问卷调查。在最后一次治疗后对患者进行3个月的随访。
与基线相比，在第4次和第6次激光治疗时，平均丘疹、脓疱数量、瘢痕疙瘩斑块大小和柔韧性均显著降低。治疗区域毛发密度降低是观察到的唯一并发症，因其病程可逆，患者可接受。与晚期（瘢痕疙瘩斑块）皮损相比，早期（丘疹脓疱性）皮损改善的百分比在统计学上显著更高。到激光治疗结束时，DLQI评分显著降低。4例患者在治疗部位出现暂时性脱发。随访期间未检测到皮损复发。
使用755纳米翠绿宝石激光治疗AKN是一种安全有效的方法，复发率低。翠绿宝石激光可显著改善患有这种毁容性慢性疾病患者的生活质量。
