Choi Jae Eun, Lee Dong Won, Seo Soo Hong, Ahn Hyo Hyun, Kye Young Chul
Department of Dermatology, College of Medicine, Korea University, Seoul.
J Cosmet Dermatol. 2018 Dec;17(6):1053-1058. doi: 10.1111/jocd.12760. Epub 2018 Oct 2.
Melasma is a common acquired facial pigmentary disorder that is resistant to various modalities of treatment. Recently, the low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser (QSNY) has emerged as the new gold standard of melasma treatment in Asia.
To evaluate the efficacy and safety of low-fluence 1064-nm QSNY in Asian patients with melasma.
Data of patients with melasma treated with low-fluence QSNY in the department of dermatology at the Korea University Anam Hospital were reviewed retrospectively. A 1064-nm QSNY with 8 mm spot size and fluence of 1.2-2.0 J/cm at 10 Hz was used. The results were evaluated using the modified Melasma Area and Severity Index (mMASI) score and the physician's global assessment (PGA).
A total of 40 Korean patients with Fitzpatrick skin type III to IV were included. Patients were treated for a median of 10 sessions at a median of 1-week intervals. The mean mMASI score decreased by 54.23% from a baseline of 3.19 ± 2.64 to 1.46 ± 1.06 after treatment. On PGA, 1 out of 40 patients (2.5%) showed excellent improvement, 14 (35%) good, 15 (37.5%) fair, 6 (15%) poor, and 4 (10%) no improvement. However, two patients showed mottled hypopigmentation and rebound hyperpigmentation.
Low-fluence 1064-nm QSNY appears to be a safe and effective treatment for Asian patients with melasma.
黄褐斑是一种常见的获得性面部色素沉着紊乱疾病，对各种治疗方式均有抵抗性。最近，低能量1064纳米调Q掺钕钇铝石榴石激光（QSNY）已成为亚洲黄褐斑治疗的新金标准。
评估低能量1064纳米QSNY对亚洲黄褐斑患者的疗效和安全性。
回顾性分析韩国大学安岩医院皮肤科用低能量QSNY治疗的黄褐斑患者的数据。使用光斑大小为8毫米、频率为10赫兹、能量密度为1.2 - 2.0焦耳/平方厘米的1064纳米QSNY。采用改良的黄褐斑面积和严重程度指数（mMASI）评分及医生整体评估（PGA）对结果进行评估。
共纳入40例皮肤类型为Fitzpatrick III至IV型的韩国患者。患者平均接受10次治疗，治疗间隔中位数为1周。治疗后，平均mMASI评分从基线的3.19 ± 2.64降至1.46 ± 1.06，下降了54.23%。在PGA评估中，40例患者中1例（2.5%）显示极佳改善，14例（35%）良好，15例（37.5%）中等，6例（15%）差，4例（10%）无改善。然而，有2例患者出现了斑驳状色素减退和色素沉着反弹。
低能量1064纳米QSNY对亚洲黄褐斑患者似乎是一种安全有效的治疗方法。
