Radmanesh Mohammad, Ghanatir Forough, Radmanesh Ramin
Dr Radmanesh Dermatologic and Laser Center, Tehran, Iran.
Department of Dermatology, Ahvaz Jundishapur Univesity of Medical Sciences, Ahvaz, Iran.
J Dermatolog Treat. 2021 Mar;32(2):258-260. doi: 10.1080/09546634.2019.1654071. Epub 2019 Aug 25.
No topical and systemic treatment is proven to be effective on Cutaneous Macular Amyloidosis (CMA). The physical removal of the deposited protein by lasers may be a better choice.
To compare the efficacy of different lasers including Pulsed dye laser (PDL), 1064 mode of Q-Switched Nd-YAG, CO, and combined CO and Q-Switched Nd:YAG lasers for the treatment of CMA.
17 adult female patients with clinical CMA and histopathological confirmation were included in this study. Four close 1 by 1 cm areas were treated simultaneously with PDL, Q-Switched Nd-YAG, CO and combined CO and Nd-YAG Lasers. The energy used for 585 nm PDL were 9 J/cm with the spot size of 5 mm. The energy used for 1064 nm mode of Nd-YAG laser was 5 Joules/cm, with the spot size of 4 mm, and the frequency of 10 hertz. The energies used for CO laser were 4 and 3.5 Micro Joules for the first and second Passes.
No desirable result obtained after PDL therapy. The Q-Switched Nd-YAG was effective in only 3 patients. All areas treated with CO laser were cleared.
The CO laser is seems to be the most effective laser treatment of CMA.
尚无局部和全身治疗方法被证明对皮肤黄斑淀粉样变（CMA）有效。通过激光物理去除沉积蛋白可能是更好的选择。
比较不同激光，包括脉冲染料激光（PDL）、调Q开关Nd:YAG激光的1064模式、CO激光以及CO与调Q开关Nd:YAG激光联合使用对CMA的治疗效果。
本研究纳入17例经临床及组织病理学确诊的成年女性CMA患者。用PDL、调Q开关Nd:YAG激光、CO激光以及CO与Nd:YAG激光联合，同时对4个相邻的1×1平方厘米区域进行治疗。585纳米PDL使用的能量为9焦耳/平方厘米，光斑大小为5毫米。Nd:YAG激光1064纳米模式使用的能量为5焦耳/平方厘米，光斑大小为4毫米，频率为10赫兹。CO激光第一次和第二次照射使用的能量分别为4和3.5微焦耳。
PDL治疗后未获得理想效果。调Q开关Nd:YAG激光仅对3例患者有效。所有接受CO激光治疗的区域均清除。
CO激光似乎是治疗CMA最有效的激光。
