Hu Sindy, Yang Ching-Sheng, Chang Shyue-Luen, Huang Yau-Li, Lin Ying-Fang, Lee Mei-Ching
Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Graduate Institute of Biochemical and Biomedical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan.
Lasers Med Sci. 2020 Aug;35(6):1377-1383. doi: 10.1007/s10103-020-02959-7. Epub 2020 Jan 21.
Q-Switched laser devices have been a standard treatment modality for dermal pigmentary disorders since the 1990s. However, the adverse events are sometimes intolerable even if the efficacy has been well accepted. These adverse events stop the patient from continuing the treatment and cause other cosmetic issues. Since 2012, the first picosecond laser for cosmetic applications was approved; it seems promising for treating pigmentary disorders in a new way, but lack strong evidence. We evaluated the efficacy and safety of a 755-nm picosecond laser for treatment of dermal pigmentary disorders in Asians. This is a 2-year retrospective study. We reviewed 36 female cases, including 8 cases of nevus of Ota and 28 cases of acquired bilateral nevus of Ota-like macules. Institutional Review Board (IRB) approval was granted by the Chang Gung Memorial Hospital medical research ethics committee (IRB 201900833B0). The epidemiologic data was collected. These patients have been treated with the 755-nm picosecond laser for 1 to 4 sessions at variable treatment interval. Our parameter settings were fluence of 2.73-3.98 J/cm, with a spot size of 2.9 to 2.4 mm under the 650-ps mode. The pulse duration is 650 ps and fluence range is from 2.73 to 3.98 J/cm. Photographs were taken prior to every treatment and 1 month following the treatment. Two dermatologists conducted the clinical evaluation independently. Clinical improvement was observed in all with a minimal side effect. A total of 88.89% of patients had moderate to marked improvement in following 1 to 4 sessions. Transient swelling and erythema were observed in all patients but resolved within 24 h. Only one patient (2.78%) developed hypopigmentation and two patients (5.56%) had hyperpigmentation temporarily. Faster clearance could be achieved by the picosecond 755-nm laser for treating dermal pigmentary disorders in Asians. The treatment course is well tolerable and has minimal side effects.
自20世纪90年代以来，调Q激光设备一直是治疗皮肤色素沉着疾病的标准治疗方式。然而，即使其疗效已被广泛认可，但其不良事件有时仍难以忍受。这些不良事件会使患者停止继续治疗，并引发其他美容问题。自2012年以来，首款用于美容的皮秒激光获得批准；它似乎有望以一种新的方式治疗色素沉着疾病，但缺乏有力证据。我们评估了755纳米皮秒激光治疗亚洲人皮肤色素沉着疾病的疗效和安全性。这是一项为期2年的回顾性研究。我们回顾了36例女性病例，包括8例太田痣和28例获得性双侧太田痣样斑。长庚纪念医院医学研究伦理委员会（IRB 201900833B0）批准了机构审查委员会（IRB）的批准。收集了流行病学数据。这些患者接受了755纳米皮秒激光治疗，治疗次数为1至4次，治疗间隔不等。我们的参数设置为能量密度2.73 - 3.98 J/cm²，在650皮秒模式下光斑大小为2.9至2.4毫米。脉冲持续时间为650皮秒，能量密度范围为2.73至3.98 J/cm²。每次治疗前和治疗后1个月拍摄照片。两名皮肤科医生独立进行临床评估。所有患者均观察到临床改善，且副作用极小。在接受1至4次治疗后，共有88.89%的患者有中度至显著改善。所有患者均出现短暂肿胀和红斑，但在24小时内消退。只有1例患者（2.78%）出现色素减退，2例患者（5.56%）暂时出现色素沉着。755纳米皮秒激光治疗亚洲人皮肤色素沉着疾病可实现更快的清除。治疗过程耐受性良好，副作用极小。
