El-Domyati Moetaz, Hosam El-Din Wael, Medhat Walid, Ibrahim Michel R, Khaled Yasmin
Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minia University, Al Minya, Egypt.
J Cosmet Dermatol. 2021 Feb;20(2):546-553. doi: 10.1111/jocd.13844. Epub 2020 Dec 3.
Striae distensae (SD) is a very common skin problem. Although a lot of treatment modalities have been proposed, few of them are effective. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many indications of cosmetic dermatology such as SD.
To objectively evaluate the use and effectiveness of CDT for treatment of SD.
Twenty patients were subjected to 8 sessions of CDT injection at 2-week intervals using carboxy-gun. Patients were photographed, and skin specimens were obtained from the treated area before and after 4 months of treatment. Using a computerized 3D camera, skin topography was objectively analyzed before and after treatment. Evaluation of collagen and elastic fibers by special histopathological staining, in addition to histometric analysis, was also done to evaluate treatment efficacy.
Clinically, SD was statistically significantly improved after CDT injection compared with baseline (mean percentage of improvement of length and width, 59.8 ± 15.9; P < .05). Meanwhile, the improvement observed by the 3D camera correlated with the clinical improvement. Histometric analysis showed an increase in epidermal thickness (P < .0001) in association with re-appearance of rete ridges following treatment. Histochemical evaluation of changes in elastic and collagen fibers after treatment showed better organization of curled and fragmented elastic fibers, which was accompanied by an increase in collagen content that became denser, arranged in bundles and parallel to the epidermis.
CDT is an effective, promising, and simple minimally invasive procedure for improving SD with few side effects and low downtime.
膨胀纹(SD)是一种非常常见的皮肤问题。尽管已经提出了许多治疗方法,但其中很少有有效的。最近,二氧化碳疗法(CDT)或羧基疗法被用于美容皮肤科的许多适应症,如SD。
客观评估CDT治疗SD的应用及有效性。
20例患者使用羧基枪每隔2周接受8次CDT注射。对患者进行拍照,并在治疗4个月前后从治疗区域获取皮肤标本。使用计算机化3D相机,客观分析治疗前后的皮肤地形图。除了组织测量分析外,还通过特殊组织病理学染色对胶原蛋白和弹性纤维进行评估,以评估治疗效果。
临床上,与基线相比,CDT注射后SD有统计学显著改善(长度和宽度的平均改善百分比为59.8±15.9;P<.05)。同时,3D相机观察到的改善与临床改善相关。组织测量分析显示治疗后表皮厚度增加(P<.0001),伴有 rete 嵴的重新出现。治疗后弹性纤维和胶原纤维变化的组织化学评估显示,卷曲和破碎的弹性纤维组织更好,同时胶原含量增加,变得更致密,排列成束并与表皮平行。
CDT是一种有效、有前景且简单的微创方法,可改善SD,副作用少,停机时间短。