多脉冲 Nd:YAG 激光治疗黄褐斑的长期疗效新方案：描述性队列研究。
New Protocol for Long-Term Results With a Multi-Pulse Nd:YAG Laser for Melasma Treatment: A Descriptive Cohort Study.
出版信息
J Drugs Dermatol. 2021 Feb 1;20(2):150-154. doi: 10.36849/JDD.1221.
BACKGROUND
Melasma is a photoaging condition with a typical clinical and histological pattern under a genetic and epigenetic context. Over the years, many treatments modalities have been proposed including topical agents, oral medication, procedures, and combination treatments aiming at different aspects of the pathogenesis including photodamage, inflammation, vascularity, and pigmentation. Recently, lasers have become an alternative for the treatment of melasma using thermal energy to target, in a selective way, the chromophore found in the skin such as melanin.
OBJECTIVE
This study aimed to show how we have implemented a multifactorial approach that not only treats the symptoms but addresses the primary underlying cause of melasma.
MATERIALS AND METHODS
Twenty female patients with dermal and mixed melasma were admitted to Medical Art between December 2017 and April 2018 and received a four-step Fotona laser protocol. Clinical evaluation of a clearance percentage of melasma was performed 1 month after the last session by a blinded dermatologist grading the images taken during the study. Follow-up evaluation was performed at 6 and 12 months following the completion of the laser treatment, which was 6 sessions. Patients were also asked following the end of the treatment about their satisfaction, which was evaluated with a 5-point scale.
RESULTS
This descriptive cohort study included patients with melasma who underwent the four-step laser protocol treatment at 2-week intervals. The clearance percentage score showed 70% with excellent reduction, 25% with good reduction in appearance of melasma, none of the patients with a fair reduction, and 5% with a poor reduction. The mean score of patient satisfaction was 4,65 ± 0,93 (93%).
CONCLUSION
Results of this study indicate that the four-step Fotona laser protocol is a safe and effective treatment option for melasma. J Drugs Dermatol. 2021;20(2):150-154. doi:10.36849/JDD.1221.
背景
黄褐斑是一种光老化疾病，在遗传和表观遗传背景下具有典型的临床和组织学模式。多年来，已经提出了许多治疗方法，包括局部制剂、口服药物、手术和联合治疗，旨在针对发病机制的不同方面，包括光损伤、炎症、血管生成和色素沉着。最近，激光已成为治疗黄褐斑的一种替代方法，利用热能以选择性方式靶向皮肤中的色素，如黑色素。
目的
本研究旨在展示我们如何实施一种多因素方法，不仅治疗症状，而且解决黄褐斑的主要潜在原因。
材料和方法
2017 年 12 月至 2018 年 4 月，20 名患有真皮和混合性黄褐斑的女性患者在 Medical Art 接受治疗，并接受了四步 Fotona 激光方案。由一位盲法皮肤科医生在研究期间拍摄的图像进行临床评估，在最后一次治疗后 1 个月评估黄褐斑清除率的百分比。在完成激光治疗后的 6 和 12 个月进行随访评估，总共进行了 6 次治疗。在治疗结束后，患者还被询问了他们的满意度，满意度用 5 分制进行评估。
结果
本描述性队列研究包括接受四步激光方案治疗的黄褐斑患者，间隔 2 周治疗一次。清除率评分显示 70%的患者有极好的改善，25%的患者黄褐斑外观有良好的改善，没有患者有一般的改善，5%的患者有较差的改善。患者满意度平均得分为 4.65±0.93（93%）。
结论
本研究结果表明，四步 Fotona 激光方案是治疗黄褐斑的一种安全有效的治疗选择。J 皮肤病药物学杂志。2021;20(2):150-154。doi:10.36849/JDD.1221.
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