Dermatology Department, Kasr Al Aini Hospital, Faculty of Medicine, Cairo University, ICDP-UEMS, Giza, Egypt.
Histology Department, Faculty of Medicine, Cairo University, Giza, Egypt.
Dermatol Surg. 2021 Jul 1;47(7):e205-e211. doi: 10.1097/DSS.0000000000002994.
Although various treatments are currently available for primary cutaneous amyloidosis (PCA), there is no entirely satisfactory treatment. Recently, fractional ablative lasers are claimed to have therapeutic effects for PCA.
To evaluate the efficacy and safety of fractional Er:YAG laser for the treatment of PCA.
Ten patients with macular and lichen amyloidosis received 4 treatment sessions with 4-week intervals. The outcome was assessed clinically (degree of pigmentation, rippling, lichenification, and itching) through photographs and histologically (amount of amyloid, melanin, epidermal thickness, and depth of rete ridges) through biopsy specimens stained with hematoxylin-eosin, Congo red, and Fontana-Masson stain. Patients were followed up for 3 months after the final treatment.
At 3-month follow-up, fractional Er:YAG laser exhibited a significant clinical and histological improvement. Patient satisfaction concurred with physicians' evaluations. Recurrence was detected in 1 patient.
In light of the authors' findings, fractional Er:YAG laser offered a great clinical and histological efficacy with excellent safety profile. Careful laser selection based on making a compromise between efficacies and safeties may improve outcome.
虽然目前有多种治疗原发性皮肤淀粉样变（PCA）的方法，但尚无完全令人满意的治疗方法。最近，有人声称分数消融激光对 PCA 具有治疗作用。
评估分数铒：YAG 激光治疗 PCA 的疗效和安全性。
10 例黄斑和苔藓样淀粉样变患者接受了 4 次治疗，间隔 4 周。通过照片评估临床结果（色素沉着、波纹、苔藓样变和瘙痒程度），通过苏木精-伊红、刚果红和Fontana-Masson 染色的活检标本评估组织学结果（淀粉样蛋白、黑色素、表皮厚度和网嵴深度）。在最后一次治疗后 3 个月对患者进行随访。
在 3 个月的随访中，分数铒：YAG 激光显示出显著的临床和组织学改善。患者满意度与医生的评估一致。1 例患者复发。
根据作者的发现，分数铒：YAG 激光具有良好的临床和组织学疗效，安全性良好。根据疗效和安全性之间的权衡仔细选择激光可能会改善结果。
