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准长脉冲 1064nmNd:YAG(微脉冲)技术治疗活动性痤疮:病例系列。

Quasi long-pulsed 1064nm Nd:YAG (micro pulsed) technology for the treatment of active acne: A case series.

机构信息

Dr. Artzi and Associates-Treatment and Research Center, Tel Aviv, Israel.

Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

出版信息

J Cosmet Dermatol. 2021 Jul;20(7):2102-2107. doi: 10.1111/jocd.14128. Epub 2021 Apr 8.

Abstract

BACKGROUND

Acne vulgaris is common dermatologic condition with an estimated prevalence of 80%. Acne has been shown to have a significant impact on patient quality of life and mental health, especially as inflammatory lesions typically occur on cosmetically sensitive areas with the potential for permanent scarring. There have been numerous advances in the treatment of inflammatory acne with light-based and laser devices. This technology permits effective treatment of active acne and scarring, with a short recovery and a decreased side effect profile as compared to medicinal standard-of-care and photodynamic therapies.

OBJECTIVE

The case series study was aimed at evaluating the safety and efficacy of a 1064 nm Nd: YAG Quasi-longed pulse laser treatment for acne vulgaris.

METHODS

This was a prospective study of 19 subjects with moderate to severe. All subjects received 1064 nm Nd: YAG Quasi-longed pulse laser treatments, at 8 J/cm fluence and accumulated 1000-4000 kJ according to treatment area at two weeks intervals. Primary end point was reaching a minimal AGSS score of between 1 and 2. Acne severity was assessed by two independent dermatologists according to AGSS scale before each treatment session and at the follow-up visit (8 weeks following last treatment). Subjects' self-assessment of Patient Global Impression of Change (PGIC) and overall satisfaction were also recorded. Safety was assessed by recording pain, adverse events, and downtime throughout the trial.

RESULTS

Investigator's US FDA AGSS scoring of acne appearance improvement shows an average of 6.6 treatments were required to reach the minimal AGSS score endpoint. Significant reduction in AGSS scores was recorded after 2 treatments (4.21 ± 0.65 vs 3.05 ± 0.83 p = 1.63E ), and maintained a statistically significant reduction rate throughout the trial. Minimal AGSS scores were still detected after 8 weeks following final treatment. Subjects scored high satisfaction rates and PGIC scores (2.9 and 5.3, respectively). Some patients reported transient erythema as only adverse events recorded in the study.

CONCLUSION

The 1064 nm Nd: YAG Quasi-longed pulse laser was found to be safe and highly effective for the treatment of facial acne. The treatments were well tolerated, and the subjects experienced no pain and no downtime. Light-based treatments do and will probably continue to play an important and enlarging role in acne management.

摘要

背景

寻常痤疮是一种常见的皮肤病,估计患病率为 80%。痤疮已被证明对患者的生活质量和心理健康有重大影响,尤其是因为炎症性病变通常发生在美容敏感区域,有永久性瘢痕的潜在风险。随着基于光和激光设备的治疗方法的不断发展,治疗炎症性痤疮取得了许多进展。与药物标准治疗和光动力疗法相比,这种技术可以有效治疗活动期痤疮和瘢痕,恢复时间短,副作用少。

目的

本病例系列研究旨在评估 1064nmNd:YAG 准长脉冲激光治疗寻常痤疮的安全性和疗效。

方法

这是一项针对 19 名中重度寻常痤疮患者的前瞻性研究。所有患者均接受 1064nmNd:YAG 准长脉冲激光治疗,每次 8J/cm 能量密度,根据治疗区域累积 1000-4000kJ,每两周治疗一次。主要终点是达到 AGSS 评分 1-2 分的最低分值。在每次治疗前和随访(末次治疗后 8 周)时,两名独立的皮肤科医生根据 AGSS 量表评估痤疮严重程度。还记录了患者的自我评估(PGIC)和总体满意度。在整个试验过程中,通过记录疼痛、不良事件和停机时间来评估安全性。

结果

研究人员根据美国食品和药物管理局(FDA)的 AGSS 评分标准评估痤疮外观改善情况,结果显示,平均需要 6.6 次治疗才能达到最低 AGSS 评分终点。在 2 次治疗后,AGSS 评分显著降低(4.21±0.65 分比 3.05±0.83 分,p=1.63E-04),并且在整个试验过程中保持了显著的降低率。末次治疗后 8 周仍可检测到最低 AGSS 评分。患者对治疗效果的满意度和 PGIC 评分均较高(分别为 2.9 和 5.3)。研究中仅记录了一些患者出现短暂的红斑等不良事件。

结论

1064nmNd:YAG 准长脉冲激光治疗面部痤疮安全有效。治疗耐受性良好,患者无疼痛且无需停机。基于光的治疗方法已经并将继续在痤疮管理中发挥重要且不断扩大的作用。

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