Abu Oun Ayat A, Ahmed Naglaa A, Hafiz Hala S A
Dermatology and Venereology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
J Cosmet Dermatol. 2022 Mar;21(3):1023-1030. doi: 10.1111/jocd.14224. Epub 2021 May 31.
Acanthosis nigricans (AN) is a common dermatological issue with several therapeutic modalities to treat. Despite retinoid is the first drug of choice in the treatment, the fractional-ablative carbon dioxide (CO ) laser has revealed as a promising procedure for the management of neck-AN, outstanding to its ability for superficial ablation of the skin surface, with trans-epidermal melanin elimination.
To decide whether fractional-ablative CO laser or retinoic acid (5%) peel is the more effective and safe choice for AN treatment.
In this study, twenty Egyptian cases with neck-AN were enrolled, where each case was exposed to four sessions with 2 weeks apart of both fractional CO laser on the right half of the neck and retinoic acid peel on the left half of the neck. Cases were assessed by a scoring system: Acanthosis Nigricans Area and Severity Index (ANASI) score, two blinded dermatologists, and dermoscopically before and one month after treatment.
We found a highly statistically significant improvement among both treated groups regarding (ANASI) score and dermatologist's assessments. Bedside, the degree of sulci cutis, cristae cutis, brown-to-dark brown dots, and milia-like cysts, dermoscopic sign improvement was evident in both treated groups. However, fractional CO laser shows the superior result to retinoic acid peel in the treatment.
Fractional CO laser and retinoic acid peel are considered effective modalities for neck-AN treatment. However, fractional CO laser was more effective.
黑棘皮病（AN）是一种常见的皮肤病学问题，有多种治疗方式。尽管维甲酸是治疗的首选药物，但分次消融二氧化碳（CO₂）激光已显示出是一种前景可观的治疗颈部AN的方法，因其能够对皮肤表面进行浅表消融，并消除表皮黑色素。
确定分次消融CO₂激光或5%维甲酸剥脱术哪种是治疗AN更有效且安全的选择。
在本研究中，纳入了20例患有颈部AN的埃及患者，每位患者颈部右侧接受4次分次CO₂激光治疗，颈部左侧接受4次维甲酸剥脱术治疗，每次治疗间隔2周。通过评分系统（黑棘皮病面积和严重程度指数（ANASI）评分）、两名盲法皮肤科医生以及在治疗前和治疗后1个月进行皮肤镜检查来评估患者。
我们发现，在（ANASI）评分和皮肤科医生的评估方面，两个治疗组均有高度统计学意义的改善。在床边检查中，两个治疗组的皮肤沟、皮肤嵴、棕色至深棕色斑点以及粟丘疹样囊肿等皮肤镜征象的改善都很明显。然而，分次CO₂激光治疗在治疗效果上优于维甲酸剥脱术。
分次CO₂激光和维甲酸剥脱术被认为是治疗颈部AN的有效方式。然而，分次CO₂激光更有效。
