Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.
Lasers Surg Med. 2022 Oct;54(8):1082-1088. doi: 10.1002/lsm.23584. Epub 2022 Jul 17.
The pulsed dye laser (PDL) is an effective modality for preventing and improving hypertrophic scars (HSs). However, the heterogeneity of the parameter settings of the laser and subjective scar assessment methods used in most studies resulting in uncertainty with treatment plans. Therefore, we investigated the treatment effect of the PDL (V-beam; Candela Laser Corporation) on HSs in post-thyroidectomy patients using three-dimensional imaging analysis and intended to provide a systemic and optimal treatment protocol.
Nineteen patients with HS after thyroidectomy underwent eight treatment sessions with the 595 nm PDL (with the dose gradually increased by 0.5 J/cm ) at 4- to 6-week intervals. Patients with an elevated lesion also received intralesional corticosteroid (ICS) treatment. After every two treatment sessions, we assessed the patients' HS using the Vancouver Scar Scale (VSS), a patient satisfaction questionnaire, and with a three-dimensional (3D) skin imaging device (Antera 3D™; Miravex Limited).
In repeated-measures analysis of variance, the mean VSS and patient satisfaction significantly improved (p < 0.001), with significant differences in these values observed until the sixth and eighth treatment sessions, respectively. In the quantitative analysis using Antera 3D™, the mean height, pigmentation, and vascularity scores were observed to be significantly improved (p < 0.001). Significant differences in these values were observed until the fourth, second, and eighth treatment sessions, respectively. Subgroup analysis according to ICS treatment showed no significant differences in scar characteristics between those with and without ICS treatment.
In this study, we found that the PDL was effective in reducing scar height, vascularity, and pigmentation in patients with thyroidectomy HS using 3D imaging analysis. Furthermore, we have suggested a cost-effective treatment plan with the 595 nm PDL.
脉冲染料激光(PDL)是预防和改善增生性瘢痕(HS)的有效手段。然而,大多数研究中激光参数设置和主观瘢痕评估方法的异质性导致治疗方案存在不确定性。因此,我们使用三维成像分析研究了 595nm PDL(V 型光束;Candela 激光公司)治疗甲状腺切除术后 HS 的效果,并旨在提供一种系统和优化的治疗方案。
19 例甲状腺切除术后 HS 患者接受了 8 次 595nm PDL(剂量逐渐增加 0.5J/cm )治疗,间隔 4-6 周。病变隆起的患者还接受了皮损内皮质类固醇(ICS)治疗。每两次治疗后,我们使用温哥华瘢痕量表(VSS)、患者满意度问卷和三维(3D)皮肤成像设备(Antera 3D™;Miravex Limited)评估患者的 HS。
重复测量方差分析显示,VSS 平均值和患者满意度均显著改善(p<0.001),第六和第八次治疗分别观察到这些值的显著差异。使用 Antera 3D™进行的定量分析显示,平均高度、色素沉着和血管评分均显著改善(p<0.001)。第四、第二和第八次治疗分别观察到这些值的显著差异。根据 ICS 治疗的亚组分析,有和没有 ICS 治疗的患者的瘢痕特征没有显著差异。
在这项研究中,我们发现 3D 成像分析显示,PDL 可有效降低甲状腺切除术 HS 患者的瘢痕高度、血管和色素沉着。此外,我们还提出了一种具有成本效益的 595nm PDL 治疗方案。