Soon Seaver L, Wambier Carlos G, Rullan Peter R, Sterling J Bart, Brody Harold J, Lee Kachiu C, Kreyden Oliver P, Landau Marina
The Skin Clinic MD (private practice), San Diego, California.
Department of Dermatology, Alpert Medical School of Brown University, Rhode Island, Rhode Island.
Dermatol Surg. 2023 Apr 1;49(4):368-373. doi: 10.1097/DSS.0000000000003708. Epub 2023 Feb 1.
Constitutional periorbital dark circles (PDC) are common in skin of color and represent a therapeutic challenge.
To summarize the experience of the International Peeling Society on the safety and effectiveness of deep chemical peeling in the treatment of constitutional PDC.
Multi-institutional, retrospective case series (1990-2020) of constitutional PDC treated by deep chemical peeling. Descriptive analysis by age, sex, Fitzpatrick phototype, phenol-croton formula, degree and durability of improvement, and complications.
Fifty-five phenol-croton oil peels were performed in 52 patients: 3 patients received a second peel for periorbital rhytids 72 to 84 months after the first peel. 92% (48/52) of patients were women; the median age was 46 years (range, 23-68 years). 89% (46/52) of patients were Fitzpatrick III-IV. Most common formula included phenol 60% to 65% and croton oil 0.6% to 0.7%. 89% (49/55) of peels demonstrated >50% clinical improvement. The median duration of improvement was 24 months (range, 1.5-168 months), and 69% (36/52) of patients demonstrated ongoing improvement at the last follow-up. 4% (2/55) of peels exhibited complications of persistent erythema that resolved without scarring.
Based on its safety and effectiveness, deep chemical peels are a treatment of choice for constitutional PDC.
先天性眶周黑眼圈（PDC）在有色人种皮肤中很常见，是一种治疗挑战。
总结国际皮肤剥脱学会关于深层化学剥脱治疗先天性PDC的安全性和有效性的经验。
对1990 - 2020年接受深层化学剥脱治疗先天性PDC的多机构回顾性病例系列进行研究。按年龄、性别、菲茨帕特里克皮肤分型、苯酚-巴豆油配方、改善程度和持久性以及并发症进行描述性分析。
52例患者共进行了55次苯酚-巴豆油剥脱：3例患者在首次剥脱72至84个月后因眶周皱纹接受了第二次剥脱。92%（48/52）的患者为女性；中位年龄为46岁（范围23 - 68岁）。89%（46/52）的患者为菲茨帕特里克III - IV型。最常用的配方包括60%至65%的苯酚和0.6%至0.7%的巴豆油。89%（49/55）的剥脱显示临床改善>50%。改善的中位持续时间为24个月（范围1.5 - 168个月），69%（36/52）的患者在最后一次随访时仍有持续改善。4%（2/55）的剥脱出现持续性红斑并发症，无瘢痕形成而消退。
基于其安全性和有效性，深层化学剥脱是先天性PDC的一种治疗选择。
