Elmasry Maha Fathy, Khalil Moemena Maher Fathi, Badawi Ashraf, Zaki Naglaa Sameh, Fahim Aya
Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Dermatology, Quesna Central Hospital, Menofia, Egypt.
Clin Cosmet Investig Dermatol. 2023 Mar 23;16:705-715. doi: 10.2147/CCID.S401479. eCollection 2023.
Acanthosis nigricans (AN) is a common chronic skin disorder clinically presents by velvety hyperpigmented lesions mainly at the flexural areas. Fractional photothermolysis has been reported to improve both pigmentary and textural changes by removing thin layers of skin with minimal thermal damage. Other options are the Q-switched (Qs) Nd:YAG (1064 nm) and Qs KTP (532 nm) lasers. Both can induce collagen remodeling by dermal photo-mechanical microdamage.
The aim of this study was to assess the clinical efficacy and the safety of fractional CO laser versus Qs Nd:YAG and KTP lasers in the treatment of acanthosis nigricans.
This randomized-controlled split neck study was conducted on 23 patients suffering from AN. For each patient, one side of the neck was randomly assigned to fractional CO laser and the other side to Qs Nd:YAG and KTP lasers every four weeks for four months followed by 4 monthly follow-up assessment. Acanthosis Nigricans Area and Severity Index (ANASI) score, melanin and erythema indices as well as Patient Satisfaction Scale (PSS) were used to assess improvement on each side separately.
There was no statistically significant difference regarding the clinical improvement between the side treated with Fractional CO laser and the side treated with Qs Nd:YAG and KTP lasers (P value >0.05). In most patients, both sides showed improvement during different sessions of therapy, as regards ANASI scores, melanin indices, patient satisfaction scores, and side effects.
In this study, we concluded that both fractional CO and Q-switched lasers proved to be a safe and effective line of treatment of acanthosis nigricans.
黑棘皮病（AN）是一种常见的慢性皮肤疾病，临床上主要表现为屈侧部位出现天鹅绒样色素沉着性皮损。据报道，分次光热解通过去除薄层皮肤并使热损伤最小化，可改善色素沉着和质地改变。其他选择包括调Q（Qs）钕：钇铝石榴石（1064纳米）激光和调Q倍频Nd:YAG（532纳米）激光。两者均可通过真皮光机械微损伤诱导胶原蛋白重塑。
本研究的目的是评估分次二氧化碳激光与调Q钕：钇铝石榴石激光和倍频Nd:YAG激光治疗黑棘皮病的临床疗效和安全性。
本随机对照双侧颈部研究纳入了23例黑棘皮病患者。对每位患者，颈部一侧每四周随机分配接受分次二氧化碳激光治疗，另一侧接受调Q钕：钇铝石榴石激光和倍频Nd:YAG激光治疗，共四个月，随后进行4次每月的随访评估。使用黑棘皮病面积和严重程度指数（ANASI）评分、黑色素和红斑指数以及患者满意度量表（PSS）分别评估每一侧的改善情况。
分次二氧化碳激光治疗侧与调Q钕：钇铝石榴石激光和倍频Nd:YAG激光治疗侧之间在临床改善方面无统计学显著差异（P值>0.05）。在大多数患者中，两侧在不同治疗阶段在ANASI评分、黑色素指数、患者满意度评分和副作用方面均有改善。
在本研究中，我们得出结论，分次二氧化碳激光和调Q激光均被证明是治疗黑棘皮病的安全有效的治疗方法。
