激光辅助前列腺素类似物治疗色素减退性瘢痕：一项系统评价

Laser-Assisted Prostaglandin Analogs in the Treatment of Hypopigmented Scars: A Systematic Review.

作者信息

Rambhia Pooja H, Pagan Angel D, Lal Karan, Goldberg David

机构信息

Dr. Rambhia is with the Department of Dermatology at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New Hyde Park, New York.

Mr. Pagan is with Ponce Health Sciences University School of Medicine in Ponce, Puerto Rico.

出版信息

J Clin Aesthet Dermatol. 2023 Sep;16(9):28-32.

PMID:37720195

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10503939/

Abstract

BACKGROUND

Hypopigmented scars are challenging to treat due to a lack of effective treatments and often transient results. Recent reports suggest that prostaglandin analog-induced hyperpigmentation may have favorable dermatological applications.

OBJECTIVE

Analyze previous studies involving the use of prostaglandin analogs in the treatment of hypopigmented scars.

METHODS

PubMed/Medline was queried through 10/01/2022 with the following search terms: (bimatoprost AND scar), (latanoprost AND scar), (travoprost AND scar), (prostaglandin analogs AND hypopigmented scars), (PGF2alpha AND hyperpigmentation), (prostaglandin analogs AND hyperpigmentation).

RESULTS

In total, 88 unique studies were reviewed for eligibility. Five studies met inclusion criteria including two prospective, double-blinded, randomized (only one was placebo-controlled), one prospective case series, one retrospective chart review, and one case report; comprising a total of 87 patients. All five studies utilized topical prostaglandin analogs as an adjunctive treatment via laser-assisted delivery. While both, the placebo-controlled and non-placebo-controlled, trials reported more than 75 percent of patients experienced at least 50 percent or more (Grade 3 or higher) improvement, the retrospective study reported 100 percent of patients experienced at least 75 percent or more (Grade 4 or higher) improvement, measured as scar repigmentation. The prospective case series and the reported single case showed overall qualitative improvement in all patients measured as repigmentation of hypopigmented and depigmented scars.

LIMITATIONS

Different laser devices, parameters, treatment frequency, and follow-up timepoints.

CONCLUSION

All studies evaluated demonstrated favorable treatment outcomes with no reported adverse events. Additional, large randomized controlled trials are needed to fully assess the effectiveness and long-term safety of PGF2α agonists for hypopigmented scars.

摘要

背景

由于缺乏有效的治疗方法且效果往往短暂，色素减退性瘢痕的治疗具有挑战性。最近的报告表明，前列腺素类似物诱导的色素沉着可能具有良好的皮肤科应用前景。

目的

分析以往关于使用前列腺素类似物治疗色素减退性瘢痕的研究。

方法

截至2022年10月1日，在PubMed/Medline数据库中进行检索，检索词如下：（比马前列素与瘢痕）、（拉坦前列素与瘢痕）、（曲伏前列素与瘢痕）、（前列腺素类似物与色素减退性瘢痕）、（前列腺素F2α与色素沉着）、（前列腺素类似物与色素沉着）。

结果

共审查了88项独特研究的入选资格。五项研究符合纳入标准，包括两项前瞻性、双盲、随机对照研究（只有一项为安慰剂对照）、一项前瞻性病例系列研究、一项回顾性病历审查和一项病例报告；共计87例患者。所有五项研究均通过激光辅助给药使用局部前列腺素类似物作为辅助治疗。虽然安慰剂对照和非安慰剂对照试验均报告超过75%的患者有至少50%或更高（3级或更高）的改善，但回顾性研究报告100%的患者有至少75%或更高（4级或更高）的改善，以瘢痕再色素沉着衡量。前瞻性病例系列研究和报告的单个病例显示，所有患者的色素减退性和色素脱失性瘢痕再色素沉着总体有定性改善。