Lupon Elise, Berkane Yanis, Bertheuil Nicolas, Cetrulo Curtis L, Vaillant Camille, Chaput Benoît, Camuzard Olivier, Lellouch Alexandre G
Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, 06001 Nice, France.
Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, 02114 Boston, MA, USA.
J Burn Care Res. 2024 May 6;45(3):601-607. doi: 10.1093/jbcr/irae030.
The treatment of postburn hypopigmentation was primarily surgical before the advent of new technologies. Medical devices and therapies are emerging to manage scar sequelae that can be disfiguring and associated with severe psychosocial impact. These innovations have been poorly investigated for hypopigmentation, but they represent a real hope. We reviewed all articles published on Pubmed up to June 2022. Included studies had to specifically focus on treating postburn hypopigmented scars. All articles evaluating transient solutions such as make-up, and articles describing inflammation-linked hypopigmentation with no etiological details or no burn injury history were excluded. Through this review, we have highlighted 6 different types of nonsurgical treatments reported in postburn leukoderma potentially allowing definitive results. Electrophoto-biomodulation or E light (combining intensive pulsed light, radiofrequency, and cooling), topical daylight psoralen UVA therapy, and lasers (fractional lasers using pulse energies or CO2FL devices, lasers-assisted drug delivery as local bimatoprost and tretinoin or pimecrolimus) have been explored with encouraging results in hypopigmented burns. Finally, other promising medical strategies include using FK506, a nonsteroidal anti-inflammatory drug, to induce melanogenesis or using melanocyte-stimulating hormones with fractional laser-assisted drug deliveries, which are expected to emerge soon.
在新技术出现之前，烧伤后色素减退的治疗主要是手术治疗。用于处理可能导致毁容并伴有严重心理社会影响的瘢痕后遗症的医疗设备和疗法正在不断涌现。这些创新方法在色素减退方面的研究较少，但它们带来了真正的希望。我们检索了截至2022年6月在PubMed上发表的所有文章。纳入的研究必须专门聚焦于治疗烧伤后色素减退性瘢痕。所有评估诸如化妆等临时解决方案的文章，以及描述与炎症相关但无病因细节或无烧伤病史的色素减退的文章均被排除。通过本次综述，我们突出了烧伤后白斑中报道的6种不同类型的非手术治疗方法，这些方法可能会产生确切效果。光生物调制或E光（结合强脉冲光、射频和冷却）、外用日光补骨脂素紫外线A疗法以及激光（使用脉冲能量的分数激光或二氧化碳分数激光设备、激光辅助药物递送如局部使用比马前列素、维甲酸或吡美莫司）已在色素减退性烧伤中进行探索并取得了令人鼓舞的结果。最后，其他有前景的医学策略包括使用非甾体抗炎药FK506诱导黑素生成，或使用促黑素细胞激素结合分数激光辅助药物递送，预计这些方法很快就会出现。
