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皮秒激光治疗后黄褐斑患者黑素细胞的调控

Modulation of Melanocyte in Melasma Patients After Picosecond Laser Treatment.

作者信息

Chen Ching-Li, Chen Chih-Chiang, Tsai Feng-Ling, Chen I-Ling, Huang Ling, Yen Yu-Chun, Hwang Chian-Yaw

机构信息

Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.

Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

J Cosmet Dermatol. 2025 Jan;24(1):e16569. doi: 10.1111/jocd.16569. Epub 2024 Sep 16.

Abstract

BACKGROUND

Melasma is a therapeutically challenging hyperpigmented skin condition. Currently, there is a lack of in vivo observation regarding changes in melanin and dendritic melanocytes after laser treatment.

OBJECTIVE

To investigate alterations in melanin and melanocytes in melasma before and after laser treatment using optical coherence tomography (OCT).

METHODS

Eight female melasma patients were enrolled in Taiwan. Based on the baseline OCT scans, the patients were categorized into either epidermal-type or mixed-type melasma and were assigned different treatment protocols accordingly. Sequential OCT images were collected from melasma lesions and normal skin at baseline, Week 4 and Week 8.

RESULTS

After 8 weeks of laser treatment, the mean Melasma Area Severity Index (MASI) score improved from 10.92 to 6.30. Results from OCT showed no significant changes in the normalized density, area, or intensity of melanin in both lesional and normal skin. At baseline, the mean length of dendritic melanocytes in the affected skin was 15% longer than those in normal skin; at Week 8, the mean length of lesional dendritic melanocytes became the same as those in normal skin. Additionally, the mean width of dendritic melanocytes decreased from being 4% wider to only 2% wider than those in normal skin.

CONCLUSION

After 8 weeks of treatment, an improvement of MASI score was noted, mainly attributable to a reduction in lesional area. OCT showed no notable change regarding melanin, but a decrease in length and width of dendritic melanocytes was noted in the lesional skin of melasma patients.

摘要

背景

黄褐斑是一种治疗上具有挑战性的色素沉着性皮肤病。目前,缺乏关于激光治疗后黑色素和树突状黑素细胞变化的体内观察。

目的

使用光学相干断层扫描(OCT)研究黄褐斑患者激光治疗前后黑色素和黑素细胞的变化。

方法

招募了8名台湾女性黄褐斑患者。根据基线OCT扫描结果,将患者分为表皮型或混合型黄褐斑,并相应地分配不同的治疗方案。在基线、第4周和第8周从黄褐斑皮损和正常皮肤收集连续的OCT图像。

结果

激光治疗8周后,平均黄褐斑面积严重程度指数(MASI)评分从10.92提高到6.30。OCT结果显示,皮损和正常皮肤中黑色素的标准化密度、面积或强度均无显著变化。基线时,受累皮肤中树突状黑素细胞的平均长度比正常皮肤长15%;在第8周,皮损中树突状黑素细胞的平均长度与正常皮肤相同。此外,树突状黑素细胞的平均宽度从比正常皮肤宽4%降至仅宽2%。

结论

治疗8周后,MASI评分有所改善,主要归因于皮损面积的减少。OCT显示黑色素无明显变化,但黄褐斑患者皮损皮肤中树突状黑素细胞的长度和宽度有所减少。

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Melasma: a clinical and epidemiological review.黄褐斑:一项临床与流行病学综述。
An Bras Dermatol. 2014 Sep-Oct;89(5):771-82. doi: 10.1590/abd1806-4841.20143063.

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