Rutnin Suthinee, Sakpuwadol Nawara, Yongpisarn Tanat, Pomsoong Cherrin, Namasondhi Amornrut, Rattananukrom Teerapong, Thadanipon Kunlawat
Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Cosmet Dermatol. 2025 Mar;24(3):e70029. doi: 10.1111/jocd.70029.
Top surgery masculinizes the chest appearance for transgender men (TM); however, some individuals may experience hypertrophic scars (HTS) or keloids following the surgery.
This study aimed to evaluate the efficacy of combined 595-nm pulsed dye laser (PDL) and intralesional triamcinolone acetonide injection (IL TAC) compared to IL TAC monotherapy for treating HTS and keloids.
Twenty-five TM with 35 pairs of bilateral symmetric postmastectomy HTS or keloids were randomly allocated to receive the combined PDL and IL TAC on the scar(s) on one side of the chest and IL TAC monotherapy on the contralateral scar(s) in four monthly treatment sessions. Clinical improvement was evaluated using the Vancouver Scar Scale (VSS). Melanin index, hemoglobin index, and scar roughness were determined before each treatment session and at 1, 3, and 6 months after the last treatment. Participant-rated satisfaction and adverse events were documented.
After two treatment sessions, scars treated with combined PDL and IL TAC demonstrated significantly greater improvements in the VSS (p = 0.012) and melanin index (p = 0.004) compared to those treated with IL TAC alone. The superior outcomes of the combined therapy persisted for 3 and 6 months after the end of treatment sessions for the VSS (p = 0.001) and melanin index (p = 0.048), respectively. Participants reported higher satisfaction for combined PDL and IL TAC than IL TAC monotherapy (p = 0.005). No serious or permanent adverse event was reported.
The addition of 595-nm PDL to IL TAC may provide more favorable outcomes for treating postmastectomy HTS and keloids among TM.
胸部手术可使跨性别男性（TM）的胸部外观男性化；然而，一些人在手术后可能会出现增生性瘢痕（HTS）或瘢痕疙瘩。
本研究旨在评估595纳米脉冲染料激光（PDL）联合病灶内注射曲安奈德（IL TAC）与单纯IL TAC治疗HTS和瘢痕疙瘩的疗效。
25名患有35对双侧对称乳房切除术后HTS或瘢痕疙瘩的TM被随机分配，在胸部一侧的瘢痕上接受PDL联合IL TAC治疗，对侧瘢痕接受单纯IL TAC治疗，共进行四个月的治疗疗程。使用温哥华瘢痕量表（VSS）评估临床改善情况。在每次治疗前以及最后一次治疗后1、3和6个月测定黑色素指数、血红蛋白指数和瘢痕粗糙度。记录参与者的满意度和不良事件。
经过两个疗程的治疗，与单纯接受IL TAC治疗的瘢痕相比，接受PDL联合IL TAC治疗的瘢痕在VSS（p = 0.012）和黑色素指数（p = 0.004）方面有显著更大的改善。联合治疗的优越效果在治疗疗程结束后3个月和6个月分别在VSS（p = 0.001）和黑色素指数（p = 0.048）方面持续存在。参与者报告对PDL联合IL TAC的满意度高于单纯IL TAC治疗（p = 0.005）。未报告严重或永久性不良事件。
在IL TAC基础上加用595纳米PDL可能为治疗TM乳房切除术后HTS和瘢痕疙瘩提供更有利的结果。
