Gnanasuriyan Ramachandran, Shanmugam Srikanth
Dermatology, Mahatma Gandhi Medical College and Research Institute, Puducherry, IND.
Cureus. 2025 Jun 15;17(6):e86047. doi: 10.7759/cureus.86047. eCollection 2025 Jun.
Introduction Acanthosis nigricans (AN) is a common skin disorder with varied aetiology and a wide palette of treatment options. Despite multiple options available for management, laser as a modality has recently evolved and shown better outcomes. Some fractional ablative lasers induce a very narrow tissue column of thermal damage and neocollagenesis, thereby improving textural irregularities, whereas retinoids, a first-line drug, help in superficial skin peeling. The study was conducted to determine the efficacy of fractional carbon dioxide (CO2) laser and retinoic acid peel and to decide which is a better and safer treatment option to address AN. Methods This is a prospective randomised controlled trial. A total of 38 patients were included in this study and divided into two equal groups. Group A was treated with fractional CO2 laser(n=19) and group B was treated with retinoic acid peel (n=19) using the sequentially numbered, opaque, sealed envelope (SNOSE) technique via allocation concealment method and a computer-generated random number table. Group A received four sessions of laser treatment at two-week intervals, and group B received four sessions of peel treatment at three-week intervals. Both groups were analysed using the acanthosis nigricans area and severity index (ANASI), dermoscopy, and two blinded dermatologists before and one month after the treatment. MedCalc software version 19.0.5 (MedCalc Software, Ostend, BEL) was used for statistical analysis. Results and conclusion There was a high statistically significant difference noted in the mean ANASI score in both groups. The fall in ANASI score that denoted the treatment response was greater in group A compared to group B, signifying superior results of fractional CO2 laser compared to retinoid acid peel. The Fractional CO2 laser was more efficacious than retinoic acid peel in the management of AN with sustainable results in the long term, minimal side effects, and required fewer sessions.
引言
黑棘皮病（AN）是一种常见的皮肤疾病，病因多样，治疗选择广泛。尽管有多种管理方法可供选择，但激光作为一种治疗方式最近有了发展并显示出更好的效果。一些剥脱性分数激光会引发非常狭窄的热损伤和新胶原形成组织柱，从而改善质地不规则情况，而一线药物维甲酸有助于浅表皮肤剥脱。本研究旨在确定分数二氧化碳（CO2）激光和维甲酸剥脱的疗效，并确定哪种是治疗AN的更好、更安全的选择。
方法
这是一项前瞻性随机对照试验。本研究共纳入38例患者，分为两组，每组19例。A组采用分数CO2激光治疗（n = 19），B组采用维甲酸剥脱治疗（n = 19），通过分配隐藏方法和计算机生成的随机数表，使用连续编号、不透明、密封信封（SNOSE）技术。A组每两周接受4次激光治疗，B组每三周接受4次剥脱治疗。两组在治疗前和治疗后1个月均使用黑棘皮病面积和严重程度指数（ANASI）、皮肤镜检查，并由两名盲法皮肤科医生进行分析。使用MedCalc软件版本19.0.5（MedCalc Software，奥斯坦德，比利时）进行统计分析。
结果与结论
两组的平均ANASI评分在统计学上有高度显著差异。表示治疗反应的ANASI评分下降在A组比B组更大，这表明分数CO2激光的效果优于维甲酸剥脱。分数CO2激光在治疗AN方面比维甲酸剥脱更有效，长期效果可持续，副作用最小，且所需治疗次数更少。
