Abstract：
BACKGROUND: Conventional high fluence Q-switched (HFQS) Alexandrite 755-nm are widely used in clinical café-au-lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q-switched (LFQS) Nd: YAG 1064-nm lasers.
OBJECTIVE: To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs.
METHODS: Within 3 months, 20 patients underwent prospective self-controlled split-lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow-up visit. Patient and physician preferences for laser selection were also recorded.
RESULTS: The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82-2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment.
CONCLUSIONS: The efficacy difference between the LFQS 1064-nm laser and HFQS 755-nm laser in treating CALMs in a 3-month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.
OBJECTIVE: To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs.
METHODS: Within 3 months, 20 patients underwent prospective self-controlled split-lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow-up visit. Patient and physician preferences for laser selection were also recorded.
RESULTS: The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82-2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment.
CONCLUSIONS: The efficacy difference between the LFQS 1064-nm laser and HFQS 755-nm laser in treating CALMs in a 3-month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.
摘要：
背景：常规的高通量Q开关（HFQS）Alexandrite755-nm被广泛用于临床咖啡斑（CALM）治疗。最近一直关注低通量Q开关(LFQS)Nd:YAG1064-nm激光器的功效和安全性。
目的：评价常规HFQS和LFQS激光治疗CALM的疗效和安全性。
方法：3个月内，根据康复率，20例患者接受了一次或两次HFQS的前瞻性自我对照分裂病变治疗，每两周六次使用LFQS。然后选择更有效的激光用于继续治疗。在比较试验期间，每两周通过视觉模拟量表（VAS）评估疗效结果。恢复过程,在试验和随访期间记录副作用和复发.还记录了患者和医生对激光选择的偏好。
结果：HFQS和LFQS治疗区域的平均VAS评分分别为2.92±0.86和2.93±1.13（p>0.05）。LFQS最显著的疗效改变是在第4次激光治疗后(VAS评分:1.82-2.37,p<0.001)。LFQS治疗的11个病灶和HFQS治疗的7个病灶达到最佳治疗效果(3.67≤VAS≤4).三名患者一侧复发(一名在LFQS，HFQS上有两个），两边有五个。副作用包括暂时性色素沉着减退，色素沉着过度,不均匀的色素沉着，斑驳的色素减退.医生认为80％的患者适合LFQS。70％的患者首选LFQS治疗后。
结论：在3个月的比较试验中，LFQS1064-nm激光和HFQS755-nm激光治疗CALM的疗效差异无统计学意义。LFQS是医生和患者的首选，并且很可能在短时间内帮助更多的患者获得比HFQS的治疗效果，暂时性不良反应较少，和更均匀的色素沉着。但它会导致斑驳的色素减退。LFQS在第4次治疗后有明显的病灶清除。
目的：评价常规HFQS和LFQS激光治疗CALM的疗效和安全性。
方法：3个月内，根据康复率，20例患者接受了一次或两次HFQS的前瞻性自我对照分裂病变治疗，每两周六次使用LFQS。然后选择更有效的激光用于继续治疗。在比较试验期间，每两周通过视觉模拟量表（VAS）评估疗效结果。恢复过程,在试验和随访期间记录副作用和复发.还记录了患者和医生对激光选择的偏好。
结果：HFQS和LFQS治疗区域的平均VAS评分分别为2.92±0.86和2.93±1.13（p>0.05）。LFQS最显著的疗效改变是在第4次激光治疗后(VAS评分:1.82-2.37,p<0.001)。LFQS治疗的11个病灶和HFQS治疗的7个病灶达到最佳治疗效果(3.67≤VAS≤4).三名患者一侧复发(一名在LFQS，HFQS上有两个），两边有五个。副作用包括暂时性色素沉着减退，色素沉着过度,不均匀的色素沉着，斑驳的色素减退.医生认为80％的患者适合LFQS。70％的患者首选LFQS治疗后。
结论：在3个月的比较试验中，LFQS1064-nm激光和HFQS755-nm激光治疗CALM的疗效差异无统计学意义。LFQS是医生和患者的首选，并且很可能在短时间内帮助更多的患者获得比HFQS的治疗效果，暂时性不良反应较少，和更均匀的色素沉着。但它会导致斑驳的色素减退。LFQS在第4次治疗后有明显的病灶清除。
