Abstract：
Hidradenitis suppurativa (HS) is a chronic inflammatory condition characterized by painful nodules, draining tunnels, and fibrotic scarring in intertriginous, hair-bearing areas. The pathogenesis involves follicular occlusion and subsequent rupture, leading to uncontrolled inflammation. Treatment options for HS are limited and lack universal effectiveness. Laser hair removal (LHR) has been explored as a potential treatment; however, the efficacy and appropriate laser modalities remain unclear. This systematic review examined the efficacy and adverse effects of LHR in HS.
A comprehensive literature search was conducted from inception to September 2023 in Ovid MEDLINE, Ovid Embase, and The Cochrane Library (Wiley) with predefined inclusion and exclusion criteria, and a meta-analysis was conducted.
Ten studies were selected (n = 227 total patients) and included six randomized controlled trials, two nonrandomized experimental studies, and two case series. Various laser modalities, including long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) (n = 115), intense pulsed light (n = 18), Alexandrite (n = 54), intralesional 1064 nm diode (n = 20), and combined fractional CO2 and long-pulsed Nd:YAG laser (n = 20), consistently demonstrated significant improvement in HS disease severity, irrespective of the disease scoring method used. Minimal adverse effects (primarily mild pain and erythema) were reported. A meta-analysis of three studies utilizing long-pulsed Nd:YAG laser demonstrated a standardized mean difference in disease severity of -1.68 (95% confidence interval: -2.99; -0.37), favoring treatment with LHR for HS.
Hair follicles are key in HS pathogenesis and all included studies showed a significant improvement in HS disease severity after LHR regardless of the laser device used, likely related to hair follicle unit destruction. HS is a complex and heterogenous condition, and multiple disease scoring methods complicate outcome comparisons across studies. However, LHR, utilizing various techniques, is an effective treatment option for HS with minimal adverse effects.
A comprehensive literature search was conducted from inception to September 2023 in Ovid MEDLINE, Ovid Embase, and The Cochrane Library (Wiley) with predefined inclusion and exclusion criteria, and a meta-analysis was conducted.
Ten studies were selected (n = 227 total patients) and included six randomized controlled trials, two nonrandomized experimental studies, and two case series. Various laser modalities, including long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) (n = 115), intense pulsed light (n = 18), Alexandrite (n = 54), intralesional 1064 nm diode (n = 20), and combined fractional CO2 and long-pulsed Nd:YAG laser (n = 20), consistently demonstrated significant improvement in HS disease severity, irrespective of the disease scoring method used. Minimal adverse effects (primarily mild pain and erythema) were reported. A meta-analysis of three studies utilizing long-pulsed Nd:YAG laser demonstrated a standardized mean difference in disease severity of -1.68 (95% confidence interval: -2.99; -0.37), favoring treatment with LHR for HS.
Hair follicles are key in HS pathogenesis and all included studies showed a significant improvement in HS disease severity after LHR regardless of the laser device used, likely related to hair follicle unit destruction. HS is a complex and heterogenous condition, and multiple disease scoring methods complicate outcome comparisons across studies. However, LHR, utilizing various techniques, is an effective treatment option for HS with minimal adverse effects.
摘要：
目的：化脓性汗腺炎（HS）是一种以痛性结节为特征的慢性炎症，排水隧道,和中间纤维化疤痕，头发区域。发病机制涉及卵泡闭塞和随后的破裂，导致不受控制的炎症。HS的治疗选择有限且缺乏普遍有效性。激光脱毛（LHR）已被探索作为一种潜在的治疗方法；然而，疗效和适当的激光方式仍不清楚.本系统评价了LHR在HS中的疗效和不良反应。
方法：从成立到2023年9月，在OvidMEDLINE进行了全面的文献检索，OvidEmbase,和具有预定义的纳入和排除标准的Cochrane图书馆(Wiley)，并进行了荟萃分析。
结果：选择了10项研究（总共227例患者），包括6项随机对照试验，两项非随机实验研究，和两个案例系列。各种激光模式，包括长脉冲掺钕钇铝石榴石（Nd：YAG）（n=115），强脉冲光（n=18），Alexandrite(n=54),内裂1064nm二极管(n=20),以及分数CO2和长脉冲Nd：YAG激光（n=20）的组合，一致证明HS疾病严重程度有显著改善，与使用的疾病评分方法无关。报告了最小的不良反应（主要是轻度疼痛和红斑）。使用长脉冲Nd：YAG激光的三项研究的荟萃分析显示，疾病严重程度的标准化平均差为-1.68（95％置信区间：-2.99；-0.37），有利于用LHR治疗HS。
结论：毛囊是HS发病机制的关键，所有纳入的研究均显示，无论使用何种激光设备，LHR后HS疾病严重程度均有显著改善，可能与毛囊单位破坏有关。HS是一个复杂和异质的条件，和多种疾病评分方法使不同研究的结果比较复杂化.然而,LHR,利用各种技术，是HS的有效治疗选择，不良反应最小。
方法：从成立到2023年9月，在OvidMEDLINE进行了全面的文献检索，OvidEmbase,和具有预定义的纳入和排除标准的Cochrane图书馆(Wiley)，并进行了荟萃分析。
结果：选择了10项研究（总共227例患者），包括6项随机对照试验，两项非随机实验研究，和两个案例系列。各种激光模式，包括长脉冲掺钕钇铝石榴石（Nd：YAG）（n=115），强脉冲光（n=18），Alexandrite(n=54),内裂1064nm二极管(n=20),以及分数CO2和长脉冲Nd：YAG激光（n=20）的组合，一致证明HS疾病严重程度有显著改善，与使用的疾病评分方法无关。报告了最小的不良反应（主要是轻度疼痛和红斑）。使用长脉冲Nd：YAG激光的三项研究的荟萃分析显示，疾病严重程度的标准化平均差为-1.68（95％置信区间：-2.99；-0.37），有利于用LHR治疗HS。
结论：毛囊是HS发病机制的关键，所有纳入的研究均显示，无论使用何种激光设备，LHR后HS疾病严重程度均有显著改善，可能与毛囊单位破坏有关。HS是一个复杂和异质的条件，和多种疾病评分方法使不同研究的结果比较复杂化.然而,LHR,利用各种技术，是HS的有效治疗选择，不良反应最小。
